Neural processing of fearful faces: effects of anxiety are gated by perceptual capacity limitations

Debate continues as to the automaticity of the amygdala's response to threat. Accounts taking a strong automaticity line suggest that the amygdala's response to threat is both involuntary and independent of attentional resources. Building on these accounts, prominent models have suggested that anxiety modulates the output of an amygdala-based preattentive threat evaluation system. Here, we argue for a modification of these models. Functional magnetic resonance imaging data were collected while volunteers performed a letter search task of high or low perceptual load superimposed on fearful or neutral face distractors. Neither high- nor low-anxious volunteers showed an increased amygdala response to threat distractors under high perceptual load, contrary to a strong automaticity account of amygdala function. Under low perceptual load, elevated state anxiety was associated with a heightened response to threat distractors in the amygdala and superior temporal sulcus, whereas individuals high in trait anxiety showed a reduced prefrontal response to these stimuli, consistent with weakened recruitment of control mechanisms used to prevent the further processing of salient distractors. These findings suggest that anxiety modulates processing subsequent to competition for perceptual processing resources, with state and trait anxiety having distinguishable influences upon the neural mechanisms underlying threat evaluation and "top-down" control.     

Electrophysiological correlates of rapid spatial orienting towards fearful faces

We investigated the spatio-temporal dynamic of attentional bias towards fearful faces. Twelve participants performed a covert spatial orienting task while recording visual event-related brain potentials (VEPs). Each trial consisted of a pair of faces (one emotional and one neutral) briefly presented in the upper visual field, followed by a unilateral bar presented at the location of one of the faces. Participants had to judge the orientation of the bar. Comparing VEPs to bars shown at the location of an emotional (valid) versus neutral (invalid) face revealed an early effect of spatial validity: the lateral occipital P1 component (approximately 130 ms post-stimulus) was selectively increased when a bar replaced a fearful face compared to when the same bar replaced a neutral face. This effect was not found with upright happy faces or inverted fearful faces. A similar amplification of P1 has previously been observed in electrophysiological studies of spatial attention using non-emotional cues. In a behavioural control experiment, participants were also better at discriminating the orientation of the bar when it replaced a fearful rather than a neutral face. In addition, VEPs time-locked to the face-pair onset revealed a C1 component (approximately 90 ms) that was greater for fearful than happy faces. Source localization (LORETA) confirmed an extrastriate origin of the P1 response showing a spatial validity effect, and a striate origin of the C1 response showing an emotional valence effect. These data suggest that activity in primary visual cortex might be enhanced by fear cues as early as 90 ms post-stimulus, and that such effects might result in a subsequent facilitation of sensory processing for a stimulus appearing at the same location. These results provide evidence for neural mechanisms allowing rapid, exogenous spatial orienting of attention towards fear stimuli.     

Emotion induction after direct intracerebral stimulations of human amygdala

Very few studies in humans have quantified the effect obtained after direct electrical stimulation of the amygdala, in terms of both emotional and physiological responses. We tested patients with drug-resistant partial epilepsies who were explored with intracerebral electrodes in the setting of presurgical evaluation. We assessed the effects of direct electric stimulations in either the right or the left amygdala on verbally self-reported emotions (Izard scale) and on psychophysiological markers of emotions by recording skin conductance responses (SCRs) and by measuring the electromyographic responses of the corrugator supercilii (EMGc). According to responses on Izard scales, electrical stimulations of the right amygdala induced negative emotions, especially fear and sadness. In contrast, stimulations of the left amygdala were able to induce either pleasant (happiness) or unpleasant (fear, anxiety, sadness) emotions. Unpleasant states induced by electrical stimulations were accompanied by an increase in EMGc activity. In addition, when emotional changes were reported after electrical stimulation, SCR amplitude for the positively valenced emotions was larger than for the negative ones. These findings provide direct in vivo evidence that the human amygdala is involved in emotional experiences and strengthen the hypothesis of a functional asymmetry of the amygdala for valence and arousal processing.     

