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Effects of antihypertensive therapy on blood pressure control, cognition, and reactivity. A placebo-controlled comparison of prazosin, propranolol, and hydrochlorothiazide.

A randomized, placebo-controlled trial was conducted to compare the effects of treatment with prazosin, propranolol, or hydrochlorothiazide on the following variables: blood pressure, cognitive and psychomotor skills, cardiovascular reactivity to natural and laboratory challenges, and serum lipid and lipoprotein levels. Side effects were recorded and patients evaluated how they felt during their treatment. Sixty-nine men, 35 percent black, aged 25 to 55 (mean 51.3) years, with diastolic blood pressures between 90 and 104 mm Hg (mean, 93.3 mm Hg), completed the study. There were no differences between active treatment groups in the proportion of patients with controlled blood pressure during the maintenance phase of the study. In the cognitive and psychomotor tests, the hydrochlorothiazide group showed significantly less improvement from baseline than the other treatment groups on the block design subscale of the Wechsler Adult Intelligence Scale-Revised, and there was a trend for the propranolol group to have less improvement from baseline than the other groups on the digit span subscale. There were no other significant pretreatment to post-treatment changes in the other cognitive or psychomotor tests, the Russell Revision of the Wechsler Memory Scale, or a number of computerized reaction-time and signal-detection tasks. In the reactivity testing, there was a significantly lower increase in heart rate in the prazosin group compared with placebo during the second laboratory challenge of the Stroop Color Interference Test. Post-treatment declines in ambulatory blood pressure were seen in all of the drug treatment groups in average and maximal diastolic and systolic blood pressures. Both propranolol and hydrochlorothiazide treatment resulted in low-density lipoprotein cholesterol levels that were higher than baseline and the hydrochlorothiazide treatment had significantly increased total cholesterol levels. In contrast, the prazosin-treated group experienced no adverse changes in these parameters. Overall, the propranolol group had significantly more moderate and severe side effects than did the other three groups. Considering the pattern of blood pressure control, cognitive and psychomotor effects, changes in lipid levels, and magnitude of side effects, prazosin seems to have the most advantageous profile in this study of the three anti-hypertensive agents evaluated.

Antihypertensive Agents↗

Altered neural substrates of cognitive control in childhood ADHD: evidence from functional magnetic resonance imaging.

OBJECTIVE: The study compared the neural bases of two cognitive control operations, interference suppression and response inhibition, between children with and children without attention deficit hyperactivity disorder (ADHD). METHOD: Ten children (7-11 years of age) with combined-type ADHD and 10 comparison subjects matched for age and gender underwent rapid event-related functional magnetic resonance imaging (fMRI) during performance of a modified flanker task. Functional maps were generated through group averaging and performance-based correlational analyses. RESULTS: Interference suppression in ADHD subjects was characterized by reduced engagement of a frontal-striatal-temporal-parietal network that subserved healthy performance. In contrast, response inhibition performance relied upon different regions in the two groups, frontal-striatal in comparison subjects but right superior temporal in ADHD children. CONCLUSIONS: Alteration in the neural basis of two cognitive control operations in childhood ADHD was characterized by distinct, rather than unitary, patterns of functional abnormality. Greater between-group overlap in the neural network activated for interference suppression than in response inhibition suggests that components of cognitive control are differentially sensitive to ADHD. The ADHD children's inability to activate the caudate nucleus constitutes a core abnormality in ADHD. Observed functional abnormalities did not result from prolonged stimulant exposure, since most children were medication naive.

Attention Deficit and Disruptive Behavior Disorder↗

The architecture of cognitive control in the human prefrontal cortex.

The prefrontal cortex (PFC) subserves cognitive control: the ability to coordinate thoughts or actions in relation with internal goals. Its functional architecture, however, remains poorly understood. Using brain imaging in humans, we showed that the lateral PFC is organized as a cascade of executive processes from premotor to anterior PFC regions that control behavior according to stimuli, the present perceptual context, and the temporal episode in which stimuli occur, respectively. The results support an unified modular model of cognitive control that describes the overall functional organization of the human lateral PFC and has basic methodological and theoretical implications.

