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Grössinger D, Spann SM, Stollberger R, Pfeuffer J, Koten JW, Wood G. Real-time fMRI neurofeedback of the anterior insula using arterial spin labelling. Eur J Neurosci 2024. [PMID: 39193617 DOI: 10.1111/ejn.16502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 07/02/2024] [Accepted: 07/28/2024] [Indexed: 08/29/2024]
Abstract
Arterial spin labelling (ASL) is the only non-invasive technique that allows absolute quantification of perfusion and is increasingly used in brain activation studies. Contrary to the blood oxygen level-dependent (BOLD) effect ASL measures the cerebral blood flow (CBF) directly. However, the ASL signal has a lower signal-to-noise ratio (SNR), than the BOLD signal, which constrains its utilization in neurofeedback studies. If successful, ASL neurofeedback can be used to aid in the rehabilitation of health conditions with impaired blood flow, for example, stroke. We provide the first ASL-based neurofeedback study incorporating a double-blind, sham-controlled design. A pseudo-continuous ASL (pCASL) approach with background suppression and 3D GRASE readout was combined with a real-time post-processing pipeline. The real-time pipeline allows to monitor the ASL signal and provides real-time feedback on the neural activity to the subject. In total 41 healthy adults (19-56 years) divided into three groups underwent a neurofeedback-based emotion imagery training of the left anterior insula. Two groups differing only in the explicitness level of instruction received real training and a third group received sham feedback. Only those participants receiving real feedback with explicit instruction showed significantly higher absolute CBF values in the trained region during neurofeedback than participants receiving sham feedback. However, responder analyses of percent signal change values show no differences in activation between the three groups. Persisting limitations, such as the lower SNR, confounding effects of arterial transit time and partial volume effects still impact negatively the implementation of ASL neurofeedback.
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Affiliation(s)
| | - Stefan M Spann
- Institute of Medical Engineering, Graz University of Technology, Graz, Austria
| | - Rudolf Stollberger
- Institute of Medical Engineering, Graz University of Technology, Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - Josef Pfeuffer
- Siemens Healthcare, Application Development, Erlangen, Germany
| | | | - Guilherme Wood
- Institute of Psychology, University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
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Zouki JJ, Eapen V, Efron D, Maxwell A, Corp DT, Silk TJ. Functional brain networks associated with the urge for action: Implications for pathological urge. Neurosci Biobehav Rev 2024; 163:105779. [PMID: 38936563 DOI: 10.1016/j.neubiorev.2024.105779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 05/26/2024] [Accepted: 06/20/2024] [Indexed: 06/29/2024]
Abstract
Tics in Tourette syndrome (TS) are often preceded by sensory urges that drive the motor and vocal symptoms. Many everyday physiological behaviors are associated with sensory phenomena experienced as an urge for action, which may provide insight into the neural correlates of this pathological urge to tic that remains elusive. This study aimed to identify a brain network common to distinct physiological behaviors in healthy individuals, and in turn, examine whether this network converges with a network we previously localized in TS, using novel 'coordinate network mapping' methods. Systematic searches were conducted to identify functional neuroimaging studies reporting correlates of the urge to micturate, swallow, blink, or cough. Using activation likelihood estimation meta-analysis, we identified an 'urge network' common to these physiological behaviors, involving the bilateral insula/claustrum/inferior frontal gyrus/supplementary motor area, mid-/anterior- cingulate cortex (ACC), right postcentral gyrus, and left thalamus/precentral gyrus. Similarity between the urge and TS networks was identified in the bilateral insula, ACC, and left thalamus/claustrum. The potential role of the insula/ACC as nodes in the network for bodily representations of the urge to tic are discussed.
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Affiliation(s)
- Jade-Jocelyne Zouki
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, VIC 3220, Australia.
| | - Valsamma Eapen
- Discipline of Psychiatry and Mental Health, UNSW School of Clinical Medicine, University of New South Wales, Kensington, NSW 2052, Australia
| | - Daryl Efron
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3010, Australia; Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia
| | - Amanda Maxwell
- Discipline of Psychiatry and Mental Health, UNSW School of Clinical Medicine, University of New South Wales, Kensington, NSW 2052, Australia
| | - Daniel T Corp
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, VIC 3220, Australia; Turku Brain and Mind Center, Clinical Neurosciences, University of Turku, Turku, FI-20014, Finland
| | - Timothy J Silk
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, VIC 3220, Australia; Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia
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Mokhlesin M, Yadegari F, Noroozi M, Ravarian A, Ghoreishi ZS. Effect of action observation training on the oral phase of swallowing in children with cerebral palsy: a pilot randomized controlled trial. LOGOP PHONIATR VOCO 2024:1-9. [PMID: 38319122 DOI: 10.1080/14015439.2023.2300081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 12/21/2023] [Indexed: 02/07/2024]
Abstract
Swallowing disorder is prevalent in children with cerebral palsy (CP), and previous studies have shown that motor-based programs benefit children with CP by facilitating motor learning. We hypothesized that action observation training (AOT) could enhance motor learning and improve the oral phase of swallowing in children. In this two-group parallel double-blind randomized controlled trial, the intervention group received AOT and sensorimotor therapy, while the control group received a sham and sensorimotor therapy. The function of the oral phase of swallowing, as the primary outcome, was measured pre-intervention, post-intervention, and at one month of follow-up. Secondary outcomes included reported symptoms of feeding problems and the impact of the child's swallowing disorder on the main caregiver, which were measured pre-intervention and post-intervention. The result of the Mann-Whitney U test showed a significant difference between the two groups in the function of the oral phase of swallowing after the intervention. Additionally, the intervention had a large effect size. However, no significant difference was found in the parent-reported scores of the feeding/swallowing impact survey and symptoms of feeding problems between the two groups. In conclusion, this pilot study provides preliminary evidence of the clinical efficacy of AOT as a safe neurorehabilitation method to improve the oral phase of swallowing in children with CP. However more studies are needed in the future.
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Affiliation(s)
- Maryam Mokhlesin
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fariba Yadegari
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mehdi Noroozi
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Aida Ravarian
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Zahra Sadat Ghoreishi
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Xie S, Liu J, Hu Y, Liu W, Ma C, Jin S, Zhang L, Kang Y, Ding Y, Zhang X, Hu Z, Cheng W, Yang Z. A normative model of brain responses to social scenarios reflects the maturity of children and adolescents' social-emotional abilities. Soc Cogn Affect Neurosci 2023; 18:nsad062. [PMID: 37930841 PMCID: PMC10649363 DOI: 10.1093/scan/nsad062] [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: 02/01/2023] [Revised: 07/19/2023] [Accepted: 10/24/2023] [Indexed: 11/08/2023] Open
Abstract
The rapid brain maturation in childhood and adolescence accompanies the development of socio-emotional functioning. However, it is unclear how the maturation of the neural activity drives the development of socio-emotional functioning and individual differences. This study aimed to reflect the age dependence of inter-individual differences in brain responses to socio-emotional scenarios and to develop naturalistic imaging indicators to assess the maturity of socio-emotional ability at the individual level. Using three independent naturalistic imaging datasets containing healthy participants (n = 111, 21 and 122), we found and validated that age-modulated inter-individual concordance of brain responses to socio-emotional movies in specific brain regions. The similarity of an individual's brain response to the average response of older participants was defined as response typicality, which predicted an individual's emotion regulation strategies in adolescence and theory of mind (ToM) in childhood. Its predictive power was not superseded by age, sex, cognitive performance or executive function. We further showed that the movie's valence and arousal ratings grounded the response typicality. The findings highlight that forming typical brain response patterns may be a neural phenotype underlying the maturation of socio-emotional ability. The proposed response typicality represents a neuroimaging approach to measure individuals' maturity of cognitive reappraisal and ToM.
