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Suchy Y, DesRuisseaux LA, Gereau Mora M, Brothers SL, Niermeyer MA. Conceptualization of the term "ecological validity" in neuropsychological research on executive function assessment: a systematic review and call to action. J Int Neuropsychol Soc 2024; 30:499-522. [PMID: 38251679 DOI: 10.1017/s1355617723000735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
OBJECTIVE "Ecological validity" (EV) is classically defined as test's ability to predict real-world functioning, either alone or together with test's similarity to real-world tasks. In neuropsychological literature on assessment of executive functions (EF), EV is conceptualized inconsistently, leading to misconceptions about the utility of tests. The goal of this systematic review was to examine how EV is conceptualized in studies of EF tests described as ecologically valid. METHOD MEDLINE and PsychINFO Databases were searched. PRISMA guidelines were observed. After applying inclusion and exclusion criteria, this search yielded 90 articles. Deductive content analysis was employed to determine how the term EV was used. RESULTS About 1/3 of the studies conceptualized EV as the test's ability to predict functional outcomes, 1/3 as both the ability to predict functional outcome and similarity to real-world tasks, and 1/3 were either unclear about the meaning of the term or relied on notions unrelated to classical definitions (e.g., similarity to real-world tasks alone, association with other tests, or the ability to discriminate between populations). CONCLUSIONS Conceptualizations of the term EV in literature on EF assessment vary grossly, subsuming the notions of criterion, construct, and face validity, as well as sensitivity/specificity. Such inconsistency makes it difficult to interpret clinical utility of tests that are described as ecologically valid. We call on the field to require that, at minimum, the term EV be clearly defined in all publications, or replaced with more concrete terminology (e.g., criterion validity).
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Affiliation(s)
- Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | | | | | | | - Madison A Niermeyer
- Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, UT, USA
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Zarshenas S, Couture M, Bier N, Giroux S, Nalder E, Lemsky C, Pigot H, Dawson DR, Gosselin N, Le Dorze G, Gagnon-Roy M, Hendryckx C, Bottari C. Implementation of an assistive technology for meal preparation within a supported residence for adults with acquired brain injury: a mixed-methods single case study. Disabil Rehabil Assist Technol 2023; 18:1330-1346. [PMID: 34918600 DOI: 10.1080/17483107.2021.2005163] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/05/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES This study aimed to investigate the feasibility of implementing an assistive technology for meal preparation called COOK within a supported community residence for a person with an acquired brain injury. METHODS Using a mixed-methods approach, a multiple baseline single-case experimental design and a descriptive qualitative study were conducted. The participant was a 47-year-old woman with cognitive impairments following a severe stroke. She received 21 sessions of training on using COOK within a shared kitchen space. During meal preparation, independence and safety were evaluated using three target behaviours: required assistance, task performance errors, and appropriate responses to safety issues, which were compared with an untrained control task, making a budget. Benefits, barriers, and facilitators were assessed via three individual interviews with the client and three focus groups with the care team. RESULTS Both quantitative and qualitative analyses showed that COOK significantly increased independence and safety during meal preparation but not in the control task. Stakeholders suggested that the availability of a training toolkit to a greater number of therapists at the residence and installation of COOK within the client's apartment would help with successful adoption of this technology. CONCLUSION COOK is a promising assistive technology for individuals with cognitive deficits who live in supported community residences.Implication For RehabilitationCOOK is a promising assistive technology for cognition to increase independence and safety in meal preparation for clients with ABI within their supported living contexts.Receiving training from an expert and the availability of technical support are imperative to the successful adoption of COOK.
