Preliminary validation of the Portuguese Edinburgh Handedness Inventory in an adult sample

Age bias in changes in finger dexterity based on brain activation and spinal motor nerve excitability induced by motor imagery practice

Elderly adults may have poorer recall ability than young adults and may not fully enjoy the effects of motor imagery. To understand the age bias of the effect of motor imagery on hand dexterity, we evaluated brain activation and spinal motor nerve excitability. Brain activation was evaluated from changes in oxygenated hemoglobin concentration, while spinal motor nerve excitability was evaluated from F-waves in eight young (mean age 21.0 ± 0.5 years) and eight elderly (mean age 69.5 ± 2.3 years) subjects of matched sex ratio at rest and during motor imagery. Purdue Pegboard scores were also measured before and after motor imagery, and changes in hand dexterity were assessed. The results showed that motor imagery improved hand dexterity without an age bias, and in a similar trend, spinal motor nerve excitability increased during motor imagery. Functional brain connectivity analysis showed the formation of a working memory network in both groups. However, in the analysis of single brain region activation, the young group, but not the elderly group, showed increased activity in the supplementary motor cortex during motor imagery. In addition, regardless of age-related changes, causal coupling indicated the supplementary motor cortex was associated with the changes of spinal motor nerve excitability. Although the changes in brain activation during motor imagery were influenced by age, motor imagery-induced improvements in hand dexterity are also expected in the elderly. Furthermore, changes in spinal motor nerve excitability may be useful in determining the qualitative aspects of motor imagery.

Speech Stream Composition Affects Statistical Learning: Behavioral and Neural Evidence

Statistical learning (SL), the ability to extract patterns from the environment, has been assumed to play a central role in whole cognition, particularly in language acquisition. Evidence has been gathered, however, from behavioral experiments relying on simplified artificial languages, raising doubts on the generalizability of these results to natural contexts. Here, we tested if SL is affected by the composition of the speech streams by expositing participants to auditory streams containing either four nonsense words presenting a transitional probability (TP) of 1 (unmixed high-TP condition), four nonsense words presenting TPs of 0.33 (unmixed low-TP condition) or two nonsense words presenting a TP of 1, and two of a TP of 0.33 (mixed condition); first under incidental (implicit), and, subsequently, under intentional (explicit) conditions to further ascertain how prior knowledge modulates the results. Electrophysiological and behavioral data were collected from the familiarization and test phases of each of the SL tasks. Behavior results revealed reliable signs of SL for all the streams, even though differences across stream conditions failed to reach significance. The neural results revealed, however, facilitative processing of the mixed over the unmixed low-TP and the unmixed high-TP conditions in the N400 and P200 components, suggesting that moderate levels of entropy boost SL.

Porto Alegre Line predicts lenticulostriate arteries encasement and extent of resection in insular gliomas. A preliminary study

Object

In insular glioma surgery, lenticulostriate arteries (LSTa) tumoral encasement increases neurological deficits risk despite intensive efforts to preserve the internal capsule's integrity. In this study, we focus on the LSTa relationships with the medial aspect of the insular tumors. We propose a new non-invasive method for LSTa involvement prediction in preoperative MRI (Porto Alegre Line). We compare it with direct intraoperative encased LSTa visualization.

Methods

A retrospective review of our database of 52 patients of insular glioma was performed. In cases with no tumor located medial to Porto Alegre line, our medial resection limit, mainly for the tumor part located next to the limen insula, was the inferior fronto-occipital fasciculus (IFOF), identified through altered speech patterns during electric subcortical stimulation. In cases with no assumed LSTa involvement, the parameter used to stop resection was the confirmation of the corticospinal tract with 10-mA stimulus. The resection limit of tumors placed medially to the Porto Alegre line was intraoperative direct LSTa visualization.

Results

The LSTa involvement was the most critical medial limiting factor in more aggressive tumor resection and an excellent overall survival (P = 0.022). In cases in which there were direct intraoperative LSTa encasement visualization, Porto Alegre Line was employed as an MRI preoperative landmark for prediction of LSTa involvement in those patients with Sensitivity, Specificity, Positive Predictive Values of 1, 0.975 and 0.923, respectively.

Conclusion

We have found that LSTa encasement is a limiting factor to reach a satisfactory extent of resection and that Porto Alegre Line can predict it.

Handedness

This chapter offers an overview of the literature on human handedness and its assessment in clinical neurologic practice and research. There are two major forms of handedness: hand preference, which describes a subjective preference to use one hand over the other for skilled motor activities like writing, and hand skill, which describes objectively measured mother skill. This chapter gives an overview of widely used questionnaires and tests to assess hand preference and hand skill, as well as suggestions on how to determine handedness categories such as left-handed, right-handed, and mixed-handed based on the results of these questionnaires and tests. Handedness is just one form of hemispheric asymmetry in the human motor system, and the chapter also provides an overview of its association with other motor asymmetries such as footedness. Moreover, the associations of handedness with functional brain activation as well as with structural markers on the cortical, subcortical, cerebellar, and spinal levels are discussed. Furthermore, the potential relevance of handedness retraining for clinical neurologic research and the association of handedness and cognitive abilities are discussed. The chapter concludes with an outlook on the critical importance of including handedness in clinical neurologic research and practice.

