Exploiting temporal predictability: event-related potential correlates of task-supportive temporal cue processing in auditory distraction

The human cognitive system has various functions to enhance performance in tasks requiring responses to stimuli. When potentially occurring stimuli are known, we can establish selective attention sets and ignore task-irrelevant events while attending task-relevant ones. When the stimulation is temporally structured, we can rely on constant temporal relationships between stimulus events to prepare for the task-relevant moments. Most distraction paradigms feature task-irrelevant events which are followed by task-relevant ones within a constant interval, and distraction is induced by randomly replacing some of the standard task-irrelevant events. The constant time interval transforms irrelevant events to task-supportive temporal cues, which are integrated into the task-behavior by the participants. The present study investigated whether distracters could be utilized as temporal cues to support task-related processing in a continuous auditory stimulation paradigm. A continuous tone featuring short and long gaps, and pitch glides was presented. Participants performed a gap duration discrimination task, while ignoring glides. Glides could be presented frequently or rarely. In the informative condition, 80% of the glides predicted the presentation time of the forthcoming gap (400 ms), while in the uninformative condition, the occurrence of gaps and glides was independent. Rare glides elicited an enhanced N1, mismatch negativity, and P3 event-related potentials in both informative and uninformative conditions. In informative conditions glides were followed by a contingent negative variation; and rare informative glides elicited an N2b, suggesting that despite triggering distraction-related processes, distracters could be integrated into the task-behavior, and could be utilized as task-supportive cues

Auditory Pattern Representations Under Conditions of Uncertainty—An ERP Study

The auditory system is able to recognize auditory objects and is thought to form predictive models of them even though the acoustic information arriving at our ears is often imperfect, intermixed, or distorted. We investigated implicit regularity extraction for acoustically intact versus disrupted six-tone sound patterns via event-related potentials (ERPs). In an exact-repetition condition, identical patterns were repeated; in two distorted-repetition conditions, one randomly chosen segment in each sound pattern was replaced either by white noise or by a wrong pitch. In a roving-standard paradigm, sound patterns were repeated 1–12 times (standards) in a row before a new pattern (deviant) occurred. The participants were not informed about the roving rule and had to detect rarely occurring loudness changes. Behavioral detectability of pattern changes was assessed in a subsequent behavioral task. Pattern changes (standard vs. deviant) elicited mismatch negativity (MMN) and P3a, and were behaviorally detected above the chance level in all conditions, suggesting that the auditory system extracts regularities despite distortions in the acoustic input. However, MMN and P3a amplitude were decreased by distortions. At the level of MMN, both types of distortions caused similar impairments, suggesting that auditory regularity extraction is largely determined by the stimulus statistics of matching information. At the level of P3a, wrong-pitch distortions caused larger decreases than white-noise distortions. Wrong-pitch distortions likely prevented the engagement of restoration mechanisms and the segregation of disrupted from true pattern segments, causing stronger informational interference with the relevant pattern informatio

An Asymmetry in the Automatic Detection of the Presence or Absence of a Frequency Modulation within a Tone: A Mismatch Negativity Study

The infrequent occurrence of a transient feature (deviance; e.g., frequency modulation, FM) in one of the regular occurring sinusoidal tones (standards) elicits the deviance related mismatch negativity (MMN) component of the event-related brain potential. Based on a memory-based comparison, MMN reflects the mismatch between the representations of incoming and standard sounds. The present study investigated to what extent the infrequent exclusion of an FM is detected by the MMN system. For that purpose we measured MMN to deviances that either consisted of the exclusion or inclusion of an FM at an early or late position within the sound that was present or absent, respectively, in the standard. According to the information-content hypothesis, deviance detection relies on the difference in informational content of the deviant relative to that of the standard. As this difference between deviants with FM and standards without FM is the same as in the reversed case, comparable MMNs should be elicited to FM inclusions and exclusions. According to the feature-detector hypothesis, however, the deviance detection depends on the increased activation of feature detectors to additional sound features. Thus, rare exclusions of the FM should elicit no or smaller MMN than FM inclusions. In passive listening condition, MMN was obtained only for the early inclusion, but not for the exclusions nor for the late inclusion of an FM. This asymmetry in automatic deviance detection seems to partly reflect the contribution of feature detectors even though it cannot fully account for the missing MMN to late FM inclusions. Importantly, the behavioral deviance detection performance in the active listening condition did not reveal such an asymmetry, suggesting that the intentional detection of the deviants is based on the difference in informational content. On a more general level, the results partly support the “fresh-afferent” account or an extended memory-comparison based account of MMN

An asymmetry in the automatic detection of the presence or absence of a frequency modulation within a tone: a mismatch negativity study