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Affiliation(s)
- Shuqi Xie
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Jingjing Liu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yang Hu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Wenjing Liu
- Department of Child and Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 201108, China
| | - Changminghao Ma
- Department of Child and Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 201108, China
| | - Shuyu Jin
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Lei Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yinzhi Kang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yue Ding
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Xiaochen Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Zhishan Hu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Wenhong Cheng
- Department of Child and Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 201108, China
- Department of Psychological Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Zhi Yang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
- Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai 200030, China
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100035, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100054, China
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Huang T, Tang L, Zhao J, Shang S, Chen Y, Tian Y, Zhang Y. Drooling disrupts the brain functional connectivity network in Parkinson's disease. CNS Neurosci Ther 2023; 29:3094-3107. [PMID: 37144606 PMCID: PMC10493659 DOI: 10.1111/cns.14251] [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: 01/24/2023] [Revised: 04/05/2023] [Accepted: 04/21/2023] [Indexed: 05/06/2023] Open
Abstract
AIMS This study aimed to investigate the causal interaction between significant sensorimotor network (SMN) regions and other brain regions in Parkinson's disease patients with drooling (droolers). METHODS Twenty-one droolers, 22 PD patients without drooling (non-droolers), and 22 matched healthy controls underwent 3T-MRI resting-state scans. We performed independent component analysis and Granger causality analysis to determine whether significant SMN regions help predict other brain areas. Pearson's correlation was computed between imaging characteristics and clinical characteristics. ROC curves were plotted to assess the diagnostic performance of effective connectivity (EC). RESULTS Compared with non-droolers and healthy controls, droolers showed abnormal EC of the right caudate nucleus (CAU.R) and right postcentral gyrus to extensive brain regions. In droolers, increased EC from the CAU.R to the right middle temporal gyrus was positively correlated with MDS-UPDRS, MDS-UPDRS II, NMSS, and HAMD scores; increased EC from the right inferior parietal lobe to CAU.R was positively correlated with MDS-UPDRS score. ROC curve analysis showed that these abnormal ECs are of great significance in diagnosing drooling in PD. CONCLUSION This study identified that PD patients with drooling have abnormal EC in the cortico-limbic-striatal-cerebellar and cortio-cortical networks, which could be potential biomarkers for drooling in PD.
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Affiliation(s)
- Ting Huang
- Department of Neurology, Nanjing First HospitalNanjing Medical UniversityNanjingChina
| | - Li‐Li Tang
- Department of NeurologyNanjing Hospital of Chinese Medicine affiliated to Nanjing University of Chinese MedicineNanjingChina
| | - Jin‐Ying Zhao
- Department of Neurology, Nanjing First HospitalNanjing Medical UniversityNanjingChina
| | - Song‖an Shang
- Department of Medical Imaging Center, Clinical Medical CollegeYangzhou UniversityYangzhouChina
| | - Yu‐Chen Chen
- Department of Radiology, Nanjing First HospitalNanjing Medical UniversityNanjingChina
| | - You‐Yong Tian
- Department of Neurology, Nanjing First HospitalNanjing Medical UniversityNanjingChina
| | - Ying‐Dong Zhang
- Department of Neurology, Nanjing First HospitalNanjing Medical UniversityNanjingChina
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Neuropsychological Evidence Underlying Counterclockwise Bias in Running: Electroencephalography and Functional Magnetic Resonance Imaging Studies of Motor Imagery. Behav Sci (Basel) 2023; 13:bs13020173. [PMID: 36829402 PMCID: PMC9952670 DOI: 10.3390/bs13020173] [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: 12/28/2022] [Revised: 01/30/2023] [Accepted: 02/04/2023] [Indexed: 02/17/2023] Open
Abstract
We aimed to answer the question "why do people run the track counterclockwise (CCW)?" by investigating the neurophysiological differences in clockwise (CW) versus CCW direction using motor imagery. Three experiments were conducted with healthy adults. Electroencephalography (EEG) was used to examine hemispheric asymmetries in the prefrontal, frontal, and central regions during CW and CCW running imagery (n = 40). We also evaluated event-related potential (ERP) N200 and P300 amplitudes and latencies (n = 66) and conducted another experiment using functional magnetic resonance imaging (fMRI) (n = 30). EEG data indicated greater left frontal cortical activation during CCW imagery, whereas right frontal activation was more dominant during CW imagery. The prefrontal and central asymmetries demonstrated greater left prefrontal activation during both CW and CCW imagery, with CCW rotation exhibiting higher, though statistically insignificant, asymmetry scores than CW rotation. As a result of the fMRI experiment, greater activation was found during CW than during CCW running imagery in the brain regions of the left insula, Brodmann area 18, right caudate nucleus, left dorsolateral prefrontal cortex, left superior parietal cortex, and supplementary motor area. In the ERP experiment, no significant differences were found depending on direction. These findings suggest that CCW rotation might be associated with the motivational approach system, behavioral activation, or positive affect. However, CW rotation reflects withdrawal motivation, behavioral inhibition, or negative affect. Furthermore, CW rotation is understood to be associated with neural inefficiency, increased task difficulty, or unfamiliarity.
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Zhang Z, Yan L, Xing X, Zhu L, Wu H, Xu S, Wan P, Ding R. Brain Activation Site of Laryngeal Elevation During Swallowing: An fMRI Study. Dysphagia 2023; 38:268-277. [PMID: 35760876 DOI: 10.1007/s00455-022-10464-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 04/28/2022] [Indexed: 01/27/2023]
Abstract
The object of this study is to investigate dysphagia caused by reduced laryngeal elevation in patients poststroke. The central mechanism of laryngeal elevation during swallowing was explored by comparing the brain activation area before and after treatment with that of healthy subjects. The treatment group included patients diagnosed with dysphagia poststroke that showed reduced laryngeal elevation. They were treated with electrical stimulation at the motor points of the muscles related to laryngeal elevation. Functional magnetic resonance imaging (fMRI) using the blood oxygenation level-dependent (BOLD) was used to observe brain activation of the normal healthy control group and treatment group during voluntary swallowing. Independent sample t test and paired sample t test were used to analyze the differences in brain activation between and within the groups. Compared with the control group, no activation was observed in the brainstem and putamen regions of the experimental group before treatment. Statistics showed that the experimental group had a wider range of brain activation than the control group pretreatment, including the left supplementary motor area, the cingulate gyrus, the inferior frontal gyrus, the right thalamus, and the right putamen. After the electrical stimulation, the brain stem subregion, the left cerebellar lobule IV and V, and parts of the cerebral cortex were more active, while the left supplementary motor area, paracentral lobule, and occipital lobule were less active post-treatment. (1) The brainstem and putamen are the specific brain regions that control laryngeal movement. (2) The enhanced activation of the cortical-basal ganglia-thalamic circuit after stroke is a compensatory mechanism. (3) The improvement of hyoid bone elevation was related to the enhanced activation of the IV and V lobes of the cerebellar hemisphere. The over-activation of the supplementary motor area poststroke would subside once the motor function improved.
