Psychometric properties of the Spanish version of the Chalder Fatigue Scale in clinical and general populations / Propiedades psicométricas de la versión española de la Escala de Fatiga de Chalder en población clínica y general

Objetivo: La Escala de Fatiga de Chalder (CFS) es una escala breve para evaluar fatiga que se utiliza en España, pero que no ha sido validada en su población. El objetivo del estudio fue adaptar y evaluar las propiedades psicométricas de la versión española de la CFS (Sp-CFS). Método: La muestra la conformaron 3,671 participantes (3.190 de la población general y 481 pacientes), con edades entre 18 y 86 años (M = 28.43; DT = 12.71), siendo el 67.6% mujeres. Las propiedades psicométricas de la escala se probaron en un diseño transversal utilizando validación cruzada (análisis factorial exploratorio y confirmatorio) y estimación de la invarianza (sexo y condición clínica). Resultados: Un modelo de cuatro factores (baja energía, problemas de sueño, problemas de concentración y disfunción cognitiva subjetiva) en lugar de un modelo original de dos factores (fatiga física y mental) proporcionó mejores índices de bondad de ajuste a los datos. La consistencia interna y la estabilidad de la escala fueron excelentes. Su validez convergente se apoyó en su asociación significativa con la ansiedad, la depresión, el estrés y los síntomas positivos y negativos del espectro de la psicosis. El instrumento no mostró diferencias significativas entre sexos ni condiciones clínicas, y discriminó entre la población general y los pacientes, obteniendo estos últimos puntajes significativamente mayores. Conclusiones: Sp-CFS es una escala fiable y válida para medir la fatiga en población general y clínica española.(AU)

Objective:The Chalder Fatigue Scale (CFS) is a brief self-report screening scale for fatigue that is used in Spain but has not been validated for the Spanish population. The aim of this study was to adapt and evalu-ate the psychometric properties of the Spanish version of the CFS (Sp-CFS). Method:The sample consisted of 3,671 participants (3,190 from the general population and 481 patients), aged 18 to 86 years (M=28.43; DT=12.71), 67.6% of whom were women. Psychometric properties of the scale were tested in a cross-sectional design using cross-validation (explora-tory and confirmatory factor analysis) and estimation of invariance (sex and clinical condition). Results:A four-factor model (low energy, sleep problems, concentration problems and subjective cognitive dysfunction) rather than an original two-factor model (physical and mental fatigue) pro-vided better indices of goodness of fit to the data. The internal consistencyand stability of the scale were excellent. Its convergent validity was sup-ported by its significant association with anxiety, depression, stress, and the positive and negative symptoms of the psychosis spectrum. The instru-ment did not show significant differences between sexes or clinical condi-tions, and it discriminated between the general population and the patients, with the latter obtaining significantly greater scores. Conclusions: Sp-CFS is a reliable and valid scale for measuring a transdiagnostic construct such as fatigue in Spanish general and clinical populations.(AU)

Attention spotlight in V1-based cortico-cortical interactions in human visual hierarchy.

Attention is often viewed as a mental spotlight, which can be scaled like a zoom lens at specific spatial locations and features a center-surround gradient. Here, we demonstrate a neural signature of attention spotlight in signal transmission along the visual hierarchy. fMRI background connectivity analysis was performed between retinotopic V1 and downstream areas to characterize the spatial distribution of inter-areal interaction under two attentional states. We found that, compared to diffused attention, focal attention sharpened the spatial gradient in the strength of the background connectivity. Dynamic causal modeling analysis further revealed the effect of attention in both the feedback and feedforward connectivity between V1 and extrastriate cortex. In a context which induced a strong effect of crowding, the effect of attention in the background connectivity profile diminished. Our findings reveal a context-dependent attention prioritization in information transmission via modulating the recurrent processing across the early stages in human visual cortex.

Testing the monitor and acceptance theory: the role of training-induced changes in monitoring- and acceptance-related capacities after attention-based, socio-emotional, or socio-cognitive mental training in reducing cortisol stress reactivity.