Fifty Years of Handedness Research: A Neurological and Methodological Update

Handedness, a complex human aspect that reflects the functional lateralization of the hemispheres, also interacts with the immune system. This study aimed to expand the knowledge of the lateralization of hand, foot, and eye activities in patients with immune-mediated (IM) or other (noIM) neurological diseases and to clarify the properties of the Edinburgh Handedness Inventory (EHI) in an Italian population. Three hundred thirty-four patients with IM or noIM diseases affecting the brain or spine and peripheral nervous system were interviewed about stressful events preceding the disease, subjective handedness, and familiarity for left-handedness or ambidexterity. The patients and 40 healthy subjects underwent EHI examination. In the whole group of participants, 24 items of the EHI were classified into five factors (Hand Transitive, Hand Refined, Hand Median, Foot, Eye), demonstrating good reliability and validity. Chronological age had a significant influence on hand and foot EHI factors and the laterality quotient (LQ), particularly on writing and painting. In the patient groups, EHI factors and the LQ were also predicted by age of disease onset, duration of disease, and family history of left-handedness or ambidexterity. No differences were found between patients and healthy subjects, but pencil use scored significantly lower in patients with IM diseases than in those with noIM brain diseases. These results demonstrate that the lateralization of hand and foot activities is not a fixed human aspect, but that it can change throughout life, especially for abstract and symbolic activities. Chronic neurological diseases can cause changes in handedness. This may explain why, unlike systemic immunological diseases, IM neurological diseases are not closely associated with left-handedness. In these patients, the long version of the EHI is appropriate for determining the lateralization of body activities to contextualize the neurological picture; therefore, these findings extend the Italian normative data sets.

Executive function in schizophrenia and autism in adults shares common components separating high and low performance groups

The profile of executive function (EF) in adults with Schizophrenia (SCZ) and autism spectrum disorder (ASD) remains unclear. This study aims to ascertain if distinct EF patterns can be identified between each clinical condition by comparing the neuropsychological profile of adults with SCZ and ASD, for whom the differential diagnosis is still highly challenging. Forty-five individuals (15 SCZ, 15 ASD, 15 controls) matched for age, sex, education level, and handedness underwent intelligence evaluation and neuropsychological testing for working memory, inhibition, planning and set-shifting, and verbal fluency subdomains. Principal component analysis (2D-PCA) using variables representing 4 domains was employed to identify patterns in neuropsychological profiles. The ASD group had lower scores on the Digits Forward subtest compared to the SCZ group (7.2 ± 2.1 vs. 9.3 ± 1.9, p = 0.003; Cohen's d: 1.05). ASD also performed significantly worse on the Stroop Word Test compared to the control group (77.7± 17.9 vs. 98.0 ± 12.7, p = 0.009; Cohen's d: 1.31). No significant differences were observed between ASD and SCZ on other EF measures. The larger contributors for the dimensions in 2D-PCA were the Digits Forward subtest and Stroop Word Test. Still, there was substantial overlap between the clinical groups. This study suggests a high degree of similarity of EF between SCZ and ASD. Through four EF measures, the discrimination of low and high-functioning EF groups spanning both diagnostic categories may help to identify the individuals who could better benefit from cognitive rehabilitation strategies.

Between-session reliability of dry-land and in-water tests to measure inter-limb asymmetries in swimmers

The aims of the present study were to: i) analyse the between-session reliability of dry-land and in-water swimming tests, and ii) investigate the prevalence of meaningful asymmetries in swimming athletes. Twenty-eight swimmers (21 males, 7 females) performed anthropometric, shoulder range of motion (ROM), countermovement jump, shoulder isokinetic torque, and 15-s tethered swimming tests two times, 1 week apart. Inter-limb asymmetries were calculated for each variable. Raw data reliability was determined using the intraclass coefficient correlation (ICC) and the typical error of measurement (TEM), and effect size (ES) was used to determine systematic bias between test sessions. At an individual level, inter-limb asymmetries were compared to the coefficient of variation (CV) to determine whether they were real. The between-session reliability was good to excellent (0.75 to 1.00) for most of the raw data, except for ROM. Between-session ES was predominately "trivial" or "small" for raw data and asymmetries, reinforcing that the values did not change significantly between the sessions. In addition, real asymmetries were seen in some tested metrics, depending on the test. In conclusion, the tested variables presented good levels of between-session reliability and were able to detect real and consistent asymmetries.

The Italian version of Edinburgh Handedness Inventory: Translation, transcultural adaptation, and validation in healthy subjects

Lateralization is a key aspect of brain architecture and handedness is its primary manifestation. The Edinburgh Handedness Inventory (EHI) and the laterality quotient (LQ) assess the direction and consistency of handedness and require translation and cross-cultural adaptation to guarantee construct validity. We developed a standardized Italian EHI version. The developed Italian version was tested on 202 Italian subjects, classified into three hand types based on their LQs: right, mixed, and left. The frequency of left-handedness in Italians and other populations was compared to previous data. LQs from the twenty- and the ten-item original inventories were also compared. We conducted a factorial analysis. Mcdonald's Omega tested internal consistency. The prevalence of left-handedness was 6.4%, consistent with prior findings in Italian samples and other EHI translations. Age was the only socio-demographic variable that significantly affected the LQ. The internal consistency of the Italian EHI was excellent. Handedness is a feature of several cognitive functions and some neuropsychological diseases; it is influenced by socio-demographic and cultural factors and the instrument used to assess it. To provide a consistent and comparable evaluation of the construct, we recommend using this validated Italian translation of the EHI.

