Comparison of central corneal thickness measured by automatic and manual analysis of optical coherence tomography.

PURPOSE: To compare central corneal thickness (CCT) measured with optical coherence tomography (OCT) using an automatic algorithm (A-OCT) vs. manual measurements (M-OCT) with respect to the gold standard ultrasound pachymetry (USP). METHODS: CCT measurements were performed on both eyes of 28 healthy subjects at four times of the day. A-OCT used an automatic software analysis of the corneal image, M-OCT was performed by two operators by setting a digital calliper on the corneal borders, and USP was performed after corneal anesthesia. Measurements were compared using a three-way repeated measures ANOVA. Bland-Altman plots were used to evaluate the agreement between OCT measurements and USP. RESULTS: Both A-OCT and M-OCT significantly underestimated the USP measures, with the mean difference, i.e., the systematic error, being larger for A-OCT (- 19.0 µm) than for M-OCT (- 6.5 µm). Good reproducibility between the two operators was observed. Bland-Altman plots showed that both OCT methods suffered from proportional errors, which were not affected by time and eye. CONCLUSIONS: Measuring CCT with OCT yielded lower values than USP. Therefore, clinicians should be aware that corneal thickness values may be influenced by the measurement method and that the various devices should not be used interchangeably in following up a given patient. Intriguingly, M-OCT had less systematic error than A-OCT, an important outcome that clinicians should consider when deciding to use an OCT device.

Non-monetary motivations of the EU agri-environmental policy adoption. A causal forest approach.

This paper investigates the non-monetary motivations of farmers' adoption of agri-environmental policies. Unlike the monetary (income) motivations, non-monetary drivers can not be directly observed but can be identified from observational data within appropriate quasi-experimental designs. A theoretical justification of farmers' choices is first formulated and a consequent natural experiment setting is derived. The latter admits heterogeneous, i.e. Individual, Treatment Effects (ITE) that, in turn, can be interpreted in terms of more targeted and tailored policy expenditure. A Causal Forest (CF) approach is adopted to estimate these ITEs for both the treated and not treated units. The approach is applied to two balanced panel samples of Italian Farm Accountancy Data Network (FADN) farms observed over the 2008-2018 period and concerns agri-environmental policies delivered through the Common Agricultural Policy (CAP). Results show how heterogeneous the farmers' response and the associated non-monetary motivations can be, thus indicating room for a more efficient policy design.

A single session of whole-body cryotherapy boosts maximal cycling performance and enhances vagal drive at rest.

Whole-body cryotherapy (WBC) has been reported to maximize physical recovery after exercise and reduce the ensuing muscle damage. In addition, WBC triggers cardiovascular responses leading to an increased vagal drive. Here we tested whether WBC may boost exercise performance as well as post-exercise recovery. Moreover, we compared the effects of WBC and exercise on sympathovagal balance and tested whether these two factors may interact. ECG was recorded in 28 healthy adults who underwent rest, all-out effort on a cycloergometer, 5 min recovery and again rest. After 3-5 days, WBC (3 min exposure to - 150 °C air) was applied and the whole procedure repeated. Total exercise duration was split into the time needed to reach peak power output (tPEAK) and the time to exhaustion (tEXH). The post-exercise exponential decay of HR was characterized by its delay from exercise cessation (tDELAY) and by its time constant (τOFF). Sympathovagal balance was evaluated by measuring HR variability power in the low (LF) and high (HF) frequency bands, both before exercise and after recovery from it. Sympathetic vs. vagal predominance was assessed by the sympathovagal index LFnu. Paired t-tests indicated that WBC increased tEXH and reduced tDELAY, speeding up the HR recovery. These results suggest that WBC may be exploited to boost exercise performance by about 12-14%. ANOVA on HR variability confirmed that exercise shifted the sympathovagal balance towards sympathetic predominance, but it also highlighted that WBC enhanced vagal drive at rest, both before exercise and after full recovery, covering ~ 70% of the exercise effect.

Policy responses to COVID-19 pandemic waves: Cross-region and cross-sector economic impact.