Mindfulness-based interventions have become a popular means to reduce stress. However, the specific mechanisms driving observed stress reduction remain understudied. The Monitor and Acceptance Theory suggests that the cultivation of monitoring and acceptance skills are necessary moderators of practice-induced stress reduction. In the context of the ReSource Project, a large healthy adult sample underwent three 3-month mental training modules targeting either attentional (Presence module), socio-affective (Affect module) or socio-cognitive skills (Perspective module). In the current study, the development of a range of inter-individual differences in mindfulness-, interoception- and compassion-related traits - which mapped to either monitoring or acceptance categories - was tracked. The relationship of these training-induced changes with cortisol stress reactivity after the three distinct 3-month training modules was explored. We found that stress sensitivity was particularly modulated by a differential adaptivity of one cultivated attentional capacity - Attention regulation - which predicted higher cortisol reactivity after mere attention training (Presence) but was associated with lower stress-induced cortisol release after additional socio-affective and socio-cognitive practice (Affect and Perspective). However, this effect did not survive multiple comparisons correction, and analyses were limited by the sample size available. We conclude that our study provides preliminary support of the Monitor and Acceptance Theory, lending weight to the advantage of primary attentional increases in order to fully harness the beneficial effects of socio-affective training, ultimately leading to stress reduction. Although training-induced increases in acceptance were not directly shown to contribute to lowering cortisol stress reactivity, the data suggest an additional benefit of socio-affective and socio-cognitive training that is not directly captured within the current analyses. Our study corroborates the importance of going beyond the training of attention monitoring to foster stress resilience, and highlights that mental training relies on the co-development of several interacting processes to successfully attenuate stress. Further exploring the overarching concept of acceptance in future research may prove beneficial to the theoretical framework of MAT, and in understanding the processes by which stress reduction occurs.

Differences in visuospatial cognition among table tennis players of different skill levels: an event-related potential study.

This study aimed to examine the influence of sport skill levels on behavioural and neuroelectric performance in visuospatial attention and memory visuospatial tasks were administered to 54 participants, including 18 elite and 18 amateur table tennis players and 18 nonathletes, while event-related potentials were recorded. In all the visuospatial attention and memory conditions, table tennis players displayed faster reaction times than nonathletes, regardless of skill level, although there was no difference in accuracy between groups. In addition, regardless of task conditions, both player groups had a greater P3 amplitude than nonathletes, and elite players exhibited a greater P3 amplitude than amateurs players. The results of this study indicate that table tennis players, irrespective of their skill level, exhibit enhanced visuospatial capabilities. Notably, athletes at the elite level appear to benefit from an augmented allocation of attentional resources when engaging in visuospatial tasks.

Sustained bias of spatial attention in a 3 T MRI scanner.

When lying inside a MRI scanner and even in the absence of any motion, the static magnetic field of MRI scanners induces a magneto-hydrodynamic stimulation of subjects' vestibular organ (MVS). MVS thereby not only causes a horizontal vestibular nystagmus but also induces a horizontal bias in spatial attention. In this study, we aimed to determine the time course of MVS-induced biases in both VOR and spatial attention inside a 3 T MRI-scanner as well as their respective aftereffects after participants left the scanner. Eye movements and overt spatial attention in a visual search task were assessed in healthy volunteers before, during, and after a one-hour MVS period. All participants exhibited a VOR inside the scanner, which declined over time but never vanished completely. Importantly, there was also an MVS-induced horizontal bias in spatial attention and exploration, which persisted throughout the entire hour within the scanner. Upon exiting the scanner, we observed aftereffects in the opposite direction manifested in both the VOR and in spatial attention, which were statistically no longer detectable after 7 min. Sustained MVS effects on spatial attention have important implications for the design and interpretation of fMRI-studies and for the development of therapeutic interventions counteracting spatial neglect.

Classification of short and long term mild traumatic brain injury using computerized eye tracking.

Accurate, and objective diagnosis of brain injury remains challenging. This study evaluated useability and reliability of computerized eye-tracker assessments (CEAs) designed to assess oculomotor function, visual attention/processing, and selective attention in recent mild traumatic brain injury (mTBI), persistent post-concussion syndrome (PPCS), and controls. Tests included egocentric localisation, fixation-stability, smooth-pursuit, saccades, Stroop, and the vestibulo-ocular reflex (VOR). Thirty-five healthy adults performed the CEA battery twice to assess useability and test-retest reliability. In separate experiments, CEA data from 55 healthy, 20 mTBI, and 40 PPCS adults were used to train a machine learning model to categorize participants into control, mTBI, or PPCS classes. Intraclass correlation coefficients demonstrated moderate (ICC > .50) to excellent (ICC > .98) reliability (p < .05) and satisfactory CEA compliance. Machine learning modelling categorizing participants into groups of control, mTBI, and PPCS performed reasonably (balanced accuracy control: 0.83, mTBI: 0.66, and PPCS: 0.76, AUC-ROC: 0.82). Key outcomes were the VOR (gaze stability), fixation (vertical error), and pursuit (total error, vertical gain, and number of saccades). The CEA battery was reliable and able to differentiate healthy, mTBI, and PPCS patients reasonably well. While promising, the diagnostic model accuracy should be improved with a larger training dataset before use in clinical environments.

