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DeGutis, Joseph

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DeGutis

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DeGutis, Joseph
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    Randomized control trial of computer-based training targeting alertness in older adults: the ALERT trial protocol
    (BioMed Central, 2018) VanVleet, Thomas; Voss, Michelle; Dabit, Sawsan; Mitko, Alex; DeGutis, Joseph
    Background: Healthy aging is associated with a decline in multiple functional domains including perception, attention, short and long-term memory, reasoning, decision-making, as well as cognitive and motor control functions; all of which are significantly modulated by an individual’s level of alertness. The control of alertness also significantly declines with age and contributes to increased lapses of attention in everyday life, ranging from minor memory slips to a lack of vigilance and increased risk of falls or motor-vehicle accidents. Several experimental behavioral therapies designed to remediate age-related cognitive decline have been developed, but differ widely in content, method and dose. Preliminary studies demonstrate that Tonic and Phasic Alertness Training (TAPAT) can improve executive functions in older adults and may be a useful adjunct treatment to enhance benefits gained in other clinically validated treatments. The purpose of the current trial (referred to as the Attention training for Learning Enhancement and Resilience Trial or ALERT) is to compare TAPAT to an active control training condition, include a larger sample of patients, and assess both cognitive and functional outcomes. Methods/design We will employ a multi-site, longitudinal, blinded randomized controlled trial (RCT) design with a target sample of 120 patients with age-related cognitive decline. Patients will be asked to complete 36 training sessions remotely (30 min/day, 5 days a week, over 3 months) of either the experimental TAPAT training program or an active control computer games condition. Patients will be assessed on a battery of cognitive and functional outcomes at four time points, including: a) immediately before training, b) halfway through training, c) within forty-eight hours post completion of total training, and d) after a three-month no-contact period post completion of total training, to assess the longevity of potential training effects. Discussion The strengths of this protocol are that it tests an innovative, in-home administered treatment that targets a fundamental deficit in adults with age-related cognitive decline; employs highly sensitive computer-based assessments of cognition as well as functional abilities, and incorporates a large sample size in an RCT design. Trial registration ClinicalTrials.gov identifier: NCT02416401.
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    Randomized control trial of computer-based rehabilitation of spatial neglect syndrome: the RESPONSE trial protocol
    (BioMed Central, 2014) Vleet, Thomas Van; DeGutis, Joseph; Dabit, Sawsan; Chiu, Christopher
    Background: Spatial neglect is a frequent and debilitating consequence of acquired brain injury and currently has no widely accepted standard of care. While previous interventions for spatial neglect have targeted patients’ overt spatial deficits (e.g., reduced contralesional visual scanning), far fewer have directly targeted patients’ non-spatial deficits (e.g., sustained attention deficits). Considering that non-spatial deficits have shown to be highly predictive of long-term disability, we developed a novel computer based training program that targets both sustained (tonic) and moment-to-moment (phasic) aspects of non-spatial attention (Tonic and Phasic Alertness Training, TAPAT). Preliminary studies demonstrate that TAPAT is safe and effective in improving both spatial and non-spatial attention deficits in the post-acute recovery phase in neglect patients. The purpose of the current trial (referred to as the REmediation of SPatial Neglect or RESPONSE trial) is to compare TAPAT to an active control training condition, include a larger sample of patients, and assess both cognitive and functional outcomes. Methods/Design We will employ a multi-site, longitudinal, blinded randomized controlled trial (RCT) design with a target sample of 114 patients with spatial neglect. Patients will either perform, at their home, the experimental TAPAT training program or an active control computer games condition for thirty minutes/day, five days a week, over three months. Patients will be assessed on a battery of cognitive and functional outcomes on three occasions: a) immediately before training, b) within forty-eight hours post completion of total training, and c) after a three-month no-contact period post completion of total training, to assess the longevity of potential training effects. Discussion The strengths of this protocol are that it tests an innovative, in-home administered treatment that targets a fundamental deficit in neglect, employs highly sensitive computer-based assessments of cognition as well as functional outcomes, and incorporates a large sample size (relative to other neglect treatment studies) in an RCT design. Trial registration ClinicalTrials.gov identifier, NCT01965951
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    Face processing improvements in prosopagnosia: successes and failures over the last 50 years
    (Frontiers Media S.A., 2014) DeGutis, Joseph; Chiu, Christopher; Grosso, Mallory E.; Cohan, Sarah
    Clinicians and researchers have widely believed that face processing cannot be improved in prosopagnosia. Though more than a dozen reported studies have attempted to enhance face processing in prosopagnosics over the last 50 years, evidence for effective treatment approaches has only begun to emerge. Here, we review the current literature on spontaneous recovery in acquired prosopagnosia (AP), as well as treatment attempts in acquired and developmental prosopagnosia (DP), differentiating between compensatory and remedial approaches. We find that for AP, rather than remedial methods, strategic compensatory training such as verbalizing distinctive facial features has shown to be the most effective approach (despite limited evidence of generalization). In children with DP, compensatory training has also shown some effectiveness. In adults with DP, two recent larger-scale studies, one using remedial training and another administering oxytocin, have demonstrated group-level improvements and evidence of generalization. These results suggest that DPs, perhaps because of their more intact face processing infrastructure, may benefit more from treatments targeting face processing than APs.