This paper proposes a modelling approach to assess the cross-region and cross-sector economic impacts of the restrictions imposed by governments to contain the COVID-19 pandemic. The nationwide lockdown imposed in Italy during the first wave of the pandemic is used as a benchmark. However, the adopted approach allows an ex-ante assessment of alternative policy responses, in the event of successive pandemic waves, in order to rationalise the policy intervention and reach the best possible compromise between containing the risk of contagion and reducing economic losses. The used approach consists of a non-linear programming model based on a multiregional Input-Output (I-O) table, which guarantees greater flexibility than traditional I-O analysis. It is applied to estimate both direct and indirect losses of GDP and employment produced by alternative policy responses represented by general and differentiated lockdowns. The evidence deriving from the Italian experience shows a sort of learning process through successive waves based on the introduction of increasingly flexible and tailored policy responses to the pandemic.

Direct current stimulation modulates the excitability of the sensory and motor fibres in the human posterior tibial nerve, with a long-lasting effect on the H-reflex.

Several studies demonstrated that transcutaneous direct current stimulation (DCS) may modulate central nervous system excitability. However, much less is known about how DC affects peripheral nerve fibres. We investigated the action of DCS on motor and sensory fibres of the human posterior tibial nerve, with supplementary analysis in acute experiments on rats. In forty human subjects, electric pulses at the popliteal fossa were used to elicit either M-waves or H-reflexes in the Soleus, before (15 min), during (10 min) and after (30 min) DCS. Cathodal or anodal current (2 mA) was applied to the same nerve. Cathodal DCS significantly increased the H-reflex amplitude; the post-polarization effect lasted up to ~ 25 min after the termination of DCS. Anodal DCS instead significantly decreased the reflex amplitude for up to ~ 5 min after DCS end. DCS effects on M-wave showed the same polarity dependence but with considerably shorter after-effects, which never exceeded 5 min. DCS changed the excitability of both motor and sensory fibres. These effects and especially the long-lasting modulation of the H-reflex suggest a possible rehabilitative application of DCS that could be applied either to compensate an altered peripheral excitability or to modulate the afferent transmission to spinal and supraspinal structures. In animal experiments, DCS was applied, under anaesthesia, to either the exposed peroneus nerve or its Dorsal Root, and its effects closely resembled those found in human subjects. They validate therefore the use of the animal models for future investigations on the DCS mechanisms.

Anticipatory Postural Adjustments associated with reaching movements are programmed according to the availability of visual information.

During goal-directed arm movements, the eyes, head, and arm are coordinated to look at and reach the target. We examined whether the expectancy of visual information about the target modifies Anticipatory Postural Adjustments (APAs). Ten standing subjects had to (1) move the eyes, head and arm, so as to reach, with both gaze and index-finger, a target of known position placed outside their visual field (Gaze-Reach); (2) look at the target while reaching it (Reach in Full Vision); (3) keep the gaze away until having touched it (Reach then Gaze) and (4) just Gaze without Reach the target. We recorded eye, head, right arm, and acromion kinematics, EMGs from upper- and lower-limb muscles, and forces exerted on the ground. In Gaze-Reach, two coordination strategies were found: when gaze preceded arm muscle recruitment (Gaze-first) and when the opposite occurred (Reach-first). APAs in acromion kinematics, leg muscles, and ground forces started significantly earlier in Gaze-first vs. Reach-first (mean time advance: 44.3 ± 8.9 ms), as it was in Reach in Full Vision vs. Reach then Gaze (39.5 ± 7.9 ms). The Gaze-first to Reach-first time-shift was similar to that between Reach in Full Vision and Reach then Gaze (p = 0.58). Moreover, Gaze without Reach data witnessed that the head-induced postural actions did not affect the APA onset in Gaze-first and Reach-first. In conclusion, in Gaze-first, the central control of posture considers visual information while planning the movement, like in Reach in Full Vision; while Reach-first is more similar to Reach then Gaze, where vision is not required.

Intended rather than actual movement velocity determines the latency of anticipatory postural adjustments.

