Automatic speech analysis to early detect functional cognitive decline in elderly population

This study aimed at evaluating whether people with a normal cognitive function can be discriminated from subjects with a mild impairment of cognitive function based on a set of acoustic features derived from spontaneous speech. Voice recordings from 90 Italian subjects (age >65 years; group 1: 47 subjects with MMSE>26; group 2: 43 subjects with 20≤ MMSE ≤26) were collected. Voice samples were processed using a MATLAB-based custom software to derive a broad set of known acoustic features. Linear mixed model analyses were performed to select the features able to significantly distinguish between groups. The selected features (% of unvoiced segments, duration of unvoiced segments, % of voice breaks, speech rate, and duration of syllables), alone or in addition to age and years of education, were used to build a learning-based classifier. The leave-one-out cross validation was used for testing and the classifier accuracy was computed. When the voice features were used alone, an overall classification accuracy of 0.73 was achieved. When age and years of education were additionally used, the overall accuracy increased up to 0.80. These performances were lower than the accuracy of 0.86 found in a recent study. However, in that study the classification was based on several tasks, including more cognitive demanding tasks. Our results are encouraging because acoustic features, derived for the first time only from an ecologic continuous speech task, were able to discriminate people with a normal cognitive function from people with a mild cognitive decline. This study poses the basis for the development of a mobile application performing automatic voice analysis on-the-fly during phone calls, which might potentially support the detection of early signs of functional cognitive decline.

Focal left prefrontal lesions and cognitive impairment: A multivariate lesion-symptom mapping approach

Despite network studies of the human brain have brought consistent evidence of brain regions with diverse functional roles, the neuropsychological approach has mainly focused on the functional specialization of individual brain regions. Relatively few neuropsychological studies try to understand whether the severity of cognitive impairment across multiple cognitive abilities can be related to focal brain injuries. Here we approached this issue by applying a latent variable modeling of the severity of cognitive impairment in brain tumor patients, followed by multivariate lesion-symptom methods identifying brain regions critically involved in multiple cognitive abilities. We observed that lesions in confined left lateral prefrontal areas including the inferior frontal junction produced the most severe cognitive deficits, above and beyond tumor histology. Our findings support the recently suggested integrated albeit modular view of brain functional organization, according to which specific brain regions are highly involved across different sub-networks and subserve a vast range of cognitive abilities. Defining such brain regions is relevant not only theoretically but also clinically, since it may facilitate tailored tumor resections and improve cognitive surgical outcomes.

Bayesian modeling of temporal expectations in the human brain

The brain predicts the timing of forthcoming events to optimize processes in response to them. Temporal predictions are driven by both our prior expectations on the likely timing of stimulus occurrence and the information conveyed by the passage of time. Specifically, such predictions can be described in terms of the hazard function, that is, the conditional probability that an event will occur, given it has not yet occurred. Events violating expectations cause surprise and often induce updating of prior expectations. While it is well-known that the brain is able to track the temporal hazard of event occurrence, the question of how prior temporal expectations are updated is still unsettled. Here we combined a Bayesian computational approach with brain imaging to map updating of temporal expectations in the human brain. Moreover, since updating is usually highly correlated with surprise, participants performed a task that allowed partially differentiating between the two processes. Results showed that updating and surprise differently modulated activity in areas belonging to two critical networks for cognitive control, the fronto-parietal (FPN) and the cingulo-opercular network (CON). Overall, these data provide a first computational characterization of the neural correlates associated with updating and surprise related to temporal expectation.

Seeing myself through my heart: Cortical processing of a single heartbeat speeds up self-face recognition

Recent research has highlighted the contribution of interoceptive signals to different aspects of bodily self-consciousness (BSC) by means of the cardio-visual stimulation - i.e. perceiving a pulsing stimulus in synchrony with one's own heart. Here, for the first time, we investigate the effects of individual heartbeats on a critical feature of BSC, namely the recognition of one's own face. Across two studies, we explored the cardiac-timing effects on a classic self-face recognition task. In Study 1, participants saw morphed faces that contained different percentages of the self-face and that of another unfamiliar individual. Study 2 used a similar design, albeit participants saw morphed faces of the self-face and that of a familiar other to provide a better control of self-familiarity. Results from both studies consistently revealed that the cortical processing of cardiac afferent signals conveyed by the firing of arterial baroreceptors affects the speed, but not the accuracy, of self-face recognition, when a single picture is presented during cardiac systole, as compared to diastole. This effect is stronger and more stable for stimuli with more self-cues than other-cues and for 'ambiguous' stimuli - i.e. at the individual point of subjective equality. Results from Study 2 also revealed that cardiac effects on the speed of self-face recognition cannot be explained simply on the basis of the imbalanced familiarity between the self's and other's faces used. The present findings highlight the interoceptive contributions to self-recognition and may be expand our understanding of pathological disturbances of self-experience.