Similar frontal and distinct posterior cortical regions mediate visual and auditory perceptual awareness

Activity in ventral visual cortex is a consistent neural correlate of visual consciousness. However, activity in this area seems insufficient to produce awareness without additional involvement of frontoparietal regions. To test the generality of the frontoparietal response, neural correlates of auditory awareness were investigated in a paradigm that previously has revealed frontoparietal activity during conscious visual perception. A within-experiment comparison showed that frontal regions were related to both visual and auditory awareness, whereas parietal activity was correlated with visual awareness and superior temporal activity with auditory awareness. These results indicate that frontal regions interact with specific posterior regions to produce awareness in different sensory modalities.     

Feeling the real world: limbic response to music depends on related content

Emotions are often object related--they are about someone or something in the world. It is yet an open question whether emotions and the associated perceptual contents that they refer to are processed by different parts of the brain or whether the brain regions that mediate emotions are also involved in the processing of the associated content they refer to. Using functional magnetic resonance imaging, we showed that simply combining music (rich in emotion but poor in information about the concrete world) with neutral films (poor in emotionality but rich in real-world details) yields increased activity in the amygdala, hippocampus, and lateral prefrontal regions. In contrast, emotional music on its own did not elicit a differential response in these regions. The finding that the amygdala, the heart of the emotional brain, responds increasingly to an emotional stimulus when it is associated with realistic scenes supports a fundamental role for concrete real-world content in emotional processing.     

Auditory evoked responses and learning and awareness during general anesthesia

BACKGROUND: There is a major distinction between conscious and unconscious learning. Monitoring the mid-latency auditory evoked responses (AER) has been proposed as a measure to ascertain the adequacy of the hypnotic state during surgery. In the present study, we investigated the presence of explicit and implicit memories after anesthesia and examined the relationships of such memories to the AER. METHODS: We studied 180 patients scheduled for elective surgical procedures. After a thiopental induction, one of four anesthetics were studied: Opioid bolus: 7.5 microg x kg(-1) fentanyl, 70% N2O, with 2.5 microg x kg(-1) supplements as needed (n=100); Opioid infusion: Alfentanil 50 microg x kg(-1) bolus, 1-1.5 microg x kg(-1) x min(-1) infusion, 70% N2O (n=40); Isoflurane 0.3%: Fentanyl 1 microg x kg(-1), 70% N2O, isoflurane 0.3% expired (n=16); Isoflurane 0.7%: Fentanyl 1 microg x kg(-1), 70% N2O, isoflurane 0.7% expired (n=23). AER were recorded before anesthesia, 5 min after surgical incision and then every 30 min until the end of surgery. A tape of either the story of the "Three Little Pigs" or the "Wizard of Oz" was played continuously between the recordings. Explicit memory was assessed postoperatively by tests of recall and recognition, and implicit memory was assessed by the frequency of story-related free associations to target words from the stories, which were solicited twice during a structured interview. RESULTS: Six patients showed explicit recall of intraoperative events: All received the opioid bolus regimen. About 7% of patients reported dreaming during anesthesia. The incidence of picking the correct story that had been presented during anesthesia averaged 49%, i.e., very close to chance level. Overall, priming occurred only at the second association tests for the opioid bolus regimen, for which the frequency of an association to the presented story among those not giving an association to the control story was 26%, which was double the frequency (13%) of an association to the control story among those not giving an association to the presented story. This was significant by McNemar's test, P=0.02. There were significant associations between awareness, priming and AER, e.g., recall was associated with higher Nb amplitudes during anesthesia and priming was associated with shorter wave latencies. CONCLUSIONS: The incidence of awareness in patients anesthetized with nitrous oxide and bolus supplementation was 6%. Thus, this anesthetic technique did not reduce the risk of awareness compared with the use of nitrous oxide alone. Implicit memory occurred during nitrous oxide and bolus supplementation. Recording AER during anesthesia may help to predict awareness and implicit memory, particularly the former. The short contents of most of the dreams which were recalled could hamper future studies in this area.     

