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BackgroundAltered amygdala activation to fear-related stimuli has been proposed to be a potential neural correlate of heightened threat sensitivity in anxiety- and stress-related disorders. However, the role of stimulus awareness and disorder specificity remains widely unclear. Here we investigated amygdala responses to conscious and unconscious fearful faces in patients suffering from panic disorder (PD), generalized anxiety disorder (GAD), or post-traumatic stress disorder (PTSD) and in a large sample of healthy controls (HC).MethodsDuring event-related functional magnetic resonance imaging participants (n = 120; 20 PD, 20 GAD, 20 PTSD, 60 HC) were confronted with briefly presented fearful faces, neutral faces, and non-faces in a backward masking paradigm. The design allowed for the analysis of trial-by-trial face detection performance and amygdala responses to fearful v. neutral faces.ResultsAll participants exhibited increased amygdala activation to fearful v. neutral faces during conscious trials. Specifically during unconscious face processing, the PTSD, compared with all other groups, showed higher right basolateral (BLA) amygdala activity to fearful v. neutral faces.ConclusionsThe present study shows that BLA amygdala hyperactivity during unconscious, but not conscious, processing of fearful faces differentiates PTSD from the investigated disorders. This finding suggests an automatic and specific neural hyper-responsivity to general fear cues in PTSD and supports the idea of categorical differences between PTSD and other anxiety-related disorders. [ABSTRACT FROM AUTHOR]

Background: Worrying has been suggested to prevent emotional and elaborative processing of fears. In cognitive-behavioral therapy (CBT), generalized anxiety disorder (GAD) patients are exposed to their fears during the method of directed threat imagery by inducing emotional reactivity. However, studies investigating neural correlates of directed threat imagery and emotional reactivity in GAD patients are lacking. The present functional magnetic resonance imaging (fMRI) study aimed at delineating neural correlates of directed threat imagery in GAD patients. Method: Nineteen GAD patients and 19 healthy controls (HC) were exposed to narrative scripts of either disorderrelated or neutral content and were encouraged to imagine it as vividly as possible. Results: Rating results showed that GAD patients experienced disorder-related scripts as more anxiety inducing and arousing than HC. These results were also reflected in fMRI data: Disorder-related v. neutral scripts elicited elevated activity in the amygdala, dorsomedial prefrontal cortex, ventrolateral prefrontal cortex and the thalamus as well as reduced activity in the ventromedial prefrontal cortex/subgenual anterior cingulate cortex in GAD patients relative to HC. Conclusion: The present study presents the first behavioral and neural evidence for emotional reactivity during directed threat imagery in GAD. The brain activity pattern suggests an involvement of a fear processing network as a neural correlate of initial exposure during directed imagery in CBT in GAD. [ABSTRACT FROM AUTHOR]

The interaction between intensity of nociceptive stimuli and cognitive load in a concomitant task is still a challenging and complex topic. Here, we investigated the interaction between top-down factors (i.e., perceptual load), induced by a visual task, and bottom-up factors (i.e., intensity of nociceptive stimuli that implicitly modifies saliency of input). Using a new experimental paradigm, in which perceptual load is varied while laser heat stimuli of different intensities are processed; we show a significant interaction between intensity of nociceptive stimuli and perceptual load on both pain ratings and task performance. High perceptual load specifically reduced intensity ratings of high intensity stimuli. However, under this condition, task performance was impaired, regardless of interindividual differences in motivation and pain catastrophizing. Thus, we showed that pain ratings can be reduced by increasing the load of attentional resources at the perceptual level of a non-pain-related task. Nevertheless, the disruptive effect of highly intensive nociceptive stimuli on the performance of the perceptual task was evident only under high load. [ABSTRACT FROM AUTHOR]