Neural correlates of fine motor grasping skills: Longitudinal insights into motor cortex activation using fNIRS

BACKGROUND

Motor learning is essential for performing specific tasks and progresses through distinct stages, including the rapid learning phase (initial skill acquisition), the consolidation phase (skill refinement), and the stable performance phase (skill mastery and maintenance). Understanding the cortical activation dynamics during these stages can guide targeted rehabilitation interventions.

METHODS

In this longitudinal randomized controlled trial, functional near-infrared spectroscopy was used to explore the temporal dynamics of cortical activation in hand-related motor learning. Thirty-one healthy right-handed individuals were randomly assigned to perform either easy or intricate motor tasks with their non-dominant hand over 10 days. We conducted 10 monitoring sessions to track cortical activation in the right hemisphere (according to lateralization principles, the primary hemisphere for motor control) and evaluated motor proficiency concurrently.

RESULTS

The study delineated three stages of nondominant hand motor learning: rapid learning (days 1 and 2), consolidation (days 3-7), and stable performance (days 8-10). There was a power-law enhancement of motor skills correlated with learning progression. Sustained activation was observed in the supplementary motor area (SMA) and parietal lobe (PL), whereas activation in the right primary motor cortex (M1R) and dorsolateral prefrontal cortex (PFCR) decreased. These cortical activation patterns exhibited a high correlation with the augmentation of motor proficiency.

CONCLUSIONS

The findings suggest that early rehabilitation interventions, such as transcranial magnetic stimulation and transcranial direct current stimulation (tDCS), could be optimally directed at M1 and PFC in the initial stages. In contrast, SMA and PL can be targeted throughout the motor learning process. This research illuminates the path for developing tailored motor rehabilitation interventions based on specific stages of motor learning.

NEW AND NOTEWORTHY

In an innovative approach, our study uniquely combines a longitudinal design with the robustness of generalized estimating equations (GEEs). With the synergy of functional near-infrared spectroscopy (fNIRS) and the Minnesota Manual Dexterity Test (MMDT) paradigm, we precisely trace the evolution of neural resources during complex, real-world fine-motor task learning. Centering on right-handed participants using their nondominant hand magnifies the intricacies of right hemisphere spatial motor processing. We unravel the brain's dynamic response throughout motor learning stages and its potent link to motor skill enhancement. Significantly, our data point toward the early-phase rehabilitation potential of TMS and transcranial direct current stimulation on the M1 and PFC regions. Concurrently, SMA and PL appear poised to benefit from ongoing interventions during the entire learning curve. Our findings carve a path for refined motor rehabilitation strategies, underscoring the importance of timely noninvasive brain stimulation treatments.

Brain Hemispheric Asymmetry in Schizophrenia and Bipolar Disorder

BACKGROUND

This study aimed to compare brain asymmetry in patients with schizophrenia (SCZ), bipolar disorder (BPD), and healthy controls to test whether asymmetry patterns could discriminate and set boundaries between two partially overlapping severe mental disorders.

METHODS

We applied a fully automated voxel-based morphometry (VBM) approach to assess structural brain hemispheric asymmetry in magnetic resonance imaging (MRI) anatomical scans in 60 participants (SCZ = 20; BP = 20; healthy controls = 20), all right-handed and matched for gender, age, and education.

RESULTS

Significant differences in gray matter asymmetry were found between patients with SCZ and BPD, between SCZ patients and healthy controls (HC), and between BPD patients and HC. We found a higher asymmetry index (AI) in BPD patients when compared to SCZ in Brodmann areas 6, 11, and 37 and anterior cingulate cortex and an AI higher in SCZ patients when compared to BPD in the cerebellum.

CONCLUSION

Our study found significant differences in brain asymmetry between patients with SCZ and BPD. These promising results could be translated to clinical practice, given that structural brain changes detected by MRI are good candidates for exploration as biological markers for differential diagnosis, besides helping to understand disease-specific abnormalities.

Enhanced salience of musical sounds in singers and instrumentalists

Music training has been linked to facilitated processing of emotional sounds. However, most studies have focused on speech, and less is known about musicians' brain responses to other emotional sounds and in relation to instrument-specific experience. The current study combined behavioral and EEG methods to address two novel questions related to the perception of auditory emotional cues: whether and how long-term music training relates to a distinct emotional processing of nonverbal vocalizations and music; and whether distinct training profiles (vocal vs. instrumental) modulate brain responses to emotional sounds from early to late processing stages. Fifty-eight participants completed an EEG implicit emotional processing task, in which musical and vocal sounds differing in valence were presented as nontarget stimuli. After this task, participants explicitly evaluated the same sounds regarding the emotion being expressed, their valence, and arousal. Compared with nonmusicians, musicians displayed enhanced salience detection (P2), attention orienting (P3), and elaborative processing (Late Positive Potential) of musical (vs. vocal) sounds in event-related potential (ERP) data. The explicit evaluation of musical sounds also was distinct in musicians: accuracy in the emotional recognition of musical sounds was similar across valence types in musicians, who also judged musical sounds to be more pleasant and more arousing than nonmusicians. Specific profiles of music training (singers vs. instrumentalists) did not relate to differences in the processing of vocal vs. musical sounds. Together, these findings reveal that music has a privileged status in the auditory system of long-term musically trained listeners, irrespective of their instrument-specific experience.

