Motor adaptation in deaf and hearing native signers.

Previous studies have suggested that deafness could lead to deficits in motor skills and other body-related abilities. However, the literature regarding motor skills in deaf adults is scarce and existing studies often included participants with heterogeneous language backgrounds and deafness etiologies, thus making it difficult to delineate the effects of deafness. In this study, we investigated motor learning in deaf native signers and hearing nonsigners. To isolate the effects of deafness and those of acquiring a signed language, we additionally tested a group of hearing native signers. Two well-established paradigms of motor learning were employed, in which participants had to adapt their hand movements to a rotation of the visual feedback (Experiment 1) or to the introduction of a force field (Experiment 2). Proprioceptive estimates were assessed before and after adaptation. Like hearing nonsigners, deaf and hearing signers showed robust adaptation in both motor adaptation paradigms. No significant differences in motor adaptation and memory were observed between deaf signers and hearing nonsigners, as well as between hearing signers and hearing nonsigners. Moreover, no discernible group differences in proprioceptive accuracy were observed. These findings challenge the prevalent notion that deafness leads to deficits in motor skills and other body-related abilities.

Sign learning of hearing children in inclusive day care centers-does iconicity matter?

An increasing number of experimental studies suggest that signs and gestures can scaffold vocabulary learning for children with and without special educational needs and/or disabilities (SEND). However, little research has been done on the extent to which iconicity plays a role in sign learning, particularly in inclusive day care centers. This current study investigated the role of iconicity in the sign learning of 145 hearing children (2;1 to 6;3 years) from inclusive day care centers with educators who started using sign-supported speech after a training module. Children's sign use was assessed via a questionnaire completed by their educators. We found that older children were more likely to learn signs with a higher degree of iconicity, whereas the learning of signs by younger children was less affected by iconicity. Children with SEND did not benefit more from iconicity than children without SEND. These results suggest that whether iconicity plays a role in sign learning depends on the age of the children.

Developmental experiences alter the temporal processing characteristics of the visual cortex: Evidence from deaf and hearing native signers.

To date, the extent to which early experience shapes the functional characteristics of neural circuits is still a matter of debate. In the present study, we tested whether congenital deafness and/or the acquisition of a sign language alter the temporal processing characteristics of the visual system. Moreover, we investigated whether, assuming cross-modal plasticity in deaf individuals, the temporal processing characteristics of possibly reorganised auditory areas resemble those of the visual cortex. Steady-state visual evoked potentials (SSVEPs) were recorded in congenitally deaf native signers, hearing native signers, and hearing nonsigners. The luminance of the visual stimuli was periodically modulated at 12, 21, and 40 Hz. For hearing nonsigners, the optimal driving rate was 12 Hz. By contrast, for the group of hearing signers, the optimal driving rate was 12 and 21 Hz, whereas for the group of deaf signers, the optimal driving rate was 21 Hz. We did not observe evidence for cross-modal recruitment of auditory cortex in the group of deaf signers. These results suggest a higher preferred neural processing rate as a consequence of the acquisition of a sign language.

The interaction of the visuo-spatial and the vestibular system depends on sensory experience in development.

In hearing individuals, vestibular and visuo-spatial functions seem to be functionally linked. Previous studies have suggested that congenitally deaf individuals are at a higher risk for vestibular problems, which in hearing adults have often been found to be associated with impairments in visuo-spatial processing. However, communicating in a sign language provides extensive practice in visuo-spatial processing, which might counteract negative effects of vestibular impairments. Here, we investigated whether the functional link between vestibular and visuo-spatial functions is mandatory, that is whether it is impenetrable to experience or context, or whether it is dependent on specific sensory and cognitive experiences. To this end, we tested a group of congenitally deaf native signers and a group of hearing nonsigners on mental rotation and balance tasks. Compared to hearing nonsigners, mental rotation was superior in the deaf signers in conditions crucial for sign language comprehension. By contrast, the balance performance of the group of deaf signers was impaired. While in the group of hearing nonsigners, balance skills correlated with mental rotation abilities, no such relationship was observed in the group of deaf signers. These results suggest that the link between vestibular and visuo-spatial functions is not fixed but can be altered or even cancelled out by certain sensory or cognitive experiences, such as the acquisition of a sign language.

Neural correlates of semantic and syntactic processing in German Sign Language.

The study of deaf and hearing native users of signed languages can offer unique insights into how biological constraints and environmental input interact to shape the neural bases of language processing. Here, we use functional magnetic resonance imaging (fMRI) to address two questions: (1) Do semantic and syntactic processing in a signed language rely on anatomically and functionally distinct neural substrates as it has been shown for spoken languages? and (2) Does hearing status affect the neural correlates of these two types of linguistic processing? Deaf and hearing native signers performed a sentence judgement task on German Sign Language (Deutsche Gebärdensprache: DGS) sentences which were correct or contained either syntactic or semantic violations. We hypothesized that processing of semantic and syntactic violations in DGS relies on distinct neural substrates as it has been shown for spoken languages. Moreover, we hypothesized that effects of hearing status are observed within auditory regions, as deaf native signers have been shown to activate auditory areas to a greater extent than hearing native signers when processing a signed language. Semantic processing activated low-level visual areas and the left inferior frontal gyrus (IFG), suggesting both modality-dependent and independent processing mechanisms. Syntactic processing elicited increased activation in the right supramarginal gyrus (SMG). Moreover, psychophysiological interaction (PPI) analyses revealed a cluster in left middle occipital regions showing increased functional coupling with the right SMG during syntactic relative to semantic processing, possibly indicating spatial processing mechanisms that are specific to signed syntax. Effects of hearing status were observed in the right superior temporal cortex (STC): deaf but not hearing native signers showed greater activation for semantic violations than for syntactic violations in this region. Taken together, the present findings suggest that the neural correlates of language processing are partly determined by biological constraints, but that they may additionally be influenced by the unique processing demands of the language modality and different sensory experiences.