Distinct and convergent visual processing of high and low spatial frequency information in faces

We tested for differential brain response to distinct spatialfrequency (SF) components in faces. During a functional magneticresonance imaging experiment, participants were presented with"hybrid" faces containing superimposed low and high SF informationfrom different identities. We used a repetition paradigm wherefaces at either SF range were independently repeated or changedacross consecutive trials. In addition, we manipulated whichSF band was attended. Our results suggest that repetition andattention affected partly overlapping occipitotemporal regionsbut did not interact. Changes of high SF faces increased responsesof the right inferior occipital gyrus (IOG) and left inferiortemporal gyrus (ITG), with the latter response being also modulatedadditively by attention. In contrast, the bilateral middle occipitalgyrus (MOG) responded to repetition and attention manipulationsof low SF. A common effect of high and low SF repetition wasobserved in the right fusiform gyrus (FFG). Follow-up connectivityanalyses suggested direct influence of the MOG (low SF), IOG,and ITG (high SF) on the FFG responses. Our results reveal thatdifferent regions within occipitotemporal cortex extract distinctvisual cues at different SF ranges in faces and that the outputsfrom these separate processes project forward to the right FFG,where the different visual cues may converge.     

Cognitive coping style modulates neural responses to emotional faces in healthy humans: a 3-T FMRI study

Repression designates coping strategies that aim to shield the organism from distressing stimuli by disregarding their aversive characteristics. In contrast, sensitization comprises coping strategies that are employed to reduce situational uncertainty such as analyzing the environment. Functional magnetic resonance imaging was used to study neural correlates of coping styles during the perception of threatening and nonthreatening socially relevant information. Pictures of human faces bearing fearful (ambiguously threatening), angry (unambiguously threatening), happy (nonthreatening), and neutral expressions were presented masked and unmasked. Two groups of subjects were examined who were defined as consistent repressors versus consistent sensitizers with the Mainz Coping Inventory. Sensitizers tended to exhibit stronger neural responses in the amygdala to unmasked fearful faces compared with repressors. Overall, repressors were cortically more responsive to fearful (ambiguously threatening) and happy (nonthreatening) facial expressions than sensitizers, whereas sensitizers presented an enhanced responsivity to angry faces in several prefrontal areas, that is, unambiguously threatening expressions. Results from time series analyses suggest that sensitizers could exhibit less top-down cortical regulation of the amygdala than repressors in the processing of fearful faces. An increased responsivity of the amygdala to ambiguously threatening stimuli may represent a biological determinant of sensitizers' feelings of uncertainty.     

Controlling emotional expression: behavioral and neural correlates of nonimitative emotional responses

Emotional facial expressions can engender similar expressions in others. However, adaptive social and motivational behavior can require individuals to suppress, conceal, or override prepotent imitative responses. We predicted, in line with a theory of "emotion contagion," that when viewing a facial expression, expressing a different emotion would manifest as behavioral conflict and interference. We employed facial electromyography (EMG) and functional magnetic resonance imaging (fMRI) to investigate brain activity related to this emotion expression interference (EEI) effect, where the expressed response was either concordant or discordant with the observed emotion. The Simon task was included as a nonemotional comparison for the fMRI study. Facilitation and interference effects were observed in the latency of facial EMG responses. Neuroimaging revealed activation of distributed brain regions including anterior right inferior frontal gyrus (brain area [BA] 47), supplementary motor area (facial area), posterior superior temporal sulcus (STS), and right anterior insula during emotion expression-associated interference. In contrast, nonemotional response conflict (Simon task) engaged a distinct frontostriatal network. Individual differences in empathy and emotion regulatory tendency predicted the magnitude of EEI-evoked regional activity with BA 47 and STS. Our findings point to these regions as providing a putative neural substrate underpinning a crucial adaptive aspect of social/emotional behavior.     

Double dissociation of V1 and V5/MT activity in visual awareness

The critical time windows of the contribution of V1 and V5/MT to visual awareness of moving visual stimuli were compared by administering transcranial magnetic stimulation (TMS) to V1 or V5/MT in various time intervals from stimulus offset during performance of a simple motion detection task. Our results show a double dissociation in which the critical period of V1 both predates and postdates that of V5/MT, and where stimulation of either V1 at V5/MT's critical period or V5/MT at V1's critical period does not impair performance. These findings demonstrate the importance of back-projections from V5/MT to V1 in awareness of real motion stimuli.     

