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Prado-Robles E, Delgado-Gil JÁ, Navarro-Prada SR, Rodríguez-Martín B, Gómez-Martínez M, Seco-Calvo J. The effects of motor imagery on trapeziometacarpal osteoarthritis in women during the post-surgical immobilisation period: A protocol for a randomised clinical trial. Br J Occup Ther 2022. [DOI: 10.1177/03080226221137771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background: Trapeziometacarpal osteoarthritis is the second most frequent degenerative hand disease and is the most functionally debilitating. The condition presents in 66% of women over 55. Motor imagery (MI) training post-surgery could help reduce rehabilitation times. Method: It is an experimental, prospective, longitudinal, parallel arm randomised clinical trial. Participants were women over 50 years old on the surgical waiting list. The experimental group will undergo MI training during the 3-week post-surgical immobilisation period. The control group will receive standard rehabilitation treatment. Outcomes will be assessed four times throughout the study using the Disabilities of the Arm, Shoulder and Hand questionnaire, the Cochin Hand Function Scale questionnaire, the Visual Analogue Scale, goniometry, baseline pinch gauge, circumferential measurement (cm), the Modified Kapandji Index and the Kinaesthetic and Visual Imagery questionnaire. Discussion: Early MI could improve hand function leading to improvements in recovery times. Trial registration: Clinical Trials registration: NCT03815734. Ethics Committee approval: 17155. Project funded in 2021.
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Affiliation(s)
| | | | | | | | | | - Jesús Seco-Calvo
- Institute of Biomedicine (IBIOMED), León University, León, Spain
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2
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Does mental practice or mirror therapy help prevent functional loss after distal radius fracture? A randomized controlled trial. J Hand Ther 2022; 35:86-96. [PMID: 33308929 DOI: 10.1016/j.jht.2020.10.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/15/2020] [Accepted: 10/22/2020] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN A randomized, single-blinded controlled trial. INTRODUCTION Therapy results after distal radius fractures (DRF) especially with older patients are often suboptimal. One possible approach for counteracting the problems are motor-cognitive training interventions such as Mental Practice (MP) or Mirror Therapy (MT), which may be applied in early rehabilitation without stressing the injured wrist. PURPOSE OF THE STUDY The aim of the study is to investigate the effects of MP and MT on wrist function after DRF. The pilot study should furthermore provide information about the feasibility of these methods. METHODS Thirty-one women were assigned either to one of the two experimental groups (MP, MT) or to a control group (relaxation intervention). The participants completed a training for six weeks, administered at their homes. Measurements were taken at four times (weeks 0, 3, 6 and 12) to document the progression in subjective function (PRWE, QuickDASH) and objective constraints of the wrist (ROM, grip strength) as well as in health-related quality of life (EQ-5D). RESULTS The results indicated that both experimental groups showed higher improvements across the intervention period compared to the control group; e.g. PRWE: MT 74.0%, MP 66.2%, CG 56.9%. While improvements in grip strength were higher for the MP group, the MT group performed better in all other measures. However, time by group interactions approached significance at best; e.g. ROM: P = .076; ηp2 = .141. CONCLUSION The superiority of MP as well as MT supports the simulation theory. Motor-cognitive intervention programs are feasible and promising therapy supplements, which may be applied in early rehabilitation to counteract the consequences of immobilization without stressing the injured wrist.
