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Cognitive motor control refers to processes that blend cognitive and motor functions in a seamless, interwoven fashion. Such functions evolve in space and time at various levels of complexity. This article focuses on conceptual issues regarding spatial and temporal aspects of motor control as well as on methods suitable for extracting information from neuronal ensembles.
Cognitive performance was assessed in older (60-75 years) and middle-aged (40-59 years) unmedicated outpatients with major depression and in healthy controls to examine potential interactive effects of age and depression. Cognitive performance was assessed from three categories of tasks: verbal, visual-spatial, and visuo-motor scanning tasks. Depressed subjects did not perform as well as controls on visuo-motor scanning tasks that included the Trail Making Tests A and B, and the Symbol Digit Modalities Test. Likewise, the older compared to the middle-aged group was slower on the visuo-motor scanning tasks. In addition, the older group showed poorer performance on visual-spatial tasks. Neither depression nor age group effects were observed for the primarily verbal tasks. Age and depression combined in an additive (noninteractive) fashion such that the older depressed subjects performed worse than the middle-aged depressed subjects, and older and middle-aged controls, on visuo-motor scanning tasks.
Cognitive impairment has repeatedly been described in bipolar disorders (BD). Serotonin (5-hydroxytryptophan; 5-HT) is possibly involved in these cognitive processes, more particularly in executive functions, learning, memory, and attention. The aim of this study was to investigate serotonergic vulnerability and its relation to cognitive functioning in healthy first-degree relatives of BD patients. We investigated the effects of an intravenous (i.v.) tryptophan (Trp) challenge and placebo on cognitive performance in 30 healthy first-degree relatives of bipolar patients (FH) and 15 matched controls in a double-blind crossover design. A distinction was made between relatives of type I BD patients (FH I) and type II BD patients (FH II). Performances on planning, memory, attention, and psychomotor tasks were assessed 3 h after Trp infusion. After Trp, planning and attention were impaired in FH subjects but not in controls. Independent of Trp, FH subjects showed cognitive deficits on memory, focused and divided attention, and psychomotor performance. FH I subjects showed more pronounced cognitive impairments then FH II and controls. In all groups, Trp impaired memory and psychomotor performance significantly. In conclusions, cognitive deficits in FH following Trp may reflect a central 5-HT vulnerability in frontal brain areas. Independent of Trp, cognitive deficits in FH provide evidence for a trait marker for BD.
A test control of the initial, intermediate and the final level of knowledge of the course and a test control of the level of acquisition of the knowledge on radionuclide diagnosis were made in 179 students of the Therapy faculty. This form of the test allows one to evaluate the level of self-training, efficiency of the studies and the level of the knowledge of the course and its consolidation. The test control helps reveal problems and themes most difficult for mastering. The test control can be used for raising the efficiency of studies at all stages.
Cognitive function was measured before and after inpatient treatment for metabolic control in 20 elderly patients with non-insulin-dependent diabetes mellitus (NIDDM). Another 20 patients still on the waiting list for this treatment, served as a control group. Glycosylated hemoglobin decreased in both groups. Psychomotor speed and concentration improved only after inpatient treatment (p < 0.01; p < 0.05, respectively). Improved performance was maintained and even enhanced 6 weeks after discharge from inpatient treatment. Performance in concentration tasks correlated with glycosylated hemoglobin (p < 0.05). It is concluded that cognitive deficits in elderly NIDDM patients can be reduced by inpatient treatment, although the benefit of glycemic control was not clearly demonstrated in this study.
Traditionally, motor and cognitive functions were studied separately; however, the investigation of processes at the interface between cognition and action has become more and more popular recently. Typical research goals include the identification of the processes involved using experimental psychological methods, and understanding the neural mechanisms underlying these processes using neurophysiological and functional neuroimaging methods. Specifically, there has been a special emphasis during the past few years on timing mechanisms, practice effects, and the application of rules in guiding action. New information concerning the neural mechanisms involved is being acquired at a rapid pace, albeit mostly within a descriptive framework. With respect to specific brain areas, a key finding has been the clear involvement of the primary motor cortex in complex tasks engaging diverse motor and cognitive dimensions.
Hierarchical control of cognitive processes was studied by examining the relationship between sequence- and task-level processing in the performance of explicit, memorized task sequences. In 4 experiments, switch costs in task-switching performance were perturbed by sequence initiation times that varied with sequence complexity, preparation time, and type of sequence transition (repetition or switch). Hierarchical control was inferred from these sequence initiation time effects and the recurrent finding of no switch cost at the first serial position across sequences, the point at which sequence-level processes are likely active in maintaining or instantiating a hierarchical control structure in working memory. These findings resonate with past research on motor programs and serial memory and provide new insights into the concepts of task set and control.
