Use of a tracing task to assess visuomotor performance: effects of age, sex, and handedness

Robotics-Based Characterization of Sensorimotor Integration in Parkinson's Disease and the Effect of Medication

Integration of multi-modal sensory inputs and modulation of motor outputs based on perceptual estimates is called Sensorimotor Integration (SMI). Optimal functioning of SMI is essential for perceiving the environment, modulating the motor outputs, and learning or modifying motor skills to suit the demands of the environment. Growing evidence suggests that patients diagnosed with Parkinson's Disease (PD) may suffer from an impairment in SMI that contributes to perceptual deficits, leading to motor abnormalities. However, the exact nature of the SMI impairment is still unclear. This study uses a robot-assisted assessment tool to quantitatively characterize SMI impairments in PD patients and how they affect voluntary movements. A set of assessment tasks was developed using a robotic manipulandum equipped with a virtual-reality system. The sensory conditions of the virtual environment were varied to facilitate the assessment of SMI. A hundred PD patients (before and after medication) and forty-three control subjects completed the tasks under varying sensory conditions. The kinematic measures obtained from the robotic device were used to evaluate SMI. The findings reveal that across all sensory conditions, PD patients had 36% higher endpoint error, 38% higher direction error in reaching tasks, and 43% higher number of violations in tracing tasks than control subjects due to impairment in integrating sensory inputs. However, they still retained motor learning ability and the ability to modulate motor outputs. The medication worsened the SMI deficits as PD patients, after medication, performed worse than before medication when encountering dynamic sensory environments and exhibited impaired motor learning ability.

Virtual Reality-based Cognitive Intervention for Enhancing Executive Functions in Community-dwelling Older Adults

With the rapid growth of the older population globally, it is anticipated that age-related cognitive decline in the prodromal phase and more severe pathological decline will increase. Moreover, currently, no effective treatment options for the disease exist. Thus, early and timely prevention actions are promising and prior strategies to preserve cognitive functions by preventing symptomatology from increasing the age-related deterioration of the functions in healthy older adults. This study aims to develop the virtual reality-based cognitive intervention for enhancing executive functions (EFs) and examine the EFs after training with the virtual reality-based cognitive intervention in community-dwelling older adults. Following inclusion/exclusion criteria, 60 community-dwelling older adults aged 60-69 years were involved in the study and randomly divided into passive control and experimental groups. Eight 60 min virtual reality-based cognitive intervention sessions were held twice a week and lasted for 1 month. The EFs (i.e., inhibition, updating, and shifting) of the participants were assessed by using standardized computerized tasks, i.e., Go/NoGo, forward and backward digit span, and Berg's card sorting tasks. Additionally, a repeated-measure ANCOVA and effect sizes were applied to investigate the effects of the developed intervention. The virtual reality-based intervention significantly improved the EFs of older adults in the experimental group. Specifically, the magnitudes of enhancement were observed for inhibitory as indexed by the response time, F(1) = 6.95, p < .05, η_p² = .11, updating as represented by the memory span, F(1) = 12.09, p < .01, η_p² = .18, and the response time, F(1) = 4.46, p = .04, η_p² = .07, and shifting abilities as indexed by the percentage of correct responses, F(1) = 5.30, p = .03, η_p² = .09, respectively. The results indicated that the simultaneous combined cognitive-motor control as embedded in the virtual-based intervention is safe and effective in enhancing EFs in older adults without cognitive impairment. Nevertheless, further studies are required to investigate the benefits of these enhancements to motor functions and emotional aspects relating to daily living and the well-being of older populations in communities.

Straying Off Course: The Negative Impact of Mind Wandering on Fine Motor Movements

The goal of this study was to examine how various degrees of perceptual decoupling during mind wandering affect fine motor control. We hypothesized that while under normal circumstances attention ensures an optimal control strategy that leads to accurate motor performance, during mind wandering the process becomes disrupted. In this study, we conducted a computer-based experiment with a tracking task. During mind wandering, motor movements were more erratic and less variable, indicative of reduced attentiveness to the continuous demands of the external task. Importantly, the deeper the reported mind wandering, the less accurate and less variable were the mouse movements, suggesting that perceptual decoupling may take place in a graded rather than in an all or nothing manner. Greater movement intermittency was associated with higher tracking accuracy, suggesting that more corrective movements toward a moving target were functional to task performance. Moreover, greater variance in velocity was negatively correlated with tracking accuracy. These findings suggest that periods of inattention to the task have a negative impact on fine motor movement control by making behavior unpredictable, providing support for the idea that there is a decoupling of sensory-motor processes during mind wandering.