Adult↗

Prefrontal and hippocampal contributions to visual associative recognition: interactions between cognitive control and episodic retrieval.

The ability to recover episodic associations is thought to depend on medial-temporal lobe mnemonic mechanisms and frontal lobe cognitive control processes. The present study examined the neural circuitry underlying non-verbal associative retrieval, and considered the consequences of successful retrieval on cognitive control demands. Event-related fMRI data were acquired while subjects retrieved strongly or weakly associated pairs of novel visual patterns in a two-alternative forced choice associative recognition paradigm. Behaviorally, successful retrieval of strongly associated relative to weakly associated pairs was more likely to be accompanied by conscious recollection of the pair's prior co-occurrence. At the neural level, right ventrolateral prefrontal cortex (VLPFC) and hippocampus were more active during successful retrieval of Strong than of Weak associations, consistent with a role in visual associative recollection. By contrast, Weak trials elicited greater activation in right anterior cingulate cortex (ACC), which may detect conflict between the similarly familiar target and foil stimuli in the absence of recollection. Consistent with this interpretation, stronger ACC activity was associated with weaker hippocampal and stronger right dorsolateral PFC (DLPFC) responses. Thus, recollection of relevant visual associations (hippocampus and VLPFC) results in lower levels of mnemonic conflict (ACC) and decreased familiarity-based monitoring demands (DLPFC). These findings highlight the interplay between cognitive control and episodic retrieval.

Adult↗

Interaural translational VOR: suppression, enhancement, and cognitive control.

We investigated the influence of cognitive factors on the early response of the interaural translational vestibuloocular reflex (tVOR) in six normal subjects. Variables were prior knowledge of direction of head motion and the position of the fixation target relative to the head [head-fixed (HF) or space-fixed (SF)]. A manually driven device provided a step-like head translation (approximately 35 mm distance, peak acceleration, 0.6-1.3 g). Subjects looked at the SF or HF target located 15 cm in front of their heads in otherwise complete darkness. The testing paradigms were: random interleaving of SF and HF targets with unknown direction of head movement, known target location with random head direction (SFR or HFR), and known target location with known head direction (SFP or HFP). Timing was always unpredictable. A "gain" of the slow phase was calculated with respect to ideal performance (maintained fixation of the SF target, recorded/ideal eye velocity computed at time of peak head velocity). At such times, there were no significant differences in gain between HF and SF trials in the random condition; the average gain was approximately 36% of ideal. On the other hand, responses in the SFR and HFR conditions differed as early as 20 ms after the head began moving. Average gain was higher (0.43 +/- 0.11 vs. 0.34 +/- 0.14; means +/- SD, P < 0.05) for each subject in the SFR than the HFR condition. For SFP and HFP, the responses differed from the onset of head motion. Average slow-phase gain was higher (0.49 +/- 0.12 vs. 0.31 +/- 0.12, P < 0.02) for each subject in SFP than in HFP. The timing of corrective saccades during the tVOR was also influenced by cognitive factors. Visual error signals seemed to be more important for triggering saccades in HF trials, whereas preprogramming, probably based on labyrinthine information, seemed to be more important in SF trials. Simulations showed that the changes in slow-phase gain with cognition could be reproduced with simple parametric adjustments of the gain of activity from otolith afferents and suggest that higher-level cognitive control of the VOR could occur as early as the synapse of peripheral afferents on neurons in the vestibular nuclei, either directly from higher level centers or via the cerebellum. In sum, the tVOR-both in its slow-phase response and the saccadic corrections-is subject to "higher-level" cognitive influences including knowledge of where the line of sight must point during head motion and the impending direction of head motion.

Acceleration↗

Programming of double-step saccade sequences: modulation by cognitive control.