The literature reports that anticipatory postural adjustments (APAs) are programmed according to movement velocity. However, the linkage between APAs and velocity has been highlighted within single subjects who were asked to voluntarily change movement velocity; therefore, till now, it has been impossible to discern whether the key factor determining APA latency was the intended movement velocity or the actual one. Aim of this study was to distinguish between these two factors. We analyzed the APA chain that stabilizes the arm during a brisk index finger flexion in two groups of subjects: (1) 29 who composed our database from previous experiments and were asked to "go-as-fast-as-possible" (go-fast), but actually performed the movement with different speeds (238-1, 180°/s), and (2) ten new subjects who performed the go-fast movement at more than 500°/s and were then asked to go-slow at about 50% of their initial velocity, thus moving at 300-800°/s. No correlation between APA latency and actual movement speed was observed when all subjects had to go-fast (p > 0.50), while delayed APAs were found in the ten new subjects when they had to go-slow (p < 0.001). Moreover, in the speed range between 300 and 800°/s, the APA latency depended only on movement instruction: subjects going fast showed earlier APAs than those going slow (p < 0.001). These data suggest a stronger role of the intended movement velocity versus the actual one in modifying the timing of postural muscles recruitment with respect to the prime mover. These results also strengthen the idea of a shared postural and voluntary command within the same motor act.

Temporal disruption of upper-limb anticipatory postural adjustments in cerebellar ataxic patients.

Voluntary movements induce postural perturbations, which are counteracted by anticipatory postural adjustments (APAs) that preserve body equilibrium. Little is known about the neural structures generating APAs, but several studies suggested a role of sensory-motor areas, basal ganglia, supplementary motor area and thalamus. However, the role of the cerebellum still remains an open question. The aim of this present paper is to shed further light on the role of cerebellum in APAs organization. Thus, APAs that stabilize the arm when the index finger is briskly flexed were recorded in 13 ataxic subjects (seven sporadic cases, four dominant ataxia type III and two autosomal recessive), presenting a slowly progressive cerebellar syndrome with four-limb dysmetria, and compared with those obtained in 13 healthy subjects. The pattern of postural activity was similar in the two groups [excitation in triceps and inhibition in biceps and anterior deltoid (AD)], but apparent modifications in timing were observed in all ataxic subjects in which, on average, triceps brachii excitation lagged the onset of the prime mover flexor digitorum superficialis by about 27 ms and biceps and AD inhibition were almost synchronous to it. Instead, in normal subjects, triceps onset was synchronous to the prime mover and biceps and AD anticipated it by about 40 ms. The observed disruption of the intra-limb APA organization confirms that the cerebellum is involved in APA control and, considering cerebellar subjects as a model of dysmetria, also supports the view that a proper APA chain may play a crucial role in refining movement metria.

Ischemic block of the forearm abolishes finger movements but not their associated anticipatory postural adjustments.

Voluntary movement is known to induce postural perturbations that are counteracted by unconscious anticipatory postural adjustments (APAs). Thus, for every movement, two motor commands are dispatched: a voluntary command recruiting the prime mover and a postural command driving the APAs. These commands are classically thought to be separated; this study investigates whether they could be instead considered as two elements within the same motor program. We analyzed the APAs in biceps brachii, triceps brachii and anterior deltoid that stabilize the arm when briskly flexing the index finger (prime mover flexor digitorum superficialis). APAs and prime mover activation were recorded before, under and after ischemic block of the forearm. Ischemia paralyzed the prime mover, thus suppressing the finger movement and the ensuing postural perturbation. If the two commands had been separated, it would have been expected that after a few failed attempts to flex the index finger, the APAs were suppressed too, being purposeless without postural perturbation. APAs were still present under ischemia even after 60 movement trials. No significant changes were found in APA amplitude in biceps and triceps among different conditions, or in the average APA latency. Inhibitory APA in anterior deltoid was reduced but still present under ischemia. In addition, the pharmacologic block of the sole median nerve produced similar effects. APAs were instead almost abolished when applying a fixation point to the wrist. The observation that APAs remained tailored to the expected perturbation even when that perturbation did not occur supports the idea of a functionally unique motor command driving both the prime mover and the muscles of the APA chain.

The role of anticipatory postural adjustments (APAs) in interlimb coordination of coupled arm movements in the parasagittal plane: I. APAs associated with fast discrete flexion and extension movements of one arm or of both arms ISO- and ANTI-directionally coupled.

