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Sandrone S, Ntonia I. Exploring the identity development of the budding neuroscientist at postgraduate level: a mixed-method study with perspectives from alumni and academics. BMC Med Educ 2022; 22:746. [PMID: 36307793 PMCID: PMC9615628 DOI: 10.1186/s12909-022-03758-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Neuroscience represents one of the most exciting frontiers in scientific research. However, given the recency of neuroscience as a discipline, its inter- and multi-disciplinary nature, the lack of educational research on brain science training, the absence of a national or global benchmark and the numerous neuroscience subfields, the development of the academic neuroscientist identity across career stages remains obfuscated. Neuroscience is not predominantly taught at the undergraduate level but presents as a postgraduate specialism, accepting graduates from a wide range of primary disciplines. METHODS This work represents the first mixed-method study exploring the development of the neuroscientist identity at the postgraduate level at a high-ranking, research-intensive UK University. It combines responses from standardised self-efficacy and professional identity questionnaires and qualitative data from nineteen semi-structured interviews with alumni and academics. RESULTS Key findings on influences, identity transitions, curricular skills and sense of belonging have been discussed. The results obtained can be mapped against the theoretical framework proposed by Laudel and Gläser in 2008, although some minor changes to the model have been suggested. DISCUSSION Implementing active learning strategies and experiential assessments, designing mentoring opportunities and creating spaces for interaction can favour the transition from students to neuroscientists and contribute to an inclusive and diverse neuroscientific community.
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Affiliation(s)
- Stefano Sandrone
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK.
| | - Iro Ntonia
- Centre for Higher Education Research and Scholarship (CHERS), Imperial College London, London, UK
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Sandrone S. Roger W. Sperry (1913-1994). J Neurol 2022; 269:5194-5195. [PMID: 35867150 PMCID: PMC9363358 DOI: 10.1007/s00415-022-11232-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 10/26/2022]
Affiliation(s)
- Stefano Sandrone
- Department of Brain Sciences, Imperial College London, London, UK.
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Sandrone S, Carlson CE. Future of Neurology & Technology: Virtual and Augmented Reality in Neurology and Neuroscience Education: Applications and Curricular Strategies. Neurology 2021; 97:740-744. [PMID: 34187858 DOI: 10.1212/wnl.0000000000012413] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Virtual reality and augmented reality have become increasingly prevalent in our lives. They are changing the way we see and interact with the world and have started percolating through medical education. In this article, we reviewed the key applications of virtual and augmented realities in neurology and neuroscience education and discussed barriers and opportunities for implementation in the curriculum. Although the long-term benefits of these approaches over more traditional learning methods and the optimal curricular balance remain mostly unexplored, virtual and augmented reality can change how we teach neurology and neuroscience.
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Affiliation(s)
- Stefano Sandrone
- From the Department of Brain Sciences (S.S.), Imperial College London, United Kingdom; and Medical College of Wisconsin (C.E.C.).
| | - Chad E Carlson
- From the Department of Brain Sciences (S.S.), Imperial College London, United Kingdom; and Medical College of Wisconsin (C.E.C.)
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Sandrone S. Eight career tips from Nobel Laureates. Nature 2021:10.1038/d41586-021-02772-4. [PMID: 34625729 DOI: 10.1038/d41586-021-02772-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Parkin BL, Daws RE, Das-Neves I, Violante IR, Soreq E, Faisal AA, Sandrone S, Lao-Kaim NP, Martin-Bastida A, Roussakis AA, Piccini P, Hampshire A. Dissociable effects of age and Parkinson's disease on instruction-based learning. Brain Commun 2021; 3:fcab175. [PMID: 34485905 PMCID: PMC8410985 DOI: 10.1093/braincomms/fcab175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 04/06/2021] [Accepted: 05/10/2021] [Indexed: 12/02/2022] Open
Abstract
The cognitive deficits associated with Parkinson's disease vary across individuals and change across time, with implications for prognosis and treatment. Key outstanding challenges are to define the distinct behavioural characteristics of this disorder and develop diagnostic paradigms that can assess these sensitively in individuals. In a previous study, we measured different aspects of attentional control in Parkinson's disease using an established fMRI switching paradigm. We observed no deficits for the aspects of attention the task was designed to examine; instead those with Parkinson's disease learnt the operational requirements of the task more slowly. We hypothesized that a subset of people with early-to-mid stage Parkinson's might be impaired when encoding rules for performing new tasks. Here, we directly test this hypothesis and investigate whether deficits in instruction-based learning represent a characteristic of Parkinson's Disease. Seventeen participants with Parkinson's disease (8 male; mean age: 61.2 years), 18 older adults (8 male; mean age: 61.3 years) and 20 younger adults (10 males; mean age: 26.7 years) undertook a simple instruction-based learning paradigm in the MRI scanner. They sorted sequences of coloured shapes according to binary discrimination rules that were updated at two-minute intervals. Unlike common reinforcement learning tasks, the rules were unambiguous, being explicitly presented; consequently, there was no requirement to monitor feedback or estimate contingencies. Despite its simplicity, a third of the Parkinson's group, but only one older adult, showed marked increases in errors, 4 SD greater than the worst performing young adult. The pattern of errors was consistent, reflecting a tendency to misbind discrimination rules. The misbinding behaviour was coupled with reduced frontal, parietal and anterior caudate activity when rules were being encoded, but not when attention was initially oriented to the instruction slides or when discrimination trials were performed. Concomitantly, Magnetic Resonance Spectroscopy showed reduced gamma-Aminobutyric acid levels within the mid-dorsolateral prefrontal cortices of individuals who made misbinding errors. These results demonstrate, for the first time, that a subset of early-to-mid stage people with Parkinson's show substantial deficits when binding new task rules in working memory. Given the ubiquity of instruction-based learning, these deficits are likely to impede daily living. They will also confound clinical assessment of other cognitive processes. Future work should determine the value of instruction-based learning as a sensitive early marker of cognitive decline and as a measure of responsiveness to therapy in Parkinson's disease.
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Affiliation(s)
- Beth L Parkin
- Department of Psychology, School of Social Science, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK
| | - Richard E Daws
- The Cognitive, Computational and Clinical Neuroscience Laboratory, Department of Medicine, Imperial College London, London W120NN, UK
| | - Ines Das-Neves
- The Cognitive, Computational and Clinical Neuroscience Laboratory, Department of Medicine, Imperial College London, London W120NN, UK
| | - Ines R Violante
- The Cognitive, Computational and Clinical Neuroscience Laboratory, Department of Medicine, Imperial College London, London W120NN, UK
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Eyal Soreq
- The Cognitive, Computational and Clinical Neuroscience Laboratory, Department of Medicine, Imperial College London, London W120NN, UK
| | - A Aldo Faisal
- Brain and Behaviour Laboratory, Department of Bioengineering, Imperial College London, London W12 0NN, UK
- Brain and Behaviour Laboratory, Department of Computing, Imperial College London, London W12 0NN, UK
- Behaviour Analytics Lab, Data Science Institute, Imperial College London, London W12 0NN, UK
- MRC London Institute of Medical Sciences, London W12 0NN, UK
| | - Stefano Sandrone
- The Cognitive, Computational and Clinical Neuroscience Laboratory, Department of Medicine, Imperial College London, London W120NN, UK
| | - Nicholas P Lao-Kaim
- Neurology Imaging Unit, Division of Neurology, Imperial College London, London W12 0NN, UK
| | - Antonio Martin-Bastida
- Neurology Imaging Unit, Division of Neurology, Imperial College London, London W12 0NN, UK
- Department of Neurology and Neurosciences, Clinica Universidad de Navarra, Pamplona-Madrid 28027, Spain
| | | | - Paola Piccini
- Neurology Imaging Unit, Division of Neurology, Imperial College London, London W12 0NN, UK
| | - Adam Hampshire
- The Cognitive, Computational and Clinical Neuroscience Laboratory, Department of Medicine, Imperial College London, London W120NN, UK
- UK DRI Care Research & Technology Centre, Imperial College London, London W12 0NN, UK
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Lorusso L, Zago S, Sandrone S. Carlo Francesco Giuseppe Bellingeri (1785-1843). J Neurol 2021; 269:1068-1069. [PMID: 34427753 DOI: 10.1007/s00415-021-10732-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/20/2021] [Accepted: 07/26/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Lorenzo Lorusso
- UOC Neurologia e Stroke Unit, Dipartimento di Neuroscienze, ASST Lecco, Presidio Merate, Lecco, Italy.
| | - Stefano Zago
- Dipartimento di Neuroscienze e Salute Mentale, U.O.C. di Neurologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
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Sandrone S, Albert DVF, Dunham SR, Kraker J, Noviawaty I, Palm M, Kushlaf H. Training in Neurology: How Lessons Learned on Teaching, Well-being, and Telemedicine During the COVID-19 Pandemic Can Shape the Future of Neurology Education. Neurology 2021; 96:e3007-e3010. [PMID: 33910943 PMCID: PMC8253563 DOI: 10.1212/wnl.0000000000012010] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The COVID-19 pandemic has a disruptive effect on neurology education, necessitating creative adjustments in the delivery of education, clinical training, and well-being. In this article, a group of educators reflects on challenges and lessons learned on teaching, well-being, and telemedicine, and how these can shape the future of neurology education. Developing standardized, rigorous evaluation of teaching methods and telemedicine, reinforcing well-being resources, and promoting international educational collaborations can improve neurology training during and after the pandemic.
