Walking modulates visual detection performance according to stride cycle phase

Walking is among our most frequent and natural of voluntary behaviours, yet the consequences of locomotion upon perceptual and cognitive function remain largely unknown. Recent work has highlighted that although walking feels smooth and continuous, critical phases exist within each step for the successful coordination of perceptual and motor function. Here, we test whether these phasic demands impact upon visual perception, by assessing performance in a visual detection task during natural unencumbered walking. We finely sample visual performance over the stride cycle as participants walk along a smooth linear path at a comfortable speed in a wireless virtual reality environment. At the group-level, accuracy, reaction times, and response likelihood show strong oscillations, modulating at approximately 2 cycles per stride (~2 Hz) with a marked phase of optimal performance aligned with the swing phase of each step. At the participant level, Bayesian inference of population prevalence reveals highly prevalent oscillations in visual detection performance that cluster in two idiosyncratic frequency ranges (2 or 4 cycles per stride), with a strong phase alignment across participants.

Continuous peripersonal tracking accuracy is limited by the speed and phase of locomotion

Recent evidence suggests that perceptual and cognitive functions are codetermined by rhythmic bodily states. Prior investigations have focused on the cardiac and respiratory rhythms, both of which are also known to synchronise with locomotion-arguably our most common and natural of voluntary behaviours. Compared to the cardiorespiratory rhythms, walking is easier to voluntarily control, enabling a test of how natural and voluntary rhythmic action may affect sensory function. Here we show that the speed and phase of human locomotion constrains sensorimotor performance. We used a continuous visuo-motor tracking task in a wireless, body-tracking virtual environment, and found that the accuracy and reaction time of continuous reaching movements were decreased at slower walking speeds, and rhythmically modulated according to the phases of the step-cycle. Decreased accuracy when walking at slow speeds suggests an advantage for interlimb coordination at normal walking speeds, in contrast to previous research on dual-task walking and reach-to-grasp movements. Phasic modulations of reach precision within the step-cycle also suggest that the upper limbs are affected by the ballistic demands of motor-preparation during natural locomotion. Together these results show that the natural phases of human locomotion impose constraints on sensorimotor function and demonstrate the value of examining dynamic and natural behaviour in contrast to the traditional and static methods of psychological science.

Auditory Personalization of EMDR Treatment to Relieve Trauma Effects: A Feasibility Study [EMDR+]

According to the WHO (World Health Organization), Eye Movement Desensitization and Reprocessing (EMDR) is an elective therapy to treat people with post-traumatic stress disorders (PTSD). In line with the personalization of therapeutic strategies, through this pilot study, we assessed in people suffering from the effects of trauma the feasibility, safety, acceptance, and efficacy of EMDR enriched with sound stimulation (by administering neutral sounds synchronized with the guided bilateral alternating stimulation of the gaze) and musical reward (musical listening based on the patients' predisposition and personal tastes). Feasibility, quantified by the number of patients who completed the treatment, was excellent as this was the case in 12 out of the 12 enrolled people with psychological trauma. Safety and acceptance, assessed by self-compiled questionnaires, were excellent, with an absence of side effects and high satisfaction. Efficacy, quantified by the number of EMDR treatment sessions required to reach the optimal scores on the Subjective Units of Disturbance (SUD) and Validity of Cognition (VOC) scales typical of EMDR protocols, revealed an average duration of 8.5 (SD 1.2) sessions, which is well below the 12 sessions considered a standard EMDR treatment duration. EMDR+ appears to be a relevant personalization of EMDR, particularly in music-sensitive people, consolidating the therapeutic alliance through a multisensory communicative bond for trauma treatment.

Deep learning identifies cardiac coupling between mother and fetus during gestation

In the last two decades, stillbirth has caused around 2 million fetal deaths worldwide. Although current ultrasound tools are reliably used for the assessment of fetal growth during pregnancy, it still raises safety issues on the fetus, requires skilled providers, and has economic concerns in less developed countries. Here, we propose deep coherence, a novel artificial intelligence (AI) approach that relies on 1 min non-invasive electrocardiography (ECG) to explain the association between maternal and fetal heartbeats during pregnancy. We validated the performance of this approach using a trained deep learning tool on a total of 941 one minute maternal-fetal R-peaks segments collected from 172 pregnant women (20–40 weeks). The high accuracy achieved by the tool (90%) in identifying coupling scenarios demonstrated the potential of using AI as a monitoring tool for frequent evaluation of fetal development. The interpretability of deep learning was significant in explaining synchronization mechanisms between the maternal and fetal heartbeats. This study could potentially pave the way toward the integration of automated deep learning tools in clinical practice to provide timely and continuous fetal monitoring while reducing triage, side-effects, and costs associated with current clinical devices.