Forgetting Alcohol: A Double-Blind, Randomized Controlled Trial Investigating Memory Inhibition Training in Young Binge Drinkers

Background

Binge Drinking (BD) has been associated with altered inhibitory control and augmented alcohol-cue reactivity. Memory inhibition (MI), the ability to voluntarily suppress unwanted thoughts/memories, may lead to forgetting of memories in several psychiatric conditions. However, despite its potential clinical implications, no study to date has explored the MI abilities in populations with substance misuse, such as binge drinkers (BDs).

Method

This study—registered in the NIH Clinical Trials Database (ClinicalTrials.gov identifier: NCT05237414)—aims firstly to examine the behavioral and electroencephalographic (EEG) correlates of MI among college BDs. For this purpose, 45 BDs and 45 age-matched non/low-drinkers (50% female) will be assessed by EEG while performing the Think/No-Think Alcohol task, a paradigm that evaluates alcohol-related MI. Additionally, this work aims to evaluate an alcohol-specific MI intervention protocol using cognitive training (CT) and transcranial direct current stimulation (tDCS) while its effects on behavioral and EEG outcomes are assessed. BDs will be randomly assigned to one MI training group: combined [CT and verum tDCS applied over the right dorsolateral prefrontal cortex (DLPFC)], cognitive (CT and sham tDCS), or control (sham CT and sham tDCS). Training will occur in three consecutive days, in three sessions. MI will be re-assessed in BDs through a post-training EEG assessment. Alcohol use and craving will be measured at the first EEG assessment, and both 10-days and 3-months post-training. In addition, behavioral and EEG data will be collected during the performance of an alcohol cue reactivity (ACR) task, which evaluates attentional bias toward alcoholic stimuli, before, and after the MI training sessions.

Discussion

This study protocol will provide the first behavioral and neurofunctional MI assessment in BDs. Along with poor MI abilities, BDs are expected to show alterations in event-related potentials and functional connectivity patterns associated with MI. Results should also demonstrate the effectiveness of the protocol, with BDs exhibiting an improved capacity to suppress alcohol-related memories after both combined and cognitive training, along with a reduction in alcohol use and craving in the short/medium-term. Collectively, these findings might have major implications for the understanding and treatment of alcohol misuse.

Clinical Trial Registration

[www.ClinicalTrials.gov], identifier [NCT05237414].

On the syllable structure effect in European Portuguese: Evidence from ERPs

Syllable effects during visual word recognition have been observed for CV but not for CVC syllables, a puzzling effect that is not explained either by the distributional frequencies of CV and CVC syllables, syllable complexity, or syllabic neighbourhood density. Furthermore, in European Portuguese (EP), syllable effects have not been found for pseudowords, suggesting that syllable activation might not precede lexical activation. Here, we combined a colour-congruency lexical decision task with the collection of electroencephalographic (EEG) data to investigate syllable effects in EP for CV and CVC words and pseudowords, with the latter presenting a match (CVC_O+P+) or a mismatch (CVC_O+P-) between their orthographic (O) and phonological (P) syllable structure to further ascertain the locus (i.e., orthographic and/or phonological) of syllable effects. Results showed syllable congruency effects in the N100, P200, and N400 ERP components for CV and CVC words suggesting the influence of different factors underlying the syllable structure effect.

Learning Words While Listening to Syllables: Electrophysiological Correlates of Statistical Learning in Children and Adults

From an early age, exposure to a spoken language has allowed us to implicitly capture the structure underlying the succession of speech sounds in that language and to segment it into meaningful units (words). Statistical learning (SL), the ability to pick up patterns in the sensory environment without intention or reinforcement, is thus assumed to play a central role in the acquisition of the rule-governed aspects of language, including the discovery of word boundaries in the continuous acoustic stream. Although extensive evidence has been gathered from artificial languages experiments showing that children and adults are able to track the regularities embedded in the auditory input, as the probability of one syllable to follow another syllable in the speech stream, the developmental trajectory of this ability remains controversial. In this work, we have collected Event-Related Potentials (ERPs) while 5-year-old children and young adults (university students) were exposed to a speech stream made of the repetition of eight three-syllable nonsense words presenting different levels of predictability (high vs. low) to mimic closely what occurs in natural languages and to get new insights into the changes that the mechanisms underlying auditory statistical learning (aSL) might undergo through the development. The participants performed the aSL task first under implicit and, subsequently, under explicit conditions to further analyze if children take advantage of previous knowledge of the to-be-learned regularities to enhance SL, as observed with the adult participants. These findings would also contribute to extend our knowledge of the mechanisms available to assist SL at each developmental stage. Although behavioral signs of learning, even under explicit conditions, were only observed for the adult participants, ERP data showed evidence of online segmentation in the brain in both groups, as indexed by modulations in the N100 and N400 components. A detailed analysis of the neural data suggests, however, that adults and children rely on different mechanisms to assist the extraction of word-like units from the continuous speech stream, hence supporting the view that SL with auditory linguistic materials changes through development.

