Stressors and coping styles of nursing students in the middle period of clinical practicum: a qualitative study.

BACKGROUND: Nursing students encounter various stressors during their clinical practicum; however, the stressors are not the same during different periods. At present, studies on the stressors and coping styles of nursing students in the middle period of their clinical practicum are rare. AIMS: The current study aimed to explore the stressors and coping styles of nursing students in the middle period of their clinical practicum. METHODS: A qualitative study with a descriptive phenomenological method was conducted to collect data from 10 nursing students undergoing the middle period of their clinical practicum from December 2020 to February 2021. The data were collected by semistructured interviews using interview outlines prepared in advance. The data were analyzed by Colaizzi's analysis method. RESULTS: The stressors experienced by nursing students in the middle period of their clinical practicum mainly included personal reasons, teaching arrangements, interpersonal relationships, occupational particularity and career planning. Additionally, nursing students coped with the stressors that they face in the clinical practicum by eliminating stressors and regulating emotions. CONCLUSIONS: Nursing students experienced various stressors and used a variety of coping styles in the middle period of their clinical practicum, which was different from what occurred in the early and late periods. Targeted interventions should be formulated and implemented to relieve nursing students' stress and guide them to adopt effective coping styles.

Factor structure and reliability of the symptom measurement of post-stroke depression in the rehabilitation stage.

BACKGROUND: The incidence of Post Stroke Depression (PSD) in the Rehabilitation Stage is high, which can bring serious physical and psychological disorders to patients. However, there is still a lack of targeted tools for screening PSD in the rehabilitation stage. Therefore, the aim of this study was to evaluate the factor structure and reliability of a measurement instrument to screen for PSD in the rehabilitation stage. METHODS: A cross-sectional study was conducted on 780 hospitalized stroke patients who were within the rehabilitation stage from May to August 2020. Exploratory factor analysis (EFA) as well as first- and second-order confirmatory factor analysis (CFA) were performed to evaluate the factor structure of the newly developed Symptom Measurement of Post-Stroke Depression in the Rehabilitation Stage (SMPSD-RS). The reliability and validity of the SMPSD-RS were also verified using several statistical methods. RESULTS: EFA extracted a 24-item, five-factor (cognition, sleep, behavior, emotion, and obsession) model that can clinically explain the symptoms of PSD during the rehabilitation stage. A first-order CFA confirmed the EFA model with good model fit indices, and the second-order CFA further confirmed the five-factor structure model and showed acceptable model fit indices. Acceptable reliability and validity were also achieved by the corresponding indicators. CONCLUSION: The SMPSD-RS was proven to have a stable factor structure and was confirmed to be reliable and valid for assessing PSD symptoms in stroke patients during the rehabilitation stage.

The effect of sleep problems on core self-evaluations in undergraduate nursing students and the role of emotion regulation and resilience: A cross-sectional study.

BACKGROUND: Nursing students are prone to sleep problems that affect their core self-evaluations. However, little attention has been paid to the specific roles of emotion regulation (including cognitive reappraisal and expressive suppression) and resilience in this process. OBJECTIVES: This study aimed to explore 1) the direct effect of sleep problems on core self-evaluations among nursing students; 2) the chain-mediating effect of cognitive reappraisal and resilience on the relationship between sleep problems and core self-evaluations; 3) the moderating effect of expressive suppression on the direct relationship between sleep problems and core self-evaluations; and 4) the moderating effect of expressive suppression on the indirect relationship between sleep problems affecting core self-evaluations through resilience. METHODS: A total of 345 nursing students completed a survey conducted between September and October 2022. Data was analyzed using descriptive analysis, Fisher exact test, Kruskal-Wallis H test, Spearman correlation analysis, and hierarchical regression analysis. Additionally, the SPSS PROCESS V4.0 plug-in was used to verify the moderated chain-mediating effect. RESULTS: Sleep problems directly affected core self-evaluations among nursing students. Cognitive reappraisal and resilience played a partial chain-mediating role in the relationship between sleep problems and core self-evaluations, with expressive suppression having a direct moderating effect. CONCLUSIONS: Opportunities exist for enhancing the core self-evaluations of nursing students by addressing their sleep problems, promoting cognitive reappraisal strategies, and increasing resilience. Additionally, encouraging expressive suppression can mitigate the negative impact of sleep problems on nursing students' core self-evaluations.