Investigating the effect of cholinergic and adrenergic blocking agents on maternal-fetal heart rates and their interactions in mice fetuses

This study examines the role of autonomic control of maternal and fetal heart rate variability (MHRV and FHRV) and their heartbeats phase coupling prevalence (CP_heartbeat) in mice. The subjects are divided into three groups: control with saline, cholinergic blockade with atropine, and β-adrenergic blockade with propranolol. Electrocardiogram signals of 27 anesthetized pregnant mice and 48 fetuses were measured for 20 min (drugs were administered after 10 min). For the coupling analysis, different maternal heartbeats were considered for one fetal beat. Results show that saline infusion did not produce any significant changes in MHRV and FHRV, as well as CP_heartbeat. Atropine increased maternal HR (MHR) and decreased MHRV significantly without any considerable effect on fetal HR (FHR) and FHRV. Propranolol infusion did not produce any significant changes in MHR and MHRV, but significantly decreased FHR and increased FHRV. Moreover, atropine had led to a decrease in CP_heartbeat when considering two and three maternal beats, and an increase for four beats; while propranolol resulted in a decrease for two heartbeats, but an increase for four and five beats. The proposed approach is useful for assessing the impact of maternal autonomic modulation activity on fetal distress and obstetric complications prevalent in pregnant mothers.

Summary: Autonomic development of fetal mice is analyzed through electrocardiography. Saline infusion does not alter maternal and fetal heart rate variation and coupling significantly. Atropine increases maternal heart rate, while propranolol lowers fetal heart rate.

Effects of cognitive workload on heart and locomotor rhythms coupling

Different physiological signals could be coupled under specific conditions, in some cases related to pathologies or reductions in system complexity. Cardiac-locomotor synchronization (CLS) has been one of the most investigating coupling. The influence of a cognitive task on walking was investigated in dual-task experiments, but how different cognitive tasks may influence CLS has poorly been investigated. Twenty healthy subjects performed a dual-task walking (coupled with verbal fluency vs calculation) on a treadmill at three different speeds (comfortable speed CS; fast-speed: CS + 2 km/h; slow-speed: CS-2 km/h) while cardiac and walking rhythms were recorded using surface electrodes and a triaxial accelerometer, respectively. According to previous studies, we found a cognitive-motor interference for which cognitive performance was affected by motor exercise, but not vice-versa. We found a CLS at the baseline condition, at fast speed in both cognitive tasks, while at comfortable speed only for the verbal fluency task. In conclusion, the cardiac and locomotor rhythms were not coupled at slow speed and at comfortable speed during subtraction task. Cognitive performances generally increased at faster speed, when cardiac locomotor coupling was stronger.

The Entrainment Frequency of Cardiolocomotor Synchronization in Long-Distance Race Emerges Spontaneously at the Step Frequency

In forced conditions, where the heart rate and step frequency have been matched, cardiolocomotor synchronization (CLS) has been recognized. However, knowledge about the occurrence of CLS and its triggers in sports gesture in real contexts is little known. To address this gap, the current study tested the hypothesis that CLS in running spontaneous conditions would emerge at entrainment bands of muscle activation frequencies associated with a freely chosen step frequency. Sixteen male long-distance runners undertook treadmill assessments running ten three-minute bouts at different speeds (7, 7.5, 8, 9, 10, 11, 12, 13, 14, and 15 km⋅h^–1). Electrocardiography and surface electromyography were recorded simultaneously. The center frequency was the mean of the frequency spectrum obtained by wavelet decomposition, while CLS magnitude was determined by the wavelet coherence coefficient (WCC) between the electrocardiography and center frequency signals. The strength of CLS affected the entrainment frequencies between cardiac and muscle systems, and for WCC values greater than 0.8, the point from which we consider the emerging CLS, the entrainment frequency was between 2.7 and 2.8 Hz. The CLS emerged at faster speeds (13–15 km⋅h^–1) most prevalently but did not affect the muscle activation bands. Spontaneous CLS occurred at faster speeds predominantly, and the entrainment frequencies matched the locomotor task, with the entrainment bands of frequencies emerging around the step frequencies (2.7–2.8 Hz). These findings are compatible with the concept that interventions that determine optima conditions of CLS may potentiate the benefits of the cardiac and muscle systems synchronized in distance runners.

Comparison of effect of aquatic interventions on cardiac modulation of obese young males in motion. A crossover trial

Study aim: The study aimed to compare the effects of passive Watsu therapy and immersion on cardiac locomotor synchronization of obese young males.