Objective: Previous simulation curricula of nontechnical skills have focused on communication skills or empathy in isolation from technical skills, using feedback from one rater. We aimed to develop and pilot an expanded simulation curriculum focused on situational performance of select character attributes with the goal of determining curricular feasibility, use of a novel psychometric rating tool, and receptivity of curriculum by participants., Design: The simulation consisted of 2 contiguous parts requiring demonstration of both technical and nontechnical skills. Participants received immediate informal feedback on technical skills; nontechnical skills, namely empathy, courage, composure, humility and clarity, were formally assessed by external raters using a novel global psychometric rating tool. They were also assessed by a standardized patient actor using the CARE Measure for empathy and via participant self-assessment. After the simulation, participants completed a self-reflection exercise and individually debriefed with personalized feedback from research team coaches. At completion, participants were invited to complete a post-curriculum survey. Intraclass correlation coefficients (ICC) were calculated to evaluate interrater reliability. Wilcoxon rank-sum tests were conducted to compare median attribute scores of student and resident participants. Post-curriculum feedback was reported with representative quotations and percentages., Setting: The simulation was piloted in a dedicated simulation center at a tertiary care academic medical center during Spring 2024., Participants: Six general surgery residents and six senior medical students pursuing surgical specialties voluntarily participated., Results: Ten participants (6 students, 4 residents) completed all components of the curriculum. Interrater reliability ranged from fair to excellent (ICC 0.68-0.98) for all attributes excluding Part 1 humility. Significantly higher median scores for resident participants were observed for courage in both parts as well as for Part 1 composure and clarity. Students scored significantly higher on Part 1 humility and Part 2 empathy. The empathy scores using the CARE Measure and our global psychometric rating tool were strongly correlated (r = 0.75). Participants generally rated themselves higher than external raters. Nearly all participants expressed that these skills are important (10, 100%) and not taught enough during training (9, 90%). Overall participant satisfaction was high., Conclusions: This expanded simulation curriculum focused on expression of character attributes as nontechnical skills was feasible and well-received by participants. Our global psychometric rating tool demonstrated partial validity as determined by strong correlation with the validated CARE Measure. This curriculum represents the first of its kind to provide deliberate practice and structured assessment focused on expression of character attributes essential to becoming an effective surgeon., (Copyright © 2024 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Anxiety disorders (AD) are associated with altered connectivity in large-scale intrinsic brain networks. It remains uncertain how much these signatures overlap across different phenotypes due to a lack of well-powered cross-disorder comparisons. We used resting-state functional magnetic resonance imaging (rsfMRI) to investigate differences in functional connectivity (FC) in a cross-disorder sample of AD patients and healthy controls (HC). Before treatment, 439 patients from two German multicenter clinical trials at eight different sites fulfilling a primary diagnosis of panic disorder and/or agoraphobia (PD/AG, N = 154), social anxiety disorder (SAD, N = 95), or specific phobia (SP, N = 190) and 105 HC underwent an 8 min rsfMRI assessment. We performed categorical and dimensional regions of interest (ROI)-to-ROI analyses focusing on connectivity between regions of the defensive system and prefrontal regulation areas. AD patients showed increased connectivity between the insula and the thalamus compared to controls. This was mainly driven by PD/AG patients who showed increased (insula/hippocampus/amygdala-thalamus) and decreased (dorsomedial prefrontal cortex/periaqueductal gray-anterior cingulate cortex) positive connectivity between subcortical and cortical areas. In contrast, SAD patients showed decreased negative connectivity exclusively in cortical areas (insula-orbitofrontal cortex), whereas no differences were found in SP patients. State anxiety associated with the scanner environment did not explain the FC between these regions. Only PD/AG patients showed pronounced connectivity changes along a widespread subcortical-cortical network, including the midbrain. Dimensional analyses yielded no significant results. The results highlighting categorical differences between ADs at a systems neuroscience level are discussed within the context of personalized neuroscience-informed treatments. PROTECT-AD's registration at NIMH Protocol Registration System: 01EE1402A and German Register of Clinical Studies: DRKS00008743. SpiderVR's registration at ClinicalTrials.gov: NCT03208400., (© 2024. The Author(s).)

