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Gulley Cox LI, Dias N, Zhang C, Zhang Y, Gorniak SL. Effects of Type II Diabetes on Proprioception during a Reach to Pinch Task. J Mot Behav 2023; 56:263-274. [PMID: 37997260 PMCID: PMC10957313 DOI: 10.1080/00222895.2023.2285888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023]
Abstract
Older adults with type II diabetes (T2D) are at risk of developing nerve disorders that result in functional impairment. Most work in proprioceptive dysfunction in older adults with T2D has focused on functional deficits of the lower limb. The purpose of this study was to examine proprioceptive effects of T2D on the upper limb in older adults. Kinematic performance of a reach-to-pinch action toward a virtual target was assessed in a T2D group (60+ years old with T2D) and a healthy age- and sex-matched control group. Tactile and vibratory thresholds did not differ between T2D and controls. Task accuracy via mean pinch location was significantly worse for persons with T2D (pwT2D) with differences in wrist extension/flexion (ex/fl), wrist abduction/adduction (ab/ad), 1st carpometacarpal (CMC) ab/ad, 2nd metacarpophalangeal (MCP2) ex/fl, MCP2 ab/ad, and digit 1 and hand transport trajectories. Group differences persisted with consideration of body mass index; sex differences in task accuracy emerged. Findings indicate that proprioception of the upper extremity is altered in pwT2D such that they exhibit a unique aperture position and aiming strategy during a reach-to-pinch action. These findings characterize functional sensorimotor impairment of the upper limb in pwT2D with respect to workspaces without visual or tactile feedback.
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Affiliation(s)
- Lauren I. Gulley Cox
- Department of Health and Human Performance, University of Houston, Houston, TX 77204
| | - Nicholas Dias
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204
| | - Chuan Zhang
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204
| | - Yingchun Zhang
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204
| | - Stacey L. Gorniak
- Department of Health and Human Performance, University of Houston, Houston, TX 77204
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Zhang D, Liu S, Huang Y, Gao J, Liu W, Liu W, Ai K, Lei X, Zhang X. Altered Functional Connectivity Density in Type 2 Diabetes Mellitus with and without Mild Cognitive Impairment. Brain Sci 2023; 13:brainsci13010144. [PMID: 36672125 PMCID: PMC9856282 DOI: 10.3390/brainsci13010144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/06/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Although disturbed functional connectivity is known to be a factor influencing cognitive impairment, the neuropathological mechanisms underlying the cognitive impairment caused by type 2 diabetes mellitus (T2DM) remain unclear. To characterize the neural mechanisms underlying T2DM-related brain damage, we explored the altered functional architecture patterns in different cognitive states in T2DM patients. Thirty-seven T2DM patients with normal cognitive function (DMCN), 40 T2DM patients with mild cognitive impairment (MCI) (DMCI), and 40 healthy controls underwent neuropsychological assessments and resting-state functional MRI examinations. Functional connectivity density (FCD) analysis was performed, and the relationship between abnormal FCD and clinical/cognitive variables was assessed. The regions showing abnormal FCD in T2DM patients were mainly located in the temporal lobe and cerebellum, but the abnormal functional architecture was more extensive in DMCI patients. Moreover, in comparison with the DMCN group, DMCI patients showed reduced long-range FCD in the left superior temporal gyrus (STG), which was correlated with the Rey auditory verbal learning test score in all T2DM patients. Thus, DMCI patients show functional architecture abnormalities in more brain regions involved in higher-level cognitive function (executive function and auditory memory function), and the left STG may be involved in the neuropathology of auditory memory in T2DM patients. These findings provide some new insights into understanding the neural mechanisms underlying T2DM-related cognitive impairment.
