Human Cervical Epidural Spinal Electrogram Topographically Maps Distinct Volitional Movements.

Little is known about the electrophysiologic activity of the intact human spinal cord during volitional movement. We analyzed epidural spinal recordings from a total of five human subjects of both sexes during a variety of upper extremity movements and found that these spinal epidural electrograms contain spectral information distinguishing periods of movement, rest, and sensation. Cervical epidural electrograms also contained spectral changes time-locked with movement. We found that these changes were primarily associated with increased power in the theta (4-8 Hz) band and feature increased theta phase to gamma amplitude coupling, and this increase in theta power can be used to topographically map distinct upper extremity movements onto the cervical spinal cord in accordance with established myotome maps of the upper extremity. Our findings have implications for the development of neurostimulation protocols and devices focused on motor rehabilitation for the upper extremity, and the approach presented here may facilitate spatiotemporal mapping of naturalistic movements.

The Volitional Control of Individual Motor Units Is Constrained within Low-Dimensional Neural Manifolds by Common Inputs.

The implementation of low-dimensional movement control by the central nervous system has been debated for decades. In this study, we investigated the dimensionality of the control signals received by spinal motor neurons when controlling either the ankle or knee joint torque. We first identified the low-dimensional latent factors underlying motor unit activity during torque-matched isometric contractions in male participants. Subsequently, we evaluated the extent to which motor units could be independently controlled. To this aim, we used an online control paradigm in which participants received the corresponding motor unit firing rates as visual feedback. We identified two main latent factors, regardless of the muscle group (vastus lateralis-medialis and gastrocnemius lateralis-medialis). The motor units of the gastrocnemius lateralis could be controlled largely independently from those of the gastrocnemius medialis during ankle plantarflexion. This dissociation of motor unit activity imposed similar behavior to the motor units that were not displayed in the feedback. Conversely, it was not possible to dissociate the activity of the motor units between the vastus lateralis and medialis muscles during the knee extension tasks. These results demonstrate that the number of latent factors estimated from linear dimensionality reduction algorithms does not necessarily reflect the dimensionality of volitional control of motor units. Overall, individual motor units were never controlled independently of all others but rather belonged to synergistic groups. Together, these findings provide evidence for a low-dimensional control of motor units constrained by common inputs, with notable differences between muscle groups.

Volitional modulation of neuronal activity in the external globus pallidus by engagement of the cortical-basal ganglia circuit.

Volitional modulation of neural activity is not confined to the cortex but extends to various brain regions. Yet, it remains unclear whether neurons in the basal ganglia structure, the external globus pallidus (GPe), can be volitionally controlled. Here, we employed a volitional conditioning task to compare the volitional modulation of GPe and primary motor cortex (M1) neurons as well as the underlying circuits and control mechanisms. The results revealed that the volitional modulation of GPe neuronal activity engaged both M1 and substantia nigra pars reticulata (SNr) neurons, indicating the involvement of the cortex-GPe-SNr loop. In contrast, the volitional modulation of M1 neurons primarily occurred through the engagement of M1 local circuitry. Furthermore, lesioning M1 neurons did not affect the volitional learning or volitional control signal in GPe, whereas lesioning of GPe neurons impaired the learning process for the volitional modulation of M1 neuronal activity at the intermediate stage. Additionally, lesion of GPe neurons enhanced M1 neuronal activity when performing the volitional control task without reward delivery and a random reward test. Taken together, our findings demonstrated that GPe neurons could be volitionally controlled by engagement of the cortical-basal ganglia circuit and inhibit learning process for the volitional modulation of M1 neuronal activity by regulating M1 neuronal activity. Thus, GPe neurons can be effectively harnessed for independent volitional modulation for neurorehabilitation in patients with cortical damage. KEY POINTS: The cortical-basal ganglia circuit contributes to the volitional modulation of GPe neurons. Volitional modulation of M1 neuronal activity mainly engages M1 local circuitry. Bilateral GPe lesioning impedes volitional learning at the intermediate stages. Lesioning of GPe neurons inhibits volitional learning process by regulating M1 neuronal activity.