The functional neuropeptide S receptor 1 (NPSR1) gene A/T variant (rs324981) is associated with fear processing. We investigated the impact of NPSR1 genotype on fear processing and on symptom reduction following treatment in individuals with spider phobia. A replication approach was applied [discovery sample: Münster (MS) nMS = 104; replication sample Würzburg (WZ) nWZ = 81]. Participants were genotyped for NPSR1 rs324981 [T-allele carriers (risk) versus AA homozygotes (no-risk)]. A sustained and phasic fear paradigm was applied during functional magnetic resonance imaging. A one-session virtual reality exposure treatment was conducted. Change of symptom severity from pre to post treatment and within session fear reduction were assessed. T-allele carriers in the discovery sample displayed lower anterior cingulate cortex (ACC) activation compared to AA homozygotes independent of condition. For sustained fear, this effect was replicated within a small cluster and medium effect size. No association with symptom reduction was found. Within-session fear reduction was negatively associated with ACC activation in T-allele carriers in the discovery sample. NPSR1 rs324981 genotype might be associated with fear processing in the ACC in spider phobia. Interpretation as potential risk-increasing function of the NPSR1 rs324981 T-allele via impaired top-down control of limbic structures remains speculative. Potential association with symptom reduction warrants further research., (© The Author(s) 2024. Published by Oxford University Press.)

Faces can acquire emotional meaning by learning to associate individuals with specific behaviors. Here, we investigated emotional evaluation and brain activations toward faces of persons who had given negative or positive evaluations to others. Furthermore, we investigated how emotional evaluations and brain activation generalize to perceptually similar faces. Valence ratings indicated learning and generalization effects for both positive and negative faces. Brain activation, measured with functional magnetic resonance imaging (fMRI), showed significantly increased activation in the fusiform gyrus (FG) to negatively associated faces but not positively associated ones. Remarkably, brain activation in FG to faces to which emotional meaning (negative and positive) was successfully generalized was decreased compared to neutral faces. This suggests that the emotional relevance of faces is not simply associated with increased brain activation in visual areas. While, at least for negative conditions, faces paired with negative feedback behavior are related to potentiated brain responses, the opposite is seen for perceptually very similar faces despite generalized emotional responses., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Lin, Bruchmann, Schindler and Straube.)

Objective: Specific phobia is a common anxiety disorder, but the literature on associated brain structure alterations exhibits substantial gaps. The ENIGMA Anxiety Working Group examined brain structure differences between individuals with specific phobias and healthy control subjects as well as between the animal and blood-injection-injury (BII) subtypes of specific phobia. Additionally, the authors investigated associations of brain structure with symptom severity and age (youths vs. adults)., Methods: Data sets from 31 original studies were combined to create a final sample with 1,452 participants with phobia and 2,991 healthy participants (62.7% female; ages 5-90). Imaging processing and quality control were performed using established ENIGMA protocols. Subcortical volumes as well as cortical surface area and thickness were examined in a preregistered analysis., Results: Compared with the healthy control group, the phobia group showed mostly smaller subcortical volumes, mixed surface differences, and larger cortical thickness across a substantial number of regions. The phobia subgroups also showed differences, including, as hypothesized, larger medial orbitofrontal cortex thickness in BII phobia (N=182) compared with animal phobia (N=739). All findings were driven by adult participants; no significant results were observed in children and adolescents., Conclusions: Brain alterations associated with specific phobia exceeded those of other anxiety disorders in comparable analyses in extent and effect size and were not limited to reductions in brain structure. Moreover, phenomenological differences between phobia subgroups were reflected in diverging neural underpinnings, including brain areas related to fear processing and higher cognitive processes. The findings implicate brain structure alterations in specific phobia, although subcortical alterations in particular may also relate to broader internalizing psychopathology.