Frontal White Matter Hyperintensities Effect on Default Mode Network Connectivity in Acute Mild Traumatic Brain Injury

The functional connectivity of the brain depends not only on the structural integrity of the cortex but also on the white matter pathways between cortical areas. White matter hyperintensities (WMH), caused by chronic hypoperfusion in the white matter, play a role in the outcome of traumatic brain injury (TBI) and other neurodegenerative disorders. Herein, we investigate how the location and volume of WMH affect the default-mode network (DMN) connectivity in acute mild TBI (mTBI) patients. Forty-six patients with acute mTBI and 46 matched healthy controls were enrolled in the study. All participants underwent T2-weighted fluid-attenuated inversion recovery magnetic resonance imaging (MRI), resting-state functional MRI (fMRI),and neuropsychological assessments. The volume and location of WMH were recorded. The relationships between the WMH volume and clinical assessments were evaluated using Spearman’s correlation. Patients with higher frontal lobe WMH volume had more severe post-concussion symptoms and poorer information processing speed. Moreover, these patients had significantly lower functional connectivity in the right middle temporal gyrus, left middle frontal gyrus, right superior frontal gyrus, and left anterior cingulate cortex, compared with patients with low frontal lobe WMH volume. Compared to the controls, the patients with high frontal WMH volume exhibited significantly lower functional connectivity in the right inferior temporal gyrus, left anterior cingulate cortex, and right superior frontal gyrus. These findings suggest that frontal lobe WMH volume may modulate the functional connectivity within the DMN. Therefore, the WMH volume in specific regions of the brain, particularly the frontal and parietal lobes, may accelerate the process of aging and cognitive impairment may be a useful biomarker for the diagnosis and prognosis of acute mTBI.

Sex Differences in Cerebral Blood Flow and Serum Inflammatory Cytokines and Their Relationships in Mild Traumatic Brain Injury

This study aimed to investigate sex differences in cerebral blood flow (CBF) and serum inflammatory cytokines, as well as their correlations in patients with acute-stage mild traumatic brain injury (mTBI). Forty-one patients with mTBI and 23 matched healthy controls underwent 3D-pseudo-continuous arterial spin labeling imaging on 3T magnetic resonance imaging. The patients underwent cognitive evaluations and measurement of a panel of ten serum cytokines: interleukin (IL)-1I, IL-4, IL-6, IL-8, IL-10, IL-12, C–C motif chemokine ligand 2, interferon-gamma, nerve growth factor-beta (β-NGF), and tumor necrosis factor-alpha (TNF-α). Spearman rank correlation analysis was performed to evaluate the relationship between inflammation levels and CBF. We found that both male and female patients showed increased IL-1L and IL-6 levels. Female patients also demonstrated overexpression of IL-8 and low expression of IL-4. As for CBF levels, three brain regions [the right superior frontal gyrus (SFG_R), left putamen, and right precuneus] increased in male patients while three brain regions [the right superior temporal gyrus (STG_R), left middle occipital gyrus, and right postcentral (PoCG_R)] decreased in female patients. Furthermore, the STG_R in female controls was positively correlated with β-NGF while the right PoCG_R in female patients was negatively correlated with IL-8. In addition, compared with male patients, female patients showed decreased CBF in the right pallidum, which was negatively correlated with IL-8. These findings revealed abnormal expression of serum inflammatory cytokines and CBF levels post-mTBI. Females may be more sensitive to inflammatory and CBF changes and thus more likely to get cognitive impairment. This may suggest the need to pay closer attention to the female mTBI group.

New data on the validity of the Fazio Laterality Inventory

The Fazio Laterality Inventory (FLI) is a recent measure of handedness. Although initially validated, there is still a lack of studies assessing its psychometric properties in samples outside the USA. The present study explores the validity of the Polish adaptation of the FLI. We used data gathered from a convenience sample of 727 participants. They completed the FLI and the Edinburgh Handedness Inventory to establish concurrent validity. Confirmatory factor analysis was used to investigate the factor structure of the FLI. In addition, an Item Response Theory (IRT) model for continuous item scores was also used to identify the discrimination and difficulty parameters of the FLI items. The Polish version of the FLI was characterized by good reliability indices and has high concurrent validity with the Edinburgh Handedness Inventory. We identified a bi-factorial structure for the questionnaire. The IRT analyses showed that the FLI items have good discrimination and difficulty parameters. Our study provides new insights into the properties of the Fazio Laterality Inventory.

Alterations in Spontaneous Neuronal Activity and Microvascular Density of the Optic Nerve Head in Active Thyroid-Associated Ophthalmopathy

PURPOSE

To investigate changes in local spontaneous brain activity in patients with active thyroid-associated ophthalmopathy (TAO) and explore the relationship between such alterations and microvascular indices.

METHODS

Thirty-six active TAO patients with active phase and 39 healthy controls (HCs) were enrolled in this study. All participants underwent resting-state functional magnetic resonance imaging (rs-fMRI), neuropsychological tests, and ophthalmological examinations. The rs-fMRI-based fractional low-frequency fluctuation amplitude (fALFF) analysis methods were used to assess spontaneous brain activity in both groups. The structure (peripapillary retinal nerve fiber layer, pRNFL) and microvascular indices (the optic nerve head (ONH) whole image vessel density, ONH-wiVD, and peripapillary vessel density) were analyzed through optical coherence tomographic angiography imaging. The relationship between abnormal spontaneous brain activity and ophthalmological indices was analyzed using the Spearman's rank correlation analysis.