The large-scale organization of shape processing in the ventral and dorsal pathways is dissociable from attention.

The two visual pathways model posits that visual information is processed through two distinct cortical systems: The ventral pathway promotes visual recognition, while the dorsal pathway supports visuomotor control. Recent evidence suggests the dorsal pathway is also involved in shape processing and may contribute to object perception, but it remains unclear whether this sensitivity is independent of attentional mechanisms that were localized to overlapping cortical regions. To address this question, we conducted two fMRI experiments that utilized different parametric scrambling manipulations in which human participants viewed novel objects in different levels of scrambling and were instructed to attend to either the object or to another aspect of the image (e.g. color of the background). Univariate and multivariate analyses revealed that the large-scale organization of shape selectivity along the dorsal and ventral pathways was preserved regardless of the focus of attention. Attention did modulate shape sensitivity, but these effects were similar across the two pathways. These findings support the idea that shape processing is at least partially dissociable from attentional processes and relies on a distributed set of cortical regions across the visual pathways.

Dorsal pulvinar inactivation leads to spatial selection bias without perceptual deficit.

The dorsal pulvinar has been implicated in visuospatial attentional and perceptual confidence processing. Pulvinar lesions in humans and monkeys lead to spatial neglect symptoms, including an overt spatial saccade bias during free choices. However, it remains unclear whether disrupting the dorsal pulvinar during target selection that relies on a perceptual decision leads to a perceptual impairment or a more general spatial orienting and choice deficit. To address this question, we reversibly inactivated the unilateral dorsal pulvinar by injecting GABA-A agonist THIP while two macaque monkeys performed a color discrimination saccade task with varying perceptual difficulty. We used Signal Detection Theory and simulations to dissociate perceptual sensitivity (d-prime) and spatial selection bias (response criterion) effects. We expected a decrease in d-prime if dorsal pulvinar affects perceptual discrimination and a shift in response criterion if dorsal pulvinar is mainly involved in spatial orienting. After the inactivation, we observed response criterion shifts away from contralesional stimuli, especially when two competing stimuli in opposite hemifields were present. Notably, the d-prime and overall accuracy remained largely unaffected. Our results underline the critical contribution of the dorsal pulvinar to spatial orienting and action selection while showing it to be less important for visual perceptual discrimination.

A one-man bilingual cocktail party: linguistic and non-linguistic effects on bilinguals' speech recognition in Mandarin and English.

Multilingual speakers can find speech recognition in everyday environments like restaurants and open-plan offices particularly challenging. In a world where speaking multiple languages is increasingly common, effective clinical and educational interventions will require a better understanding of how factors like multilingual contexts and listeners' language proficiency interact with adverse listening environments. For example, word and phrase recognition is facilitated when competing voices speak different languages. Is this due to a "release from masking" from lower-level acoustic differences between languages and talkers, or higher-level cognitive and linguistic factors? To address this question, we created a "one-man bilingual cocktail party" selective attention task using English and Mandarin speech from one bilingual talker to reduce low-level acoustic cues. In Experiment 1, 58 listeners more accurately recognized English targets when distracting speech was Mandarin compared to English. Bilingual Mandarin-English listeners experienced significantly more interference and intrusions from the Mandarin distractor than did English listeners, exacerbated by challenging target-to-masker ratios. In Experiment 2, 29 Mandarin-English bilingual listeners exhibited linguistic release from masking in both languages. Bilinguals experienced greater release from masking when attending to English, confirming an influence of linguistic knowledge on the "cocktail party" paradigm that is separate from primarily energetic masking effects. Effects of higher-order language processing and expertise emerge only in the most demanding target-to-masker contexts. The "one-man bilingual cocktail party" establishes a useful tool for future investigations and characterization of communication challenges in the large and growing worldwide community of Mandarin-English bilinguals.

Attention deployment in natural scenes: Higher-order scene statistics rather than semantics modulate the N2pc component.