The infrequent occurrence of a transient feature (deviance; e.g., frequency modulation, FM) in one of the regular occurring sinusoidal tones (standards) elicits the deviance related mismatch negativity (MMN) component of the event-related brain potential. Based on a memory-based comparison, MMN reflects the mismatch between the representations of incoming and standard sounds. The present study investigated to what extent the infrequent exclusion of an FM is detected by the MMN system. For that purpose we measured MMN to deviances that either consisted of the exclusion or inclusion of an FM at an early or late position within the sound that was present or absent, respectively, in the standard. According to the information-content hypothesis, deviance detection relies on the difference in informational content of the deviant relative to that of the standard. As this difference between deviants with FM and standards without FM is the same as in the reversed case, comparable MMNs should be elicited to FM inclusions and exclusions. According to the feature-detector hypothesis, however, the deviance detection depends on the increased activation of feature detectors to additional sound features. Thus, rare exclusions of the FM should elicit no or smaller MMN than FM inclusions. In passive listening condition, MMN was obtained only for the early inclusion, but not for the exclusions nor for the late inclusion of an FM. This asymmetry in automatic deviance detection seems to partly reflect the contribution of feature detectors even though it cannot fully account for the missing MMN to late FM inclusions. Importantly, the behavioral deviance detection performance in the active listening condition did not reveal such an asymmetry, suggesting that the intentional detection of the deviants is based on the difference in informational content. On a more general level, the results partly support the “fresh-afferent” account or an extended memory-comparison based account of MMN

Incorporating technology diffusion estimates in health economic methods - Application in a preterm birth screening case study

Low implementation of cost-effective health technologies results in inefficient use of resources in a health system. Despite this, estimates of implementation or diffusion are not routine components of analyses performed within health technology assessments (HTA), potentially due to a lack of a) methods to obtain diffusion estimates and b) understanding of the impact of diffusion estimates on health economic outcomes. This thesis contributes a) a method to estimate health technology diffusion prior to HTA and b) a modelling framework that assesses the potential impact of diffusion estimates on cost-effectiveness and expected value of information and implementation (EVII) analysis using modelling, qualitative and elicitation methods. These were illustrated in a preterm birth (PTB) screening case study. The modelling framework included extensions to an existing EVII model to make it dynamic and allow research to affect implementation; and the development of a dynamic cost-effectiveness analysis (DCEA) model that reflects price changes precipitated by diffusion and hence, the reimbursement decision. Drivers of diffusion were identified for the case study technology, aiding the design of implementation strategies. The developed method for predicting diffusion requires transformation of elicited expert beliefs to inform an existing diffusion model. Application in the PTB screening model showed that the dynamic EVII method can 1.) help more accurately assess the losses the health care payer incurs when there is decision uncertainty and low implementation and 2.) provide more realistic assessments of implementation strategies and evidence generation schemes. The applied DCEA model showed that changes in price triggered by technology diffusion significantly affect cost-effectiveness results. The method for predicting health technology diffusion and the EVII and DCEA frameworks are foreseen to be relevant in the context of HTAs of medical devices, diagnostics and drugs; particularly when there is low implementation or there is potential for future price changes conditional on diffusion

Early change detection in humans as revealed by auditory brainstem and middle-latency evoked potentials

International audienceThe ability to detect unexpected novel stimuli is crucial for survival, as it might urge a prompt adaptive response. Human auditory novelty detection has been associated to the mismatch negativity long-latency auditory-evoked potential, peaking at 100–200 ms. Yet, recent animal studies showing novelty responses at a very short latency (about 20–30 ms) in individual neurons already at the level of the midbrain and thalamus suggest that novelty detection might be a basic principle of the functional organization of the auditory system, expanding from lower levels in the brainstem along the auditory pathway up to higher-order areas of the cerebral cortex. To test this suggestion, we here measured auditory brainstem and middle latency response (MLR) to frequency novel stimuli embedded in an oddball sequence. To oversee refractoriness confounds a 'control block' was used. The results showed that occasional changes in auditory frequency information were detected as early as 30 ms (Pa waveform of the MLR) after stimulus onset. The control block precluded these effects as resulting merely from refractoriness, altogether supporting the notion of 'true' early auditory change detection in humans, matching the latency range of auditory novelty responses described in individual neurons of subhuman species. Our results suggest that auditory change detection of frequency information is a multistage process that occurs at the primary auditory cortex and is transmitted to the higher levels of the auditory pathway

Detection of simple and pattern regularity violations occurs at different levels of the auditory hierarchy

