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The neuroscience of volition is an emerging subfield of the brain sciences, with hundreds of papers on the role of consciousness in action formation published each year. This makes the state-of-the-art in the discipline poorly accessible to newcomers and difficult to follow even for experts in the field. Here we provide a comprehensive summary of research in this field since its inception that will be useful to both groups. We also discuss important ideas that have received little coverage in the literature so far. We systematically reviewed a set of 2220 publications, with detailed consideration of almost 500 of the most relevant papers. We provide a thorough introduction to the seminal work of Benjamin Libet from the 1960s to 1980s. We also discuss common criticisms of Libet's method, including temporal introspection, the interpretation of the assumed physiological correlates of volition, and various conceptual issues. We conclude with recent advances and potential future directions in the field, highlighting modern methodological approaches to volition, as well as important recent findings., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

In 1983 Benjamin Libet and colleagues published a paper apparently challenging the view that the conscious intention to move precedes the brain's preparation for movement. The experiment initiated debates about the nature of intention, the neurophysiology of movement, and philosophical and legal understanding of free will and moral responsibility. Here we review the concept of "conscious intention" and attempts to measure its timing. Scalp electroencephalographic activity prior to movement, the Bereitschaftspotential, clearly begins prior to the reported onset of conscious intent. However, the interpretation of this finding remains controversial. Numerous studies show that the Libet method for determining intent, W time, is not accurate and may be misleading. We conclude that intention has many different aspects, and although we now understand much more about how the brain makes movements, identifying the time of conscious intention is still elusive., (Published by Elsevier Ltd.)

Volitional control is at the core of brain-machine interfaces (BMI) adaptation and neuroprosthetic-driven learning to restore motor function for disabled patients, but neuroplasticity changes and neuromodulation underlying volitional control of neuroprosthetic learning are largely unexplored. To better study volitional control at annotated neural population, we have developed an operant neuroprosthetic task with closed-loop feedback system by volitional conditioning of population calcium signal in the M1 cortex using fiber photometry recording. Importantly, volitional conditioning of the population calcium signal in M1 neurons did not improve within-session adaptation, but specifically enhanced across-session neuroprosthetic skill learning with reduced time-to-target and the time to complete 50 successful trials. With brain-behavior causality of the neuroprosthetic paradigm, we revealed that proficiency of neuroprosthetic learning by volitional conditioning of calcium signal was associated with the stable representational (plasticity) mapping in M1 neurons with the reduced calcium peak. Furthermore, pharmacological blockade of adenosine A 2A receptors facilitated volitional conditioning of neuroprosthetic learning and converted an ineffective volitional conditioning protocol to be the effective for neuroprosthetic learning. These findings may help to harness neuroplasticity for better volitional control of neuroprosthetic training and suggest a novel pharmacological strategy to improve neuroprosthetic learning in BMI adaptation by targeting striatal A 2A receptors., (Copyright © 2020. Published by Elsevier Ltd.)

Suicidal behaviour poses a significant public health concern. Research into the factors that distinguish between the emergence of suicide ideation and the enactment of a suicide attempt is crucial. This study tests central tenets of the Integrated Motivational-Volitional Model of suicidal behaviour (IMV, O'Connor and Kirtley, 2018) which posits that volitional phase factors govern the transition from thinking to attempting suicide. 299 adults completed a face-to-face interview and were allocated to groups based on their suicidal history: Suicide attempt group (N = 100), suicide ideation group (N = 105), and a control group (N = 94). Measures were taken at baseline, at 1-month and 6-months follow-up. As predicted, the attempt group differed from the ideation group on all volitional phase factors. Those who had attempted suicide reported higher capability for suicide, were more likely to have a family member or friend who had self-injured or attempted suicide, and were more impulsive. In keeping with the IMV model, the ideation and attempt groups had similar scores on the motivational factors. Defeat and entrapment were significant predictors of ideation at baseline, and mediation analyses indicated that defeat had an indirect effect on ideation through entrapment at baseline and at 1-month follow-up. The results support the IMV model and suggest that entrapment should be routinely included in suicide risk assessments. Further research to test predictors of the transition from suicide ideation to suicide attempts is crucial to inform future intervention development and health care delivery., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