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Inglese A, Santandrea S. Post-arthrolysis rehabilitation in a patient with wrist stiffness secondary to distal radio-ulnar fracture: A case report. Physiother Theory Pract 2022:1-15. [PMID: 35272585 DOI: 10.1080/09593985.2022.2045657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Arthrolysis is usually performed when stiffness has a disabling effect on quality of life and in cases where physiotherapy has not been effective. This report describes one patient with a chronic stiff wrist who underwent open arthrolysis. The purpose of this case report is to describe the rehabilitation following arthrolysis, in order to illustrate the effects of intensive physiotherapy for this patient. CASE DESCRIPTION A 54-year-old woman with chronic wrist stiffness secondary to a radio-ulnar fracture was described. The patient presented severe pain and unsatisfactory wrist range of motion and muscle strength almost 2 years after the traumatic event. INTERVENTION Post-arthrolysis rehabilitation was based on edema control, manual therapy, transcutaneous electrical nerve stimulation (TENS), static splinting and strengthening exercises. In addition, graded motor imagery and proprioceptive rehabilitation were included to address impaired motor control. Outcome measures of passive range of motion (PROM), active range of motion (AROM), grip and pinch strength, numeric rating scale (NRS), disability of the arm, shoulder and hand (DASH) and patient-rated wrist/hand evaluation (PRWHE) were recorded. CONCLUSIONS The outcomes of this case report suggest that arthrolysis combined with immediate and intensive physiotherapy were a suitable option for the treatment of post-traumatic wrist stiffness in this patient. The passive motion measured intraoperatively was maintained, while pain, functional active motion and strength were improved allowing for social reintegration.
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Affiliation(s)
- Andrea Inglese
- Poliambulatorio Shoulder Team, viale Andrea Costa 33, 47122 Forlì, Italy
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4
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Saetta G, Ho JT, Bekrater-Bodmann R, Brugger P, Dijkerman CH, Lenggenhager B. Limb apparent motion perception: Modification by tDCS, and clinically or experimentally altered bodily states. Neuropsychologia 2021; 162:108032. [PMID: 34600001 DOI: 10.1016/j.neuropsychologia.2021.108032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/26/2021] [Accepted: 09/21/2021] [Indexed: 12/24/2022]
Abstract
Limb apparent motion perception (LAMP) refers to the illusory visual perception of a moving limb upon observing two rapidly alternating photographs depicting the same limb in two different postures. Fast stimulus onset asynchronies (SOAs) induce the more visually guided perception of physically impossible movements. Slow SOAs induce the perception of physically possible movements. According to the motor theory of LAMP, the latter perception depends upon the observer's sensorimotor representations. Here, we tested this theory in two independent studies by performing a central (study 1) and peripheral (study 2) manipulation of the body's sensorimotor states during two LAMP tasks. In the first sham-controlled transcranial direct current stimulation between-subject designed study, we observed that the dampening of left sensorimotor cortex activity through cathodal stimulation biased LAMP towards the more visually guided perception of physically impossible movements for stimulus pairs at slow SOAs. In the second, online within-subject designed study, we tested three participant groups twice: (1) individuals with an acquired lower limb amputation, either while wearing or not wearing their prosthesis (2) individuals with body integrity dysphoria (i.e., with a desire for amputation of a healthy leg) while sitting in a regular position or binding up the undesired leg (to simulate the desired amputation); (3) able-bodied individuals while sitting in a normal position or sitting on one of their legs. We found that the momentary sensorimotor state crucially impacted LAMP in individuals with an amputation and able-bodied participants, but not in BID individuals. Taken together, the results of these two studies substantiate the motor theory of LAMP.
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Affiliation(s)
- Gianluca Saetta
- Department of Psychology, University of Zurich, Switzerland; Department of Experimental Psychology, Utrecht University, the Netherlands.
