Abstract-While the relation between systolic blood pressure (SBP) and vascular events is linear down to the high-normal range, the relation between SBP and cognition is less clear. We cross-sectionally assessed the relation between SBP and cognition in a cohort extending from mid-to late-life. From a total of 2200 community-dwelling individuals we recruited 377 aged 44 to 82 years (median: 64 years, 171 male) in the SEARCH-Health study (Systematic evaluation and alteration of risk factors for cognitive health). Participants were studied with a comprehensive neuropsychological test battery that provided, based on principal component analysis, 5 composite scores for cognition (learning and memory, attention and executive function, spatial skills, working memory, and verbal skills). Key Words: hypertension Ⅲ cognition Ⅲ age Ⅲ risk factors E pidemiologic studies have shown that systolic blood pressure (SBP) is linearly associated with the risk of myocardial infarction and stroke. 1-3 Cardio-and cerebrovascular diseases are related to cognitive decline in large population and patient-based cohorts. 4 -11 Recent evidence further indicates that the summation of vascular brain lesions, white matter damage from small vessel disease, and typical Alzheimer pathology interact bidirectionally and jointly contribute to dementia, even when each type of lesion, on its own, would not be severe enough to cause dementia. 12,13 However, epidemiological reports suggest that the direct association between blood pressure and cognitive function, eg, without an intermediate clinical outcome such as stroke, is complex and may be life period-dependent. Long-term follow-up studies found that elevated SBP, occurring in midlife, increases the risk of developing clinical manifest dementia in old age. 14,15 Along the same line, time survival analyses demonstrate that use of antihypertensive medication is associated with a reduced incidence of dementia. 16 Clinical trials showed that antihypertensive treatment in nondemented elderly subjects with a resting systolic blood pressure of more than 160 mm Hg reduced the incidence of subsequent dementia. Thus after 4 years there were only half as many cases of dementia in the treatment as compared with the placebo group. [17][18][19] Conversely, other antihypertensive intervention studies did not reveal significant effects on cognition. 20 -22 However, problems were patients lost to follow-up, active medication given to placebo patients as their blood pressure exceeded per-set values, and insensitive cognitive testing. 23 Observational studies in late-life showed that also low blood pressure was associated with dementia. 24,25 In the Kungsholmen project participants with a SBP below 140 mm Hg were more often diagnosed as demented than those with SBP above 140 mm Hg. 26,27 The suggestion of a nonlinear J-or even U-shaped relation between cognitive function and SBP raises doubts as to how rigorously blood pressure should be lowered. The aim of our study was to determine the relation between cognitive ...

The processing of fearful facial expressions is prioritized by the human brain. This priority is maintained across various information processing stages as evident in early, intermediate and late components of event-related brain potentials (ERP). However, emotional modulations are inconsistently reported for these different processing stages. In this preregistered study, we investigated how feature-based attention differentially affects ERPs to fearful and neutral faces in 40 participants. The tasks required participants to discriminate either the orientation of lines overlaid onto the face, the sex of the face, or the face’s emotional expression, increasing attention to emotion-related features. We found main effects of emotion for the N170, EPN and LPP. While N170 emotional modulations were task-independent, interactions of emotion and task were observed for the EPN and LPP. While EPN emotion effects were found in the sex and emotion tasks, the LPP emotion effect was mainly driven by the emotion task. This study shows that early responses to fearful faces are task-independent (N170) and likely based on low-level and configural information, while during later processing stages, attention to the face (EPN) or—more specifically—to the face’s emotional expression (LPP) is crucial for reliable amplified processing of emotional faces.

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In neuroscientific studies, the naturalness of face presentation differs; a third of published studies makes use of close-up full coloured faces, a third uses close-up grey-scaled faces and another third employs cutout grey-scaled faces. Whether and how these methodological choices affect emotion-sensitive components of the event-related brain potentials (ERPs) is yet unclear. Therefore, this pre-registered study examined ERP modulations to close-up full-coloured and grey-scaled faces as well as cutout fearful and neutral facial expressions, while attention was directed to no-face oddballs. Results revealed no interaction of face naturalness and emotion for any ERP component, but showed, however, large main effects for both factors. Specifically, fearful faces and decreasing face naturalness elicited substantially enlarged N170 and early posterior negativity amplitudes and lower face naturalness also resulted in a larger P1.This pattern reversed for the LPP, showing linear increases in LPP amplitudes with increasing naturalness. We observed no interaction of emotion with face naturalness, which suggests that face naturalness and emotion are decoded in parallel at these early stages. Researchers interested in strong modulations of early components should make use of cutout grey-scaled faces, while those interested in a pronounced late positivity should use close-up coloured faces.