While the question whether free will exists or not has concerned philosophers for centuries, empirical research on this question is relatively young. About 35 years ago Benjamin Libet designed an experiment that challenged the common intuition of free will, namely that conscious intentions are causally efficacious. Libet demonstrated that conscious intentions are preceded by a specific pattern of brain activation, suggesting that unconscious processes determine our decisions and we are only retrospectively informed about these decisions. Libet-style experiments have ever since dominated the discourse about the existence of free will and have found their way into the public media. Here we review the most important challenges to the common interpretation of Libet-style tasks and argue that the common interpretation is questionable. Brain activity preceding conscious decisions reflects the decision process rather than its outcome. Furthermore, the decision process is configured by conditional intentions that participants form at the beginning of the experiment. We conclude that Libet-style tasks do not provide a serious challenge to our intuition of free will., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Self-generated, voluntary actions, are preceded by a slow negativity in the scalp electroencephalography (EEG) signal recorded from frontal regions (termed 'readiness potential'; RP). This signal, and its lateralized subcomponent (LRP), is mainly regarded as preparatory motor activity associated with the forthcoming voluntary motor act. However, it is not clear whether this neural signature is associated with preparatory motor activity, expectation of its associated sensory consequences, or both. Here we recorded EEG data from 14 healthy subjects while they performed self-paced button presses with their right index and middle fingers. Button-presses with one finger triggered a sound (motor+sound condition), while button-presses with the other finger did not (motor-only condition). Additionally, subjects listened to externally-generated sounds delivered in expected timings (sound-only condition). We found that the RP amplitude (locked to time of button press) was significantly more negative in the motor+sound compared with motor-only conditions. Importantly, no signal negativity was observed prior to expected sound delivery in the sound-only condition. Thus, the differences in RP amplitude between motor+sound and motor-only conditions are beyond differences in mere expectation of a forthcoming auditory sound. Our results suggest that information regarding expected auditory consequences is represented in the RP preceding voluntary action execution., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Despite behavioral and electrophysiological evidence for dissociations between endogenous (voluntary) and exogenous (reflexive) attention, fMRI results have yet to consistently and clearly differentiate neural activation patterns between these two types of attention. This study specifically aimed to determine whether activity in the dorsal fronto-parietal network differed between endogenous and exogenous conditions. Participants performed a visual discrimination task in endogenous and exogenous attention conditions while undergoing fMRI scanning. Analyses revealed robust and bilateral activation throughout the dorsal fronto-parietal network for each condition, in line with many previous results. In order to investigate possible differences in the balance of neural activity within this network with greater sensitivity, a priori regions of interest (ROIs) were selected for analysis, centered on the frontal eye fields (FEF) and intraparietal sulcus (IPS) regions identified in previous studies. The results revealed a significant interaction between region, condition, and hemisphere. Specifically, in the left hemisphere, frontal areas were more active than parietal areas, but only during endogenous attention. Activity in the right hemisphere, in contrast, remained relatively consistent for these regions across conditions. Analysis of this activity over time indicates that this left-hemispheric regional imbalance is present within the FEF early, at 3-6.5 s post-stimulus presentation, whereas a regional imbalance in the exogenous condition is not evident until 6.5-8 s post-stimulus presentation. Overall, our results provide new evidence that although the dorsal fronto-parietal network is indeed associated with both types of attentional orienting, regions of the network are differentially engaged over time and across hemispheres depending on the type of attention., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Stopping an action at the very last moment is an important feature of human behavioural flexibility. Intentional inhibition has been defined as the ability to inhibit an action on the basis of an internal decision process. Without this ability, actions would be impulsive and would leave little space to correct misguided decisions. Previous research suggests that making a choice between action alternatives activates a specific "choice network" that includes the rostral cingulate zone (RCZ), the anterior insula (AI), the dorsolateral prefrontal cortex (DLPFC) and the inferior parietal lobe (IPL). The activity of this network has shown to be influenced by non-conscious (subliminal) stimuli. In this study, we tested whether the same regions are recruited by free-choices to inhibit and modulated by unconscious information as reported in the case of free-choices to act. Using functional magnetic resonance imaging (fMRI) we manipulated the degree of 'freedom' of the choice between acting and inhibiting an action by introducing explicit cues or leaving the participants free to choose between action alternatives. We included subliminal masked primes to test whether responses to targets were facilitated and/or obstructed by conditions of congruency and incongruency between primes and targets. Our findings confirmed higher activation of the "choice network" in free-choice trials when compared to cued choices. However subliminal priming failed to significantly influence participants' responses, in free-choice conditions., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Preclinical and clinical neurophysiological and neurorehabilitation research has generated rather surprising levels of recovery of volitional sensory-motor function in persons with chronic motor paralysis following a spinal cord injury. The key factor in this recovery is largely activity-dependent plasticity of spinal and supraspinal networks. This key factor can be triggered by neuromodulation of these networks with electrical and pharmacological interventions. This review addresses some of the systems-level physiological mechanisms that might explain the effects of electrical modulation and how repetitive training facilitates the recovery of volitional motor control. In particular, we substantiate the hypotheses that: (1) in the majority of spinal lesions, a critical number and type of neurons in the region of the injury survive, but cannot conduct action potentials, and thus are electrically non-responsive; (2) these neuronal networks within the lesioned area can be neuromodulated to a transformed state of electrical competency; (3) these two factors enable the potential for extensive activity-dependent reorganization of neuronal networks in the spinal cord and brain, and (4) propriospinal networks play a critical role in driving this activity-dependent reorganization after injury. Real-time proprioceptive input to spinal networks provides the template for reorganization of spinal networks that play a leading role in the level of coordination of motor pools required to perform a given functional task. Repetitive exposure of multi-segmental sensory-motor networks to the dynamics of task-specific sensory input as occurs with repetitive training can functionally reshape spinal and supraspinal connectivity thus re-enabling one to perform complex motor tasks, even years post injury., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

A main distinction has been proposed between voluntary and automatic mechanisms underlying temporal orienting (TO) of selective attention. Voluntary TO implies the endogenous directing of attention induced by symbolic cues. Conversely, automatic TO is exogenously instantiated by the physical properties of stimuli. A well-known example of automatic TO is sequential effects (SEs), which refer to the adjustments in participants' behavioral performance as a function of the trial-by-trial sequential distribution of the foreperiod between two stimuli. In this study a group of healthy adults underwent a cued reaction time task purposely designed to assess both voluntary and automatic TO. During the task, both post-cue and post-target event-related potentials (ERPs) were recorded by means of a high spatial resolution EEG system. In the results of the post-cue analysis, the P3a and P3b were identified as two distinct ERP markers showing distinguishable spatiotemporal features and reflecting automatic and voluntary a priori expectancy generation, respectively. The brain source reconstruction further revealed that distinct cortical circuits supported these two temporally dissociable components. Namely, the voluntary P3b was supported by a left sensorimotor network, while the automatic P3a was generated by a more distributed frontoparietal circuit. Additionally, post-cue contingent negative variation (CNV) and post-target P3 modulations were observed as common markers of voluntary and automatic expectancy implementation and response selection, although partially dissociable neural networks subserved these two mechanisms. Overall, these results provide new electrophysiological evidence suggesting that distinct neural substrates can be recruited depending on the voluntary or automatic cognitive nature of the cognitive mechanisms subserving TO., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Voluntary actions are often accompanied by a conscious experience of intention. The content of this experience, and its neural basis, remain controversial. On one view, the mind just retrospectively ascribes intentions to explain the occurrence of actions that lack obvious triggering stimuli. Here, we use EEG frequency analysis of sensorimotor rhythms to investigate brain activity when a participant (CL, co-author of this paper) with congenital absence of the left hand and arm, prepared and made a voluntary action with the right or the phantom "left hand". CL reported the moment she experienced the intention to press a key. This timepoint was then used as a marker for aligning and averaging EEG. In a second condition, CL was asked to prepare the action on all trials, but then, on some trials, to cancel the action at the last moment. For the right hand, we observed a typical reduction in beta-band spectral power prior to movement, followed by beta rebound after movement. When CL prepared but then cancelled a movement, we found a characteristic EEG pattern reported previously, namely a left frontal increase in spectral power close to the time of the perceived intention to move. Interestingly, the same neural signatures of positive and inhibitory volition were also present when CL prepared and inhibited movements with her phantom left hand. These EEG signals were all similar to those reported previously in a group of 14 healthy volunteers. Our results suggest that conscious intention may depend on preparatory brain activity, and not on making, or ever having made, the corresponding physical body movement. Accounts that reduce conscious volition to mere retrospective confabulation cannot easily explain our participant's neurophenomenology of action and inhibition. In contrast, the results are consistent with the view that specific neural events prior to movement may generate conscious experiences of positive and negative volition., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Inhibition is a major form of self-regulation. As such, it depends on self-awareness and comparing oneself to standards and is also susceptible to fluctuations in willpower resources. Ego depletion is the state of reduced willpower caused by prior exertion of self-control. Ego depletion undermines inhibition both because restraints are weaker and because urges are felt more intensely than usual. Conscious inhibition of desires is a pervasive feature of everyday life and may be a requirement of life in civilized, cultural society, and in that sense it goes to the evolved core of human nature. Intentional inhibition not only restrains antisocial impulses but can also facilitate optimal performance, such as during test taking. Self-regulation and ego depletion- may also affect less intentional forms of inhibition, even chronic tendencies to inhibit. Broadly stated, inhibition is necessary for human social life and nearly all societies encourage and enforce it., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