| | - Jasmine T Ho
- Department of Psychology, University of Zurich, Switzerland
| | - Robin Bekrater-Bodmann
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Peter Brugger
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry (PUK), Zurich, Switzerland; Neuropsychology Unit, Valens Rehabilitation Centre, Valens, Switzerland
| | - Chris H Dijkerman
- Department of Experimental Psychology, Utrecht University, the Netherlands
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Where in the Brain is "the Other's" Hand? Mapping Dysfunctional Neural Networks in Somatoparaphrenia. Neuroscience 2021; 476:21-33. [PMID: 34537314 DOI: 10.1016/j.neuroscience.2021.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 01/08/2023]
Abstract
Somatoparaphrenia refers to the delusional belief, typically observed in right brain-damaged patients, that the contralesional limbs belong to someone else. Here, we aimed to uncover the neural activity associated with this productive, i.e. confabulatory, component in a patient, S.P.P., with a large right-sided lesion of both cortical and subcortical gray and white matter. He claimed that his left paralyzed hand belonged to his mother. In a block-design functional magnetic resonance (fMRI) experiment, S.P.P. imagined that the mother would move her (i.e. his left) hand (condition "mother"). Subtraction of the activity elicited by control conditions (imagery of self-generated movement of either left or right hand) from that in the "mother" condition resulted in the focal activation of the pars opercularis of the right inferior frontal gyrus (rIFG). In a separate, resting-state fMRI experiment with S.P.P. and 21 healthy controls, we examined the functional connectivity of the rIFG and the affected hand somatosensory network to the rest of the brain. We found a negative correlation between the activity in the rIFG and that of Broca area and the temporo-parietal junction in the left hemisphere. Furthermore, the affected hand somatosensory network was disconnected from the left secondary somatosensory cortex. Our results link the productive component of somatoparaphrenia to the activity of crucial hubs for integrating the multimodal signals of the affected hand. Furthermore, they provide the first direct evidence supporting the "left narrator model", proposed by Halligan et al. (1995), according to which the confabulations of somatoparaphrenia are due to a disconnection of left hemisphere language areas from right hemisphere parieto-temporal cortex.
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Brain Abnormalities in Individuals with a Desire for a Healthy Limb Amputation: Somatosensory, Motoric or Both? A Task-Based fMRI Verdict. Brain Sci 2021; 11:brainsci11091248. [PMID: 34573269 PMCID: PMC8468102 DOI: 10.3390/brainsci11091248] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/16/2021] [Accepted: 09/17/2021] [Indexed: 11/25/2022] Open
Abstract
Body integrity dysphoria (BID), a long-lasting desire for the amputation of physically healthy limbs, is associated with reduced fMRI resting-state functional connectivity of somatosensory cortices. Here, we used fMRI to evaluate whether these findings could be replicated and expanded using a task-based paradigm. We measured brain activations during somatosensory stimulation and motor tasks for each of the four limbs in ten individuals with a life-long desire for the amputation of the left leg and fourteen controls. For the left leg, BID individuals had reduced brain activation in the right superior parietal lobule for somatosensory stimulation and in the right paracentral lobule for the motor task, areas where we previously found reduced resting-state functional connectivity. In addition, for somatosensory stimulation only, we found a robust reduction in activation of somatosensory areas SII bilaterally, mostly regardless of the stimulated body part. Areas SII were regions of convergent activations for signals from all four limbs in controls to a significantly greater extent than in subjects with BID. We conclude that BID is associated with altered integration of somatosensory and, to a lesser extent, motor signals, involving limb-specific cortical maps and brain regions where the first integration of body-related signals is achieved through convergence.
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Dylan RM, Charalambos P, Aymeric G, Florent L. Motor imagery and action observation following immobilization-induced hypoactivity: a narrative review. Ann Phys Rehabil Med 2021; 65:101541. [PMID: 34023499 DOI: 10.1016/j.rehab.2021.101541] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 04/12/2021] [Accepted: 04/22/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND In sports, the risk of pathology or event that leads to an injury, a cessation of practice or even to an immobilization is high. The subsequent reduction of physical activity, or hypoactivity, induces neural and muscular changes that adversely affect motor skills and functional motor rehabilitation. Because the implementation of physical practice is difficult, if not impossible, during and immediately following injury or immobilization, complementary techniques have been proposed to minimize the deleterious impact of hypoactivity on neuromuscular function. OBJECTIVE The current narrative review aimed to discuss the contributions of motor imagery and action observation, which enhance motor (re)learning and induce neural adaptations in both healthy individuals and injured athletes. METHODS Online literature research for studies of the effects of motor imagery, action observation and their combination on hypoactivity, extracting relevant publications within the last decade (2009-2020). RESULTS From published studies and the authors' knowledge of both motor imagery and action observation, some elements are provided for developing applied protocols during and after the immobilization period. Such interventions consist of associating congruent action observation with kinesthetic motor imagery of different movements, organized in increasing difficulty. The aim is to maintain motor functions and promote motor relearning by activating sensorimotor cortical areas and corticomotor pathways of the injured effector. CONCLUSION This narrative review supports the implementation of combined motor imagery and action observation protocols in the context of sports rehabilitation.