Common intentional binding effects across diverse sensory modalities in touch-free voluntary actions.

The intentional binding effect refers to the phenomenon where the perceived temporal interval between a voluntary action and its sensory consequence is subjectively compressed. Prior research revealed the importance of tactile feedback from the keyboard on this effect. Here we examined the necessity of such tactile feedback by utilizing a touch-free key-press device without haptic feedback, and explored how initial/outcome sensory modalities (visual/auditory/tactile) and their consistency influence the intentional binding effect. Participants estimated three delay lengths (250, 550, or 850 ms) between the initial and outcome stimuli. Results showed that regardless of the combinations of sensory modalities between the initial and the outcome stimuli (i.e., modal consistency), the intentional binding effect was only observed in the 250 ms delay condition. This findings indicate a stable intentional binding effect both within and across sensory modalities, supporting the existence of a shared mechanism underlying the binding effect in touch-free voluntary actions.

Free will: An Example of the Dopaminergic System.

Neuroscience has convinced people that much of their behavior is determined by causes unknown to them and beyond their control. However, are advances in neuroscience truly a prerequisite for such beliefs? Robert Kane's theory of ultimate responsibility is libertarian theory. Its innovative nature makes it possible to discuss the neurophysiological basis of its postulates. Using the functions of the midbrain dopaminergic system as an example, this article provides an overview of this neurophysiological basis. According to Kane, if we are to be ultimately responsible for our wills as well as for our actions, some actions in our lives must lack sufficient motives and causes. These are self-forming actions. Dopamine is hypothesized to mediate self-forming action execution. Dopamine not only mediates action but also ensures synaptic plasticity in the brain, that is, learning from action; hence, dopamine changes the acting individual and provides the formation of our own wills. The basal ganglia, which are the main target of dopamine in the brain, act through parallel pathways and are involved in decision-making processes. Dopamine is also involved in the regulation of the neurodynamical properties of prefrontal cortex networks with random spiking noise. It can be assumed that the activity of the dopaminergic system is closely related to the physiological basis of free will.

Adecuación del esfuerzo terapéutico, una estrategia al final de la vida / The suitability of therapeutic effort: an end-of-life strategy

El tratamiento al final de la vida y la atención a las necesidades de sus familiares no son adecuados por diversos motivos: la sociedad niega u oculta la muerte, es muy difícil predecirla con exactitud, con frecuencia el tratamiento está fragmentado entre diferentes especialistas y hay una insuficiente formación en medicina paliativa, incluyendo habilidades de comunicación. Se producen frecuentes conflictos relacionados con las decisiones que se toman al final de su vida, especialmente en la adecuación del esfuerzo terapéutico. La actitud de los profesionales sobre la adecuación del esfuerzo terapéutico no es homogénea y cambia según la especialidad, la experiencia y las propias creencias. La atención primaria constituye una situación privilegiada para acercarse a la vida y a los valores de nuestros pacientes y sus familiares, y no solo a la enfermedad, lo que hace que sea el lugar adecuado para orientar y asesorar al paciente sobre la preparación y registro del documento de últimas voluntades (AU)

End-of-life treatment and attention to the needs of relatives are not adequate for several reasons: Society denies or hides the death; it is very difficult to predict it accurately; treatment is frequently fragmented between different specialists, and there is insufficient palliative medicine training, including communication skills. There are frequent conflicts with decisions made at the end of life, particularly the suitability of therapeutic effort. The attitude of professionals on the adequacy of therapeutic effort is not homogenous, and varies depending on the specialty, experience, and beliefs. Many doctors are still afraid of inconveniencing patients. Primary care is in a privileged position to approach the life and values of our patients and their families, and not just the disease, which makes it the right place to guide and advise the patient on the preparation and registration of living wills (AU)

Síntomas básicos en la esquizofrenia, su estudio clínico y relevancia en investigación / Basic symptoms in schizophrenia, their clinical study and relevance in research

