Kristian Sandberg

Transcranial magnetic stimulation is used to make inferences about relationships between brain areas and their functions because, in contrast to neuroimaging tools, it modulates neuronal activity. The central aim of this article is to critically evaluate to what extent it is possible to draw causal inferences from repetitive TMS data. To that end, we describe the logical limitations of inferences based on rTMS experiments. The presented analysis suggests that rTMS alone does not provide the sort of premises that are sufficient to warrant strong inferences about the direct causal properties of targeted brain structures. Overcoming these limitations demands a close look at the designs of rTMS studies, especially the methodological and theoretical conditions which are necessary for the functional decomposition of the relations between brain areas and cognitive functions. The main points of this article are that TMS-based inferences are limited in that stimulation-related causal effects are not equivalent to structure-related causal effects due to TMS side effects, the electric field distribution, and the sensitivity of neuroimaging and behavioral methods in detecting structure-related effects and disentangling them from confounds. Moreover, the postulated causal effects can be based on indirect effects. A few suggestions on how to manage some of these limitations are presented. We discuss the benefits of combining rTMS with neuroimaging in experimental reasoning and we address the restrictions and requirements of rTMS control conditions. The use of neuroimaging and control conditions allows stronger inferences to be gained, but the strength of the inferences that can be drawn depends on the individual experiment’s designs. Moreover, in some cases, TMS might not be an appropriate method of answering causality-related questions or the hypotheses have to account for the limitations of this technique. We hope this summary and formalization of the reasoning behind rTMS research can be of use not only for scientists and clinicians who intend to interpret rTMS results causally but also for philosophers interested in causal inferences based on brain stimulation research.

In their comment on Sandberg, Timmermans, Overgaard, and Cleeremans , Dienes and Seth argue that increased sensitivity of the Perceptual Awareness Scale is a consequence of the scale being less exclusive rather than more exhaustive. According to Dienes and Seth, this is because PAS may measure some conscious content, though not necessarily relevant conscious content, “If one saw a square but was only aware of seeing a flash of something, then one has not consciously seen a square.” In this reply, we claim that there is a difference between conscious visual experience, which may be partial, and the resulting conscious content, which is conceptual. Whereas PAS measures the first, confidence judgments and post-decision wagering measure the second

Comparison of behavioural measures of consciousness has attracted much attention recently. In a recent article, Szczepanowski et al. conclude that confidence ratings predict accuracy better than both the perceptual awareness scale and post-decision wagering when using stimuli with emotional content . Although we find the study interesting, we disagree with the conclusion that CR is superior to PAS because of two methodological issues. First, the conclusion is not based on a formal test. We performed this test and found no evidence that CR predicted accuracy better than PAS . Second, Szczepanowski et al. used the present version of PAS in a manner somewhat different from how it was originally intended, and the participants may not have been adequately instructed. We end our commentary with a set of recommendations for future studies using PAS

What is the best way of assessing the extent to which people are aware of a stimulus? Here, using a masked visual identification task, we compared three measures of subjective awareness: The Perceptual Awareness Scale , through which participants are asked to rate the clarity of their visual experience; confidence ratings , through which participants express their confidence in their identification decisions, and Post-decision wagering , in which participants place a monetary wager on their decisions. We conducted detailed explorations of the relationships between awareness and identification performance, looking to determine which scale best correlates with performance, and whether we can detect performance in the absence of awareness and how the scales differ from each other in terms of revealing such unconscious processing. Based on these findings we discuss whether perceptual awareness should be considered graded or dichotomous. Results showed that PAS showed a much stronger performance-awareness correlation than either CR or PDW, particularly for low stimulus intensities. In general, all scales indicated above-chance performance when participants claimed not to have seen anything. However, such above-chance performance only showed when we also observed a correlation between awareness and performance. Thus PAS seems to be the most exhaustive measure of awareness, and we find support for above-chance performance in the absence of subjective awareness, but such unconscious knowledge only contributes to performance when we observe conscious knowledge as well. Similarities and differences between scales are discussed in the light of consciousness theories and response strategies

When consciousness is examined using subjective ratings, the extent to which processing is conscious or unconscious is often estimated by calculating task performance at the subjective threshold or by calculating the correlation between accuracy and awareness. However, both these methods have certain limitations. In the present article, we propose describing task accuracy and awareness as functions of stimulus intensity as suggested by Koch and Preuschoff . The estimated lag between the curves describes how much stimulus intensity must increase for awareness to change proportionally as much as accuracy and the slopes of the curves are used to assess how fast accuracy and awareness increases and whether awareness is dichotomous. The method is successfully employed to assess consciousness characteristics on data from four different awareness scales