Data-based predictions of individual Cognitive Behavioral Therapy (CBT) treatment response are a fundamental step towards precision medicine. Past studies demonstrated only moderate prediction accuracy (i.e. ability to discriminate between responders and non-responders of a given treatment) when using clinical routine data such as demographic and questionnaire data, while neuroimaging data achieved superior prediction accuracy. However, these studies may be considerably biased due to very limited sample sizes and bias-prone methodology. Adequately powered and cross-validated samples are a prerequisite to evaluate predictive performance and to identify the most promising predictors. We therefore analyzed resting state functional magnet resonance imaging (rs-fMRI) data from two large clinical trials to test whether functional neuroimaging data continues to provide good prediction accuracy in much larger samples. Data came from two distinct German multicenter studies on exposure-based CBT for anxiety disorders, the Protect-AD and SpiderVR studies. We separately and independently preprocessed baseline rs-fMRI data from n = 220 patients (Protect-AD) and n = 190 patients (SpiderVR) and extracted a variety of features, including ROI-to-ROI and edge-functional connectivity, sliding-windows, and graph measures. Including these features in sophisticated machine learning pipelines, we found that predictions of individual outcomes never significantly differed from chance level, even when conducting a range of exploratory post-hoc analyses. Moreover, resting state data never provided prediction accuracy beyond the sociodemographic and clinical data. The analyses were independent of each other in terms of selecting methods to process resting state data for prediction input as well as in the used parameters of the machine learning pipelines, corroborating the external validity of the results. These similar findings in two independent studies, analyzed separately, urge caution regarding the interpretation of promising prediction results based on neuroimaging data from small samples and emphasizes that some of the prediction accuracies from previous studies may result from overestimation due to homogeneous data and weak cross-validation schemes. The promise of resting-state neuroimaging data to play an important role in the prediction of CBT treatment outcomes in patients with anxiety disorders remains yet to be delivered., Competing Interests: Declaration of competing interest The authors declare there is no conflict of interests., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Objectives: Deep thermal injuries are among the most serious injuries in childhood, often resulting in scarring and functional impairment. However, accurate assessment of burn depth by clinical judgment is challenging. Optical coherence tomography (OCT) provides structural images of the skin and can detect blood flow within the papillary plexus. In this study, we determined the depth of the capillary network in healthy and thermally injured skin and compared it with clinical assessment., Methods: In 25 children between 7 months and 15 years of age (mean age 3.5 years (SD±4.14)) with thermal injuries of the ventral thoracic wall, we determined the depth of the capillary network using OCT. Measurements were performed on healthy skin and at the center of the thermal injury (16 grade IIa, 9 grade IIb). Comparisons were made between healthy skin and thermal injury., Results: The capillary network of the papillary plexus in healthy skin was detected at 0.33 mm (SD±0.06) from the surface. In grade IIb injuries, the depth of the capillary network was 0.36 mm (SD±0.06) and in grade IIa injuries 0.23 mm (SD±0.04) (Mann-Whitney U test: p<0.001). The overall prediction accuracy is 84 %., Conclusions: OCT can reliably detect and differentiate the depth of the capillary network in both healthy and burned skin. In clinical IIa wounds, the capillary network appears more superficial due to the loss of the epidermis, but it is still present in the upper layer, indicating a good prognosis for spontaneous healing. In clinical grade IIb wounds, the papillary plexus was visualized deeper, which is a sign of impaired blood flow., Competing Interests: Competing interests: None., (© 2024 the author(s), published by De Gruyter, Berlin/Boston.)

To define the morphologic pattern of pediatric hand burns as visualized via optical coherence tomography (OCT) and dynamic OCT (D-OCT). We designed a scoring system to assess the depths of burn wounds on pediatric hands and tested this score in our cohort of children with burn injuries to the hand. Overall, 67 hand burns in 48 children (0-15 years) were prospectively examined. Scans were interpreted by two independent observers. Relevant OCT findings were surface irregularity, loss of epidermis, loss of dermal pattern (skin lines or papillary spots, loss of surface regularity and irregular vascular pattern of the plexus papillaris. Score values were calculated retrospectively. A score of 4 was associated with spontaneous healing without the need for skin grafting, with a positive predictive value of 97%. Deeper wounds with delayed healing and/or the need of skin grafting received a score of 5 or above, with an agreement of medical healing in 80% and a positive predictive value of 56%. OCT and D-OCT provide clinically useful additional information in cases of pediatric hand burns. The OCT burn score has the potential to support clinical decision making and, subsequently, improve clinical outcomes and shorten hospital stays.