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Affiliation(s)
- Zhiyi Zhang
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
- Department of Rehabilitation, Shanghai Seventh People's Hospital, Shanghai, 200137, China
| | - Ling Yan
- Department of Rehabilitation Medicine, Shanghai Ruijin Rehabilitation Hospital, Shanghai, 200023, China
| | - Xiangxin Xing
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
- Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, 201203, China
| | - Lequn Zhu
- Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China
| | - Haoyue Wu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Shuangjing Xu
- Department of Neurological Rehabilitation, Kunshan Rehabilitation Hospital, Suzhou, 215300, Jiangsu Province, China
| | - Ping Wan
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
| | - Ruiying Ding
- Department of Communication Science and Disorders, Elmhurst University, Elmhurst, IL, 60126, USA.
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Proverbio AM, Tacchini M, Jiang K. Event-related brain potential markers of visual and auditory perception: A useful tool for brain computer interface systems. Front Behav Neurosci 2022; 16:1025870. [PMID: 36523756 PMCID: PMC9744781 DOI: 10.3389/fnbeh.2022.1025870] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/03/2022] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVE A majority of BCI systems, enabling communication with patients with locked-in syndrome, are based on electroencephalogram (EEG) frequency analysis (e.g., linked to motor imagery) or P300 detection. Only recently, the use of event-related brain potentials (ERPs) has received much attention, especially for face or music recognition, but neuro-engineering research into this new approach has not been carried out yet. The aim of this study was to provide a variety of reliable ERP markers of visual and auditory perception for the development of new and more complex mind-reading systems for reconstructing the mental content from brain activity. METHODS A total of 30 participants were shown 280 color pictures (adult, infant, and animal faces; human bodies; written words; checkerboards; and objects) and 120 auditory files (speech, music, and affective vocalizations). This paradigm did not involve target selection to avoid artifactual waves linked to decision-making and response preparation (e.g., P300 and motor potentials), masking the neural signature of semantic representation. Overall, 12,000 ERP waveforms × 126 electrode channels (1 million 512,000 ERP waveforms) were processed and artifact-rejected. RESULTS Clear and distinct category-dependent markers of perceptual and cognitive processing were identified through statistical analyses, some of which were novel to the literature. Results are discussed from the view of current knowledge of ERP functional properties and with respect to machine learning classification methods previously applied to similar data. CONCLUSION The data showed a high level of accuracy (p ≤ 0.01) in the discriminating the perceptual categories eliciting the various electrical potentials by statistical analyses. Therefore, the ERP markers identified in this study could be significant tools for optimizing BCI systems [pattern recognition or artificial intelligence (AI) algorithms] applied to EEG/ERP signals.
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Affiliation(s)
- Alice Mado Proverbio
- Laboratory of Cognitive Electrophysiology, Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Marta Tacchini
- Laboratory of Cognitive Electrophysiology, Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Kaijun Jiang
- Laboratory of Cognitive Electrophysiology, Department of Psychology, University of Milano-Bicocca, Milan, Italy
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
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Cheng I, Takahashi K, Miller A, Hamdy S. Cerebral control of swallowing: An update on neurobehavioral evidence. J Neurol Sci 2022; 442:120434. [PMID: 36170765 DOI: 10.1016/j.jns.2022.120434] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/07/2022] [Accepted: 09/18/2022] [Indexed: 01/07/2023]
Abstract
This review aims to update the current knowledge on the cerebral control of swallowing. We review data from both animal and human studies spanning across the fields of neuroanatomy, neurophysiology and neuroimaging to evaluate advancements in our understanding in the brain's role in swallowing. Studies have collectively shown that swallowing is mediated by multiple distinct cortical and subcortical regions and that lesions to these regions can result in dysphagia. These regions are functionally connected in separate groups within and between the two hemispheres. While hemispheric dominance for swallowing has been reported in most human studies, the laterality is inconsistent across individuals. Moreover, there is a shift in activation location and laterality between swallowing preparation and execution, although such activation changes are less well-defined than that for limb motor control. Finally, we discussed recent neurostimulation treatments that may be beneficial for dysphagia after brain injury through promoting the reorganization of the swallowing neural network.
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Affiliation(s)
- Ivy Cheng
- Centre for Gastrointestinal Sciences, Division of Diabetes, Gastroenterology and Endocrinology, School of Medical Sciences, University of Manchester, UK.
| | - Kazutaka Takahashi
- Department of Organismal Biology and Anatomy, University of Chicago, USA
| | - Arthur Miller
- Division of Orthodontics, Department of Orofacial, Sciences, School of Dentistry, University of California at San Francisco, USA
| | - Shaheen Hamdy
- Centre for Gastrointestinal Sciences, Division of Diabetes, Gastroenterology and Endocrinology, School of Medical Sciences, University of Manchester, UK
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Brain activity in healthy elderly persons when presented with swallowing-related videos: A functional magnetic resonance imaging study. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2022. [DOI: 10.1016/j.ajoms.2022.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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11
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Xiong H, Chen JJ, Gikaro JM, Wang CG, Lin F. Activation Patterns of Functional Brain Network in Response to Action Observation-Induced and Non-Induced Motor Imagery of Swallowing: A Pilot Study. Brain Sci 2022; 12:brainsci12101420. [PMID: 36291353 PMCID: PMC9599111 DOI: 10.3390/brainsci12101420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/09/2022] [Accepted: 10/18/2022] [Indexed: 11/20/2022] Open
Abstract
Action observation (AO) combined with motor imagery (MI) was verified as more effective in improving limb function than AO or MI alone, while the underlying mechanism of swallowing was ambiguous. The study aimed at exploring the efficacy of AO combined with MI in swallowing. In this study, twelve subjects performed the motor imagery of swallowing (MI-SW) during magnetoencephalography (MEG) scanning, and trials were divided into three groups: the non-induced group (control group, CG), male AO-induced group (M-AIG), and female AO-induced group (F-AIG). We used event-related spectral perturbations (ERSPs) and phase locking value (PLV) to assess the degree of activation and connectivity of the brain regions during MI-SW in the three groups. The results showed that compared to CG, F-AIG and M-AIG significantly activated more brain regions in the frontoparietal, attention, visual, and cinguloopercular systems. In addition, M-AIG significantly activated the sensorimotor cortex compared to CG and F-AIG. For the brain network, F-AIG and M-AIG increased the diffusion of non-hub hot spots and cold hubs to the bilateral hemispheres which enhanced interhemispheric functional connectivity and information transmission efficiency in the MI-SW task. This study provided supporting evidence that AO induction could enhance the effect of MI-SW and supported the application of AO-induced MI-SW in clinical rehabilitation.
