The effect of motor imagery on quality of movement when performing reaching tasks in healthy subjects: A proof of concept

IntroductionThe use of motor imagery (MI) has been shown to offer significant improvements in movement performance in sports, and is now receiving a lot of attention as a relatively new therapeutic approach which can be applied in rehabilitation. However, the effects of MI on the quality of movement is still unclear. This study explored the immediate effect of MI on reaching tasks in healthy subjects.Methods17 healthy individuals (33 ± 8.2 years) participated in the study. Surface electromyography (sEMG) and inertial measurement units (IMU) were used to identify muscle activity and angular velocity in both upper limbs. Participants performed a reach task using their dominant and non-dominant arms at their most comfortable speed, they were then asked to imagine themselves performing the same reaching task, and finally they were asked to repeat the reaching task.ResultsSignificant decreases were seen in the muscle activity between pre and post MI for Biceps Brachii, Anterior Deltoid and Triceps Brachii. In addition, a significant increase was seen in extension angular velocity post MI.DiscussionThe results indicate that the use of MI just after physical practice appears to have an immediate effect on the muscle activity and kinematics during a reaching task, which may suggest an improved quality of movement.ConclusionThis proof of concept study shows the potential for MI to improve the quality of performing reaching task and offers a possible therapeutic option for Stroke survivors and other neuromuscular disorders.     

Effects of cognitive- and motor-dual tasks on postural control regularity following anterior cruciate ligament reconstruction

BackgroundHigh injury rates following anterior cruciate ligament reconstruction (ACLR) motivate the need to better understand lingering movement deficiencies following return to sport. Athletic competition involves various types of sensory, motor, and cognitive challenges; however, postural control deficiencies during this spectrum of conditions are not well understood following ACLR.Research questionTo what extent is postural control altered following ACLR in the presence of sensory, motor, and cognitive challenges, and does postural control correlate with patient-reported symptoms?MethodsFourteen individuals following ACLR (4 m/10 f, 21.2 ± 2.4 yr, 76.9 ± 19.1 kg, 1.70 ± 0.14 m) and fourteen matched healthy controls (4 m/10 f, 21.2 ± 1.4 yr, 75.4 ± 15.3 kg, 1.70 ± 0.15 m) participated in the study. Participants completed single-leg balance, ACLR limb or matched side for controls, under four conditions: 1) eyes open, 2) eyes closed, 3) visual-cognitive dual task (i.e., reverse digit span), and 4) motor dual task (i.e., catching a ball). Sample entropy (SEn) was calculated for each balance condition to characterize regularity of center of pressure control. Participants also completed patient-reported outcomes to characterize self-reported knee function, symptoms, and fear. A mixed effects model tested for differences in SEn between balance conditions, and Spearman correlations tested for relationships between SEn and patient-reported outcomes.ResultsA significant Group-by-Condition interaction was detected (P = 0.043). While the motor dual task and eyes closed balance conditions were associated with the lowest SEn for both groups, only the visual-cognitive dual task condition demonstrated a significant difference between groups, with the ACLR group having lower SEn [95% confidence interval for ΔSEn: (0.03, 0.35)]. Lower KOOS-Sport scores were associated with decreased SEn for the ACLR group (ρ = 0.81, P < 0.001).SignificanceThese findings are consistent with ACLR individuals using a less automatic approach to postural control compared to controls, particularly when presented with a visual-cognitive challenge. Altered neuromuscular control persists well after ACLR surgery and can be related to patient-reported outcomes.     

Neural Correlates of Failed Inhibitory Control as an Early Marker of Disordered Eating in Adolescents