Does listing for heart transplant for longer than 30 days before ventricular assist device implantation influence utilization of psychotherapeutic support and outcome?

OBJECTIVES: Previous studies indicate that patients with mechanical ventricular assist devices (VADs) experience high psychosocial and emotional distress. Listing for transplant may trigger psychosocial adjustment to the transplantation as an upcoming critical life-event. We hypothesized that patients could profit from this adaptation when implantation of a VAD becomes necessary. METHODS: We arbitrarily chose a cut-off at 30 days after being put on the heart transplantation (HTX) waiting list. Eighteen patients were listed for HTX for >30 days (referred to as 'listed') and 26 for shorter periods or not at all ('non-listed'). Survival, the occurrence of mental disorders, the number of contacts of the patient with the psychologist and times spent on psychotherapeutic support for both patient groups and for their families were analysed. RESULTS: Survival after VAD implantation (observation time) and mental disorders were comparable for listed and non-listed patients. Mental disorders were developed in 80% of all patients irrespective of the listing group. The utilization of supportive psychotherapy did not differ between the listed and the non-listed group with regard to the number of contacts and to the time needed for individual therapy. Moreover, the number of families who requested support did not differ between the groups nor did the time spent on family therapy. However, the number of contacts and the time for individual psychotherapeutic support correlated with the observation time, whereas the time spent on family therapy did not. In contrast, family therapy correlated inversely with age. In addition, we compared bridge-to-transplantation patients with destination therapy patients. There were no differences in the occurrence of mental disorders, the number of contacts or in the time expenses for individual and for family therapy, neither for all patients nor after stratification for listing. CONCLUSIONS: Our data indicate that listing for HTX for >30 days before VAD implantation does not reduce the utilization of psychotherapeutic support by VAD patients. We assume that structured emotional and psychosocial support by the interdisciplinary VAD team, including professional supportive psychotherapy, is indispensable for successful coping of VAD patients and their families.

Supportive psychotherapy for patients with heart transplantation or ventricular assist devices.

OBJECTIVE: Both heart transplant (HTX) candidates and patients on ventricular assist device (VAD) support suffer from severe heart failure and have to fear life-threatening complications. For both patient groups, the importance of screening for and treatment of psychosocial problems and mental disorders to optimize compliance and survival has been acknowledged. We compared the use of psychotherapeutic support by patients with primary HTX, on VAD support, either on destination therapy or to be transplanted, and successfully bridged to transplant. In addition, we evaluated the use for supportive psychotherapy for the families of our patients and present two typical cases. METHODS: Patients with primary HTX (HTX(prim), n=16), with VAD on destination therapy (VAD(dest), n=15), with VAD waiting for transplant (VAD(htx), n=9), and patients who have been successfully bridged on VAD to transplant (HTX(vad), n=11) were analyzed during the preoperative and the in-hospital postoperative period. International Classification of Diseases (ICD 10) diagnoses, number of contacts with the psychologist, time expenses for individual interventions, family interventions, and concomitant communication were assessed. RESULTS: Adjustment disorders were the most prevalent disturbances. HTX(vad) patients needed more psychotherapeutic interventions and required more time for individual support than HTX(prim) patients. Partners and families of almost one-half of all patients made use of supportive psychotherapy; there were no differences between the groups with regard to the needed time. Further, the groups did not differ in the time expenses for concomitant communication with the psychologist. At the latest contact with the psychologist, three VAD(dest) patients did not need further psychotherapy at this time; also, one VAD patient waiting for transplant and two after primary HTX were psychosocially stable. CONCLUSION: Our data reflect the high emotional distress, especially of HTX(vad) patients. Our data suggest further that patients on VAD support experience psychosocial and emotional stress as severe as HTX candidates and recipients do. Patients on destination therapy and those who are waiting for transplantation do not differ in this regard. The high complexity of the psychosocial problems of VAD and HTX patients warrants professional psychotherapeutic support.

Analysis of polymorphic sites in the promoter of the nitric oxide synthase 2 gene.

A point mutation (G --> C) in the gene promoter for the human nitric oxide synthase (NOS) 2 at position -954 is associated with protection against severe Plasmodium falciparum malaria in Gabon. Carriers of this mutation show higher basal levels of nitric oxide production than wild type individuals. To obtain information about the possible binding transcription factors, nucleic proteins from the lung carcinoma cell line were enriched by affinity chromatography using DEAE-Sepharose and immobilized oligonucleotides derived from the promoter sequence. A mutational analysis was performed on 30 samples to detect polymorphisms in the NOS2 promoter region that contains important NF-kappaB sites. Three point mutations were identified in this region. In vitro studies with promoter constructs showed an altered expression of the marker gene depending on the promoter variant used.