Which properties of a natural scene affect visual search? We consider the alternative hypotheses that low-level statistics, higher-level statistics, semantics, or layout affect search difficulty in natural scenes. Across three experiments (n = 20 each), we used four different backgrounds that preserve distinct scene properties: (a) natural scenes (all experiments); (b) 1/f noise (pink noise, which preserves only low-level statistics and was used in Experiments 1 and 2); (c) textures that preserve low-level and higher-level statistics but not semantics or layout (Experiments 2 and 3); and (d) inverted (upside-down) scenes that preserve statistics and semantics but not layout (Experiment 2). We included "split scenes" that contained different backgrounds left and right of the midline (Experiment 1, natural/noise; Experiment 3, natural/texture). Participants searched for a Gabor patch that occurred at one of six locations (all experiments). Reaction times were faster for targets on noise and slower on inverted images, compared to natural scenes and textures. The N2pc component of the event-related potential, a marker of attentional selection, had a shorter latency and a higher amplitude for targets in noise than for all other backgrounds. The background contralateral to the target had an effect similar to that on the target side: noise led to faster reactions and shorter N2pc latencies than natural scenes, although we observed no difference in N2pc amplitude. There were no interactions between the target side and the non-target side. Together, this shows that-at least when searching simple targets without own semantic content-natural scenes are more effective distractors than noise and that this results from higher-order statistics rather than from semantics or layout.

Comparison of trait and state mind wandering among schizotypal, subclinically depressed, and control individuals.

BACKGROUND: Mind wandering is a common phenomenon in daily life. However, the manifestations and cognitive correlates of mind wandering in different subclinical populations remain unclear. In this study, these aspects were examined in individuals with schizotypal traits and individuals with depressive symptoms, i.e., subclinical populations of patients with schizophrenia and depression. METHODS: Forty-two individuals with schizotypal traits, 42 individuals with subclinical depression, and 42 controls were recruited to complete a mind wandering thought sampling task (state level) and a mind wandering questionnaire (trait level). Measures of rumination and cognitive functions (attention, inhibition, and working memory) were also completed by participants. RESULTS: Both subclinical groups exhibited more state and trait mind wandering than did the control group. Furthermore, individuals with schizotypal traits demonstrated more trait mind wandering than individuals with subclinical depression. Rumination, sustained attention, and working memory were associated with mind wandering. In addition, mind wandering in individuals with subclinical depression can be accounted for by rumination or attention, while mind wandering in individuals with high schizotypal traits cannot be accounted for by rumination, attention, or working memory. CONCLUSIONS: The results suggest that individuals with high schizotypal traits and subclinical depression have different patterns of mind wandering and mechanisms. These findings have implications for understanding the unique profile of mind wandering in subclinical individuals.

Effects of fruit and vegetable intake on memory and attention: a systematic review of randomized controlled trials.

BACKGROUND: Memory and attention are important for daily functioning, and their function deteriorates due to aging. However, fruit and vegetable consumption are one of the protective factors against deterioration in memory and attention. This systematic review of randomized controlled trials (RCTs) aims to identify the effects of fruit and vegetable consumption on memory and attention. METHODS: We conducted a systematic search in EBSCOhost, ProQuest, PubMed, Embase, and Web of Science from inception up to 06/09/2022. The inclusion criteria were peer-reviewed articles, fruit and vegetable intake measured using randomized controlled trials, and the outcome measures that showed the results of memory and attention scores. Two researchers independently extracted articles that met the selection criteria and evaluated the quality of each study. RESULTS: There were 70 articles identified from the databases, of which 13 articles met the inclusion criteria and were included in this systematic review. There were 493 participants in total. The results show that consumption of fruit and vegetable intake improved memory and attention in longitudinal studies (10 to 12 weeks). Children showed improvement in immediate recall after supplementation with blueberries. Older adults required a higher dose of fruit and vegetable intake consumption to achieve significant improvement compared with children and younger adults. Furthermore, the effect of fruits and vegetables on memory showed better immediate memory recall than delayed recall. CONCLUSION: This systematic review showed that there is an improvement in memory and attention with fruit and vegetable intake consumption. Hence, awareness of fruit and vegetable intake consumption is important to maintain cognitive health.

[Neural Mechanisms of Attention].

Classical evidence for neural mechanisms of attention resulted from findings that attention to sensory signals modulated sensory neuronal responses in both humans and non-human animals. These findings led scientists to propose a variety of sophisticated information-processing and mathematical models of attention. Recent advances in neuroimaging and studies including hemispatial neglect and attention deficits in patients have also facilitated understanding of neural mechanisms of attention in terms of functional specialization and large-scale brain network. Here, we reviewed neural mechanisms of attention from classical literature up to recent advances.