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Affiliation(s)
- Sareh Zarshenas
- School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Canada
| | - Mélanie Couture
- Centre for Research and Expertise in Social Gerontology (CREGÉS), CIUSSS West-Central Montreal, Côte Saint-Luc, Canada
- Department of Psychology, Université de Sherbrooke, Sherbrooke, Canada
| | - Nathalie Bier
- School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, Canada
| | - Sylvain Giroux
- DOMUS Laboratory, Department of Computer Science, Faculty of Science, Université de Sherbrooke, Sherbrooke, Canada
- Centre de recherche sur le vieillissement- Research Center on Aging, CSSS-IUGS, Sherbrooke, Canada
| | - Emily Nalder
- Occupational Science and Occupational Therapy Department, University of Toronto, Toronto, Canada
- March of Dimes Canada, Toronto, Canada
- Toronto Rehabilitation Institute-KITE, University Health Network, Toronto, Canada
| | - Carolyn Lemsky
- Psychiatry Department, University of Toronto, Toronto, Canada
| | - Hélène Pigot
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Canada
- DOMUS Laboratory, Department of Computer Science, Faculty of Science, Université de Sherbrooke, Sherbrooke, Canada
- Centre de recherche sur le vieillissement- Research Center on Aging, CSSS-IUGS, Sherbrooke, Canada
| | - Deirdre R Dawson
- Occupational Science and Occupational Therapy Department, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
| | - Nadia Gosselin
- Center for Advanced Research in Sleep Medicine (CARSM), Montreal, Canada
- Department of Psychology, Université de Montréal, Montréal, Canada
| | - Guylaine Le Dorze
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Canada
- School of Speech-Language Pathology and Audiology, Université de Montréal, Montreal, Canada
| | - Mireille Gagnon-Roy
- School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Canada
| | - Charlotte Hendryckx
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Canada
- Department of Psychology, Université de Montréal, Montréal, Canada
| | - Carolina Bottari
- School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Canada
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Júlio F, Ribeiro MJ, Simões MR, Castelo-Branco M, Januário C. Assessing the impact of age on everyday cognitive function with a virtual environment task: The EcoKitchen. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-11. [PMID: 37847996 DOI: 10.1080/23279095.2023.2265521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
More realistic assessment tools are imperative for a better understanding of the impact of age-related cognitive deficits on functional status. With this in mind, we probed the ability of the EcoKitchen, a non-immersive virtual environment task with increasing executively demanding kitchen chores, to detect the effects of aging on the simulated everyday functioning of healthy adults. Fifty-three adults (age between 23 and 77 years) were assessed with the EcoKitchen and a set of conventional paper-and-pencil neuropsychological tests. The associations between the baseline features of study participants and each of the two different assessment methods were examined. The associations between the EcoKitchen variables and an executive composite score were also explored. Our results showed that older individuals present deficits in the performance of both the EcoKitchen task and standard assessment methods. Notably, we found that, unlike conventional tests, accuracy in the EcoKitchen task was not related to the education level and IQ score of participants. Moreover, the EcoKitchen performance time was significantly correlated with executive tests. We have demonstrated that the EcoKitchen task, an ecologically relevant computerized neuropsychological assessment tool, might be more suitable than classic paper-and-pencil tests to capture the impact of aging on everyday cognitive function, as it proved to be less prone to the influence of confounding factors. Additionally, we have shown that executive function plays an important role in the timely performance of cognitively challenging virtual environment tasks.