Previous research on the neural correlates of consciousness (NCC) in visual perception revealed an early event-related potential (ERP), the visual awareness negativity (VAN), to be associated with stimulus awareness. However, due to the use of brief stimulus presentations in previous studies, it remains unclear whether awareness-related negativities represent a transient onset-related response or correspond to the duration of a conscious percept. Studies are required that allow prolonged stimulus presentation under aware and unaware conditions. The present ERP study aimed to tackle this challenge by using a novel stimulation design. Male and female human participants (n = 62) performed a visual task while task-irrelevant line stimuli were presented in the background for either 500 or 1000 ms. The line stimuli sometimes contained a face, which needed so-called visual one-shot learning to be seen. Half of the participants were informed about the presence of the face, resulting in faces being perceived by the informed but not by the uninformed participants. Comparing ERPs between the informed and uninformed group revealed an enhanced negativity over occipitotemporal electrodes that persisted for the entire duration of stimulus presentation. Our results suggest that sustained visual awareness negativities (SVAN) are associated with the duration of stimulus presentation., (© 2024. The Author(s).)

Social evaluative feedback informs the receiver of the other's views, which may contain judgments of personality-related traits and/or the level of likability. Such kinds of social evaluative feedback are of particular importance to humans. Event-related potentials (ERPs) can directly measure where in the processing stream feedback valence, expectancy, or contextual relevance modulate information processing. This review provides an overview and systematization of studies and early, mid-latency, and late ERP effects. Early effects were inconsistently reported for all factors. Feedback valence effects are more consistently reported for specific mid-latency ERPs (Reward Positivity, RewP, and Early Posterior Negativity, EPN) and late positivities (P3 and Late Positive Potential, LPP). Unexpected feedback consistently increased the Feedback Related Negativity (FRN) and, less consistently, decreased P3 amplitudes. Contextual relevance of the sender (e.g., human vs computer sender) or self-relatedness increased mid-latency to late ERPs. Interactions between valence and other factors were less often found, arising during mid-latency stages, where most consistent interactions showed larger EPN and P3 amplitude differences for valent feedback in a more relevant context. The ERP findings highlight that social evaluative feedback is consistently differentiated during mid-latency processing stages. The review discusses the relevance of findings, possible shortcomings of different experimental designs, and open questions. Furthermore, we suggest concrete venues for future research., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Although highly effective on average, exposure-based treatments do not work equally well for all patients with anxiety disorders. The identification of pre-treatment response-predicting patient characteristics may enable patient stratification. Preliminary research highlights the relevance of inhibitory fronto-limbic networks as such. We aimed to identify pre-treatment neural signatures differing between exposure treatment responders and non-responders in spider phobia and to validate results through rigorous replication. Data of a bi-centric intervention study comprised clinical phenotyping and pre-treatment resting-state functional connectivity (rsFC) data of n = 79 patients with spider phobia (discovery sample) and n = 69 patients (replication sample). RsFC data analyses were accomplished using the Matlab-based CONN-toolbox with harmonized analyses protocols at both sites. Treatment response was defined by a reduction of >30% symptom severity from pre- to post-treatment (Spider Phobia Questionnaire Score, primary outcome). Secondary outcome was defined by a reduction of >50% in a Behavioral Avoidance Test (BAT). Mean within-session fear reduction functioned as a process measure for exposure. Compared to non-responders and pre-treatment, results in the discovery sample seemed to indicate that responders exhibited stronger negative connectivity between frontal and limbic structures and were characterized by heightened connectivity between the amygdala and ventral visual pathway regions. Patients exhibiting high within-session fear reduction showed stronger excitatory connectivity within the prefrontal cortex than patients with low within-session fear reduction. Whereas these results could be replicated by another team using the same data (cross-team replication), cross-site replication of the discovery sample findings in the independent replication sample was unsuccessful. Results seem to support negative fronto-limbic connectivity as promising ingredient to enhance response rates in specific phobia but lack sufficient replication. Further research is needed to obtain a valid basis for clinical decision-making and the development of individually tailored treatment options. Notably, future studies should regularly include replication approaches in their protocols., (© 2024. The Author(s).)