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Affiliation(s)
- Hao Xiong
- Department of Rehabilitation Medicine, Sir Run Run Hospital Nanjing Medical University, Nanjing 211100, China
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing 210029, China
| | - Jin-Jin Chen
- Department of Rehabilitation Medicine, Sir Run Run Hospital Nanjing Medical University, Nanjing 211100, China
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing 210029, China
| | - John M. Gikaro
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing 210029, China
| | - Chen-Guang Wang
- Department of Rehabilitation Medicine, Sir Run Run Hospital Nanjing Medical University, Nanjing 211100, China
| | - Feng Lin
- Department of Rehabilitation Medicine, Sir Run Run Hospital Nanjing Medical University, Nanjing 211100, China
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
- Correspondence: ; Tel.: +86-025-87115719
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12
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Song M, Jeong H, Kim J, Jang SH, Kim J. An EEG-based asynchronous MI-BCI system to reduce false positives with a small number of channels for neurorehabilitation: A pilot study. Front Neurorobot 2022; 16:971547. [PMID: 36172602 PMCID: PMC9510756 DOI: 10.3389/fnbot.2022.971547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/08/2022] [Indexed: 11/22/2022] Open
Abstract
Many studies have used motor imagery-based brain–computer interface (MI-BCI) systems for stroke rehabilitation to induce brain plasticity. However, they mainly focused on detecting motor imagery but did not consider the effect of false positive (FP) detection. The FP could be a threat to patients with stroke as it can induce wrong-directed brain plasticity that would result in adverse effects. In this study, we proposed a rehabilitative MI-BCI system that focuses on rejecting the FP. To this end, we first identified numerous electroencephalogram (EEG) signals as the causes of the FP, and based on the characteristics of the signals, we designed a novel two-phase classifier using a small number of EEG channels, including the source of the FP. Through experiments with eight healthy participants and nine patients with stroke, our proposed MI-BCI system showed 71.76% selectivity and 13.70% FP rate by using only four EEG channels in the patient group with stroke. Moreover, our system can compensate for day-to-day variations for prolonged session intervals by recalibration. The results suggest that our proposed system, a practical approach for the clinical setting, could improve the therapeutic effect of MI-BCI by reducing the adverse effect of the FP.
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Affiliation(s)
- Minsu Song
- Department of Medical Device, Korea Institute of Machinery and Materials, Daegu, South Korea
| | - Hojun Jeong
- School of Mechanical Engineering, Sungkyunkwan University, Gyeonggi-do, South Korea
| | - Jongbum Kim
- Department of Robotics Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, South Korea
| | - Sung-Ho Jang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, South Korea
| | - Jonghyun Kim
- School of Mechanical Engineering, Sungkyunkwan University, Gyeonggi-do, South Korea
- *Correspondence: Jonghyun Kim
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13
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Orth L, Meeh J, Gur RC, Neuner I, Sarkheil P. Frontostriatal circuitry as a target for fMRI-based neurofeedback interventions: A systematic review. Front Hum Neurosci 2022; 16:933718. [PMID: 36092647 PMCID: PMC9449529 DOI: 10.3389/fnhum.2022.933718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/08/2022] [Indexed: 11/19/2022] Open
Abstract
Dysregulated frontostriatal circuitries are viewed as a common target for the treatment of aberrant behaviors in various psychiatric and neurological disorders. Accordingly, experimental neurofeedback paradigms have been applied to modify the frontostriatal circuitry. The human frontostriatal circuitry is topographically and functionally organized into the "limbic," the "associative," and the "motor" subsystems underlying a variety of affective, cognitive, and motor functions. We conducted a systematic review of the literature regarding functional magnetic resonance imaging-based neurofeedback studies that targeted brain activations within the frontostriatal circuitry. Seventy-nine published studies were included in our survey. We assessed the efficacy of these studies in terms of imaging findings of neurofeedback intervention as well as behavioral and clinical outcomes. Furthermore, we evaluated whether the neurofeedback targets of the studies could be assigned to the identifiable frontostriatal subsystems. The majority of studies that targeted frontostriatal circuitry functions focused on the anterior cingulate cortex, the dorsolateral prefrontal cortex, and the supplementary motor area. Only a few studies (n = 14) targeted the connectivity of the frontostriatal regions. However, post-hoc analyses of connectivity changes were reported in more cases (n = 32). Neurofeedback has been frequently used to modify brain activations within the frontostriatal circuitry. Given the regulatory mechanisms within the closed loop of the frontostriatal circuitry, the connectivity-based neurofeedback paradigms should be primarily considered for modifications of this system. The anatomical and functional organization of the frontostriatal system needs to be considered in decisions pertaining to the neurofeedback targets.
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Affiliation(s)
- Linda Orth
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
| | - Johanna Meeh
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Ruben C. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Irene Neuner
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
- Institute of Neuroscience and Medicine 4, Forschungszentrum Jülich, Jülich, Germany
| | - Pegah Sarkheil
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
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14
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Motor Imagery: How to Assess, Improve Its Performance, and Apply It for Psychosis Diagnostics. Diagnostics (Basel) 2022; 12:diagnostics12040949. [PMID: 35453997 PMCID: PMC9025310 DOI: 10.3390/diagnostics12040949] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/03/2022] [Accepted: 04/07/2022] [Indexed: 11/16/2022] Open
Abstract
With this review, we summarize the state-of-the-art of scientific studies in the field of motor imagery (MI) and motor execution (ME). We composed the brain map and description that correlate different brain areas with the type of movements it is responsible for. That gives a more complete and systematic picture of human brain functionality in the case of ME and MI. We systematized the most popular methods for assessing the quality of MI performance and discussed their advantages and disadvantages. We also reviewed the main directions for the use of transcranial magnetic stimulation (TMS) in MI research and considered the principal effects of TMS on MI performance. In addition, we discuss the main applications of MI, emphasizing its use in the diagnostics of various neurodegenerative disorders and psychoses. Finally, we discuss the research gap and possible improvements for further research in the field.
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15
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Jaroszynski C, Job A, Jedynak M, David O, Delon-Martin C. Tinnitus Perception in Light of a Parietal Operculo-Insular Involvement: A Review. Brain Sci 2022; 12:334. [PMID: 35326290 PMCID: PMC8946618 DOI: 10.3390/brainsci12030334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/21/2022] [Accepted: 02/24/2022] [Indexed: 12/07/2022] Open
Abstract
In tinnitus literature, researchers have increasingly been advocating for a clearer distinction between tinnitus perception and tinnitus-related distress. In non-bothersome tinnitus, the perception itself can be more specifically investigated: this has provided a body of evidence, based on resting-state and activation fMRI protocols, highlighting the involvement of regions outside the conventional auditory areas, such as the right parietal operculum. Here, we aim to conduct a review of available investigations of the human parietal operculo-insular subregions conducted at the microscopic, mesoscopic, and macroscopic scales arguing in favor of an auditory-somatosensory cross-talk. Both the previous literature and new results on functional connectivity derived from cortico-cortical evoked potentials show that these subregions present a dense tissue of interconnections and a strong connectivity with auditory and somatosensory areas in the healthy brain. Disrupted integration processes between these modalities may thus result in erroneous perceptions, such as tinnitus. More precisely, we highlight the role of a subregion of the right parietal operculum, known as OP3 according to the Jülich atlas, in the integration of auditory and somatosensory representation of the orofacial muscles in the healthy population. We further discuss how a dysfunction of these muscles could induce hyperactivity in the OP3. The evidence of direct electrical stimulation of this area eliciting auditory hallucinations further suggests its involvement in tinnitus perception. Finally, a small number of neuroimaging studies of therapeutic interventions for tinnitus provide additional evidence of right parietal operculum involvement.
