Motor imagery for paediatric neurorehabilitation: how much do we know? Perspectives from a systematic review

Background

Motor Imagery (MI) is a cognitive process consisting in mental simulation of body movements without executing physical actions: its clinical use has been investigated prevalently in adults with neurological disorders.

Objectives

Review of the best-available evidence on the use and efficacy of MI interventions for neurorehabilitation purposes in common and rare childhood neurological disorders.

Methods

systematic literature search conducted according to PRISMA by using the Scopus, PsycArticles, Cinahl, PUBMED, Web of Science (Clarivate), EMBASE, PsychINFO, and COCHRANE databases, with levels of evidence scored by OCEBM and PEDro Scales.

Results

Twenty-two original studies were retrieved and included for the analysis; MI was the unique or complementary rehabilitative treatment in 476 individuals (aged 5 to 18 years) with 10 different neurological conditions including, cerebral palsies, stroke, coordination disorders, intellectual disabilities, brain and/or spinal cord injuries, autism, pain syndromes, and hyperactivity. The sample size ranged from single case reports to cohorts and control groups. Treatment lasted 2 days to 6 months with 1 to 24 sessions. MI tasks were conventional, graded or ad-hoc. MI measurement tools included movement assessment batteries, mental chronometry tests, scales, and questionnaires, EEG, and EMG. Overall, the use of MI was stated as effective in 19/22, and uncertain in the remnant studies.

Conclusion

MI could be a reliable supportive/add-on (home-based) rehabilitative tool for pediatric neurorehabilitation; its clinical use, in children, is highly dependent on the complexity of MI mechanisms, which are related to the underlying neurodevelopmental disorder.

Self-Efficacy and the Digit Ratio in a Group of Sports University Students

Self-efficacy is one's awareness of being able to cope optimally with different situations. Perceived self-efficacy is a belief that closely involves emotional and personological functioning. In fact, when one perceives oneself as capable, the likelihood of success increases significantly. The aim of this research was to verify a possible correlation between self-efficacy and the Digit Ratio (2D:4D), referred to as prenatal androgen levels, and whether these correlate with some psychological variables, considering possible gender differences. This study involved 56 sports university students, whose 2D:4D ratio was calculated. Moreover, self-assessment questionnaires: the Self-efficacy Scale (SES), the Big Five Questionnaire-2 (BFQ-2), the Profile of Mood State (POMS), the State-Trait Anxiety Inventory Form Y (STAI-Y) and the Emotional Regulation Questionnaire (ERQ) were administered. The data show that the perceived levels of self-efficacy seem to be influenced by an innate predisposition linked to prenatal androgen values to which the subjects were exposed during uterine life (2D:4D). This negative correlation indicates that the higher the value of the digit ratio, the more likely it is that the level of perceived self-efficacy will be lower. Finally, the degree of perceived self-efficacy also seems to depend on the levels of subjective anxiety, understood both as a personological disposition and a contingent condition, and the latter also seems to be influenced by prenatal androgen levels, particularly in women.

Emotion Recognition: Photoplethysmography and Electrocardiography in Comparison

Automatically recognizing negative emotions, such as anger or stress, and also positive ones, such as euphoria, can contribute to improving well-being. In real-life, emotion recognition is a difficult task since many of the technologies used for this purpose in both laboratory and clinic environments, such as electroencephalography (EEG) and electrocardiography (ECG), cannot realistically be used. Photoplethysmography (PPG) is a non-invasive technology that can be easily integrated into wearable sensors. This paper focuses on the comparison between PPG and ECG concerning their efficacy in detecting the psychophysical and affective states of the subjects. It has been confirmed that the levels of accuracy in the recognition of affective variables obtained by PPG technology are comparable to those achievable with the more traditional ECG technology. Moreover, the affective psychological condition of the participants (anxiety and mood levels) may influence the psychophysiological responses recorded during the experimental tests.

Cognitive Performances: The Role of Digit Ratio (D2:D4) With a Protective Factor for Anxiety

This study aimed to identify a possible correlation between the D2:D4 ratio and state and/or trait anxiety in adult healthy subjects and, if so, whether it exists any difference between men and women. In addition, we also wanted to observe whether there is a relationship between participants' age and state and/or trait anxiety. The research involved 125 subjects of both sexes, who were calculated the D2:D4 ratio and were administered the self-assessment questionnaire State-Trait Anxiety Inventory (STAI-Y). Results show that there are positive significant correlations between the D2:D4 ratio and score at state anxiety and trait anxiety, in the total sample. However, if men are examined separately from women, it can be observed that only men have a statistically significant relationship between D2:D4 ratios and state anxiety and trait anxiety. Moreover, about possible relations between the age of participants and state and trait anxiety, a significant negative relationship was observed, without differences between men and women. However, only subjects with a D2:D4 ratio ≥ 1, without differences between men and women, showed a statistically significant negative linear correlation between their age and their state and trait anxiety. The present data allow us to conclude that a low D2:D4 ratio (<1) represents a protective factor against anxiety in both men and women and that this protection seems likely to act throughout life.

Effects of General Fatigue Induced by Exhaustive Exercise on Posture and Gait Stability of Healthy Young Men

Bipedal walking is a composite task requiring integration of many control circuitries in the brain and spinal cord. The present study was carried out to verify whether an increase in blood lactate, such as that associated with a high intensity exercise, is able to significantly modify the qualitative and/or quantitative aspects of human walking. Eighteen healthy physically male participants, aged between 20 and 24 years (M = 21.8, SD = 1.22), were recruited for the study. For this purpose, the experimental protocol included the measure of blood lactate levels with the aim of assessing possible relations between lactate blood values and different aspect of walking after an exhaustive exercise. An exhaustive exercise was associated with a strong increase of blood lactate levels and produced a significant worsening in the ability to maintain the bipodalic upright posture as well as the fluidity of walking. Our results suggest that exhausting bouts impose greater challenges on postural control.