Alterations in regional homogeneity and functional connectivity in the cerebellum of patients with sporadic amyotrophic lateral sclerosis.

OBJECTIVE: The purpose of this study was to examine the cerebellum's local and global functional characteristics in individuals with sporadic amyotrophic lateral sclerosis (sALS) and their correlation with clinical data. METHODS: Resting-state functional magnetic resonance imaging was performed on 39 patients with sALS and on 23 healthy controls. Regional homogeneity (ReHo) in the cerebellum of all participants was analyzed, and the cerebellar regions with differences in ReHo were considered regions of interest (ROIs). In addition, the functional connectivity between the ROIs and other brain regions was analyzed. RESULTS: In patients with sALS, ReHo increased in parts of the posterior cerebellar lobe. Then, the two regions with increased ReHo of the cerebellum were used as seeds, and further analysis revealed that the connectivity of the right cerebellum to the right medial superior frontal gyrus, left lingual gyrus (calcarine sulcus), left precentral gyrus, left supplementary motor area, and right Crus II was significantly increased. CONCLUSION: The results demonstrate that resting-state functional connectivity changes in both motor and extra-motor regions of the cerebellum in patients with sALS, and that the cerebellum plays a pathophysiological role in sALS.

Emotion regulation in undergraduate nursing students: A latent profile analysis.

BACKGROUND: Current research on emotion regulation of undergraduate nursing students mainly focused on the overall level of emotion regulation and its relationship with other variables, ignoring the individual heterogeneity of emotion regulation of undergraduate nursing students. AIM: By latent profile analysis (LPA), this study aimed to identify different emotion regulation profiles among undergraduate nursing students and to explore demographic and personal factors associated with different emotion regulation profiles. METHOD: This was a cross-sectional study. A total of 578 nursing students were investigated by the demographic questionnaire, the emotion regulation scale, the Connor-Davidson resilience scale-10 item and the core self-evaluations scale. LPA was used to analyze the latent profiles of emotion regulation among undergraduate nursing students. And multiple logistic regression was used to explore the predictors of different profiles. RESULT: Three potential profiles were identified: profile 1-- low suppression and moderate reappraisal group, profile 2-- moderate suppression and high reappraisal group, profile 3-- high suppression and high reappraisal group. Resilience, family monthly income and perception of nursing profession were predictors of different profiles. CONCLUSION: Most nursing students were classified into profile 2 and their emotion regulation was relatively good. However, students in profile 1 were with moderate cognitive reappraisal and students in profile 3 were with high expressive suppression, and their emotion regulation need to be further improved by increasing their cognitive reappraisal and decreasing their expressive suppression. Strategies tails to improve resilience, increase scholarships and change the perception of nursing profession may be effective ways to improve emotion regulation of undergraduate nursing students in different profiles.

Psychometric properties of the post-stroke depression scale in the sequelae stage.

Aim: To evaluate the psychometric properties of the Post-Stroke Depression Scale in the Sequelae Stage (PSDS-SS). Background: The incidence of the sequelae stage Post-Stroke Depression (PSD) is high, and the best screening tools are still lacking. Under this circumstances, our research team developed the PSDS-SS by Delphi method, but its psychometric properties need to be further verified. Method: This was a cross-sectional study. Seven hundred and sixteen stroke patients in the sequelae stage were enrolled by purpose sampling from May 2022 to September 2022. The exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to verify the factor structure of the scale. The reliability of the scale was tested by Cronbach's α coefficient, test-retest reliability and composite reliability. The validity of the scale was tested by criterion-related validity, convergent and discriminant validity. Result: Eight items were deleted through item analysis. The EFA ended up with a 5-factor scale including 24 items after removing one item with low factor loading. Finally, a 21-item model was established by confirmatory factor analysis, and all the fit indexes were acceptable. The reliability and validity of the total scale and each factor are acceptable. Conclusion: The PSDS-SS has a stable factor structure, and demonstrated good reliability and validity. And it would be an effective tool to assess PSD in the sequelae stage.

Eight-week antidepressant treatment changes intrinsic functional brain topology in first-episode drug-naïve patients with major depressive disorder.