Material and methods: Twenty-six volunteer obese males participated in this study (age 18.3 ± 0.32, BMI 36.9 ± 6.52). Heart rate variability parameters were recorded in different positions by the Polar H7 heart rate sensor and HRV+ software. Participants were assigned to two groups, randomly, in a single-blinded crossover design. Kubios HRV 2.2 and MATLAB were used to analyze the bio-signals. Statistical analysis was performed via t-test and ANOVA (analysis of variance) using SPSS. For the significance in results and group comparison, the paired t-test and the independent t-test were used respectively.

Results: Combined results indicated that Watsu therapy increased 3 HRV vertical position parameters and immersion increased 3 HRV non-locomotor parameters, significantly (p < 0.05).

Conclusion: The findings show that Watsu and immersion improved the specific autonomic cardiac modulation. However, non-contact immersion seemed to provide better synchronization of cardiac control and locomotion. The close contact Watsu approach provided improvements in autonomic cardiac regulation. Collectively, these improvements suggest the combination of both therapies in maximizing the cardiac benefits sought by aquatic therapy programs.

Estimating Fetal Age by Fetal Maternal Heart Rate Coupling Parameters

Beat-by-beat maternal and fetal heart couplings were reported to be evident throughout the fetal development. However, it is still unknown whether maternal-fetal heartbeat coupling parameters are associated with fetal development, and the potential interrelationships. Therefore, this study aims to investigate the associations of coupling parameters with fetal gestational age by multivariate regression models. Ten min abdominal lead-based maternal and fetal ECG signals were collected from 16 healthy pregnant women with healthy singleton pregnancies (19-32 weeks). Maternal and Fetal Heart Rate Variability (MHRV and FHRV) values as well as maternal-fetal heart rate coupling (strength, measured by A) parameters at various coupling ratios (associated with different Maternal:Fetal heartbeat ratios of 1:2, 1:3, 2:3, 2:4, 3:4, and 3:5) were calculated. Based on those features stepwise multivariate regression models were constructed by validating against the gold standard gestational age identified by crown-rump length from doppler echocardiogram. Among all models, the best model (Root Mean Square Error, RMSE=1.92) was found to be significantly (p<0.05) associated with mean fetal heart rate, mean maternal heart rate, standard deviation of maternal heart rate, λ[1:3], λ[2:3], λ[2:4]. Correlation coefficients and Bland Altman plots were constructed to statistically validate the results. The model developed based on coupling parameters only, showed the second-best performance (RMSE=2.50). Therefore, combining maternal and fetal heart rate variability parameters with maternal-fetal heart rate coupling values (rather than considering FHRV or MHRV parameters only) is found to be better associated with fetal development.Clinical relevance- This is a brief additional statement on why this might be of interest to practicing clinicians. Example: This establishes the anesthetic efficacy of 10% intraosseous injections with epinephrine to positively influence cardiovascular function.

Enhancement of Synchronization between Physiological Signals during Exercise: A Preliminary Investigation

During running, interactions were considered between three physiological oscillators - the heart, breaths, and steps. During intense exercise, the oscillations of all three systems are close to regular, producing good conditions to observe and characterise synchronization. The origin, as well as any physiological significance, of synchronization between these systems during running is not fully accepted or understood. Furthermore, the impact on synchronization of controlling both breathing and step rate has not been previously reported in detail. This study aims to measure cardiolocomotor, cardiorespiratory and respiratory- locomotor synchronization during different running protocols. Breathing was controlled by taking a fixed number of steps per breath (ratios of 5:1 and 3:1). Step rate was then guided at rates close to active heart rate, to instigate 1:1 phase-locking. Instantaneous phase difference quantified synchronization episodes. We have successfully observed all three forms of synchronization during all running protocols. Furthermore, coupling between heartbeats and steps was more pronounced when step rate was guided, and both cardiorespiratory and respiratory-locomotor coupling were extended when breathing rate was fixed to steps. These are exciting initial results from a novel experimental design, highlighting the complex interconnection that exists between these three systems during running, and the conditions to best observe the phenomena.

Effect of β-blocker on maternal-fetal heart rates and coupling in pregnant mice and fetuses

The aim of this preliminary study is to look how maternal-fetal heart rates and their coupling patterns are influenced by injection of β blocker(propranolol) into pregnant mice. Total of 6 pregnant female mice were divided into two groups [control (N=3) and β blockade (N=3)]. On 17.5-day mean heart rate of mothers and fetuses (MHR and FHR) were simultaneously measured for 20 minutes (10 minutes under normal condition and 10 minutes with saline (to control group) and propranolol (to the β blockade group) solution by using an invasive maternal and fetal electrocardiogram techniques with needle electrodes. Results show that FHR decreased and maternal-fetal heart rate coupling (λ) patterns changed with propranolol infusion (no change with saline). Statistical test showed that changes (increase/decrease from pre to post values) in mean, rmssd and power spectral density (PSD) (2~4 Hz)) of MHR, short term variability of FHR, PSD (0.0~1.0 Hz) of FHR and λ were found to be significantly associated with treatment types (saline to propranolol). The presented results and protocol allow for assessment of β adrenergic control of maternal and fetal heart, which will further enhance the value of the mouse as a model of heritable human pregnancy and hypertension.