An event-related brain potential (ERP) component called visual mismatch negativity (MMN) is automatically elicited when sequential rules inherent in a visual stimulus sequence are violated. To elucidate whether the visual MMN-generating processes are strictly determined in a bottom-up (i.e., stimulus-driven) manner, or can be modulated by top-down control, we investigated whether or not visual MMN is affected by prior information about the occurrence of rule violation derived from the participant׳s voluntary action. The participants were required to produce a visual stimulus sequence by pressing one button frequently (about 90%) and another button infrequently (10%) in random order; an oddball sequence consisting of repetition-rule-conforming and -violating stimuli in Experiment 1 and a more complex sequence consisting of change-rule-conforming and -violating stimuli in Experiment 2. Frequently-performed button presses triggered rule-conforming stimuli (81%), but occasionally rule-violating stimuli (9%). In contrast, infrequently-performed button presses triggered rule-violating stimuli (9%), but occasionally rule-conforming stimuli (1%). The results showed that visual MMN was elicited by rule-violating stimuli triggered by frequently-performed button presses, while it was not elicited by physically the same rule-violating stimuli triggered by infrequently-performed button presses. That is, visual MMN was strongly affected by action-based prior information about the occurrence of rule violation. This result suggests that the visual MMN-generating processes can be flexibly controlled in a top-down manner, so that rule violation that can carry significant information is selectively detected., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Involuntary movements such as spontaneous eye blinks can be successfully inhibited at will. Little do we know how the voluntary motor circuits countermand spontaneous blinks. Do the voluntary inhibitory commands act to pause or to turn off the endogenous blink generator, or does inhibition intersect and counter the generator׳s excitatory outputs? In theory, the time taken for the system to generate an after-inhibition blink will reflect onto the form of inhibition. For instance, if voluntary commands were to turn the blink generator off then the after-blink latency would be fixed to the inhibition offset and reflect the time it takes for the generator to rebound and turn on. In this study we measured the after-blink latency from the offset of voluntary inhibition. Volunteers inhibited their blinks in response to sound tones of randomly varying durations. At the offset volunteers withdrew the inhibition and relaxed. Interestingly, the spontaneous after-blinks were fixed to the offset of the inhibition as if the generator rebounded from an off state. The after-blink latency was not related to the duration of the inhibition, and inhibiting even for a small fraction of the mean inter-blink interval generated an after-blink time-locked to the inhibition offset. Interestingly, the insertion of voluntary blinks after inhibition further altered the blink generator by delaying the spontaneous after-blinks. We propose that the inhibition of spontaneous blinks at the level of the generator allows for highly effective voluntary countermanding. Nevertheless, the withdrawal of such inhibition was strongly associated with motor excitation., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

In a series of experiments Marc Jeannerod revealed that we have very little awareness of the details and causes of our actions. We are, however, vividly aware of being in control of our actions and this gives us a sense of responsibility. These feelings arise, first, from intentional binding which creates a perception of agency, linking an intentional action to its outcome and, second, from the counterfactual reasoning that we could have chosen some other action. These feelings of responsibility play a critical role in creating social cohesion since they allow people to be held to account for deliberate antisocial behaviour. Jeannerod's studies also showed that we are unaware of how little we know about our actions and so are happy to make up stories about the nature and causes of our behaviour. These stories often do not correspond with the underlying cognitive and neural processes, but they can be changed through instructions and through discussion with others. Our experience of responsibility for action emerges during our upbringing through exposure to our culture. This creates consensus about the causes of behaviour, but not necessarily accuracy., (© 2013 Elsevier Ltd. All rights reserved.)