Prediction of state anxiety by machine learning applied to photoplethysmography data

Background

As the human behavior is influenced by both cognition and emotion, affective computing plays a central role in human-machine interaction. Algorithms for emotions recognition are usually based on behavioral analysis or on physiological measurements (e.g., heart rate, blood pressure). Among these physiological signals, pulse wave propagation in the circulatory tree can be assessed through photoplethysmography (PPG), a non-invasive optical technique. Since pulse wave characteristics are influenced by the cardiovascular status, which is affected by the autonomic nervous activity and hence by the psychophysiological state, PPG might encode information about emotional conditions. The capability of a multivariate data-driven approach to estimate state anxiety (SA) of healthy participants from PPG features acquired on the brachial and radial artery was investigated.

Methods

The machine learning method was based on General Linear Model and supervised learning. PPG was measured employing a custom-made system and SA of the participants was assessed through the State-Trait Anxiety Inventory (STAI-Y) test.

Results

A leave-one-out cross-validation framework showed a good correlation between STAI-Y score and the SA predicted by the machine learning algorithm (r = 0.81; p = 1.87∙10⁻⁹). The preliminary results suggested that PPG can be a promising tool for emotions recognition, convenient for human-machine interaction applications.

Executive Functions During Submaximal Exercises in Male Athletes: Role of Blood Lactate

The present study was carried out among 20 healthy young male athletes to determine whether aerobic exercise performed at two different intensities is able to affect executive functions. For this purpose, we used the Stroop Color Word Test (SCWT) to evaluate the ability to inhibit cognitive interference and the Trail Making Test (TMT) to assess organized visual search, set shifting, and cognitive flexibility. Simple Reaction Time (RT), as a measure of perception and response execution, was also evaluated. The experimental protocol included the measure of blood lactate levels with the aim of assessing possible relations between lactate blood values and selected executive functions after a 30-min steady-state test performed at 60% and at 80% of VO2max. The results showed that a 30-min aerobic exercise is not associated with a worsening of executive functions as long as the blood lactate levels stay within the 4 mmol/l threshold.

Postural Control and Stress Exposure in Young Men: Changes in Cortisol Awakening Response and Blood Lactate

Background: It has recently been noticed that the quantity of stress affects postural stability in young women. The study was conducted with the goal of investigating whether increased stress may damagingly effect posture control in 90 young men (71 right-handed and 19 left-handed) while maintaining an upright bipedal posture, while keeping their eyes open or closed. Perceived Stress Scale (PSS) was administered and changes in free cortisol levels were monitored (Cortisol Awakening Response, CAR) in order to evaluate the amount of stress present during awakening, while the Profile of Mood States (POMS) was used to estimate distress on the whole. Posture control was evaluated with the use of a force platform, which, while computing a confidence ellipse area of 95%, was engaged by the Center of Pressure through five stability stations and was sustained for a minimum of 52 s, with and without visual input. Another goal of the experiment was to find out whether or not cortisol increases in CAR were linked with rises of blood lactate levels. Results: CAR, PSS and POMS were found to be extensively related. Furthermore, it has been observed that increases in salivary cortisol in CAR are associated with small but significant increases in blood lactate levels. As expected, stress levels did affect postural stability. Conclusions: The results of the present study confirm that the level of stress can influence postural stability, and that this influence is principally obvious when visual information is not used in postural control.

Postural Control and Stress Exposure in Young Men: Changes in Cortisol Awakening Response and Blood Lactate

BACKGROUND

It has recently been noticed that the quantity of stress affects postural stability in young women. The study was conducted with the goal of investigating whether increased stress may damagingly effect posture control in 90 young men (71 right-handed and 19 left-handed) while maintaining an upright bipedal posture, while keeping their eyes open or closed. Perceived Stress Scale (PSS) was administered and changes in free cortisol levels were monitored (Cortisol Awakening Response, CAR) in order to evaluate the amount of stress present during awakening, while the Profile of Mood States (POMS) was used to estimate distress on the whole. Posture control was evaluated with the use of a force platform, which, while computing a confidence ellipse area of 95%, was engaged by the Center of Pressure through five stability stations and was sustained for a minimum of 52 s, with and without visual input. Another goal of the experiment was to find out whether or not cortisol increases in CAR were linked with rises of blood lactate levels.

RESULTS

CAR, PSS and POMS were found to be extensively related. Furthermore, it has been observed that increases in salivary cortisol in CAR are associated with small but significant increases in blood lactate levels. As expected, stress levels did affect postural stability.

CONCLUSIONS

The results of the present study confirm that the level of stress can influence postural stability, and that this influence is principally obvious when visual information is not used in postural control.

Multi-Site Photoplethysmographic and Electrocardiographic System for Arterial Stiffness and Cardiovascular Status Assessment

The development and validation of a system for multi-site photoplethysmography (PPG) and electrocardiography (ECG) is presented. The system could acquire signals from 8 PPG probes and 10 ECG leads. Each PPG probe was constituted of a light-emitting diode (LED) source at a wavelength of 940 nm and a silicon photomultiplier (SiPM) detector, located in a back-reflection recording configuration. In order to ensure proper optode-to-skin coupling, the probe was equipped with insufflating cuffs. The high number of PPG probes allowed us to simultaneously acquire signals from multiple body locations. The ECG provided a reference for single-pulse PPG evaluation and averaging, allowing the extraction of indices of cardiovascular status with a high signal-to-noise ratio. Firstly, the system was characterized on optical phantoms. Furthermore, in vivo validation was performed by estimating the brachial-ankle pulse wave velocity (baPWV), a metric associated with cardiovascular status. The validation was performed on healthy volunteers to assess the baPWV intra- and extra-operator repeatability and its association with age. Finally, the baPWV, evaluated via the developed instrumentation, was compared to that estimated with a commercial system used in clinical practice (Enverdis Vascular Explorer). The validation demonstrated the system's reliability and its effectiveness in assessing the cardiovascular status in arterial ageing.

Risk-taking behavior, the second-to-fourth digit ratio and psychological features in a sample of cavers

Background

The risk-taking behavior is largely modulated by the subject's history, its lifestyles, by the characteristics of the situations with which it is compared, and also by the effects of prenatal androgens. Thus, the personality of the single person is a significant predictor of such way of acting.