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Affiliation(s)
- Stefano Sandrone
- From Imperial College London (S.S.), UK; A.B. Baker Section on Neurological Education (S.S., D.V.F.A., S.R.D., J.K., I.N., M.P., H.K.), American Academy of Neurology, Minneapolis, MN; Department of Pediatrics, Division of Child Neurology (D.V.F.A.), Nationwide Children's Hospital and the Ohio State University, Columbus; Washington University in Saint Louis (S.R.D.), MO; Department of Clinical Neurosciences (J.K.), Tulane University School of Medicine, New Orleans, LA; Department of Neurology, Epilepsy Division (I.N.), University of Massachusetts Medical School, Boston; Department of Neurology (M.P.), University of Texas Health Science Center at San Antonio; and Department of Neurology & Rehabilitation Medicine (H.K.), University of Cincinnati, OH.
| | - Dara V F Albert
- From Imperial College London (S.S.), UK; A.B. Baker Section on Neurological Education (S.S., D.V.F.A., S.R.D., J.K., I.N., M.P., H.K.), American Academy of Neurology, Minneapolis, MN; Department of Pediatrics, Division of Child Neurology (D.V.F.A.), Nationwide Children's Hospital and the Ohio State University, Columbus; Washington University in Saint Louis (S.R.D.), MO; Department of Clinical Neurosciences (J.K.), Tulane University School of Medicine, New Orleans, LA; Department of Neurology, Epilepsy Division (I.N.), University of Massachusetts Medical School, Boston; Department of Neurology (M.P.), University of Texas Health Science Center at San Antonio; and Department of Neurology & Rehabilitation Medicine (H.K.), University of Cincinnati, OH
| | - S Richard Dunham
- From Imperial College London (S.S.), UK; A.B. Baker Section on Neurological Education (S.S., D.V.F.A., S.R.D., J.K., I.N., M.P., H.K.), American Academy of Neurology, Minneapolis, MN; Department of Pediatrics, Division of Child Neurology (D.V.F.A.), Nationwide Children's Hospital and the Ohio State University, Columbus; Washington University in Saint Louis (S.R.D.), MO; Department of Clinical Neurosciences (J.K.), Tulane University School of Medicine, New Orleans, LA; Department of Neurology, Epilepsy Division (I.N.), University of Massachusetts Medical School, Boston; Department of Neurology (M.P.), University of Texas Health Science Center at San Antonio; and Department of Neurology & Rehabilitation Medicine (H.K.), University of Cincinnati, OH
| | - Jessica Kraker
- From Imperial College London (S.S.), UK; A.B. Baker Section on Neurological Education (S.S., D.V.F.A., S.R.D., J.K., I.N., M.P., H.K.), American Academy of Neurology, Minneapolis, MN; Department of Pediatrics, Division of Child Neurology (D.V.F.A.), Nationwide Children's Hospital and the Ohio State University, Columbus; Washington University in Saint Louis (S.R.D.), MO; Department of Clinical Neurosciences (J.K.), Tulane University School of Medicine, New Orleans, LA; Department of Neurology, Epilepsy Division (I.N.), University of Massachusetts Medical School, Boston; Department of Neurology (M.P.), University of Texas Health Science Center at San Antonio; and Department of Neurology & Rehabilitation Medicine (H.K.), University of Cincinnati, OH
| | - Ika Noviawaty
- From Imperial College London (S.S.), UK; A.B. Baker Section on Neurological Education (S.S., D.V.F.A., S.R.D., J.K., I.N., M.P., H.K.), American Academy of Neurology, Minneapolis, MN; Department of Pediatrics, Division of Child Neurology (D.V.F.A.), Nationwide Children's Hospital and the Ohio State University, Columbus; Washington University in Saint Louis (S.R.D.), MO; Department of Clinical Neurosciences (J.K.), Tulane University School of Medicine, New Orleans, LA; Department of Neurology, Epilepsy Division (I.N.), University of Massachusetts Medical School, Boston; Department of Neurology (M.P.), University of Texas Health Science Center at San Antonio; and Department of Neurology & Rehabilitation Medicine (H.K.), University of Cincinnati, OH
| | - Michael Palm
- From Imperial College London (S.S.), UK; A.B. Baker Section on Neurological Education (S.S., D.V.F.A., S.R.D., J.K., I.N., M.P., H.K.), American Academy of Neurology, Minneapolis, MN; Department of Pediatrics, Division of Child Neurology (D.V.F.A.), Nationwide Children's Hospital and the Ohio State University, Columbus; Washington University in Saint Louis (S.R.D.), MO; Department of Clinical Neurosciences (J.K.), Tulane University School of Medicine, New Orleans, LA; Department of Neurology, Epilepsy Division (I.N.), University of Massachusetts Medical School, Boston; Department of Neurology (M.P.), University of Texas Health Science Center at San Antonio; and Department of Neurology & Rehabilitation Medicine (H.K.), University of Cincinnati, OH
| | - Hani Kushlaf
- From Imperial College London (S.S.), UK; A.B. Baker Section on Neurological Education (S.S., D.V.F.A., S.R.D., J.K., I.N., M.P., H.K.), American Academy of Neurology, Minneapolis, MN; Department of Pediatrics, Division of Child Neurology (D.V.F.A.), Nationwide Children's Hospital and the Ohio State University, Columbus; Washington University in Saint Louis (S.R.D.), MO; Department of Clinical Neurosciences (J.K.), Tulane University School of Medicine, New Orleans, LA; Department of Neurology, Epilepsy Division (I.N.), University of Massachusetts Medical School, Boston; Department of Neurology (M.P.), University of Texas Health Science Center at San Antonio; and Department of Neurology & Rehabilitation Medicine (H.K.), University of Cincinnati, OH.
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Farheen AS, George IC, Singhal D, Troxell RM, Pillai J, Schneider L, Lomen-Hoerth C, Graves JS, Sandrone S, Nobleza COS. Current Status and Future Strategies for Mentoring Women in Neurology. Neurology 2021; 97:30-37. [PMID: 34088876 DOI: 10.1212/wnl.0000000000012242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 03/08/2021] [Indexed: 11/15/2022] Open
Abstract
The American Academy of Neurology's (AAN) 2017 Gender Disparity Report identified improving mentorship as a key intervention to fill the leadership and pay gaps for women in neurology. Here we summarize the literature on mentoring women, provide an outline of ideal components of programs geared toward closing gender gaps, and present a mentoring program for AAN members. The strategies discussed share similarities with those for closing gaps related to race, ethnicity, and religion. Developing effective mentorship and sponsorship programs is essential to ensure a sufficiently diverse pool of academic faculty and private practitioners and to establish equal representation in leadership roles in this field.
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Affiliation(s)
- Amtul S Farheen
- From the Lebanon VA Medical Center (A.S.F.), PA; Massachusetts General Hospital (I.C.G.), Boston; University of Oklahoma College of Medicine (D.S.), Oklahoma City; Rady Children's Hospital-San Diego (R.M.T., J.S.G.), CA; Drexel University College of Medicine (J.P.), Philadelphia, PA; Stanford Center for Sleep Sciences and Medicine (L.S.); Sierra Pacific Mental Illness Research Education and Clinical Centers (L.S.), VA Palo Alto Health Care System, Palo Alto; UCSF Medical Center (C.L.-H.); Department of Neurosciences (J.S.G.), UCSD, San Diego, CA; Imperial College London (S.S.), UK; University of Mississippi Medical Center (C.O.S.N.), Jackson; and Penn State Hershey Medical Center (A.S.F.)
| | - Ilena C George
- From the Lebanon VA Medical Center (A.S.F.), PA; Massachusetts General Hospital (I.C.G.), Boston; University of Oklahoma College of Medicine (D.S.), Oklahoma City; Rady Children's Hospital-San Diego (R.M.T., J.S.G.), CA; Drexel University College of Medicine (J.P.), Philadelphia, PA; Stanford Center for Sleep Sciences and Medicine (L.S.); Sierra Pacific Mental Illness Research Education and Clinical Centers (L.S.), VA Palo Alto Health Care System, Palo Alto; UCSF Medical Center (C.L.-H.); Department of Neurosciences (J.S.G.), UCSD, San Diego, CA; Imperial College London (S.S.), UK; University of Mississippi Medical Center (C.O.S.N.), Jackson; and Penn State Hershey Medical Center (A.S.F.)
| | - Divya Singhal
- From the Lebanon VA Medical Center (A.S.F.), PA; Massachusetts General Hospital (I.C.G.), Boston; University of Oklahoma College of Medicine (D.S.), Oklahoma City; Rady Children's Hospital-San Diego (R.M.T., J.S.G.), CA; Drexel University College of Medicine (J.P.), Philadelphia, PA; Stanford Center for Sleep Sciences and Medicine (L.S.); Sierra Pacific Mental Illness Research Education and Clinical Centers (L.S.), VA Palo Alto Health Care System, Palo Alto; UCSF Medical Center (C.L.-H.); Department of Neurosciences (J.S.G.), UCSD, San Diego, CA; Imperial College London (S.S.), UK; University of Mississippi Medical Center (C.O.S.N.), Jackson; and Penn State Hershey Medical Center (A.S.F.)
| | - Regina M Troxell
- From the Lebanon VA Medical Center (A.S.F.), PA; Massachusetts General Hospital (I.C.G.), Boston; University of Oklahoma College of Medicine (D.S.), Oklahoma City; Rady Children's Hospital-San Diego (R.M.T., J.S.G.), CA; Drexel University College of Medicine (J.P.), Philadelphia, PA; Stanford Center for Sleep Sciences and Medicine (L.S.); Sierra Pacific Mental Illness Research Education and Clinical Centers (L.S.), VA Palo Alto Health Care System, Palo Alto; UCSF Medical Center (C.L.-H.); Department of Neurosciences (J.S.G.), UCSD, San Diego, CA; Imperial College London (S.S.), UK; University of Mississippi Medical Center (C.O.S.N.), Jackson; and Penn State Hershey Medical Center (A.S.F.)
| | - Jyoti Pillai
- From the Lebanon VA Medical Center (A.S.F.), PA; Massachusetts General Hospital (I.C.G.), Boston; University of Oklahoma College of Medicine (D.S.), Oklahoma City; Rady Children's Hospital-San Diego (R.M.T., J.S.G.), CA; Drexel University College of Medicine (J.P.), Philadelphia, PA; Stanford Center for Sleep Sciences and Medicine (L.S.); Sierra Pacific Mental Illness Research Education and Clinical Centers (L.S.), VA Palo Alto Health Care System, Palo Alto; UCSF Medical Center (C.L.-H.); Department of Neurosciences (J.S.G.), UCSD, San Diego, CA; Imperial College London (S.S.), UK; University of Mississippi Medical Center (C.O.S.N.), Jackson; and Penn State Hershey Medical Center (A.S.F.)
