Changes In Target Location Research Articles

Recent developments in the field of radiotherapy for the management of lung cancer.

Lung cancer has a poor prognosis, and further improvements in outcomes are needed. Radiotherapy plays an important role in the treatment of unresectable lung cancer, and there have been recent developments in the field of radiotherapy for the management of lung cancer. However, to date, there have been few reviews on the improvement in treatment outcomes associated with high precision radiotherapy for lung cancer. Thus, this review aimed to summarize the recent developments in radiotherapy techniques and indicate the future directions in the use of radiotherapy for lung cancer. Stereotactic body radiotherapy (SBRT) for unresectable stage I lung cancer has been reported to improve local control rates without severe adverse events, such as radiation pneumonitis. For locally advanced lung cancer, a combination of chemoradiotherapy and adjuvant immune checkpoint inhibitors dramatically improves treatment outcomes, and intensity-modulated radiotherapy (IMRT) enables safer radiation therapy with less frequent pneumonitis. Particle beam therapy, such as carbon-ion radiotherapy and proton beam therapy, has been administered as advanced medical care for patients with lung cancer. Since 2024, it has been covered under insurance for early stage lung cancer with tumors ≤ 5cm in size in Japan. In addition to chemotherapy, local ablative radiotherapy improves treatment outcomes in patients with oligometastatic stage IV lung cancer. A particular problem with radiotherapy for lung cancer is that the target location changes with respiratory motion, and various physical methods have been used to control respiratory motion. Recently, coronavirus disease has had a major impact on lung cancer treatment, and cancer treatment during situations, such as the coronavirus pandemic, must be performed carefully. To improve treatment outcomes for lung cancer, it is necessary to fully utilize evolving radiotherapy modalities, and the role of radiotherapy in lung cancer treatment is expected to increase.

Superior performance by two new methods in identifying the online reaction time of reaching movements.

Reaching movements can be redirected during their progress to handle unexpected visual changes, such as a change in target location. It is important to know when these redirections start, i.e., the online reaction time (oRT), but this information is not readily evident since redirections are embedded within a time-varying baseline movement that differs from trial to trial. The one previous study that evaluated the performance of different oRT identification methods utilized simulated redirections with the exact same onset, rather than a range of onsets as would be typically encountered. We addressed this gap by utilizing batches of "hybrid" trials with temporal spread in their oRTs. Each hybrid trial combined a sampled baseline movement with an idealized corrective response. Two new methods had the most accurate identification of online reaction times: 1) a threshold-aligned grand mean regression, and 2) a template-based approach we term the canonical correction search. The threshold-aligned grand mean regression is simple to implement and effective. The canonical correction search is a more complex procedure but arguably better linked to the underlying response. Applying the two methods to a published dataset revealed more delayed oRTs than was previously reported along with new information such as the width of oRT distributions. Taken together, our results demonstrate the utility of two new methods for dissecting corrective action from ongoing movement.NEW & NOTEWORTHY Advancing our understanding of visual feedback control requires methods that accurately identify the onset of corrective action. We developed a modified regression approach and a template-based approach to identify the online reaction time of single-reaching movements. Both outperform previous methods when challenged by temporal jitter in the response onset and increased background noise.

Same, but different: Binding effects in auditory, but not visual detection performance

Responding to a stimulus leads to the integration of response and stimulus’ features into an event file. Upon repetition of any of its features, the previous event file is retrieved, thereby affecting ongoing performance. Such integration-retrieval explanations exist for a number of sequential tasks (that measure these processes as ’binding effects’) and are thought to underlie all actions. However, based on attentional orienting literature, Schöpper, Hilchey, et al. (2020) could show that binding effects are absent when participants detect visual targets in a sequence: In visual detection performance, there is simply a benefit for target location changes (inhibition of return). In contrast, Mondor and Leboe (2008) had participants detect auditory targets in a sequence, and found a benefit for frequency repetition – presumably reflecting a binding effect in auditory detection performance. In the current study, we conducted two experiments, that only differed in the modality of the target: Participants signaled the detection of a sound (N = 40) or of a visual target (N = 40). Whereas visual detection performance showed a pattern incongruent with binding assumptions, auditory detection performance revealed a non-spatial feature repetition benefit, suggesting that frequency was bound to the response. Cumulative reaction time distributions indicated that the absence of a binding effect in visual detection performance was not caused by overall faster responding. The current results show a clear limitation to binding accounts in action control: Binding effects are not only limited by task demands, but can entirely depend on target modality.