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Affiliation(s)
- Filipa Júlio
- Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
| | - Maria J Ribeiro
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Mário R Simões
- Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
- Faculty of Psychology and Education Sciences, Center for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Cristina Januário
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Coimbra University Hospital, Coimbra, Portugal
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Chicchi Giglioli IA, Pérez Gálvez B, Gil Granados A, Alcañiz Raya M. The Virtual Cooking Task: A Preliminary Comparison Between Neuropsychological and Ecological Virtual Reality Tests to Assess Executive Functions Alterations in Patients Affected by Alcohol Use Disorder. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2021; 24:673-682. [PMID: 33761276 DOI: 10.1089/cyber.2020.0560] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Alcohol use disorder (AUD) is a major global problem. Neuropsychological studies have shown that AUD causes deficits in executive functions (EFs), a set of higher order cognitive skills that govern individual behavior in everyday situations. Many standardized neuropsychological tests are used to evaluate EF. These are reliable and valid but have limitations in predicting real-life performance. To address this, we present a preliminary study to test the virtual cooking task (VCT) as an alternative to standardized neuropsychological tests. The VCT includes four subtasks developed to assess attentional, planning, and cognitive shifting abilities; it was tested in an immersive three-dimensional environment. To evaluate the VCT performance and standardized neuropsychological tests, data were gathered from a sample of healthy subjects (control group [CG]; n = 23) and AUD patients (n = 18). The standardized neuropsychological measures used consisted of questionnaires (Attentional Control Scale, Barratt Impulsiveness Scale, and Cognitive Flexibility Scale) and specific tests (Dot-probe task, Go/No-go test, Stroop test, the trail making test, and Tower of London test). The results showed significant higher correlations for AUD patients than for the CG for the VCT, questionnaires, and specific tests, mainly related to planning and cognitive shifting abilities. Furthermore, comparative analyses of the VCT performance showed that the AUD patients made more errors and had higher latency times than the CG. The present study provides initial evidence that a more ecologically valid assessment can be a useful tool to detect cognitive impairments in many neuropsychological and mental disorders, affecting daily activities.
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Affiliation(s)
- Irene Alice Chicchi Giglioli
- Department of Graphics Engineering, Instituto de Investigación e Innovación en Bioingeniería (I3B), Universitat Politècnica de València, València, Spain
| | - Bartolomé Pérez Gálvez
- Health Department, Unidad de Alcohología, Hospital Universitario de San Juan, Alicante, Spain.,Departamento de Medicina Clínica, Universidad Miguel Hernández, Elche, Spain
| | - Andrea Gil Granados
- Department of Graphics Engineering, Instituto de Investigación e Innovación en Bioingeniería (I3B), Universitat Politècnica de València, València, Spain
| | - Mariano Alcañiz Raya
- Department of Graphics Engineering, Instituto de Investigación e Innovación en Bioingeniería (I3B), Universitat Politècnica de València, València, Spain
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Kim H, Son H. A Moderated-Mediation Model of the Relationship between Dietary Satisfaction and Fatigue in Older Adults with Diabetes: The Role of Meal Planning and Depressive Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8823. [PMID: 33261015 PMCID: PMC7729502 DOI: 10.3390/ijerph17238823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 01/12/2023]
Abstract
Little research has examined the pathways between psychological factors and fatigue in older adults with diabetes. This study explored the pathways between diet-related quality of life and depressive symptoms in predicting fatigue using a moderated-mediation model. A convenience sample of adults ≥65 years (n = 127) with diabetes completed a cross-sectional survey including measures of fatigue severity, diet-related quality of life, and depressive symptoms, and a moderated-mediation analysis assessed the relationships between them. Diet satisfaction was negatively related to fatigue, which was mediated by depressive symptoms. In the moderated-mediation model, diet satisfaction had a conditional effect on fatigue through the mediating effect of depressive symptoms, moderated by meal planning difficulty. At higher levels of perceived meal planning difficulty, lower diet satisfaction was indirectly associated with higher fatigue through depressive symptoms, but this pathway was non-significant at lower levels. Findings suggest that supportive care for diet therapy might improve psychological outcomes in older adults with diabetes, especially for those having difficulties with daily dietary practice. Meal planning difficulties in the dietary management of diabetes accompanied by low diet satisfaction may lead to negative psychological outcomes. Monitoring satisfaction and burdens associated with dietary practices could improve fatigue in this population.