Methods

The present study aimed to explore the relationship between Digit Ratio Measurement (2D:4D) and personality factors capable to be good predictors for choosing highly risky activities, such as caving. Furthermore, our purpose was to investigate whether 2D:4D ratio is related to cavers' affective states and to assess the personological and emotional features of 34 healthy cavers, aged between 24 and 71 years (M = 39.70, SD = 9.81).

Results

Data analysis showed several significant correlations between 2D:4D and Deliberate Risk Taking (RTI) and Precautionary Behavior (RTI), confirming that 2D:4D is a reliable index able to predict risk-taking behaviors. Furthermore, data analysis showed that Conscientiousness and its sub-dimension Scrupulousness (BFQ-2) are recurrent among significant correlations; in particular, the latter reports negative correlations with many factors of POMS. Moreover, all participants seemed to have a good attitude to collaboration, in terms of goal-direct strategy, and an adequate management of negative affective states, useful to maintaining a good level of stress within the group. Finally, the BFQ-2 factor Openness to culture seemed to be a predominant feature in the cavers, and this feature could be considered as predictive in the choice of an activity, such as caving, which requires curiosity, perseverance and a great planning of cave exploration.

Cognitive Deficits and White Matter Alterations in Highly Trained Scuba Divers

Nitrogen gas (N2), present in the normal atmospheric air, is a potential source of risk for scuba divers. It seems probable that myelin can represent, in hyperbaric conditions, a preferential site for the accumulation of N2 in central nervous system (CNS). The purpose of this study is to verify whether the practice of the scuba diving is capable to determine a damage of the brain white matter (WM) in a dose dependent manner and, consequently, possible deficiency of their cognitive abilities. For this purpose, 54 professional scuba divers (35 men and 19 women), with at least 2,000 dives in their careers, were studied. Possible alterations of brain WM were evaluated in terms of Fractional anisotropy (FA) by using Diffusion Tensor Imaging, whereas possible cognitive impairments were verified by means of neuropsychological testing, by studying: (1) General mental capability (2) Executive functioning; (3) Visuospatial construction such as Rey Complex Figure; (4) Attention and orientation: (5) Selective attention capacity and processing speed ability; (6) Memory. The results showed alteration of the WM in terms of changes in FA; these alterations, statistically significant but quantitatively quite modest, were mainly observed in the WM of the anterior part of the brain, whereas no differences were observed between left and right hemisphere. The alterations of the WM were associated with changes, also in this case statistically significant but quantitatively quite modest, of the cognitive functions, in particular of those dependent on the prefrontal cortex, such as attention and memory function. The present study leads to the conclusion that repeated dives, even performed in compliance with the current decompression tables, can progressively lead in the CNS to the formation of micro-lesions in the myelin sheet capable of altering the functioning of the neuron.

Role of lactic acid on cognitive functions

Objectives: The aim of this research was to establish cognitive changes in relation to blood lactate levels obtained during slow performance of a regimen of exercise sessions. Methods: A total of 15 male professional bodybuilders participated in the study; CrossFit® professionals performed the Workout 15.5, Week 5 Open 2015 consisting of 27-21-15-9 repetitions for time of Row (calories) and Thrusters, with 1-min recovery. Blood lactate, blood glucose, reaction time (RT), execution time of a dual cognitive task, number of errors, and number of omissions were measured at rest, at conclusion of the session, and after recovery for 15 min. Results: The bodybuilders had slightly elevated basal lactate levels than in untrained individuals. The bodybuilders showed significantly increased lactacidemia and decreased RT after completing the training session. Need to define what onset of blood lactate accumulation (OBLA) means. Conclusion: We conclude that bodybuilding fitness regimens lead to an increase in basal lactate levels to 3.16 mmol/L and that acute training sessions can improve attentional performance in relation to lactacidemia, suggesting pro-cognitive effects of a workout.

Ergojump evaluation of the explosive strength in volleyball athletes pre- and post-fascial treatment

It has previously been demonstrated that physiological mechanisms are involved in muscle pain and fatigue, as the nociceptive afferents of the fascial system are able to modulate the afferent response of the central nervous system. The purpose of the present study was to evaluate a sample of volleyball players, and investigate whether osteopathic treatment of the lower limb muscle groups improved the explosive force of the limbs, whilst reducing spasms and tension, releasing tissue strain and correcting posture. A randomized control study was performed to evaluate 57 athletes who underwent fascial manipulative treatment to assess if such treatment affected the muscle strength of the lower limbs. The treatment group demonstrated a statistically significant improvement in the squatting jump test (P<0.0001) and in the counter movement jump test (P<0.0001). Furthermore, the control group did not exhibit any improvement in the squatting jump test (P<0.56) or in the counter movement jump test (P<0.32). The results suggested that correction of the fascial system required a minimum time of 30 days in order to obtain an improvement of fascial mechanics and sports performance. Therefore, use of a fascial protocol during athletic training will help improve the balance of the bands and, as a direct consequence, improve the efficiency of the musculoskeletal system, thereby reducing the risk of injury. It would therefore be advisable to perform osteopathic treatment techniques every two months during an athletic season to maintain the balance of the fascial system and obtain the most efficient results.

Digit ratio, personality and emotions in skydivers

The aim of the present study was investigate if there is an association between second-to-fourth digit length (2D:4D) ratio and personality factors capable of serving as predictors of individual choice towards high-risk activities in a group of experts skydivers; Furthermore, their skills in regulating anxiety and emotions were assessed. The 2D:4D ratio of the right hand of 41 expert skydivers was measured and each of them completed four questionnaires: Big Five Questionnaire-2 (BFQ-2), Profile of Mood States (POMS), State-Trait Anxiety Inventory Form Y (STAI-Y) and Risk-Taking Inventory. Lower 2D:4D ratios did not appear associated with a greater propensity for taking risks but rather with a lower aptitude to assume precautions in unsafe conditions. In fact, the only sub-dimensions of personality, analyzed by the BFQ-2, correlated with the 2D:4D ratio were conscientiousness and agreeableness. Furthermore, prior to launch, the skydiver's level of stress, measured by the POMS, or state anxiety, measured by the STAI-Y, was not significantly correlated with 2D:4D ratio; whereas there was significant positive correlation between 2D:4D values and trait anxiety. Data analysis further revealed that social desirability correlated negatively with state anxiety and total mood disturbance index, and positively with emotion control. The present results suggest that lower 2D:4D ratio may represent a significant predictor of less attentive precautionary behavior when risk-taking.