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Affiliation(s)
- Chloé Jaroszynski
- University Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France; (C.J.); (M.J.); (O.D.)
| | - Agnès Job
- Institut de Recherche Biomédicale des Armées, IRBA, 91220 Brétigny-sur-Orge, France;
| | - Maciej Jedynak
- University Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France; (C.J.); (M.J.); (O.D.)
- Aix Marseille University, Inserm, INS, Inst Neurosci Syst, 13005 Marseille, France
| | - Olivier David
- University Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France; (C.J.); (M.J.); (O.D.)
- Aix Marseille University, Inserm, INS, Inst Neurosci Syst, 13005 Marseille, France
| | - Chantal Delon-Martin
- University Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France; (C.J.); (M.J.); (O.D.)
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Sobczak AM, Bohaterewicz B, Fafrowicz M, Zyrkowska A, Golonka N, Domagalik A, Beldzik E, Oginska H, Rekas M, Bronicki D, Romanowska-Dixon B, Bolsega-Pacud J, Karwowski W, Farahani F, Marek T. Brain Functional Network Architecture Reorganization and Alterations of Positive and Negative Affect, Experiencing Pleasure and Daytime Sleepiness in Cataract Patients after Intraocular Lenses Implantation. Brain Sci 2021; 11:brainsci11101275. [PMID: 34679340 PMCID: PMC8533692 DOI: 10.3390/brainsci11101275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 12/20/2022] Open
Abstract
Background: Cataracts are associated with progressive blindness, and despite the decline in prevalence in recent years, it remains a major global health problem. Cataract extraction is reported to influence not only perception, attention and memory but also daytime sleepiness, ability to experience pleasure and positive and negative affect. However, when it comes to the latter, the magnitude and prevalence of this effect still remains uncertain. The current study aims to evaluate the hemodynamic basis of daytime sleepiness, ability to experience pleasure and positive and negative affect in cataract patients after the intraocular lens (IOL) implantation. Methods: Thirty-four cataract patients underwent resting-state functional magnetic resonance imaging evaluation before and after cataract extraction and intraocular lens implantation. Both global and local graph metrics were calculated in order to investigate the hemodynamic basis of excessive sleepiness (ESS), experiencing pleasure (SHAPS) as well as positive and negative affect (PANAS) in cataract patients. Results: Eigenvector centrality and clustering coefficient alterations associated with cataract extraction are significantly correlated with excessive sleepiness, experiencing pleasure as well as positive and negative affect. Conclusions: The current study reveals the hemodynamic basis of sleepiness, pleasure and affect in patients after cataract extraction and intraocular lens implantation. The aforementioned mechanism constitutes a proof for changes in functional network activity associated with postoperative vision improvement.
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Affiliation(s)
- Anna Maria Sobczak
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
- Correspondence: (A.M.S.); (B.B.)
| | - Bartosz Bohaterewicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Department of Psychology of Individual Differences, Psychological Diagnosis, and Psychometrics, Institute of Psychology, University of Social Sciences and Humanities, 03-815 Warsaw, Poland
- Correspondence: (A.M.S.); (B.B.)
| | - Magdalena Fafrowicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Aleksandra Zyrkowska
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
| | - Natalia Golonka
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
| | - Aleksandra Domagalik
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Ewa Beldzik
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Halszka Oginska
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Marek Rekas
- Ophthalmology Department, Military Institute of Medicine, 04-349 Warsaw, Poland; (M.R.); (D.B.)
| | - Dominik Bronicki
- Ophthalmology Department, Military Institute of Medicine, 04-349 Warsaw, Poland; (M.R.); (D.B.)
| | - Bozena Romanowska-Dixon
- Department of Ophthalmology and Ocular Oncology, Medical College, Jagiellonian University, 31-008 Kraków, Poland; (B.R.-D.); (J.B.-P.)
| | - Joanna Bolsega-Pacud
- Department of Ophthalmology and Ocular Oncology, Medical College, Jagiellonian University, 31-008 Kraków, Poland; (B.R.-D.); (J.B.-P.)
| | - Waldemar Karwowski
- Computational Neuroergonomics Laboratory, Department of Industrial Engineering & Management Systems, University of Central Florida, Orlando, FL 32816, USA; (W.K.); (F.F.)
| | - Farzad Farahani
- Computational Neuroergonomics Laboratory, Department of Industrial Engineering & Management Systems, University of Central Florida, Orlando, FL 32816, USA; (W.K.); (F.F.)
- Biostatistics Department, John Hopkins University, Baltimore, MD 21218, USA
| | - Tadeusz Marek
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
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Huang PL, Wang SJ, Sun RF, Zhu ZM, Li XL, Li WS, Wang MY, Lin M, Gong WJ. Increased activation of the caudate nucleus and parahippocampal gyrus in Parkinson's disease patients with dysphagia after repetitive transcranial magnetic stimulation: a case-control study. Neural Regen Res 2021; 17:1051-1058. [PMID: 34558532 PMCID: PMC8552866 DOI: 10.4103/1673-5374.324863] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) has been shown to effectively improve impaired swallowing in Parkinson's disease (PD) patients with dysphagia. However, little is known about how rTMS affects the corresponding brain regions in this patient group. In this case-control study, we examined data from 38 PD patients with dysphagia who received treatment at Beijing Rehabilitation Medicine Academy, Capital Medical University. The patients received high-frequency rTMS of the motor cortex once per day for 10 successive days. Changes in brain activation were compared via functional magnetic resonance imaging in PD patients with dysphagia and healthy controls. The results revealed that before treatment, PD patients with dysphagia showed greater activation in the precentral gyrus, supplementary motor area, and cerebellum compared with healthy controls, and this enhanced activation was weakened after treatment. Furthermore, before treatment, PD patients with dysphagia exhibited decreased activation in the parahippocampal gyrus, caudate nucleus, and left thalamus compared with healthy controls, and this activation increased after treatment. In addition, PD patients with dysphagia reported improved subjective swallowing sensations after rTMS. These findings suggest that swallowing function in PD patients with dysphagia improved after rTMS of the motor cortex. This may have been due to enhanced activation of the caudate nucleus and parahippocampal gyrus. The study protocol was approved by the Ethics Committee of Beijing Rehabilitation Hospital of Capital Medical University (approval No. 2018bkky017) on March 6, 2018 and was registered with Chinese Clinical Trial Registry (registration No. ChiCTR 1800017207) on July 18, 2018.