RESULTS

Compared with HCs, active TAO patients had increased fALFF in the right inferior temporal gyrus (R.ITG) and left posterior cingulate gyrus (L.PCC), but decreased fALFF in the right calcarine (R.CAL). The fALFF values in L.PCC were positively correlated with peripapillary vessel density, whereas fALFF values in R.CAL were negatively related to peripapillary vessel density.

CONCLUSIONS

This study demonstrates that changes in spontaneous brain activity of active TAO are accompanied by peripapillary microvascular variations. These results provide insights into the pathophysiological mechanisms of active TAO. In addition, the combination of fALFF values and peripapillary vessel density may be served as important references for better clinical decision making.

The non-transparent usage and reporting of the Edinburgh Handedness Inventory in functional magnetic resonance imaging literature: a survey of studies published since 2013

Subject handedness is an important parameter to be evaluated and accounted for in neuroscience studies dealing with laterality. The aim of this study was to survey for the details of how researchers administered the Edinburgh handedness inventory (EHI) to assess subject handedness. Web of Science and PubMed databases was searched on 3 August 2021 to identify functional magnetic resonance imaging (fMRI) articles published since 2013 using the EHI or citing Oldfield, the original paper that introduced the EHI. Articles not actually using the EHI and/or its variants were excluded. Two reviewers performed the screening independently and disagreements were solved by mutual consensus. Most of the 406 studies using the EHI did not report details regarding the number of items (94.1%), identity of items (96.1%), response format (97.0%), and cutoff score for right-handedness (87.2%). Items were found dropped or replaced, with response format and cutoff score changed without citing references that justified the modifications. A clearer reporting of the details of the EHI as an assessment tool for determining subject handedness should be encouraged.

A fundamental distinction in early neural processing of implicit social interpretation in schizophrenia and bipolar disorder

BACKGROUND

Social cognition impairment is a key phenomenon in serious mental disorders such as schizophrenia (SCZ) and bipolar disorder (BPD). Although genetic and neurobiological studies have suggested common neural correlates, here we hypothesized that a fundamental dissociation of social processing occurs at an early level in these conditions.

METHODS

Based on the hypothesis that key structures in the social brain, namely the temporoparietal junction, should present distinctive features in SCZ and BPD during low-level social judgment, we conducted a case-control study in SCZ (n = 20) and BPD (n = 20) patients and controls (n = 20), using task-based fMRI during a Theory of Mind (ToM) visual paradigm leading to interpretation of social meaning based on simple geometric figures.

RESULTS

We found opposite neural responses in two core ToM regions: SCZ patients showed social content-related deactivation (relative to controls and BPD) of the right supramarginal gyrus, while the opposite pattern was found in BPD; reverse patterns, relative to controls and SCZ, were found in the left posterior superior temporal gyrus, a region involved in inferring other's intentions. Receiver-operating-characteristic curve analysis showed 88% accuracy in discriminating the two clinical groups based on these neural responses.

CONCLUSIONS

These contrasting activation patterns of the temporoparietal junction in SCZ and BPD represent mechanistic differences of social cognitive dysfunction that may be explored as biomarkers or therapeutic targets.

Aerobic Exercise After Left-Sided Stroke Improves Gait Speed and Endurance: A Prospective Cohort Study

OBJECTIVE

The aim of the study was to investigate the effects of aerobic exercise on individuals who have had a stroke and showed baseline scores lower than the standard scores for the 6-min and 10-meter walk tests.

DESIGN

Individuals were assigned to groups according to gait performance, defined by the standard values in the 6-min and 10-meter walk tests (standard baseline score and lower baseline score), and brain injury side. Aerobic exercise, 30 mins per day, 2 times a week, for a total of 12 wks. The 6-min and 10-meter walk tests in five assessments: initial, after 4, 8, 12 wks, and 4 wks of follow-up, analyzed by multivariate analysis, with P value of less than 0.05.

RESULTS

The 6-min walk test data showed an increase in endurance for lower baseline score and left-brain injury, during assessments 4, and follow-up, compared with standard baseline score (F4,84 = 14.64). Lower baseline score showed endurance increase for assessments 2, 3, 4, and follow-up compared with assessment 1 (F4,84 = 7.70). The 10-meter walk test data showed an increase in speed for lower baseline score and left-brain injury, during assessments 3, 4, and follow-up, compared with assessment 1, 4, and follow-up, compared with assessment 2 (F4,84 = 5.33).

CONCLUSIONS

Aerobic exercise increases gait endurance and speed in individuals who have had a stroke, with left-brain injury, and lower baseline score in the 6-min and 10-meter walk tests.

Immediate effects of myofascial release maneuver applied in different lower limb muscle chains on postural sway

BACKGROUND

There is little evidence about the myofascial release maneuver (MLM) targeting the fascial tissue and its effect on postural balance. This study investigated the immediate effects of the MLM in different lower limb muscle chains on the postural sway of healthy men.

METHODS

Sixty-three healthy men (27.2 ± 4.7 years) were randomly assigned to 7 groups (n = 9 each) to receive MLM applied to the lower limb muscle chains (anterior, posterior, medial, lateral, anterior/posterior, and medial/lateral) or placebo intervention. Skin pressure during the 3-min MLM was determined by the visual analog scale between 5 and 7 as previously assessed on participants. Posturography analysis of the elliptical area (Area) and average velocity (Vavg) of the center-of-pressure displacement was performed before and immediately after the MLM in single-leg support and with eyes closed.