Background: Previous studies indicate that negative symptoms reflect a separable domain of pathology from other symptoms of schizophrenia. However, it is currently unclear whether negative symptoms themselves are multi-faceted, and whether sub-groups of patients who display unique negative symptom profiles can be identified., Methods: A data-driven approach was used to examine the heterogeneity of negative symptom presentations in two samples: Study 1 included 199 individuals with schizophrenia assessed with a standard measure of negative symptoms and Study 2 included 169 individuals meeting criteria for deficit schizophrenia (i.e., primary and enduring negative symptoms) assessed with a specialized measure of deficit symptoms. Cluster analysis was used to determine whether different groups of patients with distinct negative symptoms profiles could be identified., Results: Across both studies, we found evidence for two distinctive negative symptom sub-groups: one group with predominantly Avolition-Apathy (AA) symptoms and another with a predominantly Diminished Expression (DE) profile. Follow-up discriminant function analyses confirmed the validity of these groups. AA and DE negative symptom sub-groups significantly differed on clinically relevant external validators, including measures of functional outcome, premorbid adjustment, clinical course, disorganized symptoms, social cognition, sex, and ethnicity., Conclusions: These results suggest that distinct subgroups of patients with elevated AA or DE can be identified within the broader diagnosis of schizophrenia and that these subgroups show clinically meaningful differences in presentation. Additionally, AA tends to be associated with poorer outcomes than DE, suggesting that it may be a more severe aspect of psychopathology., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Negative symptoms of schizophrenia are normally grouped into a single category. However, the diversity of such symptoms suggests that they are actually made up of more than one dimension. The DSM-V proposes two negative symptom domains, namely expressive deficits and avolition/asociality. We investigated whether the negative symptoms do indeed have two dimensions. An exploratory factor analysis was carried out based on interviews with the PANSS (664 patients). We restricted our analysis to items that had been described as negative symptoms in previous factor analyses. The symptom structure was then tested for stability by performing a confirmatory factor analysis on PANSS interviews from a separate cohort (2172 patients). Exploratory factor analysis yielded a two-factor structure of negative symptoms. The first factor consisted of PANSS items Flat affect, Poor rapport, Lack of spontaneity, Mannerisms and posturing, Motor retardation, and Avolition. The second factor consisted of Emotional withdrawal, Passive/apathetic social withdrawal, and Active social avoidance. The first factor could be related to expressive deficits, reflecting a loss of initiative, and the second factor to social amotivation, related to community interaction. This factor structure supports the DSM-V classification and may be relevant for pathophysiology and treatment of schizophrenia and other psychotic disorders., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Objective: The present study examined the relationship between volitional modes of coping (self-regulation, volitional inhibition, and self-control) and depression in individuals with multiple sclerosis., Methods: A cross-sectional study of 121 participants aged 22-60 years with clinically defined MS who were consecutively admitted to a neurological rehabilitation center during a 23-month period. Correlation analyses and hierarchical regressions were conducted to evaluate the predictive value of volitional competencies (Volitional Components Questionnaire, short form, VCQ-S) on depression (Centre for Epidemiologic Studies Depression Scale, CES-D), while controlling for demographic (age, gender, and education) and certain clinical variables (Expanded Disability Status Scale, EDSS; disease duration; and Modified Fatigue Impact Scale, MFIS)., Results: Hierarchical regression analyses of depression revealed a model in which 68% of the variance in the CES-D was explained by daily stress situations (VCQ-S), self-regulation (VCQ-S), fatigue (MFIS), and education. However, when the analysis included only participants who had scored above the cut-off of the CES-D (n=42), the VCQ-S factor volitional inhibition seemed to play a more relevant part in depression. In particular, the VCQ-S scales stimulation of self-access, stimulation of volitional inhibition, self-motivation, and emotional perseverance/state orientation after failure appear to be valuable predictors on CES-D., Conclusions: The results suggest that personality-accentuated volitional coping competencies elicited by daily stressful situations could be a relevant factor for depressive mood states in individuals with MS. However, to clarify the exact relationships of this rather circular framework, longitudinal study designs with objective measurements and a stronger focus on MS-specific stressors are needed., (Copyright © 2012 Elsevier Inc. All rights reserved.)

The capacity to inhibit and withhold actions is a key feature of human cognition. Withholding action forms the basis of self-control, delayed gratification, social contracts, and trust in others. Most experimental studies of this function come from studying the processing of external stop signals. However, another important aspect of inhibition is 'will-power', i.e., intentional inhibitory control over one's own actions, in the absence of external countermanding signals. We review whether a concept of intentional inhibition is justified, and how it might differ from externally triggered inhibition. Further, we consider three types of neuroscientific evidence that can clarify the brain's mechanisms of inhibition: neuropsychology, neurostimulation and neuroimaging. Finally, we propose a model in which intentional inhibition, unlike externally triggered inhibition, is linked to representing longer range consequences of action decisions. We suggest that the human brain contains a 'neural brake' mechanism that blocks specific ongoing motor activity, and that this mechanism plays a key role in action decisions., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Difficulty with literacy acquisition is only one of the symptoms of developmental dyslexia. Dyslexic children also show poor motor coordination and postural control. Those problems could be associated with automaticity, i.e., difficulty in performing a task without dispending a fair amount of conscious efforts. If this is the case, dyslexic children would show difficulties in using "unperceived" sensory cues to control body sway. Therefore, the aim of the study was to examine postural control performance and the coupling between visual information and body sway in dyslexic children. Ten dyslexic children and 10 non-dyslexic children stood upright inside a moving room that remained stationary or oscillated back and forward at frequencies of 0.2 or 0.5 Hz. Body sway magnitude and the relationship between the room's movement and body sway were examined. The results indicated that dyslexic children oscillated more than non-dyslexic children in both stationary and oscillating conditions. Visual manipulation induced body sway in all children but the coupling between visual information and body sway was weaker and more variable in dyslexic children. Based upon these results, we can suggest that dyslexic children use visual information to postural control with the same underlying processes as non-dyslexic children; however, dyslexic children show poorer performance and more variability while relating visual information and motor action even in a task that does not require an active cognitive and conscious motor involvement, which may be a further evidence of automaticity problem., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

An important aspect of volition is the internal decision whether to act or to withhold an action. We used EEG frequency analysis of sensorimotor rhythms to investigate brain activity when people prepare and then cancel a voluntary action. Participants used a rotating clock-hand to report when they experienced the intention to press a key with their right hand, even on trials where they freely decided to inhibit movement at the last moment. On action trials, we observed the classical pattern of reduced beta-band spectral power prior to movement, followed by beta rebound after movement. On inhibition trials where participants prepared but then cancelled a movement, we found a left frontal increase in spectral power (event-related synchronisation: ERS) peaking 12 ms before the perceived intention to move. This neural correlate of intentional inhibition was significantly different from the activity at the corresponding moment in action trials. The results are discussed in the context of a recent model of voluntary action (WWW model; Brass & Haggard, 2008). Planned actions can be subjected to a final predictive check which either commits actions for execution or suspends and withholds them. The neural mechanism of intentional inhibition may play an important role in self-control., (Crown Copyright 2009. Published by Elsevier Ltd. All rights reserved.)

In this paper, we propose a computational model for arm reaching control and learning. Our model describes not only the mechanism of motor control but also that of learning. Although several motor control models have been proposed to explain the control mechanism underlying well-trained arm reaching movements, it has not been fully considered how the central nervous system (CNS) learns to control our body. One of the great abilities of the CNS is that it can learn by itself how to control our body to execute required tasks. Our model is designed to improve the performance of control in a trial-and-error manner which is commonly seen in human's motor skill learning. In this paper, we focus on a reaching task in the sagittal plane and show that our model can learn and generate accurate reaching toward various target points without prior knowledge of arm dynamics. Furthermore, by comparing the movement trajectories with those made by human subjects, we show that our model can reproduce human-like reaching motions without specifying desired trajectories.

