Eye-hand coordination during visuomotor adaptation with different rotation angles

Serum neutralizing capacity and T-cell response against the omicron BA.1 variant in seropositive children and their parents one year after SARS-CoV-2 infection

Introduction

Durability of immune protection against reinfection with SARS-CoV-2 remains enigmatic, especially in the pediatric population and in the context of immune-evading variants of concern. Obviously, this knowledge is required for measures to contain the spread of infection and in selecting rational preventive measures.

Methods

Here, we investigated the serum neutralization capacity of 36 seropositive adults and 34 children approximately one year after infection with the ancestral Wuhan strain of SARS-CoV-2 by using a pseudovirus neutralization assay.

Results

We found that 88.9% of seropositive adult (32/36) and 94.1% of seropositive children (32/34) convalescents retained the neutralizing activity against the SARS-CoV-2 Wuhan strain (WT). Although, the neutralization effect against Omicron BA.1 (B.1.1.529.1) was significantly lower, 70.6% (24/34) of children and 41.7% (15/36) of adults possessed BA.1 cross-neutralizing antibodies. The spike 1 (S1)-specific T cell recall capacity using an activation-induced marker assay was analyzed in 18 adults and 16 children. All participants had detectable S1-specific CD4 T cells against WT, and 72.2% (13/18) adults and 81,3% (13/16) children had detectable S1 WT-specific CD8 T cells. CD4 cross-reactivity against BA.1 was demonstrated in all investigated adults (18/18), and 66.7% (12/18) adult participants had also detectable specific CD8 BA.1 T cells while we detected BA.1 S1 reactive CD4 and CD8 T cells in 81.3% (13/16) children.

Discussion

Together, our findings demonstrate that infection with the ancestral strain of SARS-CoV-2 in children as well as in adults induces robust serological as well as T cell memory responses that persist over at least 12 months. This suggests persistent immunological memory and partial cross-reactivity against Omicron BA.1.

Delay of gaze fixation during reaching movement with the non-dominant hand to a distant target

The present study examined the effects of hand and task difficulty on eye-hand coordination related to gaze fixation behavior (i.e., fixating a gaze to the target until reach completion) in single reaching movements. Twenty right-handed young adults made reaches on a digitizer, while looking at a visual target and feedback of hand movements on a computer monitor. Task difficulty was altered by having three target distances. In a small portion of trials, visual feedback was randomly removed at the target presentation. The effect of a moderate amount of practice was also examined using a randomized trial schedule across target-distance and visual-feedback conditions in each hand. The results showed that the gaze distances covered during the early reaching phase were reduced, and the gaze fixation to the target was delayed when reaches were performed with the left hand and when the target distance increased. These results suggest that when the use of the non-dominant hand or an increased task difficulty reduces the predictability of hand movements and its sensory consequences, eye-hand coordination is modified to enhance visual monitoring of the reach progress prior to gaze fixation. The randomized practice facilitated this process. Nevertheless, variability of reach trajectory was more increased without visual feedback for right-hand reaches, indicating that control of the dominant arm integrates more visual feedback information during reaches. These results together suggest that the earlier gaze fixation and greater integration of visual feedback during right-hand reaches contribute to the faster and more accurate performance in the final reaching phase.

Motor Coordination and Grip Strength of the Dominant and Non-Dominant Affected Upper Limb Depending on the Body Position—An Observational Study of Patients after Ischemic Stroke

Stroke is one of the leading causes of human disability globally. Motor function deficits resulting from a stroke affect the entire body, but relatively often it is the upper limbs that remain ineffective, which is very limiting in everyday life activities. The finding in neurorehabilitation that trunk control contributes to upper limb function is relatively common but has not been confirmed in clinical trials. This observational prospective study aims to analyze the effect of the position of the trunk and the affected upper limb on the coordination and grip strength of the affected dominant and non-dominant hand and wrist in people after ischemic stroke. The research was carried out at the Department of Neurological Rehabilitation, on a group of 60 patients with acute ischemic stroke. A Hand Tutor device and a hand dynamometer were used for the main measurements of the motor coordination parameters (maximum range of motion, frequency of movement) and the grip strength of the dominant and non-dominant upper limb. The patients were examined in two positions: sitting without back support and lying on the back with stabilization of the upper limb. Higher and relevant results were observed in the non-dominant hand, in the supine position in terms of motor coordination parameters of the fingers (p = 0.019; p = 0.011) and wrist (p = 0.033), and grip strength (p = 0.017). Conclusions: The laying position and stabilization of the affected upper limb in the acute phase following ischemic stroke is more beneficial for the coordination of movements and grip strength of the non-dominant hand.