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Affiliation(s)
- Dongsheng Zhang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an 710068, China
| | - Shasha Liu
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an 710068, China
| | - Yang Huang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an 710068, China
| | - Jie Gao
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an 710068, China
| | - Weirui Liu
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an 710068, China
| | - Wanting Liu
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an 710068, China
| | - Kai Ai
- Department of Clinical Science, Philips Healthcare, Xi’an 710000, China
| | - Xiaoyan Lei
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an 710068, China
| | - Xiaoling Zhang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an 710068, China
- Correspondence: ; Tel.: +86-13087581380
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Bao YW, Shea YF, Chiu PKC, Kwan JSK, Chan FHW, Chow WS, Chan KH, Mak HKF. The fractional amplitude of low-frequency fluctuations signals related to amyloid uptake in high-risk populations—A pilot fMRI study. Front Aging Neurosci 2022; 14:956222. [PMID: 35966783 PMCID: PMC9372772 DOI: 10.3389/fnagi.2022.956222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPatients with type 2 diabetes mellitus (T2DM) and subjective cognitive decline (SCD) have a higher risk to develop Alzheimer's Disease (AD). Resting-state-functional magnetic resonance imaging (rs-fMRI) was used to document neurological involvement in the two groups from the aspect of brain dysfunction. Accumulation of amyloid-β (Aβ) starts decades ago before the onset of clinical symptoms and may already have been associated with brain function in high-risk populations. However, this study aims to compare the patterns of fractional amplitude of low-frequency fluctuations (fALFF) maps between cognitively normal high-risk groups (SCD and T2DM) and healthy elderly and evaluate the association between regional amyloid deposition and local fALFF signals in certain cortical regions.Materials and methodsA total of 18 T2DM, 11 SCD, and 18 healthy elderlies were included in this study. The differences in the fALFF maps were compared between HC and high-risk groups. Regional amyloid deposition and local fALFF signals were obtained and further correlated in two high-risk groups.ResultsCompared to HC, the altered fALFF signals of regions were shown in SCD such as the left posterior cerebellum, left putamen, and cingulate gyrus. The T2DM group illustrated altered neural activity in the superior temporal gyrus, supplementary motor area, and precentral gyrus. The correlation between fALFF signals and amyloid deposition was negative in the left anterior cingulate cortex for both groups. In the T2DM group, a positive correlation was shown in the right occipital lobe and left mesial temporal lobe.ConclusionThe altered fALFF signals were demonstrated in high-risk groups compared to HC. Very early amyloid deposition in SCD and T2DM groups was observed to affect the neural activity mainly involved in the default mode network (DMN).
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Affiliation(s)
- Yi-Wen Bao
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yat-Fung Shea
- Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | | | - Joseph S. K. Kwan
- Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Felix Hon-Wai Chan
- Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Wing-Sun Chow
- Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Koon-Ho Chan
- Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Henry Ka-Fung Mak
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- *Correspondence: Henry Ka-Fung Mak
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Liu J, Yang X, Li Y, Xu H, Ren J, Zhou P. Cerebral Blood Flow Alterations in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Arterial Spin Labeling Studies. Front Aging Neurosci 2022; 14:847218. [PMID: 35250549 PMCID: PMC8888831 DOI: 10.3389/fnagi.2022.847218] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 01/26/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveArterial spin labeling (ASL) studies have revealed inconsistent regional cerebral blood flow (CBF) alterations in patients with type 2 diabetes mellitus (T2DM). The aim of this systematic review and meta-analysis was to identify concordant regional CBF alterations in T2DM.MethodsA systematic review was conducted to the published literatures comparing cerebral perfusion between patients with T2DM and healthy controls using ASL. The seed-based d mapping (SDM) was further used to perform quantitative meta-analysis on voxel-based literatures and to estimate the regional CBF alterations in patients with T2DM. Metaregression was performed to explore the associations between clinical characteristics and cerebral perfusion alterations.ResultsA total of 13 studies with 14 reports were included in the systematic review and 7 studies with 7 reports were included in the quantitative meta-analysis. The qualitative review found widespread CBF reduction in cerebral lobes in T2DM. The meta-analysis found increased regional CBF in right supplementary motor area and decreased regional CBF in bilateral middle occipital gyrus, left caudate nucleus, right superior parietal gyrus, and left calcarine fissure/surrounding cortex in T2DM.ConclusionThe patterns of cerebral perfusion alterations, characterized by the decreased CBF in occipital and parietal lobes, might be the neuropathology of visual impairment and cognitive aging in T2DM.
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Lima KCA, Santos GOC, Donato SSV, Borges L, Hatanaka E, de Freitas PB. Grip and load force control and coordination in individuals with diabetes in different manipulation tasks. Hum Mov Sci 2021; 77:102793. [PMID: 33845277 DOI: 10.1016/j.humov.2021.102793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/25/2021] [Accepted: 04/01/2021] [Indexed: 10/21/2022]
Abstract
The study aimed to investigate the control and coordination of grip force (normal component) and load force (tangential component) in three different manipulation tasks in individuals with diabetes with and with no diagnosis of diabetic peripheral neuropathy (DPN) and healthy controls. Twenty-four individuals with type 2 diabetes mellitus, 12 with no (nDPN) and 12 with DPN (wDPN), and 12 healthy controls performed three manipulation tasks (static holding, lifting and holding, and oscillation) with the dominant hand, using an instrumented handle. Relative safety margin (% of GF exerted above the minimum GF needed to hold the object) was measured in all tasks. Individuals with diabetes from the nDPN and wDPN groups set lower relative safety margin than controls only in the static holding task. No other group effect was revealed, except a lower coefficient of friction between skin and object surface in individuals with DPN. The coordination between grip and load force and grip force control was not affected by the diabetes during dynamic manipulation tasks (lifting and holding and oscillation). However, when individuals with diabetes without and with DPN performed a manipulation task in which the inflow of cutaneous information was small and stable (static holding), grip force control was affected by the disease. This finding indicates that individuals with type 2 diabetes mellitus not diagnosed with DPN, already show mild impairments in the nervous system that could affect grip force control and that could be one of the first signs of neuropathy caused by the diabetes.