Human cognition performs granulation of the seemingly homogeneous temporal sequences of perceptual experiences into meaningful and comprehensible chunks of fuzzy concepts and behaviors. These knowledge granules are stored and consequently accessed during action selection and decisions. A dynamical approach is presented here to interpret experimental findings using K (Katchalsky) models. In the K model, meaningful knowledge is repetitiously created and processed in the form of sequences of oscillatory patterns of neural activity distributed across space and time. These patterns are not rigid but flexible and intermittent; soon after they arise through phase transitions, they dissipate. Computational implementations demonstrate the operation of the model based on the principles of intentional brain dynamics.

The success of brain-machine interfaces (BMI) is enabled by the remarkable ability of the brain to incorporate the artificial neuroprosthetic 'tool' into its own cognitive space and use it as an extension of the user's body. Unlike other tools, neuroprosthetics create a shared space that seamlessly spans the user's internal goal representation of the world and the external physical environment enabling a much deeper human-tool symbiosis. A key factor in the transformation of 'simple tools' into 'intelligent tools' is the concept of co-adaptation where the tool becomes functionally involved in the extraction and definition of the user's goals. Recent advancements in the neuroscience and engineering of neuroprosthetics are providing a blueprint for how new co-adaptive designs based on reinforcement learning change the nature of a user's ability to accomplish tasks that were not possible using conventional methodologies. By designing adaptive controls and artificial intelligence into the neural interface, tools can become active assistants in goal-directed behavior and further enhance human performance in particular for the disabled population. This paper presents recent advances in computational and neural systems supporting the development of symbiotic neuroprosthetic assistants.

Goal-directed behavior is a hallmark of cognition. An important prerequisite to goal-directed behavior is that of prediction. In order to establish a goal and devise a plan, one needs to see into the future and predict possible future events. Our earlier work has suggested that compensation mechanisms for neuronal transmission delay may have led to a preliminary form of prediction. In that work, facilitating neuronal dynamics was found to be effective in overcoming delay (the Facilitating Activation Network model, or FAN). The extrapolative property of the delay compensation mechanism can be considered as prediction for incoming signals (predicting the present based on the past). The previous FAN model turns out to have a limitation especially when longer delay needs to be compensated, which requires higher facilitation rates than FAN's normal range. We derived an improved facilitating dynamics at the neuronal level to overcome this limitation. In this paper, we tested our proposed approach in controllers for 2D pole balancing, where the new approach was shown to perform better than the previous FAN model. Next, we investigated the differential utilization of facilitating dynamics in sensory vs. motor neurons and found that motor neurons utilize the facilitating dynamics more than the sensory neurons. These findings are expected to help us better understand the role of facilitating dynamics in delay compensation, and its potential development into prediction, a necessary condition for goal-directed behavior.

How do reactive and planned behaviors interact in real time? How are sequences of such behaviors released at appropriate times during autonomous navigation to realize valued goals? Controllers for both animals and mobile robots, or animats, need reactive mechanisms for exploration, and learned plans to reach goal objects once an environment becomes familiar. The SOVEREIGN (Self-Organizing, Vision, Expectation, Recognition, Emotion, Intelligent, Goal-oriented Navigation) animat model embodies these capabilities, and is tested in a 3D virtual reality environment. SOVEREIGN includes several interacting subsystems which model complementary properties of cortical What and Where processing streams and which clarify similarities between mechanisms for navigation and arm movement control. As the animat explores an environment, visual inputs are processed by networks that are sensitive to visual form and motion in the What and Where streams, respectively. Position-invariant and size-invariant recognition categories are learned by real-time incremental learning in the What stream. Estimates of target position relative to the animat are computed in the Where stream, and can activate approach movements toward the target. Motion cues from animat locomotion can elicit head-orienting movements to bring a new target into view. Approach and orienting movements are alternately performed during animat navigation. Cumulative estimates of each movement are derived from interacting proprioceptive and visual cues. Movement sequences are stored within a motor working memory. Sequences of visual categories are stored in a sensory working memory. These working memories trigger learning of sensory and motor sequence categories, or plans, which together control planned movements. Predictively effective chunk combinations are selectively enhanced via reinforcement learning when the animat is rewarded. Selected planning chunks effect a gradual transition from variable reactive exploratory movements to efficient goal-oriented planned movement sequences. Volitional signals gate interactions between model subsystems and the release of overt behaviors. The model can control different motor sequences under different motivational states and learns more efficient sequences to rewarded goals as exploration proceeds.

The present study examines a new alertness training strategy (Self-Alert Training, SAT) designed to explore the relationship between the top-down control processes governing arousal and sustained attention. In order to maximally target frontal control systems SAT combines a previously validated behavioural self-alerting technique [Robertson, I. H., Tegner, R., Tham, K., Lo, A., & Nimmo-Smith, I. (1995). Sustained attention training for unilateral neglect: Theoretical and rehabilitation implications. Journal of Clinical and Experimental Neuropsychology, 17, 416-430] with an autonomic arousal biofeedback protocol in which participants learn to modulate their own arousal levels. The SAT protocol was first validated with a group of 23 neurologically healthy participants and then independently tested in a group of 18 adults with ADHD to determine its clinical utility. Half of the participants in each group were assigned to a placebo condition to control for non-specific effects. All participants performed the sustained attention to response task (SART) during pre- and post-training testing sessions to assess training effects on sustained attention. By the end of SAT all participants were able to modulate their own arousal levels without external prompting. Comparison of pre- and post-training baseline data indicated that, as predicted, SAT was associated with increased levels of autonomic arousal accompanied by improved accuracy on the SART. In contrast, participants in the placebo condition exhibited a gradual reduction in arousal over time and increased reaction time variability indicative of a vigilance decrement. These data demonstrate that the recruitment of top-down control processes during volitional modulation of arousal leads to improved sustained attention. These findings have important implications for the rehabilitation of attention deficits arising from frontal dysfunction.

Theoretical and empirical research on the cognitive functions of the prefrontal cortex have established that this region mediates what have been called 'executive' processes that can influence working and long-term memory. Despite the accumulation of such empirical evidence, the dependence of purely mnemonic portions of memory tasks on PFC remains unresolved. To address this issue, we performed an analysis of reports of performance on tests of working memory of patients with lesions of the dorsolateral prefrontal cortex, focusing on published reports in the literature of simple span and delayed-response tasks. We found that none of the eleven studies of forward verbal and spatial span in patients with prefrontal cortical lesions that we reviewed (reflecting the performance of 166 individual patients) demonstrated a statistically significant deficit relative to normal controls. In contrast, our review of the delayed-response literature indicated that there are conditions under which PFC lesions disrupt delayed-response performance. Based on the results of our review of the literature, we present testable hypotheses about the working memory functions of the PFC.