BACKGROUND: A recent study revealed disrupted topological organization of whole-brain networks in patients with major depressive disorder (MDD); however, these results were mostly driven by recurrent MDD patients, rather than first-episode drug-naïve (FEDN) patients. Furthermore, few longitudinal studies have explored the effects of antidepressant therapy on the topological organization of whole-brain networks. METHODS: We collected clinical and neuroimaging data from 159 FEDN MDD patients and 152 normal controls (NCs). A total of 115 MDD patients completed an eight-week antidepressant treatment procedure. Topological features of brain networks were calculated using graph theory-based methods and compared between FEDN MDD patients and NCs, as well as before and after treatment. RESULTS: Decreased global efficiency, local efficiency, small-worldness, and modularity were found in pretreatment FEDN MDD patients compared with NCs. Nodal degrees, betweenness, and efficiency decreased in several networks compared with NCs. After antidepressant treatment, the global efficiency increased, while the local efficiency, the clustering coefficient of the network, the path length, and the normalized characteristic path length decreased. Moreover, the reduction rate of the normalized characteristic path length was positively correlated with the reduction rate of retardation factor scores. LIMITATIONS: The interaction effects of groups and time on the topological features were not explored because of absence of the eighth-week data of NC group. CONCLUSIONS: The topological architecture of functional brain networks is disrupted in FEDN MDD patients. After antidepressant therapy, the global efficiency shifted toward recovery, but the local efficiency deteriorated, suggesting a correlation between recovery of retardation symptoms and global efficiency.

Aberrant modular segregation of brain networks in female patients with bulimia nervosa.

OBJECTIVE: Bulimia nervosa (BN) is an eating disorder associated with the dysfunction of intrinsic brain networks. However, whether the network disruptions in BN patients manifest as dysconnectivity or imbalances of network modular segregation remains unclear. METHOD: We collected data from 41 women with BN and 41 matched healthy control (HC) women. We performed graph theory analysis based on resting-state functional magnetic resonance imaging (RS-fMRI) data; then, we computed the participation coefficient (PC) among brain modules to characterize the modular segregation for the BN and HC groups. The number of intra- and inter-modular connections was calculated to explain the PC changes. Additionally, we examined the potential associations of the measures mentioned above with clinical variables within the BN group. RESULTS: Compared with the HC group, the BN group showed significantly decreased PC in the fronto-parietal network (FPN), cingulo-opercular network (CON), and cerebellum (Cere). Additionally, the number of intra-modular connections of the default mode network (DMN) and the number of the inter-modular connections between the DMN and CON, FPN and Cere, and CON and Cere in the BN group were lower than those in the HC group. The nodal level analysis showed that the BN group had a decreased PC of the anterior prefrontal cortex (aPFC), dorsal frontal cortex (dFC), inferior parietal lobule (IPL), thalamus, and angular gyrus. Further, these metrics were significantly correlated with clinical variables in the BN group. DISCUSSION: These findings may provide novel insights to capture atypical topologies associated with pathophysiology mechanisms and clinical symptoms underlying BN.

Corrigendum: Development and initial validation of a clinical measure to assess symptoms of post-stroke depression in stroke patients at the rehabilitation stage.

[This corrects the article DOI: 10.3389/fpsyg.2022.928257.].

Development and initial validation of a clinical measure to assess symptoms of post-stroke depression in stroke patients at the rehabilitation stage.

Background: The high incidence of post-stroke depression (PSD) during rehabilitation exerts a negative effect on the treatment and functional recovery of patients with stroke and increases the risk of mortality. It is necessary to screen PSD in the rehabilitation stage and thus provide effective intervention strategies. However, existing measurements used to assess PSD in the rehabilitation stage in patients with stroke lack specificity. This study aimed to develop a clinical measure to assess symptoms of PSD in the rehabilitation stage. Methods: The research team created the initial items through a literature review and semi-structured interviews of patients with stroke. Then, the symptom-related items were estimated by three panels: healthcare professionals (N = 41), Delphi experts (N = 15), and patients with stroke in the rehabilitation stage (N = 30). Results: The literature review and semi-structured interview produced 51 symptom-related items including six domains, and the items were reduced to 47 by the healthcare professionals. The symptom-related items were further reduced to 33 items by a two-round Delphi consultation. The initiative coefficients of the two Delphi rounds were 71.4 and 100%, the expert authority coefficients were both 0.85, Kendall's W were 0.152 and 0.408 (p < 0.01), and the coefficient of variation (CV) were 0.05-0.32 and 0.00-0.18, respectively. The item-level content validity index (I-CVI) was 0.53-1.00, the scale-level CVI/universal agreement (S-CVI/UA) was 0.26, and the S-CVI/average (S -CVI/Ave) was 0.85 for the first found Delphi consultation; the I-CVI was 0.67-1.00, the S-CVI/UA was 0.61, and the S-CVI/Ave was 0.97 for the second round Delphi consultation. All content validity indicators have been significantly improved compared with the first round. Using mean ≥ 4 and full score ≥ 0.5, combined with CV ≤ 0.16 as the item criteria, a clinical measure of PSD with 33 items and 6 dimensions (cognition, sleep, behavior, emotion, body, and guilt) was finally formed after two rounds. The patients with stroke made no further revisions after evaluation. Conclusion: The research team developed a specific tool with good content validity to assess the symptoms of PSD in the rehabilitation stage.