Italian Age of Acquisition Norms for a Large Set of Words (ItAoA)

Age of acquisition (AoA) is an important psycholinguistic variable that affects the performance of healthy individuals and patients in a large variety of cognitive tasks. For this reason, it becomes more and more compelling to collect new AoA norms for a large set of stimuli in order to allow better control and manipulation of AoA in future research. An important motivation of the present study is to extend previous Italian norms by collecting AoA ratings for a much larger range of Italian words for which concreteness and semantic-affective norms are now available thus ensuring greater coverage of words varying along these dimensions. In the present study, we collected AoA ratings for 1,957 Italian content words (adjectives, nouns, and verbs), by asking healthy adult participants to estimate the age at which they thought they had learned the word in a Web survey procedure. First, we found high split-half correlation within our sample, suggesting strong internal reliability. Second, our data indicate that the ratings collected in this study are as valid and reliable as those collected in previous studies for Italian across different age populations (adult and children) and other languages. Finally, we analyzed the relation between AoA ratings and other lexical-semantic variables (e.g., word frequency, imageability, valence, arousal) and showed that these correlations were generally consistent with the correlations reported in other normative studies for Italian and other languages. Therefore, our new AoA norms are a valuable source of information for future research in the Italian language. The full database is available at the Open Science Framework (osf.io/3trg2).

No grammatical gender effect on affective ratings: evidence from Italian and German languages

In this study, we tested the linguistic relativity hypothesis by studying the effect of grammatical gender (feminine vs. masculine) on affective judgments of conceptual representation in Italian and German. In particular, we examined the within- and cross-language grammatical gender effect and its interaction with participants' demographic characteristics (such as, the raters' age and sex) on semantic differential scales (affective ratings of valence, arousal and dominance) in Italian and German speakers. We selected the stimuli and the relative affective measures from Italian and German adaptations of the ANEW (Affective Norms for English Words). Bayesian and frequentist analyses yielded evidence for the absence of within- and cross-languages effects of grammatical gender and sex- and age-dependent interactions. These results suggest that grammatical gender does not affect judgments of affective features of semantic representation in Italian and German speakers, since an overt coding of word grammar is not required. Although further research is recommended to refine the impact of the grammatical gender on properties of semantic representation, these results have implications for any strong view of the linguistic relativity hypothesis.

Affordances after spinal cord injury

Spinal cord injury can cause cognitive impairments even when no cerebral lesion is appreciable. As patients are forced to explore the environment in a non-canonical position (i.e., seated on a wheelchair), a modified relation with space can explain motor-related cognitive differences compared to non-injured individuals. Peripersonal space is encoded in motor terms, that is, in relation to the representation of action abilities and is strictly related to the affordance of reachability. In turn, affordances, the action possibilities suggested by relevant properties of the environment, are related to the perceiver's peripersonal space and motor abilities. One might suppose that these motor-related cognitive abilities are compromised when an individual loses the ability to move. We shed light on this issue in 10 patients with paraplegia and 20 matched controls. All have been administered an affordances-related reachability judgement task adapted from Costantini, Ambrosini, Tieri, Sinigaglia, and Committeri (2010, Experimental Brain Research, 207, 95) and neuropsychological tests. Our findings demonstrate that patients and controls show the same level of accuracy in estimating the location of their peripersonal space boundaries, but only controls show the typical overestimation of reaching range. Secondly, patients show a higher variability in their judgements than controls. Importantly, this finding is related to the patients' ability to perform everyday tasks. Finally, patients are not faster in making their judgements on reachability in peripersonal space, while controls are. Our results suggest that not moving freely or as usual in the environment impact decoding of action-related properties even when the upper limbs are not compromised.