The capacity to detect and correct errors is thought to engage cognitive control. To probe the nature of such control in relation to eye movements, subjects performed a double-step task under different instructions: to FOLLOW the appearance of successive targets; or to cancel the initial saccade and REDIRECT gaze to the final target location. Saccade sequences occurred in the FOLLOW and REDIRECT conditions where they represented correct and corrective behaviour, respectively. We observed that corrective responses were faster than correct responses, and concurrent preparation of saccades was facilitated during error correction. These results are consistent with psychological theories that posit supervisory cognitive control over action during error correction.

Cognition↗

Neurocognitive mechanisms of cognitive control: the role of prefrontal cortex in action selection, response inhibition, performance monitoring, and reward-based learning.

Convergent evidence highlights the differential contributions of various regions of the prefrontal cortex in the service of cognitive control, but little is understood about how the brain determines and communicates the need to recruit cognitive control, and how such signals instigate the implementation of appropriate performance adjustments. Here we review recent progress from cognitive neuroscience in examining some of the main constituent processes of cognitive control as involved in dynamic decision making: goal-directed action selection, response activation and inhibition, performance monitoring, and reward-based learning. Medial frontal cortex is found to be involved in performance monitoring: evaluating outcome vis-a-vis expectancy, and detecting performance errors or conflicting response tendencies. Lateral and orbitofrontal divisions of prefrontal cortex are involved in subsequently implementing appropriate adjustments.

Animals↗

Cognitive control and parsing: reexamining the role of Broca's area in sentence comprehension.

A century of investigation into the role of the human frontal lobes in complex cognition, including language processing, has revealed several interesting but apparently contradictory findings. In particular, the results of numerous studies suggest that left inferior frontal gyrus (LIFG), which includes Broca's area, plays a direct role in sentence-level syntactic processing. In contrast, other brain-imaging and neuropsychological data indicate that LIFG is crucial for cognitive control--specifically, for overriding highly regularized, automatic processes, even when a task involves syntactically undemanding material (e.g., single words, a list of letters). We provide a unifying account of these findings, which emphasizes the importance of general cognitive control mechanisms for the syntactic processing of sentences. On the basis of a review of the neurocognitive and sentence-processing literatures, we defend the following three hypotheses: (1) LIFG is part of a network of frontal lobe subsystems that are generally responsible for the detection and resolution of incompatible stimulus representations; (2) the role of LIFG in sentence comprehension is to implement reanalysis in the face of misinterpretation; and (3) individual differences in cognitive control abilities in nonsyntactic tasks predict correlated variation in sentence-processing abilities pertaining to the recovery from misinterpretation.

Aphasia, Broca↗

Immature frontal lobe contributions to cognitive control in children: evidence from fMRI.

Event-related fMRI was employed to characterize differences in brain activation between children ages 8-12 and adults related to two forms of cognitive control: interference suppression and response inhibition. Children were more susceptible to interference and less able to inhibit inappropriate responses than were adults. Effective interference suppression in children was associated with prefrontal activation in the opposite hemisphere relative to adults. In contrast, effective response inhibition in children was associated with activation of posterior, but not prefrontal, regions activated by adults. Children failed to activate a region in right ventrolateral prefrontal cortex that was recruited for both types of cognitive control by adults. Thus, children exhibited immature prefrontal activation that varied according to the type of cognitive control required.

Adult↗

Stimulation of STN impairs aspects of cognitive control in PD.

OBJECTIVE: To test the hypothesis that subthalamic nucleus (STN) stimulation in Parkinson disease (PD) patients affects working memory and response inhibition performance, particularly under conditions of high demand on cognitive control. METHODS: To test this hypothesis, spatial working memory (spatial delayed response [SDR]) and response inhibition (Go-No-Go [GNG]) tasks requiring varying levels of cognitive control were administered to patients with PD with previously implanted bilateral STN stimulators (n = 24). Patients did not take PD medications overnight. Data were collected while bilateral stimulators were on and off, counterbalancing the order across subjects. RESULTS: On the SDR task, STN stimulation decreased patients' working memory performance under a high but not low memory load condition (effect of stimulator condition on high load only and condition x load interaction, p < 0.05). On the GNG task, STN stimulation reduced discriminability on a high but not medium inhibition condition (effect of stimulator condition on high inhibition level only, p = 0.05; condition x inhibition level interaction, p = 0.07). CONCLUSION: STN stimulation reduces working memory and response inhibition performance under conditions of greater challenge to cognitive control despite significant improvement of motor function.