A condition that produces sensory recalibration and abolishes multisensory integration

We examined the influence of extended exposure to a visuomotor rotation, which induces both motor adaptation and sensory recalibration, on (partial) multisensory integration in a cursor-control task. Participants adapted to a 30° (adaptation condition) or 0° (control condition) visuomotor rotation by making center-out movements to remembered targets. In subsequent test trials of sensory integration, they made center-out movements with variable visuomotor rotations and judged the position of hand or cursor at the end of these movements. Test trials were randomly embedded among twice the number of maintenance trials with 30° or 0° rotation. The biases of perceived hand (or cursor) position toward the cursor (or hand) position were measured. We found motor adaptation together with proprioceptive and visual recalibrations in the adaptation condition. Unexpectedly, multisensory integration was absent in both the adaptation and control condition. The absence stemmed from the extensive experience of constant visuomotor rotations of 30° or 0°, which probably produced highly precise predictions of the visual consequences of hand movements. The frequently confirmed predictions then dominated the estimate of the visual movement consequences, leaving no influence of the actual visuomotor rotations in the minority of test trials. Conversely, multisensory integration was present for sensed hand positions when these were indirectly assessed from movement characteristics, indicating that the relative weighting of discrepant estimates of hand position was different for motor control. The existence of a condition that abolishes multisensory integration while keeping sensory recalibration suggests that mechanisms that reduce sensory discrepancies (partly) differ between integration and recalibration.

Visual processing speed in hemianopia patients secondary to acquired brain injury: a new assessment methodology

Background

There is a clinical need to identify diagnostic parameters that objectively quantify and monitor the effective visual ability of patients with homonymous visual field defects (HVFDs). Visual processing speed (VPS) is an objective measure of visual ability. It is the reaction time (RT) needed to correctly search and/or reach for a visual stimulus. VPS depends on six main brain processing systems: auditory-cognitive, attentional, working memory, visuocognitive, visuomotor, and executive. We designed a new assessment methodology capable of activating these six systems and measuring RTs to determine the VPS of patients with HVFDs.

Methods

New software was designed for assessing subject visual stimulus search and reach times (S-RT and R-RT respectively), measured in seconds. Thirty-two different everyday visual stimuli were divided in four complexity groups that were presented along 8 radial visual field positions at three different eccentricities (10^o, 20^o, and 30^o). Thus, for each HVFD and control subject, 96 S- and R-RT measures related to VPS were registered. Three additional variables were measured to gather objective data on the validity of the test: eye-hand coordination mistakes (ehcM), eye-hand coordination accuracy (ehcA), and degrees of head movement (dHM, measured by a head-tracker system). HVFD patients and healthy controls (30 each) matched by age and gender were included. Each subject was assessed in a single visit. VPS measurements for HFVD patients and control subjects were compared for the complete test, for each stimulus complexity group, and for each eccentricity.

Results

VPS was significantly slower (p < 0.0001) in the HVFD group for the complete test, each stimulus complexity group, and each eccentricity. For the complete test, the VPS of the HVFD patients was 73.0% slower than controls. They also had 335.6% more ehcMs, 41.3% worse ehcA, and 189.0% more dHMs than the controls.

Conclusions

Measurement of VPS by this new assessment methodology could be an effective tool for objectively quantifying the visual ability of HVFD patients. Future research should evaluate the effectiveness of this novel method for measuring the impact that any specific neurovisual rehabilitation program has for these patients.