Individual Differences in Verbal and Spatial Stroop Tasks: Interactive Role of Handedness and Domain

A longstanding debate in psychology concerns the relation between handedness and cognitive functioning. The present study aimed to contribute to this debate by comparing performance of right- and non-right-handers on verbal and spatial Stroop tasks. Previous studies have shown that non-right-handers have better inter-hemispheric interaction and greater access to right hemisphere processes. On this ground, we expected performance of right- and non-right-handers to differ on verbal and spatial Stroop tasks. Specifically, relative to right-handers, non-right-handers should have greater Stroop effect in the color-word Stroop task, for which inter-hemispheric interaction does not seem to be advantageous to performance. By contrast, non-right-handers should be better able to overcome interference in the spatial Stroop task. This is for their preferential access to the right hemisphere dealing with spatial material and their greater inter-hemispheric interaction with the left hemisphere hosting Stroop task processes. Our results confirmed these predictions, showing that handedness and the underlying brain asymmetries may be a useful variable to partly explain individual differences in executive functions.

Structural hemispheric asymmetries underlie verbal Stroop performance

Performance on tasks involving cognitive control such as the Stroop task is often associated with left lateralized brain activations. Based on this neuro-functional evidence, we tested whether leftward structural grey matter asymmetries would also predict inter-individual differences in combatting Stroop interference. To check for the specificity of the results, both a verbal Stroop task and a spatial one were administered to a total of 111 healthy young individuals, for whom T1-weighted magnetic resonance imaging (MRI) images were also acquired. Surface thickness and area estimations were calculated using FreeSurfer. Participants' hemispheres were registered to a symmetric template and Laterality Indices (LI) for the surface thickness and for the area at each vertex in each participant were computed. The correlation of these surface LI measures with the verbal and spatial Stroop effects (incongruent-congruent difference in trial performance) was assessed at each vertex by means of general linear models at the whole-brain level. We found a significant correlation between performance and surface area LI in an inferior posterior temporal cluster (overlapping with the so-called visual word form area, VWFA), with a more left-lateralized area in this region associated with a smaller Stroop effect only in the verbal task. These results point to an involvement of the VWFA for higher-level processes based on word reading, including the suppression of this process when required by the task, and could be interpreted in the context of cross-hemispheric rivalry.

The role of expectation in multisensory body representation - neural evidence

Sensory events contribute to body ownership, the feeling that the body belongs to me. However, the encoding of sensory events is not only reactive, but also proactive in that our brain generates prediction about forthcoming stimuli. In previous studies, we have shown that prediction of sensory events is a sufficient condition to induce the sense of body ownership. In this study, we investigated the underlying neural mechanisms. Participants were seated with their right arm resting upon a table just below another smaller table. Hence, the real hand was hidden from the participant's view and a life-sized rubber model of a right hand was placed on the small table in front of them. Participants observed a wooden plank while approaching - without touching - the rubber hand. We measured the phenomenology of the illusion by means of questionnaire. Neural activity was recorded by means of near-infrared spectroscopy (fNIRS). Results showed higher activation of multisensory parietal cortices in the rubber hand illusion induced by touch expectation. Furthermore, such activity was correlated with the subjective feeling of owning the rubber hand. Our results enrich current models of body ownership suggesting that our multisensory brain regions generate prediction on what could be my body and what could not. This finding might have interesting implications in all those cases in which body representation is altered, anorexia, bulimia nervosa and obesity, among others.

The combined action of a passive exoskeleton and an EMG-controlled neuroprosthesis for upper limb stroke rehabilitation: First results of the RETRAINER project

The combined use of Functional Electrical Stimulation (FES) and robotic technologies is advocated to improve rehabilitation outcomes after stroke. This work describes an arm rehabilitation system developed within the European project RETRAINER. The system consists of a passive 4-degrees-of-freedom exoskeleton equipped with springs to provide gravity compensation and electromagnetic brakes to hold target positions. FES is integrated in the system to provide additional support to the most impaired muscles. FES is triggered based on the volitional EMG signal of the same stimulated muscle; in order to encourage the active involvement of the patient the volitional EMG is also monitored throughout the task execution and based on it a happy or sad emoji is visualized at the end of each task. The control interface control of the system provides a GUI and multiple software tools to organize rehabilitation exercises and monitor rehabilitation progress. The functionality and the usability of the system was evaluated on four stroke patients. All patients were able to use the system and judged positively its wearability and the provided support. They were able to trigger the stimulation based on their residual muscle activity and provided different levels of active involvement in the exercise, in agreement with their level of impairment. A randomized controlled trial aimed at evaluating the effectiveness of the RETRAINER system to improve arm function after stroke is currently ongoing.