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Affiliation(s)
- Kauê C A Lima
- Institute of Physical Activity and Sports Sciences and Interdisciplinary Graduate Program in Health Sciences, Cruzeiro do Sul University, Sao Paulo, Brazil
| | - Gabriela O C Santos
- Institute of Physical Activity and Sports Sciences and Interdisciplinary Graduate Program in Health Sciences, Cruzeiro do Sul University, Sao Paulo, Brazil
| | - Stephanie S V Donato
- Institute of Physical Activity and Sports Sciences and Interdisciplinary Graduate Program in Health Sciences, Cruzeiro do Sul University, Sao Paulo, Brazil
| | - Leandro Borges
- Institute of Physical Activity and Sports Sciences and Interdisciplinary Graduate Program in Health Sciences, Cruzeiro do Sul University, Sao Paulo, Brazil
| | - Elaine Hatanaka
- Institute of Physical Activity and Sports Sciences and Interdisciplinary Graduate Program in Health Sciences, Cruzeiro do Sul University, Sao Paulo, Brazil
| | - Paulo B de Freitas
- Institute of Physical Activity and Sports Sciences and Interdisciplinary Graduate Program in Health Sciences, Cruzeiro do Sul University, Sao Paulo, Brazil.
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Huang X, Wen Z, Tong Y, Qi CX, Shen Y. Altered resting cerebral blood flow specific to patients with diabetic retinopathy revealed by arterial spin labeling perfusion magnetic resonance imaging. Acta Radiol 2021; 62:524-532. [PMID: 32551803 DOI: 10.1177/0284185120932391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Previous neuroimaging studies have shown that patients with diabetic retinopathy (DR) were accompanied by abnormalities in cerebral functional and structural architecture, whereas the resting cerebral blood flow (CBF) alterations in patients with DR are not well understood. PURPOSE To explore CBF alterations in patients with DR using pseudo-continuous arterial spin labeling (pCASL) imaging. MATERIAL AND METHODS Thirty-one individuals with DR (15 men, 16 women; mean age = 53.38 ± 9.12 years) and 33 healthy controls (HC) (12 men, 21 women; mean age = 51.61 ± 9.84 years) closely matched for age, sex, and education, underwent pCASL imaging scans. Two-sample T test was conducted to compare different CBF values between two groups. RESULTS Patients with DR exhibited significantly increased CBF values in the left middle temporal gyrus (Brodmann's area, BA 22) and the bilateral supplementary motor area (BA3) and decreased CBF values in the bilateral calcarine (BA17,18) and bilateral caudate relative to HC group (two-tailed, voxel level at P < 0.01, Gaussian random field (GRF), cluster level at P < 0.05). Moreover, the HbA1c (%) level showed a positive correlation with CBF values in the bilateral caudate (r = 0.473, P = 0.007) in patients with DR. CONCLUSION Our results highlighted that patients with DR had abnormal CBF values in the visual cortices, caudate, middle temporal gyrus, and supplementary motor area, which might reflect vision and sensorimotor and cognition dysfunction in patients with DR. These findings might help us to understanding the neural mechanism of patients with DR.