Los síntomas básicos consisten en sutiles molestias subclínicas, experimentadas subjetivamente por el paciente, principalmente referidas a la volición, la afectividad, el pensamiento y lenguaje, la percepción, la memoria, la acción motora, las funciones vegetativas centrales, el control de procesos cognitivos auomáticos y la tolerancia al estrés. Descritos inicialmente por Huber, desde una aproximación fenomenológica, forman parte de las manifestaciones más precoces de la esquizofrenia, a lo largo de cuyo curso pueden adquirir diferente evolución. Su presentación durante la fase prodrómica de la enfermedad, para cuya evaluación han sido desarrollados diferentes instrumentos, constituye (junto con los criterios ultra-high risk) una de las 2 principales aproximaciones para su caracterización, lo que permite definir estados clínicos de riesgo para el desarrollo de psicosis. En la presente revisión se ofrece una visión actualizada del concepto de síntomas básicos, subrayando su potencial valor a la hora de establecer correlatos neurobiológicos de interés en la investigación etiopatogénica (AU)

Basic symptoms consist of subtle sub-clinical disturbances subjectively experienced by schizophrenia patients. These are mainly related to drive, affect, thinking and language, perception, memory, motor action, central vegetative functions, control of cognitive processes, and stress tolerance. Initially described by Huber, from a phenomenological approach, basic symptoms are part of the earliest features of schizophrenia, and they can evolve along the course of the disorder. Their assessment during the prodromal phase of the disease (together with ultra-high risk criteria) is one of the 2 main approaches that allow the definition of states of clinical risk for the development of psychosis. The present review provides an updated view of the concept of basic symptoms, highlighting its potential value in establishing neurobiological correlates of interest in aetiopathogenic research (AU)

Ideología y ética de la voluntad. Una base para la reflexión bioética / Ideology and free will. A reflecion for bioethics

Este artículo trata sobre la ética de la voluntad que tiene su origen en las ideologías modernas de nuestro siglo. La voluntad, convertida en deseo, se vuelve sobre sí misma para acrecentar su propio poder. La ética de la voluntad se funda en la decisión de un individuo, que prioriza su voluntad sobre la razón y encuentra muchos obstáculos para actuar libremente. Kant para evitar en la moral los límites de una voluntad arbitraria, distingue al sujeto empírico, determinado por sus apetitos, del sujeto moral o racional, con una voluntad libre de condicionamientos. La ética de la voluntad es un reflejo del sujeto empírico kantiano y las ideologías vigentes. Frente a las ideologías se propone la vuelta a la tradición clásica, una ética que reflexiona sobre la vida humana y la realización del hombre en el mundo

This article is about the ethics of the will that is caused by modern ideologie of our century. The will, becomes desire, turns on itself to increase its own power. The ethics of the will is based on the decision of an individual, which prioritizes its will over reason and find many obstacles to act freely. Kant to avoid the moral limits of an arbitrary will, distinguishes the empirical subject, determined by their appetites, from the moral or rational subject, with a free will of conditioning. The ethics of the will is a reflection of Kant’s empirical subject and current ideologies. Against ideologies the classical tradition is proposed, an ethic that reflects on human life and the realization of man in the world

Association between the increase in brain temperature and physical performance at different exercise intensities and protocols in a temperate environment