Coupling stability during cyclic arm movements in the horizontal (transverse) plane is lower in ISO- than in ANTI-directional coupling. We proposed that such impairment arises from the interference exerted in ISO by the anticipatory postural adjustments (APAs) linked to the primary movements. To evaluate if a link between coupling stability and postural adjustments also exist for arm movements with different postural requirements, we focused on arm(s) flexion-extension in the parasagittal plane and started by analysing the APAs distribution in arm, trunk and leg muscles. Fast flexion and extension of the right arm elicited APAs in the left anterior and posterior deltoid that replicated the excitation-inhibition of the homologous prime movers; this pattern would favour ISO and contrast ANTI-coupled movements. Instead, in the left latissimus dorsi, APAs were opposite to the voluntary actions in the right latissimus dorsi, thus favouring ANTI coupling. Symmetrical APAs were also elicited in right and left erector spinae (RES, LES) and asymmetrical APAs in Ischiocruralis (RIC, LIC), while an antero-posterior force (Fy) and a moment about the vertical axis (Tz) were discharged to the ground. When fast discrete movements were ISO-coupled, APAs were symmetrical in trunk (RES, LES) and leg (RIC, LIC) muscles and a large Fy but no Tz was generated. In ANTI coupling, APAs in RES and LES remained symmetrical, whereas they became antisymmetrical in RIC and LIC. A large Tz and a small Fy were recorded. In conclusion, during parasagittal movements, APAs in are elicited in both ISO and ANTI coupling, at variance with horizontal movements where they are only present in ISO. This would suggest that the difference in coupling stability between the two modes is smaller (or even reversed) in parasagittal with respect to horizontal arm movements.

The role of anticipatory postural adjustments in interlimb coordination of coupled arm movements in the parasagittal plane: II. Postural activities and coupling coordination during cyclic flexion-extension arm movements, ISO- and ANTI-directionally coupled.

When coupling cyclic adduction-abduction movements of the arms in the transverse (horizontal) plane, isodirectional (ISO) coupling is less stable than antidirectional (ANTI) coupling. We proposed that such deficiency stems from the disturbing action that anticipatory postural adjustments exert on ISO coupling. To ascertain if postural adjustments differentiate ISO versus ANTI coupling coordination in other types of cyclic arm movements, we examined flexion-extension oscillations in the parasagittal plane. Oscillations of the right arm alone elicited cyclic Postural Adjustments (PAs) in the left Anterior Deltoid and Posterior Deltoid, which replicated the excitation-inhibition pattern of the prime movers right Anterior Deltoid, right Posterior Deltoid. Cyclic PAs also developed symmetrically in Erector Spinae (RES and LES) and in phase opposition in Ischiocruralis (RIC and LIC), so as to discharge to the ground both an anteroposterior force, Fy, and a moment about the vertical axis, Tz. Oscillations of both arms in ISO coupling induced symmetric PAs in both ES and IC muscles, thus generating a large Fy but no Tz. In ANTI coupling, PAs in RES and LES remained symmetric but smaller in size, while PAs in RIC and LIC were large and opposite in phase, resulting in a large Tz and small Fy. Altogether, PAs would thus favour ISO and hamper ANTI parasagittal movements because (1) in the motor pathways to the prime movers of either arm, a convergence would occur between the voluntary commands and the commands for PAs linked to the movement of the other arm, the two commands having the same sign (excitatory or inhibitory) during ISO and an opposite sign during ANTI; (2) the postural effort of trunk and leg muscles would be higher for generating Tz in ANTI than Fy in ISO. These predictions fit with the finding that coupling stability was lower in ANTI than in ISO, i.e., opposite to horizontal movements. In conclusion, in both parasagittal and horizontal arm movements, the less coordinated coupling mode was the one constrained by postural adjustments through the two above mechanisms.

The role of anticipatory postural adjustments in interlimb coordination of coupled arm movements in the parasagittal plane: III. difference in the energy cost of postural actions during cyclic flexion-extension arm movements, ISO- and ANTI-directionally coupled.

When oscillating the upper limbs together in the parasagittal plane, movements coordination is lower (i.e., variability of the interlimb relative phase is higher) in antidirectional (ANTI) than in isodirectional (ISO) coupling. In contrast, we previously observed that for arm movements in the horizontal plane, the coordination was worse in ISO than ANTI and the energetic cost of postural activities was higher in ISO. Having hypothesised that the higher postural cost was one factor responsible for the coordination deficit in horizontal ISO, we measured the oxygen uptake ([Formula: see text]) in parasagittal movements, expecting that in this case too, the postural cost is higher in the less-coordinated mode (ANTI). Breath-by-breath metabolic ([Formula: see text], [Formula: see text]) and cardiorespiratory (HR, [Formula: see text]) parameters were measured in seven participants, who performed cyclic flexions-extensions in the parasagittal plane with either one arm or both arms, in ISO or ANTI coupling and at 1.4, 2.2 and 2.6 Hz. In each condition, the intermittent exercise (12 s movement, 12 s rest) lasted 264 s. A force platform recorded the mechanical actions to the ground. The exercise metabolic cost ([Formula: see text]) was found to be significantly higher in parasagittal ANTI than ISO. The movement amplitude being equal in the two modes, the ANTI-ISO difference should be ascribed to postural activities. This would confirm that the less-coordinated coupling mode requires the higher postural effort in parasagittal movements too. When rising the movement frequency, [Formula: see text] increased and linearly correlated with the coordination loss. Comparison of parasagittal with horizontal movements showed that [Formula: see text] was lower in parasagittal ANTI than in horizontal ISO (the less-coordinated modes), while it was not different between parasagittal ISO and horizontal ANTI (the more-coordinated modes).