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Affiliation(s)
- Rannaud Monany Dylan
- Cognition, Action et Plasticité Sensorimotrice (CAPS), INSERM UMR1093, UFR STAPS, Université de Bourgogne Franche-Comté, F-21000 Dijon, France
| | - Papaxanthis Charalambos
- Cognition, Action et Plasticité Sensorimotrice (CAPS), INSERM UMR1093, UFR STAPS, Université de Bourgogne Franche-Comté, F-21000 Dijon, France
| | - Guillot Aymeric
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité EA 7424, F-69622 Villeurbanne Cedex, France
| | - Lebon Florent
- Cognition, Action et Plasticité Sensorimotrice (CAPS), INSERM UMR1093, UFR STAPS, Université de Bourgogne Franche-Comté, F-21000 Dijon, France.
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Nagashima I, Takeda K, Harada Y, Mochizuki H, Shimoda N. Age-Related Differences in Strategy in the Hand Mental Rotation Task. Front Hum Neurosci 2021; 15:615584. [PMID: 33776667 PMCID: PMC7987654 DOI: 10.3389/fnhum.2021.615584] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 02/18/2021] [Indexed: 11/26/2022] Open
Abstract
Mental imagery of movement is a potentially valuable rehabilitation task, but its therapeutic efficacy may depend on the specific cognitive strategy employed. Individuals use two main strategies to perform the hand mental rotation task (HMRT), which involves determining whether a visual image depicts a left or right hand. One is the motor imagery (MI) strategy, which involves mentally simulating one’s own hand movements. In this case, task performance as measured by response time (RT) is subject to a medial–lateral effect wherein the RT is reduced when the fingertips are directed medially, presumably as the actual motion would be easier. The other strategy is to employ visual imagery (VI), which involves mentally rotating the picture and is not subject to this medial–lateral effect. The rehabilitative benefits of the HMRT are thought to depend on the MI strategy (mental practice), so it is essential to examine the effects of individual factors such as age, image perspective (e.g., palm or back of the hand), and innate ability (as indicated by baseline RT) on the strategy adopted. When presented with pictures of the palm, all subjects in the current study used the MI strategy, regardless of age and ability. In contrast, when subjects were presented with pictures of the back of the hand, the VI strategy predominated among the young age group regardless of performance, while the strategy used by middle-age and elderly groups depended on performance ability. In the middle-age and elderly groups, the VI approach predominated in those with high performance skill, whereas the MI strategy predominated among those with low performance skill. Thus, higher-skill middle-aged and elderly individuals may not necessarily form a motion image during the HMRT, potentially limiting rehabilitation efficacy.