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Affiliation(s)
- Hyerang Kim
- Department of Nursing Science, Howon University, 64 Howondae 3gil, Impi, Gunsan 54058, Jeollabuk-do, Korea;
| | - Heesook Son
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea
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Cerasa A, Arcuri F, Pignataro LM, Serra S, Messina D, Carozzo S, Biafora A, Ceraudo C, Abbruzzino L, Pignolo L, Basta G, Tonin P. The cooking therapy for cognitive rehabilitation of cerebellar damage: A case report and a review of the literature. J Clin Neurosci 2018; 59:357-361. [PMID: 30337124 DOI: 10.1016/j.jocn.2018.09.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 09/26/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND IMPORTANCE The therapeutic approach for cerebellar damages heavily relies on neurorehabilitation since there are no medications that may improve clinical symptoms mainly those related to cognitive dysfunctions. Nevertheless, neurorehabilitation programs tailored to cerebellar damages have never been validated. Here we describe a new rehabilitation approach based on cooking training (CT). The idea that cooking may stimulate cerebellar activity relies on previous evidence demonstrating the beneficial effect on the executive functions as well as in promoting neural plasticity within the cerebellum. Indeed, CT requires motor/mental coordination, thinking flexibly, planning, implementing strategies, shifting and self-monitoring behaviors, all functions drastically affected in cerebellar disorders. CASE DESCRIPTION A 68-year-old male stroke patient with isolated right cerebellar ischemia in the posterior cerebellum characterized by mild executive dysfunctions. After intensive six weekly two-hour sessions, we found that CT was effective in improving some cognitive abilities in a context of mild motor impairment. In particular, deficits in the execution of the Symbol digit modality test and Wisconsin card-sorting test were recovered. CONCLUSION The comparison of our data with those reported in previous studies confirmed the Schmahmann's hypothesis on the effectiveness of neurorehabilitation approaches in cerebellar patients acting as external timekeeping of conscious thoughts.
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Affiliation(s)
- Antonio Cerasa
- IBFM, National Research Council, 88100 Catanzaro, Italy; S. Anna Institute and Research in Advanced Neurorehabilitation (RAN), 88900 Crotone, Italy.
| | - Francesco Arcuri
- S. Anna Institute and Research in Advanced Neurorehabilitation (RAN), 88900 Crotone, Italy
| | | | | | - Demetrio Messina
- Department of Neurology, "S. Giovanni di Dio" Hospital, Largo Bologna, 88900 Crotone, Italy
| | - Simone Carozzo
- S. Anna Institute and Research in Advanced Neurorehabilitation (RAN), 88900 Crotone, Italy
| | - Antonio Biafora
- Cooking Soon Association, Loc. Garga 9 San Giovanni in Fiore, 87055 Cosenza, Italy
| | - Caterina Ceraudo
- Cooking Soon Association, Loc. Garga 9 San Giovanni in Fiore, 87055 Cosenza, Italy
| | - Luca Abbruzzino
- Cooking Soon Association, Loc. Garga 9 San Giovanni in Fiore, 87055 Cosenza, Italy
| | - Loris Pignolo
- S. Anna Institute and Research in Advanced Neurorehabilitation (RAN), 88900 Crotone, Italy
| | - Giuseppina Basta
- S. Anna Institute and Research in Advanced Neurorehabilitation (RAN), 88900 Crotone, Italy
| | - Paolo Tonin
- S. Anna Institute and Research in Advanced Neurorehabilitation (RAN), 88900 Crotone, Italy
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Cerasa A, Pignolo L, Tonin P. How can we restore cognitive deficits in patients with cerebellar damages? J Neurol Sci 2018; 387:92-93. [PMID: 29571879 DOI: 10.1016/j.jns.2018.01.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/24/2018] [Accepted: 01/29/2018] [Indexed: 10/18/2022]
Affiliation(s)
- Antonio Cerasa
- IBFM, National Research Council, Catanzaro, Italy; S. Anna Institute and Research in Advanced Neurorehabilitation (RAN) Crotone, Italy.
| | - Loris Pignolo
- S. Anna Institute and Research in Advanced Neurorehabilitation (RAN) Crotone, Italy
| | - Paolo Tonin
- S. Anna Institute and Research in Advanced Neurorehabilitation (RAN) Crotone, Italy
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Satler C, Guimarães L, Tomaz C. Planning ability impairments in probable Alzheimer's disease patients: Evidence from the Tower of London test. Dement Neuropsychol 2017; 11:137-144. [PMID: 29213505 PMCID: PMC5710682 DOI: 10.1590/1980-57642016dn11-020006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Alzheimer's disease (AD) is associated with progressive impairment of
higher-level cognitive abilities. Previous research suggests that early
impairment of executive functions occurs during the course of the disease, but
few studies have specifically investigated planning ability in an AD
population.