Eye Movements during Visuomotor Adaptation Represent Only Part of the Explicit Learning

Visuomotor rotations are learned through a combination of explicit strategy and implicit recalibration. However, measuring the relative contribution of each remains a challenge and the possibility of multiple explicit and implicit components complicates the issue. Recent interest has focused on the possibility that eye movements reflects explicit strategy. Here we compared eye movements during adaptation to two accepted measures of explicit learning: verbal report and the exclusion test. We found that while reporting, all subjects showed a match among all three measures. However, when subjects did not report their intention, the eye movements of some subjects suggested less explicit adaptation than what was measured in an exclusion test. Interestingly, subjects whose eye movements did match their exclusion could be clustered into the following two subgroups: fully implicit learners showing no evidence of explicit adaptation and explicit learners with little implicit adaptation. Subjects showing a mix of both explicit and implicit adaptation were also those where eye movements showed less explicit adaptation than did exclusion. Thus, our results support the idea of multiple components of explicit learning as only part of the explicit learning is reflected in the eye movements. Individual subjects may use explicit components that are reflected in the eyes or those that are not or some mixture of the two. Analysis of reaction times suggests that the explicit components reflected in the eye movements involve longer reaction times. This component, according to recent literature, may be related to mental rotation.

Visual and proprioceptive recalibrations after exposure to a visuomotor rotation

Adaptation to a visuomotor rotation in a cursor-control task is accompanied by proprioceptive recalibration, whereas the existence of visual recalibration is uncertain and has even been doubted. In the present study, we tested both visual and proprioceptive recalibration; proprioceptive recalibration was not only assessed by means of psychophysical judgments of the perceived position of the hand, but also by an indirect procedure based on movement characteristics. Participants adapted to a gradually introduced visuomotor rotation of 30° by making center-out movements to remembered targets. In subsequent test trials, they made center-out movements without visual feedback or observed center-out motions of a cursor without moving the hand. In each test trial, they judged the endpoint of hand or cursor by matching the position of the hand or of a visual marker, respectively, moving along a semicircular path. This path ran through all possible endpoints of the center-out movements. We observed proprioceptive recalibration of 7.3° (3.1° with the indirect procedure) and a smaller, but significant, visual recalibration of 1.3°. Total recalibration of 8.6° was about half as strong as motor adaptation, the adaptive shift of the movement direction. The evidence of both proprioceptive and visual recalibration was obtained with a judgment procedure that suggests that recalibration is restricted to the type of movement performed during exposure to a visuomotor rotation. Consequently, identical physical positions of the hand can be perceived differently depending on how they have been reached, and similarly identical positions of a cursor on a monitor can be perceived differently.

Eye movements do not play an important role in the adaptation of hand tracking to a visuomotor rotation

Adapting hand movements to changes in our body or the environment is essential for skilled motor behavior. Although eye movements are known to assist hand movement control, how eye movements might contribute to the adaptation of hand movements remains largely unexplored. To determine to what extent eye movements contribute to visuomotor adaptation of hand tracking, participants were asked to track a visual target that followed an unpredictable trajectory with a cursor using a joystick. During blocks of trials, participants were either allowed to look wherever they liked or required to fixate a cross at the center of the screen. Eye movements were tracked to ensure gaze fixation as well as to examine free gaze behavior. The cursor initially responded normally to the joystick, but after several trials, the direction in which it responded was rotated by 90°. Although fixating the eyes had a detrimental influence on hand tracking performance, participants exhibited a rather similar time course of adaptation to rotated visual feedback in the gaze-fixed and gaze-free conditions. More importantly, there was extensive transfer of adaptation between the gaze-fixed and gaze-free conditions. We conclude that although eye movements are relevant for the online control of hand tracking, they do not play an important role in the visuomotor adaptation of such tracking. These results suggest that participants do not adapt by changing the mapping between eye and hand movements, but rather by changing the mapping between hand movements and the cursor’s motion independently of eye movements.

NEW & NOTEWORTHY Eye movements assist hand movements in everyday activities, but their contribution to visuomotor adaptation remains largely unknown. We compared adaptation of hand tracking under free gaze and fixed gaze. Although our results confirm that following the target with the eyes increases the accuracy of hand movements, they unexpectedly demonstrate that gaze fixation does not hinder adaptation. These results suggest that eye movements have distinct contributions for online control and visuomotor adaptation of hand movements.

