This study provides prospective validation that functional connectivity between an individual's rTMS cortical target and the subgenual cingulate predicts antidepressant response. Implications for improving the cortical rTMS target for depression are discussed.

Acquiring a new skill requires learning multiple aspects of a task simultaneously. For example, learning a piano sonata requires learning the musical notes and being able to implement this goal by learning the appropriate sequence of finger movements. After practice, skill continues to develop off-line during a period of consolidation. Here we show that different aspects of a procedural memory are processed separately during consolidation: Only the movement sequence is enhanced over the day; whereas only the goal is enhanced over a night of sleep. This double dissociation suggests that distinct systems, enhancing different aspects of a procedural memory, support improvements during consolidation. Consolidation is not a single process; instead, there are multiple routes to off-line learning, and the engagement of these distinct mechanisms is determined by when consolidation takes place. movement control ͉ procedural learning ͉ consolidation ͉ sleep C lassically, a distinction has been made between how a movement is performed and the spatial target or goal of the movement (1). For example, a pianist makes a series of finger movements to fulfill the goal of playing notes in a sonata. Enhanced knowledge of either the finger movements or the goal of these movements can produce an increase in skill (2-4). During practice, distinct mechanisms may be engaged to support the simultaneous acquisition of both components (5-7). Skill can also develop off-line, between practice sessions, during consolidation (8, 9). Skill enhancement during consolidation, like practice, may involve the simultaneous enhancement of both the goal and the movement. Alternatively, the principles operating during consolidation may differ from those during practice: Skill components may be enhanced separately. This result would imply that the mechanisms engaged simultaneously during practice are engaged separately during consolidation.It is possible to distinguish between the goal and the movement components of skill in a procedural sequence learning task (2). In the present experiment, participants acquired skill in the serial reaction time task (SRTT). In this task, a visual cue can appear at any one of four positions arranged horizontally on a computer screen (10). Each screen position corresponds to a button on a response box. A trial begins when a cue appears. The participant presses the appropriate response button, ending the trial, and after a short fixed delay, another cue is presented. Unbeknownst to the participant, the visual cues follow a specific spatial pattern that is learned as both a sequence of finger movements and as a sequence of response buttons to push, or goals (2-4). After training with one hand, these two skill components can be distinguished by probing skill with the untrained hand (Fig. 1). By switching hands, the same finger is no longer associated with the same response. So, although the same sequence of response buttons is required, this goal is achieved by using a different set of finger movements. Thus the goal remain...

Perception of facial configuration is impaired in patients with prosopagnosia whose lesions involve the right fusiform gyrus. This deficit is especially manifest when attention must be distributed across numerous facial elements. It does not occur with more anterior bilateral temporal lesions. Loss of this ability may contribute to the recognition defect in some forms of prosopagnosia.

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Behind every skilled movement lies months of practice. However, practice alone is not responsible for the acquisition of all skill; performance can improve between, not just within, practice sessions. An important principle shaping these offline improvements may be an individual's awareness of learning a new skill. New skills, such as a sequence of finger movements, can be learned unintentionally (with little awareness for the sequence, implicit learning) or intentionally (explicit learning). We measured skill in an implicit and explicit sequence-learning task before and after a 12 hr interval. This interval either did (8 p.m. to 8 a.m.) or did not (8 a.m. to 8 p.m.) include a period of sleep. Following explicit sequence learning, offline skill improvements were only observed when the 12 hr interval included sleep. This overnight improvement was correlated with the amount of NREM sleep. The same improvement could also be observed in the evening (with an interval from 8 p.m. to 8 p.m.), so it was not coupled to retesting at a particular time of day and cannot therefore be attributed to circadian factors. In contrast, in the implicit learning task, offline learning was observed regardless of whether the 12 hr interval did or did not contain a period of sleep. However, these improvements were not observed with only a 15 min interval between sessions. Therefore, the practice available within each session cannot account for these skill improvements. Instead, sufficient time is necessary for offline learning to occur. These results show a behavioral dissociation, based upon an individual's awareness for having learned a sequence of finger movements. Offline learning is sleep dependent for explicit skills but time dependent for implicit skills.

We are all familiar with acquiring skills during practice, but skill can also continue to develop between practice sessions. These "off-line" improvements are frequently supported by sleep, but they can be time dependent when a skill is acquired unintentionally. The magnitude of these over-day and overnight improvements is similar, suggesting that a similar mechanism may support both types of off-line improvements. However, here we show that disruption of the primary motor cortex with repetitive transcranial magnetic stimulation blocks off-line improvements over the day but not overnight. This suggests that a memory may be rescued overnight and subsequently enhanced or that different aspects of a skill, with differential dependencies on the primary motor cortex, are enhanced over day and overnight. Off-line improvements of similar magnitude are not supported by similar mechanisms; instead, the mechanisms engaged may depend on brain state.

This study provides Class I evidence that paroxetine and venlafaxine XR are effective in treating depression in patients with PD.

Those with high baseline stress levels are more likely to develop mild cognitive impairment (MCI) and Alzheimer's Disease (AD). While meditation may reduce stress and alter the hippocampus and default mode network (DMN), little is known about its impact in these populations. Our objective was to conduct a “proof of concept” trial to determine whether Mindfulness Based Stress Reduction (MBSR) would improve DMN connectivity and reduce hippocampal atrophy among adults with MCI. 14 adults with MCI were randomized to MBSR vs. usual care and underwent resting state fMRI at baseline and follow-up. Seed based functional connectivity was applied using posterior cingulate cortex as seed. Brain morphometry analyses were performed using FreeSurfer. The results showed that after the intervention, MBSR participants had increased functional connectivity between the posterior cingulate cortex and bilateral medial prefrontal cortex and left hippocampus compared to controls. In addition, MBSR participants had trends of less bilateral hippocampal volume atrophy than control participants. These preliminary results indicate that in adults with MCI, MBSR may have a positive impact on the regions of the brain most related to MCI and AD. Further research with larger sample sizes and longer-follow-up are needed to further investigate the results from this pilot study.