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Affiliation(s)
- Izumi Nagashima
- Department of Occupational Therapy, Faculty of Health Sciences, Kyorin University, Mitaka, Japan
| | - Kotaro Takeda
- Faculty of Rehabilitation, School of Healthcare, Fujita Health University, Toyoake, Japan
| | - Yusuke Harada
- Department of Occupational Therapy, Faculty of Health Sciences, Kyorin University, Mitaka, Japan
| | - Hideki Mochizuki
- Department of Occupational Therapy, Faculty of Health Sciences, Kyorin University, Mitaka, Japan
| | - Nobuaki Shimoda
- Department of Rehabilitation, Faculty of Health Sciences, Tokyo Kasei University, Sayama, Japan
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Zapparoli L, Seghezzi S, Sacheli LM, Verga C, Banfi G, Paulesu E. Eyes wide shut: How visual cues affect brain patterns of simulated gait. Hum Brain Mapp 2020; 41:4248-4263. [PMID: 32639101 PMCID: PMC7502842 DOI: 10.1002/hbm.25123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 06/11/2020] [Accepted: 06/22/2020] [Indexed: 11/09/2022] Open
Abstract
In the last 20 years, motor imagery (MI) has been extensively used to train motor abilities in sport and in rehabilitation. However, MI procedures are not all alike as much as their potential beneficiaries. Here we assessed whether the addition of visual cues could make MI performance more comparable with explicit motor performance in gait tasks. With fMRI we also explored the neural correlates of these experimental manipulations. We did this in elderly subjects who are known to rely less on kinesthetic information while favoring visual strategies during motor performance. Contrary to expectations, we found that the temporal coupling between execution and imagery times, an index of the quality of MI, was less precise when participants were allowed to visually explore the environment. While the brain activation patterns of the gait motor circuits were very similar in both an open‐eyed and eye‐shut virtual walking MI task, these differed for a vast temporo‐occipito‐parietal additional activation for open‐eyed MI. Crucially, the higher was the activity in this posterior network, the less accurate was the MI performance with eyes open at a clinical test of gait. We conclude that both visually‐cued and internally‐cued MI are associated with the neurofunctional activation of a gait specific motor system. The less precise behavioral coupling between imagined and executed gait while keeping eyes open may be attributed to the processing load implied in visual monitoring and scanning of the environment. The implications of these observations for rehabilitation of gait with MI are discussed.
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Affiliation(s)
- Laura Zapparoli
- Psychology Department & Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy.,fMRI Unit, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Silvia Seghezzi
- Psychology Department & Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy.,PhD Program in Neuroscience of School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Lucia Maria Sacheli
- Psychology Department & Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy.,fMRI Unit, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Chiara Verga
- Psychology Department & Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy
| | - Giuseppe Banfi
- fMRI Unit, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,School of Medicine, San Raffaele Vita e Salute University, Milan, Italy
| | - Eraldo Paulesu
- Psychology Department & Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy.,fMRI Unit, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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Zapparoli L, Sacheli LM, Seghezzi S, Preti M, Stucovitz E, Negrini F, Pelosi C, Ursino N, Banfi G, Paulesu E. Motor imagery training speeds up gait recovery and decreases the risk of falls in patients submitted to total knee arthroplasty. Sci Rep 2020; 10:8917. [PMID: 32488010 PMCID: PMC7265300 DOI: 10.1038/s41598-020-65820-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/29/2020] [Indexed: 01/01/2023] Open
Abstract
With Motor imagery (MI), movements are mentally rehearsed without overt actions; this procedure has been adopted in motor rehabilitation, primarily in brain-damaged patients. Here we rather tested the clinical potentials of MI in purely orthopaedic patients who, by definition, should maximally benefit of mental exercises because of their intact brain. To this end we studied the recovery of gait after total knee arthroplasty and evaluated whether MI combined with physiotherapy could speed up the recovery of gait and even limit the occurrence of future falls. We studied 48 patients at the beginning and by the end of the post-surgery residential rehabilitation program: half of them completed a specific MI training supported by computerized visual stimulation (experimental group); the other half performed a non-motoric cognitive training (control group). All patients also had standard physiotherapy. By the end of the rehabilitation, the experimental group showed a better recovery of gait and active knee flexion-extension movements, and less pain. The number of falls or near falls after surgery was significantly lower in the experimental group. These results show that MI can improve gait abilities and limit future falls in orthopaedic patients, without collateral risks and with limited costs.
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Affiliation(s)
- Laura Zapparoli
- Psychology Department and NeuroMI - Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy. .,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
| | - Lucia Maria Sacheli
- Psychology Department and NeuroMI - Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Silvia Seghezzi
- Psychology Department and NeuroMI - Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy.,PhD Program in Neuroscience, School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - Matteo Preti
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | | | | | - Catia Pelosi
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | | | - Giuseppe Banfi
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,University Vita e Salute San Raffaele, Milan, Italy
| | - Eraldo Paulesu
- Psychology Department and NeuroMI - Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy. .,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
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