| | - Logan Schneider
- From the Lebanon VA Medical Center (A.S.F.), PA; Massachusetts General Hospital (I.C.G.), Boston; University of Oklahoma College of Medicine (D.S.), Oklahoma City; Rady Children's Hospital-San Diego (R.M.T., J.S.G.), CA; Drexel University College of Medicine (J.P.), Philadelphia, PA; Stanford Center for Sleep Sciences and Medicine (L.S.); Sierra Pacific Mental Illness Research Education and Clinical Centers (L.S.), VA Palo Alto Health Care System, Palo Alto; UCSF Medical Center (C.L.-H.); Department of Neurosciences (J.S.G.), UCSD, San Diego, CA; Imperial College London (S.S.), UK; University of Mississippi Medical Center (C.O.S.N.), Jackson; and Penn State Hershey Medical Center (A.S.F.)
| | - Catherine Lomen-Hoerth
- From the Lebanon VA Medical Center (A.S.F.), PA; Massachusetts General Hospital (I.C.G.), Boston; University of Oklahoma College of Medicine (D.S.), Oklahoma City; Rady Children's Hospital-San Diego (R.M.T., J.S.G.), CA; Drexel University College of Medicine (J.P.), Philadelphia, PA; Stanford Center for Sleep Sciences and Medicine (L.S.); Sierra Pacific Mental Illness Research Education and Clinical Centers (L.S.), VA Palo Alto Health Care System, Palo Alto; UCSF Medical Center (C.L.-H.); Department of Neurosciences (J.S.G.), UCSD, San Diego, CA; Imperial College London (S.S.), UK; University of Mississippi Medical Center (C.O.S.N.), Jackson; and Penn State Hershey Medical Center (A.S.F.)
| | - Jennifer S Graves
- From the Lebanon VA Medical Center (A.S.F.), PA; Massachusetts General Hospital (I.C.G.), Boston; University of Oklahoma College of Medicine (D.S.), Oklahoma City; Rady Children's Hospital-San Diego (R.M.T., J.S.G.), CA; Drexel University College of Medicine (J.P.), Philadelphia, PA; Stanford Center for Sleep Sciences and Medicine (L.S.); Sierra Pacific Mental Illness Research Education and Clinical Centers (L.S.), VA Palo Alto Health Care System, Palo Alto; UCSF Medical Center (C.L.-H.); Department of Neurosciences (J.S.G.), UCSD, San Diego, CA; Imperial College London (S.S.), UK; University of Mississippi Medical Center (C.O.S.N.), Jackson; and Penn State Hershey Medical Center (A.S.F.)
| | - Stefano Sandrone
- From the Lebanon VA Medical Center (A.S.F.), PA; Massachusetts General Hospital (I.C.G.), Boston; University of Oklahoma College of Medicine (D.S.), Oklahoma City; Rady Children's Hospital-San Diego (R.M.T., J.S.G.), CA; Drexel University College of Medicine (J.P.), Philadelphia, PA; Stanford Center for Sleep Sciences and Medicine (L.S.); Sierra Pacific Mental Illness Research Education and Clinical Centers (L.S.), VA Palo Alto Health Care System, Palo Alto; UCSF Medical Center (C.L.-H.); Department of Neurosciences (J.S.G.), UCSD, San Diego, CA; Imperial College London (S.S.), UK; University of Mississippi Medical Center (C.O.S.N.), Jackson; and Penn State Hershey Medical Center (A.S.F.)
| | - Christa O'Hana S Nobleza
- From the Lebanon VA Medical Center (A.S.F.), PA; Massachusetts General Hospital (I.C.G.), Boston; University of Oklahoma College of Medicine (D.S.), Oklahoma City; Rady Children's Hospital-San Diego (R.M.T., J.S.G.), CA; Drexel University College of Medicine (J.P.), Philadelphia, PA; Stanford Center for Sleep Sciences and Medicine (L.S.); Sierra Pacific Mental Illness Research Education and Clinical Centers (L.S.), VA Palo Alto Health Care System, Palo Alto; UCSF Medical Center (C.L.-H.); Department of Neurosciences (J.S.G.), UCSD, San Diego, CA; Imperial College London (S.S.), UK; University of Mississippi Medical Center (C.O.S.N.), Jackson; and Penn State Hershey Medical Center (A.S.F.).
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Jolly AE, Bălăeţ M, Azor A, Friedland D, Sandrone S, Graham NSN, Zimmerman K, Sharp DJ. Detecting axonal injury in individual patients after traumatic brain injury. Brain 2021; 144:92-113. [PMID: 33257929 PMCID: PMC7880666 DOI: 10.1093/brain/awaa372] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/11/2020] [Accepted: 08/17/2020] [Indexed: 12/04/2022] Open
Abstract
Poor outcomes after traumatic brain injury (TBI) are common yet remain difficult to predict. Diffuse axonal injury is important for outcomes, but its assessment remains limited in the clinical setting. Currently, axonal injury is diagnosed based on clinical presentation, visible damage to the white matter or via surrogate markers of axonal injury such as microbleeds. These do not accurately quantify axonal injury leading to misdiagnosis in a proportion of patients. Diffusion tensor imaging provides a quantitative measure of axonal injury in vivo, with fractional anisotropy often used as a proxy for white matter damage. Diffusion imaging has been widely used in TBI but is not routinely applied clinically. This is in part because robust analysis methods to diagnose axonal injury at the individual level have not yet been developed. Here, we present a pipeline for diffusion imaging analysis designed to accurately assess the presence of axonal injury in large white matter tracts in individuals. Average fractional anisotropy is calculated from tracts selected on the basis of high test-retest reliability, good anatomical coverage and their association to cognitive and clinical impairments after TBI. We test our pipeline for common methodological issues such as the impact of varying control sample sizes, focal lesions and age-related changes to demonstrate high specificity, sensitivity and test-retest reliability. We assess 92 patients with moderate-severe TBI in the chronic phase (≥6 months post-injury), 25 patients in the subacute phase (10 days to 6 weeks post-injury) with 6-month follow-up and a large control cohort (n = 103). Evidence of axonal injury is identified in 52% of chronic and 28% of subacute patients. Those classified with axonal injury had significantly poorer cognitive and functional outcomes than those without, a difference not seen for focal lesions or microbleeds. Almost a third of patients with unremarkable standard MRIs had evidence of axonal injury, whilst 40% of patients with visible microbleeds had no diffusion evidence of axonal injury. More diffusion abnormality was seen with greater time since injury, across individuals at various chronic injury times and within individuals between subacute and 6-month scans. We provide evidence that this pipeline can be used to diagnose axonal injury in individual patients at subacute and chronic time points, and that diffusion MRI provides a sensitive and complementary measure when compared to susceptibility weighted imaging, which measures diffuse vascular injury. Guidelines for the implementation of this pipeline in a clinical setting are discussed.
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Affiliation(s)
- Amy E Jolly
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK.,UK Dementia Research Institute Care Research and Technology Centre, Imperial College London and the University of Surrey, London, W12 0NN UK
| | - Maria Bălăeţ
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - Adriana Azor
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - Daniel Friedland
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - Stefano Sandrone
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - Neil S N Graham
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - Karl Zimmerman
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - David J Sharp
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK.,UK Dementia Research Institute Care Research and Technology Centre, Imperial College London and the University of Surrey, London, W12 0NN UK
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10
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Abstract
The COVID-19 global pandemic has forced the higher education sector to transition to an uncharted remote-learning format. This offers an opportunity to adopt active learning, which increases students’ performance compared to lectures, narrows achievement gaps for underrepresented students, and promotes equity and inclusivity, as the basis of STEM education.
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Affiliation(s)
- Stefano Sandrone
- The Computational, Cognitive and Clinical Neuroimaging Laboratory (C(3)NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom.
| | - Gregory Scott
- The Computational, Cognitive and Clinical Neuroimaging Laboratory (C(3)NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom.
| | - William J Anderson
- Department of Stem Cell and Regenerative Biology, Harvard University, and Harvard Stem Cell Institute, Cambridge, USA.
| | - Kiran Musunuru
- Cardiovascular Institute, Department of Medicine, and Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA.
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11
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Sandrone S, Carlson C. Gamification and game-based education in neurology and neuroscience: Applications, challenges, and opportunities. Brain Disorders 2021. [DOI: 10.1016/j.dscb.2021.100008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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12
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Keser Z, Patino J, Rodriguez YA, Beck RC, Kupcha LA, McCullough LD, Sandrone S, Furr Stimming E. Expanding the duration of the neurology clerkship – does it matter? Brain Disorders 2021. [DOI: 10.1016/j.dscb.2021.100007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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13
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Sarva H, Patino GA, Rashid M, Owens JWM, Robbins MS, Sandrone S. The status of neurology fellowships in the United States: clinical needs, educational barriers, and future outlooks. BMC Med Educ 2021; 21:108. [PMID: 33596875 PMCID: PMC7891131 DOI: 10.1186/s12909-021-02536-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 02/04/2021] [Indexed: 06/12/2023]
Abstract
The need for subspecialty-trained neurologists is growing in parallel with increasing disease burden. However, despite the immense burden of neurological diseases, like headache and neurodegenerative disorders, recruitment into these subspecialties remains insufficient in the United States. In this manuscript, a group of educators from the American Academy of Neurology's A.B. Baker Section on Neurological Education sought to review and discuss the current landscape of neurology fellowships in the United States, the factors driving fellowship recruitment and the educational barriers. Moreover, suggestions to potentially improve recruitment for under-selected fellowships, which can contribute towards an alignment between neurological education and neurological needs, and future educational scenarios are discussed.
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Affiliation(s)
- Harini Sarva
- A.B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, USA.
- Weill Cornell Medicine, New York, NY, USA.
| | - Gustavo A Patino
- A.B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, USA
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Mehmood Rashid
- A.B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, USA
- The University of Toledo, Toledo, OH, USA
| | - James W M Owens
- A.B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, USA.