Stress and coping styles among nursing students during the initial period of the clinical practicum: A cross-section study.

Objectives: This study aimed to explore the level of stress, types of stressors, type of coping styles, and factors influencing stress levels and coping styles among nursing students during the initial period of the clinical practicum. Methods: A cross-sectional survey design was used. In September 2017, participants were recruited from a tertiary hospital in Zhejiang Province, China, using a convenience sampling method. A demographic characteristics questionnaire, the Intern Nursing Student Stressor Scale, and the Simple Coping Style Questionnaire were used to collect data. Data were analyzed using descriptive analysis, independent sample t-tests, one-way analysis of variance, Pearson's correlation analysis, and multiple linear regression analysis. Results: A total of 158 nursing students were recruited, most of whom were female, undergraduates, and from rural areas. The nursing students perceived a moderate level of stress during the initial period of the clinical practicum. The need for knowledge and skills was the most common source of stress. Positive coping styles were most commonly adopted. Nursing students who were undergraduates, only children, and chose nursing major involuntarily experienced higher stress levels than those who were junior college students, not only children, and chose nursing major voluntarily. Nursing undergraduates were more likely to use positive coping styles than junior college students. Male nursing students and those experiencing higher stress levels related to the "environment and equipment of the wards" and the "nature and content of the work" were more likely to use negative coping styles. Conclusion: Nursing educators should offer targeted guidance based on the stress reported during the clinical practicum and the demographic characteristics of the nursing students. Guidance should be provided to encourage nursing students to adopt effective coping strategies and reduce stress.

Perceived social support in Chinese family caregivers of patients with dementia.

AIM: This study aimed to describe levels of social support and explore the factors predictive of social support for Chinese family caregivers of patients with dementia. BACKGROUND: Social support levels and their predictive factors in Chinese dementia caregivers have not been well documented, which need to be further clarified to provide a basis for creating effective social support strategies. METHODS: This was a cross-sectional study with 91 participants who completed a demographic questionnaire and the Social Support Rating Scale from 2015 to 2016. RESULTS: Chinese family caregivers of patients with dementia received moderate social support. Caregivers' subjective support domain scores and support utilization domain scores were significantly lower than those of the normal Chinese population, whereas caregivers' total social support scores were higher than those of the normal Chinese population. Family caregivers' monthly household income, educational level and place of residence were predictors of their own social support. CONCLUSION: Social support in Chinese caregivers of patients with dementia needs to be improved, especially the subjective support and support utilization. Healthcare professionals should pay special attention to caregivers with a lower monthly household income and educational level and caregivers who lived in the suburban area.

Symptom clusters of early-stage poststroke depression: A mixed-methods study.

AIM: To identify the symptom clusters of early-stage poststroke depression (PSD) and provide an in-depth understanding of the symptoms. DESIGN: A mixed-methods study with a convenient sampling method was used. METHODS: A cross-sectional questionnaire survey in 231 stroke patients and semi-structured interviews in 14 stroke patients were conducted in the neurological department of a comprehensive hospital in Southeast China. Data from the questionnaire survey were analysed through descriptive and exploratory factor analyses; data from the semi-structured interview were transcribed verbatim and analysed through inductive content analysis. This study adheres to the GRAMMS checklist. RESULTS: Exploratory factor analysis revealed six symptom clusters of early-stage PSD that accounted for an ideal variance in PSD: nervous, wakefulness, emotional, dull, guilt and low mood. Further, inductive content analysis revealed five themes that were like the above symptom clusters, except for the dull symptom cluster.

[Advance in sepsis-related coagulation disorders and immunity response].