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Affiliation(s)
- Xin Huang
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
| | - Zhi Wen
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
| | - Yan Tong
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
| | - Chen-Xing Qi
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
| | - Yin Shen
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
- Medical Research Institute, Wuhan University, Wuhan, Hubei, PR China
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Gorniak SL, Ochoa N, Cox LIG, Khan A, Ansari S, Thames B, Ray H, Lu YF, Hibino H, Watson N, Dougherty PM. Sex-based differences and aging in tactile function loss in persons with type 2 diabetes. PLoS One 2020; 15:e0242199. [PMID: 33180801 PMCID: PMC7660517 DOI: 10.1371/journal.pone.0242199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/29/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Recent evidence of significant sex-based differences in the presentation of Type 2 Diabetes Mellitus (DM) and its complications has been found in humans, which may contribute to sex-based differences in reduced functionality and quality of life. Some functionality, such as tactile function of the hands, has significant direct impact on quality of life. The purpose of the current study was to explore the impact of DM and sex on tactile function, with consideration of variability in health state measures. RESEARCH DESIGN AND METHODS A case-control single time point observational study from 2012-2020 in an ethnically diverse population-based community setting. The sample consists of 132 adult individuals: 70 independent community dwelling persons with DM (PwDM) and 62 age- and sex-matched controls (42 males and 90 females in total). The Semmes-Weinstein monofilament test was used to evaluate tactile sensation of the hands. RESULTS Tactile sensation thresholds were adversely impacted by sex, age, degree of handedness, high A1c, diagnosis of DM, and neuropathy. Overall, strongly right-handed older adult males with poorly controlled DM and neuropathy possessed the poorest tactile discrimination thresholds. When self-identified minority status was included in a secondary analysis, DM diagnosis was no longer significant; negative impacts of age, neuropathy, degree of handedness, and high A1c remained significant. CONCLUSIONS The data indicate significant impacts of male sex, age, degree of handedness, self-identified minority status, and metabolic health on the development of poor tactile sensation. This combination of modifiable and non-modifiable factors are important considerations in the monitoring and treatment of DM complications.
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Affiliation(s)
- Stacey L. Gorniak
- Department of Health and Human Performance, University of Houston, Houston, TX, United States of America
- * E-mail:
| | - Nereyda Ochoa
- Department of Health and Human Performance, University of Houston, Houston, TX, United States of America
| | - Lauren I. Gulley Cox
- Department of Health and Human Performance, University of Houston, Houston, TX, United States of America
| | - Aisha Khan
- Department of Health and Human Performance, University of Houston, Houston, TX, United States of America
| | - Sahifah Ansari
- Department of Health and Human Performance, University of Houston, Houston, TX, United States of America
| | - Beatriz Thames
- Department of Health and Human Performance, University of Houston, Houston, TX, United States of America
| | - Haley Ray
- Department of Health and Human Performance, University of Houston, Houston, TX, United States of America
| | - Yoshimi F. Lu
- Department of Health and Human Performance, University of Houston, Houston, TX, United States of America
| | - Hidetaka Hibino
- Department of Health and Human Performance, University of Houston, Houston, TX, United States of America
| | - Nikita Watson
- Department of Health and Human Performance, University of Houston, Houston, TX, United States of America
| | - Patrick M. Dougherty
- Department of Pain Medicine Research, University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
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Pollonini L, Gulley Cox L, Gorniak SL. Hemodynamic Function of Forearm Muscle in Postmenopausal Women With Type 2 Diabetes. J Aging Phys Act 2020; 28:723-730. [PMID: 32315982 DOI: 10.1123/japa.2019-0221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 11/18/2022]
Abstract
Changes in the hemodynamic function of muscle are speculated as a causal mechanism for reduced motor capabilities with aging in Type 2 diabetes mellitus (DM). The focus of this study was to evaluate changes in muscle oxygenation during sustained force production in postmenopausal women with DM compared with controls. Near-infrared spectroscopy was used to monitor deoxyhemoglobin and oxyhemoglobin in the flexor digitorum superficialis. Sensorimotor function and health state covariates were also assessed. Increased deoxyhemoglobin was found during force production, whereas oxyhemoglobin remained constant. Changes were found in the time structure of the hemodynamic data during force production. No between-group differences were found; instead, measures covaried with the health state. Sex-based differences in the manifestation of DM-related sensorimotor dysfunction are likely. These data indicate that basic cardiovascular health measures may be more beneficial to monitoring hyperemic status and muscle function in postmenopausal women with DM, compared with DM diagnosis.