Contrasting Age Effects on Complexity of Tracking Force and Force Fluctuations During Monorhythmic Contraction

This study contrasted the stochastic force component between young and older adults, who performed pursuit tracking/compensatory tracking by exerting in-phase/antiphase forces to match a sinusoidal target. Tracking force was decomposed into the force component containing the target frequency and the nontarget force fluctuations (stochastic component). Older adults with inferior task performance had higher complexity (entropy across time; p = .005) in total force. For older adults, task errors were negatively correlated with force fluctuation complexity (pursuit tracking: r = -.527 to -.551; compensatory tracking: r = -.626 to -.750). Notwithstanding an age-related increase in total force complexity (p = .004), older adults exhibited lower complexity of the stochastic force component than young adults did (low frequency: p = .017; high frequency: p = .035). Those older adults with a higher complexity of stochastic force had better task performance due to the underlying use of a richer gradation strategy to compensate for impaired oscillatory control.

Digital biomarkers for Alzheimer's disease: the mobile/ wearable devices opportunity

Alzheimer's Disease (AD) represents a major and rapidly growing burden to the healthcare ecosystem. A growing body of evidence indicates that cognitive, behavioral, sensory, and motor changes may precede clinical manifestations of AD by several years. Existing tests designed to diagnose neurodegenerative diseases, while well-validated, are often less effective in detecting deviations from normal cognitive decline trajectory in the earliest stages of the disease. In the quest for gold standards for AD assessment, there is a growing interest in the identification of readily accessible digital biomarkers, which harness advances in consumer grade mobile and wearable technologies. Topics examined include a review of existing early clinical manifestations of AD and a path to the respective sensor and mobile/wearable device usage to acquire domain-centric data towards objective, high frequency and passive digital phenotyping.

Concussion history is negatively associated with visual-motor force complexity: evidence for persistent effects on visual-motor integration

OBJECTIVES

Long-term monitoring of concussion recovery requires time- and cost-effective methods. Physiologic complexity may be useful in evaluating visual-motor integration following concussion. The purpose of this study was to quantify the extent to which prior number of concussions influenced visual-motor tracking force complexity.

METHODS

Thirty-five individuals with a self-reported concussion history (age: 20.92 ± 1.98) and 15 without (age: 20.92 ± 2.21) performed an isometric visual-motor tracking task, using index finger force to trace a straight line across a computer screen. Finger force root mean square error (RMSE), multi-scale complexity, and average power from 0 to 12 Hertz (Hz) were calculated. Individual multiple regressions were fit to these outcomes.

RESULTS

Force complexity decreased linearly with an increasing number of concussions (R² = 0.101). Males had more complex force overall (R² = 0.219) and greater 4-8 Hz average power (R² = 0.193). The 8-12 Hz average power decreased significantly for individuals with prior loss of consciousness (LOC) and increasing numbers of concussions (R² = 0.143).

CONCLUSION

Individuals exhibited linear decreases in visual-motor tracking force complexity with increasing numbers of concussions, influenced by both gender and a history of LOC. These findings indicate cumulative changes in the ways in which previously concussed individuals process and integrate visual information to guide behaviour.

Spiral tracing on a touchscreen is influenced by age, hand, implement, and friction

Dexterity impairments are well documented in older adults, though it is unclear how these influence touchscreen manipulation. This study examined age-related differences while tracing on high- and low-friction touchscreens using the finger or stylus. 26 young and 24 older adults completed an Archimedes spiral tracing task on a touchscreen mounted on a force sensor. Root mean square error was calculated to quantify performance. Root mean square error increased by 29.9% for older vs. young adults using the fingertip, but was similar to young adults when using the stylus. Although other variables (e.g., touchscreen usage, sensation, and reaction time) differed between age groups, these variables were not related to increased error in older adults while using their fingertip. Root mean square error also increased on the low-friction surface for all subjects. These findings suggest that utilizing a stylus and increasing surface friction may improve touchscreen use in older adults.

Distinct cognitive performance and patterns of drug use among early and late onset cocaine users

INTRODUCTION

Adolescence is a crucial period for neurodevelopment, but few studies have investigated the impact of early cocaine use on cognitive performance and patterns of substance use.

METHODS

We evaluated 103 cocaine dependent inpatients divided in two groups: early-onset users (EOG; n=52), late-onset users (LOG; n=51), and 63 healthy controls. Neuropsychological functioning was evaluated using Digits Forward (DF) and Backward (DB), Trail Making Test (TMT), Stroop Color Word Test (SCWT), Controlled Oral Word Association Test (COWAT), Wisconsin Card Sorting Test (WCST), Rey Osterrieth Complex Figure Test (ROCFT), Frontal Assessment Battery (FAB), and Iowa Gambling Test (IGT). Use of alcohol and other drugs was assessed with the Addiction Severity Index (ASI-6).