The effect of loneliness on cancer mortality

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Background: Convergent findings indicate the need of broadening the vision of cancer beyond known prognostic factors, as many variables of different nature equally affect the course of disease. Loneliness has been found to be associated with various health outcomes, but its relationship with cancer remains unclear. Here we aimed to investigate the specific effect of loneliness and other demographic, psychological, and clinical variables on cancer mortality and to validate the Italian UCLA Loneliness Scale in cancer patients. Methods: This descriptive and correlational study was conducted at the Veneto Institute of Oncology in Padua. 400 patients undergoing chemotherapy from 01/2014 to 06/2015 were enrolled. The sample was stratified by sex and age (4 groups, 40-80 y). We collected demographic, clinical (site and stage of cancer, type of chemotherapy, death date), and psychosocial [self-esteem (RSE), perceived social support (MSPSS), social interaction anxiety (SIAS), personality (EPQR), and depression (BDI)] data. Results: GLM analyses: loneliness was higher in women than men (F(1,398) = 7.5, p = .006) and it linearly increased with age (F(1,398) = 10.9, p = .001). Loneliness was also influenced by marital status (F(3,396) = 2.9, p = .037), cohabitant offspring (F(1,398) = 7, p = .008), and educational level (F(3,396) = 4.7, p = .003), but not by clinical variables (all ps > .05). Correlation analyses: loneliness was inversely related to RSE (r = -.51), MSPSS (r = -.52), and extroversion (r = -.32), and directly related to SIAS (r = .46), neuroticism (r = .43), and BDI (r = .44). More importantly, a hierarchical binomial logistic regression revealed that patients’ mortality was reliably predicted by gender, stage of cancer at diagnosis, time from diagnosis to UCLA collection, BDI, and UCLA (HL χ2(8) = 3.53, p = .90). In particular, high BDI predicted higher mortality (Wald = 11.6, p < .001); surprisingly, after controlling for BDI and other effects, high loneliness predicted lower mortality (Wald = 7, p = .008). Conclusions: Our results replicate prior research and reveal a surprising association between loneliness and mortality risk after partialling out the impact of, especially, depression. This suggests the role of loneliness on cancer course as an important health concern.

Domain-general Stroop Performance and Hemispheric Asymmetries: A Resting-state EEG Study

The ability to suppress irrelevant information while executing a task, also known as interference resistance ability, is a function of pFC that is critical for successful goal-directed human behavior. In the study of interference resistance and, more generally, executive functions, two key questions are still open: Does pFC contribute to cognitive control abilities through lateralized but domain-general mechanisms or through hemispheric specialization of domain-specific processes? And what are the underlying causes of interindividual differences in executive control performance? To shed light on these issues, here we employed an interindividual difference approach to investigate whether participants' hemispheric asymmetry in resting-state electrophysiological brain dynamics may reflect their variability in domain-general interference resistance. We recorded participants' resting-state electroencephalographic activity and performed spectral power analyses on the estimated cortical source activity. To measure participants' lateralized brain dynamics at rest, we computed the right–left hemispheric asymmetry score for the β/α power ratio. To measure their domain-general interference resistance ability, verbal and spatial Stroop tasks were used. Robust correlations followed by intersection analyses showed that participants with stronger resting-state-related left-lateralized activity in different pFC regions, namely the mid-posterior superior frontal gyrus, middle and posterior middle frontal gyrus, and inferior frontal junction, were more able to inhibit irrelevant information in both domains. The present results confirm and extend previous findings showing that neurophysiological difference factors may explain interindividual differences in executive functioning. They also provide support for the hypothesis of a left pFC hemispheric specialization for domain-independent phasic cognitive control processes mediating Stroop performance.

