The Montreal Imaging Stress Task: using functional imaging to investigate the effects of perceiving and processing psychosocial stress in the human brain.

OBJECTIVE We developed a protocol for inducing moderate psychologic stress in a functional imaging setting and evaluated the effects of stress on physiology and brain activation. METHODS The Montreal Imaging Stress Task (MIST), derived from the Trier Mental Challenge Test, consists of a series of computerized mental arithmetic challenges, along with social evaluative threat components that are built into the program or presented by the investigator. To allow the effects of stress and mental arithmetic to be investigated separately, the MIST has 3 test conditions (rest, control and experimental), which can be presented in either a block or an event-related design, for use with functional magnetic resonance imaging (fMRI) or positron emission tomography (PET). In the rest condition, subjects look at a static computer screen on which no tasks are shown. In the control condition, a series of mental arithmetic tasks are displayed on the computer screen, and subjects submit their answers by means of a response interface. In the experimental condition, the difficulty and time limit of the tasks are manipulated to be just beyond the individual's mental capacity. In addition, in this condition the presentation of the mental arithmetic tasks is supplemented by a display of information on individual and average performance, as well as expected performance. Upon completion of each task, the program presents a performance evaluation to further increase the social evaluative threat of the situation. RESULTS In 2 independent studies using PET and a third independent study using fMRI, with a total of 42 subjects, levels of salivary free cortisol for the whole group were significantly increased under the experimental condition, relative to the control and rest conditions. Performing mental arithmetic was linked to activation of motor and visual association cortices, as well as brain structures involved in the performance of these tasks (e.g., the angular gyrus). CONCLUSIONS We propose the MIST as a tool for investigating the effects of perceiving and processing psychosocial stress in functional imaging studies.