Stimulus-driven updating of long-term context memories in visual search

Visual search for a target is faster when the spatial layout of nontarget items is repeatedly encountered, illustrating that learned contextual invariances can improve attentional selection (contextual cueing). This type of contextual learning is usually relatively efficient, but relocating the target to an unexpected location (within otherwise unchanged layouts) typically abolishes contextual cueing. Here, we explored whether bottom-up attentional guidance can mediate the efficient contextual adaptation after the change. Two experiments presented an initial learning phase, followed by a subsequent relocation phase that introduced target location changes. This location change was accompanied by transient attention-guiding signals that either up-modulated the changed target location (Experiment 1), or which provided an inhibitory tag to down-modulate the initial target location (Experiment 2). The results from these two experiments showed reliable contextual cueing both before and after the target location change. By contrast, an additional control experiment (Experiment 3) that did not present any attention-guiding signals together with the changed target showed no reliable cueing in the relocation phase, thus replicating previous findings. This pattern of results suggests that attentional guidance (by transient stimulus-driven facilitatory and inhibitory signals) enhances the flexibility of long-term contextual learning.

Distributed attention beats the down-side of statistical context learning in visual search.

Spatial attention can be deployed with a narrower focus to process individual items or distributed relatively broadly to process larger parts of a scene. This study investigated how focused- versus distributed-attention modes contribute to the adaptation of context-based memories that guide visual search. In two experiments, participants were either required to fixate the screen center and use peripheral vision for search (“distributed attention”), or they could freely move their eyes, enabling serial scanning of the search array (“focused attention”). Both experiments consisted of an initial learning phase and a subsequent test phase. During learning, participants searched for targets presented either among repeated (invariant) or nonrepeated (randomly generated) spatial layouts of distractor items. Prior research showed that repeated encounters of invariant display arrangements lead to long-term context memory about these arrays, which can then come to guide search (contextual-cueing effect). The crucial manipulation in the test phase was a change of the target location within an otherwise constant distractor layout, which has previously been shown to abolish the cueing effect. The current results replicated these findings, although importantly only when attention was focused. By contrast, with distributed attention, the cueing effect recovered rapidly and attained a level comparable to the initial effect (before the target location change). This indicates that contextual cueing can adapt more easily when attention is distributed, likely because a broad attentional set facilitates the flexible updating of global (distractor-distractor), as compared to more local (distractor-target), context representations—allowing local changes to be incorporated more readily.

Fast responses to stepping-target displacements when walking.

Key points Goal‐directed arm movements can be adjusted at short latency to target shifts.We tested whether similar adjustments are present during walking on a treadmill with shifting stepping targets.Participants responded at short latency with an adequate gain to small shifts of the stepping targets.Movements of the feet during walking are controlled in a similar way to goal‐directed arm movements if balance is not violated. It is well‐known that goal‐directed hand movements can be adjusted to small changes in target location with a latency of about 100 ms. We tested whether people make similar fast adjustments when a target location for foot placement changes slightly as they walk over a flat surface. Participants walked at 3 km/h on a treadmill on which stepping stones were projected. The stones were 50 cm apart in the walking direction. Every 5–8 steps, a stepping stone was unexpectedly displaced by 2.5 cm in the medio‐lateral direction. The displacement took place during the first half of the swing phase. We found fast adjustments of the foot trajectory, with a latency of about 155 ms, initiated by changes in muscle activation 123 ms after the perturbation. The responses corrected for about 80% of the perturbation. We conclude that goal‐directed movements of the foot are controlled in a similar way to those of the hand, thus also giving very fast adjustments.