- University of Washington, Seattle, Washington, USA.
| | - Matthew S Robbins
- A.B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, USA
- Weill Cornell Medicine, New York, NY, USA
| | - Stefano Sandrone
- A.B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, USA
- Imperial College London, London, UK
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14
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Nęcka E, Gruszka A, Hampshire A, Sarzyńska-Wawer J, Anicai AE, Orzechowski J, Nowak M, Wójcik N, Sandrone S, Soreq E. The Effects of Working Memory Training on Brain Activity. Brain Sci 2021; 11:brainsci11020155. [PMID: 33503877 PMCID: PMC7911688 DOI: 10.3390/brainsci11020155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/31/2020] [Accepted: 01/11/2021] [Indexed: 12/29/2022] Open
Abstract
This study aimed to investigate if two weeks of working memory (WM) training on a progressive N-back task can generate changes in the activity of the underlying WM neural network. Forty-six healthy volunteers (23 training and 23 controls) were asked to perform the N-back task during three fMRI scanning sessions: (1) before training, (2) after the half of training sessions, and (3) at the end. Between the scanning sessions, the experimental group underwent a 10-session training of working memory with the use of an adaptive version of the N-back task, while the control group did not train anything. The N-back task in the scanning sessions was relatively easy (n = 2) in order to ensure high accuracy and a lack of between-group differences at the behavioral level. Such training-induced differences in neural efficiency were expected. Behavioral analyses revealed improved performance of both groups on the N-back task. However, these improvements resulted from the test-retest effect, not the training outside scanner. Performance on the non-trained stop-signal task did not demonstrate any transfer effect. Imaging analysis showed changes in activation in several significant clusters, with overlapping regions of interest in the frontal and parietal lobes. However, patterns of between-session changes of activation did not show any effect of training. The only finding that can be linked with training consists in strengthening the correlation between task performance accuracy and activation of the parietal regions of the neural network subserving working memory (left superior parietal lobule and right supramarginal gyrus posterior). These results suggest that the effects of WM training consist in learning that, in order to ensure high accuracy in the criterion task, activation of the parietal regions implicated in working memory updating must rise.
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Affiliation(s)
- Edward Nęcka
- Faculty of Philosophy, Institute of Psychology, Jagiellonian University in Kraków, 31-007 Krakow, Poland; (A.G.); (M.N.); (N.W.)
- Correspondence: ; Tel.: +48-126-332-432
| | - Aleksandra Gruszka
- Faculty of Philosophy, Institute of Psychology, Jagiellonian University in Kraków, 31-007 Krakow, Poland; (A.G.); (M.N.); (N.W.)
| | - Adam Hampshire
- The C3NL Lab, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London SW7 2BU, UK; (A.H.); (A.-E.A.); (S.S.); (E.S.)
| | | | - Andreea-Elena Anicai
- The C3NL Lab, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London SW7 2BU, UK; (A.H.); (A.-E.A.); (S.S.); (E.S.)
| | - Jarosław Orzechowski
- Department of Cognitive Psychology and Psychology of Individual Differences, Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities, 53-238 Wrocław, Poland;
| | - Michał Nowak
- Faculty of Philosophy, Institute of Psychology, Jagiellonian University in Kraków, 31-007 Krakow, Poland; (A.G.); (M.N.); (N.W.)
| | - Natalia Wójcik
- Faculty of Philosophy, Institute of Psychology, Jagiellonian University in Kraków, 31-007 Krakow, Poland; (A.G.); (M.N.); (N.W.)
| | - Stefano Sandrone
- The C3NL Lab, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London SW7 2BU, UK; (A.H.); (A.-E.A.); (S.S.); (E.S.)
| | - Eyal Soreq
- The C3NL Lab, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London SW7 2BU, UK; (A.H.); (A.-E.A.); (S.S.); (E.S.)
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15
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Beppi C, Ribeiro Violante I, Scott G, Sandrone S. EEG, MEG and neuromodulatory approaches to explore cognition: Current status and future directions. Brain Cogn 2021; 148:105677. [PMID: 33486194 DOI: 10.1016/j.bandc.2020.105677] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/26/2020] [Accepted: 12/27/2020] [Indexed: 01/04/2023]
Abstract
Neural oscillations and their association with brain states and cognitive functions have been object of extensive investigation over the last decades. Several electroencephalography (EEG) and magnetoencephalography (MEG) analysis approaches have been explored and oscillatory properties have been identified, in parallel with the technical and computational advancement. This review provides an up-to-date account of how EEG/MEG oscillations have contributed to the understanding of cognition. Methodological challenges, recent developments and translational potential, along with future research avenues, are discussed.
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Affiliation(s)
- Carolina Beppi
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Department of Neurology, University Hospital Zurich and University of Zurich, Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
| | - Inês Ribeiro Violante
- Computational, Cognitive and Clinical Neuroscience Laboratory (C3NL), Department of Brain Sciences, Imperial College London, London, United Kingdom; School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom.
| | - Gregory Scott
- Computational, Cognitive and Clinical Neuroscience Laboratory (C3NL), Department of Brain Sciences, Imperial College London, London, United Kingdom.
| | - Stefano Sandrone
- Computational, Cognitive and Clinical Neuroscience Laboratory (C3NL), Department of Brain Sciences, Imperial College London, London, United Kingdom.
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16
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Beppi C, Violante IR, Hampshire A, Grossman N, Sandrone S. Patterns of Focal- and Large-Scale Synchronization in Cognitive Control and Inhibition: A Review. Front Hum Neurosci 2020; 14:196. [PMID: 32670035 PMCID: PMC7330107 DOI: 10.3389/fnhum.2020.00196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 04/30/2020] [Indexed: 01/08/2023] Open
Abstract
Neural synchronization patterns are involved in several complex cognitive functions and constitute a growing trend in neuroscience research. While synchrony patterns in working memory have been extensively discussed, a complete understanding of their role in cognitive control and inhibition is still elusive. Here, we provide an up-to-date review on synchronization patterns underlying behavioral inhibition, extrapolating common grounds, and dissociating features with other inhibitory functions. Moreover, we suggest a schematic conceptual framework and highlight existing gaps in the literature, current methodological challenges, and compelling research questions for future studies.
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Affiliation(s)
- Carolina Beppi
- Neuroscience Center Zürich (ZNZ), University of Zürich (UZH) and Swiss Federal Institute of Technology in Zürich (ETH), Zurich, Switzerland
- Department of Neurology, University Hospital Zürich, University of Zürich, Zurich, Switzerland
| | - Ines R. Violante
- Computational, Cognitive and Clinical Neuroscience Laboratory (C3NL), Department of Brain Sciences, Imperial College London, London, United Kingdom
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Adam Hampshire
- Computational, Cognitive and Clinical Neuroscience Laboratory (C3NL), Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Nir Grossman
- Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Stefano Sandrone
- Computational, Cognitive and Clinical Neuroscience Laboratory (C3NL), Department of Brain Sciences, Imperial College London, London, United Kingdom
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17
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Sandrone S, Schneider LD. Active and Distance Learning in Neuroscience Education. Neuron 2020; 106:895-898. [DOI: 10.1016/j.neuron.2020.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/23/2020] [Accepted: 05/28/2020] [Indexed: 11/15/2022]
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18
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Keser Z, Rodriguez YA, Tremont J, Hsieh PH, McCullough LD, Sandrone S, Stimming EF. The role of residents in medical students' neurology education: current status and future perspectives. BMC Med Educ 2020; 20:115. [PMID: 32299428 PMCID: PMC7164350 DOI: 10.1186/s12909-020-02036-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 04/06/2020] [Indexed: 05/17/2023]
Abstract
BACKGROUND Neurophobia, a well-described fear of neurology, affects medical students worldwide and may be one of the factors contributing to a shortage of neurologists in the United States. Residents spend a considerable amount of time with medical students; therefore, we sought to understand better the impact neurology residents have on medical students during their neurology clerkship and their subsequent interest in neurology. We aimed to identify and implement strategies to decrease neurophobia and increase the number of students pursuing neurology as a career. METHODS Third-year medical students (n = 234) of UTHealth's McGovern Medical School rotating through their neurology core clerkship completed two surveys regarding their rotation experiences. Surveys were completed anonymously before and after the clerkship to measure their interest and confidence in neurology and the impact of their interactions with the neurology residents during the clerkship. In parallel, residents participated in a teaching workshop focused on small group teaching to improve their teaching effectiveness. Non-parametrical comparison and ordinal regression analyses were utilized for data analyses. RESULTS Medical students reported a statistically significant increase in their confidence in managing neurological conditions and interest in pursuing a neurology residency after their clerkship. There was a significant association between the medical students' overall rotation experience and the residents' teaching effectiveness. The overall clerkship experience correlated with the medical students' interest and confidence in neurology. There was a trend towards an increase in residents' teaching effectiveness and students' rotation experience after a resident teaching workshop. Additionally, of note, students who rotated on both and outpatient and inpatient sites during their clerkship reported an increased interest in neurology. CONCLUSION Our study supports that resident-led teaching efforts are important in improving medical students' neurologic education and their interest in neurology. Our data also supports that the interest in neurology increased for medical students after their neurology clerkship. We examined future strategies to implement "near-peer" teaching activities to enhance the medical students' neurologic educational experience. These strategies could potentially mitigate neurophobia and ultimately lead to a much-needed increase in future neurologists.
