Look at Me: Early Gaze Engagement Enhances Corticospinal Excitability During Action Observation

Direct gaze is a powerful social cue able to capture the onlooker’s attention. Beside gaze, head and limb movements as well can provide relevant sources of information for social interaction. This study investigated the joint role of direct gaze and hand gestures on onlookers corticospinal excitability (CE). In two experiments we manipulated the temporal and spatial aspects of observed gaze and hand behavior to assess their role in affecting motor preparation. To do this, transcranial magnetic stimulation (TMS) on the primary motor cortex (M1) coupled with electromyography (EMG) recording was used in two experiments. In the crucial manipulation, we showed to participants four video clips of an actor who initially displayed eye contact while starting a social request gesture, and then completed the action while directing his gaze toward a salient object for the interaction. This way, the observed gaze potentially expressed the intention to interact. Eye tracking data confirmed that gaze manipulation was effective in drawing observers’ attention to the actor’s hand gesture. In the attempt to reveal possible time-locked modulations, we tracked CE at the onset and offset of the request gesture. Neurophysiological results showed an early CE modulation when the actor was about to start the request gesture looking straight to the participants, compared to when his gaze was averted from the gesture. This effect was time-locked to the kinematics of the actor’s arm movement. Overall, data from the two experiments seem to indicate that the joint contribution of direct gaze and precocious kinematic information, gained while a request gesture is on the verge of beginning, increases the subjective experience of involvement and allows observers to prepare for an appropriate social interaction. On the contrary, the separation of gaze cues and body kinematics can have adverse effects on social motor preparation. CE is highly susceptible to biological cues, such as averted gaze, which is able to automatically capture and divert observer’s attention. This point to the existence of heuristics based on early action and gaze cues that would allow observers to interact appropriately.

Combination SGLT2 inhibitor and GLP-1 receptor agonist therapy: a complementary approach to the treatment of type 2 diabetes

Among persons with type 2 diabetes (t2d), the development of glucose intolerance involves dysfunction in several organs and tissues, including the muscle, liver, pancreas, kidney, gastrointestinal tract, adipose tissue, and brain. individuals with t2d typically have a number of comorbidities, including hypertension, hyperlipidemia, and being overweight or obese, and are, consequently, at high cardiovascular risk. guidelines recommend a comprehensive care strategy that includes treatment of diabetes-related complications and comorbidities beyond those related to hyperglycemia. use of glucose-lowering therapies with complementary activities that address multiple facets of the disease may improve long-term outcomes for patients with t2d. two recent drug classes developed for use in t2d, glucagon-like peptide-1 receptor agonists (glp-1ras) and sodium glucose cotransporter 2 (sglt2) inhibitors, have been shown in clinical trials to have beneficial effects on glycemic control, body weight, cardiovascular risk factors, and (for liraglutide, semaglutide, and empagliflozin) cardiovascular outcomes, while having an acceptable safety profile. between them, these drug classes directly or indirectly affect many of the organs and tissues involved in the pathogenesis of t2d, and their beneficial effects on glycemic- and cardiovascular-related parameters are likely to be complementary and potentially additive. in the largest clinical trial of a glp-1ra and an sglt2 inhibitor in combination (duration-8), patients with t2d (n = 685) who received exenatide plus dapagliflozin added to their treatment regimen for 28 weeks had significantly greater reductions from baseline in glycated hemoglobin, body weight, and systolic blood pressure compared with patients who received either drug as monotherapy. this review summarizes the complementary aspects of these drug classes and presents the available data among patients receiving dual therapy with a glp-1ra and an sglt2 inhibitor.