Physiologically based microenvironment for in vitro neural differentiation of adipose-derived stem cells

The limited capacity of nervous system to promote a spontaneous regeneration and the high rate of neurodegenerative diseases appearance are keys factors that stimulate researches both for defining the molecular mechanisms of pathophysiology and for evaluating putative strategies to induce neural tissue regeneration. In this latter aspect, the application of stem cells seems to be a promising approach, even if the control of their differentiation and the maintaining of a safe state of proliferation should be troubled. Here, we focus on adipose tissue-derived stem cells and we seek out the recent advances on the promotion of their neural differentiation, performing a critical integration of the basic biology and physiology of adipose tissue-derived stem cells with the functional modifications that the biophysical, biomechanical and biochemical microenvironment induces to cell phenotype. The pre-clinical studies showed that the neural differentiation by cell stimulation with growth factors benefits from the integration with biomaterials and biophysical interaction like microgravity. All these elements have been reported as furnisher of microenvironments with desirable biological, physical and mechanical properties. A critical review of current knowledge is here proposed, underscoring that a real advance toward a stable, safe and controllable adipose stem cells clinical application will derive from a synergic multidisciplinary approach that involves material engineer, basic cell biology, cell and tissue physiology.

Effects of age and sex on epigenetic modification induced by an acute physical exercise

It has been observed that, after 2 hours of aerobic exercise, plasma interleukin-6 (IL-6) increases whereas nuclear concentrations of enzyme DNA methyltransferase (DNMT) 3B significantly decreased in peripheral blood mononuclear cells (PBMCs), with no change observed in DNMT3A. The aim of the present study was to detect differences in these changes induced by exercise in plasma IL-6 levels as well as in PBMC nuclear concentrations of DNMT3A and DNMT3B, in relation to age and sex. Four groups were studied: 12 young men (24.8 ± 1.77 years old), 12 young women (23.8 ± 1.81 years old), 12 adult men (45.8 ± 1.82 years old), 12 adult women (mean 44.5 ± 2.07 years old). Participants had to run at 60% of maximal oxygen consumption (VO2max) for 120 minutes, interspersed with sprints at 90% of VO2max for the last 30 seconds of every 10 minutes. About 250 μL of PBMCs (1 × 10 cells) were treated with 100 μL of either pre-exercise plasma or post-exercise plasma and nuclear DNMT3A and DNMT3B concentrations were quantified. No change in nuclear concentration of DNMT3A following the exercise was observed. Conversely, nuclear concentrations of DNMT3B significantly decreased, with a reduction of about 78% in young men, 72% in young women, 61% in adult men, and 53% in adult women. Moreover, a strong positive correlation between the nuclear concentration of DNMT3B in PBMC following stimulation with post-exercise plasma and post-exercise plasma concentrations of IL-6 was observed in all the 4 studied groups. This study confirms that a single bout of endurance exercise is sufficient to decrease nuclear concentrations of DNMT3B and thus protein upregulation. Moreover, the epigenetic mechanisms induced by exercise apparently cause more intense changes in men than in women and that, in both of them, this effect seems to decrease with age.

A subnanomolar concentration of Pituitary Adenylate Cyclase-Activating Polypeptide (PACAP) pre-synaptically modulates glutamatergic transmission in the rat hippocampus acting through acetylcholine

The neuropeptide PACAP modulates synaptic transmission in the hippocampus exerting multiple effects through different receptor subtypes: the underlying mechanisms have not yet been completely elucidated. The neurotransmitter acetylcholine (ACh) also exerts a well-documented modulation of hippocampal synaptic transmission and plasticity. Since PACAP was shown to stimulate ACh release in the hippocampus, we tested whether PACAP acting through ACh might indirectly modulate glutamate-mediated synaptic transmission at a pre- and/or at a post-synaptic level. Using patch clamp on rat hippocampal slices, we tested PACAP effects on stimulation-evoked AMPA receptor-mediated excitatory post-synaptic currents (EPSCs_AMPA) in the CA3-CA1 synapse and on spontaneous miniature EPSCs (mEPSCs) in CA1 pyramidal neurons. A subnanomolar dose of PACAP (0.5nM) decreased EPSCs_AMPA amplitude, enhanced EPSC paired-pulse facilitation (PPF) and reduced mEPSC frequency, indicating a pre-synaptic decrease of glutamate release probability: these effects were abolished by simultaneous blockade of muscarinic and nicotinic ACh receptors, indicating the involvement of endogenous ACh. The effect of subnanomolar PACAP was abolished by a PAC1 receptor antagonist but not by a VPAC receptor blocker. At a higher concentration (10nM), PACAP inhibited EPSCs_AMPA: this effect persisted in the presence of ACh receptor antagonists and did not involve any change in PPF or in mEPSC frequency, thus was not mediated by ACh and was exerted post- synaptically on CA1 pyramidal neurons. We suggest that a high-affinity PAC1 receptor pre-synaptically modulates hippocampal glutamatergic transmission acting through ACh. Therefore, administration of PACAP at very low doses might be envisaged in cognitive diseases with reduced cholinergic transmission.

Attentive processes, blood lactate and CrossFit®

OBJECTIVES

To analyze the influences of blood lactate produced during a specific session of CrossFit® on intensity and selectivity of attention. The first was evaluated by measuring the reaction time and the second by analyzing divided attention with a dual task.

METHODS

Fifteen male professionals of CrossFit® volunteered in the study. The training session was the Workout Of the Day (WOD) called 15.5, marked as: 27-21-15-9 repetitions (without recovery) in term of calories measured by using a rowing ergometer (e.g. 27 rowed calories) and in term of barbell full squats (raising a weight of 43 kg for men and of 29.5 kg for women). Blood lactate, blood glucose, reaction time, execution time of a dual task, number of errors and number of omissions were measured at rest, at the conclusion of the session and 15 minutes after its end.

