Dissociating Two Stages of Preparation in the Stop Signal Task Using fMRI

Often we must balance being prepared to act quickly with being prepared to suddenly stop. The stop signal task (SST) is widely used to study inhibitory control, and provides a measure of the speed of the stop process that is robust to changes in subjects’ response strategy. Previous studies have shown that preparation affects inhibition. We used fMRI to separate activity that occurs after a brief (500 ms) warning stimulus (warning-phase) from activity that occurs during responses that follow (response-phase). Both of these phases could contribute to the preparedness to stop because they both precede stop signals. Warning stimuli activated posterior networks that signal the need for top-down control, whereas response phases engaged prefrontal and subcortical networks that implement top-down control. Regression analyses revealed that both of these phases affect inhibitory control in different ways. Warning-phase activity in the cerebellum and posterior cingulate predicted stop latency and accuracy, respectively. By contrast, response-phase activity in fronto-temporal areas and left striatum predicted go speed and stop accuracy, in pre-supplementary motor area affected stop accuracy, and in right striatum predicted stop latency and accuracy. The ability to separate hidden contributions to inhibitory control during warning-phases from those during response-phases can aid in the study of models of preparation and inhibitory control, and of disorders marked by poor top-down control.     

Toxic shock syndrome in a patient with systemic lupus erythematosus.

A case is presented of toxic shock syndrome in a patient with systemic lupus erythematosus. Toxic shock syndrome is rarely reported in patients who are immunosuppressed, perhaps because such patients are often treated vigorously with antibiotics at the earliest sign of infection. The association in this case may have been coincidental.