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Affiliation(s)
- Zafer Keser
- Neurology Department, UTHealth McGovern Medical School, 6431 Fannin Street, Suite 7.044, Houston, TX, 77030, USA.
| | - Yvo A Rodriguez
- Neurology Department, UTHealth McGovern Medical School, 6431 Fannin Street, Suite 7.044, Houston, TX, 77030, USA
| | - Jennifer Tremont
- Neurology Department, UTHealth McGovern Medical School, 6431 Fannin Street, Suite 7.044, Houston, TX, 77030, USA
| | - Peggy H Hsieh
- Internal Medicine Department, UTHealth McGovern Medical School, Houston, TX, 77030, USA
| | - Louise D McCullough
- Neurology Department, UTHealth McGovern Medical School, 6431 Fannin Street, Suite 7.044, Houston, TX, 77030, USA
| | - Stefano Sandrone
- Department of Brain Sciences, Imperial College London, London, UK
| | - Erin F Stimming
- Neurology Department, UTHealth McGovern Medical School, 6431 Fannin Street, Suite 7.044, Houston, TX, 77030, USA
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19
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Hampshire A, Zadel A, Sandrone S, Soreq E, Fineberg N, Bullmore ET, Robbins TW, Sahakian BJ, Chamberlain SR. Inhibition-Related Cortical Hypoconnectivity as a Candidate Vulnerability Marker for Obsessive-Compulsive Disorder. Biol Psychiatry Cogn Neurosci Neuroimaging 2020; 5:222-230. [PMID: 31806485 PMCID: PMC7003031 DOI: 10.1016/j.bpsc.2019.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 09/19/2019] [Accepted: 09/27/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a prevalent neuropsychiatric condition, with biological models implicating disruption of cortically mediated inhibitory control pathways, ordinarily serving to regulate our environmental responses and habits. The aim of this study was to evaluate inhibition-related cortical dysconnectivity as a novel candidate vulnerability marker of OCD. METHODS In total, 20 patients with OCD, 18 clinically asymptomatic first-degree relatives of patients with OCD, and 20 control participants took part in a neuroimaging study comprising a functional magnetic resonance imaging stop signal task. Brain activations during the contrasts of interest were cluster thresholded, and a three-dimensional watershed algorithm was used to decompose activation maps into discrete clusters. Functional connections between these key neural nodes were examined using a generalized psychophysiological interaction model. RESULTS The three groups did not differ in terms of age, education level, gender, IQ, or behavioral task parameters. Patients with OCD exhibited hyperactivation of the bilateral occipital cortex during the task versus the other groups. Compared with control participants, patients with OCD and their relatives exhibited significantly reduced connectivity between neural nodes, including frontal cortical, middle occipital cortical, and cerebellar regions, during the stop signal task. CONCLUSIONS These findings indicate that hypoconnectivity between anterior and posterior cortical regions during inhibitory control represents a candidate vulnerability marker for OCD. Such vulnerability markers, if found to generalize, may be valuable to shed light on etiological processes contributing not only to OCD but also obsessive-compulsive-related disorders more widely.
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Affiliation(s)
- Adam Hampshire
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - Ana Zadel
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - Stefano Sandrone
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - Eyal Soreq
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - Naomi Fineberg
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Edward T Bullmore
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Trevor W Robbins
- Department of Experimental Psychology, University of Cambridge, Cambridge, United Kingdom; Behavioural and Clinical Neurosciences Institute, University of Cambridge, Cambridge, United Kingdom
| | - Barbara J Sahakian
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom.
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20
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Sandrone S, Berthaud JV, Carlson C, Cios J, Dixit N, Farheen A, Kraker J, Owens JWM, Patino G, Sarva H, Weber D, Schneider LD. Education Research: Flipped classroom in neurology: Principles, practices, and perspectives. Neurology 2020; 93:e106-e111. [PMID: 31262995 DOI: 10.1212/wnl.0000000000007730] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
How to most effectively deliver a large amount of information in an engaging environment that encourages critical thinking is a question that has long plagued educators. With ever-increasing demands on both resident and faculty time, from shrinking duty hours to increased patient complexity, combined with the exponential growth of medical knowledge and unequal access to the spectrum of neurologic subspecialties around the country, this question has become especially pertinent to neurology residency training. A team of educators from the American Academy of Neurology's A.B. Baker Section on Neurological Education sought to review the current evidence regarding the implementation of the flipped classroom format. This educational model has only recently been applied to health care education along the training continuum, and a small collection of articles has, so far, used disparate methods of curricular implementation and assessment. While the feedback from learners is generally positive, a number of obstacles to implementation exist, most notably learner time commitments. These are presented with discussion of potential solutions along with suggestions for future studies.
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Affiliation(s)
- Stefano Sandrone
- From the A.B. Baker Section on Neurological Education (S.S., J.V.B., C.C., J.C., N.D., A.F., J.K., J.W.M.O., G.P., H.S., D.W., L.D.S.), American Academy of Neurology, Minneapolis, MN; Imperial College London (S.S.), UK; University of Michigan (J.V.B.), Ann Arbor; Medical College of Wisconsin (C.C.), Milwaukee; Ohio State University (J.C.), Columbus; Weill Cornell Medicine (N.D., H.S.), New York, NY; Lebanon VA Medical Center (A.F.), PA; Tulane University School of Medicine (J.K.), New Orleans, LA; University of Washington (J.W.M.O.), Seattle; Oakland University William Beaumont School of Medicine (G.P.), Auburn Hills, MI; St. Louis University (D.W.), MO; and Stanford University (L.D.S.), CA.
| | - Jimmy V Berthaud
- From the A.B. Baker Section on Neurological Education (S.S., J.V.B., C.C., J.C., N.D., A.F., J.K., J.W.M.O., G.P., H.S., D.W., L.D.S.), American Academy of Neurology, Minneapolis, MN; Imperial College London (S.S.), UK; University of Michigan (J.V.B.), Ann Arbor; Medical College of Wisconsin (C.C.), Milwaukee; Ohio State University (J.C.), Columbus; Weill Cornell Medicine (N.D., H.S.), New York, NY; Lebanon VA Medical Center (A.F.), PA; Tulane University School of Medicine (J.K.), New Orleans, LA; University of Washington (J.W.M.O.), Seattle; Oakland University William Beaumont School of Medicine (G.P.), Auburn Hills, MI; St. Louis University (D.W.), MO; and Stanford University (L.D.S.), CA
| | - Chad Carlson
- From the A.B. Baker Section on Neurological Education (S.S., J.V.B., C.C., J.C., N.D., A.F., J.K., J.W.M.O., G.P., H.S., D.W., L.D.S.), American Academy of Neurology, Minneapolis, MN; Imperial College London (S.S.), UK; University of Michigan (J.V.B.), Ann Arbor; Medical College of Wisconsin (C.C.), Milwaukee; Ohio State University (J.C.), Columbus; Weill Cornell Medicine (N.D., H.S.), New York, NY; Lebanon VA Medical Center (A.F.), PA; Tulane University School of Medicine (J.K.), New Orleans, LA; University of Washington (J.W.M.O.), Seattle; Oakland University William Beaumont School of Medicine (G.P.), Auburn Hills, MI; St. Louis University (D.W.), MO; and Stanford University (L.D.S.), CA
| | - Jacquelyne Cios
- From the A.B. Baker Section on Neurological Education (S.S., J.V.B., C.C., J.C., N.D., A.F., J.K., J.W.M.O., G.P., H.S., D.W., L.D.S.), American Academy of Neurology, Minneapolis, MN; Imperial College London (S.S.), UK; University of Michigan (J.V.B.), Ann Arbor; Medical College of Wisconsin (C.C.), Milwaukee; Ohio State University (J.C.), Columbus; Weill Cornell Medicine (N.D., H.S.), New York, NY; Lebanon VA Medical Center (A.F.), PA; Tulane University School of Medicine (J.K.), New Orleans, LA; University of Washington (J.W.M.O.), Seattle; Oakland University William Beaumont School of Medicine (G.P.), Auburn Hills, MI; St. Louis University (D.W.), MO; and Stanford University (L.D.S.), CA
| | - Neel Dixit
- From the A.B. Baker Section on Neurological Education (S.S., J.V.B., C.C., J.C., N.D., A.F., J.K., J.W.M.O., G.P., H.S., D.W., L.D.S.), American Academy of Neurology, Minneapolis, MN; Imperial College London (S.S.), UK; University of Michigan (J.V.B.), Ann Arbor; Medical College of Wisconsin (C.C.), Milwaukee; Ohio State University (J.C.), Columbus; Weill Cornell Medicine (N.D., H.S.), New York, NY; Lebanon VA Medical Center (A.F.), PA; Tulane University School of Medicine (J.K.), New Orleans, LA; University of Washington (J.W.M.O.), Seattle; Oakland University William Beaumont School of Medicine (G.P.), Auburn Hills, MI; St. Louis University (D.W.), MO; and Stanford University (L.D.S.), CA
| | - Amtul Farheen
- From the A.B. Baker Section on Neurological Education (S.S., J.V.B., C.C., J.C., N.D., A.F., J.K., J.W.M.O., G.P., H.S., D.W., L.D.S.), American Academy of Neurology, Minneapolis, MN; Imperial College London (S.S.), UK; University of Michigan (J.V.B.), Ann Arbor; Medical College of Wisconsin (C.C.), Milwaukee; Ohio State University (J.C.), Columbus; Weill Cornell Medicine (N.D., H.S.), New York, NY; Lebanon VA Medical Center (A.F.), PA; Tulane University School of Medicine (J.K.), New Orleans, LA; University of Washington (J.W.M.O.), Seattle; Oakland University William Beaumont School of Medicine (G.P.), Auburn Hills, MI; St. Louis University (D.W.), MO; and Stanford University (L.D.S.), CA