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Hibino H, Gorniak SL. Effects of aging on rapid grip force responses during bimanual manipulation of an active object. Exp Brain Res 2020; 238:2161-2178. [PMID: 32661648 PMCID: PMC10103105 DOI: 10.1007/s00221-020-05865-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 07/01/2020] [Indexed: 12/17/2022]
Abstract
Rapid grip force responses to unexpected pulling loads on the fingertips are deteriorated in older adults due to, in part, age-related declines in somatosensory function. Such reports are limited to one-hand conditions despite the higher frequency of using two hands together in daily living activities of older adults. Unexpected perturbations during bimanual movements elicit goal-oriented and cortically-meditated bilateral rapid motor responses. Since aging is associated with declined somatosensory and cognitive functions, we hypothesized that bilateral rapid motor responses differ between young and older adults, such that older adults exert stronger grip forces following perturbation and the unperturbed hand is more involved in stabilizing the object in older adults. We tested our hypothesis by comparing the rapid grip force responses of both hands in young and older adults. A total of 13 right-handed young individuals (24.2 ± 4.0 years old, 5 men) and 13 right-handed older individuals (68.7 ± 7.1 years old, 5 men) were recruited. Tactile detection threshold, fingertip friction, and the rapid grip force responses of both hands triggered by unpredicted pulling loads during grip-lift movements were assessed. Older adults had higher tactile detection thresholds and lower fingertip friction compared to young adults. Regardless of age, rapid motor responses were found in both the perturbed (right) hand and the indirectly perturbed (left) hand at 73 ms and 135 ms after the perturbation, respectively, while magnitudes of the responses depended on perturbation magnitudes. Higher values in maximum grip force and maximum grip force rate were found in older adults as compared to young adults. In older adults, the indirectly perturbed (left) hand was more involved in stabilizing the object as compared to young healthy adults. The current study suggests that age-related changes in the peripheral and central nervous systems contribute to the greater involvement of the indirectly perturbed hand in older adults.
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Affiliation(s)
- Hidetaka Hibino
- Department of Health and Human Performance, University of Houston, 3855 Holman St., Garrison 104, Houston, TX, 77204-6015, USA
| | - Stacey L Gorniak
- Department of Health and Human Performance, University of Houston, 3855 Holman St., Garrison 104, Houston, TX, 77204-6015, USA.
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Meng H, Gorniak SL. Effects of adiposity on postural control and cognition in older adults. Gait Posture 2020; 82:147-152. [PMID: 32927221 DOI: 10.1016/j.gaitpost.2020.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 08/19/2020] [Accepted: 09/01/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Understanding the impacts of increased adiposity on postural control and cognitive deficits in adults is critical for health practitioners in recommending or prescribing effective weight loss regimens. Despite prior work in this area, the knowledge of increased adiposity impacts on postural control and cognitive deficits in older adults (OAs) is still limited. RESEARCH QUESTION The purposes of the current study were: (a) to assess the relationship between postural measures and adiposity measures by using regression model analyses and, (b) to examine the impacts of increased adiposity and age on cognitive performance. METHODS A total of thirty (30) individuals aged 60+ years participated in the study. Participants were classified into three groups based upon their BMI scores at the onset of the study. The normal weight (NW) (BMI: 18.5-24.9 kg/m2), the overweight (OW) (BMI: 25-29.9 kg/m2), and the obese (OB) groups (BMI: 30-40 kg/m2) each had five females and five males. Participants were required to perform two test sessions: (1) anthropometry assessment and body composition scanning; and (2) evaluation of plantar tactile function, postural control, and cognitive function. RESULTS Overall, our findings indicate that increased adiposity in OAs is associated with declines in both cognitive function and postural control. SIGNIFICANCE Our data also indicate that measures such as BMI and abdominal fat mass amounts/ratios offer the best insight to the impact of adiposity on cognitive function and postural control measures. However, further work is still needed to clarify the mechanistic links between adiposity and cognitive-postural deficits.
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Affiliation(s)
- Hao Meng
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, United States
| | - Stacey L Gorniak
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, United States.
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11
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Gorniak SL, Wagner VE, Vaughn K, Perry J, Cox LG, Hernandez AE, Pollonini L. Functional neuroimaging of sensorimotor cortices in postmenopausal women with type II diabetes. NEUROPHOTONICS 2020; 7:035007. [PMID: 32905073 PMCID: PMC7467056 DOI: 10.1117/1.nph.7.3.035007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/14/2020] [Indexed: 05/19/2023]
Abstract
Significance: Deficits in sensorimotor function in persons with type II diabetes mellitus (PwDM) have traditionally been considered a result of peripheral nerve damage. Emerging evidence has suggested that factors outside of nerve damage due to type II diabetes mellitus, such as impaired hemodynamic function, contribute significantly to both sensory and motor deficits in PwDM. Aim: The focus of the current study was to evaluate functional cortical hemodynamic activity during sensory and motor tasks in PwDM. Approach: Functional near-infrared spectroscopy was used to monitor oxyhemoglobin (HbO) and deoxyhemoglobin (HbR) across the cortex during sensory and motor tasks involving the hands. Results: Decline in HbO across sensory and motor regions of interest was found in PwDM with simultaneous deficits in manual motor tasks, providing the first evidence of functional cortical hemodynamic activity deficits relating to motor dysfunction in PwDM. Similar deficits were neither specifically noted in HbR nor during evaluation of sensory function. Health state indices, such asA 1 c , blood pressure, body mass index, and cholesterol, were found to clarify group effects. Conclusions: Further work is needed to clarify potential sex-based differences in PwDM during motor tasks as well as the root of reduced cortical HbO indices but unchanged HbR indices in PwDM.