RESULTS

The levels of the blood lactate before the start of the session were considerably higher than those which normally occur at rest (<2 mmol /L), with a mean value of 4.5 mmol /l (± 1.99 SD). At the end of the workout session the blood lactate exhibited a significant increase, reaching a mean value of 13.8 mmol /l (± 1.18 SD) and then returning to values similar to the initial ones after 15 minutes. Blood glucose did not exhibit any statistically significant differences during the session. Reaction time, execution time, number of errors and number of omissions exhibited a significant worsening concomitantly with the increase in blood lactate.

CONCLUSION

Athletes practicing CrossFit®, with high levels of blood lactate even at rest, should consequently have attentional performances somewhat limited.

Effects of an Exhaustive Exercise on Motor Skill Learning and on the Excitability of Primary Motor Cortex and Supplementary Motor Area

We examined, on 28 healthy adult subjects, the possible correlations of an exhaustive exercise, and the consequent high blood lactate levels, on immediate (explicit) and delayed (implicit) motor execution of sequential finger movements (cognitive task). Moreover, we determined with transcranial magnetic stimulation whether changes in motor performance are associated with variations in excitability of primary motor area (M1) and supplementary motor area (SMA). We observed that, after an acute exhaustive exercise, the large increase of blood lactate is associated with a significant worsening of both explicit and implicit sequential visuomotor task paradigms, without gender differences. We also found that, at the end of the exhaustive exercise, there is a change of excitability in both M1 and SMA. In particular, the excitability of M1 was increased whereas that of SMA decreased and, also in this case, without gender differences. These results support the idea that an increase of blood lactate after an exhaustive exercise appears to have a protective effect at level of primary cortical areas (as M1), although at the expense of efficiency of adjacent cortical regions (as SMA).

Where did the motor function of the cerebellum come from?

Until the end of 18th century, the role of the cerebellum remained obscure. The turning point occurred when Luigi Galvani showed that muscle contraction is due to electricity and Alessandro Volta produced the battery, an apparatus based on the pairing of silver and zinc plates separated by brine soaked paper disks, capable to generate electricity. Luigi Rolando, at beginning of 19th century, was impressed by these two observations. He thought that, since the brain generates the movement, it must contain a device generating electricity. As a battery, it should be formed by overlapping disks and the cerebellum for Rolando seemed to be the right structure for such a characteristic laminar organization. He argued that, if the cerebellum is the battery that produces electricity for muscle activity, its removal would produce paralysis. Consequently, Rolando removed the cerebellum in a young goat and observed that the animal, before dying, could no longer stand up. He concluded that the cerebellum is a motor structure as it generates the electricity which produces the movement. The conclusions of Rolando were criticized by Marie-Jean-Pierre Flourens who observed that animals undergoing cerebellectomy were still able to move, even if with problems of balance. Flourens concluded that the role of the cerebellum “is to put in order or to coordinate movements wanted by certain parts of the nervous system, excited by others”. It was necessary to wait up to 1891 when Luigi Luciani, observing a dog survived the cerebellectomy, described a triad of symptoms (asthenia, atony and astasis), unquestionably of cerebellar origin.

Evidence for a functional subdivision of Premotor Ear-Eye Field (Area 8B)

The Supplementary Eye Field (SEF) and the Frontal Eye Field (FEF) have been described as participating in gaze shift control. Recent evidence suggests, however, that other areas of the dorsomedial prefrontal cortex also influence gaze shift. Herein, we have investigated electrically evoked ear- and eye movements from the Premotor Ear-Eye Field, or PEEF (area 8B) of macaque monkeys. We stimulated PEEF during spontaneous condition (outside the task performance) and during the execution of a visual fixation task (VFT). In the first case, we functionally identified two regions within the PEEF: a core and a belt. In the core region, stimulation elicited forward ear movements; regarding the evoked eye movements, in some penetrations, stimulation elicited contraversive fixed-vectors with a mean amplitude of 5.14°; while in other penetrations, we observed prevalently contralateral goal-directed eye movements having end-points that fell within 15° in respect to the primary eye position. On the contrary, in the belt region, stimulation elicited backward ear movements; regarding the eye movements, in some penetrations stimulation elicited prevalently contralateral goal-directed eye movements having end-points that fell within 15° in respect to the primary eye position, while in the lateral edge of the investigated region, stimulation elicited contralateral goal-directed eye movements having end-points that fell beyond 15° in respect to the primary eye position. Stimulation during VFT either did not elicit eye movements or evoked saccades of only a few degrees. Finally, even though no head rotation movements were observed during the stimulation period, we viewed a relationship between the duration of stimulation and the neck forces exerted by the monkey's head. We propose an updated vision of the PEEF composed of two functional regions, core and belt, which may be involved in integrating auditory and visual information important to the programming of gaze orienting movements.

Stress exposure and postural control in young females

The aim of this study was to determine if heightened stress had an adverse affect on the postural control of 14 young right‑handed females during quiet standing in either the presence or the absence of visual input. The level of stress was evaluated by measuring the free cortisol response to awakening (cortisol awakening response; CAR) and by employing the perceived stress scale (PSS). Overall mood disturbance was measured using the profile of mood states (POMS). Postural control was evaluated using a force platform by measuring the 95% confidence ellipse area described by the center of pressure during 5 balance positions maintained for at least 52 sec, each with open and closed eyes. The results of this study revealed a significant positive correlation between CAR, PSS and POMS for each of the studied subjects. Furthermore, it was observed that whilst the level of stress was capable of influencing postural stability, this influence was particularly evident when no visual information was available. Additionally, it was determined that maintenance of posture is easier when the dominant foot is ahead, regardless of visual input.