The purpose of this study was to determine whether significant attentional resources are required to accurately monitor changes in bodily orientation, using vestibular information. This question was addressed firstly using a dual-task paradigm in which orientation perception tasks and a speeded auditory tone discrimination task were carried out either singly or in combination. For the active orientation perception task, subjects were seated in darkness on a motorised chair which could be rotated about an earth-vertical axis. Following passive angular displacements, subjects were required to return the chair to their perceived starting position, using a joy-stick which controlled chair motion. For the speeded auditory task, subjects pushed a hand-held button as fast as possible when a tone was presented over headphones. When the two tasks were combined, reaction times on the auditory task increased. Reaction time also increased when subjects were simply asked to fixate during rotation. A second experiment demonstrated that if attention was occupied by performance of a demanding mental arithmetic task during the passive rotation, accuracy of subsequently repositioning the chair to the origin declined, implying that change in orientation had been less accurately registered when performing the concurrent mental task. In combination, these findings indicate that a small but significant degree of attention or cognitive effort is necessary to monitor accurately the direction and amplitude of a brief angular rotation, and to suppress vestibulo-ocular reflex eye movement.

The chronometry of real and imagined movements was investigated in a group of children with developmental coordination disorder (DCD) and a group of matched controls. The visually-guided pointing task was used to investigate the speed for accuracy trade-offs that occur as target size is varied for both real and imagined performance. In the control group, the speed for accuracy trade-off for both real and imagined performance conformed to Fitts' law. In the DCD group only real movements conformed to Fitts' law. This pattern of performance suggests that children with DCD have an impairment in the ability to generate internal representations of volitional movements. This may reflect part of a general impairment in the processing of efference copy in DCD.

The contribution of each cerebral hemisphere to the generation of semantic category meanings at automatic and strategic levels of processing was investigated in a priming experiment where prime and target words were independently projected to the left or right visual fields (LVF or RVF). Non-associated category exemplars were employed as related pairs in a lexical decision task and presented in two experimental conditions. The first condition was designed to elicit automatic processing, so related pairs comprised 20% of the positive set, stimulus pairs were temporally separated by a stimulus onset asynchrony (SOA) of 250 ms, and there was no allusion to the presence of related pairs in the instructions to subjects. The second condition, designed to invoke controlled processing, incorporated a relatedness proportion of 50%, stimulus pairs separated by an SOA of 750 ms, and instructions which informed subjects of the presence and use of category exemplar pairs in the stimulus set. In the first condition, a prime directed to either visual field facilitated responses to categorically related targets subsequently projected to the RVF, while in the second condition a prime directed to either visual field facilitated responses to related targets projected to the LVF. The facilitation effects obtained in both conditions appeared to reflect automatic processes, while strategic processes were invoked in the left, but not the right hemisphere in the second condition. The results suggest that both hemispheres have automatic access to semantic category meanings, although the timecourse of activation of semantic category meanings is slower in the right hemisphere than in the left.

We studied the involvement of the right parietal cortex in visual conjunction search, where two features are present in the array and spatial attention and feature binding is required, and in subset search, where two features are also present but only one of them is needed in order to group stimuli together (the subset) and allow parallel processing without the need for feature binding. Six patients with right parietal lobe lesions, six age-matched controls, and three control patients with left parietal lesions were tested on these two tasks. Patients with right parietal lesions were significantly slower than normal controls in the conjunction task, especially for target-absent trials. In the subset condition, neither normal control subjects nor patients with left parietal damage showed a difference between target-present and target-absent trials whereas right parietal patients showed a significant difference between target-present and target-absent responses. The results suggest a role for the right parietal cortex in shifting attention to the next stimulus once binding of features has taken place or selecting spatial areas containing the desired feature in a subset search, but that parietal cortex is not required for binding the features of the object.

A location-based ('select-what, respond-where') priming task was used to examine three measures of selective attention (interference (INT), negative priming (NP), and inhibition of return (IOR)) as a function of focal brain pathology and the complexity of target selection. Control subjects showed different patterns of performance for the three attentional measures as a function of complexity, suggesting some independence among INT, NP, and IOR. Brain-damaged subjects showed significant response slowing, as well as a number of lesion-specific attentional abnormalities. Right frontal (including bifrontal) damage resulted in proportionally increased interference related to task complexity. Left posterior damage increased IOR in the most complex task, while left frontal damage reversed the control pattern of IOR as a function of complexity. Right hemisphere (right posterior and right frontal damage) pathology resulted in a virtual loss of negative priming at all levels of task complexity; left and bifrontal damage resulted in diminished NP only related to increases in the complexity of selection. INT, NP, and IOR are mediated by different brain regions and their expression can be modulated by the complexity of the selection task.

This experiment investigated whether Parkinson's disease (PD) patients experience problems in producing stroke size, stroke duration or both, in a handwriting task. Thirteen PD patients and 15 elderly controls wrote four patterns of varying complexity on a digitizer tablet. The participants were instructed to execute the writing movements: at a normal size and speed; as fast as possible; two times larger than normal; and two times larger and as fast as possible. PD patients had no difficulty increasing speed while maintaining size and had no difficulty increasing size while maintaining speed. However, they showed significantly smaller size increases in the two times larger condition as compared to the elderly controls. The conditions were also simulated by a neural network model of normal and PD movement control that produced a stroke pattern that approximated the experimental data. For the instructions used, the results suggest that when patients scale speed, they have no difficulty controlling force amplitude, but when they scale stroke size, they have a problem controlling force amplitude. Thus, PD patients may have reduced capability to maintain a given force level for the stroke time periods tested with the instructions.

We have previously demonstrated that performance on a brief and conceptually simple laboratory task (the Sustained Attention to Response Test: SART) was predictive of everyday attentional failures and action slips in brain injured patients and normal control participants. The SART is a go-no-go paradigm in which the no-go target appears rarely and unpredictably. Performance on this measure was previously interpreted as requiring sustained attention to response rather than a putative 'response inhibition' capacity. Three further studies are presented which support this claim. They demonstrate that performance is crucially determined by the duration of time over which attention must be maintained on one's own actions that this demand underpins the task's relationship to everyday attentional lapses. In keeping with a number of recent studies it suggests that inefficiencies in the maintenance of attentional control may be apparent over much briefer periods than is traditionally considered using vigilance measures and analysis.