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Affiliation(s)
- Stacey L. Gorniak
- University of Houston, Department of Health and Human Performance, Houston, Texas, United States
| | - Victoria E. Wagner
- University of Houston, Department of Psychology, Houston, Texas, United States
| | - Kelly Vaughn
- University of Houston, Department of Psychology, Houston, Texas, United States
| | - Jonathan Perry
- University of Houston, Department of Engineering Technology, Houston, Texas, United States
| | - Lauren Gulley Cox
- University of Houston, Department of Health and Human Performance, Houston, Texas, United States
| | - Arturo E. Hernandez
- University of Houston, Department of Psychology, Houston, Texas, United States
| | - Luca Pollonini
- University of Houston, Department of Engineering Technology, Houston, Texas, United States
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12
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Ferris JK, Inglis JT, Madden KM, Boyd LA. Brain and Body: A Review of Central Nervous System Contributions to Movement Impairments in Diabetes. Diabetes 2020; 69:3-11. [PMID: 31862690 DOI: 10.2337/db19-0321] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 10/20/2019] [Indexed: 11/13/2022]
Abstract
Diabetes is associated with a loss of somatosensory and motor function, leading to impairments in gait, balance, and manual dexterity. Data-driven neuroimaging studies frequently report a negative impact of diabetes on sensorimotor regions in the brain; however, relationships with sensorimotor behavior are rarely considered. The goal of this review is to consider existing diabetes neuroimaging evidence through the lens of sensorimotor neuroscience. We review evidence for diabetes-related disruptions to three critical circuits for movement control: the cerebral cortex, the cerebellum, and the basal ganglia. In addition, we discuss how central nervous system (CNS) degeneration might interact with the loss of sensory feedback from the limbs due to peripheral neuropathy to result in motor impairments in individuals with diabetes. We argue that our understanding of movement impairments in individuals with diabetes is incomplete without the consideration of disease complications in both the central and peripheral nervous systems. Neuroimaging evidence for disrupted central sensorimotor circuitry suggests that there may be unrecognized behavioral impairments in individuals with diabetes. Applying knowledge from the existing literature on CNS contributions to motor control and motor learning in healthy individuals provides a framework for hypothesis generation for future research on this topic.
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Affiliation(s)
- Jennifer K Ferris
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - J Timothy Inglis
- Department of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, Canada
| | - Kenneth M Madden
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Lara A Boyd
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Gorniak SL, Ray H, Lee BC, Wang J. Cognitive-Motor Impairment in Manual Tasks in Adults With Type 2 Diabetes. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2019; 40:113-121. [PMID: 31658863 DOI: 10.1177/1539449219880536] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adults with type 2 diabetes (T2D) experience decline in cognitive function compared with controls. Cognitive function is a major component in the performance of daily activities that involve motor components. The aim of this project was to evaluate working memory cognitive deficits and sensorimotor deficits in adults with T2D versus healthy participants. Ten community-dwelling persons with T2D and 10 age- and sex-matched healthy controls were recruited. Cognitive function, tactile function, motor function, and health state measures were evaluated. Reduced cognitive function, tactile function, and motor function were exhibited in the T2D group. Cognitive and motor functions remained impaired versus controls during tasks with both cognitive and motor components (dual tasks). Health state measures were found to covary with measures of interest. The conclusions of this article are as follows: (a) systemic deficits beyond tactile dysfunction contribute to reduced hand/finger function in T2D, and (b) participants with T2D demonstrate impairments in working memory, tactile function, and motor function.