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Affiliation(s)
- Corina Satler
- PhD, Adjunct Professor, Faculty of Ceilandia, UnB, University of Brasilia, Brasilia, DF, Brazil
| | - Luiza Guimarães
- Undergraduate Student, Laboratory of Neurosciences and Behavior, Department of Physiological Sciences, University of Brasilia, Brasilia, DF, Brazil
| | - Carlos Tomaz
- Undergraduate Student, Laboratory of Neurosciences and Behavior, Department of Physiological Sciences, University of Brasilia, Brasilia, DF, Brazil.,PhD, Full Professor, Neuroscience Research Program, University CEUMA, São Luis, MA, Brazil
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Cerasa A, Sarica A, Martino I, Fabbricatore C, Tomaiuolo F, Rocca F, Caracciolo M, Quattrone A. Increased cerebellar gray matter volume in head chefs. PLoS One 2017; 12:e0171457. [PMID: 28182712 PMCID: PMC5300254 DOI: 10.1371/journal.pone.0171457] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 01/21/2017] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE Chefs exert expert motor and cognitive performances on a daily basis. Neuroimaging has clearly shown that that long-term skill learning (i.e., athletes, musicians, chess player or sommeliers) induces plastic changes in the brain thus enabling tasks to be performed faster and more accurately. How a chef's expertise is embodied in a specific neural network has never been investigated. METHODS Eleven Italian head chefs with long-term brigade management expertise and 11 demographically-/ psychologically- matched non-experts underwent morphological evaluations. RESULTS Voxel-based analysis performed with SUIT, as well as, automated volumetric measurement assessed with Freesurfer, revealed increased gray matter volume in the cerebellum in chefs compared to non-experts. The most significant changes were detected in the anterior vermis and the posterior cerebellar lobule. The magnitude of the brigade staff and the higher performance in the Tower of London test correlated with these specific gray matter increases, respectively. CONCLUSIONS We found that chefs are characterized by an anatomical variability involving the cerebellum. This confirms the role of this region in the development of similar expert brains characterized by learning dexterous skills, such as pianists, rock climbers and basketball players. However, the nature of the cellular events underlying the detected morphological differences remains an open question.
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Affiliation(s)
- Antonio Cerasa
- Istituto di Bioimmagini e Fisiologia Molecolare, Consiglio Nazionale delle Ricerche, Catanzaro, Italy
| | - Alessia Sarica
- Istituto di Bioimmagini e Fisiologia Molecolare, Consiglio Nazionale delle Ricerche, Catanzaro, Italy
| | - Iolanda Martino
- Istituto di Bioimmagini e Fisiologia Molecolare, Consiglio Nazionale delle Ricerche, Catanzaro, Italy
| | - Carmelo Fabbricatore
- Istituto Istruzione Superiore “Mancini”, Cosenza, Italy
- Federazione Italiana Cuochi, Rome, Italy
| | - Francesco Tomaiuolo
- Fondazione Volterra Ricerche “Auxilium Vitae”, Volterra, Italy
- Unità Operativa di Psicologia Clinica, Azienda Ospedaliero Universitaria, Pisa, Italy
| | - Federico Rocca
- Istituto di Bioimmagini e Fisiologia Molecolare, Consiglio Nazionale delle Ricerche, Catanzaro, Italy
| | - Manuela Caracciolo
- Istituto di Bioimmagini e Fisiologia Molecolare, Consiglio Nazionale delle Ricerche, Catanzaro, Italy
| | - Aldo Quattrone
- Istituto di Bioimmagini e Fisiologia Molecolare, Consiglio Nazionale delle Ricerche, Catanzaro, Italy
- Istituto di Neurologia, Università "Magna Graecia", Catanzaro, Italy
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