Development of the Continuous Number Identification Test (CNIT): feasibility of dynamic assessment of speech intelligibility

Objective: The present study was motivated by a need for a speech intelligibility test capable of indexing dynamic changes in the environment and adaptive processing in hearing aids. The Continuous Number Identification Test (CNIT) was developed to meet these aims.Design: From one location in the free field, speech was presented in noise (∼2 words/s) with a 100-ms inter-word interval. On average, every fourth word was a target digit and all other words were monosyllabic words. Non-numeric words had a fixed presentation level such that the dominant signal-to-noise-ratio (SNR) was held at +6 dB SNR relative to background maskers. To prevent ceiling effects, however, targets were presented at a user-specific SNR, determined by an initial adaptive-tracking procedure that estimated the 79.4% speech reception threshold.Study sample: Ten normal-hearing listeners participated.Results: The CNIT showed comparable psychometric qualities of other established speech tests for long time scales (Exp. 1). Target-location changes did not affect performance on the CNIT (Exp. 2), but the test did show high temporal resolution in assessing sudden changes to SNR (Exp. 3).Conclusions: The CNIT is highly customisable, and the initial experiments tested feasibility of its primary features which set it apart from currently available speech-in-noise tests.

The effect of age and perturbation time on online control during rapid pointing.

Visual and proprioceptive information is used differently at different phases of a reach. The time at which a target perturbation occurs during a reach therefore has a significant impact on how an individual can compensate for this perturbation though online control. With healthy ageing, there are notable changes to both sensory and motor control that impact motor performance. However, how the online control process changes with age is not yet fully understood. We used a target perturbation paradigm and manipulated the time at which a target perturbation occurred during the reach to investigate how healthy ageing impacts sensorimotor control. We measured how the latency of the correction and the magnitude of the corrective response changed with perturbation time and quantified the difference across groups using a percentage difference measure. For both groups, online corrections to early perturbations were more easily accounted for than those to late perturbations, despite late perturbations eliciting faster correction latencies. While there was no group difference in accuracy, older participants were slower overall and produced a correction to a change in target location proportionally less often despite similar correction latencies. We speculate that the differences in the time during the reach that the correction is first identified may explain the differences in correction latencies observed between the perturbation time conditions.

Rapid online corrections for upper limb reaches to perturbed somatosensory targets: evidence for non-visual sensorimotor transformation processes.

When performing upper limb reaches, the sensorimotor system can adjust to changes in target location even if the reaching limb is not visible. To accomplish this task, sensory informationabout the new target location and the current position of the unseen limb are used to program online corrections. Previous researchers have argued that, prior to the initiation of corrections, somatosensory information from the unseen limb must be transformed into a visual reference frame. However, most of these previous studies involved movements to visual targets. The purpose of the present study was to determine if visual sensorimotor transformations are also necessary for the online control of movements to somatosensory targets. Participants performed reaches towards somatosensory and visual targets without vision of their reaching limb. Target positions were either stationary, or perturbed before (~ 450ms), or after movement onset (~ 100ms or ~ 200ms). In response to target perturbations after movement onset, participants exhibited shorter correction latencies, larger correction magnitudes, and smaller movement endpoint errors when they reached to somatosensory targets as compared to visual targets. Because reference frame transformations have been shown to increase both processing time and errors, these results indicate that hand position was not transformed into visual reference frame during online corrections for movements to somatosensory targets. These findings support the idea that different sensorimotor transformations are used for the online control of movements to somatosensory and visual targets.

Taking Attention Out of Context: Frontopolar Transcranial Magnetic Stimulation Abolishes the Formation of New Context Memories in Visual Search.

