Questionnaire | page 1

Registration as a study participant

at the MPI for Human Cognitive and Brain Sciences Leipzig

Surname *

First name *

Birthday * Format (DD.MM.YYYY)

Email *

Gender *

female

male

diverse

Handedness *

right

left

ambidextrous

reeducated

Native language *

I would like to participate in studies*

at the institute (Leipzig) and online

only at the institute (Leipzig)

online only

Street / House number *

Place *

Zip code *

Phone number *

We conduct various studies with the following research content / research methods. Are you interested in specific areas? Then please select one or more fields and answer a few more questions. If you do not want to make a selection, you can simply go on to the next question.

Life and Health Research

Height *

Weight *

Language and Music Research

If you play a musical instrument(s), which do you play or have you played?
Wind instruments Wind instruments Recorder Wind instruments Trumpet Wind instruments Transverse flute Wind instruments Bassoon Wind instruments Horn Wind instruments Trumpet Wind instruments Trombone Wind instruments Clarinet Wind instruments Harmonica Wind instruments Oboe Wind instruments Saxophone Wind instruments Shawm	Stringed instruments Stringed instruments Banjo Stringed instruments Bass Stringed instruments Viola Stringed instruments Cello Stringed instruments Guitar Stringed instruments Harp Stringed instruments Violin Stringed instruments Double bass Stringed instruments Ukulele	Percussion instruments Percussion instruments Cymbals Percussion instruments Drum Percussion instruments Triangle Percussion instruments Timpani Percussion instruments Percussion Percussion instruments Gong	Keyboard instruments Keyboard instruments Accordion Keyboard instruments Harpsichord Keyboard instruments Piano Keyboard instruments Grand piano Keyboard instruments Organ Keyboard instruments Keyboard

Have you learned a second language before the age of 6?

Do you have dyslexia?

not specified

yes

Cognitive Research (e.g. memory, spatial perception and navigation, visual and auditory perception)

Electrophysiological procedures: EEG, MEG Electroencephalography (EEG) is used to measure the electrical voltage fluctuations that occur during brain activity. This is done via measuring surface electrodes on the head, which are provided with contact gel and mounted in a cap. Magnetoencephalography (MEG) measures magnetic fields above the surface of the head that are generated by the synchronous activity of neurons in the brain. These very weak magnetic fields are registered with special magnetic field sensors, which are arranged helmet-like in the MEG device. EEG and MEG are non-invasive and harmless examination methods that have been used in clinical and/or scientific everyday life for decades. There are no special restrictions for participation in EEG or MEG studies.

Imaging methods (f)MRI MRI uses strong magnetic fields to provide high-resolution images of the anatomical structure of the brain as well as detailed pictures of the brain functioning. MRI is a non-invasive imaging procedure that has been used in medical diagnostics for more than 30 years. The examination is painless and harmless. Due to the strong magnetic field and the relative confinement in the MRI machine, a certain group of people cannot be examined with the MRI, e.g. if: - there is metal that cannot be removed from the body (e.g. bone screws, joint prostheses, retainers, or braces) - tattoos on the neck or genital area, or tattoos larger than 20 cm in diameter are present. - claustrophobia is present If you are interested in MRI examinations, possible contraindications will be clarified in advance.

Stimulation methods (tMS, tDCS/tACS) Transcranial magnetic stimulation (TMS) is a method that uses strong magnetic fields to stimulate or inhibit areas of the brain in order to simultaneously observe changes in perception and behavior. The stimulation is done by means of a magnetic coil through the intact skull. TMS has been used for more than 30 years in both research and routine clinical diagnostics. According to the current state of science, there are no known harmful short- or long-term side effects with tMS. tDCS is a procedure with which brain activity in areas of the human brain can be influenced by means of electrical stimulation. tDCS uses a low, subthreshold direct electrical current that is hardly noticeable to the test persons. The stimulation takes place through the skull. tDCS is a well-tolerated, non-invasive, and painless procedure with very few side effects. Due to the intrinsic stimulation by strong magnetic fields or electrical stimulation, a certain group of people cannot participate in tMS examinations, e.g. if: - metal or electronic devices are present in the body (e.g. intracranial metal parts, implanted heart or brain pacemakers) - you have a seizure disorder (epilepsy) - regular headaches or migraines are present If you are interested in TMS and/or tDCS examinations, possible contraindications will be clarified in advance.

Psycho-physiological procedures (e.g. ECG, SCR, blood tests) Electrocardiography (ECG) is used to record the activity of the heart. For this purpose, some electrodes are stuck on the body (e.g. back or chest). Skin conductance (SCR) and pulse are used, for example, to examine the processing intensity of tasks or stimuli. For this purpose, two electrodes are attached to e.g. two different fingers (SCR) or an infrared finger clip (pulse). All methods are harmless and a standard procedure that has been used in clinical and/or scientific life for decades. There are no special restrictions for participation in studies using ECG, SCR or pulse.

Pain Studies In pain studies, individually adapted non-painful and painful stimuli are administered to your skin, such as heat stimuli or pressure stimuli. These stimuli are always below your pain tolerance. All methods are harmless and a standard procedure that has been used in clinical and/or scientific life for decades.

Comment

Information on data storage and study participation

We assure you that your data will be treated confidentially, stored exclusively within the Max Planck Institute for Human Cognitive and Brain Sciences (MPI-CBS), and not passed on to third parties. Only a clearly defined group of MPI-CBS staff members responsible for recruiting study participants will have access to the data. The data is used exclusively for the purpose of inviting you to participate in scientific studies. You have the option, at any time, to have your data in the database permanently deleted. To do so, please write an e-mail with the subject "Delete" to the address: db_management@cbs.mpg.de

* I have read and agree to the information on data storage and study participation. You may contact me to participate in a study.

yes

* I have read and agree to the detailed information on data protection.

yes