RESULTS

Analyses of covariance controlling for age, IQ and years of education showed that EOG presented worse performance in attention span (DF, p=0.020), working memory (DB, p=0.001), sustained attention (WCST, p=0.030), declarative memory (ROCFT, p=0.031) and general executive functioning (FAB, p=0.003) when compared with the control group. LOG presented impairments on divided attention (TMT, p=0.003) and general executive functioning (FAB, p=0.001) in relation to the control group. EOG presented higher use of cannabis and alcohol than LOG (p≤0.001).

CONCLUSION

Early-onset cocaine users display more pronounced neuropsychological alterations than controls, as well as a greater frequency of polydrug consumption than LOG. The prominent cognitive deficits in EOG probably reflect the deleterious interference of cocaine use with early stages of neurodevelopment. This may be related to more severe clinical characteristics of substance disorder in this subgroup, including polysubstance abuse.

Moving to Capture Children's Attention: Developing a Methodology for Measuring Visuomotor Attention

Attention underpins many activities integral to a child's development. However, methodological limitations currently make large-scale assessment of children's attentional skill impractical, costly and lacking in ecological validity. Consequently we developed a measure of 'Visual Motor Attention' (VMA)-a construct defined as the ability to sustain and adapt visuomotor behaviour in response to task-relevant visual information. In a series of experiments, we evaluated the capability of our method to measure attentional processes and their contributions in guiding visuomotor behaviour. Experiment 1 established the method's core features (ability to track stimuli moving on a tablet-computer screen with a hand-held stylus) and demonstrated its sensitivity to principled manipulations in adults' attentional load. Experiment 2 standardised a format suitable for use with children and showed construct validity by capturing developmental changes in executive attention processes. Experiment 3 tested the hypothesis that children with and without coordination difficulties would show qualitatively different response patterns, finding an interaction between the cognitive and motor factors underpinning responses. Experiment 4 identified associations between VMA performance and existing standardised attention assessments and thereby confirmed convergent validity. These results establish a novel approach to measuring childhood attention that can produce meaningful functional assessments that capture how attention operates in an ecologically valid context (i.e. attention's specific contribution to visuomanual action).

Reliability and validity of neurobehavioral function on the Psychology Experimental Building Language test battery in young adults

Background. The Psychology Experiment Building Language (PEBL) software consists of over one-hundred computerized tests based on classic and novel cognitive neuropsychology and behavioral neurology measures. Although the PEBL tests are becoming more widely utilized, there is currently very limited information about the psychometric properties of these measures.

Methods. Study I examined inter-relationships among nine PEBL tests including indices of motor-function (Pursuit Rotor and Dexterity), attention (Test of Attentional Vigilance and Time-Wall), working memory (Digit Span Forward), and executive-function (PEBL Trail Making Test, Berg/Wisconsin Card Sorting Test, Iowa Gambling Test, and Mental Rotation) in a normative sample (N = 189, ages 18–22). Study II evaluated test–retest reliability with a two-week interest interval between administrations in a separate sample (N = 79, ages 18–22).

Results. Moderate intra-test, but low inter-test, correlations were observed and ceiling/floor effects were uncommon. Sex differences were identified on the Pursuit Rotor (Cohen’s d = 0.89) and Mental Rotation (d = 0.31) tests. The correlation between the test and retest was high for tests of motor learning (Pursuit Rotor time on target r = .86) and attention (Test of Attentional Vigilance response time r = .79), intermediate for memory (digit span r = .63) but lower for the executive function indices (Wisconsin/Berg Card Sorting Test perseverative errors = .45, Tower of London moves = .15). Significant practice effects were identified on several indices of executive function.

Conclusions. These results are broadly supportive of the reliability and validity of individual PEBL tests in this sample. These findings indicate that the freely downloadable, open-source PEBL battery (http://pebl.sourceforge.net) is a versatile research tool to study individual differences in neurocognitive performance.

Dynamical disease: Challenges for nonlinear dynamics and medicine

Dynamical disease refers to illnesses that are associated with striking changes in the dynamics of some bodily function. There is a large literature in mathematics and physics which proposes mathematical models for the physiological systems and carries out analyses of the properties of these models using nonlinear dynamics concepts involving analyses of the stability and bifurcations of attractors. This paper discusses how these concepts can be applied to medicine.