This study investigates the causal contribution of the left frontopolar cortex (FPC) to the processing of violated expectations from learned target-distractor spatial contingencies during visual search. The experiment consisted of two phases: learning and test. Participants searched for targets presented either among repeated or nonrepeated target-distractor configurations. Prior research showed that repeated encounters of identically arranged displays lead to memory about these arrays, which then can come to guide search (contextual cueing effect). The crucial manipulation was a change of the target location, in a nevertheless constant distractor layout, at the transition from learning to test. In addition to this change, we applied repetitive transcranial magnetic stimulation (rTMS) over the left lateral FPC, over a posterior control site, or no rTMS at all (baseline; between-group manipulation) to see how FPC rTMS influences the ability of observers to adapt context-based memories acquired in the training phase. The learning phase showed expedited search in repeated relative to nonrepeated displays, with this context-based facilitation being comparable across all experimental groups. For the test phase, the recovery of cueing was critically dependent on the stimulation site: Although there was evidence of context adaptation toward the end of the experiment in the occipital and no-rTMS conditions, observers with FPC rTMS showed no evidence of relearning at all after target location changes. This finding shows that FPC plays an important role in the regulation of prediction errors in statistical context learning, thus contributing to an update of the spatial target-distractor contingencies after target position changes in learned spatial arrays.

FMEA of MR-Only Treatment Planning in the Pelvis

PurposeTo evaluate the implementation of a magnetic resonance (MR)-only workflow (ie, implementing MR simulation as the primary planning modality) using failure mode and effects analysis (FMEA) in comparison with a conventional multimodality (MR simulation in conjunction with computed tomography simulation) workflow for pelvis external beam planning. Methods and MaterialsTo perform the FMEA, a multidisciplinary 9-member team was assembled and developed process maps, identified potential failure modes (FMs), and assigned numerical values to the severity (S), frequency of occurrence (O), and detectability (D) of those FMs. Risk priority numbers (RPNs) were calculated via the product of S, O, and D as a metric for evaluating relative patient risk. An alternative 3-digit composite number (SOD) was computed to emphasize high-severity FMs. Fault tree analysis identified the causality chain leading to the highest-severity FM. ResultsSeven processes were identified, 3 of which were shared between workflows. Image fusion and target delineation subprocesses using the conventional workflow added 9 and 10 FMs, respectively, with 6 RPNs >100. By contrast, synthetic computed tomography generation introduced 3 major subprocesses and propagated 46 unique FMs, 15 with RPNs >100. For the conventional workflow, the largest RPN scores were introduced by image fusion (RPN range, 120-192). For the MR-only workflow, the highest RPN scores were from inaccuracies in target delineation resulting from misinterpretation of MR images (RPN = 240) and insufficient management of patient- and system-level distortions (RPN = 210 and 168, respectively). Underestimation (RPN = 140) or overestimation (RPN = 192) of bone volume produced higher RPN scores. The highest SODs for both workflows were related to changes in target location because of internal anatomy changes (conventional = 961, MR-only = 822). ConclusionsFMEA identified areas for mitigating risk in MR-only pelvis RTP, and SODs identified high-severity process modes. Efforts to develop a quality management program to mitigate high FMs are underway.

Online adjustments of leg movements in healthy young and old.

Online movement adjustments are crucial for daily life. This is especially true for leg movements in relation to gait, where failed adjustments can lead to falls, especially in elderly. However, most research has focused on reach adjustments following changes in target location. This arm research reports two categories of online adjustments (see Gaveau et al., Neuropsychologia 55:25-40, 2014 for review). Small, frequently undetected, target location shifts invoke fast, automatic adjustments, usually without awareness. In contrast, large target location shifts can lead to slow, voluntary adjustments. These fast and slow adjustments presumably rely on different neural networks, with a possible role for subcortical pathways for the fast responses. Do leg movement adjustments also fall into these two categories? We review the literature on leg movement adjustments and show that it is indeed possible to discern fast and slow adjustments. More specifically, we provide an overview of studies showing adjustments during step preparation, initiation, unobstructed, and obstructed gait. Fast adjustments were found both during stepping and gait. In the extreme case, even step adjustments appear to be further modifiable online, e.g., when avoiding obstacles during tripping. In older adults, movement adjustments are generally slower and of smaller magnitude, consistent with a greater risk of falling. However, fast responses seem less affected by aging, consistent with the idea of independent parallel mechanisms controlling movement adjustments (Gomi, Curr Opin Neurobiol 18:558-567, 2008). Finally, putative neural pathways are discussed.

Task-Irrelevant Expectation Violations in Sequential Manual Actions: Evidence for a "Check-after-Surprise" Mode of Visual Attention and Eye-Hand Decoupling.