RESULTS

A two-way repeated measures analysis of variance showed no interaction effect of factors group and time (Area: p = 0.210, ω² = 0.004; Vavg: p = 0.358, ω² < 0.001). Within-factor main effect of time was observed for both Area (p < 0.001, ω² = 0.038) and Vavg (p < 0.001, ω² = 0.028), with decreased Area and Vavg after all interventions. No between-factor main effect of group was observed for Area or Vavg (MLM or placebo, p = 0.188 or higher).

CONCLUSION

MLM applied to the lower limb muscle chains showed no immediate specific effects on postural sway in healthy men. Pre-post effects of MLM were not different from those elicited by a superficial massage. MLM in lower limb muscle chains is not advocated for an immediate improvement of postural balance in this population.

Not All Emotions Are Equal: Fear Chemosignals Lower Awareness Thresholds Only for Fearful Faces

Exposure to body odors (chemosignals) collected under different emotional states (i.e., emotional chemosignals) can modulate our visual system, biasing visual perception. Recent research has suggested that exposure to fear body odors, results in a generalized faster access to visual awareness of different emotional facial expressions (i.e., fear, happy, and neutral). In the present study, we aimed at replicating and extending these findings by exploring if these effects are limited to fear odor, by introducing a second negative body odor—that is, disgust. We compared the time that 3 different emotional facial expressions (i.e., fear, disgust, and neutral) took to reach visual awareness, during a breaking continuous flash suppression paradigm, across 3 body odor conditions (i.e., fear, disgust, and neutral). We found that fear body odors do not trigger an overall faster access to visual awareness, but instead sped-up access to awareness specifically for facial expressions of fear. Disgust odor, on the other hand, had no effects on awareness thresholds of facial expressions. These findings contrast with prior results, suggesting that the potential of fear body odors to induce visual processing adjustments is specific to fear cues. Furthermore, our results support a unique ability of fear body odors in inducing such visual processing changes, compared with other negative emotional chemosignals (i.e., disgust). These conclusions raise interesting questions as to how fear odor might interact with the visual processing stream, whilst simultaneously giving rise to future avenues of research.

Morphometry and gyrification in bipolar disorder and schizophrenia: A comparative MRI study

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Increased right globus pallidus is a consistent marker in schizophrenia (SCZ).

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Left supramarginal gyrification increases in bipolar disorder (BPD) in contrast with SCZ.

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Gyrification analysis may help distinguish early phases of BPD and SCZ.

Schizophrenia is believed to be a neurodevelopmental disease with high heritability. Differential diagnosis is often challenging, especially in early phases, namely with other psychotic disorders or even mood disorders. such as bipolar disorder with psychotic symptoms. Key pathophysiological changes separating these two classical psychoses remain poorly understood, and current evidence favors a more dimensional than categorical differentiation between schizophrenia and bipolar disorder. While established biomarkers like cortical thickness and grey matter volume are heavily influenced by post-onset changes and thus provide limited possibility of accessing early pathologies, gyrification is assumed to be more specifically determined by genetic and early developmental factors. The aim of our study was to compare both classical and novel morphometric features in these two archetypal psychiatric disorders. We included 20 schizophrenia patients, 20 bipolar disorder patients and 20 age- and gender-matched healthy controls. Data analyses were performed with CAT12/SPM12 applying general linear models for four morphometric measures: gyrification and cortical thickness (surface-based morphometry), and whole-brain grey matter/grey matter volume (voxel-based morphometry - VBM). Group effects were tested using age and gender as covariates (and total intracranial volume for VBM). Voxel-based morphometry analysis revealed a schizophrenia vs. control group effect on regional grey matter volume (p < 0.05, familywise error correction) in the right globus pallidus. There was no group effect on white matter volume when correcting for multiple comparisons neither on cortical thickness. Gyrification changes in clinical samples were found in the left supramarginal gyrus (BA40) – increased and reduced gyrification, respectively, in BPD and SCZ patients - and in the right inferior frontal gyrus (BA47), with a reduction in gyrification of the SCZ group when compared with controls. The joint analysis of different morphometric features, namely measures such as gyrification, provides a promising strategy for the elucidation of distinct phenotypes in psychiatric disorders. Different morphological change patterns, highlighting specific disease trajectories, could potentially generate neuroimaging-derived biomarkers, helping to discriminate schizophrenia from bipolar disorder in early phases, such as first-episode psychosis patients.

Surgical treatment of drug-resistant epilepsy caused by gliomas in eloquent areas: experience report

INTRODUCTION

Drug-resistant epilepsy associated with central nervous system tumors is generally caused by low grade gliomas. This group of tumors is usually found in brain eloquent areas, such as the insular lobe, rolandic cortex and supplementary motor area and, historically, possess a greater risk of postoperative deficits.

OBJECTIVE

The aim of this investigation was to present our surgical experience on patients with drug-resistant epilepsy caused by gliomas in eloquent areas. We retrospectively investigated variables that impact seizure control, such as tumor location, extent of resection, invasion into the lenticulostriate arteries in the patient, especially those with insular gliomas.

METHODS

Out of 67 patients with eloquent area brain tumors operated on in our service between 2007 and 2016, 14 patients had symptoms of drug-resistant epilepsy. Volumetric analysis, extent of resection (EOR), type of approach and mapping, among other factors were correlated with the 12-month postoperative seizure outcome.