Cognitive-behavioral approaches appear to offer a viable alternative for the management of arthritis pain. Controlled studies have documented the efficacy of CBT protocols for managing pain in individuals having OA and RA. Preliminary studies examining the efficacy of CBT for FM patients have also yielded encouraging results. A number of clinical and research issues need attention if CBT is to be incorporated into rheumatology practice settings. These issues include identifying the most important components of CBT, developing strategies for matching CBT interventions to patients' readiness for behavior change, testing the efficacy of different therapy formats (e.g., individual versus group), broadening the scope of CBT to address issues other than pain, and insurance reimbursement.
Adolescence marks the beginning of adult-level cognitive control of behavior supported by the brain maturation processes of synaptic pruning and myelination. Cognitive development studies on adolescence indicate that this period is characterized by improvements in the performance of existing abilities including speed and capacity of information processing and the ability to have consistent cognitive control of behavior. Although adolescents can behave at adult levels in some ways, brain imaging studies indicate that the functional organization of brain systems that support higher-cognitive processes are not fully mature. Synaptic pruning allows for more efficient local computations, enhancing the ability of discrete brain regions to support high-level cognitive control of behavior including working memory. Myelination increases the speed of neuronal transmission supporting the collaboration of a widely distributed circuitry, integrating regions that support top-down cognitive control of behavior. Functional brain imaging methods allow for the characterization of the relationship between cognitive development and brain maturation as we can map progressions in the establishment of distributed brain circuitry and its relation to enhanced cognitive control of behavior. We present a review on the maturation (as distinct from "development" in emphasizing the transition to maturity and stabilization) of response inhibition, brain structure, and brain function through adolescence. We also propose a model for brain-behavior maturation that allows for the qualitative changes in cognitive processes that occur during adolescence.
The purpose of this study was to investigate the effect of aging on human postural control during cognitive tasks. Forty-eight subjects between the ages of 20 to 60 years underwent a series of balance tests that placed increasingly more demand on sensorimotor and cognitive mechanisms. Balance tests were based on a dynamic posturography device called EquiTest. The standard clinical protocol consisted of assessing the subject's stability in six different sensory conditions as the inputs from the proprioceptive and visual systems were altered in a systematic manner. The subjects were also tested with the head extended backwards. This represents an additional sensory condition in which the input from the vestibular system is modified. In order to investigate the role of cognitive function on the postural control mechanisms, the balance tests were performed either with or without an attention-demanding task. The test sequence was randomized to account for simple order effects. The relative contribution and interaction of sensory modification, cognitive tasking, and age were assessed. The results showed that head extension significantly increased postural sway in sensory conditions in which the proprioceptive input was altered. The effects of cognitive tasking and age group assignment were only approaching significance.
Reduced ability to regulate motor behavior seems to be an essential aspect of Attention-Deficit Hyperactivity Disorder (ADHD) and may reflect deficits in behavioral response inhibition. In this respect, pragmatic clinical experience over the last two decades, in daily practice, training of motor control has played an important role within multimodal treatment approaches, although an adequate proof of its efficacy is still lacking. Therefore, to examine the efficacy of sensorimotor training, 12 children with ADHD (two groups of six) were treated with both sensorimotor training and (as control) cognitive behavioral training using a within-subject cross-over design. Each treatment had a duration of 4 months (20 sessions), yielding a total of 40 sessions for the completed cross-over design. Results showed that Sensorimotor Training improved sensorimotor coordination slightly, while Cognitive Behavioral Training ameliorated cognitive impulse control. Hyperactivity and anxious-depressive/aggressive behavior were markedly reduced by Sensorimotor Training but not by Cognitive Behavioral Training. In conclusion, a combined treatment may be recommended since compensation and regulation of inhibitory deficits in ADHD come into play within the framework of both kinds of training.
To explore the way that children's cognitive functioning relates to stressors they report experiencing in every day life, this study used the approach of cognitive control theory, which defines cognition as a set of mobile functions that, in serving adaptation, shift in their organization. Children (N = 93), ranging in age from 56 to 115 months, were administered individually the Life Stressor Interview and several cognitive control tasks. Children who reported being exposed to arguments and threatening gestures among adults made more errors when focusing attention while distracted by stimuli concerning nurture. Children who reported being upset by shootings and fights had more difficulty remembering test information depicting two persons in a shoot-out. The results are discussed in terms of the potential value of an approach that integrates cognitive activity with personality.
A cognitive social learning model of the maintenance of problem drinking is presented. Basic constructs involving social skills acquisition, experienced cognitive control and self-efficacy expectations as they relate to alcoholism are discussed. It is concluded that the model provides a useful theoretical framework in which to conceptualize the development, maintenance and treatment of drinking problems. A number of specific suggestions are made for further research which test various hypotheses generated by this model.