Parallel learning processes of a visuomotor adaptation task in a changing environment

During the control of reaching movements, a key contribution of the visual system is the localization of relevant environmental targets. In motor adaptation processes, the visual evaluation of effector motor behavior enables learning from errors, which demands continuous visual attentional focus. However, most current adaptation paradigms include static targets; therefore, when a learning situation develops in a highly variable environment and there is a double demand for visual resources (environment and motor performance), the evolution of learning processes is unknown. In order to understand how learning processes evolve in a variable environment, a video game task was designed in which subjects were asked to manage a 60° counterclockwise-rotated cursor to capture descending targets with initially unpredictable trajectories. During the task, the cursor and eye movements were recorded to dissect visuomotor coordination. We observed that the pursuit of the targets conditioned a predominant and continuous visual inspection of the environment instead of the rotated cursor. As learning progressed, subjects exhibited a linear reduction in directional error and selected a motor strategy based on the degree of reward, which improved the performance. These results suggest that when the environment demands high visual attention, error-based and reinforced motor learning processes are implemented simultaneously, thus enabling efficient predictive behavior.

Context-dependent concurrent adaptation to static and moving targets

Is the neural control of movements towards moving targets independent to that of static targets? In the following experiments, we used a visuomotor rotation adaptation paradigm to examine the extent to which adapting arm movements to static targets generalize to that of moving targets (i.e. pursuit or tracking). In the first and second experiments, we showed that adaptation to perturbed tracking movements generalizes to reaching movements; reach aftereffects following perturbed tracking were about half the size (≈9°) of those produced following reach training (≈ 19°). Given these findings, in the final experiment we associated opposing perturbations (-30° and +30°) with either reaching or tracking movements and presented them within the same experimental block to determine whether these contexts allow for dual adaptation. We found that the group that experienced opposing perturbations was able to reduce both reaching and tracking errors, as well as produce reach aftereffects following dual training of ≈7°, which were substantially smaller than those produced when reach training was not concurrent with tracking training. This reduction in reach aftereffects is consistent with the extent of the interference from tracking training as measured by the reach aftereffects produced when only that condition was performed. These results suggest partial, but not complete, overlap in the learning processes involved in the acquisition of tracking and reaching movements.

Eye-hand coordination during visuomotor adaptation: effects of hemispace and joint coordination

We previously examined adaptive changes of eye-hand coordination during learning of a visuomotor rotation. Gazes during reaching movements were initially directed to a feedback cursor in early practice, but were gradually shifted toward the target with more practice, indicating an emerging gaze anchoring behavior. This adaptive pattern reflected a functional change of gaze control from exploring the cursor-hand relation to guiding the hand to the task goal. The present study further examined the effects of hemispace and joint coordination associated with target directions on this behavior. Young adults performed center-out reaching movements to four targets with their right hand on a horizontal digitizer, while looking at a rotated visual feedback cursor on a computer monitor. To examine the effect of hemispace related to visual stimuli, two out of the four targets were located in the ipsilateral workspace relative to the hand used, the other two in the contralateral workspace. To examine the effect of hemispace related to manual actions, two among the four targets were related to reaches made in the ipsilateral workspace, the other two to reaches made in the contralateral workspace. Furthermore, to examine the effect of the complexity of joint coordination, two among the four targets were reaches involving a direct path from the start to the target involving elbow movements (simple), whereas the other two targets were reaches involving both shoulder and elbow movements (complex). The results showed that the gaze anchoring behavior gradually emerged during practice for reaches made in all target directions. The speed of this change was affected mainly by the hemispace related to manual actions, whereas the other two effects were minimal. The gaze anchoring occurred faster for the ipsilateral reaches than for the contralateral reaches; gazes prior to the gaze anchoring were also directed less at the cursor vicinity but more at the mid-area between the starting point and the target. These results suggest that ipsilateral reaches result in a better predictability of the cursor-hand relation under the visuomotor rotation, thereby prompting an earlier functional change of gaze control through practice from a reactive to a predictive control.

Eye-Hand Coordination during Visuomotor Adaptation with Different Rotation Angles: Effects of Terminal Visual Feedback