Attention to simultaneous unrelated auditory and visual events: behavioral and neural correlates

The cognitive and neural bases of the ability to focus attention on information in one sensory modality while ignoring information in another remain poorly understood. We hypothesized that bimodal selective attention results from increased activity in corresponding sensory cortices with a suppression of activity in non-corresponding sensory cortices. In a functional magnetic resonance imaging (fMRI) study, we presented melodies and shapes alone (unimodal) or simultaneously (bimodal). Subjects monitored for changes in an attended modality while ignoring the other. Subsequently, memory for both attended and unattended stimuli was tested. Subjects remembered attended stimuli equally well in unimodal and bimodal conditions, and significantly better than ignored stimuli in bimodal conditions. When a subject focused on a stimulus, the blood-oxygen-level-dependent (BOLD) response increased in sensory cortices corresponding to that modality in both unimodal and bimodal conditions. Additionally, the BOLD response decreased in sensory cortices corresponding to the non-presented modality in unimodal conditions and the unattended modality in bimodal conditions. We conclude that top-down attentional effects modulate the interaction of sensory cortical areas by gating sensory input. This interaction between sensory cortices enhances processing of one modality at the expense of the other during selective attention, and subsequently affects memory encoding.     

Electrophysiological correlates of visual adaptation to faces and body parts in humans

The existence of facial aftereffects suggests that shape-selective mechanisms at the higher stages of visual object coding -- similarly to the early processing of low-level visual features -- are adaptively recalibrated. Our goal was to uncover the ERP correlates of shape-selective adaptation and to test whether it is also involved in the visual processing of human body parts. We found that prolonged adaptation to female hands -- similarly to adaptation to female faces -- biased the judgements about the subsequently presented hand test stimuli: they were perceived more masculine than in the control conditions. We also showed that these hand aftereffects are size and orientation invariant. However, no aftereffects were found when the adaptor and test stimuli belonged to different categories (i.e. face adaptor and hand test, or vice versa), suggesting that the underlying adaptation mechanisms are category-specific. In accordance with the behavioral results, both adaptation to faces and hands resulted in a strong and category-specific modulation -- reduced amplitude and increased latency -- of the N170 component of ERP responses. Our findings suggest that shape-selective adaptation is a general mechanism of visual object processing and its neural effects are primarily reflected in the N170 component of the ERP responses.     

Behavioural,cognitive and emotional responses to SARS: differences between college students in Beijing and Suzhou

This research was designed to explore the differences in behaviour, cognition and emotion between college students in Beijing and Suzhou, who were under different external stresses during the severe acute respiratory syndrome (SARS) prevalence time in China from 22 April to 23 June, 2003. A ‘Psychological responses questionnaire on SARS’ designed by the authors was filled out by subjects. A total of 268 valid cases were collected in Beijing through e‐mails or websites, and 397 valid copies were collected in Suzhou through pencil‐and‐paper tests. The two groups differed in their behaviours, cognitions and emotions. Cognitive and behavioural responses of the Beijing sample changed along with the time and the epidemic situation, and so did the negative emotions of the Suzhou sample. Path analysis of the Beijing sample found support for the mediating effects of the cognition on the relationships of stress and the emotional and behavioural responses, while the results of the Suzhou sample did not. Differences between the two samples are discussed. Copyright © 2005 John Wiley & Sons, Ltd.     

七氟醚麻醉下瑞芬太尼抑制小儿切皮反应的血浆靶浓度

目的 确定七氟醚麻醉下瑞芬太尼抑制小儿切皮时躯体和心血管反应的血浆靶浓度.方法 择期全麻手术小儿75例,年龄2～5岁,ASA Ⅰ级,随机均分为五组,七氟醚吸入诱导后,采用Minto药代动力学模型靶控输注瑞芬太尼,血浆靶浓度分别为1、2、3、4、5 ng/ml(R1～R5组),维持呼气末七氟醚浓度稳定在1.5%,15 min后开始切皮.切皮即刻,小儿发生体动为躯体反应阳性;MAP或HR较切皮前升高或增快＞15%为心血管反应阳性.Probit法计算瑞芬太尼抑制50%和95%患儿切皮即刻躯体和心血管反应的有效血浆靶浓度(Cp50和CP95).结果 五组瑞芬太尼抑制切皮时躯体反应有效构成比分别为0/15、5/15、12/15、15/15、15/15;抑制心血管反应有效构成比分别为0/15、2/15、8/15、13/15、14/15.结论 在1.5%七氟醚麻醉下,瑞芬太尼抑制2～5岁小儿切皮时躯体反应的Cp50及其95%可信区间为2.29(1.92～2.59)ng/ml,Cp95及其95%可信区间为3.53(3.02～5.03)ng/ml;抑制心血管反应的Cp50及其95%可信区间为2.89(2.46～3.29)ng/ml,Cp95及其95%可信区间为4.99(4.19～7.18)ng/ml.     