Regulation of maternal-fetal heart rates and coupling in mice fetuses

The aim of this preliminary study is to investigate if there is any evidence of maternal-fetal heart rate coupling in mice fetuses and how the coupling patterns are regulated by vagal nervous system on beat by beat. Total of 6 pregnant female mice were divided into two groups [control (N=3) and vagal blockade (N=3)]. On 17.5-day beat-to-beat heart rates of mothers and fetuses (MHR and FHR) were simultaneously measured for 20 minutes (10 minutes under normal condition and 10 minutes with saline (to control group) and atropine (to the vagal blockade group)) solution by using an invasive maternal and fetal electrocardiogram techniques with needle electrodes. Results show that occasional strong maternal-fetal heart rate coupling (strength was measured by $\lambda$) appeared and its patterns changed with atropine infusion (no change with saline). Additionally, fisher's exact test shows that changes (increase/decrease from pre to post injection values) in mean, rmssd and power spectral density (PSD) (2~4 Hz) of MHR, rmssd FHR and PSD (2~4 Hz) of${\lambda }$were found to be significantly (p<0.05) associated with treatment types (saline/ atropine). The presented results and protocol allow for the first time in the assessment of autonomic regulation of maternal and fetal heart and their interactions, which will further enhance the value of the mouse as a murine model of heritable human pregnancy and perinatal complications due to maternal conditions.

Preliminary Evaluation of Fetal Congenital Heart Defects Changes on Fetal-Maternal Heart Rate Coupling Strength

Monitoring fetal heart rate in an important aspect in evaluating fetal well being. Maternal-fetal interaction has shown evolution during fetal maturation. In this work, we studied maternal-fetal heart rate synchronization in early and late gestation fetuses. We also evaluated variations in the synchronization due to congenital heart defect (CHD). Maternal-fetal heart rate synchronization for 22 early gestation (Age < 32 weeks), $late gestation (Age >32 weeks) and 7 CHD fetuses (5 of them with gestational age < 32 weeks). The synchronization ratio between the mother and the fetus was more localized at certain fetus heart rate in the early gestation group while it was spreading over more fetal heart rate for the late group. For example, for maternal primary cycle of 3 beat- to-beat (m=3), the synchronization ratio of 5 fetus beats (n=5) contributed 60±30% of the whole coupling ratios for the early group while it contributed 30°30% for the late group (p< 0.01). On the other hand, the coupling ratio of m:n=3:7 contributed 4±17% of the early group and 13±24% for the late group (p< 0.05). The standard deviation of the phase coherence index $(\lambda_{-\mathrm{S}\mathrm{D}})$ for both the late and the CHD groups were significantly higher than the early group at different values. For example, $\lambda -\mathrm{S}\mathrm{D} was 0.006\pm 0.004$ for the early group while it was 0.009±0.008 for the late group (p< 0.01) and 0.01± 0.002 for the CHD group (p< 0.01) for m=3. The variation between the early and late normal groups might indicate a healthy development of the autonomic nervous system while the higher variation in the CHD group could be a good marker for impairment of the cardiac autonomic activity. Further coupling analysis with more abnormal cases is needed to verify these findings.

3Mo: A Model for Music-Based Biofeedback

In the domain of sports and motor rehabilitation, it is of major importance to regulate and control physiological processes and physical motion in most optimal ways. For that purpose, real-time auditory feedback of physiological and physical information based on sound signals, often termed “sonification,” has been proven particularly useful. However, the use of music in biofeedback systems has been much less explored. In the current article, we assert that the use of music, and musical principles, can have a major added value, on top of mere sound signals, to the benefit of psychological and physical optimization of sports and motor rehabilitation tasks. In this article, we present the 3Mo model to describe three main functions of music that contribute to these benefits. These functions relate the power of music to Motivate, and to Monitor and Modify physiological and physical processes. The model brings together concepts and theories related to human sensorimotor interaction with music, and specifies the underlying psychological and physiological principles. This 3Mo model is intended to provide a conceptual framework that guides future research on musical biofeedback systems in the domain of sports and motor rehabilitation.