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Affiliation(s)
- Pei-Ling Huang
- Department of Neurological Rehabilitation, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Song-Jian Wang
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Rui-Feng Sun
- Department of Neurological Rehabilitation, Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Zi-Man Zhu
- Department of Neurological Rehabilitation, Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Xiao-Ling Li
- Department of Neurological Rehabilitation, Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Wen-Shan Li
- Department of Neurological Rehabilitation, Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Meng-Yue Wang
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Meng Lin
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Wei-Jun Gong
- Department of Neurological Rehabilitation, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
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18
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Molecular and Neural Mechanism of Dysphagia Due to Cancer. Int J Mol Sci 2021; 22:ijms22137033. [PMID: 34210012 PMCID: PMC8269194 DOI: 10.3390/ijms22137033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 12/21/2022] Open
Abstract
Cancer is one of the most common causes of death worldwide. Along with the advances in diagnostic technology achieved through industry–academia partnerships, the survival rate of cancer patients has improved dramatically through treatments that include surgery, radiation therapy, and pharmacotherapy. This has increased the population of cancer “survivors” and made cancer survivorship an important part of life for patients. The senses of taste and smell during swallowing and cachexia play important roles in dysphagia associated with nutritional disorders in cancer patients. Cancerous lesions in the brain can cause dysphagia. Taste and smell disorders that contribute to swallowing can worsen or develop because of pharmacotherapy or radiation therapy; metabolic or central nervous system damage due to cachexia, sarcopenia, or inflammation can also cause dysphagia. As the causes of eating disorders in cancer patients are complex and involve multiple factors, cancer patients require a multifaceted and long-term approach by the medical care team.
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Li H, Fan K, Ma J, Wang B, Qiao X, Yan Y, Du W, Wang L. Massage Therapy's Effectiveness on the Decoding EEG Rhythms of Left/Right Motor Imagery and Motion Execution in Patients With Skeletal Muscle Pain. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE-JTEHM 2021; 9:2100320. [PMID: 33738147 PMCID: PMC7965939 DOI: 10.1109/jtehm.2021.3056911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 12/18/2020] [Accepted: 01/27/2021] [Indexed: 11/09/2022]
Abstract
Objective: Most of effectiveness assessments of the widely-used Massage therapy were based on subjective routine clinical assessment tools, such as Visual Analogue Scale (VAS) score. However, few studies demonstrated the impact of massage on the Electroencephalograph (EEG) rhythm decoding of Motor imagery (MI) and motion execution (ME) with trunk left/right bending in patients with skeletal muscle pain. Method: We used the sample entropy (SampEn), permutation entropy (PermuEn), common spatial pattern (CSP) features, support vector machine (SVM) and logic regression (LR) classifiers. We also used the convolutional neural network (CNN) and attention-based bi-directional long short-term memory (BiLSTM) for classification. Results: The averaged SampEn and PermuEn values of alpha rhythm decreased in almost fourteen channels for five statuses (quiet, MI with left/right bending, ME with left/right bending). It indicated that massage alleviates the pain for the patients of skeletal pain. Furthermore, compared with the SVM and LR classifiers, the BiLSTM method achieved a better area under curve (AUC) of 0.89 for the classification of MI with trunk left/right bending before massage. The AUC became smaller after massage than that before massage for the classification of MI with trunk left/right bending using CNN and BiLSTM methods. The Permutation direct indicator (PDI) score showed the significant difference for patients in different statuses (before vs after massage, and MI vs ME). Conclusions: Massage not only affects the quiet status, but also affects the MI and ME. Clinical Impact: Massage therapy may affect a bit on the accuracy of MI with trunk left/right bending and it change the topography of MI and ME with trunk left/right bending for the patients with skeletal muscle pain.
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Affiliation(s)
- Huihui Li
- Shenzhen Institute of Advanced TechnologyChinese Academy of SciencesShenzhen518055China
| | - Kai Fan
- North China Institute of Aerospace EngineeringLangfang065000China
| | - Junsong Ma
- School of Electronic Engineering and AutomationGuilin University of Electronic TechnologyGuilin541004China
| | - Bo Wang
- Electronic and Communication Engineering DepartmentWuhan University of TechnologyWuhan430070China
| | - Xiaohao Qiao
- Electronic and Communication Engineering DepartmentWuhan University of TechnologyWuhan430070China
| | - Yan Yan
- Shenzhen Institute of Advanced TechnologyChinese Academy of SciencesShenzhen518055China
| | - Wenjing Du
- Shenzhen Institute of Advanced TechnologyChinese Academy of SciencesShenzhen518055China
| | - Lei Wang
- Shenzhen Institute of Advanced TechnologyChinese Academy of SciencesShenzhen518055China
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20
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Crary MA. Adult Neurologic Disorders. Dysphagia 2021. [DOI: 10.1016/b978-0-323-63648-3.00004-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Matsuo M, Iso N, Fujiwara K, Moriuchi T, Matsuda D, Mitsunaga W, Nakashima A, Higashi T. Comparison of cerebral activation between motor execution and motor imagery of self-feeding activity. Neural Regen Res 2021; 16:778-782. [PMID: 33063742 PMCID: PMC8067926 DOI: 10.4103/1673-5374.295333] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Motor imagery is defined as an act wherein an individual contemplates a mental action of motor execution without apparent action. Mental practice executed by repetitive motor imagery can improve motor performance without simultaneous sensory input or overt output. We aimed to investigate cerebral hemodynamics during motor imagery and motor execution of a self-feeding activity using chopsticks. This study included 21 healthy right-handed volunteers. The self-feeding activity task comprised either motor imagery or motor execution of eating sliced cucumber pickles with chopsticks to examine eight regions of interest: pre-supplementary motor area, supplementary motor area, bilateral prefrontal cortex, premotor area, and sensorimotor cortex. The mean oxyhemoglobin levels were detected using near-infrared spectroscopy to reflect cerebral activation. The mean oxyhemoglobin levels during motor execution were significantly higher in the left sensorimotor cortex than in the supplementary motor area and the left premotor area. Moreover, significantly higher oxyhemoglobin levels were detected in the supplementary motor area and the left premotor area during motor imagery, compared to motor execution. Supplementary motor area and premotor area had important roles in the motor imagery of self-feeding activity. Moreover, the activation levels of the supplementary motor area and the premotor area during motor execution and motor imagery are likely affected by intentional cognitive processes. Levels of cerebral activation differed in some areas during motor execution and motor imagery of a self-feeding activity. This study was approved by the Ethical Review Committee of Nagasaki University (approval No. 18110801) on December 10, 2018.