There is evidence that brain temperature (Tbrain) provides a more sensitive index than other core body temperatures in determining physical performance. However, no study has addressed whether the association between performance and increases in Tbrain in a temperate environment is dependent upon exercise intensity, and this was the primary aim of the present study. Adult male Wistar rats were subjected to constant exercise at three different speeds (18, 21, and 24 m/min) until the onset of volitional fatigue. Tbrain was continuously measured by a thermistor inserted through a brain guide cannula. Exercise induced a speed-dependent increase in Tbrain, with the fastest speed associated with a higher rate of Tbrain increase. Rats subjected to constant exercise had similar Tbrain values at the time of fatigue, although a pronounced individual variability was observed (38.7-41.7°C). There were negative correlations between the rate of Tbrain increase and performance for all speeds that were studied. These results indicate that performance during constant exercise is negatively associated with the increase in Tbrain, particularly with its rate of increase. We then investigated how an incremental-speed protocol affected the association between the increase in Tbrain and performance. At volitional fatigue, Tbrain was lower during incremental exercise compared with the Tbrain resulting from constant exercise (39.3±0.3 vs 40.3±0.1°C; P<0.05), and no association between the rate of Tbrain increase and performance was observed. These findings suggest that the influence of Tbrain on performance under temperate conditions is dependent on exercise protocol.

Adaptación del Cuestionario de Voluntad de Trabajo a una muestra de universitarios españoles / Adaptation of Will-to-Work Questionnaire to a sample of Spanish undergraduate students

El objetivo del presente estudio es evaluar las propiedades psicométricas del Cuestionario de Voluntad de Trabajo adaptado a una muestra de estudiantes universitarios españoles, tanto en su versión de autoinforme como en la versión destinada a evaluar los pares. Los participantes de este estudio son 194 estudiantes de la Universidad de Barcelona, a los que se aplicaron tanto el cuestionario de Voluntad de Trabajo (CVT) como su versión para evaluar a los pares (CVT-P), así como las subescalas de Perseverancia y Distorsión del Big Factor Questionnaire. Los resultados sugieren la eliminación de dos de los ítems de los cuestionarios CVT y CVT-P. Las correlaciones ítem-total corregidas y la consistencia interna fue adecuada para ambos, y el análisis factorial confirmatorio confirma su unidimensionalidad. La relación entre la escala CVT y las demás medidas criterio es adecuada. En conclusión, podemos afirmar que las escalas CVT y CVT-P obtuvieron unas adecuadas propiedades psicométricas tras la depuración de las mismas (AU)

The aim of the present study was to assess the psychometric properties of the Will-to-work scale both in its self-reported and peer forms in a sample of Spanish undergraduate students. Participants of this study were 194 students from the University of Barcelona, who completed the following questionnaires: Will-to-work scale (WW), peer Will-to-work scale (PWW), and the Perseverance and Distortion subscales from the Big Factor Questionnaire. Results of this study suggested the need of deleting two of the items from the WW and PWW. Adequate item-total correlations were found, as well as acceptable values of internal consistency coefficients in both scales. The confirmatory factor analysis confirmed the one-factor structure of both scales. Relationships between WW and other criteria measures were also adequate. Finally, we can conclude that WW and PWW questionnaires obtained adequate psychometric properties after considering their refinement (AU)

Documento de voluntades anticipadas: opinión de los profesionales sanitarios de Atención Primaria / Advanced Directives Document: opinion of the primary health care professionals

Objetivo: Conocer la opinión de los profesionales sanitarios de la Atención Primaria (AP) sobre el Documento de Voluntades Anticipadas (DVA). Diseño. Estudio descriptivo transversal. Emplazamiento. Seis centros de salud de Tenerife. Sujetos. Médicos, enfermeros y residentes de medicina familiar y comunitaria. Método; Los participantes recibieron información escrita sobre el DVA junto con un cuestionario de seis preguntas cerradas diseñado específicamente. Resultados. Participaron un total de 113 profesionales (38,7% médicos; 22,6% residentes de Medicina Familiar y 38,7% enfermeros). El 60,6% fueron mujeres. La media de edad fue de 38,59 años (desviación típica [DT]: 9,4) y la media de experiencia laboral de 14,68 años (DT: 10,24). El 68,1% de los participantes conocía la posibilidad de realizar el DVA. El 70% respondió que el paciente debería tener la iniciativa de hablar sobre el DVA. Un 53,2% consideró la consulta de AP como el entorno adecuado, existiendo diferencias según la categoría profesional (residentes: 70,8%, enfermeros: 48,7% y médicos de AP 46,3%; p = 0,005) y según los años de experiencia laboral (menos de 15 años: 66,88%, más de 15 años: 36,84%; p = 0,05). Un 60,7% se sentiría cómodo abordando el tema. Las principales dificultades se encontraron al hablar de la muerte con el paciente (52,2%) o explicar trámites administrativos (45,1%). Conclusiones. El DVA es conocido por más de la mitad de los profesionales de AP, prefiriendo que sea el paciente el que tome la iniciativa. El considerar la consulta de AP el entorno adecuado para hablar del DVA es bien valorado, sobre todo por los profesionales con menos años de experiencia (AU)