Coagulation disorder or disseminated intravascular coagulation (DIC) is a clinicopathological syndrome, in which the imbalance between coagulation and fibrinolysis is the main pathogenesis, and systemic microthrombosis and systemic bleeding tendency are the main clinical manifestations. The clinical outcome is often the induction of systemic multiple organ dysfunction. As a common complication of sepsis, DIC significantly increases the mortality of septic patients. The coagulation disorder in sepsis is closely related to the inflammatory response of the body. Studying the mechanism of sepsis-related coagulation disorder will provide new possibilities for its early diagnosis and prognosis evaluation. This article reviews the latest research progress on the molecular mechanism of sepsis-related coagulation disorders in immunity and inflammation, in order to provide new possibilities for potential therapeutic targets.

Neural correlates of the effect of implementation intention on prospective memory.

Prospective memory (PM) refers to the ability to remember to do something in the future. Implementation intention refers to a self-regulatory strategy in the form of "If …, then …" planning that can improve PM performance. However, the neural basis of the effect of implementation intention on PM remains unclear, as do the phases of PM that are affected by implementation intention. This study aimed to address these issues. Healthy participants were randomly assigned to the implementation intention (n = 18) and typical instruction (n = 20) conditions. All of them underwent functional magnetic resonance imaging (fMRI) scanning when performing a PM task, which differentiated encoding, maintenance, and execution phases. Results demonstrated that participants in the implementation intention group showed different brain activations compared to participants in the typical instruction group. During the encoding phase, the implementation intention group showed increased activations in the inferior frontal gyrus (BA 10) and supramarginal gyrus (BA 40) compared to the typical instruction group; during the maintenance phase, the typical instruction group showed stronger activations in the inferior frontal gyrus (BA 46) than the implementation intention group; during the execution phase, the typical instruction group showed increased activations in the precentral gyrus (BA 6) and middle frontal gyrus (BA 8) than the implementation intention group. These results demonstrated the neural correlates of implementation intention on PM in different phases, and support the conclusion of our previous review based on fMRI evidence that implementation intention's improvement of PM performance is not fully automatic.

Striatal Functional Connectivity Alterations After Two-Week Antidepressant Treatment Associated to Enduring Clinical Improvement in Major Depressive Disorder.

Background: Only less than 40% of patients with Major depressive disorder (MDD) can achieve remission after several weeks of initial antidepressant treatment. Predicting whether the prescribed treatment is effective in the following course may help clinicians modify the treatment regimen in time, and reduce the staggering burden for patients and society. However, there are not yet reliable markers based on neurobiological change after a treatment regimen steadily applied, for predicting clinical treatment outcome. The striatal circuits often exhibit abnormality for MDD patients, and are implicated in antidepressant treatments. Methods: Nineteen first-episode drug-naive MDD patients (nine females, mean age was 30 years old) were recruited to undergo clinical symptom assessment and resting state fMRI scanning at baseline, after 2 and 8 weeks of treatment with duloxetine. A seed-based analysis was used to obtain functional connectivity (FC) maps of six sub-regions of the stratum, then we explored the relationship of 2-week changes of striatal FC with clinical symptom improvement after 8-week duloxetine treatment. Results: The results revealed that 2-week FC changes of the striatal cognitive and affective subdivisions with the frontoparietal regions positively correlated with 8-week symptom improvement. We also found that early FC changes between the striatal motor subdivision and the motor-related cortical regions negatively correlated with later symptom improvement. Conclusions: These findings suggest that change of the FC of the cortical-striatal circuits at the early stage of treatment is critical for later remission of MDD. Furthermore, the association between the FC change and symptom improvement may have significant implication for clinical practice to regard neural changes as reference for evaluating how antidepressant treatment works.

Improving motivation through real-time fMRI-based self-regulation of the nucleus accumbens.