RESULTS

Univariate analysis showed that the factors showing statistical relevance with seizure control were preoperative volume (p = 0.005), EOR (p = 0.028) and postoperative volume (p = 0.030).

CONCLUSION

There was a statistically significant association between the EOR and the Engel score for epilepsy control: an EOR < 70 was associated with Engel II, III, IV and an EOR > 90 was associated with Engel I. Eloquent area gliomas can safely be resected when surgeons use not only microsurgical anatomy concepts but also brain mapping.

Psychometric properties of the Spanish version of the Edinburgh Handedness Inventory in a sample of Chilean undergraduates

An individual's nervous and cognitive systems are lateralized, and handedness represents a behavioral manifestation of such organization. Therefore, accurately and reliably measuring handedness has repercussion on our understanding of both the human brain and cognition. The Edinburgh Handedness Inventory (EHI) is the most frequently used instrument to measure handedness both in clinical practice and research. We assessed the psychometric properties of the Spanish version of the EHI in a sample of 348 Chilean university students by confirmatory factor analysis. Cronbach's alpha and composite reliability were calculated to evaluate the internal consistency and reliability of the EHI, while the average variance extracted was estimated to evaluate its convergent validity. A 10-item unifactorial structure was confirmed, with factor loadings ≥0.50, showing excellent goodness-of-fit indicators, very high internal consistency and adequate composite reliability and convergent validity. Socio-demographic variables (sex, area of residence and belonging to an indigenous people or community) did not significantly modulate the EHI scores. Overall, by using this validated version of the EHI to accurately and reliably measure handedness in the greater Spanish population, researchers will be able to produce robust data to tackle the still open questions of lateralization in human cognitive and neural architecture.

Factor analysis of the Home Handedness Questionnaire: Unimanual and role differentiated bimanual manipulation as separate dimensions of handedness

Questionnaires are commonly used to measure handedness. However, popular measures do not capture hand preference by skill type, thus reducing handedness to a single dimension. An exception is the Home Handedness Questionnaire (HHQ), an action-based measure developed initially for children, which measures skills across two dimensions of handedness: unimanual actions and role differentiated bimanual manipulation (RDBM). The goal of the current study was to confirm the factor structure of the HHQ in a large sample of adults (N = 1051). A secondary goal was to measure RDBM hand preference in adults. To further validate the HHQ, participants also completed the Edinburgh Handedness Inventory (EHI). Confirmatory factor analysis verified the two-factor structure of the HHQ, and a one-factor solution was replicated for the EHI. Individuals that were classified as consistent on the EHI had stronger preferences for unimanual and RDBM hand use on the HHQ. Right hand patterning was reduced for RDBM compared to unimanual on the HHQ, and the EHI. The HHQ was found to be reliable and valid against the EHI. The HHQ offers researchers a tool to examine individual differences across manual skills that comprise the neuropsychological phenomenon handedness, and to more broadly examine laterality patterns with respect to cognition.

Lower Posttraumatic α-Synuclein Level Associated With Altered Default Mode Network Connectivity Following Acute Mild Traumatic Brain Injury

This study aimed to investigate the changes of α-synuclein in serum and its relationship with default mode network (DMN) connectivity after acute mild traumatic brain injury (mild TBI). Fifty-two patients with mild TBI at the acute phase and 47 matched healthy controls were enrolled in the study. All participants received resting-state functional magnetic resonance imaging (fMRI) and neuropsychological assessments. Relations between the levels of α-synuclein in serum and clinical assessments were obtained using multivariate linear regression. Results showed that the patients with lower α-synuclein presented more complaints on post-concussion symptoms and depression. Moreover, patients with high levels of α-synuclein exhibited significantly decreased functional connectivity in the left precuneus and increased functional connectivity in both the left anterior cingulate cortex and ventro-medial prefrontal cortex (MPFC) compared with patients with low levels of α-synuclein. These findings supported that α-synuclein may modulate the functional connectivity within the DMN and suggest the feasibility of using α-synuclein as an objective biomarker for diagnosis and prognosis of mild TBI.

Assessment and analysis of human laterality for manipulation and communication using the Rennes Laterality Questionnaire

Despite significant scientific advances, the nature of the left-hemispheric systems involved in language (speech and gesture) and manual actions is still unclear. To date, investigations of human laterality focused mainly on non-communication functions. Although gestural laterality data have been published for infants and children, relatively little is known about laterality of human gestural communication. This study investigated human laterality in depth considering non-communication manipulation actions and various gesture types involving hands, feet, face and ears. We constructed an online laterality questionnaire including 60 items related to daily activities. We collected 317 594 item responses by 5904 randomly selected participants. The highest percentages of strong left-lateralized (6.76%) and strong right-lateralized participants (75.19%) were for manipulation actions. The highest percentages of mixed left-lateralized (12.30%) and ambidextrous (50.23%) participants were found for head-related gestures. The highest percentage of mixed right-lateralized participants (55.33%) was found for auditory gestures. Every behavioural category showed a significant population-level right-side bias. More precisely, participants were predominantly right-lateralized for non-communication manual actions, for visual iconic, visual symbolic, visual deictic (with and without speech), tactile and auditory manual gestures as well as for podial and head-related gestures. Our findings support previous studies reporting that humans have left-brain predominance for gestures and complex motor activities such as tool-use. Our study shows that the Rennes Laterality Questionnaire is a useful research instrument to assess and analyse human laterality for both manipulation and communication functions.