Action perception as hypothesis testing

We present a novel computational model that describes action perception as an active inferential process that combines motor prediction (the reuse of our own motor system to predict perceived movements) and hypothesis testing (the use of eye movements to disambiguate amongst hypotheses). The system uses a generative model of how (arm and hand) actions are performed to generate hypothesis-specific visual predictions, and directs saccades to the most informative places of the visual scene to test these predictions - and underlying hypotheses. We test the model using eye movement data from a human action observation study. In both the human study and our model, saccades are proactive whenever context affords accurate action prediction; but uncertainty induces a more reactive gaze strategy, via tracking the observed movements. Our model offers a novel perspective on action observation that highlights its active nature based on prediction dynamics and hypothesis testing.

Affective Norms for Italian Words in Older Adults: Age Differences in Ratings of Valence, Arousal and Dominance

In line with the dimensional theory of emotional space, we developed affective norms for words rated in terms of valence, arousal and dominance in a group of older adults to complete the adaptation of the Affective Norms for English Words (ANEW) for Italian and to aid research on aging. Here, as in the original Italian ANEW database, participants evaluated valence, arousal, and dominance by means of the Self-Assessment Manikin (SAM) in a paper-and-pencil procedure. We observed high split-half reliabilities within the older sample and high correlations with the affective ratings of previous research, especially for valence, suggesting that there is large agreement among older adults within and across-languages. More importantly, we found high correlations between younger and older adults, showing that our data are generalizable across different ages. However, despite this across-ages accord, we obtained age-related differences on three affective dimensions for a great number of words. In particular, older adults rated as more arousing and more unpleasant a number of words that younger adults rated as moderately unpleasant and arousing in our previous affective norms. Moreover, older participants rated negative stimuli as more arousing and positive stimuli as less arousing than younger participants, thus leading to a less-curved distribution of ratings in the valence by arousal space. We also found more extreme ratings for older adults for the relationship between dominance and arousal: older adults gave lower dominance and higher arousal ratings for words rated by younger adults with middle dominance and arousal values. Together, these results suggest that our affective norms are reliable and can be confidently used to select words matched for the affective dimensions of valence, arousal and dominance across younger and older participants for future research in aging.

Spatiotemporal processing of somatosensory stimuli in schizotypy

Unusual interaction behaviors and perceptual aberrations, like those occurring in schizotypy and schizophrenia, may in part originate from impaired remapping of environmental stimuli in the body space. Such remapping is contributed by the integration of tactile and proprioceptive information about current body posture with other exteroceptive spatial information. Surprisingly, no study has investigated whether alterations in such remapping occur in psychosis-prone individuals. Four hundred eleven students were screened with respect to schizotypal traits using the Schizotypal Personality Questionnaire. A subgroup of them, classified as low, moderate, and high schizotypes were to perform a temporal order judgment task of tactile stimuli delivered on their hands, with both uncrossed and crossed arms. Results revealed marked differences in touch remapping in the high schizotypes as compared to low and moderate schizotypes. For the first time here we reveal that the remapping of environmental stimuli in the body space, an essential function to demarcate the boundaries between self and external world, is altered in schizotypy. Results are discussed in relation to recent models of 'self-disorders' as due to perceptual incoherence.

Body posture differentially impacts on visual attention towards tool, graspable, and non-graspable objects

Viewed objects have been shown to afford suitable actions, even in the absence of any intention to act. However, little is known as to whether gaze behavior (i.e., the way we simply look at objects) is sensitive to action afforded by the seen object and how our actual motor possibilities affect this behavior. We recorded participants' eye movements during the observation of tools, graspable and ungraspable objects, while their hands were either freely resting on the table or tied behind their back. The effects of the observed object and hand posture on gaze behavior were measured by comparing the actual fixation distribution with that predicted by 2 widely supported models of visual attention, namely the Graph-Based Visual Saliency and the Adaptive Whitening Salience models. Results showed that saliency models did not accurately predict participants' fixation distributions for tools. Indeed, participants mostly fixated the action-related, functional part of the tools, regardless of its visual saliency. Critically, the restriction of the participants' action possibility led to a significant reduction of this effect and significantly improved the model prediction of the participants' gaze behavior. We suggest, first, that action-relevant object information at least in part guides gaze behavior. Second, postural information interacts with visual information to the generation of priority maps of fixation behavior. We support the view that the kind of information we access from the environment is constrained by our readiness to act. (PsycINFO Database Record