Although the cerebellum contributes to higher-order cognitive and emotional functions relevant to posttraumatic stress disorder (PTSD), prior research on cerebellar volume in PTSD is scant, particularly when considering subregions that differentially map on to motor, cognitive, and affective functions. In a sample of 4215 adults (PTSD n = 1642; Control n = 2573) across 40 sites from the ENIGMA-PGC PTSD working group, we employed a new state-of-the-art deep-learning based approach for automatic cerebellar parcellation to obtain volumetric estimates for the total cerebellum and 28 subregions. Linear mixed effects models controlling for age, gender, intracranial volume, and site were used to compare cerebellum volumes in PTSD compared to healthy controls (88% trauma-exposed). PTSD was associated with significant grey and white matter reductions of the cerebellum. Compared to controls, people with PTSD demonstrated smaller total cerebellum volume, as well as reduced volume in subregions primarily within the posterior lobe (lobule VIIB, crus II), vermis (VI, VIII), flocculonodular lobe (lobule X), and corpus medullare (all p -FDR  < 0.05). Effects of PTSD on volume were consistent, and generally more robust, when examining symptom severity rather than diagnostic status. These findings implicate regionally specific cerebellar volumetric differences in the pathophysiology of PTSD. The cerebellum appears to play an important role in higher-order cognitive and emotional processes, far beyond its historical association with vestibulomotor function. Further examination of the cerebellum in trauma-related psychopathology will help to clarify how cerebellar structure and function may disrupt cognitive and affective processes at the center of translational models for PTSD., (© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Posttraumatic stress disorder (PTSD) is associated with lower cortical thickness (CT) in prefrontal, cingulate, and insular cortices in diverse trauma-affected samples. However, some studies have failed to detect differences between PTSD patients and healthy controls or reported that PTSD is associated with greater CT. Using data-driven dimensionality reduction, we sought to conduct a well-powered study to identify vulnerable networks without regard to neuroanatomic boundaries. Moreover, this approach enabled us to avoid the excessive burden of multiple comparison correction that plagues vertex-wise methods. We derived structural covariance networks (SCNs) by applying non-negative matrix factorization (NMF) to CT data from 961 PTSD patients and 1124 trauma-exposed controls without PTSD. We used regression analyses to investigate associations between CT within SCNs and PTSD diagnosis (with and without accounting for the potential confounding effect of trauma type) and symptom severity in the full sample. We performed additional regression analyses in subsets of the data to examine associations between SCNs and comorbid depression, childhood trauma severity, and alcohol abuse. NMF identified 20 unbiased SCNs, which aligned closely with functionally defined brain networks. PTSD diagnosis was most strongly associated with diminished CT in SCNs that encompassed the bilateral superior frontal cortex, motor cortex, insular cortex, orbitofrontal cortex, medial occipital cortex, anterior cingulate cortex, and posterior cingulate cortex. CT in these networks was significantly negatively correlated with PTSD symptom severity. Collectively, these findings suggest that PTSD diagnosis is associated with widespread reductions in CT, particularly within prefrontal regulatory regions and broader emotion and sensory processing cortical regions., (© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Emotional attention describes the prioritized processing of emotional information to help humans quickly detect biologically salient stimuli and initiate appropriate reactions. Humans can also voluntarily attend to specific stimulus features that are target-relevant. Electrophysiological studies have shown specific temporal interactions between voluntary and emotional attention, while no such studies exist for natural sounds (e.g., explosions, running water, applause). In two experiments ( N = 40, each), we examined event-related potentials (ERPs) toward target relevant or irrelevant negative, neutral, or positive sounds. Target relevance was induced by the instruction to respond blockwise to either negative, neutral, or positive sounds. Emotional sounds elicited increased fronto-central N1 and P2 amplitudes and a larger late positive potential (LPP), with more sustained effects for negative sounds. Target relevance increased amplitudes during an early LPP interval (400-900 ms) but did not interact with the valence of the sounds. These results show early and late ERP modulations for natural sounds, which do not interact with the target relevance of the sound valence, in contrast to findings from the visual domain. Thus, findings indicate little temporal overlap between emotional processes and target relevance effects in the auditory domain. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