When performing sequential manual actions (e.g., cooking), visual information is prioritized according to the task determining where and when to attend, look, and act. In well-practiced sequential actions, long-term memory (LTM)-based expectations specify which action targets might be found where and when. We have previously demonstrated (Foerster and Schneider, 2015b) that violations of such expectations that are task-relevant (e.g., target location change) cause a regression from a memory-based mode of attentional selection to visual search. How might task-irrelevant expectation violations in such well-practiced sequential manual actions modify attentional selection? This question was investigated by a computerized version of the number-connection test. Participants clicked on nine spatially distributed numbered target circles in ascending order while eye movements were recorded as proxy for covert attention. Target’s visual features and locations stayed constant for 65 prechange-trials, allowing practicing the manual action sequence. Consecutively, a task-irrelevant expectation violation occurred and stayed for 20 change-trials. Specifically, action target number 4 appeared in a different font. In 15 reversion-trials, number 4 returned to the original font. During the first task-irrelevant change trial, manual clicking was slower and eye scanpaths were larger and contained more fixations. The additional fixations were mainly checking fixations on the changed target while acting on later targets. Whereas the eyes repeatedly revisited the task-irrelevant change, cursor-paths remained completely unaffected. Effects lasted for 2–3 change trials and did not reappear during reversion. In conclusion, an unexpected task-irrelevant change on a task-defining feature of a well-practiced manual sequence leads to eye-hand decoupling and a “check-after-surprise” mode of attentional selection.

Modulation of Neural Variability in Premotor, Motor, and Posterior Parietal Cortex during Change of Motor Intention.

No single study has been performed on neural variability during update of motor intention across monkey premotor, motor, and posterior parietal cortex. In perturbed reaches, target location changed unexpectedly during reaction time and the correction of hand trajectory required updating the original motor plan. Comparing unperturbed versus perturbed reaches revealed that neural variability displayed a complex context- and area-dependent pattern of modulation because, before trajectory correction, similar initial hand movements were associated with different patterns of variability depending on the instruction signal, and therefore on the future hand path and final destination. Furthermore, neural variability predicted both slow and fast hand movement corrections, also offering a neural underpinning to the phenomenon that it takes less time to correct than to initiate hand movement.

A Rapid Tactile-Motor Reflex Automatically Guides Reaching toward Handheld Objects

The ability to respond quickly and effectively when objects in the world suddenly change position is essential for skilled action, and previous work has documented how unexpected changes in the location of a visually presented target during reaching can elicit rapid reflexive (i.e., automatic) corrections of the hand's trajectory [1-12]. In object manipulation and tool use, the sense of touch can also provide information about changes in the location of reach targets. Consider the many tasks where we reach with one hand to part of an object grasped by the other hand: reaching to a berry while holding a branch, reaching for a cap while grasping a bottle, and reaching toward a dog's collar while holding the dog's leash. In such cases, changes in the position of the reach target, due to wind, slip, or an active agent, can be detected, in principle, through touch. Here, we show that when people reach with their right hand to a target attached to the far end of a rod contacted, at the near end, by their left hand, an unexpected change in target location caused by rod rotation rapidly evokes an effective reach correction. That is, spatial information about a change in target location provided by tactile inputs to one hand elicits a rapid correction of the other hand's trajectory. Inaddition to uncovering a tactile-motor reflex thatcan support manipulatory actions, our results demonstrate that automatic reach corrections to moving targets are not unique to visually registered changes in target location.

The attentive homunculus: ERP evidence for somatotopic allocation of attention in tactile search

Our brain constantly receives tactile information from the body’s surface. We often only become aware of this information when directing our attention towards the body. Here, we report a study investigating the behavioural and neural response when selecting a target amongst distractor vibrations presented simultaneously to several locations either across the hands or body. Comparable visual search studies have revealed the N2pc as the neural correlate of visual selective attention. Analogously, we describe an enhanced negativity contralateral to the tactile target side. This effect is strongest over somatosensory areas and lasts approximately 200ms from the onset of the somatosensory N140 ERP component. Based on these characteristics we named this electrophysiological signature of attentional tactile target selection during tactile search the N140-central-contralateral (N140cc). Furthermore, we present supporting evince that the N140cc reflects attentional enhancement of target rather than suppression of distractor locations; the component was not reliably altered by distractor but rather by target location changes. Taken together, our findings present a novel electrophysiological marker of tactile search and show how attentional selection of touch operates by mainly enhancing task relevant locations within the somatosensory homunculus.