This study examined adaptive changes of eye-hand coordination during a visuomotor rotation task under the use of terminal visual feedback. Young adults made reaching movements to targets on a digitizer while looking at targets on a monitor where the rotated feedback (a cursor) of hand movements appeared after each movement. Three rotation angles (30°, 75° and 150°) were examined in three groups in order to vary the task difficulty. The results showed that the 30° group gradually reduced direction errors of reaching with practice and adapted well to the visuomotor rotation. The 75° group made large direction errors of reaching, and the 150° group applied a 180° reversal shift from early practice. The 75°and 150° groups, however, overcompensated the respective rotations at the end of practice. Despite these group differences in adaptive changes of reaching, all groups gradually adapted gaze directions prior to reaching from the target area to the areas related to the final positions of reaching during the course of practice. The adaptive changes of both hand and eye movements in all groups mainly reflected adjustments of movement directions based on explicit knowledge of the applied rotation acquired through practice. Only the 30° group showed small implicit adaptation in both effectors. The results suggest that by adapting gaze directions from the target to the final position of reaching based on explicit knowledge of the visuomotor rotation, the oculomotor system supports the limb-motor system to make precise preplanned adjustments of reaching directions during learning of visuomotor rotation under terminal visual feedback.

Eye tracking a self-moved target with complex hand-target dynamics

Previous work has shown that the ability to track with the eye a moving target is substantially improved when the target is self-moved by the subject's hand compared with when being externally moved. Here, we explored a situation in which the mapping between hand movement and target motion was perturbed by simulating an elastic relationship between the hand and target. Our objective was to determine whether the predictive mechanisms driving eye-hand coordination could be updated to accommodate this complex hand-target dynamics. To fully appreciate the behavioral effects of this perturbation, we compared eye tracking performance when self-moving a target with a rigid mapping (simple) and a spring mapping as well as when the subject tracked target trajectories that he/she had previously generated when using the rigid or spring mapping. Concerning the rigid mapping, our results confirmed that smooth pursuit was more accurate when the target was self-moved than externally moved. In contrast, with the spring mapping, eye tracking had initially similar low spatial accuracy (though shorter temporal lag) in the self versus externally moved conditions. However, within ∼5 min of practice, smooth pursuit improved in the self-moved spring condition, up to a level similar to the self-moved rigid condition. Subsequently, when the mapping unexpectedly switched from spring to rigid, the eye initially followed the expected target trajectory and not the real one, thereby suggesting that subjects used an internal representation of the new hand-target dynamics. Overall, these results emphasize the stunning adaptability of smooth pursuit when self-maneuvering objects with complex dynamics.

3D Printout Models vs. 3D-Rendered Images: Which Is Better for Preoperative Planning?

INTRODUCTION

Correct interpretation of a patient's anatomy and changes that occurs secondary to a disease process are crucial in the preoperative process to ensure optimal surgical treatment. In this study, we presented 3 different pancreatic cancer cases to surgical residents in the form of 3D-rendered images and 3D-printed models to investigate which modality resulted in the most appropriate preoperative plan.

METHODS

We selected 3 cases that would require significantly different preoperative plans based on key features identifiable in the preoperative computed tomography imaging. 3D volume rendering and 3D printing were performed respectively to create 2 different training ways. A total of 30, year 1 surgical residents were randomly divided into 2 groups. Besides traditional 2D computed tomography images, residents in group A (n = 15) reviewed 3D computer models, whereas in group B, residents (n = 15) reviewed 3D-printed models. Both groups subsequently completed an examination, designed in-house, to assess the appropriateness of their preoperative plan and provide a numerical score of the quality of the surgical plan.

RESULTS

Residents in group B showed significantly higher quality of the surgical plan scores compared with residents in group A (76.4 ± 10.5 vs. 66.5 ± 11.2, p = 0.018). This difference was due in large part to a significant difference in knowledge of key surgical steps (22.1 ± 2.9 vs. 17.4 ± 4.2, p = 0.004) between each group. All participants reported a high level of satisfaction with the exercise.

CONCLUSION

Results from this study support our hypothesis that 3D-printed models improve the quality of surgical trainee's preoperative plans.

A Randomized Comparison Simulating Face to Face Endotracheal Intubation of Pentax Airway Scope, C-MAC Video Laryngoscope, Glidescope Video Laryngoscope, and Macintosh Laryngoscope

OBJECTIVES

Early airway management is very important for severely ill patients. This study aimed to investigate the efficacy of face to face intubation in four different types of laryngoscopes (Macintosh laryngoscope, Pentax airway scope (AWS), Glidescope video laryngoscope (GVL), and C-MAC video laryngoscope (C-MAC)).