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Affiliation(s)
| | | | | | - Jing Wang
- University of Texas Health San Antonio, USA
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Yahya A, Kluding P, Pasnoor M, Wick J, Liu W, Dos Santos M. The impact of diabetic peripheral neuropathy on pinch proprioception. Exp Brain Res 2019; 237:3165-3174. [PMID: 31586215 DOI: 10.1007/s00221-019-05663-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 09/28/2019] [Indexed: 12/01/2022]
Abstract
This study aims to investigate the impact of type 2 diabetes (T2D) and diabetic peripheral neuropathy (DPN) on pinch proprioception and to establish the correlations with sensory impairments. We collected data from a total of 36 participants (healthy, n = 12; T2D without DPN, n = 11; and T2D + DPN, n = 13), all matched for age, 60 ± 6 years. Pinch proprioception was determined through 3 trials of attempts to actively reproduce 15° of pinch position without visual feedback. Target accuracy and precision was compared between groups using Kruskal-Wallis test. Sensation was tested through the two-point discrimination and Semmes-Weinstein monofilaments applied on the fingers. Sensory measures were correlated with pinch proprioception measures via Spearman's rank test. The T2D + DPN group showed significant decrements in accuracy and precision as compared to the T2D-only (p = 0.003 and p = 0.006, respectively) and the healthy groups (both p = 0.002); no significant differences were found between T2D-only and healthy. Spearman's rank showed moderate (r = 0.45-0.66, p < 0.001) correlations between pinch proprioception and sensory measures. Our results showed pinch proprioception disruption in people with T2D + DPN, but not in people with T2D-only. The awareness of pinch proprioceptive deficits is paramount for the safety of individuals with T2D and DPN. Moderate correlations between sensory impairments and pinch proprioceptive deficits suggest that not only superficial/discriminative sensation is implicated in proprioceptive decrements. Other mechanisms such as damage to muscle spindles or central nervous system associated with T2D + DPN warrant further investigations.
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Affiliation(s)
- Abdalghani Yahya
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Mail stop 2002, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA.
| | - Patricia Kluding
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Mail stop 2002, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Mamatha Pasnoor
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jo Wick
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Wen Liu
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Mail stop 2002, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Marcio Dos Santos
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Mail stop 2002, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
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Gorniak SL, Lu FY, Lee BC, Massman PJ, Wang J. Cognitive impairment and postural control deficit in adults with Type 2 diabetes. Diabetes Metab Res Rev 2019; 35:e3089. [PMID: 30338902 PMCID: PMC6590678 DOI: 10.1002/dmrr.3089] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/26/2018] [Accepted: 10/12/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Diseases induced by metabolic disorders, eg, Type 2 diabetes, has recently been linked to both sensory and motor deficit in the absence of a formal clinical diagnosis of peripheral neuropathy. Studies have demonstrated mild cognitive impairment in diabetic patients, which also plays a role in one's loss of ability to successfully perform basic motor activities. This project focused on evaluating cognitive function while maintaining balance. We hypothesized that simultaneous cognitive and motor deficit would occur among adults with Type 2 diabetes versus healthy age- and sex-matched control during a balance task. METHODS A sample of 10 Type 2 diabetes patients and 10 age-matched and sex-matched controls underwent a series of sensory, motor, cognitive, and cognitive-motor evaluations. Blood pressure and A1c levels were assessed. RESULTS Significantly lower cognitive function scores, particularly in the domain of working memory, were exhibited in the diabetic group than controls. Balance in the diabetic group was overall poorer in both single- and dual-tasks than controls. When diabetic patients were asked to verbally recall different words while maintaining their balance, their accuracy rate was significantly lower than controls. Some health state measures were found to co-vary with motor function. Increased body mass index in the diabetic group did not account for motor function deficit. SIGNIFICANCE Our data suggest that: (1) systemic deficit beyond tactile dysfunction and increased body mass index contribute to reduced motor function in diabetes, and (2) both balance and working memory functions are simultaneously impaired in patients with Type 2 diabetes.
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Affiliation(s)
- Stacey L. Gorniak
- Department of Health and Human Performance, University of Houston, Houston, TX 77204
- Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX 77204
| | - Fangmei Yoshimi Lu
- Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX 77204
| | - Beom Chan Lee
- Department of Health and Human Performance, University of Houston, Houston, TX 77204
- Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX 77204
| | - Paul J. Massman
- Department of Psychology, University of Houston, Houston, TX 77204
| | - Jing Wang
- School of Nursing, The University of Texas Health San Antonio, San Antonio TX 78229
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Pollonini L, Younes L, Gorniak SL. Hemodynamic function during finger force production tasks in healthy adults. Muscle Nerve 2017; 56:472-478. [PMID: 27935081 PMCID: PMC6510247 DOI: 10.1002/mus.25499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 11/23/2016] [Accepted: 11/30/2016] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Near-infrared spectroscopy (NIRS) is a noninvasive technique used to measure muscle hemodynamics. The focus of this study was to evaluate changes in muscle oxygenation during sustained maximal force production in young, healthy control individuals to establish baseline function in an ideal population. METHODS NIRS was used to monitor reduced hemoglobin (HbR) and oxygenated hemoglobin (HbO) in forearm muscles. Hemodynamic responses during force production tasks were monitored in real time. RESULTS During handgrip exercises, maximal force production declined significantly. Increased HbR was found while HbO remained constant. The correlation between force production and HbO was positive (r = 0.18), while the correlation between force and HbR was negative (r = -0.48). The application of NIRS to monitor the correlation between force production and hemodynamic measures in the forearm was successful. These data set the foundation for future use of NIRS as a diagnostic tool for individuals with peripheral vascular disease: Muscle Nerve 56: 472-478, 2017.