'Nurturing the brain' is an emerging research field integrating brain science, child care and education, which also involves child neurology. It has emerged from the recent remarkable progress in brain science and strong social demands for improvements in child care and education. This article reviews the current status of three major research themes in this field. First, developmental disorders represented by attention deficit/hyperactivity disorder, autism and Asperger syndrome often introduce difficulties in child care and education, which are to be addressed by appropriate assessment and treatment of affected children based on new knowledge of the pathogenesis of these disorders. Second, recent progress in research on the critical/sensitive periods of development of brain structures and functions promises useful advice for teachers and parents regarding optimal timing and ways of teaching various subjects. Third, the development of the brain throughout infancy, childhood and adolescence is paralleled by the growth and maturation of the mind. Neuronal mechanisms underlying the theory of mind, mirror neurons, internal model, cognitive control, and cognitive emotion regulation are important themes that bridge our understandings of the brain and the mind.
This study compared the effect of a behavioral type of personal control and cognitive personal control information on cataract patients' postoperative orientation, indeterminate stimulus experiences, mood states, and performance (Ellis, 1972; Johnson, 1975; Seligman, 1975). Subjects were 40 patients, age 50 or older, scheduled for their first unilateral cataract surgical experience. Using a four-condition experimental design, patients were randomly assigned to: (1) behavioral instructions (behavioral control), (2) sensory information (cognitive control), (3) both behavioral instructions and sensory information, or (4) general information. It was found that neither behavioral nor cognitive control interventions had a significant effect on any of the dependent variables. However, the combination of behavioral and cognitive control intervention significantly reduced the number of days after discharge before patients elected to venture from their homes. No significant differences were found between experimental conditions in frequency of patient-reported indeterminate stimulus experiences (ISE).
Event related potentials (ERPs) during the Go- and the NoGo-condition of the Continuous Performance Test (CPT) were applied to investigate the neurophysiological basis of cognitive response control. These conditions of the test represent the execution and the inhibition of an anticipated motor response. In a previous study, the comprehensive spatial analysis of the ERPs allowed to define a parameter which robustly reflected the anteriorization of the positive P300 field area during the NoGo- compared to the Go-condition (NoGo-anteriorisation, NGA). The result was found consistently in all investigated subjects. The present study replicated the finding in 27 healthy subjects without any exception. Moreover, the latencies were longer and the amplitudes showed a trend to be higher in the NoGo- compared to the Go-ERP. This is interpreted as a sign of higher processing demands in the NoGo-condition. In conclusion, the ability of the NGA to express reliably the differences of brain activity leading to execution or suppression of a prepared motor response qualifies this parameter as a topographical standard-index for cognitive response control.
The cognitive theory of obsessive-compulsive disorder (OCD) is the most widely accepted account of the aetiology and maintenance of this disorder in adults. This paper investigated whether cognitive processes were evident in a sample of children with a primary diagnosis of OCD. Using an idiographic approach, as proposed by the Obsessive-Compulsive Cognitions Working Group, this paper assessed cognitive appraisals of responsibility, probability, severity, thought-action fusion, self-doubt and cognitive control. Ratings of these cognitive appraisals were obtained across a sample of children with OCD, and were compared with ratings from a clinical control group of anxious children and a non-clinic control group. It was hypothesised that consistent with the cognitive theory of OCD, children in the OCD group would display higher estimations of these cognitive processes in comparison to anxious and non-clinic children. Results of this investigation provide preliminary support for a cognitive conceptualisation of OCD during childhood. OCD children reported significantly higher ratings of responsibility, severity, thought action fusion and less cognitive control in comparison to non-clinic children. OCD children could also be clearly differentiated from anxious children on ratings of cognitive control. Implications of this investigation are discussed and directions for future research are highlighted.
To clarify the functional role of human pre-supplementary motor area (pre-SMA) in 'cognitive' motor control as compared with other non-primary motor cortices (SMA-proper and lateral premotor areas) and prefrontal area, we recorded epicortical field potentials by using subdural electrodes in five epileptic patients during presurgical evaluation, whose pre-SMA, SMA-proper, prefrontal and lateral premotor areas were defined by electric cortical stimulation and recent anatomical orientations according to the bicommissural plane and callosal grid system. An S1-Go/NoGo choice and delayed reaction task (S1-choice paradigm) and a warned choice Go/NoGo reaction task (S2-choice paradigm) with inter-stimulus intervals of 2 s were employed. The results showed (i) transient potentials with onset and peak latencies of about 200 and 600 ms, respectively, after S1 in the S1-choice paradigm mainly at pre-SMA and to a lesser degree at the prefrontal and lateral premotor areas, but not in the S2-choice paradigm. At SMA-proper, a similar but much smaller potential was seen after S1 in both S1- and S2-choice paradigms and (ii) slow sustained potentials between S1 and S2 in both S1- and S2-choice paradigms in all of the non-primary motor areas investigated (pre-SMA, SMA-proper and lateral premotor areas) and prefrontal area. It is concluded that pre-SMA plays a more important role in cognitive motor control which involves sensory discrimination and decision making or motor selection for the action after stimuli, whereas SMA-proper is one of the main generators of Bereitschaftspotential preceding self-paced, voluntary movements. In the more general anticipation of and attention to the forthcoming stimuli, non-primary motor cortices including pre-SMA, SMA-proper and lateral premotor area, and the prefrontal area are commonly involved.