Anthropometrics Related to the Performance of a Sample of Male Swimmers

The main purpose of the present investigation of 21 elite male swimmers was to assess whether the Ape Index (the ratio between the individual's arm span and height) and/or the second-to-fourth digit length ratio (2D:4D), i.e., the ratio between the length of the second and the fourth fingers of the right hand, are associated with the performance of high-level swimmers, when mood and / or executive function are covaried. The results showed no statistically significant correlation between the Ape Index and 2D:4D ratio, performance, executive function, or mood. In contrast, statistically significant correlations were found between 2D:4D ratio and performance, executive function, and mood. Regressions indicated that 2D:4D ratio and not Ape Index is related to the performances of a sample of male swimmers.

Attention and Blood Lactate Levels in Equestrians Performing Show Jumping

In equestrian show jumping, attention is particularly important to ensure maximum accuracy. Due to the anaerobic nature of the jumping and its requirement for precision coordination between human and horse, there may be a relation between the onset of lactic threshold and decrease in attention. In 12 healthy and injury-free equestrians (6 men, 6 women), the effects (blood lactate and glucose) of a show jumping course (250 m long with eight vertical obstacles with a height of 1.15 m height) on capacity and selectivity of attention was assessed. A typical reaction time paradigm and test of divided attention were administered. At the end of the course a significant increase of blood lactate was observed, whereas blood glucose did not significantly change. A deterioration of attention (intensity and selectivity) and a worsening of performance with increasing of blood lactate were observed. The present results led to the conclusion that the increase in blood lactate that occurs in riders executing a show jumping course is associated with worsening of both attentive capabilities and performance.

Consensus paper: current views on the role of cerebellar interpositus nucleus in movement control and emotion

In the present paper, we examine the role of the cerebellar interpositus nucleus (IN) in motor and non-motor domains. Recent findings are considered, and we share the following conclusions: IN as part of the olivo-cortico-nuclear microcircuit is involved in providing powerful timing signals important in coordinating limb movements; IN could participate in the timing and performance of ongoing conditioned responses rather than the generation and/or initiation of such responses; IN is involved in the control of reflexive and voluntary movements in a task- and effector system-dependent fashion, including hand movements and associated upper limb adjustments, for quick effective actions; IN develops internal models for dynamic interactions of the motor system with the external environment for anticipatory control of movement; and IN plays a significant role in the modulation of autonomic and emotional functions.

Changes in mood states and salivary cortisol levels following two months of training in elite female water polo players

Psychological and physiological markers have been used to maximize competitive sport preparation. The aim of the present study was to evaluate the effects of two months of training and competitions on mood states and salivary cortisol diurnal variation in 15 female elite water polo players. The results demonstrated that the β coefficient values of the regression slope of cortisol values on sampling time was significantly flatter following the training period. The values of the area under the cortisol curve (AUC) 'with respect to ground' (AUCg) and those of the β coefficients of the slope of the diurnal change in cortisol levels were highly negatively correlated. The slope correlated positively with the dysfunctional Profile of Mood States scale and negatively with the functional scale. AUCg correlated negatively with dysfunctional factors and positively with the vigor index. These findings support the hypothesis that subclinical hypocortisolism and a flattened diurnal rhythm of cortisol may play a role in determining dysfunctional mood states.

Recovery of damaged skeletal muscle in mdx mice through low-intensity endurance exercise

The lack of dystrophin in mdx mice leads to cycles of muscle degeneration and regeneration processes. Various strategies have been proposed in order to reduce the muscle-wasting component of muscular dystrophy, including implementation of an exercise programme. The aim of this study was to examine how low-intensity endurance exercise affects the degeneration-regeneration process in dystrophic muscle of male mdx mice. Mice were subjected to low-intensity endurance exercise by running on a motorized Rota-Rod for 5 days/week for 6 weeks. Histomorphological analysis showed a significant reduction of measured inflammatory-necrotic areas in both gastrocnemius and quadriceps muscle of exercised mdx mice as compared to matched sedentary mdx mice. The degenerative-regenerative process was also evaluated by examining the protein levels of connexin 39 (Cx39), a specific gene expressed in injured muscles. Cx39 was not detected in sedentary wild type mice, whereas it was found markedly increased in sedentary mdx mice, revealing active muscle degeneration-regeneration process. These Cx39 protein levels were significantly reduced in muscles of mdx mice exercised for 30 and 40 days, revealing together with histomorphological analysis a strong reduction of degeneration process in mice subjected to low-intensity endurance exercise. Muscles of exercised mdx mice did not show significant changes in force and fatigue resistance as compared to sedentary mdx mice. Overall in this study we found that specific low-intensity endurance exercise induces a beneficial effect probably by reducing the degeneration of dystrophic muscle.

Unique antineoplastic profile of Saquinavir-NO, a novel NO-derivative of the protease inhibitor Saquinavir, on the in vitro and in vivo tumor formation of A375 human melanoma cells

We have recently shown that covalent attachment of the nitric oxide (NO) moiety to the HIV protease inhibitor Saquinavir (Saq) produced a qualitatively new chemical entity, named Saquinavir-NO (Saq-NO), with enhanced anticancer properties and reduced toxicity both in vitro and in vivo. The aim of this study was to address several unanswered questions both on the pharmacological profile of Saq-NO as well as on the in vivo role of NO in the oncogenesis of A375 human melanoma cells. To this end, we have evaluated here the impact of single and combined effects of Saq-NO, Saq, the NO-donor DETA NONOate and the iNOS inhibitor L-NAME on the in vitro as well as in vivo growth of the iNOS positive A375 cells. Our data confirm clear-cut evidence for a strong and powerful anti-melanoma action of Saq-NO that is not duplicable by the combined use of Saq and DETA NONOate. Surprisingly, but also in agreement with the complex and multifaceted role of endogenous NO in A375 cells, both DETA NONOate and L-NAME significantly suppressed the in vivo growth of xenotransplants.

Creatine ingestion effects on oxidative stress in a steady-state test at 75% VO(2max)

AIM

The present study was carried out with the aim to analyze the role of creatine on oxidative stress during exercise, i.e. whether creatine is a pro-oxidative or an antioxidant substance.