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Affiliation(s)
- Luca Pollonini
- Department of Engineering Technology, University of Houston, Houston, TX 77204
- Abramson Center for the Future of Health, University of Houston, Houston, TX 77204
| | - Lena Younes
- Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX 77204
| | - Stacey L. Gorniak
- Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX 77204
- Department of Health and Human Performance, University of Houston, Houston, TX 77204
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Engel-Yeger B, Darawsha Najjar S, Darawsha M. The relationship between health related quality of life and sensory deficits among patients with diabetes mellitus. Disabil Rehabil 2017; 40:3005-3011. [PMID: 28805083 DOI: 10.1080/09638288.2017.1365382] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE (1) To profile sensory deficits examined in the ability to process sensory information from daily environment and discriminate between tactile stimuli among patients with controlled and un-controlled diabetes mellitus. (2) Examine the relationship between the sensory deficits and patients' health-related quality of life. METHODS This study included 115 participants aged 33-55 with uncontrolled (n = 22) or controlled (n = 24) glycemic levels together with healthy subjects (n = 69). All participants completed the brief World Health Organization Quality of Life Questionnaire, the Adolescent/Adult Sensory Profile and performed the tactile discrimination test. RESULTS Sensory deficits were more emphasized among patients with uncontrolled glycemic levels as expressed in difficulties to register sensory input, lower sensation seeking in daily environments and difficulties to discriminate between tactile stimuli. They also reported the lowest physical and social quality of life as compared to the other two groups. Better sensory seeking and registration predicted better quality of life. Disease control and duration contributed to these predictions. CONCLUSIONS Difficulties in processing sensory information from their daily environments are particularly prevalent among patients with uncontrolled glycemic levels, and significantly impacted their quality of life. Clinicians should screen for sensory processing difficulties among patients with diabetes mellitus and understand their impacts on patients' quality of life. Implications for Rehabilitation Patients with diabetes mellitus, and particularly those with uncontrolled glycemic levels, may have difficulties in processing sensory information from daily environment. A multidisciplinary intervention approach is recommended: clinicians should screen for sensory processing deficits among patients with diabetes mellitus and understand their impacts on patients' daily life. By providing the patients with environmental adaptations and coping strategies, clinicians may assist in optimizing sensory experiences in real life context and elevate patients' quality of life. Relating to quality of life and emphasizing a multidisciplinary approach is of major importance in broadening our understanding of health conditions and providing holistic treatment for patients.
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Affiliation(s)
- Batya Engel-Yeger
- a Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences , University of Haifa , Haifa , Israel
| | - Sanaa Darawsha Najjar
- a Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences , University of Haifa , Haifa , Israel
| | - Mahmud Darawsha
- b Department of Family Medicine , Clalit Health Services , Sachnin , Israel
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Coefficient of Friction at the Fingertips in Type II Diabetics Compared to Healthy Adults. J Appl Biomech 2017; 33:185-188. [PMID: 27918701 PMCID: PMC6510242 DOI: 10.1123/jab.2016-0147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Clinical observations suggest that type II diabetes patients are more susceptible to skin changes, which may be associated with reduced coefficient of friction at the fingertips. Reduced coefficient of friction may explain recent reports of fine motor dysfunction in diabetic patients. Coefficient of friction was evaluated using slip force evaluation in a cross-sectional cohort of diabetic patients and age- and sex-matched healthy controls. Covariates of tactile sensation, disease duration, glycated hemoglobin, and clinical diagnosis of peripheral neuropathy were also assessed. A significant decrease in fingertip coefficient of friction in the diabetic group was found as compared to controls. Health state covariates did not alter the strength of between-group differences in statistical analyses. This finding of between-group differences for fingertip frictional properties suggests that causative factors of reported manual motor dysfunction lie in both the distal and proximal portions of the nervous system.
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