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    Anticipation of Monetary Reward Can Attenuate the Vigilance Decrement
    (Public Library of Science, 2016) Esterman, Michael; Grosso, Mallory; Liu, Guanyu; Mitko, Alex; Morris, Rachael; DeGutis, Joseph
    Motivation and reward can have differential effects on separate aspects of sustained attention. We previously demonstrated that continuous reward/punishment throughout a sustained attention task improves overall performance, but not vigilance decrements. One interpretation of these findings is that vigilance decrements are due to resource depletion, which is not overcome by increasing overall motivation. However, an alternative explanation is that as one performs a continuously rewarded task there are less potential gains/losses as the task progresses, which could decrease motivation over time, producing a vigilance decrement. This would predict that keeping future gains/losses consistent throughout the task would reduce the vigilance decrement. In the current study, we examined this possibility by comparing two versions (continuous-small loss vs. anticipate-large loss) of a 10-minute gradual onset continuous performance task (gradCPT), a challenging go/no-go sustained attention task. Participants began each task with the potential to keep $18. In the continuous-small-loss version, small monetary losses were accrued continuously throughout the task for each error. However, in the anticipate-large-loss version, participants lost all $18 if they erroneously responded to one target that always appeared toward the end of the vigil. Typical vigilance decrements were observed in the continuous-small-loss condition. In the anticipate-large-loss condition, vigilance decrements were reduced, particularly when the anticipate-large loss condition was completed second. This suggests that the looming possibility of a large loss can attenuate the vigilance decrement and that this attenuation may occur most consistently after sufficient task experience. We discuss these results in the context of current theories of sustained attention.
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    Interpersonal early‐life trauma alters amygdala connectivity and sustained attention performance
    (John Wiley and Sons Inc., 2017) Fortenbaugh, Francesca; Corbo, Vincent; Poole, Victoria; McGlinchey, Regina; Milberg, William; Salat, David; DeGutis, Joseph; Esterman, Michael
    Abstract Introduction: Interpersonal early life trauma (I‐ELT) is associated with a myriad of functional impairments in adulthood, increased risk of drug addiction, and neuropsychiatric disorders. While deficits in emotional regulation and amygdala functioning are well characterized, deficits in general cognitive functioning have also been documented. However, the neural underpinnings of cognitive dysfunction in adults with a history of I‐ELT and the potential relationship between amygdala‐based functional connectivity and behavioral performance are currently poorly understood. This study examined how I‐ELT affects the cognitive and neural mechanisms supporting sustained attention. Methods: A total of 66 Veterans (18 with and 48 without a history of I‐ELT) completed a nonemotional sustained attention task during functional MRI. Results: The individuals with I‐ELT showed significant impairments in sustained attention (i.e., higher error rates, greater response variability). This cohort exhibited increased amygdala functional connectivity with the prefrontal cortex and decreased functional connectivity with the parahippocampal gyrus when compared to those without I‐ELT. These connections were significantly correlated with individual differences in sustained attention performance. Notably, classification analyses revealed that the pattern of amygdala connectivity across the whole brain was able to classify I‐ELT status with 70% accuracy. Conclusion: These results provide evidence of a lasting negative impact for those with a history of I‐ELT on sustained attention ability. They also highlight a critical role for amygdala functioning in cognitive control and sustained attention for those with a history of I‐ELT, which may underlie the observed attention deficits in clinical assessments and cognitive tests involving both emotional and nonemotional stimuli.
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    Gender Differences in Sustained Attentional Control Relate to Gender Inequality across Countries
    (Public Library of Science, 2016) Riley, Elizabeth B.; Okabe, Hidefusa; Germine, Laura; Wilmer, Jeremy; Esterman, Michael; DeGutis, Joseph
    Sustained attentional control is critical for everyday tasks and success in school and employment. Understanding gender differences in sustained attentional control, and their potential sources, is an important goal of psychology and neuroscience and of great relevance to society. We used a large web-based sample (n = 21,484, from testmybrain.org) to examine gender differences in sustained attentional control. Our sample included participants from 41 countries, allowing us to examine how gender differences in each country relate to national indices of gender equality. We found significant gender differences in certain aspects of sustained attentional control. Using indices of gender equality, we found that overall sustained attentional control performance was lower in countries with less equality and that there were greater gender differences in performance in countries with less equality. These findings suggest that creating sociocultural conditions which value women and men equally can improve a component of sustained attention and reduce gender disparities in cognition.
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    Individual Differences in Holistic Processing Predict the Own-Race Advantage in Recognition Memory
    (Public Library of Science, 2013) DeGutis, Joseph; Mercado, Rogelio J.; Wilmer, Jeremy; Rosenblatt, Andrew
    Individuals are consistently better at recognizing own-race faces compared to other-race faces (other-race effect, ORE). One popular hypothesis is that this recognition memory ORE is caused by differential own- and other-race holistic processing, the simultaneous integration of part and configural face information into a coherent whole. Holistic processing may create a more rich, detailed memory representation of own-race faces compared to other-race faces. Despite several studies showing that own-race faces are processed more holistically than other-race faces, studies have yet to link the holistic processing ORE and the recognition memory ORE. In the current study, we sought to use a more valid method of analyzing individual differences in holistic processing by using regression to statistically remove the influence of the control condition (part trials in the part-whole task) from the condition of interest (whole trials in the part-whole task). We also employed regression to separately examine the two components of the ORE: own-race advantage (regressing other-race from own-race performance) and other-race decrement (regressing own-race from other-race performance). First, we demonstrated that own-race faces were processed more holistically than other-race faces, particularly the eye region. Notably, using regression, we showed a significant association between the own-race advantage in recognition memory and the own-race advantage in holistic processing and that these associations were weaker when examining the other-race decrement. We also demonstrated that performance on own- and other-race faces across all of our tasks was highly correlated, suggesting that the differences we found between own- and other-race faces are quantitative rather than qualitative. Together, this suggests that own- and other-race faces recruit largely similar mechanisms, that own-race faces more thoroughly engage holistic processing, and that this greater engagement of holistic processing is significantly associated with the own-race advantage in recognition memory.