While inattentional blindness and deafness studies have revealed neural correlates of consciousness (NCC) without the confound of task relevance in the visual and auditory modality, comparable studies for the somatosensory modality are lacking. Here, we investigated NCC using functional magnetic resonance imaging (fMRI) in an inattentional numbness paradigm. Participants (N = 44) received weak electrical stimulation on the left hand while solving a demanding visual task. Half of the participants were informed that task-irrelevant weak tactile stimuli above the detection threshold would be applied during the experiment, while the other half expected stimuli below the detection threshold. Unexpected awareness assessments after the experiment revealed that altogether 10 participants did not consciously perceive the somatosensory stimuli during the visual task. Awareness was not significantly modulated by prior information. The fMRI data show that awareness of stimuli led to increased activation in the contralateral secondary somatosensory cortex. We found no significant effects of stimulus awareness in the primary somatosensory cortex or frontoparietal areas. Thus, our results support the hypothesis that somatosensory stimulus awareness is mainly based on activation in higher areas of the somatosensory cortex and does not require strong activation in extended anterior or posterior networks, which is usually seen when perceived stimuli are task-relevant., (© 2023. The Author(s).)

Although virtual-reality exposure treatment (VRET) for anxiety disorders is an efficient treatment option for specific phobia, mechanisms of action for immediate and sustained treatment response need to be elucidated. Towards this aim, core therapy process variables were assessed as predictors for short- and long-term VR treatment outcomes. In a bi-centric study, n = 186 patients with spider phobia completed a baseline-assessment, a one-session VRET, a post-therapy assessment, and a 6-month-follow-up assessment (ClinicalTrials.gov, ID: NCT03208400). Short- and long-term outcomes regarding self-reported symptoms in the spider phobia questionnaire (SPQ) and final patient-spider distance in the behavioral avoidance test (BAT) were predicted via logistic regression models with the corresponding baseline score, age, initial fear activation, within-session fear reduction and fear expectancy violation as predictors. To predict long-term remission status at 6-month-follow-up, dimensional short-term changes in the SPQ and BAT were additionally included. Higher within-session fear reductions predicted better treatment outcomes (long-term SPQ; short- and long-term BAT). Lower initial fear activation tended to be associated with better long-term outcomes (SPQ), while fear expectancy violation was not associated with any outcome measure. Short-term change in the SPQ predicted remission status. Findings highlight that in VRET for spider phobia, the experience of fear reduction is central for short- and long-term treatment success and should be focused by therapists., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Recent advances in data-driven computational approaches have been helpful in devising tools to objectively diagnose psychiatric disorders. However, current machine learning studies limited to small homogeneous samples, different methodologies, and different imaging collection protocols, limit the ability to directly compare and generalize their results. Here we aimed to classify individuals with PTSD versus controls and assess the generalizability using a large heterogeneous brain datasets from the ENIGMA-PGC PTSD Working group., Methods: We analyzed brain MRI data from 3,477 structural-MRI; 2,495 resting state-fMRI; and 1,952 diffusion-MRI. First, we identified the brain features that best distinguish individuals with PTSD from controls using traditional machine learning methods. Second, we assessed the utility of the denoising variational autoencoder (DVAE) and evaluated its classification performance. Third, we assessed the generalizability and reproducibility of both models using leave-one-site-out cross-validation procedure for each modality., Results: We found lower performance in classifying PTSD vs. controls with data from over 20 sites (60 % test AUC for s-MRI, 59 % for rs-fMRI and 56 % for d-MRI), as compared to other studies run on single-site data. The performance increased when classifying PTSD from HC without trauma history in each modality (75 % AUC). The classification performance remained intact when applying the DVAE framework, which reduced the number of features. Finally, we found that the DVAE framework achieved better generalization to unseen datasets compared with the traditional machine learning frameworks, albeit performance was slightly above chance., Conclusion: These results have the potential to provide a baseline classification performance for PTSD when using large scale neuroimaging datasets. Our findings show that the control group used can heavily affect classification performance. The DVAE framework provided better generalizability for the multi-site data. This may be more significant in clinical practice since the neuroimaging-based diagnostic DVAE classification models are much less site-specific, rendering them more generalizable., Competing Interests: Declaration of Competing Interest Dr. Thompson received partial grant support from Biogen, Inc., and Amazon, Inc., for work unrelated to the current study; Dr. Lebois reports unpaid membership on the Scientific Committee for International Society for the Study of Trauma and Dissociation (ISSTD), grant support from the National Institute of Mental Health, K01 MH118467 and the Julia Kasparian Fund for Neuroscience Research, McLean Hospital. Dr. Lebois also reports spousal IP payments from Vanderbilt University for technology licensed to Acadia Pharmaceuticals unrelated to the present work. ISSTD and NIMH were not involved in the analysis or preparation of the manuscript; Dr. Etkin reports salary and equity from Alto Neuroscience, equity from Mindstrong Health and Akili Interactive. Other authors have no conflicts of interest to declare., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Negative emotional content is prioritized across different stages of information processing as reflected by different components of the event-related potential (ERP). In this preregistered study (N = 40), we investigated how varying the attentional focus allows us to dissociate the involvement of specific ERP components in the processing of negative and neutral words. Participants had to discriminate the orientation of lines overlaid onto the words, the word type (adjective/noun), or the emotional content (negative/neutral). Thus, attention was either not focused on words (distraction task), non-emotional aspects, or the emotional relevance of words. Regardless of the task, there were no significant differences between negative and neutral words for the P1, N1, or P2 components. In contrast, interactions between emotion and task were observed for the early posterior negativity (EPN) and late positive potential (LPP). EPN differences were absent during the distraction task but were present in the other two tasks. LPP emotion differences were found only when attention was directed to the emotional content of words. Our study adds to the evidence that early ERP components do not reliably separate negative and neutral words. However, results show that mid-latency and late stages of emotion processing are separable by different attention tasks. The EPN represents a stage of attentional enhancement of negative words given sufficient attentional resources. Differential activations during the LPP stage are associated with more elaborative processing of the emotional meaning of words., (© 2023. Springer Nature Limited.)