Pre- and poststimulus alpha rhythms are related to conscious visual perception: a high-resolution EEG study

Conscious and unconscious visuospatial processes have been related to parietooccipital cortical activation as revealed by late visual-evoked potentials. Here the working hypothesis was that a specific pattern of pre- and poststimulus theta (about 4-6 Hz) and alpha (about 6-12 Hz) rhythms is differently represented during conscious compared with unconscious visuospatial processes. Electroencephalographic (EEG) data (128 channels) were recorded in normal adults during a visuospatial task. A cue stimulus appeared at the right or left (equal probability) monitor side for a "threshold time" inducing about 50% of correct recognitions. It was followed (2 s) by visual go stimuli at spatially congruent or incongruent position with reference to the cue location. Left (right) mouse button was clicked if the go stimulus appeared at the left (right) monitor side. Then, subjects said "seen" if they had detected the cue stimulus or "not seen" if missed (self-report). Sources of theta and alpha rhythms during seen and not seen EEG epochs were estimated by low-resolution electromagnetic brain topography software. Results showed that the prestimulus "low-band" (about 6-10 Hz) alpha rhythms in frontal, parietal, and occipital areas were stronger in power in the seen than in the not seen trials. After the visual stimulation, the power of the "high-band" (about 10-12 Hz) alpha rhythms in parietal and occipital areas decreased more in the seen than in the not seen trials. The present results suggest that visuospatial consciousness covary--presumably with a facilitatory effect--with the power of both pre- and poststimulus alpha rhythms.     

Increasing awareness of HIV pre‐exposure prophylaxis (PrEP) and willingness to use HIV PrEP among men who have sex with men: a systematic review and meta‐analysis of global data

IntroductionIntegrated knowledge regarding pre‐exposure prophylaxis (PrEP) awareness and willingness to use PrEP can be useful for HIV prevention in high incidence groups. This review summarizes the awareness of PrEP and willingness to use PrEP among men who have sex with men (MSM).MethodsOnline electronic databases were searched before 31 August 2021. A meta‐analysis was conducted to pool studies analysing PrEP awareness and willingness to use PrEP. LOESS regression and linear regression were applied to fit the trends over time for the proportion of MSM aware of PrEP and willing to use PrEP. Dose–response meta‐analysis (DRMA) was conducted by a restricted cubic spline model to explore the relationship between willingness to use PrEP and selected factors.Results and DiscussionA total of 156 articles involving 228,403 MSM were included. The pooled proportions of MSM aware of PrEP and willing to use PrEP were 50.0 (95% CI: 44.8–55.2) and 58.6% (95% CI: 54.8–62.4), respectively. PrEP awareness varied among countries with different economic status and different WHO regions, among different publication and research years, PrEP types and support policies. PrEP willingness differed among countries with different economic status and groups with different risks of HIV. The awareness of PrEP increased from 2007 to 2019 with a slope of 0.040260 (p<0.0001), while the proportion of MSM willing to use PrEP decreased from 2007 to 2014 (slope = –0.03647, p = 0.00390) but increased after 2014 (slope = 0.04187, p = 0.03895). The main facilitators of willingness to use PrEP were PrEP awareness, condomless sexual behaviours, high perceived risk of HIV infection and influence of social network. The main barriers were doubts about the efficacy and side effects of PrEP. DRMA results indicated that MSM with more sexual partners and lower level of education were more willing to use PrEP. No publication bias was observed.ConclusionsThe proportions of PrEP awareness and willingness to use PrEP among MSM have increased since 2014, although the awareness was low and the willingness was moderate. Improving awareness of PrEP through increasing access to PrEP‐related health education and enhancing risk perceptions of HIV infection could have positive effects on the willingness to use PrEP among MSM.