On the time course of rapid and repeatable response induction

As reinforcers are delivered for a particular response, that response increases. Other similar responses also increase, with the extent to which this increase is seen being positively related to the similarity between the responses. This process, called induction, is pronounced during initial response acquisition, and dissipates as the target response is established. The present experiment examined this process in a paradigm wherein responses to one of five nose poke receptacles results in reinforcement for six sessions in each condition and the target location changes between conditions. Consistent patterns of induction were seen across conditions, with patterns of induction dissipating within each condition.

Error Detection is Critical for Visual-Motor Corrections.

The target article (Smeets, Oostwoud Wijdenes, & Brenner, 2016) proposes that short latency responses to changes in target location during reaching reflect an unconscious, continuous, and incremental minimization of the distance between the hand and the target, which does not require detection of the change in target location. We, instead, propose that short-latency visuomotor responses invoke reflex- or startle-like mechanisms, an idea supported by evidence that such responses are both automatic and resistant to cognitive influences. In addition, the target article fails to address the biological underpinnings for the range of response latencies reported across the literature, including the circuits that might underlie the proposed sensorimotor loops. When considering the range of latencies reported in the literature, we propose that mechanisms grounded in neurophysiology should be more informative than the simple information processing perspective adopted by the target article.

ERP correlates of auditory goal-directed behavior of younger and older adults in a dynamic speech perception task

The ability to understand speech under adverse listening conditions deteriorates with age. In addition to genuine hearing deficits, age-related declines in attentional and inhibitory control are assumed to contribute to these difficulties. Here, the impact of task-irrelevant distractors on speech perception was studied in 28 younger and 24 older participants in a simulated “cocktail party” scenario. In a two-alternative forced-choice word discrimination task, the participants responded to a rapid succession of short speech stimuli (“on” and “off”) that was presented at a frequent standard location or at a rare deviant location in silence or with a concurrent distractor speaker. Behavioral responses and event-related potentials (mismatch negativity MMN, P3a, and reorienting negativity RON) were analyzed to study the interplay of distraction, orientation, and refocusing in the presence of changes in target location. While shifts in target location decreased performance of both age groups, this effect was more pronounced in the older group. Especially in the distractor condition, the electrophysiological measures indicated a delayed attention capture and a delayed re-focussing of attention toward the task-relevant stimulus feature in the older group, relative to the young group. In sum, the results suggest that a delay in the attention switching mechanism contribute to the age-related difficulties in speech perception in dynamic listening situations with multiple speakers.

Visually-guided correction of hand reaching movements: The neurophysiological bases in the cerebral cortex

The ability of human and non-human primates to make fast corrections to hand movement trajectories after a sudden shift in the target’s location is a key feature of visuo-motor behavior. In healthy individuals, hand movements smoothly adapt to a change in target location without needing to complete the movement to the first target location, as typical of parietal patients. This finding indicates that the nervous system continuously monitors the visual scene and is able to integrate new information in order to produce an efficient motor response. In this paper, we review the kinematics, reaction times and muscle activity observed during the online correction of hand movements as well as the underlying neurophysiological processes studied through single-cell neural recordings in monkeys. Brain stimulation, lesion and imaging studies in humans are also discussed. We demonstrate that while online correction mechanisms strongly depend on the activity of a parieto-frontal network of which the posterior parietal cortex is a crucial node, these mechanisms proceed smoothly and are similar to what is observed during simple point-to-point movements. Online correction of hand movements would rely on feedforward and feedback mechanisms in the parietal cortex, as part of the activity within the fronto-parietal network for the planning and execution of visuo-motor tasks.