Testing the domain-general nature of monitoring in the spatial and verbal cognitive domains

While it is well-established that monitoring the environment for the occurrence of relevant events represents a key executive function, it is still unclear whether such a function is mediated by domain-general or domain-specific mechanisms. We investigated this issue by combining event-related potentials (ERPs) with a behavioral paradigm in which monitoring processes (non-monitoring vs. monitoring) and cognitive domains (spatial vs. verbal) were orthogonally manipulated in the same group of participants. They had to categorize 3-dimensional visually presented words on the basis of either spatial or verbal rules. In monitoring blocks, they additionally had to check whether the word displayed a specific spatial configuration or whether it contained a certain consonant. The behavioral results showed slower responses for both spatial and verbal monitoring trials compared to non-monitoring trials. The ERP results revealed that monitoring did not interact with domain, thus suggesting the involvement of common underlying mechanisms. Specifically, monitoring acted on low-level perceptual processes (as expressed by an enhanced visual N1 wave and a sustained posterior negativity for monitoring trials) and on higher-level cognitive processes (involving larger positive modulations by monitoring trials over frontal and parietal scalp regions). The source reconstruction analysis of the ERP data confirmed that monitoring was associated with increased activity in visual areas and in right prefrontal and parietal regions (i.e., superior and inferior frontal gyri and posterior parietal cortex), which previous studies have linked to spatial and temporal monitoring. Our findings extend this research by supporting the domain-general nature of monitoring in the spatial and verbal domains.

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Previous studies suggest that monitoring relies on domain-general mechanisms.

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We combined EEG with a novel experimental design to directly test this hypothesis.

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Spatial and verbal non-monitoring and monitoring tasks were performed.

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Results confirmed the domain-general nature of monitoring.

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EEG source reconstruction showed the involvement of common right fronto-parietal areas.

Electrophysiological Evidence for Domain-General Processes in Task-Switching

The ability to flexibly switch between tasks is a hallmark of cognitive control. Despite previous studies that have investigated whether different task-switching types would be mediated by distinct or overlapping neural mechanisms, no definitive consensus has been reached on this question yet. Here, we aimed at directly addressing this issue by recording the event-related potentials (ERPs) elicited by two types of task-switching occurring in the context of spatial and verbal cognitive domains. Source analysis was also applied to the ERP data in order to track the spatial dynamics of brain activity underlying task-switching abilities. In separate blocks of trials, participants had to perform either spatial or verbal switching tasks both of which employed the same type of stimuli. The ERP analysis, which was carried out through a channel- and time-uninformed mass univariate approach, showed no significant differences between the spatial and verbal domains in the modulation of switch and repeat trials. Specifically, relative to repeat trials, switch trials in both domains were associated with a first larger positivity developing over left parieto-occipital electrodes and with a subsequent larger negativity distributed over mid-left fronto-central sites. The source analysis reconstruction for the two ERP components complemented these findings by highlighting the involvement of left-lateralized prefrontal areas in task-switching. Overall, our results join and extend recent research confirming the existence of left-lateralized domain-general task-switching processes.

Neuro-mechanics of muscle coordination during recumbent pedaling in post-acute stroke patients

Motor impairment after stroke has been hypothesized to be related, among others, to impairments in the modular control of movement. In this study we analyzed muscle coordination and pedal forces during a recumbent pedaling exercise from a sample of post-acute stroke patients (n=5) and a population of age-matched healthy individuals (n=4). Healthy subjects and the less impaired patients showed a shared modular organization of pedaling based on 4 similar muscle synergies. The most impaired patient, characterized by a Motricity Index of 52/100, showed a reduced complexity (only 2 muscle synergies for the affected side). Differences between healthy subjects and post-stroke patients in the execution of the task were identified in terms of unbalance in mechanical work production, which well corresponded to the level of impairment. This pedaling unbalance could be traced back to different activation strategies of the 4 identified modules. Investigation on a more representative sample will provide a full characterization of the neuro-mechanics of pedaling after stroke, helping our understandings of the disruption of motor coordination at central level after stroke and of the most effective solutions for functional recovery.