BackgroundBinge eating and other forms of disordered eating behavior (DEB) are associated with failed inhibitory control. This study investigated the neural correlates of failed inhibitory control as a potential biomarker for DEB.MethodsThe study used prospective longitudinal data from the European IMAGEN study adolescent cohort. Participants completed baseline assessments (questionnaires and a brain scan [functional magnetic resonance imaging]) at 14 years of age and a follow-up assessment (questionnaires) at 16 years of age. Self-reported binge eating and/or purging were used to indicate presence of DEB. Neural correlates of failed inhibition were assessed using the stop signal task. Participants were categorized as healthy control subjects (reported no DEB at both time points), maintainers (reported DEB at both time points), recoverers (reported DEB at baseline only), and developers (reported DEB at follow-up only). Forty-three individuals per group with complete scanning data were matched on gender, age, puberty, and intelligence (N = 172).ResultsAt baseline, despite similar task performance, incorrectly responding to stop signals (failed inhibitory control) was associated with greater recruitment of the medial prefrontal cortex and anterior cingulate cortex in the developers compared with healthy control subjects and recoverers.ConclusionsGreater recruitment of the medial prefrontal and anterior cingulate regions during failed inhibition accords with abnormal evaluation of errors contributing to DEB development. As this precedes symptom onset and is evident despite normal task performance, neural responses during failed inhibition may be a useful biomarker of vulnerability for DEB. This study highlights the potential value of prospective neuroimaging studies for identifying markers of illness before the emergence of behavior changes.     

Sustainability and switching of biologics for psoriasis and psoriatic arthritis at Fukuoka University Psoriasis Registry

Biologics are efficacious for treating psoriasis vulgaris (PsV) and psoriatic arthritis (PsA), but sometimes must be terminated or changed for various reasons including ineffectiveness or adverse events. To find the optimal choice of biologics for treating psoriasis, we analyzed the real‐world data on drug survival and the reason for terminating or switching biologics. Medical records from patients with PsV or PsA, who visited the Department of Dermatology, Fukuoka University Hospital from 2010 to 2017, were analyzed. Two hundred and eleven patients received biologics, and 147 patients (69.7%) were treated with only one biologic, while 64 patients (30.3%) were switched to different products. Frequently used biologics in PsV were ustekinumab (UST), infliximab and adalimumab when calculated by patient‐year. Tumor necrosis factor inhibitor (TNFi) use decreased while UST and interleukin (IL)‐17 inhibitors increased in newly introduced patients. UST showed the highest survival rate as a first‐line drug, but the advantage was lost in the second reagent's group. The major reasons for terminating/switching biologics were as follows: primary ineffectiveness (26.4%), secondary loss of efficacy (36.5%), patient's preference, including referral to nearby hospital, or stopped visiting (22.6%), side‐effects (7.7%), comorbidities (3.4%) and economic burden (2.4%). In PsA patients, TNFi are more frequently employed than in PsV patients, although switching to UST or IL‐17 inhibitors showed an increasing trend. Biologic reagents were changed mostly because of primary or secondary loss of efficacy, which affected drug survival. Further research is needed to find the optimal choice of biologics with larger samples at multiple facilities.     

Comparing Task Trainers to Standardized Patients for Gynecologic Assessment Skills

A quality improvement project was undertaken to assess nurse practitioner student feedback regarding low-fidelity task trainers and standardized patients for assessment of gynecologic exams. Initial practice with low-fidelity equipment helps students become familiar with equipment and technique, whereas use of standardized patients helps students apply those techniques and adapt them to individual persons. Use of standardized patients enabled students to engage in trauma-informed care while learning sensitive and proficient gynecologic exams. Barriers such as cost, availability of live models, and continued training will need to be addressed in future projects.     

Neuroimaging of valence decisions in children and adults

To date, the neural underpinnings of affective components in language processing in children remain largely unknown. To fill this gap, the present study examined behavioural and neural correlates of children and adults performing the same auditory valence decision task with an event-related fMRI paradigm. Based on previous findings in adults, activations in anterior and posterior cingulate cortex, orbitofrontal cortex and left inferior frontal gyrus were expected for both positive and negative valence categories. Recent behavioural findings on valence decisions showed similar ratings and reaction time patterns in children and adults. This finding was successfully replicated in the present study. On a neural level, our analysis of affective language processing showed activations in regions associated with both semantic (superior and middle temporal and frontal) and affective (anterior and posterior cingulate, orbitofrontal and inferior frontal, insula and amygdala) processing. Neural activations in children and adults were systematically different in explicit affective word processing. In particular, adults showed a more distributed semantic network activation while children recruited additional subcortical structures.