Motor interference in interactive contexts

Action observation and execution share overlapping neural substrates, so that simultaneous activation by observation and execution modulates motor performance. Previous literature on simple prehension tasks has revealed that motor influence can be two-sided: facilitation for observed and performed congruent actions and interference for incongruent actions. But little is known of the specific modulations of motor performance in complex forms of interaction. Is it possible that the very same observed movement can lead either to interference or facilitation effects on a temporally overlapping congruent executed action, depending on the context? To answer this question participants were asked to perform a reach-to-grasp movement adopting a precision grip (PG) while: (i) observing a fixation cross, (ii) observing an actor performing a PG with interactive purposes, (iii) observing an actor performing a PG without interactive purposes. In particular, in the interactive condition the actor was shown trying to pour some sugar on a large cup located out of her reach but close to the participant watching the video, thus eliciting in reaction a complementary whole-hand grasp. Notably, fine-grained kinematic analysis for this condition revealed a specific delay in the grasping and reaching components and an increased trajectory deviation despite the observed and executed movement’s congruency. Moreover, early peaks of trajectory deviation seem to indicate that socially relevant stimuli are acknowledged by the motor system very early. These data suggest that interactive contexts can determine a prompt modulation of stimulus–response compatibility effects.

The left side of motor resonance

Motor resonance is defined as the internal activation of an observer's motor system, specifically attuned to the perceived movement. In social contexts, however, different patterns of observed and executed muscular activation are frequently required. This is the case, for instance, of seeing a key offered with a precision grip and received by opening the hand. Novel evidence suggests that compatibility effects in motor resonance can be altered by social response preparation. What is not known is how handedness modulates this effect. The present study aimed at determining how a left- and a right-handed actor grasping an object and then asking for a complementary response influences corticospinal activation in left- and right-handers instructed to observe the scene. Transcranial magnetic stimulation (TMS)-induced motor evoked potentials (MEPs) were thus recorded from the dominant hands of left- and right-handers. Interestingly, requests posed by the right-handed actor induced a motor activation in the participants' respective dominant hands, suggesting that left-handers tend to mirror right-handers with their most efficient hand. Whereas requests posed by the left-handed actor activated the anatomically corresponding muscles (i.e., left hand) in all the participants, right-handers included. Motor resonance effects classically reported in the literature were confirmed when observing simple grasping actions performed by the right-handed actor. These findings indicate that handedness influences both congruent motor resonance and complementary motor preparation to observed actions.

Grasping intentions: from thought experiments to empirical evidence

Skepticism has been expressed concerning the possibility to understand others' intentions by simply observing their movements: since a number of different intentions may have produced a particular action, motor information—it has been argued—might be sufficient to understand what an agent is doing, but not her remote goal in performing that action. Here we challenge this conclusion by showing that in the absence of contextual information, intentions can be inferred from body movement. Based on recent empirical findings, we shall contend that: (1) intentions translate into differential kinematic patterns; (2) observers are especially attuned to kinematic information and can use early differences in visual kinematics to anticipate the intention of an agent in performing a given action; (3) during interacting activities, predictions about the future course of others' actions tune online action planning; (4) motor activation during action observation subtends a complementary understanding of what the other is doing. These findings demonstrate that intention understanding is deeply rooted in social interaction: by simply observing others' movements, we might know what they have in mind to do and how we should act in response.

When emulation becomes reciprocity

It is well known that perceiving another's body movements activates corresponding motor representations in an observer's brain. It is nevertheless true that in many situations simply imitating another's actions would not be an effective or appropriate response, as successful interaction often requires complementary rather than emulative movements. At what point does the automatic tendency to mirror another's actions become the inclination to carry out appropriate, complementary movements? In the present study, single-pulse transcranial magnetic stimulation (TMS) was used to explore corticospinal excitability in participants observing action sequences evoking imitative or complementary movements. TMS was delivered at five time points corresponding to different moments in time when key kinematic landmarks characterizing an observed action occurred. A variation in motor evoked potentials (MEPs) confirmed that the motor system flexibly shifts from imitative to complementary action tendencies. That shift appears to take place very precociously in time. Observers are attuned to advance movement information and can use it to anticipate a future course of action and to prepare for an appropriate, complementary action. Altogether, these findings represent a step forward in research concerning social action-perception coupling mechanisms providing important data to better understand the role of predictive simulation in social contexts.