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Affiliation(s)
- Moemi Matsuo
- Unit of Medical Science, Nagasaki University Graduate School of Biomedical Sciences; Center for Child Mental Health Care and Education, Nagasaki University, Nagasaki, Japan
| | - Naoki Iso
- Department of Rehabilitation, Faculty of Health Sciences, Tokyo Kasei University, Saitama, Japan
| | - Kengo Fujiwara
- Unit of Medical Science, Nagasaki University Graduate School of Biomedical Sciences; Zeshinkai General Incorporated Association, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Takefumi Moriuchi
- Unit of Medical Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Daiki Matsuda
- Unit of Medical Science, Nagasaki University Graduate School of Biomedical Sciences; The Japanese Red Cross, Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Wataru Mitsunaga
- Unit of Medical Science, Nagasaki University Graduate School of Biomedical Sciences; Unit of Rehabilitation, Nagasaki University Hospital, Nagasaki, Japan
| | - Akira Nakashima
- Unit of Medical Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Toshio Higashi
- Unit of Medical Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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22
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Labeit B, Claus I, Muhle P, Regner L, Suntrup-Krueger S, Dziewas R, Warnecke T. Effect of cognitive and motor dual-task on oropharyngeal swallowing in Parkinson's disease. Eur J Neurol 2020; 28:754-762. [PMID: 33084118 DOI: 10.1111/ene.14603] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/14/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dysphagia frequently occurs in patients with Parkinson's disease (PD) and is associated with severe complications. However, the underlying pathology is poorly understood at present. This study investigated the effect of cognitive and motor dual-task interference on oropharyngeal swallowing in PD. METHODS Thirty PD patients (23 men, mean age 65.90 ± 9.32 years, mean Hoehn and Yahr stage 2.62 ± 0.81, mean UPDRS 18.00 ± 7.18) were examined using flexible endoscopic evaluation of swallowing (FEES). FEES was performed during three paradigms: at baseline without interference, during a cognitive dual-task, and during a motor dual-task. Oropharyngeal swallowing function was rated using a score which was validated to detect changes in PD related dysphagia. The three paradigms were compared using a two-way-repetitive-measures-ANOVA and a post-hoc-analysis. RESULTS Mean swallowing score in baseline FEES was 10.67 ± 5.89. It significantly increased (worsened) to 15.97 ± 7.62 (p < 0.001) in the motor dual-task and to 14.55 ± 7.49 (p < 0.001) in the cognitive dual-task. Premature bolus spillage and pharyngeal residue both significantly increased during both of the dual-task conditions whereas penetration/aspiration events did not change. CONCLUSION Oropharyngeal swallowing in patients with PD is not purely reflexive but requires mental capacity. Additional allocation of attentional resources in the central control of swallowing seems to be an effective compensatory mechanism in PD-related dysphagia: The proposed dual-task protocol may be useful to challenge swallowing functional reserve. Conversely, as a therapeutic strategy, it could be beneficial to focus attention on swallowing and to avoid dual-task situations.
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Affiliation(s)
- Bendix Labeit
- Department of Neurology with Institute of Translational Neurology, University of Muenster, Muenster, Germany.,Institute for Biomagnetism and Biosignalanalysis, University of Muenster, Muenster, Germany
| | - Inga Claus
- Department of Neurology with Institute of Translational Neurology, University of Muenster, Muenster, Germany
| | - Paul Muhle
- Department of Neurology with Institute of Translational Neurology, University of Muenster, Muenster, Germany.,Institute for Biomagnetism and Biosignalanalysis, University of Muenster, Muenster, Germany
| | - Liesa Regner
- Department of Neurology with Institute of Translational Neurology, University of Muenster, Muenster, Germany
| | - Sonja Suntrup-Krueger
- Department of Neurology with Institute of Translational Neurology, University of Muenster, Muenster, Germany.,Institute for Biomagnetism and Biosignalanalysis, University of Muenster, Muenster, Germany
| | - Rainer Dziewas
- Department of Neurology with Institute of Translational Neurology, University of Muenster, Muenster, Germany
| | - Tobias Warnecke
- Department of Neurology with Institute of Translational Neurology, University of Muenster, Muenster, Germany
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23
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Bioelectrical Signals for the Diagnosis and Therapy of Functional Gastrointestinal Disorders. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10228102] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Coordinated contractions and motility patterns unique to each gastrointestinal organ facilitate the digestive process. These motor activities are coordinated by bioelectrical events, sensory and motor nerves, and hormones. The motility problems in the gastrointestinal tract known as functional gastrointestinal disorders (FGIDs) are generally caused by impaired neuromuscular activity and are highly prevalent. Their diagnosis is challenging as symptoms are often vague and difficult to localize. Therefore, the underlying pathophysiological factors remain unknown. However, there is an increasing level of research and clinical evidence suggesting a link between FGIDs and altered bioelectrical activity. In addition, electroceuticals (bioelectrical therapies to treat diseases) have recently gained significant interest. This paper gives an overview of bioelectrical signatures of gastrointestinal organs with normal and/or impaired motility patterns and bioelectrical therapies that have been developed for treating FGIDs. The existing research evidence suggests that bioelectrical activities could potentially help to identify the diverse etiologies of FGIDs and overcome the drawbacks of the current clinically adapted methods. Moreover, electroceuticals could potentially be effective in the treatment of FGIDs and replace the limited existing conventional therapies which often attempt to treat the symptoms rather than the underlying condition.
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Battel I, Calvo I, Walshe M. Interventions Involving Biofeedback to Improve Swallowing in People With Parkinson Disease and Dysphagia: A Systematic Review. Arch Phys Med Rehabil 2020; 102:314-322. [PMID: 32861667 DOI: 10.1016/j.apmr.2020.06.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 06/01/2020] [Accepted: 06/22/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To examine the effectiveness of biofeedback used in the treatment of adults with Parkinson disease (PD) and dysphagia, define the factors associated with biofeedback treatment outcomes, and inform a theory to guide the implementation of biofeedback in future dysphagia interventions. DATA SOURCES A systematic review using a narrative synthesis approach of all published and unpublished studies were sought with no date or language restrictions. Ten electronic databases (EMBASE, PubMed, CINAHL, Web of Science, Scopus, Science Direct, AMED, The Cochrane Database of Systematic Reviews, ProQuest Dissertations and Theses A & I, Google Scholar) were searched from inception to April 2019. This search was updated in January 2020. The methodological quality of included studies was assessed using Downs and Black checklist. STUDY SELECTION Four studies were included. The methodological quality of the included studies was low with a high risk of bias. Data were analyzed narratively and descriptively. Despite the heterogeneity of the included studies, the findings suggest that interventions incorporating visual biofeedback may have positive effects on swallowing-related quality of life. CONCLUSIONS Based on these preliminary findings, we provide directions for further research and clinical interventions that incorporate an augmentative biofeedback component of swallowing interventions in people with PD. Future studies should be rigorously designed and set appropriate biofeedback treatment in terms of types, schedules, and timing.