METHOD

Ninety-five nurses and emergency medical technicians were trained to use the AWS, C-MAC, GVL and Macintosh laryngoscope with standard airway trainer manikin and face to face intubation. We compared VCET (vocal cord exposure time), tube pass time, 1st ventilation time, VCET to tube pass time, tube pass time to 1st ventilation time, and POGO (percentage of glottis opening) score. In addition, we compared success rate according to the number of attempts and complications.

RESULT

VCET was similar among all laryngoscopes and POGO score was higher in AWS. AWS and Macintosh blade were faster than GVL and C-MAC in total intubation time. Face to face intubation success rate was lower in GVL than other laryngoscopes.

CONCLUSION

AWS and Macintosh were favorable laryngoscopes in face to face intubation. GVL had disadvantage performing face to face intubation.

Reliance on visual attention during visuomotor adaptation: an SSVEP study

Visuomotor adaptation involves the learning of a new mapping between a spatial goal and well-learned movements. In order to learn a new visuomotor transformation, visual attention is needed to monitor movements and their visual consequences. Once a transformation is learnt, it can be executed automatically without attentional control. Using steady-state visual evoked potentials (SSVEPs) measured from EEG activity, we examined how visual attention changes during the early phase of visuomotor adaptation. SSVEPs were elicited by a green disc flickering at 15 Hz which was either the movement target or the cursor that participants controlled. Participants performed an adapted continuous visuomotor adaptation task with either 60° or 120° screen cursor rotation, and changes in 15-Hz SSVEP power were examined. Participants' performance improved over time in all conditions, with the rate of learning significantly influenced by the degree of rotation. SSVEPs at 15 Hz showed a significant change over time with adaptation for 60° rotations, but not for 120° rotations, such that SSVEPs elicited by the stimuli were significantly lower for 60° compared with 120° rotation conditions over the last adaptation blocks. This suggests that visual attention to the movement target and feedback reduces over time as performance improves during visuomotor adaptation for easier rotations, but must be maintained throughout the task for more difficult 120° rotations that might require more strategic control.

Impaired visuomotor adaptation in adults with ADHD

Attention-deficit hyperactivity disorder (ADHD) is a prevalent psychiatric disorder in children that often continues into adulthood. It has been suggested that motor impairments in ADHD are associated with underlying cerebellar pathology. If such is the case, individuals with ADHD should be impaired on motor tasks requiring healthy cerebellar function. To test this, we compared performance of individuals with ADHD and ADHD-like symptoms with non-ADHD controls on a visuomotor adaptation task known to be impaired following cerebellar lesions. Participants adapted reaching movements to a visual representation that was rotated by 30°. Individuals with ADHD and those with ADHD-like symptoms took longer to correct the angle of movement once the rotation was applied relative to controls. However, post-adaptation residual effect did not differ for individuals with ADHD and ADHD-like symptoms compared to the control group. These results are consistent with the hypothesis that mild cerebellar deficits are evident in the motor performance of adults with ADHD.

Gaze locations affect explicit process but not implicit process during visuomotor adaptation

The role of vision in implicit and explicit processes involved in adaptation to novel visuomotor transformations is not well-understood. We manipulated subjects' gaze locations through instructions during a visuomotor rotation task that established a conflict between implicit and explicit processes. Subjects were informed of a rotated visual feedback (45° counterclockwise from the desired target) and instructed to counteract it by using an explicit aiming strategy to the neighboring target (45° clockwise from the target). Simultaneously, they were instructed to gaze at either the desired target (target-gaze group), the neighboring target (hand-target-gaze group), or anywhere (free-gaze group) during aiming. After initial elimination of behavioral errors caused by strategic aiming, the subjects gradually overcompensated the rotation in the early practice, thereby increasing behavioral errors (i.e., a drift). This was caused by an implicit adaptation overriding the explicit strategy. Notably, prescribed gaze locations did not affect this implicit adaptation. In the late practice, the target-gaze and free-gaze groups reduced the drift, whereas the hand-target-gaze group did not. Furthermore, the free-gaze group changed gaze locations for strategic aiming through practice from the neighboring target to the desired target. The onset of this change was correlated with the onset of the drift reduction. These results suggest that gaze locations critically affect explicit adjustments of aiming directions to reduce the drift by taking into account the implicit adaptation that is occurring in parallel. Taken together, spatial eye-hand coordination that ties the gaze and the reach target influences the explicit process but not the implicit process.