METHODS

In a randomized double-blind study involving 30 adult males, we examined plasma lactate, oxidative stress markers (malondialdehyde, MDA) and glutathione redox ratio (GSSG·GSH-1), antioxidative systems (vitamins A, E, C), and ergospirometric responses (respiratory quotient and relative oxygen uptake) before and after 30 min steady-state tests 75% VO2max (placebo and creatine).

RESULTS

Ergospirometric tests, hematocrit values, blood lactate as well as vitamins A, E and C concentrations did not show significant differences between creatine and placebo testing. Conversely, oxidative stress markers MDA and GSSG·GSH-1 increased during placebo trials much more than in creatine trials.

CONCLUSION

This is the first report documenting that a creatine loading, i.e., a 0.3 g/kg/die of creatine ingestion for 5 consecutive days, could reduce the oxidative stress, whereas its consumption may not have a clear metabolic advantage in certain aerobic activities.

Therapeutic potential of carbon monoxide in multiple sclerosis

Carbon monoxide (CO) is produced during the catabolism of free haem, catalyzed by haem oxygenase (HO) enzymes, and its physiological roles include vasodilation, neurotransmission, inhibition of platelet aggregation and anti-proliferative effects on smooth muscle. In vivo preclinical studies have shown that exogenously administered quantities of CO may represent an effective treatment for conditions characterized by a dysregulated immune response. The carbon monoxide-releasing molecules (CORMs) represent a group of compounds capable of carrying and liberating controlled quantities of CO in the cellular systems. This review covers the physiological and anti-inflammatory properties of the HO/CO pathway in the central nervous system. It also discusses the effects of CORMs in preclinical models of inflammation. The accumulating data discussed herein support the possibility that CORMs may represent a novel class of drugs with disease-modifying properties in multiple sclerosis.

Physical and cognitive stimulation in Alzheimer Disease. the GAIA Project: a pilot study

Several data suggest that physical activity and cognitive stimulation have a positive effect on the quality of life (QoL) of people with Alzheimer's disease (AD), slowing the decline due to the disease. A pilot project was undertaken to assess the effect of cognitive stimulation, physical activity, and socialization on patients with AD and their informal caregiver's QoL and mood. Fourteen patients with AD were randomly divided into active treatment group and control group. At the end of treatment, a significant improvement in apathy, anxiety, depression, and QoL in the active treatment group was found. Considering caregivers, those of the active treatment group exhibited a significant improvement in their mood and in their perception of patients' QoL. This study provides evidence that a combined approach based on cognitive stimulation, physical activity, and socialization is a feasible tool to improve mood and QoL in patients with AD and their caregivers.

Neuronal activity reflecting progression of trials in the pre-supplementary motor area of macaque monkey: an expression of neuronal flexibility

We studied the activity of single neurons in the pre-supplementary motor area (pre-SMA) of macaque monkeys as they performed two visuomotor tasks, called the visual fixation task and the visual fixation-blink task. Both tasks involved a sequence of three visual stimuli, red followed by yellow and green. The tasks differed in that the latter one had a gap within the period of the red stimulus, called a "blink". The tasks were performed in two modes, one of which included movements of both the arm and eye and the other of which involved only eye movements. In the arm-eye mode, the monkeys had to press a bar and fixate the red stimulus that appeared after bar press. To receive a reward, both the bar press and visual fixation had to be maintained until the green stimulus triggered bar release. In the eye mode, bar press and bar release were eliminated from the task. Of the 42 neurons active during the visual fixation task, 15 showed task-related activity in both arm-eye and eye modes, and our analysis focused on these cells. We found that the introduction of the blink in visual fixation-blink task abolished the task-related activity of these cells over the course of 2-4 trials. This finding suggests a role for the pre-SMA in reflecting progression of trials as an updating of motor instruction.

The second-to-fourth digit ratio correlates with the rate of academic performance in medical school students

Prenatal androgens have important organizing effects on the development and future behavior of the brain. The second-to-fourth digit length ratio (2D:4D) has been proposed as a marker of these prenatal androgen effects, with a relatively longer fourth finger indicating higher prenatal androgen exposure. 2D:4D has been shown to predict the success of men who play sports and of financial traders. However, to date little is known regarding the effects of prenatal androgens on academic performance, for example, admission to and success in a highly competitive university system such as the state-run Italian medical schools. Here, we report the findings of a study conducted at the University of Catania Medical School, Italy, in which the 2D:4D ratio was sampled in a group of 48 male students. The 2D:4D ratios were found to be correlated with the performance of the students on the admission test to the medical school, their salivary testosterone levels and their aggressiveness; however, no correlation was observed with the mean score on exams during the course of study. Our results suggest that pre and/or postnatal androgens increase performance in situations that require prompt decision-making and the ability to take risks, but do not influence performance when a more analytical and planned approach is called for.

Neuronal NOS expression in rat's cuneate nuclei following passive forelimb movements and median nerve stimulation

Nitric oxide (NO) synthase (NOS) has been observed in the Cuneate Nuclei (CN), suggesting a role for NO in the modulation of their neurons' activity. The present study was undertaken to evaluate whether passive movement of forelimb as well as electric stimulation of medial nerve modulate the expression of neuronal isoform of NOS (nNOS) within CN. The experiments were carried out on 21 male Wistar rats, by using two different protocols. In the first group of rats the median nerve was stimulated with high frequency trains (phasic stimulation) or at constant frequency (tonic stimulation); as a control, in the third group, no stimulus was delivered. Moreover, in the second group of rats, we imposed to the animal's left forepaw circular paths at a roughly constant speed (continuous movement), or rapid flexions and extensions of the wrist (sudden movement); as a control, in the third group, no movement was imposed. After the experimental session, free-floating frontal sections of medulla oblongata were processed for nNOS or glutamate (GLU) immunohistochemistry. Phasic stimulation of the median nerve or sudden movements of the forelimb determines a significant decrement of the nNOS-positive neurons within the ipsilateral CN, whereas no effects were observed on GLU positive cells. We have also found a peculiar topographical distribution within IN of nNOS-positive neurons: positive cells were clustered at periphery of some "niches" having circular or elliptical form, with GLU positive cells at center.