On the covert orienting of visual attention task (COVAT), responses to targets appearing at the location indicated by a non-predictive spatial cue are faster than responses to targets appearing at uncued locations when stimulus onset asynchrony (SOA) is less than approximately 200 ms. For longer SOAs, this pattern reverses and RTs to targets appearing at uncued locations become faster than RTs to targets appearing at the cued location. This facilitation followed by inhibition has been termed the biphasic effect of non-predictive peripheral spatial cues. Currently, there is debate about whether these two processes are independent. This issue was addressed in a series of experiments where the temporal overlap between the peripheral cue and target was manipulated at both short and long SOAs. Results showed that facilitation was present only when the SOA was short and there was temporal overlap between cue and target. Conversely, inhibition occurred only when the SOA was long and there was no temporal overlap between cue and target. The biphasic effect, with an early facilitation followed by a later inhibition, occurred only when the cue duration was fixed such that there was temporal overlap between the cue and target at short but not long SOAs. In a final experiment, the duration of targets the temporal overlap between cue and target and the SOA were manipulated factorially. The results showed that facilitation occurred only when the SOA was short, there was temporal overlap between cue and target and the target remained visible until the subject responded. These results suggest that the facilitation and inhibition found on COVATs which use non-informative peripheral cues are independent processes and their presence and magnitude is related to the temporal properties of cues and targets.

Neuropsychological test batteries are repeatedly administered to evaluate changes over time or the effects of clinical interventions. Relationships between scores on different tests within batteries are also examined to test models for associations between functional deficits. These comparisons may be misleading unless Test/Re-test reliability for individual tests is satisfactory. Interpretations of repeated measurements also depend on the extent to which improvement with practice varies between tasks and between more and less able individuals. Test/Re-test correlations and practice effects for two neuropsychological test batteries (CANTAB, ISPOCD) and from laboratory tasks commonly used in cognitive assessments of older people were obtained from large groups of healthy elderly. Tests in neuropsychological batteries varied markedly in test/re-test reliability which, in some cases, fell below levels considered methodologically acceptable. Putative measures of 'frontal' or 'executive' function, in which performance may be markedly improved by abrupt discovery of an appropriate strategy, were especially likely to show low reliability. Most tests showed significant practice effects, and on some these are substantial enough to compromise comparisons on repeated testing. On a minority of tests practice effects were counter-intuitive, in that less able showed significantly more gains than more able individuals.

The ability to suppress reflexive responses in favor of voluntary motor acts is crucial for everyday life. Both abilities can be tested with an oculomotor task, the antisaccade task. This task requires subjects to suppress a reflexive prosaccade to a flashed visual stimulus and instead to generate a voluntary saccade to the opposite side. This article reviews what is currently known about the neural structures and processes which are involved in the performance of this task. Current data show that a variety of brain lesions, neurological diseases and psychiatric disorders result in errors, i.e. prosaccades towards the stimulus, in this task. Brain imaging studies have shown that a widely distributed cortical and subcortical network is active during the generation of antisaccades. These findings are discussed and the potential of the antisaccade task for diagnostic purposes is evaluated.

Based on the converging evidence supporting the view of domain specific object and spatial working memory processes, the question was addressed whether the property of domain specificity holds equally for temporal information. Using a selective interference paradigm the objective was to test a dissociation of the processing of temporal duration and spatial location information in working memory of intact human subjects. Subjects performed a temporal and a spatial memory task in which they were required to indicate whether the study and the test stimuli were the same or different in duration (temporal memory) or in location (spatial memory) as primary tasks. Both primary tasks were combined with three types of interference tasks, a spatial classification memory task, a temporal classification memory task and a non-interference baseline task--to be performed in-between the presentation of study and test stimuli. Memory for temporal duration was shown to be impaired by the temporal classification task but not by the spatial classification task; memory for spatial position showed the opposite pattern of impairment. These data thus provide evidence for the view that temporal and spatial working memory contents are subject to selective interference, reflecting a functional dissociation in the processing of temporal duration and spatial location information. The results are interpreted as evidence for the domain specificity in the processing of temporal information in working memory.

A functional magnetic resonance imaging (fMRI) study was conducted to determine whether prefrontal cortex (PFC) increases activity in working memory (WM) tasks as a specific result of the demands placed on WM, or to other processes affected by the greater difficulty of such tasks. Increased activity in dorsolateral PFC (DLPFC) was observed during task conditions that placed demands on active maintenance (long retention interval) relative to control conditions matched for difficulty. Furthermore, the activity was sustained over the entire retention interval and did not increase when task difficulty was manipulated independently of WM requirements. This contrasted with the transient increases in activity observed in the anterior cingulate, and other regions of frontal cortex, in response to increased task difficulty but not WM demands. Thus, this study established a double-dissociation between regions responsive to WM versus task difficulty, indicating a specific involvement of DLPFC and related structures in WM function.

Although many individuals with traumatic brain injury (TBI) perform well on standard neuropsychological tests, they often exhibit marked functional difficulties. The functions which are impaired seem to be analogous to the role of the central executive system (CES) in Baddeley's [Working Memory, 1986, Oxford University Press, New York] widely accepted model of working memory. The purpose of this study was to investigate CES function in individuals with TBI with a dual-task paradigm. We studied 25 non-demented persons who were at various stages in their recovery from severe TBI and compared their performance on a dual-task paradigm to a group of age-matched controls. Our dual-task paradigm measured performance on a simple visual reaction time task both alone (baseline) and during concurrent tasks of articulation or digit span. Subjects were also assessed with other neuropsychological tests of executive function. TBI patients had slower reaction times on the primary task when performed alone (P < 0.05) and greater decrements in performance during dual-task conditions (P < 0.01). They also exhibited significantly greater deficits than control subjects on other measures of executive function. Although correlations between dual-task performance and other executive measures were quite low, principle components analysis suggested that a common factor does exist between these measures. These findings support the conclusion that TBI patients have a working memory impairment that is due to dysfunction of the CES and which may be related to executive function deficits as measured by standard neuropsychological testing.