| | - Jessica Kraker
- From the A.B. Baker Section on Neurological Education (S.S., J.V.B., C.C., J.C., N.D., A.F., J.K., J.W.M.O., G.P., H.S., D.W., L.D.S.), American Academy of Neurology, Minneapolis, MN; Imperial College London (S.S.), UK; University of Michigan (J.V.B.), Ann Arbor; Medical College of Wisconsin (C.C.), Milwaukee; Ohio State University (J.C.), Columbus; Weill Cornell Medicine (N.D., H.S.), New York, NY; Lebanon VA Medical Center (A.F.), PA; Tulane University School of Medicine (J.K.), New Orleans, LA; University of Washington (J.W.M.O.), Seattle; Oakland University William Beaumont School of Medicine (G.P.), Auburn Hills, MI; St. Louis University (D.W.), MO; and Stanford University (L.D.S.), CA
| | - James W M Owens
- From the A.B. Baker Section on Neurological Education (S.S., J.V.B., C.C., J.C., N.D., A.F., J.K., J.W.M.O., G.P., H.S., D.W., L.D.S.), American Academy of Neurology, Minneapolis, MN; Imperial College London (S.S.), UK; University of Michigan (J.V.B.), Ann Arbor; Medical College of Wisconsin (C.C.), Milwaukee; Ohio State University (J.C.), Columbus; Weill Cornell Medicine (N.D., H.S.), New York, NY; Lebanon VA Medical Center (A.F.), PA; Tulane University School of Medicine (J.K.), New Orleans, LA; University of Washington (J.W.M.O.), Seattle; Oakland University William Beaumont School of Medicine (G.P.), Auburn Hills, MI; St. Louis University (D.W.), MO; and Stanford University (L.D.S.), CA
| | - Gustavo Patino
- From the A.B. Baker Section on Neurological Education (S.S., J.V.B., C.C., J.C., N.D., A.F., J.K., J.W.M.O., G.P., H.S., D.W., L.D.S.), American Academy of Neurology, Minneapolis, MN; Imperial College London (S.S.), UK; University of Michigan (J.V.B.), Ann Arbor; Medical College of Wisconsin (C.C.), Milwaukee; Ohio State University (J.C.), Columbus; Weill Cornell Medicine (N.D., H.S.), New York, NY; Lebanon VA Medical Center (A.F.), PA; Tulane University School of Medicine (J.K.), New Orleans, LA; University of Washington (J.W.M.O.), Seattle; Oakland University William Beaumont School of Medicine (G.P.), Auburn Hills, MI; St. Louis University (D.W.), MO; and Stanford University (L.D.S.), CA
| | - Harini Sarva
- From the A.B. Baker Section on Neurological Education (S.S., J.V.B., C.C., J.C., N.D., A.F., J.K., J.W.M.O., G.P., H.S., D.W., L.D.S.), American Academy of Neurology, Minneapolis, MN; Imperial College London (S.S.), UK; University of Michigan (J.V.B.), Ann Arbor; Medical College of Wisconsin (C.C.), Milwaukee; Ohio State University (J.C.), Columbus; Weill Cornell Medicine (N.D., H.S.), New York, NY; Lebanon VA Medical Center (A.F.), PA; Tulane University School of Medicine (J.K.), New Orleans, LA; University of Washington (J.W.M.O.), Seattle; Oakland University William Beaumont School of Medicine (G.P.), Auburn Hills, MI; St. Louis University (D.W.), MO; and Stanford University (L.D.S.), CA
| | - Daniel Weber
- From the A.B. Baker Section on Neurological Education (S.S., J.V.B., C.C., J.C., N.D., A.F., J.K., J.W.M.O., G.P., H.S., D.W., L.D.S.), American Academy of Neurology, Minneapolis, MN; Imperial College London (S.S.), UK; University of Michigan (J.V.B.), Ann Arbor; Medical College of Wisconsin (C.C.), Milwaukee; Ohio State University (J.C.), Columbus; Weill Cornell Medicine (N.D., H.S.), New York, NY; Lebanon VA Medical Center (A.F.), PA; Tulane University School of Medicine (J.K.), New Orleans, LA; University of Washington (J.W.M.O.), Seattle; Oakland University William Beaumont School of Medicine (G.P.), Auburn Hills, MI; St. Louis University (D.W.), MO; and Stanford University (L.D.S.), CA
| | - Logan D Schneider
- From the A.B. Baker Section on Neurological Education (S.S., J.V.B., C.C., J.C., N.D., A.F., J.K., J.W.M.O., G.P., H.S., D.W., L.D.S.), American Academy of Neurology, Minneapolis, MN; Imperial College London (S.S.), UK; University of Michigan (J.V.B.), Ann Arbor; Medical College of Wisconsin (C.C.), Milwaukee; Ohio State University (J.C.), Columbus; Weill Cornell Medicine (N.D., H.S.), New York, NY; Lebanon VA Medical Center (A.F.), PA; Tulane University School of Medicine (J.K.), New Orleans, LA; University of Washington (J.W.M.O.), Seattle; Oakland University William Beaumont School of Medicine (G.P.), Auburn Hills, MI; St. Louis University (D.W.), MO; and Stanford University (L.D.S.), CA
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Sandrone S, Berthaud JV, Carlson C, Cios J, Dixit N, Farheen A, Kraker J, Owens JWM, Patino G, Sarva H, Weber D, Schneider LD. Active Learning in Psychiatry Education: Current Practices and Future Perspectives. Front Psychiatry 2020; 11:211. [PMID: 32390876 PMCID: PMC7190786 DOI: 10.3389/fpsyt.2020.00211] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 03/03/2020] [Indexed: 01/21/2023] Open
Abstract
Over the past few decades, medical education has seen increased interest in the use of active learning formats to engage learners and promote knowledge application over knowledge acquisition. The field of psychiatry, in particular, has pioneered a host of novel active learning paradigms. These have contributed to our understanding of the role of andragogy along the continuum of medical education, from undergraduate to continuing medical education. In an effort to frame the successes and failures of various attempts at integrating active learning into healthcare curricula, a group of educators from the A. B. Baker Section on Neurological Education from the American Academy of Neurology reviewed the state of the field in its partner field of medical neuroscience. Herein we provide a narrative review of the literature, outlining the basis for implementing active learning, the novel formats that have been used, and the lessons learned from qualitative and quantitative analysis of the research that has been done to date. While preparation time seems to present the greatest obstacle to acceptance from learners and educators, there is generally positive reception to the new educational formats. Additionally, most assessments of trainee performance have suggested non-inferiority (if not superiority). However, occasional mixed findings point to a need for better assessments of the type of learning that these new formats engender: knowledge application rather than acquisition. Moreover, this field is relatively nascent and, in order to ascertain how best to integrate active learning into psychiatry education, a framework for quantitative outcome assessments is needed going forward.
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Affiliation(s)
- Stefano Sandrone
- A.B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN, United States.,Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Jimmy V Berthaud
- A.B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN, United States.,Department of Neurology, University of Michigan, Ann Arbor, MI, United States
| | - Chad Carlson
- A.B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN, United States.,Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Jacquelyne Cios
- A.B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN, United States.,Department of Neurology, Ohio State University, Columbus, OH, United States
| | - Neel Dixit
- A.B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN, United States.,Department of Neurology, Weill Cornell Medicine, New York, NY, United States
| | - Amtul Farheen
- A.B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN, United States.,Department of Neurology, Lebanon VA Medical Center, Lebanon, PA, United States
| | - Jessica Kraker
- A.B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN, United States.,Department of Neurology, Tulane University School of Medicine, New Orleans, LA, United States
| | - James W M Owens
- A.B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN, United States.,Department of Neurology, Division of Pediatric Neurology, University of Washington, Washington, Seattle, WA, United States
| | - Gustavo Patino
- A.B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN, United States.,Department of Biomedical Sciences, Division of Neuroscience, Oakland University William Beaumont School of Medicine, Auburn Hills, MI, United States
| | - Harini Sarva
- A.B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN, United States.,Department of Neurology, Weill Cornell Medicine, New York, NY, United States
| | - Daniel Weber
- A.B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN, United States.,Department of Neurology, St. Louis University, St. Louis, MO, United States
| | - Logan D Schneider
- A.B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN, United States.,Stanford/VA Alzheimer's Center, Palo Alto VA Health Care System, Livermore, CA, United States.,Sierra Pacific Mental Illness Research Education and Clinical Centers, VA Palo Alto Health Care System, Livermore, CA, United States
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Sandrone S, Berthaud JV, Carlson C, Cios J, Dixit N, Farheen A, Kraker J, Owens JWM, Patino G, Sarva H, Weber D, Schneider LD. Strategic Considerations for Applying the Flipped Classroom to Neurology Education. Ann Neurol 2019; 87:4-9. [PMID: 31581320 DOI: 10.1002/ana.25609] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 09/24/2019] [Accepted: 09/24/2019] [Indexed: 01/12/2023]
Abstract
Nowadays, the "flipped classroom" approach is taking the center stage within medical education. However, very few reports on the implementation of the flipped classroom in neurology have been published to date, and this educational model still represents a challenge for students and educators alike. In this article, neurology educators from the American Academy of Neurology's A. B. Baker Section on Neurological Education analyze reports of flipped classroom in other medical/surgical subspecialties, review the current implementation in neurology, and discuss future strategies to flip the neurology curriculum through contextualization of the benefits and the consequences. ANN NEUROL 2020;87:4-9.