Representation of movement velocity in the rat's interpositus nucleus during passive forelimb movements

The interpositus nucleus (IN) receives a large amount of sensory information from the limbs and, in turn, elaborates signals for movement control. In this paper, we tried to gather evidence on the possibility that neurons in the IN may elaborate sensory representations of the forelimb kinematics and, particularly, of the movement velocity vector. For this purpose, the forepaw of anesthetized rats was attached to a computer-controlled robot arm displaced passively along two types of trajectories (circular and figure eight), with the limb joints unconstrained. The firing activity of single cells was recorded and related to limb position and the two components of the movement velocity vector, namely, movement speed and direction. By using multiple regression analysis, we found that 12 out of 85 (14%) neurons were modulated by position, 18 out of 85 (21%) neurons were modulated by direction, 24 out of 85 (28%) neurons were modulated by movement speed, and 31 out of 85 (37%) neurons were sensitive to the full movement velocity vector. Most of the neurons modulated only by the speed component of the velocity vector (19 out of 24) were located in the posterior portion of the IN, whereas neurons in the anterior portion were mostly related to both components of the velocity vector. These results suggest that sensory information related to whole-limb movement velocity may be encoded by the IN, indicating also that the posterior interpositus may preferentially represent movement speed.

A galactose-free diet enriched in soy isoflavones and antioxidants results in delayed onset of symptoms of Krabbe disease in twitcher mice

Krabbe disease or globoid cell leukodystrophy is an autosomal recessively inherited disorder caused by the deficiency of galactocerebrosidase, the lysosomal enzyme that catalyzes the hydrolysis of galactose from galactosylceramide and galactosylsphingosine (psychosine). Psychosine accumulation results in the loss of myelin and oligodendrocytes in the brain of Krabbe patients as well as twitcher mice (natural model of human Krabbe disease). The aim of the present research was to investigate in twitcher mice the potential role of a diet deficient in galactose enriched in soy isoflavones and a pool of antioxidants molecules, such as l-glutathione, coenzyme Q10, xanthophylls, in counteracting the toxic effects derived by psychosine accumulation. A second goal of this manuscript was to demonstrate suppression of the apoptotic effects of psychosine in cultured oligodendrocyte progenitor mice cells (OLP-II) with antioxidants. The affected twitcher mice began the milk-derivatives free diet on post-natal day 15 although they also received mother's milk until post-natal day 18. Nevertheless, average life span was increased 50%, from 32+/-2 to 48+/-3 days, onset of tremor was delayed 17 days (from 21 days in the untreated twitcher mice to 38 days in the treated affected mice) and the gait in the treated mice was normal until almost a week after the untreated animals died (38+/-1 days versus 32 days at death). Weight gain in the treated animals also progressed to 38 days compared with 22 days for the untreated affected twitcher mice. Protection of the OLP-II cells against psychosine was shown using the MTT test (the ability of the tetrazolium salt MTT to form a dark blue formazan product by mitochondrial dehydrogenase in viable cells) and assay of expression of p53 and TNF-related apoptosis-inducing ligand (TRAIL). The results showed a time-dependent and concentration-dependent decrease of OLP-II viability on exposure to psychosine and dose-dependent protection with the antioxidants xanthophylls and glutathione. They also demonstrated that psychosine-induced p53 induction of apoptosis and TNF-related apoptosis-inducing ligand receptors could be decreased by l-glutathione and xanthophylls. A dietary approach may constitute a promising clinical management of the late-infantile and juvenile forms of Krabbe leukodystrophy.

Elevated blood lactate is associated with increased motor cortex excitability

No information has yet been provided about the influence of blood lactate levels on the excitability of the cerebral cortex, in particular, of the motor cortex. The aim of the present study was to examine the effects of high blood lactate levels, induced with a maximal cycling or with an intravenous infusion, on motor cortex excitability. The study was carried out on 17 male athletes; all the subjects performed a maximal cycling test on a mechanically braked cycloergometer, whereas 6 of them were submitted to the intravenous infusion of a lactate solution (3 mg/kg in 1 min). Before the exercise or the injection, at the end, as well as 5 and 10 min after the conclusion, venous blood lactate was measured and excitability of the motor cortex was evaluated by using the transcranial magnetic stimulation. In both of these experimental conditions, it was observed that an increase of blood lactate is associated with a decrease of motor threshold, that is, an enhancement of motor cortex excitability. We conclude by hypothesizing that in the motor cortex the lactate could have a protective role against fatigue.

Expression of cell fate determinants and plastic changes after neurotoxic lesion of adult mice spinal cord by cholera toxin-B saporin

Recent studies have attempted to repair the damaged spinal cord (SC) by stimulating neurogenesis or neuroplasticity. Sonic hedgehog (Shh), Notch-1 and Numb are involved in the stem cell functioning. Additionally, Notch-1 has a role as modulator of synaptic plasticity. However, little is known about the role of these proteins in the adult SC after removal of motoneurons. In this study, we have injected cholera toxin-B saporin into the gastrocnemius muscle to induce a depletion of motoneurons within the lumbar SC of adult mice, and analysed the expression of choline acetyltransferase (ChAT), Synapsin-I, Shh, Notch-1 and Numb proteins. The functional outcome of the lesion was monitored by grid walk and rotarod tasks. The neurotoxin lesion determined a motoneuron depletion and a transient decrease of ChAT, Synapsin-I, Shh and Numb levels in the lumbar SC. ChAT was associated with Synapsin-I expression and motor performance at 1 week but not 1 month after lesion, suggesting that the recovery of locomotion could depend on synaptic plasticity, at least in an early phase. Shh and Notch-1 were associated with Synapsin-I levels, suggesting a role in modulating synaptic plasticity. Numb expression also appeared reduced after lesion and linked to motor performance. Moreover, unlike other lesion models, we observed glial reaction but no evidence of cell proliferation within the depleted SC. Given the mentioned roles of Shh, Notch-1 and Numb, we believe that an in vivo manipulation of their signalling after lesion could represent a suitable way to improve functional recovery by modulating synaptic plasticity and/or neurogenesis.