Pediatric Slow-Progressive, but Not Non-Progressive Cerebellar Ataxia Delays Intra-Limb Anticipatory Postural Adjustments in the Upper Arm.

We recently investigated the role of the cerebellum during development, reporting that children with genetic slow-progressive ataxia (SlowP) show worse postural control during quiet stance and gait initiation compared to healthy children (H). Instead, children with genetic non-progressive ataxia (NonP) recalled the behavior of H. This may derive from compensatory networks, which are hindered by disease progression in SlowP while free to develop in NonP. In the aim of extending our findings to intra-limb postural control, we recorded, in 10 NonP, 10 SlowP and 10 H young patients, Anticipatory Postural Adjustments (APAs) in the proximal muscles of the upper-limb and preceding brisk index finger flexions. No significant differences in APA timing occurred between NonP and H, while APAs in SlowP were delayed. Indeed, the excitatory APA in Triceps Brachii was always present but significantly delayed with respect to both H and NonP. Moreover, the inhibitory APAs in the Biceps Brachii and Anterior Deltoid, which are normally followed by a late excitation, could not be detected in most SlowP children, as if inhibition was delayed to the extent where there was overlap with a late excitation. In conclusion, disease progression seems to be detrimental for intra-limb posture, supporting the idea that inter- and intra-limb postures seemingly share the same control mechanism.

Hand immobilization affects arm and shoulder postural control.

It is a common experience, immediately after the removal of a cast or a splint, to feel motor awkwardness, which is usually attributed to muscular and joint immobilization. However, the same feeling may also be perceived after a brief period of immobilization. We provide evidence that this last effect stems from changes in the cortical organization of the focal movement as well as in the associated anticipatory postural adjustments. Indeed, these two aspects of the motor act are strongly correlated, although scaled in different manners. In fact, they are both shaped in the primary motor cortex, they both undergo similar amplitude and latency modulation and, as we will show, they are both impaired by the immobilization of the lone prime mover. Neuromuscular effects of limb immobilization are well known; however, most papers focus on changes occurring in the pathways projecting to the prime mover, which acts on the immobilized joint. Conversely, this study investigates the effect of immobilization on anticipatory postural adjustments. Indeed, we show that 12 h of wrist and fingers immobilization effectively modify anticipatory postural adjustments of the elbow and the shoulder, that is, those joints not immobilized within the fixation chain. Accordingly, the motor impairment observed after short-term immobilization most likely stems from the unbalance between anticipatory postural adjustments and the focal movement.

A Novel Viewpoint on the Anticipatory Postural Adjustments During Gait Initiation.

Anticipatory postural adjustments (APAs) are the coordinated muscular activities that precede the voluntary movements to counteract the associated postural perturbations. Many studies about gait initiation call APAs those activities that precede the heel-off of the leading foot, thus taking heel-off as the onset of voluntary movement. In particular, leg muscles drive the center of pressure (CoP) both laterally, to shift the body weight over the trailing foot and backward, to create a disequilibrium torque pushing forward the center of mass (CoM). However, since subjects want to propel their body rather than lift their foot, the onset of gait should be the CoM displacement, which starts with the backward CoP shift. If so, the leg muscles driving such a shift are the prime movers. Moreover, since the disequilibrium torque is mechanically equivalent to a forward force acting at the pelvis level, APAs should be required to link the body segments to the pelvis: distributing such concentrated force throughout the body would make all segments move homogeneously. In the aim of testing this hypothesis, we analyzed gait initiation in 15 right-footed healthy subjects, searching for activities in trunk muscles that precede the onset of the backward CoP shift. Subjects stood on a force plate for about 10 s and then started walking at their natural speed. A minimum of 10 trials were collected. A force plate measured the CoP position while wireless probes recorded the electromyographic activities. Recordings ascertained that at gait onset APAs develop in trunk muscles. On the right side, Rectus Abdominis and Obliquus Abdominis were activated in 11 and 13 subjects, respectively, starting on average 33 and 54 ms before the CoP shift; Erector Spinae (ES) at L2 and T3 levels was instead inhibited (9 and 7 subjects, 104 and 120 ms). On the contralateral side, the same muscles showed excitatory APAs (abdominals in 11 and 12 subjects, 27 and 82 ms; ES in 10 and 7 subjects, 75 and 32 ms). The results of this study provide a novel framework for distinguishing postural from voluntary actions, which may be relevant for the diagnosis and rehabilitation of gait disorders.