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Affiliation(s)
- Stefano Sandrone
- A. B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN.,Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Jimmy V Berthaud
- A. B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN.,Department of Neurology, University of Michigan, Ann Arbor, MI
| | - Chad Carlson
- A. B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN.,Department of Neurology, Medical College of Wisconsin, Milwaukee, WI
| | - Jacquelyne Cios
- A. B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN.,Department of Neurology, Ohio State University, Columbus, OH
| | - Neel Dixit
- A. B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN.,Department of Neurology, Weill Cornell Medicine, New York, NY
| | - Amtul Farheen
- A. B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN.,Neurology Service, Lebanon VA Medical Center, Lebanon, PA
| | - Jessica Kraker
- A. B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN.,Department of Neurology, Tulane University School of Medicine, New Orleans, LA
| | - James W M Owens
- A. B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN.,Department of Neurology, University of Washington, Seattle, WA
| | - Gustavo Patino
- A. B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN.,Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI
| | - Harini Sarva
- A. B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN.,Department of Neurology, Weill Cornell Medicine, New York, NY
| | - Daniel Weber
- A. B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN.,Department of Neurology, St Louis University, St Louis, MO
| | - Logan D Schneider
- A. B. Baker Section on Neurological Education, American Academy of Neurology, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA.,Sierra Pacific Mental Illness Research Education and Clinical Centers, VA Palo Alto Health Care System, Palo Alto, CA
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Hampshire A, Sandrone S, Hellyer PJ. A Large-Scale, Cross-Sectional Investigation Into the Efficacy of Brain Training. Front Hum Neurosci 2019; 13:221. [PMID: 31338032 PMCID: PMC6629869 DOI: 10.3389/fnhum.2019.00221] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 06/17/2019] [Indexed: 11/24/2022] Open
Abstract
Brain training is a large and expanding industry, and yet there is a recurrent and ongoing debate concerning its scientific basis or evidence for efficacy. Much of evidence for the efficacy of brain training within this debate is from small-scale studies that do not assess the type of “brain training,” the specificity of transfer effects, or the length of training required to achieve a generalized effect. To explore these factors, we analyze cross-sectional data from two large Internet-cohort studies (total N = 60,222) to determine whether cognition differs at the population level for individuals who report that they brain train on different devices, and across different timeframes, with programs in common use circa 2010–2013. Examining scores for an assessment of working-memory, reasoning and verbal abilities shows no cognitive advantages for individuals who brain train. This contrasts unfavorably with significant advantages for individuals who regularly undertake other cognitive pursuits such as computer, board and card games. However, finer grained analyses reveal a more complex relationship between brain training and cognitive performance. Specifically, individuals who have just begun to brain train start from a low cognitive baseline compared to individuals who have never engaged in brain training, whereas those who have trained for a year or more have higher working-memory and verbal scores compared to those who have just started, thus suggesting an efficacy for brain training over an extended period of time. The advantages in global function, working memory, and verbal memory after several months of training are plausible and of clinically relevant scale. However, this relationship is not evident for reasoning performance or self-report measures of everyday function (e.g., employment status and problems with attention). These results accord with the view that although brain training programs can produce benefits, these might extend to tasks that are operationally similar to the training regime. Furthermore, the duration of training regime required for effective enhancement of cognitive performance is longer than that applied in most previous studies.
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Affiliation(s)
- Adam Hampshire
- The Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - Stefano Sandrone
- The Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - Peter John Hellyer
- Centre for Neuroimaging Sciences, King's College London, London, United Kingdom
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Hampshire A, Daws RE, Neves ID, Soreq E, Sandrone S, Violante IR. Probing cortical and sub-cortical contributions to instruction-based learning: Regional specialisation and global network dynamics. Neuroimage 2019; 192:88-100. [PMID: 30851447 DOI: 10.1016/j.neuroimage.2019.03.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 02/28/2019] [Accepted: 03/03/2019] [Indexed: 11/29/2022] Open
Abstract
Diverse cortical networks and striatal brain regions are implicated in instruction-based learning (IBL); however, their distinct contributions remain unclear. We use a modified fMRI paradigm to test two hypotheses regarding the brain mechanisms that underlie IBL. One hypothesis proposes that anterior caudate and frontoparietal regions transiently co-activate when new rules are being bound in working memory. The other proposes that they mediate the application of the rules at different stages of the consolidation process. In accordance with the former hypothesis, we report strong activation peaks within and increased connectivity between anterior caudate and frontoparietal regions when rule-instruction slides are presented. However, similar effects occur throughout a broader set of cortical and sub-cortical regions, indicating a metabolically costly reconfiguration of the global brain state. The distinct functional roles of cingulo-opercular, frontoparietal and default-mode networks are apparent from their activation throughout, early and late in the practice phase respectively. Furthermore, there is tentative evidence of a peak in anterior caudate activity mid-way through the practice stage. These results demonstrate how performance of the same simple task involves a steadily shifting balance of brain systems as learning progresses. They also highlight the importance of distinguishing between regional specialisation and global dynamics when studying the network mechanisms that underlie cognition and learning.
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Affiliation(s)
- Adam Hampshire
- Computational, Cognitive and Clinical Neuroscience Laboratory, Department of Medicine, Imperial College London, London W12 0NN, UK.
| | - Richard E Daws
- Computational, Cognitive and Clinical Neuroscience Laboratory, Department of Medicine, Imperial College London, London W12 0NN, UK
| | - Ines Das Neves
- Computational, Cognitive and Clinical Neuroscience Laboratory, Department of Medicine, Imperial College London, London W12 0NN, UK
| | - Eyal Soreq
- Computational, Cognitive and Clinical Neuroscience Laboratory, Department of Medicine, Imperial College London, London W12 0NN, UK
| | - Stefano Sandrone
- Computational, Cognitive and Clinical Neuroscience Laboratory, Department of Medicine, Imperial College London, London W12 0NN, UK
| | - Ines R Violante
- Computational, Cognitive and Clinical Neuroscience Laboratory, Department of Medicine, Imperial College London, London W12 0NN, UK; School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
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Sandrone S, Berthaud JV, Chuquilin M, Cios J, Ghosh P, Gottlieb-Smith RJ, Kushlaf H, Mantri S, Masangkay N, Menkes DL, Nevel KS, Sarva H, Schneider LD. Neurologic and neuroscience education. Neurology 2018; 92:174-179. [DOI: 10.1212/wnl.0000000000006716] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 09/21/2018] [Indexed: 01/06/2023] Open
Abstract
Neurologic disorders are among the most frequent causes of morbidity and mortality in the United States. Moreover, the current shortfall of neurologists is expected to worsen over the coming decade. As a consequence, many patients with neurologic disorders will be treated by physicians and primary care providers without formal neurologic training. Furthermore, a pervasive and well-described fear of neurology, termed neurophobia, has been identified in medical student cohorts, residents, and among general practitioners. In this article, members of the American Academy of Neurology A.B. Baker Section on Neurological Education review current guidelines regarding neurologic and neuroscience education, contextualize the genesis and the negative consequences of neurophobia, and provide strategies to mitigate it for purposes of mentoring future generations of health care providers.
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Sandrone S, van Gijn J. Macdonald Critchley (1900-1997). J Neurol 2017; 265:1244-1245. [PMID: 29164311 DOI: 10.1007/s00415-017-8672-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 11/01/2017] [Accepted: 11/07/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Stefano Sandrone
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Jan van Gijn
- Emeritus Professor of Neurology, University of Utrecht, Utrecht, The Netherlands
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Catani M, Dell'Acqua F, Budisavljevic S, Howells H, Thiebaut de Schotten M, Froudist-Walsh S, D'Anna L, Thompson A, Sandrone S, Bullmore ET, Suckling J, Baron-Cohen S, Lombardo MV, Wheelwright SJ, Chakrabarti B, Lai MC, Ruigrok ANV, Leemans A, Ecker C, Consortium MA, Craig MC, Murphy DGM. Frontal networks in adults with autism spectrum disorder. Brain 2016; 139:616-30. [PMID: 26912520 PMCID: PMC4805089 DOI: 10.1093/brain/awv351] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
It has been postulated that autism spectrum disorder is underpinned by an 'atypical connectivity' involving higher-order association brain regions. To test this hypothesis in a large cohort of adults with autism spectrum disorder we compared the white matter networks of 61 adult males with autism spectrum disorder and 61 neurotypical controls, using two complementary approaches to diffusion tensor magnetic resonance imaging. First, we applied tract-based spatial statistics, a 'whole brain' non-hypothesis driven method, to identify differences in white matter networks in adults with autism spectrum disorder. Following this we used a tract-specific analysis, based on tractography, to carry out a more detailed analysis of individual tracts identified by tract-based spatial statistics. Finally, within the autism spectrum disorder group, we studied the relationship between diffusion measures and autistic symptom severity. Tract-based spatial statistics revealed that autism spectrum disorder was associated with significantly reduced fractional anisotropy in regions that included frontal lobe pathways. Tractography analysis of these specific pathways showed increased mean and perpendicular diffusivity, and reduced number of streamlines in the anterior and long segments of the arcuate fasciculus, cingulum and uncinate--predominantly in the left hemisphere. Abnormalities were also evident in the anterior portions of the corpus callosum connecting left and right frontal lobes. The degree of microstructural alteration of the arcuate and uncinate fasciculi was associated with severity of symptoms in language and social reciprocity in childhood. Our results indicated that autism spectrum disorder is a developmental condition associated with abnormal connectivity of the frontal lobes. Furthermore our findings showed that male adults with autism spectrum disorder have regional differences in brain anatomy, which correlate with specific aspects of autistic symptoms. Overall these results suggest that autism spectrum disorder is a condition linked to aberrant developmental trajectories of the frontal networks that persist in adult life.
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Affiliation(s)
- Marco Catani
- 1 Sackler Institute for Translational Neurodevelopment, and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College, London, UK 2 NatBrainLab, Centre for Neuroimaging Sciences, Institute of Psychiatry, King's College, London, UK
| | - Flavio Dell'Acqua
- 2 NatBrainLab, Centre for Neuroimaging Sciences, Institute of Psychiatry, King's College, London, UK
| | - Sanja Budisavljevic
- 1 Sackler Institute for Translational Neurodevelopment, and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College, London, UK
| | - Henrietta Howells
- 1 Sackler Institute for Translational Neurodevelopment, and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College, London, UK
| | - Michel Thiebaut de Schotten
- 1 Sackler Institute for Translational Neurodevelopment, and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College, London, UK
| | - Seán Froudist-Walsh
- 1 Sackler Institute for Translational Neurodevelopment, and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College, London, UK
| | - Lucio D'Anna
- 1 Sackler Institute for Translational Neurodevelopment, and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College, London, UK
| | - Abigail Thompson
- 1 Sackler Institute for Translational Neurodevelopment, and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College, London, UK
| | - Stefano Sandrone
- 1 Sackler Institute for Translational Neurodevelopment, and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College, London, UK
| | - Edward T Bullmore
- 3 Cambridgeshire and Peterborough NHS Foundation Trust 4 Brain Mapping Unit, Department of Psychiatry, University of Cambridge, UK
| | - John Suckling
- 3 Cambridgeshire and Peterborough NHS Foundation Trust 4 Brain Mapping Unit, Department of Psychiatry, University of Cambridge, UK 5 Autism Research Centre, Department of Psychiatry, University of Cambridge, UK
| | - Simon Baron-Cohen
- 3 Cambridgeshire and Peterborough NHS Foundation Trust 5 Autism Research Centre, Department of Psychiatry, University of Cambridge, UK
| | - Michael V Lombardo
- 5 Autism Research Centre, Department of Psychiatry, University of Cambridge, UK 6 Department of Psychology and Center for Applied Neuroscience, University of Cyprus, Cyprus
| | - Sally J Wheelwright
- 5 Autism Research Centre, Department of Psychiatry, University of Cambridge, UK
| | - Bhismadev Chakrabarti
- 5 Autism Research Centre, Department of Psychiatry, University of Cambridge, UK 7 Centre for Integrative Neuroscience and Neurodynamics, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Meng-Chuan Lai
- 5 Autism Research Centre, Department of Psychiatry, University of Cambridge, UK 8 Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Canada 9 Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taiwan
| | - Amber N V Ruigrok
- 5 Autism Research Centre, Department of Psychiatry, University of Cambridge, UK
| | - Alexander Leemans
- 10 Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Christine Ecker
- 1 Sackler Institute for Translational Neurodevelopment, and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College, London, UK
| | | | - Michael C Craig
- 1 Sackler Institute for Translational Neurodevelopment, and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College, London, UK 11 National Autism Unit, South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Declan G M Murphy
- 1 Sackler Institute for Translational Neurodevelopment, and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College, London, UK
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Sandrone S. Decoupling motor plans from perceptual decisions to investigate whether and when decisions are embodied. J Neurophysiol 2014; 112:1603-5. [PMID: 24623506 DOI: 10.1152/jn.00308.2013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Decision making is a crucial part of our life: we sense information from the environment and perform our motor response. However, "whether" and "when" decisions are embodied still needs to be fully elucidated. Neuroimaging data obtained by the disentanglement of perceptual decision from motor preparation revealed an increase in connectivity between inferior frontal cortex and sensory regions, and the important role played by intraparietal sulcus in motor decisions. The results obtained as well as the new research questions prompted by this work are carefully discussed herein.
