Unraveling the role of ectopic thymic tissue in patients undergoing thymectomy for myasthenia gravis

Extended thymectomy has been considered the goal of surgery for myasthenia gravis (MG) mainly due to the existence of ectopic thymic tissue. Recently, ectopic thymic tissue has attracted increasing attention in patients with MG following thymectomy. However, the specific role of ectopic thymic tissue in patients with MG is still under debate. A systematic search of the literature was performed on PubMed and Medline according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISM) statement. Studies evaluating the rate of ectopic thymic tissue in patients with MG with or without thymoma were included. Extraction was performed for all eligible studies and the rate of ectopic thymic tissue at common locations was calculated. Eighteen out of fifty-nine studies were eligible for inclusion, of which ten studies reported the common locations of ectopic thymic tissue in mediastinal fat. Of these ten studies, the presence of ectopic thymic tissue was investigated in different anatomical locations in 882 patients, of whom, 509 patients (58%) have at least one positive location with the most common ones being anterior mediastinal fat, pericardiophrenic angles, aortopulmonary window, cervical region (pretracheal fat) and lateral to phrenic nerves. On the other hand, nine studies analyzed the influence of the presence of ectopic thymic tissue on the clinical outcomes of MG patients. Of these, six found that the presence of ectopic thymic tissue in MG patients is a significant predictor of poor outcome after thymectomy, however, the other three did not find a significance. Altogether, ectopic thymic tissue is likely to present in more than a half of patients undergoing thymectomy for MG. Besides, MG patients who have ectopic thymic tissue after thymectomy do not seem to have as good outcome as those who have not

The Flexible Nature of Unconscious Cognition

The cognitive signature of unconscious processes is hotly debated recently. Generally, consciousness is thought to mediate flexible, adaptive and goal-directed behavior, but in the last decade unconscious processing has rapidly gained ground on traditional conscious territory. In this study we demonstrate that the scope and impact of unconscious information on behavior and brain activity can be modulated dynamically on a trial-by-trial basis. Participants performed a Go/No-Go experiment in which an unconscious (masked) stimulus preceding a conscious target could be associated with either a Go or No-Go response. Importantly, the mapping of stimuli onto these actions varied on a trial-by-trial basis, preventing the formation of stable associations and hence the possibility that unconscious stimuli automatically activate these control actions. By eliminating stimulus-response associations established through practice we demonstrate that unconscious information can be processed in a flexible and adaptive manner. In this experiment we show that the same unconscious stimulus can have a substantially different effect on behavior and (prefrontal) brain activity depending on the rapidly changing task context in which it is presented. This work suggests that unconscious information processing shares many sophisticated characteristics (including flexibility and context-specificity) with its conscious counterpart

The role of prediction and outcomes in adaptive cognitive control

Humans adaptively perform actions to achieve their goals. This flexible behaviour requires two core abilities: the ability to anticipate the outcomes of candidate actions and the ability to select and implement actions in a goal-directed manner. The ability to predict outcomes has been extensively researched in reinforcement learning paradigms, but this work has often focused on simple actions that are not embedded in hierarchical and sequential structures that are characteristic of goal-directed human behaviour. On the other hand, the ability to select actions in accordance with high-level task goals, particularly in the presence of alternative responses and salient distractors, has been widely researched in cognitive control paradigms. Cognitive control research, however, has often paid less attention to the role of action outcomes. The present review attempts to bridge these accounts by proposing an outcome-guided mechanism for selection of extended actions. Our proposal builds on constructs from the hierarchical reinforcement learning literature, which emphasises the concept of reaching and evaluating informative states, i.e., states that constitute subgoals in complex actions. We develop an account of the neural mechanisms that allow outcome-guided action selection to be achieved in a network that relies on projections from cortical areas to the basal ganglia and back-projections from the basal ganglia to the cortex. These cortico-basal ganglia-thalamo-cortical ‘loops’ allow convergence – and thus integration – of information from non-adjacent cortical areas (for example between sensory and motor representations). This integration is essential in action sequences, for which achieving an anticipated sensory state signals the successful completion of an action. We further describe how projection pathways within the basal ganglia allow selection between representations, which may pertain to movements, actions, or extended action plans. The model lastly envisages a role for hierarchical projections from the striatum to dopaminergic midbrain areas that enable more rostral frontal areas to bias the selection of inputs from more posterior frontal areas via their respective representations in the basal ganglia.This work is supported by the Biotechnology and Biological Sciences Research Council (BBSRC) Grant BB/I019847/1, awarded to NY and FW

Contingency and contiguity of imitative behaviour affect social affiliation

Actions of others automatically prime similar responses in an agent’s behavioural repertoire. As a consequence, perceived or anticipated imitation facilitates own action control and, at the same time, imitation boosts social affiliation and rapport with others. It has previously been suggested that basic mechanisms of associative learning can account for behavioural effects of imitation, whereas a possible role of associative learning for affiliative processes is poorly understood at present. Therefore, this study examined whether contingency and contiguity, the principles of associative learning, affect also the social effects of imitation. Two experiments yielded evidence in favour of this hypothesis by showing more social affiliation in conditions with high contingency (as compared to low contingency) and in conditions of high contiguity (compared to low contiguity)

Towards a cognitive neuroscience of intentional action and non-action

Contains fulltext : 90570.pdf (publisher's version ) (Closed access)The question of how we can voluntarily control our behaviour has an enduring fascination for researchers from different disciplines such as philosophy and psychology. At the same time, this question is also related to issues of social relevance such as responsibility and self-control. While research on willed action was long obsessed with the problem of free will, important research in this domain has shifted away from this problem and rather investigates the functional and neural mechanisms underlying intentional action. Recent brain imaging research showed that intentional behaviour can be distinguished from externally guided behaviour on a functional neuroanatomical level. Furthermore, it was proposed that intentional action can be decomposed into different subcomponents. Here we provide an overview of the functional neuroanatomy of intentional action. Furthermore, we discuss recent research of our group on intentional stopping and intentional nonaction