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Affiliation(s)
- Irene Battel
- Department of Clinical Speech & Language Studies, University of Dublin, Trinity College Dublin, Dublin, Republic of Ireland.
| | - Irene Calvo
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy
| | - Margaret Walshe
- Department of Clinical Speech & Language Studies, University of Dublin, Trinity College Dublin, Dublin, Republic of Ireland
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Jing YH, Lin T, Li WQ, Wu C, Li X, Ding Q, Wu MF, Xu GQ, Lan Y. Comparison of Activation Patterns in Mirror Neurons and the Swallowing Network During Action Observation and Execution: A Task-Based fMRI Study. Front Neurosci 2020; 14:867. [PMID: 32973431 PMCID: PMC7472888 DOI: 10.3389/fnins.2020.00867] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 07/27/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Observation of a goal-directed motor action can excite the respective mirror neurons, and this is the theoretical basis for action observation (AO) as a novel tool for functional recovery during stroke rehabilitation. To explore the therapeutic potential of AO for dysphagia, we conducted a task-based functional magnetic resonance imaging (fMRI) study to identify the brain areas activated during observation and execution of swallowing in healthy participants. METHODS Twenty-nine healthy volunteers viewed the following stimuli during fMRI scanning: an action-video of swallowing (condition 1, defined as AO), a neutral image with a Chinese word for "watching" (condition 2), and a neutral image with a Chinese word for "swallowing" (condition 3). Action execution (AE) was defined as condition 3 minus condition 2. One-sample t-tests were performed to define the brain regions activated during AO and AE. RESULTS Many brain regions were activated during AO, including the middle temporal gyrus, inferior frontal gyrus, pre- and postcentral gyrus, supplementary motor area, hippocampus, brainstem, and pons. AE resulted in activation of motor areas as well as other brain areas, including the inferior parietal lobule, vermis, middle frontal gyrus, and middle temporal gyrus. Two brain areas, BA6 and BA21, were activated with both AO and AE. CONCLUSION The left supplementary motor area (BA6) and left middle temporal gyrus (BA21), which contains mirror neurons, were activated in both AO and AE of swallowing. In this study, AO activated mirror neurons and the swallowing network in healthy participants, supporting its potential value in the treatment of dysphagia.
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Affiliation(s)
- Ying-hua Jing
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Tuo Lin
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Wan-qi Li
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou, China
| | - Cheng Wu
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Xue Li
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou, China
| | - Qian Ding
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Man-feng Wu
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Guang-qing Xu
- Department of Rehabilitation Medicine, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yue Lan
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou, China
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Szynkiewicz SH, Kamarunas E, Drulia T, Nobriga CV, Griffin L, O'Donoghue CR. A Randomized Controlled Trial Comparing Physical and Mental Lingual Exercise for Healthy Older Adults. Dysphagia 2020; 36:474-482. [PMID: 32770381 DOI: 10.1007/s00455-020-10164-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 07/25/2020] [Indexed: 11/25/2022]
Abstract
Mental practice using motor imagery (MP-MI) has been shown to improve motor outcomes of upper and lower extremities especially when combined with physical exercise. Here, we studied community-dwelling, healthy older adults to determine the effects of including an MP-MI component with lingual strengthening exercise. In this pilot study, twenty-nine typically aging participants were assigned to an intervention group: physical lingual exercise (n = 7), physical and MP-MI lingual exercise (n = 8), MPMI lingual exercise (n = 7), or a control group (placebo exercise) (n = 7). All participants completed the assigned exercise regimen with three sessions per day, three days a week, for 6 consecutive weeks. Maximum isometric pressure (MIP) and regular effort saliva swallowing (RESS) pressure were collected at baseline and weeks 2, 4, and 6. A post hoc Bonferroni corrected treatment effect from baseline to week 6 was shown for only participants in the MP-MI/Physical exercise group for MIP (p = 0.003 MPMI/ Physical group; p = 0.11 Control group; p = 0.32 Physical only group; p = 0.14 MP-MI only group) and RESS (p = 0.009 MP-MI/Physical group; p = 0.14 Control group; p = 0.10 Physical only group; p = 0.04 MP-MI only group). Findings also indicate spontaneous carryover of significantly increased swallowing pressure when mental and physical exercise are combined. In conclusion, the potential effect of including an MPMI lingual exercise component in preventative and rehabilitative frameworks with older persons to possibly enhance functional swallowing improvement is promising and should be investigated.
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Affiliation(s)
- Sarah H Szynkiewicz
- College of Science and Mathematics, Communication Sciences and Disorders, University of South Florida, Sarasota-Manate, 8350 N. Tamiami Trail, Sarasota, FL, 34243, USA. .,School of Health Professions, Communication Sciences and Disorders, Samford University, 800 Lakeshore Drive, Birmingham, AL, 35229, USA.
| | - Erin Kamarunas
- College of Health and Behavioral Studies, Communication Sciences and Disorders, James Madison University, MSC 4304, 235 Martin Luther King Jr. Way, Harrisonburg, VA, 22807, USA
| | - Teresa Drulia
- Harris College of Nursing and Health Sciences, Davies School of Communication Sciences and Disorders, Texas Christian University, TCU Box 297450, Fort Worth, TX, 76109, USA
| | - Christina V Nobriga
- School of Allied Health Professions, Communication Sciences and Disorders, Loma Linda University, Loma Linda, CA, 92350, USA
| | - Lindsay Griffin
- College of Health and Behavioral Studies, Communication Sciences and Disorders, James Madison University, MSC 4304, 235 Martin Luther King Jr. Way, Harrisonburg, VA, 22807, USA.,School of Communications, Communication Sciences and Disorders, Emerson College, 120 Boylston Street, Boston, MA, 02116, USA
| | - Cynthia R O'Donoghue
- College of Health and Behavioral Studies, Communication Sciences and Disorders, James Madison University, MSC 4304, 235 Martin Luther King Jr. Way, Harrisonburg, VA, 22807, USA
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Szynkiewicz SH, Nobriga CV, Cheung A, Khoury L, Piven M, Quibin K. Mental Practice Using Motor Imagery in Dysphagia Rehabilitation: A Survey of Practicing Speech-Language Pathologists. Semin Speech Lang 2020; 41:349-364. [PMID: 32375193 DOI: 10.1055/s-0040-1709204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Mental practice (MP) using motor imagery is recognized as an effective clinical tool in rehabilitative medicine for improving motor performance. Preliminary data using MP in dysphagia rehabilitation are promising, though nothing is known about the current landscape among speech-language pathologists (SLPs) relating to MP implementation. This nationwide study surveys practicing SLPs about knowledge and practice patterns of using MP to gain a better understanding of the current knowledge, as well as perceived benefits and challenges in using MP. Descriptive data are reported and open-ended questions analyzed for emerging themes using inductive coding. Over half of the participants were familiar or somewhat familiar with motor imagery in the context of dysphagia rehabilitation, though only 16% of those SLPs reported using MP with a patient. Nearly 75% of respondents expressed interest in learning more about MP. Emerging themes include factors SLPs perceive to limit patient engagement, evidence-based practice concerns, and therapeutic environmental factors. More research on MP and access to training for clinicians is needed in the area of dysphagia rehabilitation to address acknowledged interest in MP.
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Affiliation(s)
- Sarah H Szynkiewicz
- College of Science and Mathematics, University of South Florida, Sarasota-Manatee, Sarasota, Florida
| | - Christina V Nobriga
- Communication Sciences and Disorders, Loma Linda University, Loma Linda, California
| | - Ashley Cheung
- Communication Sciences and Disorders, Loma Linda University, Loma Linda, California
| | - Lauren Khoury
- College of Science and Mathematics, University of South Florida, Sarasota-Manatee, Florida
| | - Morgan Piven
- College of Science and Mathematics, University of South Florida, Sarasota-Manatee, Florida
| | - Kassandra Quibin
- Communication Sciences and Disorders, Loma Linda University, Loma Linda, California
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