Virtual delivery of improvisational movement and social engagement interventions in the IMOVE trial during the COVID-19 pandemic.

Background: IMOVE evaluated the contributions of movement and social engagement to quality of life, brain network connectivity, and motor and social-emotional functioning in people with early-stage Alzheimer's disease participating with a caregiver. In response to COVID-19 restrictions, a pilot study was conducted to assess integrity of key elements of the intervention and feasibility of virtual intervention delivery. Methods: Participants in the parent study were randomized to one of 4 study conditions (Movement Group [MG], Movement Alone [MA], Social Group [SG], or Usual Care [UC; control]). To test virtual adaptations of each condition, groups of three participant-caregiver dyads (6 individuals) who had completed the parent trial participated in virtual adaptation classes. We adopted an engineering-inspired, rapid refinement model to optimize virtual interventions on the dimensions of social connectedness, fun, and physical exertion. After completing one iteration, participants gave feedback and adjustments were made to the intervention. This process was repeated until no further adjustments were needed. Results: The MA arm easily transitioned to virtual format. The virtual MG intervention required the most iterations, with participants reporting needs for additional technology support, higher level of physical exertion, and stronger social connection. The virtual SG intervention reported good social connection, but needed additional technology instruction and measures to promote equal participation. Conclusions: Our pilot study results underscore the feasibility of delivering remote social and/or dance interventions for older adults and provide a useful road map for other research teams interested in increasing their reach by adapting in-person group behavioral interventions for remote delivery.

Neural Correlates of a Trance Process and Alternative States of Consciousness in a Traditional Healer.

Trance processes are a form of altered states of consciousness (ASC) widely reported across cultures. Entering these states is often linked to auditory stimuli such as singing, chanting, or rhythmic drumming. While scientific research into this phenomenon is relatively nascent, there is emerging interest in investigating the neural correlates of altered states of consciousness such as trance. This report aims to add to this field of ASC through exploring how the perception of an experienced Sangoma (traditional South African healer) entering a trance process correlates to blood-oxygen-level-dependent (BOLD) signal modulation with auditory stimuli. Functional Magnetic Resonance Imaging (fMRI) data were analyzed using a General Linear Model comparing music versus no music condition multiplied by the percept of experiencing trance (High or Low). Positive BOLD activation was shown in the auditory cortex in both hemispheres during a trance process. Other brain regions tightly correlated to trance perception were the right parietal, right frontal, and area prostriata (p < 0.05, Bonferroni corrected). The orbitofrontal cortex (part of the Default Mode Network) was negatively activated and most correlated with music when trance was high, showing the largest differential between high and low trance perception. This is the first study to directly correlate BOLD signal variations in an expert subject's percept of trance onset and intensity, providing insight into the neural signature and dynamics of this unique form of ASC. Future studies should examine in greater detail the perception of trance processes in expert subjects, adding other neuroimaging modalities to further investigate how these brain regions are modulated by trance expertise.

Mobile brain/body Imaging in dance: A dynamic transdisciplinary field for applied research.

Neuroscience of dance is an emerging field with important applications related to health and well-being, as dance has shown potential to foster adaptive neuroplasticity and is increasingly popular as a therapeutic activity or adjunct therapy for people living with conditions such as Parkinson's and Alzheimer's diseases. However, the multimodal nature of dance presents challenges to researchers aiming to identify mechanisms involved when dance is used to combat neurodegeneration or support healthy ageing. Requiring simultaneous engagement of motor and cognitive domains, dancing includes coordination of systems involved in timing, memory and spatial learning. Studies on dance to this point rely primarily on assessments of brain dynamics and structure through pre/post-tests or studies on expertise, as traditional brain imaging modalities restrict participant movement to avoid movement-related artefacts. In this paper, we describe the process of designing and implementing a study that uses mobile brain/body imaging (MoBI) to investigate real-time changes in brain dynamics and behaviour during the process of learning and performing a novel dance choreography. We show the potential for new insights to emerge from the coordinated collection of movement and brain-based data, and the implications of these in an emerging field whose medium is motion.

Multinetwork Motor Learning as a Model for Dance in Neurorehabilitation.

With expanding applications for dance in geriatrics, including rehabilitation and pre-habilitation of neurodegenerative conditions, an examination of how elements of dance may contribute to specific improvements is called for. "Dance" can refer to a vast number of diverse practices; dancing may be rehearsed or improvised, performed with or without music, and may include a wide variety of styles of movement and accompanying sounds; some dances, such as tango and other social dance forms, rely on a partner, while many folk and cultural forms are group-based; artistic and contemporary forms may consist of solo exploration/performance. Research on the impacts of dance-based interventions has spanned in many different varieties of dance, and often the specifics of dance interventions involved are sparsely provided. This paper offers a brief review of elements central to many dance forms that may contribute to rehabilitation, suggesting hypotheses for future research and training, examining how elements of dance may foster adaptive plasticity. Primary topics include motor learning, motor control, spatial navigation, action observation, and entrainment, with suggested future considerations as to how imagery, imagination, multisensory integration, mental rehearsal, volitional movement, and creativity in nonexpert populations contribute to a multinetwork toolbox that may be neuroprotective.

Improvisational Movement to Improve Quality of Life in Older Adults With Early-Stage Dementia: A Pilot Study.

Alzheimer's disease has profound effects on quality of life, affecting not only cognition, but mobility and opportunities for social engagement. Dance is a form of movement that may be uniquely suited to help maintain quality of life for older adults, including those with dementia, because it inherently incorporates movement, social engagement, and cognitive stimulation. Here, we describe the methods and results of the pilot study for the IMOVE trial (NCT03333837, www.clinicaltrials.gov), a clinical trial designed to use improvisational dance classes to test the effects of movement and social engagement in people with mild cognitive impairment (MCI) or early-stage dementia. The pilot study was an 8-week investigation into the feasibility and potential effects of an improvisational dance intervention on people with MCI or early-stage dementia (PWD/MCI) and their caregivers (CG). The pilot aimed to assess changes in quality of life, balance, mood, and functional brain networks in PWD/MCI and their CG. Participants were recruited as dyads (pairs) that included one PWD/MCI and one CG. Ten total dyads were enrolled in the pilot study with five dyads assigned to the usual care control group and five dyads participating in the dance intervention. The intervention arm met twice weekly for 60 min for 8 weeks. Attendance and quality of life assessed with the Quality of Life in Alzheimer's disease (QoL-AD) questionnaire were the primary outcomes. Secondary outcomes included balance, mood and brain network connectivity assessed through graph theory analysis of functional magnetic resonance imaging (fMRI). Class attendance was 96% and qualitative feedback reflected participants felt socially connected to the group. Increases in quality of life and balance were observed, but not mood. Brain imaging analysis showed increases in multiple brain network characteristics, including global efficiency and modularity. Further investigation into the positive effects of this dance intervention on both imaging and non-imaging metrics will be carried out on the full clinical trial data. Results from the trial are expected in the summer of 2022.