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Rossi S, Cinti A, Viberti F, Benelli A, Neri F, De Monte D, Giannotta A, Romanella S, Smeralda C, Donniacuo A, Prattichizzo D, Pasqualetti P, Santarnecchi E, Mandalà M. Frequency-dependent tuning of the human vestibular "sixth sense" by transcranial oscillatory currents. Clin Neurophysiol 2023; 153:123-132. [PMID: 37481873 DOI: 10.1016/j.clinph.2023.06.013] [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: 01/22/2023] [Revised: 05/04/2023] [Accepted: 06/12/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE The vestibular cortex is a multisensory associative region that, in neuroimaging investigations, is activated by slow-frequency (1-2 Hz) galvanic stimulation of peripheral receptors. We aimed to directly activate the vestibular cortex with biophysically modeled transcranial oscillatory current stimulation (tACS) in the same frequency range. METHODS Thirty healthy subjects and one rare patient with chronic bilateral vestibular deafferentation underwent, in a randomized, double-blind, controlled trial, to tACS at slow (1 or 2 Hz) or higher (10 Hz) frequency and sham stimulations, over the Parieto-Insular Vestibular Cortex (PIVC), while standing on a stabilometric platform. Subjective symptoms of motion sickness were scored by Simulator Sickness Questionnaire and subjects' postural sways were monitored on the platform. RESULTS tACS at 1 and 2 Hz induced symptoms of motion sickness, oscillopsia and postural instability, that were supported by posturographic sway recordings. Both 10 Hz-tACS and sham stimulation on the vestibular cortex did not affect vestibular function. As these effects persisted in a rare patient with bilateral peripheral vestibular areflexia documented by the absence of the Vestibular-Ocular Reflex, the possibility of a current spread toward peripheral afferents is unlikely. Conversely, the 10 Hz-tACS significantly reduced his chronic vestibular symptoms in this patient. CONCLUSIONS Weak electrical oscillations in a frequency range corresponding to the physiological cortical activity of the vestibular system may generate motion sickness and postural sways, both in healthy subjects and in the case of bilateral vestibular deafferentation. SIGNIFICANCE This should be taken into account as a new side effect of tACS in future studies addressing cognitive functions. Higher frequencies of stimulation applied to the vestibular cortex may represent a new interventional option to reduce motion sickness in different scenarios.
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Affiliation(s)
- Simone Rossi
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy; Oto-Neuro-Tech Conjoined Lab, Policlinico Le Scotte, University of Siena, Italy.
| | - Alessandra Cinti
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
| | - Francesca Viberti
- Otolaryngology, Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Italy
| | - Alberto Benelli
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
| | - Francesco Neri
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy; Oto-Neuro-Tech Conjoined Lab, Policlinico Le Scotte, University of Siena, Italy
| | - David De Monte
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
| | - Alessandro Giannotta
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
| | - Sara Romanella
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
| | - Carmelo Smeralda
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
| | - Aniello Donniacuo
- Otolaryngology, Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Italy
| | - Domenico Prattichizzo
- Oto-Neuro-Tech Conjoined Lab, Policlinico Le Scotte, University of Siena, Italy; Siena Robotics and Systems (SiRS) Lab, Department of Information Engineering and Mathematics, University of Siena, Siena, Italy
| | | | - Emiliano Santarnecchi
- Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Marco Mandalà
- Oto-Neuro-Tech Conjoined Lab, Policlinico Le Scotte, University of Siena, Italy; Otolaryngology, Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Italy
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Ivusza P, Hortobágyi T, Sebesi B, Gáspár B, Fésüs Á, Varga M, Malmos V, Váczi M. No Difference in the Acute Effects of Randomization vs. Blocking of Units of Lower-Extremity Proprioceptive Training on Balance and Postural Control in Young Healthy Male Adults. Front Physiol 2022; 13:824651. [PMID: 35557968 PMCID: PMC9086394 DOI: 10.3389/fphys.2022.824651] [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: 11/29/2021] [Accepted: 04/01/2022] [Indexed: 11/13/2022] Open
Abstract
Random practice is a form of differential learning and its favorable acute effects on motor performance are well described when visual tasks are practiced. However, no study to date has investigated the acute effects of differential learning using variable proprioceptive stimuli instead of the visual cues. The aim of the present study was to compare the acute effects of randomized versus blocked lower-extremity proprioceptive training stimuli on balance and postural adjustments. In two conditions, healthy young males (n = 15, age = 23 years) performed 16 one-legged landings on a board tilted in four directions: 1) tilt direction unknown and randomized and 2) tilt direction known with order of presentation blocked. Multi-segmental angular sway while balancing on an unstable surface and postural responses to perturbation stimulus by surface tilts were measured before and 4 min after training. Overall frontal-plane postural sway on the unstable surface decreased (p < 0.05, η2 = 0.022) in both conditions, while sagittal-plane postural sway remained unchanged. When the surface was toes-up tilted in the perturbation test, the sagittal-plane shank-thigh-pelvis alignment improved in both conditions (p < 0.05, η2 = 0.017), but the direction of the segmental positioning was non-uniform across participants. We conclude that randomization vs. blocking of units of lower-extremity proprioceptive training did not affect balance and postural control in our cohort of healthy young adults but the improvements were test-specific.