Dual-Hemisphere Transcranial Direct Current Stimulation on Parietal Operculum Does Not Affect the Programming of Intra-limb Anticipatory Postural Adjustments.

Evidence shows that the postural and focal components within the voluntary motor command are functionally unique. In 2015, we reported that the supplementary motor area (SMA) processes Anticipatory Postural Adjustments (APAs) separately from the command to focal muscles, so we are still searching for a hierarchically higher area able to process both components. Among these, the parietal operculum (PO) seemed to be a good candidate, as it is a hub integrating both sensory and motor streams. However, in 2019, we reported that transcranial Direct Current Stimulation (tDCS), applied with an active electrode on the PO contralateral to the moving segment vs. a larger reference electrode on the opposite forehead, did not affect intra-limb APAs associated to brisk flexions of the index-finger. Nevertheless, literature reports that two active electrodes of opposite polarities, one on each PO (dual-hemisphere, dh-tDCS), elicit stronger effects than the "active vs. reference" arrangement. Thus, in the present study, the same intra-limb APAs were recorded before, during and after dh-tDCS on PO. Twenty right-handed subjects were tested, 10 for each polarity: anode on the left vs. cathode on the right, and vice versa. Again, dh-tDCS was ineffective on APA amplitude and timing, as well as on prime mover recruitment and index-finger kinematics. These results confirm the conclusion that PO does not take part in intra-limb APA control. Therefore, our search for an area in which the motor command to prime mover and postural muscles are still processed together will have to address other structures.

Pharmacokinetics of orally administered melatonin in critically ill patients.

Critically ill patients exhibit reduced melatonin secretion, both in nocturnal peaks and basal daytime levels. Oral melatonin supplementation may be useful for known sedative and antioxidant properties. Its early enteral absorption and daily pharmacokinetics were determined in two cohorts of six high-risk patients in this prospective trial. During their third and fourth Intensive Care Unit (ICU) day, they underwent two different sets of repeated blood samples to detect serum melatonin levels through radio-immuno-assay. Cohort 1: samples taken at 20:00, 20:45, 21:30, 24:00, 03:00, 06:00, 14:00, 20:00 to describe the daily pharmacokinetics. Cohort 2: 20:00, 20:05, 20:10, 20:20, 20:30, 20:45 to study the early absorption. On ICU day 3, endogenous levels were measured, while the absorption of exogenous melatonin was determined on ICU day 4 after administration, at 20:00, of 3 mg melatonin. All basal levels were below the expected values. Following enteral administration, pharmacological levels were already reached in 5 min, with a serum peak after 16 min (half-absorption time: 3 min 17 s). The maximum serum level observed was 11040 pg/mL and the disappearance rate indicated a half-elimination time of 1 hr 34 min. Serum melatonin levels decreased significantly after midnight; pharmacological levels were maintained up to 10 hr following administration. No excessive sleepiness was reported in this patient group. Critically ill patients exhibited reduced melatonin secretion, as reported in the literature. Despite the critical illness, the oral bioavailability was satisfactory: serum levels after oral administration showed basically unchanged intestinal absorption, while disappearance rate was slower than reported elsewhere in healthy volunteers.

Difference in the metabolic cost of postural actions during iso- and antidirectional coupled oscillations of the upper limbs in the horizontal plane.