Objective. To know primary care (PC) health professional´s opinion about advanced directives (AD). Design. Cross sectional, descriptive study. SETTING. Six health care centres in Tenerife. Participants. Primary care physicians, nurses and family medicine residents. Methods. Participants received written information on the AD along with a questionnaire that consisted of six closedended questions specially designed for this study. Results. 113 professionals participated (38,7% PC physicians, 22,6% family medicine residents and 38,7% nurses). 60,7% were women. The mean age was 38,59 years (SD: 9,4) and the average number of years of work experience was 14,68% (SD: 10,24). Over 68,1% knew the possibility of performing an AD. About 70% answered that patients take the initiative in discussing AD. Fifty-three percent considered a primary care visit as a suitable opportunity to discuss AD, but there were differences according to professional category (residents physicians: 70,8%, nurses: 48,7%, PC physicians: 46,3%, p = 0,005) and years of working experience (<15 years: 66,8%, >15 years: 36,84%, p = 0,05). Over 60,7% felt comfortable dealing with this subject. The main difficulties were found when talking about death with the patient (52,2%) or explaining administrative procedures (45,1%). Conclusions : More than a half of the primary care professionals knew AD, and they preferred patients to take the initiative regarding this subject. Considering primary care visit a suitable moment to discuss AD is well appreciated, especially by those professionals with less experience (AU)

La voluntad de morir / The death wish

En la carta del 19 de febrero de 1923, Ferenczi da cuenta a Groddeck de la muerte de una paciente suya por anemia perniciosa. De esa misma enfermedad moriría 10 años después el mismo Ferenczi. En esos 10 años su contribución teórico clínica fue extraordinaria y atravesó momentos cruciales del desarrollo de la teoría psicoanalítica como la conceptualización de Freud sobre la pulsión de muerte, la configuración de la segunda tópica, la publicación de Thalassa y "el principio de afirmación del displacer", la segunda teoría de Freud sobre la angustia y un intercambio epistolar con Groddeck que permite percibir los primeros esbozos de una teoría sobre la sintomatología psicosomática que sería posteriormente desarrollada. El autor intenta establecer las conexiones teóricas entre todos estos argumentos, destacando la aportación genial de Ferenczi que se nutría en muchos momentos de su propia experiencia patológica y de su propio sufrimiento interno. Una de las obras en las que con mayor claridad se refleja esta cuestión, es en su trabajo sobre "El niño mal recibido y la pulsión de muerte", donde aparece claramente conceptualizada la voluntad de morir, a la que se refiere todo este trabajo (AU)

In a letter of the 19th of February, 1923, Ferenczi tells Groddeck about the death of a patient of his by progressive pernicious anaemia. Ferenczi would die of that same illness ten years later. In those ten years his theoretical-clinical contribution was extraordinary, and went through crucial moments of the development of psychoanalytical theory such as Freud´s death drive, the configuration of the second topic, the publication of Thalassa and the problem of the acceptance of unpleasant ideas, Freud´s second theory of anxiety, and a correspondence with Groddeck that allows us to perceive the first outline of a theory on psycosomatic symptomatolgy that would be developed later. The author endeavours to establish some theoretical connections between these two arguments, highlighting Ferenczi´s brilliant contribution, which was often fueled by his own pathological experience and inner suffering. One of the works in which this matter is treated with great clarity is The Unwelcome Child and his Death Drive, in which the death wish, to which I will refer to throghout this work, is clearly conceptualized (AU)