Auditory deviance detection in humans is indexed by the mismatch negativity (MMN), a component of the auditory evoked potential (AEP) of the electroencephalogram (EEG) occurring at a latency of 100-250 ms after stimulus onset. However, by using classic oddball paradigms, differential responses to regularity violations of simple auditory features have been found at the level of the middle latency response (MLR) of the AEP occurring within the first 50 ms after stimulus (deviation) onset. These findings suggest the existence of fast deviance detection mechanisms for simple feature changes, but it is not clear whether deviance detection among more complex acoustic regularities could be observed at such early latencies. To test this, we examined the pre-attentive processing of rare stimulus repetitions in a sequence of tones alternating in frequency in both long and middle latency ranges. Additionally, we introduced occasional changes in the interaural time difference (ITD), so that a simple-feature regularity could be examined in the same paradigm. MMN was obtained for both repetition and ITD deviants, occurring at 150 ms and 100 ms after stimulus onset respectively. At the level of the MLR, a difference was observed between standards and ITD deviants at the Na component (20-30 ms after stimulus onset), for 800 Hz tones, but not for repetition deviants. These findings suggest that detection mechanisms for deviants to simple regularities, but not to more complex regularities, are already activated in the MLR range, supporting the view that the auditory deviance detection system is organized in a hierarchical manner

EffECTively Treating Depression: A Pilot Study Examining Manualized Group CBT as Follow-Up Treatment After ECT

Background: There is an urgent need for effective follow-up treatments after acute electroconvulsive therapy (ECT) in depressed patients. Preliminary evidence suggests psychotherapeutic interventions to be a feasible and efficacious follow-up treatment. However, there is a need for research on the long-term usefulness of such psychotherapeutic offers in a naturalistic setting that is more representative of routine clinical practice. Therefore, the aim of the current pilot study was to investigate the effects of a half-open continuous group cognitive behavioral therapy (CBT) with cognitive behavioral analysis system of psychotherapy elements as a follow-up treatment for all ECT patients, regardless of response status after ECT, on reducing depressive symptoms and promoting psychosocial functioning. Method: Group CBT was designed to support patients during the often-difficult transition from inpatient to outpatient treatment. In a non-controlled pilot trial, patients were offered 15weekly sessions of manualized group CBT (called EffECTiv 2.0). The Montgomery-Åsberg Depression Rating Scale was assessed as primary outcome; the Beck Depression Inventory, WHO Quality of Life Questionnaire-BREF, and the Cognitive Emotion Regulation Questionnaire were assessed as secondary outcomes. Measurements took place before individual group start, after individual group end, and 6months after individual group end. Results: During group CBT, Post-ECT symptom reduction was not only maintained but there was a tendency toward a further decrease in depression severity. This reduction could be sustained 6months after end of the group, regardless of response status after ECT treatment. Aspects of quality of life and emotion regulation strategies improved during group CBT, and these improvements were maintained 6months after the end of the group. Conclusion: Even though the interpretability of the results is limited by the small sample and the non-controlled design, they indicate that manualized group CBT with cognitive behavioral analysis system of psychotherapy elements might pose a recommendable follow-up treatment option after acute ECT for depressed patients, regardless of response status after ECT. This approach might not only help to further reduce depressive symptoms and prevent relapse, but also promote long-term psychosocial functioning by improving emotion regulation strategies and psychological quality of life and thus could be considered as a valuable addition to clinical routine after future validation

Using event-related brain potentials to evaluate motor-auditory latencies in virtual reality

Actions in the real world have immediate sensory consequences. Mimicking these in digital environments is within reach, but technical constraints usually impose a certain latency (delay) between user actions and system responses. It is important to assess the impact of this latency on the users, ideally with measurement techniques that do not interfere with their digital experience. One such unobtrusive technique is electroencephalography (EEG), which can capture the users' brain activity associated with motor responses and sensory events by extracting event-related potentials (ERPs) from the continuous EEG recording. Here we exploit the fact that the amplitude of sensory ERP components (specifically, N1 and P2) reflects the degree to which the sensory event was perceived as an expected consequence of an own action (self-generation effect). Participants (N = 24) elicit auditory events in a virtual-reality (VR) setting by entering codes on virtual keypads to open doors. In a within-participant design, the delay between user input and sound presentation is manipulated across blocks. Occasionally, the virtual keypad is operated by a simulated robot instead, yielding a control condition with externally generated sounds. Results show that N1 (but not P2) amplitude is reduced for self-generated relative to externally generated sounds, and P2 (but not N1) amplitude is modulated by delay of sound presentation in a graded manner. This dissociation between N1 and P2 effects maps back to basic research on self-generation of sounds. We suggest P2 amplitude as a candidate read-out to assess the quality and immersiveness of digital environments with respect to system latency