Cognition Disorders↗

Load theory of selective attention and cognitive control.

A load theory of attention in which distractor rejection depends on the level and type of load involved in current processing was tested. A series of experiments demonstrates that whereas high perceptual load reduces distractor interference, working memory load or dual-task coordination load increases distractor interference. These findings suggest 2 selective attention mechanisms: a perceptual selection mechanism serving to reduce distractor perception in situations of high perceptual load that exhaust perceptual capacity in processing relevant stimuli and a cognitive control mechanism that reduces interference from perceived distractors as long as cognitive control functions are available to maintain current priorities (low cognitive load). This theory resolves the long-standing early versus late selection debate and clarifies the role of cognitive control in selective attention.

Analysis of Variance↗

Schizotypy facets, cognitive control, and emotion.

This research examined whether facets of schizotypy were differentially related to cognitive control and emotion-processing traits. In a confirmatory factor analysis (N = 261), a 3-factor model of schizotypy exhibited good fit and fit significantly better than a 2-factor model. In addition, only disorganized schizotypy was associated with poor cognitive control (specifically, prepotent inhibition). Moreover, disorganized but not positive schizotypy was associated with increased emotional confusion and increased emotionality. In contrast, negative schizotypy was associated with increased emotional confusion but decreased emotionality. These results suggest that disorganized schizotypy is related to dysregulation of both cognition and emotion and that negative schizotypy might reflect deficits in the experience and processing of emotion and not just in emotional expression.

Adolescent↗

Cognitive control under contingencies in anxious and depressed adolescents: an antisaccade task.

BACKGROUND: Emotion-related perturbations in cognitive control characterize adult mood and anxiety disorders. Fewer data are available to confirm such deficits in youth. Studies of cognitive control and error processing can provide an ideal template to examine these perturbations. Antisaccade paradigms are particularly well suited for this endeavor because they provide exquisite behavioral measures of modulation of response errors. METHODS: A new monetary reward antisaccade task was used with 28 healthy, 11 anxious, and 12 depressed adolescents. Performance accuracy, saccade latency, and peak velocity of incorrect responses were analyzed. RESULTS: Performance accuracy across all groups was improved by incentives (obtain reward, avoid punishment). However, modulation of saccade errors by incentives differed by groups. In incentive trials relative to neutral trials, inhibitory efficiency (saccade latency) was enhanced in healthy, unaffected in depressed, and diminished in anxious adolescents. Modulation of errant actions (saccade peak velocity) was improved in the healthy group and unchanged in both the anxious and depressed groups. CONCLUSIONS: These findings provide grounds for testing hypotheses related to the impact of motivation deficits and emotional interference on directed action in adolescents with mood and anxiety disorders. Furthermore, neural mechanisms can now be examined by using this task paired with functional neuroimaging.

Adolescent↗

Neural mechanisms of cognitive control: an integrative model of stroop task performance and FMRI data.

We address the connection between conceptual knowledge and cognitive control using a neural network model. This model extends a widely held theory of cognitive control [Cohen, J. D., Dunbar, K., & McClelland, J. L. On the control of automatic processes: A parallel distributed processing model of the Stroop effect. Psychological Review, 97, 332-361, 1990] so that it can explain new empirical findings. Leveraging other computational modeling work, we hypothesize that representations used for task control are recruited from preexisting representations for categories, such as the concept of color relevant to the Stroop task we model here. This hypothesis allows the model to account for otherwise puzzling fMRI results, such as increased activity in brain regions processing to-be-ignored information. In addition, biologically motivated changes in the model's pattern of connectivity show how global competition can arise when inhibition is strictly local, as it seems to be in the cortex. We also discuss the potential for this theory to unify models of task control with other forms of attention.