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Affiliation(s)
- Stefano Sandrone
- NATBRAINLAB - Neuroanatomy and Tractography Brain Laboratory, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, London, United Kingdom
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Favero-Longo SE, Sandrone S, Matteucci E, Appolonia L, Piervittori R. Spores of lichen-forming fungi in the mycoaerosol and their relationships with climate factors. Sci Total Environ 2014; 466-467:26-33. [PMID: 23892020 DOI: 10.1016/j.scitotenv.2013.06.057] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 06/12/2013] [Accepted: 06/13/2013] [Indexed: 06/02/2023]
Abstract
Fungal particulates are a dominant component of the bioaerosol, but aerobiological studies traditionally focused on a limited set of fungi having relevance as allergens or plant pathogens. This study first analyzes the occurrence of lichen meiospores in the mycoaerosol, quantitatively evaluating in the atmosphere of an alpine environment the occurrence of polar diblastic spores, unequivocally attributable to the lichen family Teloschistaceae. The analysis of air-samples collected one week per month for one year with a Hirst-type sampler displayed a low percentage occurrence of polar-diblastic spores (<0.1%) with respect to the whole mycoaerosol, dominated by Cladosporium. Spearman's correlation tests on aerobiological and climatic data highlighted a strong relationship between the detection of Teloschistaceae spores and rainfall events, excluding seasonal patterns or daily rhythms of dispersion. The fact that all the air-sampled spores were attributable to the species of Teloschistaceae occurring in the site, together with laboratory observations of predominant short range dispersal patterns for polar diblastic and other lichen spores, indicated that sexual reproduction is mostly involved in the local expansion of colonization, dispersal from a long distance appearing a less probable phenomenon. These findings indicated that responses of lichen communities to climate factors, usually related to physiological processes, also depend on their influence on meiospore dispersal dynamics. Spatial limitations in dispersal, however, have to be taken into account in evaluating lichen distributional shifts as indicators of environmental changes.
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Affiliation(s)
- S E Favero-Longo
- Dipartimento di Scienze della Vita e Biologia dei Sistemi, Università di Torino, Viale Mattioli 25, 10125 Torino, Italy.
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Sandrone S. A DMN-based functional taxonomy of the resting human brain: Is essential really invisible to the eye? Brain Res Bull 2013; 99:A1-3. [DOI: 10.1016/j.brainresbull.2013.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Revised: 06/21/2013] [Accepted: 06/30/2013] [Indexed: 12/13/2022]
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Peruzzotti-Jametti L, Cambiaghi M, Bacigaluppi M, Gallizioli M, Gaude E, Mari S, Sandrone S, Cursi M, Teneud L, Comi G, Musco G, Martino G, Leocani L. Safety and efficacy of transcranial direct current stimulation in acute experimental ischemic stroke. Stroke 2013; 44:3166-74. [PMID: 23982710 DOI: 10.1161/strokeaha.113.001687] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND PURPOSE Transcranial direct current stimulation is emerging as a promising tool for the treatment of several neurological conditions, including cerebral ischemia. The therapeutic role of this noninvasive treatment is, however, limited to chronic phases of stroke. We thus ought to investigate whether different stimulation protocols could also be beneficial in the acute phase of experimental brain ischemia. METHODS The influence of both cathodal and anodal transcranial direct current stimulation in modifying brain metabolism of healthy mice was first tested by nuclear magnetic resonance spectroscopy. Then, mice undergoing transient proximal middle cerebral artery occlusion were randomized and treated acutely with anodal, cathodal, or sham transcranial direct current stimulation. Brain metabolism, functional outcomes, and ischemic lesion volume, as well as the inflammatory reaction and blood brain barrier functionality, were analyzed. RESULTS Cathodal stimulation was able, if applied in the acute phase of stroke, to preserve cortical neurons from the ischemic damage, to reduce inflammation, and to promote a better clinical recovery compared with sham and anodal treatments. This finding was attributable to the significant decrease of cortical glutamate, as indicated by nuclear magnetic resonance spectroscopy. Conversely, anodal stimulation induced an increase in the postischemic lesion volume and augmented blood brain barrier derangement. CONCLUSIONS Our data indicate that transcranial direct current stimulation exerts a measurable neuroprotective effect in the acute phase of stroke. However, its timing and polarity should be carefully identified on the base of the pathophysiological context to avoid potential harmful side effects.
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Affiliation(s)
- Luca Peruzzotti-Jametti
- From the Neuroimmunology Unit (L.P.-J., M.B., M.G., S.S., G.C., G.M.) and Experimental Neurophysiology Unit, Division of Neuroscience, Institute of Experimental Neurology (INSPE), DIBIT-II, San Raffaele Scientific Institute (M.C., M.C., L.T., G.C., L.L.), Vita-Salute San Raffaele University, Milan, Italy; and Dulbecco Telethon Institute, Biomolecular NMR Laboratory c/o Center for Translational Genomics and Bioinformatics, Ospedale San Raffaele, Milan, Italy (E.G., S.M., G.M.)
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Sandrone S. Self through the Mirror (Neurons) and Default Mode Network: What Neuroscientists Found and What Can Still be Found There. Front Hum Neurosci 2013; 7:383. [PMID: 23898248 PMCID: PMC3721436 DOI: 10.3389/fnhum.2013.00383] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Accepted: 07/03/2013] [Indexed: 12/20/2022] Open
Affiliation(s)
- Stefano Sandrone
- NATBRAINLAB - Neuroanatomy and Tractography Brain Laboratory, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, UK ; Institute of Neuroinformatics, University of Zurich and ETH Zurich Zurich, Switzerland
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Affiliation(s)
- Stefano Sandrone
- NATBRAINLAB-Neuroanatomy and Tractography Brain Laboratory, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College, London, SE5 8AF, UK,
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Affiliation(s)
- Stefano Sandrone
- NATBRAINLAB - Neuroanatomy and Tractography Brain Laboratory, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College, London, SE5 8AF, UK,
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Affiliation(s)
- Stefano Sandrone
- NATBRAINLAB - Neuroanatomy and Tractography Brain Laboratory, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, UK ; Institute of Neuroinformatics, University of Zurich and ETH Zurich Zurich, Switzerland
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Sandrone S, Bacigaluppi M, Galloni MR, Cappa SF, Moro A, Catani M, Filippi M, Monti MM, Perani D, Martino G. Weighing brain activity with the balance: Angelo Mosso's original manuscripts come to light. ACTA ACUST UNITED AC 2013; 137:621-33. [PMID: 23687118 DOI: 10.1093/brain/awt091] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Neuroimaging techniques, such as positron emission tomography and functional magnetic resonance imaging are essential tools for the analysis of organized neural systems in working and resting states, both in physiological and pathological conditions. They provide evidence of coupled metabolic and cerebral local blood flow changes that strictly depend upon cellular activity. In 1890, Charles Smart Roy and Charles Scott Sherrington suggested a link between brain circulation and metabolism. In the same year William James, in his introduction of the concept of brain blood flow variations during mental activities, briefly reported the studies of the Italian physiologist Angelo Mosso, a multifaceted researcher interested in the human circulatory system. James focused on Mosso's recordings of brain pulsations in patients with skull breaches, and in the process only briefly referred to another invention of Mosso's, the 'human circulation balance', which could non-invasively measure the redistribution of blood during emotional and intellectual activity. However, the details and precise workings of this instrument and the experiments Mosso performed with it have remained largely unknown. Having found Mosso's original manuscripts in the archives, we remind the scientific community of his experiments with the 'human circulation balance' and of his establishment of the conceptual basis of non-invasive functional neuroimaging techniques. Mosso unearthed and investigated several critical variables that are still relevant in modern neuroimaging such as the 'signal-to-noise ratio', the appropriate choice of the experimental paradigm and the need for the simultaneous recording of differing physiological parameters.
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Peruzzotti-Jametti L, Bacigaluppi M, Sandrone S, Cambiaghi M. Emerging subspecialties in Neurology: Transcranial stimulation. Neurology 2013; 80:e33-5. [DOI: 10.1212/wnl.0b013e3182833d74] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Affiliation(s)
- Stefano Sandrone
- Vita-Salute San Raffaele UniversityMilan, Italy
- Neuroimmunology Unit, Division of Neuroscience, Institute of Experimental Neurology, San Raffaele HospitalMilan, Italy
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