Detecting and responding to emotional facial expressions is of high relevance for social interactions and survival.

To date it is poorly understood how and when deviance processing interacts with awareness and task relevance. Furthermore, an important issue in the study of consciousness is the prevalent confound of conscious perception with the requirement of reporting it. This study addresses these topics using a no-report inattentional blindness paradigm with a visual oddball sequence of geometrical shapes presented to male and female human participants. Electrophysiological responses were obtained in three physically identical Phases A-C that differed only with respect to the instructions: (A) participants were uninformed about the shapes and attended an unrelated foreground task (inattentional blind), (B) were informed about the shapes but still attended the foreground task, and (C) attended the shapes. Conscious processing of shapes was indexed by the visual awareness negativity but not a P3. Deviance processing was associated with the visual mismatch negativity independently of consciousness and task relevance. The oddball P3, however, only emerged when the stimuli were task relevant, and was absent for consciously perceived but task irrelevant stimuli. The P3 thus does not represent a reliable marker of stimulus awareness. This result pattern supports the view of hierarchical predictive processing, where lower levels display automatic deviance processing, whereas higher levels require attention and task relevance.

Sustained anticipatory anxiety is central to Generalized Anxiety Disorder (GAD). During anticipatory anxiety, phasic threat responding appears to be mediated by the amygdala, while sustained threat responding seems related to the bed nucleus of the stria terminalis (BNST). Although sustained anticipatory anxiety in GAD patients was proposed to be associated with BNST activity alterations, firm evidence is lacking. We aimed to explore temporal characteristics of BNST and amygdala activity during threat anticipation in GAD patients. Nineteen GAD patients and nineteen healthy controls (HC) underwent functional magnetic resonance imaging (fMRI) during a temporally unpredictable threat anticipation paradigm. We defined phasic and a systematic variation of sustained response models for blood oxygen level-dependent responses during threat anticipation, to disentangle temporally dissociable involvement of the BNST and the amygdala. GAD patients relative to HC responded with increased phasic amygdala activity to onset of threat anticipation and with elevated sustained BNST activity that was delayed relative to the onset of threat anticipation. Both the amygdala and the BNST displayed altered responses during threat anticipation in GAD patients, albeit with different time courses. The results for the BNST activation hint towards its role in sustained threat responding, and contribute to a deeper understanding of pathological sustained anticipatory anxiety in GAD.

Temporal lobe epilepsy with amygdala enlargement (TLE-AE) is increasingly recognized as a distinct adult electroclinical syndrome. However, functional consequences of morphological alterations of the amygdala in TLE-AE are poorly understood. Here, two emotional stimulation designs were employed to investigate subjective emotional rating and skin conductance responses in a sample of treatment-naïve patients with suspected or confirmed autoimmune TLE-AE (n = 12) in comparison to a healthy control group (n = 16). A subgroup of patients completed follow-up measurements after treatment. As compared to healthy controls, patients with suspected or confirmed autoimmune TLE-AE showed markedly attenuated skin conductance responses and arousal ratings, especially pronounced for anxiety-inducing stimuli. The degree of right amygdala enlargement was significantly correlated with the degree of autonomic arousal attenuation. Furthermore, a decline of amygdala enlargement following prompt aggressive immunotherapy in one patient suffering from severe confirmed autoimmune TLE-AE with a very recent clinical onset was accompanied by a significant improvement of autonomic responses. Findings suggest dual impairments of autonomic and cognitive discrimination of stimulus arousal as hallmarks of emotional processing in TLE-AE. Emotional responses might, at least partially, recover after successful treatment, as implied by first single case data.