Algorithms↗

Clinical, imaging, lesion, and genetic approaches toward a model of cognitive control.

The ability to suppress or override competing attentional and behavioral responses is a key component of cognitive processes. This ability continues to develop throughout childhood and appears to be disrupted in a number of childhood disorders (e.g., attention deficit/hyperactivity disorder and Tourette syndrome). At least two brain regions have been implicated repeatedly in these disorders--the frontal lobes and the basal ganglia. The common problem in cognitive control and overlap in implicated brain regions across disorders suggest a single underlying biological mechanism. At the same time, the distinct symptomatology observed across these disorders suggests multiple mechanisms are at play. This article presents converging evidence from clinical, neuroimaging, lesion, and genetic studies to provide a mechanistic model of cognitive control whereby the basal ganglia are involved in inhibition of competing actions and the frontal cortex is involved in representing the relevant thoughts and guiding the appropriate behaviors.

Adolescent↗

Adjustments of cognitive control in younger and older adults.

The effects of aging on behavioral and electrophysiological indices of adjustments of cognitive control were examined in two experiments. Specifically, we considered the effects of aging of patterns of response time and modulations of the event-related brain potentials (ERPs) on sequential trial effects, error-related slowing, and local switch costs in two modified Stroop tasks. The behavioral data reveal that sequential trial effects were observed when color, but not word, identification was required and that these effects were similar in younger and older adults; that the degree of error-related slowing was similar for younger and older adults in Experiment 1 and greater in older than younger adults in Experiment 2; that local switch costs in response time were similar in younger and older adults and that the requirement to switch between color and word identification resulted in a dramatic increase in the number of color intrusion errors in older adults in Experiment 2. The ERP data revealed that endogenously generated adjustments of cognitive control were associated with a parietal slow wave that mirrored the behavioral data and was similar in amplitude in younger and older adults and an anterior frontal slow wave that was absent in older adults. The ERP data also revealed that an enhancement of the P3 component and a frontal slow wave that differentiated color switch trials from color non-switch and word trials in younger adults were attenuated in older adults.

Adult↗

Emotional modulation of cognitive control: approach-withdrawal states double-dissociate spatial from verbal two-back task performance.

Emotional states might selectively modulate components of cognitive control. To test this hypothesis, the author randomly assigned 152 undergraduates (equal numbers of men and women) to watch short videos intended to induce emotional states (approach, neutral, or withdrawal). Each video was followed by a computerized 2-back working memory task (spatial or verbal, equated for difficulty and appearance). Spatial 2-back performance was enhanced by a withdrawal state and impaired by an approach state; the opposite pattern held for verbal performance. The double dissociation held more strongly for participants who made more errors than average across conditions. The results suggest that approach-withdrawal states can have selective influences on components of cognitive control, possibly on a hemispheric basis. They support and extend several frameworks for conceptualizing emotion-cognition interactions.

Adolescent↗

Cognitive control in closed head injury: context maintenance dysfunction or prepotent response inhibition deficit?

The authors contrasted 2 potential explanations for the cognitive control deficits observed in closed head injury (CHI): a prepotent response inhibition deficit or a deficit in context maintenance, defined as the guidance of appropriate responding by task-relevant information. Healthy and CHI participants performed the traditional card Stroop task and a single-trial Stroop task sensitive to context maintenance deficits. As predicted by a context maintenance deficit, moderate to severe CHI participants showed higher error rates in the single-trial Stroop task only, and only when task instructions had to be maintained over a long delay. Moreover, context maintenance impairment and generalized slowing were both related to reports of daily functioning in CHI participants. Thus, context maintenance could be a useful framework for characterizing cognitive control deficits in CHI.

Adult↗