When oscillating the upper limbs in the horizontal plane, the effort required to maintain posture is higher when the limbs move isodirectionally (ISO coupling) than when they move mirror symmetrical, i.e., antidirectionally (ANTI). Movements stability and accuracy are much lower in ISO than in ANTI and the higher postural requests may be one factor contributing to the coordination deficiency of ISO movements. On this background, we measured the metabolic cost of ISO and ANTI movements in order to (1) quantitatively evaluate the supplemental effort required by ISO coupling, (2) establish whether it can be entirely ascribed to postural activities, and (3) compare it with the effort paid for the primary movement. Breath-by-breath metabolic (VO2, VCO2) and cardio-respiratory (HR, VE) parameters were measured in six participants, who performed intermittent exercises (5 min long, 12 s movement, 12 s rest) of cyclic arm adduction-abduction in the horizontal plane with either one arm or both arms in ISO or ANTI coupling, at 1.4 and 2.0 Hz. A force platform recorded the reaction forces to ground and the torque about the trunk vertical axis (Tz). At both frequencies and at metabolic steady-state, the mean values of both VO2 and Tz were found to be larger during ISO than ANTI coupling. Moreover, a linear relation was found between metabolic cost and Tz. Lastly, during ANTI coupling virtually all the energy was spent for the primary movement whilst the large increase in energy expenditure when passing from ANTI to ISO was almost entirely ascribable to postural activities.

Heart Rate Kinetics and Sympatho-Vagal Balance Accompanying a Maximal Sprint Test.

When a maximal sprint starts, heart rate (HR) quickly increases. After the exercise ends, HR keeps high for seconds before recovering with a roughly exponential decay. Such decay and its time constant (τoff) have been widely studied, but less attention was devoted to the time delay (tdelay) between sprint end and HR decay onset. Considering the correlation between sympatho-vagal balance and performance, as well as the occurrence of heart failure in cardiopaths during the post-exercise phase, we evaluated sympatho-vagal balance before and after sprint, trying to correlate it with both tdelay and τoff. R-R intervals, recorded in 24 healthy adults from 5 min before to 5 min after a 60-m sprint-test (from Storniolo et al., 2017, with permission of all authors), were re-processed to extract HR variability power (LF and HF) in the low- and high-frequency ranges, respectively. The sympatho-vagal balance, evaluated in pre-test resting period (LF/HF)REST and at steady-state recovery (LF/HF)RECOV, was correlated with tdelay and τoff. Both (LF/HF)REST and (LF/HF)RECOV had a skewed distribution. Significant rank correlation was found for (LF/HF)REST vs. τoff and for (LF/HF)RECOV vs. both τoff and tdelay. The difference (LF/HF)RECOV-REST had a normal distribution and a strong partial correlation with tdelay but not with τoff. Thus, a long tdelay marks a sympathetic activity that keeps high after exercise, while a high sympathetic activity before sprint leads to a slow recovery (high τoff), seemingly accompanying a poor performance.

Transcranial Direct Current Stimulation on Parietal Operculum Contralateral to the Moving Limb Does Not Affect the Programming of Intra-Limb Anticipatory Postural Adjustments.

Recent data suggest that the parietal operculum acts as an integration center within a multimodal network, originating from different primary sensory and motor cortices and projecting to frontal, parietal and temporal cortical hubs, which in turn govern cognitive and motor functions. Thus, parietal operculum might also play a crucial role in the integrated control of voluntary movement and posture. As a first step to test this hypothesis, the Anticipatory Postural Adjustments (APAs) stabilizing the arm when the index-finger is briskly flexed were recorded, on the preferred side, in three groups of 10 healthy subjects, before, during and after CATHODAL or ANODAL transcranial Direct Current Stimulation (tDCS, 20 min at 2 mA) applied over the contralateral Parietal Operculum (coPO). Results were compared to those obtained in a SHAM group. In agreement with literature, in the SHAM group the activation of the prime mover Flexor Digitorum Superficialis was preceded by an inhibitory APA in Biceps Brachii and Anterior Deltoid, and almost simultaneous to an excitatory APA in Triceps Brachii. The same pattern was observed in both the CATHODAL and ANODAL groups, with no significant tDCS effects on APAs amplitude and timing. Index-finger kinematics were also unchanged. These negative results suggest that the coPO does not disturb the key network governing APAs in index-finger flexion. Since it has been well documented that such APAs share many features with those observed in trunk and limb muscles when performing several other movements, we suggest that coPO may not be crucial to the general APA control.