OBJECTIVE: Impaired nucleus accumbens (NAcc) activation is associated with amotivation and anhedonia, which are resistant to treatment with antipsychotics and antidepressants in schizophrenia. In this study, healthy participants were trained to self-regulate the activation of their NAcc, a brain region that plays an important role in motivation, using real-time functional magnetic resonance imaging (fMRI) neurofeedback. METHOD: The experimental group (N = 19) received feedback from the NAcc, whereas the control group (N = 5) received "sham" feedback from the posterior parahippocampal gyrus, a control brain region not normally related to motivation. All participants were trained to use mental strategies to regulate their NAcc activations in a 3T MRI scanner. RESULTS: For the learning effect of NAcc regulation, we found that the majority of participants (74%) in the experimental group successfully learned to self-regulate the NAcc. They also showed improved behavioral performance in motivation and decreased functional connectivity between the NAcc and the ventral medial prefrontal cortex and an increase in small-world properties in the reward circuit after training, indicating improved information integration in reward processing. However, improvement in motivation and modification of function connectivity were not observed in the sham control group and the participants who failed to self-regulate the NAcc in the experimental group. Self-regulation was influenced by the baseline motivation. CONCLUSIONS: These findings suggest that the NAcc could be self-regulated using real-time fMRI neurofeedback and can result in improved motivation in cognitive tasks. (PsycINFO Database Record

Altered Resting-State Brain Activities in Drug-Naïve Major Depressive Disorder Assessed by fMRI: Associations With Somatic Symptoms Defined by Yin-Yang Theory of the Traditional Chinese Medicine.

Identification of biological markers for defining subtypes of major depressive disorder (MDD) is critical for better understanding MDD pathophysiology and finding effective treatment intervention. The "Yin and Yang" theory is a fundamental concept of traditional Chinese Medicine (TCM). The theory differentiates MDD patients into two subtypes, Yin and Yang, based on their somatic symptoms, which had empirically been used for the delivery of effective treatment in East Asia. Nonetheless, neural processes underlying Yin and Yang types in MDD are poorly understood. In this study, we aim to provide physiological evidence using functional magnetic resonance imaging (fMRI) to identify altered resting-state brain activity associated with Yin and Yang types in drug-naïve MDD patients. The Yin type and Yang type MDD patients showed increased amplitude of low-frequency fluctuation (ALFF) in different cortical brain areas in the parietal, temporal, and frontal lobe, compared to matched healthy controls. Differential ALFF is also observed in several cortical areas in frontal lobe and insula between Yin and Yang type group. Of note, although ALFF is increased in the inferior parietal lobe in both Yin and Yang type group, inferior parietal lobe-centered functional connectivity (FC) is increased in Yang type, but is decreased in Ying type, compared with matched healthy controls. These results suggest that differential resting-state brain activity and functional connectivity in Yin and Yang types may contribute to biological measures for better stratification of heterogeneous MDD patients.

Neural correlates of audiovisual sensory integration.

OBJECTIVE: The present study aimed to investigate the neural basis of information matching during sensory integration using a spatial-temporal matching task in healthy individuals. METHOD: A total of 37 healthy participants were recruited to match spatial dots with an auditory tone sequence in a 3T GE Discovery MR750 scanner. In addition, they were examined with the sensory integration subscale of the Cambridge Neurological Inventory. RESULTS: We found that the bilateral occipital-parietal conjunction cortex and the precentral frontal gyrus were activated during the matching condition rather than in the nonmatching condition. Activation of the occipital-parietal conjunction cortex was associated with integration of information across visual and auditory modalities, whereas activation of the precentral frontal gyrus was associated with decision making of movements. In addition, activation of the left superior frontal gyrus was associated with scores on the sensory integration subscale of the Cambridge Neurological Inventory. CONCLUSIONS: These findings suggest that the bilateral occipital-parietal conjunction cortex is responsible for matching information input from multiple modalities during audiovisual sensory integration. (PsycINFO Database Record

Neural mechanism and heritability of complex motor sequence and audiovisual integration: A healthy twin study.

Complex motor sequencing and sensory integration are two key items in scales assessing neurological soft signs. However, the underlying neural mechanism and heritability of these two functions is not known. Using a healthy twin design, we adopted two functional brain imaging tasks focusing on fist-edge-palm (FEP) complex motor sequence and audiovisual integration (AVI). Fifty-six monozygotic twins and 56 dizygotic twins were recruited in this study. The pre- and postcentral, temporal and parietal gyri, the supplementary motor area, and the cerebellum were activated during the FEP motor sequence, whereas the precentral, temporal, and fusiform gyri, the thalamus, and the caudate were activated during AVI. Activation in the supplementary motor area during FEP motor sequence and activation in the precentral gyrus and the thalamic nuclei during AVI exhibited significant heritability estimates, ranging from 0.5 to 0.62. These results suggest that activation in cortical motor areas, the thalamus and the cerebellum associated with complex motor sequencing and audiovisual integration function may be heritable.