In an our recent preliminary study, we reported the neuropsychological finding of a double dissociation in the frontal lobe functioning between 25 OCD patients and 25 schizophrenics. The first group performed normally in the Wisconsin Card Sorting Test (WCST), which is considered sensitive to Dorso-Lateral Prefrontal Cortex (DLPFC) dysfunctions and abnormally to the Object Alternation Test (OAT), which has been proposed as a tool sensitive to Orbito-Frontal Cortex (OFC); on the other hand, schizophrenics performed abnormally to the WCST and normally to the OAT. The present study, conducted on a new sample of 60 schizophrenic in-patients, 60 OCD in-patients and 30 normal subjects, matched according to age, educational level, handedness and duration of illness, confirms our preliminary data and it suggests a more selective impairment of OFC system in OCD and of DLPFC in schizophrenia. Moreover, schizophrenic patients with paranoid subtype showed worse WCST performance compared to non-paranoid subtype. Our results could open some interesting perspectives about the neuroanatomical systems involved in these two major psychiatric illnesses and so, about their pharmacological treatment, on the basis of the prominent catecholaminergic characterization of the DLPFC and, respectively, the cholinergic innervation of the OFC.

The effect of distractor load on visual search was examined in a patient with visual neglect following infarction of the right frontal lobe. The spatial extent of his left-sided neglect was modified greatly by changing stimulus attributes. When targets were highly discriminable compared to distractors, or distractor density was low, or when the subject was asked to cancel distractors as well as targets, he was able to direct his search to the extreme left of search arrays and there was little or no evidence of neglect. By contrast, similar changes in distractor load had little or no effect on the neglect of a patient with a fronto-parietal lesion. These findings suggest that distractability towards ipsilesional stimuli may be an important component of neglect in individuals with only frontal lobe injury.

Insufficient attention to tasks can result in slips of action as automatic, unintended action sequences are triggered inappropriately. Such slips arise in part from deficits in sustained attention, which are particularly likely to happen following frontal lobe and white matter damage in traumatic brain injury (TBI). We present a reliable laboratory paradigm that elicits such slips of action and demonstrates high correlations between the severity of brain damage and relative-reported everyday attention failures in a group of 34 TBI patients. We also demonstrate significant correlations between self- and informant-reported everyday attentional failures and performance on this paradigm in a group of 75 normal controls. The paradigm (the Sustained Attention to Response Task-SART) involves the withholding of key presses to rare (one in nine) targets. Performance on the SART correlates significantly with performance on tests of sustained attention, but not other types of attention, supporting the view that this is indeed a measure of sustained attention. We also show that errors (false presses) on the SART can be predicted by a significant shortening of reaction times in the immediately preceding responses, supporting the view that these errors are a result of 'drift' of controlled processing into automatic responding consequent on impaired sustained attention to task. We also report a highly significant correlation of -0.58 between SART performance and Glasgow Coma Scale Scores in the TBI group.

A cued reaction time task was used to test the hypothesis that there is an 'object-based' component to shifts of attention mediating the detection of luminance increment targets. The test stimulus consisted of two intersecting triangles forming a 'Star of David'. In two experiments, the cue was a brief brightening of one triangle. The target (a bright green dot) appeared on one of the triangles after a delay of 100, 200 or 500 msec. In one experiment, the target was more likely to appear on the cued triangle. In a second experiment, there was no contingency between cue and target. In both cases, reaction times to targets which appeared outside (but not inside) the cued triangle were more than 10 msec longer than other targets, but only at the shorter cue-target delays. This indicates that the attentional system which regulates luminance increment detection cannot select the cued triangle. It appears that the attentional spotlight can be briefly deformed into a triangular shape, and that it is the rapid, fast-decaying and reflexive exogenous system, rather than the slower acting, persistent and voluntary endogenous system, that mediates this effect. A third experiment using a central, symbolic cue showed no significant cue-validity effects, indicating no contribution from the endogenous system. It is concluded that tasks requiring only stimulus detection cannot unequivocally discriminate between spatial and object-based components of attention.

Eye movements were recorded during the inspection of dot patterns in control subjects and in patients with acquired unilateral brain damage involving posterior parietal or frontal cortical regions. Normal subjects adapted their oculomotor scanning pattern effectively to the stimulus configuration. Patients' oculomotor scanning patterns were characterized by a rather rigid sequence of fixations and saccades, with no evidence for a systematic and flexible spatio-temporal organization. In a stimulus condition where dots were grouped, patients with frontal damage accurately shifted their gaze between the dot groups, but had difficulties with dot sampling. These observations suggest that the posterior parietal damage mainly affected the visuo-spatial guidance of the scanpath, whereas the frontal damage impaired its planning. It is concluded that both, posterior parietal and frontal brain structures, and their reciprocal connections, are part of a distributed neural network subserving visually-guided oculomotor scanning, and that the spatio-temporal organization of the scanpath depends critically on both structures and their close co-operation.

Learning and forgetting a prose passage was studied in 20 patients with Parkinson's disease and in 20 normal control subjects by means of stochastic models, with the aim of identifying the learning and retaining abilities that are affected by Parkinson's disease. Results suggested that Parkinson's disease patients are impaired in developing automatic processing both during learning and retaining, while functions that require active attention are spared. The automatic/intentional dissociation, which is the hallmark of motor disturbance in Parkinson's disease, extends to memory abilities, and, on the grounds of neuroanatomical, neurochemical and neurophysiological correlates, suggests that the memory deficit in Parkinson's disease may be contingent on a dysfunction of the medial prefrontal-cingulate cortex.

Although planning is important for the functioning of patients with dementia of the Alzheimer Type (DAT), little is known about response programming in DAT. This study used a cueing paradigm coupled with quantitative kinematic analysis to document the preparation and execution of movements made by a group of 12 DAT patients and their age and sex matched controls. Participants connected a series of targets placed upon a WACOM SD420 graphics tablet, in response to the pattern of illumination of a set of light emitting diodes (LEDs). In one condition, participants could programme the upcoming movement, whilst in another they were forced to reprogramme this movement on-line (i.e. they were not provided with advance information about the location of the upcoming target). DAT patients were found to have programming deficits, taking longer to initiate movements, particularly in the absence of cues. While problems spontaneously programming a movement might cause a greater reliance upon on-line guidance, when both groups were required to guide the movement on-line, DAT patients continued to show slower and less efficient movements implying declining sensori-motor function; these differences were not simply due to strategy or medication status.