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Affiliation(s)
- Patrik Ivusza
- Institution of Sport Sciences and Physical Education, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Tibor Hortobágyi
- Institution of Sport Sciences and Physical Education, Faculty of Sciences, University of Pécs, Pécs, Hungary.,Center for Human Movement Sciences, University Medical Center, University of Groningen, Groningen, Netherlands
| | - Balázs Sebesi
- Institution of Sport Sciences and Physical Education, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Balázs Gáspár
- Institution of Sport Sciences and Physical Education, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Ádám Fésüs
- Institution of Sport Sciences and Physical Education, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Mátyás Varga
- Institution of Sport Sciences and Physical Education, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Vanessza Malmos
- Faculty of Humanities, Institute of English Studies, University of Pécs, Pécs, Hungary
| | - Márk Váczi
- Institution of Sport Sciences and Physical Education, Faculty of Sciences, University of Pécs, Pécs, Hungary
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McCamley J, Bergamini E, Grimpampi E. Balance on different unstable supports: a complementary approach based on linear and non-linear analyses. Med Biol Eng Comput 2022; 60:863-873. [PMID: 35141819 DOI: 10.1007/s11517-022-02504-4] [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: 07/19/2021] [Accepted: 01/10/2022] [Indexed: 11/27/2022]
Abstract
Maintenance of postural control is a complex task that requires the integration of different sensory-motor processes. To improve postural control, balance training is often implemented using unstable surfaces. Little is known, however, about how different surfaces compare in terms of postural control strategy. Non-linear dynamical system analysis, like recurrent quantification analysis (RQA) applied to the center of pressure (CoP) trajectory, represents a useful tool in this respect. The aim of this study is to investigate the effects of different unstable supports on the CoP trajectory through a complementary approach based on linear and non-linear analyses. Seventeen healthy adults performed barefoot single-leg balance trials on a force plate and on three different balance training devices (soft disc, foam pad, and pillow). Sets of parameters were extracted from the CoP trajectories using classical stabilometric analysis (sway path, mean velocity, root mean square) and RQA (percent recurrence and determinism, maximum line length, entropy). Both classical and RQA analyses highlighted significant differences between stable (force plate) and unstable conditions (p < 0.001). Conversely, only classical stabilometric parameters showed significant differences among the considered balance training devices, indicating that the different characteristics of the devices do not influence the dynamic/temporal structure of the CoP trajectory. Analysis of the center of pressure trajectory during single-leg standing on three different balance training devices and on a rigid surface using both linear and non-linear techniques.
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Affiliation(s)
- John McCamley
- Human Motion Laboratory, MORE Foundation, 18444 N 25th Ave., Suite 110, Phoenix, AZ, 85023, USA
- Center for Research in Human Movement Variability, Department of Biomechanics, University of Nebraska at Omaha, 6160 University Drive South, Omaha, NE, 68182-0860, USA
| | - Elena Bergamini
- Department of Movement, Human and Health Sciences, Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome "Foro Italico", Piazza Lauro de Bosis 15, 00135, Rome, Italy.