Thin, flat textile roofing offers negligible heat insulation. In warm areas, such roofing membranes are therefore equipped with metallized surfaces to reflect solar heat radiation, thus reducing the warming inside a textile building. Heat reflection effects achieved by metallic coatings are always accompanied by shading effects as the metals are non-transparent for visible light (VIS). Transparent conductive oxides (TCOs) are transparent for VIS and are able to reflect heat radiation in the infrared. TCOs are, e.g., widely used in the display industry. To achieve the perfect coatings needed for electronic devices, these are commonly applied using costly vacuum processes at high temperatures. Vacuum processes, on account of the high costs involved and high processing temperatures, are obstructive for an application involving textiles. Accepting that heat-reflecting textile membranes demand less perfect coatings, a wet chemical approach has been followed here when producing transparent heat-reflecting coatings. Commercially available TCOs were employed as colloidal dispersions or nanopowders to prepare sol-gel-based coating systems. Such coatings were applied to textile membranes as used for architectural textiles using simple coating techniques and at moderate curing temperatures not exceeding 130 °C. The coatings achieved about 90% transmission in the VIS spectrum and reduced near-infrared transmission (at about 2.5 µm) to nearly zero while reflecting up to 25% of that radiation. Up to 35% reflection has been realized in the far infrared, and emissivity values down to ε = 0.5777 have been measured., Competing Interests: The authors declare no conflicts of interest.

The N170 is the most prominent electrophysiological signature of face processing. While facial expressions reliably modulate the N170, there is considerable variance in N170 modulations by other sources of emotional relevance. Therefore, we systematically review and discuss this research area using different methods to manipulate the emotional relevance of inherently neutral faces. These methods were categorized into (1) existing pre-experimental affective person knowledge (e.g., negative attitudes towards outgroup faces), (2) experimentally instructed affective person knowledge (e.g., negative person information), (3) contingency-based affective learning (e.g., fear-conditioning), or (4) the immediate affective context (e.g., emotional information directly preceding the face presentation). For all categories except the immediate affective context category, the majority of studies reported significantly increased N170 amplitudes depending on the emotional relevance of faces. Furthermore, the potentiated N170 was observed across different attention conditions, supporting the role of the emotional relevance of faces on the early prioritized processing of configural facial information, regardless of low-level differences. However, we identified several open research questions and suggest venues for further research., (Copyright © 2023 Elsevier Ltd. All rights reserved.)