Temperamento e hipertensión arterial. Divertimento / Temperament and arterial hypertension. Divertissement

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Deseos en los adolescentes de la calle / Wishes in the adolescents street children

Identificar los 3 deseos más frecuentes de 42 adolescentes de ambos sexos entre 10 y 17 años, albergados en las casas "Abuelita Mami" y " Mi Tío Simón", de la Alcaldía de Caracas y compararlos con los deseos de 42 pacientes de la consulta de Medicina del Adolescente del Hospital J.M de Los Ríos en el lapso marzo-junio de 1997. El deseo más frecuente se relacionó con estudios (33 por ciento) en muchachos de la calle. Otros fueron buena salud (19,5 por ciento) en niños de consulta. Unión familiar y afecto: todos los grupos, especialmente muchachos de la calle (11,9 por ciento). Trabajar: muchachos de la calle (14,2 por ciento). Recreación: niños de la calle (14,2 por ciento). A ambos grupos se les aplicó un instrumento de autoevaluación, en el cual se solicita la descripción de tres deseos que se analizaron de acuerdo a orden de frecuencia por método porcentual. Los deseos fueron diferentes en ambos grupos de adolescentes. Los muchachos de la calle desean estudiar y trabajar. Es importante reinsertar a los muchachos de la calle a su núcleo familiar, debido a la carencia afectiva que manifiestan a través de los deseos

Psicología y psicopatología de los conflictos. Las oposiciones lógicas (II): modalidades, querencias y afectaciones. El sistema psíquico relacional / Psychology and psychopathology of the conflicts. The logic oppositions (II): modalities, affections and affectations. The relational psychical system

En la segunda parte de este trabajo estudiaremos en especial la forma en que las querencias modifican (modalizan) los enunciados. Distinguiremos algunas dimensiones semánticas fundamentales para el trabajo psicoterapéutico según las polaridades de las querencias, especialmente en torno a la identidad (individualidad y relación) con respecto al poder y a la sexualidad (AU)

Sobre la afectación (II): valor, creencia y afectación / On the affectation (II): value, belief and affectation

En la segunda parte del trabajo trataremos sobre las afectaciones (consecuencia de los sucesos psíquicos) en su relación con los valores, las creencias y los procesos de deliberación (AU)

Síntomas psicóticos incongruentes con el humor en la manía: una revisión / Psychotic symtoms incongruent with mood in mania: a review

No disponible

Desarrollos actuales en el estudio del control emocional / New developments in the study of emotional control

Se lleva a cabo una revisión sobre el control emocional y se plantea un enfoque en el que la emoción es vista como una reacción formada por un conjunto de distintas respuestas sobre las que el individuo posee diferente grado de control (voluntario versus automático). Desde este enfoque, se analizan algunos fenómenos que han ocupado un lugar destacado en el desarrollo del modelo de los tres sistemas de respuesta emocional (el fraccionamiento de respuesta, la desincronía y la discordancia entre sistemas de respuesta). Se propone una explicación de estos fenómenos en base al diferente grado de control que el individuo posee sobre sus respuestas emocionales y se argumenta sobre cuáles pueden ser las variables situacionales e individuales que pueden generar mayor discordancia. Se revisa la literatura sobre la influencia de la alta demanda de control (como tarea experimental) sobre la discordancia, así como aquellas investigaciones que se centran en el estudio de las características de los sujetos con estilo represivo de afrontamiento, destacando la tendencia de estos individuos a controlar sus emociones negativas, su alto nivel de control percibido, y la discordancia que se produce entre su experiencia emocional (muy baja) y su activación fisiológica (muy elevada). Por último, se sugieren implicaciones para el tratamiento de los desórdenes emocionales (especialmente, los trastornos de ansiedad) que pueden suponer una mejora de la eficacia y el mantenimiento, así como una disminución de la discordancia (AU)