| | - Eleni Grimpampi
- Decathlon SportsLab, Movement Sciences Department, 4 Rue Professeur Langevin, 59000, Lille, France
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Schlader ZJ, Schwob J, Hostler D, Cavuoto L. Simultaneous assessment of motor and cognitive tasks reveals reductions in working memory performance following exercise in the heat. Temperature (Austin) 2021; 9:344-356. [PMID: 36339090 PMCID: PMC9629122 DOI: 10.1080/23328940.2021.1992239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This study tested the hypothesis that, following exercise in the heat, motor task performance will be impaired when assessed simultaneously with a cognitive task. In a randomized, crossover and counterbalanced design, twelve healthy adults (23 ± 2 years, 5 women) completed four 10-minute exercise circuits involving upper and lower body exercise in a moderate (18.1 ± 1.7°C, 38 ± 10% relative humidity) and a hot (40.3 ± 1.1°C, 26 ± 5% relative humidity) environment. Experimental testing was completed in a temperate thermal environment before exercise (~25°C) and in either the moderate or hot environment following exercise. The 3 Back test (a test of working memory) was used as the cognitive task and postural sway was used as the motor task. Cognitive and motor task performance assessments were conducted both individually (solo) and simultaneously (dual). At the end of exercise, core temperature (by 0.4 ± 0.3°C, P < 0.001), heart rate (by 12 ± 18 bpm, P = 0.025), and mean skin temperature (by 7.6 ± 0.8°C, P < 0.001) were higher in the Hot trial compared to Moderate. During solo testing, postural sway increased from pre- to post-exercise in the Hot (P ≤ 0.028), but not the Moderate (P ≥ 0.261) trial. During dual testing, postural sway did not differ between trials (P ≥ 0.065) or over time (P ≥ 0.094). During solo testing, 3 Back performance did not differ between trials (P = 0.810) or over time (P = 0.707), but during dual testing 3 Back performance following exercise was reduced in the Hot compared to the Moderate trial (P = 0.028). Simultaneous assessment of motor and cognitive tasks reveals that motor performance is reduced following exercise in the heat. .
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Affiliation(s)
- Zachary J. Schlader
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, USA,Department of Kinesiology, School of Public Health, Indiana University, Bloomington, USA
| | - Jacqueline Schwob
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, USA
| | - David Hostler
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, USA,Department of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, USA
| | - Lora Cavuoto
- Department of Industrial and Systems Engineering, School of Engineering and Applied Sciences, University at Buffalo, Buffalo, USA,CONTACT Lora Cavuoto
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Boonsinsukh R, Khumnonchai B, Saengsirisuwan V, Chaikeeree N. The effect of the type of foam pad used in the modified Clinical Test of Sensory Interaction and Balance (mCTSIB) on the accuracy in identifying older adults with fall history. Hong Kong Physiother J 2020; 40:133-143. [PMID: 33005077 PMCID: PMC7526061 DOI: 10.1142/s1013702520500134] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 06/20/2020] [Indexed: 11/18/2022] Open
Abstract
Background The type of foam pad used in the modified Clinical Test of Sensory Interaction and Balance (mCTSIB) influences the accuracy with which elderly fallers are identified. Two types of foam are commonly used in practice: Airex and Neurocom foam. Objective The aim of this study was to assess the accuracy with which elderly fallers can be identified when the Airex foam and Neurocom foam are used in the mCTSIB. Methods One hundred eighty-four elderly participants with a mean age of 69 years were classified into faller and nonfaller groups based on their 12-month fall history. Balance stability was measured under four conditions of the mCTSIB for 120 s each: standing on a floor or a foam pad with their eyes open or eyes closed. The time needed to maintain stability was measured by a stopwatch, and postural sway characteristics were measured using an acceleration-based system. Comparisons between groups were performed by two-way mixed ANOVA. The accuracy of differentiating elderly fallers from nonfallers with different foam types was evaluated using receiver operating characteristic curve (ROC) analysis. The time to maintain stability under four conditions of the mCTSIB (composite score) and under two conditions on the foam (foam score) were used for the ROC analysis. Results The results showed that the nonfallers required more time to maintain stability and had a smaller sway area than the fallers ( p < 0 . 001 ). The foam led to a larger difference between groups, suggesting the use of foam in examining the risk of falls. The Airex and the Neurocom foam pads led to a large area under the curve (0.93 to 0.95) in identifying elderly fallers and nonfallers when the composite and foam scores were used. A cutoff score of 447/480 s for the composite score and 223/240 s for the foam score yielded a posttest accuracy of 88% to 89%, with a sensitivity of 0.80-0.92 and specificity of 0.88-0.95. Conclusion In conclusion, Airex and Neurocom foam can be used interchangeably with guidance in the mCTSIB, as they led to the accurate identification of elderly fallers among older persons who could walk and live independently in the community.
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Affiliation(s)
- Rumpa Boonsinsukh
- Faculty of Physical Therapy, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Bodin Khumnonchai
- Faculty of Physical Therapy and Sport Medicine, Rangsit University, Pathum Thani, Thailand
| | | | - Nithinun Chaikeeree
- Faculty of Physical Therapy, Srinakharinwirot University, Nakhon Nayok, Thailand
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