[Neural Mechanisms of Visual Search and Working Memory].

Visual search is a useful experimental paradigm investigating various aspects of attention. For efficient search, participants must avoid revisiting previously viewed objects. Inhibitory tagging and inhibition of return are phenomena related to this process, but their neural mechanisms are yet to be elucidated. Recent studies have shown that the rate of revisit behavior during visual search correlates with working memory capacity. This suggests that top-down signals from the frontal executive system alter the priority map that guides attention and eye movements. With this in mind, we have developed a novel visual search paradigm with many identical distractors and an evaluation model that assesses multiple parameters of working memory. The model incorporated memory capacity, memory decay, and utility rate, and when applied to data obtained from experimental animals, these parameters could be reliably evaluated. Furthermore, using the behavioral paradigm and model, we found that systemic administration of subanesthetic dose of ketamine decreased utility rate and memory capacity, while nicotine administration increased utility rate. Since our behavioral paradigm does not require complex instruction, it can be applied to a variety of patients in future clinical studies.

[The Frontal Lobe and Top-down Control of Attention].

The concept of attention in cognitive science encompasses a bidirectional nature: bottom-up attention based on the salience of sensory stimuli, and top-down attention, which involves voluntary control over aspects such as intensity, allocation, selectivity, and duration. Top-down attention is believed to be primarily realized through the frontal lobes that monitor on-going information processing. This monitoring helps detect situations requiring intervention and manipulates lower-level information processing systems as a part of executive functions.

[Subcategories of Attention Function and Its Assessment Methods].

The subcategories of attention function have various classification methods. In this section, we have listed subcategories that are easily applicable to neuropsychology, namely selective, sustained, spatial, and divided attention, attentional inhibition, and attention shifting. Among them, selective attention is a function excluding unnecessary information from a myriad of data while selecting essential information. Sustained attention, in contrast, is a function directing attention to information over a certain period and maintaining it during task execution, are the two basic subfunctions in attention. Attentional inhibition, divided attention, and attention shifting are regarded as attentional control functions or executive control of attention, which are closely related with working memory and executive function. However, there is also an overlap observed among these subfunctions. Since our cognitive activities are intertwined with attention functions, it is challenging to purely extract specific attention functions.

[Working Memory and Controlled Attention].

Short-term memory is crucial for higher cognitive functions, yet its storage capacity is severely limited. Thus, it is necessary to selectively retain information relevant to our goals by controlling attention. This is facilitated by working memory, which consists of short-term storage and executive attention. In this review, I introduce the psychological model and measurement tasks of working memory and discuss the significance of attentional control for remembering information appropriately and stably.

[Rehabilitative Intervention for Attentional Disturbance].

Several evidence-based guidelines of rehabilitative intervention for attentional disturbance following acquired brain injury have been published. The author introduced two cutting-edge guidelines: Japan Stroke Society Guideline 2021 for the Treatment of Stroke [Revised version 2023]; and INCOG 2.0 Guideline for Cognitive Rehabilitation Following Traumatic Brain Injury, PartII: Attention and Information Processing Speed (2023). The effect of the cognitive rehabilitation should be evaluated by change of performance in real-world tasks and activities as well as measures of various neuropsychological tests including paced auditory serial addition task (PASAT) and trail making test. Direct attention training such as Attention Process Training (APT) series or computer-based training may be useful especially for stroke patients. Dual-task training may specifically improve multi-tasking performance. Time pressure management can improve speed of performance on everyday tasks for patients with slowed information processing. Metacognitive training using everyday activities may be recommended for mild to moderate impairments. Modifications of environment and/or tasks may also be helpful to decrease errors in daily activities.

[Impairment of Attention in Dementia].

Impairment of attention, especially complex attention, appears in the early stage of dementia. Complex attention is one of the six neurocognitive domains, which are disturbed in dementia. Impairment of complex attention promotes symptoms of dementia, difficulties in activities of daily living (ADLs), and disturbed communication in dementia due to Alzheimer disease, Lewy body disease, and cerebrovascular diseases. Despite its importance, research on "impairment of attention in dementia" is scarce. We look forward to future studies addressing this topic. In this article, we emphasized on providing care for ADL and communication for people with dementia, who have attention deficits.