Effects of skin-to-skin contact in supported diagonal flexion positioning on movement quality in very preterm infants at term age.

BACKGROUND: Preterm birth is associated with a high risk of long-term neuromotor disabilities such as coordination of movements, deficient antigravity limb movement, less adaptive postural control strategies, head deformities… AIMS: The aim of the present study was to examine the potential positive impact of a Supported Diagonal Flexion (SDF) skin-to-skin contact (SSC) positioning on the neuromotor development and movement quality of very preterm infants at term age. STUDY DESIGN: Monocentric prospective matched-pair case-control study. SUBJECTS: Thirty very preterm infants and their mother were proposed either SDF SSC positioning (n = 15) or Vertical SSC positioning (n = 15). OUTCOME MEASURES: Amiel-Tison Neurological Assessment at Term (ATNAT) and observation of the spontaneous motor activity were assessed at term corrected age. RESULTS: Infants in the SDF group had less dolichocephaly (adj. p = .014) and arms in candlestick position (adj. p = .048). Only 3 in the SDF group against 11 in the vertical group showed nonoptimal spontaneous motor activity. Infants in the SDF group had more positive signs such as foot-to-foot contact (adj. p = .047) or arms movements toward midline (adj. p = .046 and 0.011). CONCLUSIONS: The present study shows that nonoptimal spontaneous motor activity was increased and dolichocephaly was more common in the vertical group. Consistently with current guidelines, it is critical to consider preterm infants' postures during SSC or while in incubators or cradles.

Reflection on traditional sporting games: the impact of bodily involvement on empathic dimensions.

The aim of this study was to investigate bodily engagement and involvement in traditional sporting games (TSGs), with a focus on the development of empathy. Even though the current research on empathy has been focused on its emotional component, the name "empathy" alludes to a considerably more profound dimension than emotional engagement. Empathy refers to the ability to perceive another person's private life through the exchange of contextual factors provided through interactive sports activities. In this study, based on real-world experiences, it has been demonstrated that traditional sporting games stimulate, preserve, or reveal empathic capacities in several ways. Games can show and sustain the full potential of empathic dispositions if they are present at a young age. Moreover, by examining empathy through the prism of a TSG, we recognized them as a source of relational empathy and feelings developed to various degrees by direct involvement. As a result, we may define empathy as an integrated pedagogy that can be more successfully conducted through TSGs which are multifaceted because of their internal and external logic systems. Essentially, the hypotheses discussed in this study allow us to postulate that the physical gaming involvement of players, such as role changes, influences the individual's empathic dimensions. Furthermore, the characteristics of traditional sporting game interaction networks may serve as a source of encouragement or inspiration for a wide range of games (theatrical, social, etc.).

Neural Substrates for Hand and Shoulder Movement in Healthy Adults: A Functional near Infrared Spectroscopy Study.

Characterization of cortical activation patterns during movements in healthy adults may help our understanding of how the injured brain works. Upper limb motor tasks are commonly used to assess impaired motor function and to predict recovery in individuals with neurological disorders such as stroke. This study aimed to explore cortical activation patterns associated with movements of the hand and shoulder using functional near-infrared spectroscopy (fNIRS) and to demonstrate the potential of this technology to distinguish cerebral activation between distal and proximal movements. Twenty healthy, right-handed participants were recruited. Two 10-s motor tasks (right-hand opening-closing and right shoulder abduction-adduction) were performed in a sitting position at a rate of 0.5 Hz in a block paradigm. We measured the variations in oxyhemoglobin (HbO2) and deoxyhemoglobin (HbR) concentrations. fNIRS was performed with a 24-channel system (Brite 24®; Artinis) that covered most motor control brain regions bilaterally. Activation was mostly contralateral for both hand and shoulder movements. Activation was more lateral for hand movements and more medial for shoulder movements, as predicted by the classical homunculus representation. Both HbO2 and HbR concentrations varied with the activity. Our results showed that fNIRS can distinguish patterns of cortical activity in upper limb movements under ecological conditions. These results suggest that fNIRS can be used to measure spontaneous motor recovery and rehabilitation-induced recovery after brain injury. The trial was restropectively registered on January 20, 2023: NCT05691777 (clinicaltrial.gov).

Gross Motor Development in Preschoolers through Conductivist and Constructivist Physical Recreational Activities: Comparative Research.

Developing gross motor function implies strengthening the basic body position and the balance associated with posture and mobility, for which different teaching models and psycho-pedagogical interventions are applied. OBJECTIVE: to develop gross motor function in male preschoolers through physical recreational activities based on conductivist (Group 1) and constructivist (Group 2) teaching and determine the best teaching paradigm. Two basic skills were studied in two homogeneous independent samples (walking: w = 0.641; running: w = 0.556), selecting 25 children for each group (3-4 years) through the use of intentional sampling. The gross skills evaluation was based on norms established by the Education Ministry, including a mood assessment. RESULTS: each group improved their basic skills in the post-test (Group 1: W = 0.001; W = 0.001. Group 2: W = 0.046; W = 0.038), but the conductivist paradigm was superior (w = 0.033; w = 0.027). Group 1 presented better indicators in the motor evaluations "Acquired" and "In Process" than Group 2, and lower percentages in the "Initiated" evaluation than Group 2 in the abilities "walking" as well as "running", which were significantly different in the "Initiated" evaluation (p = 0.0469) for the walking ability, and significantly different in the "Initiated" and "Acquired" evaluations (p = 0.0469; p = 0.0341, respectively) for the running skill. CONCLUSIONS: The conductivist teaching model was superior in terms of gross motor function optimization.

The minimal clinically important difference of the motricity index score.

INTRODUCTION: The Motricity Index (MI) can predict motor function after rehabilitation, but its minimal clinically important difference (MCID) has not been established. The primary study aim was to estimate the MCID value of the MI arm score. METHODS: Between 2017 and 2018, 173 participants hospitalized with confirmed ischemic stroke were recruited into an observational rehabilitation study. Participants with motor weakness as measured by the Fugl-Meyer upper-extremity (FM-UE) and MI with complete baseline and follow-up assessments at 3 months were included in this analysis. The longitudinal recovery of the MI arm score was anchored to having a poor outcome based on the FM-UE recovery (<9) longitudinally. Results reported include the area-under-curve (AUC), along with sensitivity, specificity, and optimal cut-points based on maximizing the Youden statistic. RESULTS: Sixty-nine patients (median [IQR] age 70 [18] years; 48% male; 54% white) were included in the final analysis. Mean ± standard deviation outcome scores at 3-months were: MI arm: 83.19 ± 22.80; FM-UE: 53.04 ± 17.26. For the primary results, the MI arm score optimal MCID cutoff for observed recovery was 13 points with a sensitivity of 80% (95% Confidence Interval (CI)(67.6%, 92.4%)) and a specificity of 69.0% (95% CI (52.1, 85.8%)), and the AUC was 0.8082 (0.7007, 0.9157). CONCLUSIONS: This was the first study to report the MCID of the MI arm score, as anchored to the FM-UE recovery between acute evaluation and 3-months. The estimated optimal MCID of improvement in the MI arm score was 13 points.

Longitudinal prediction of motor dysfunction after stroke: a disconnectome study.

Motricity is the most commonly affected ability after a stroke. While many clinical studies attempt to predict motor symptoms at different chronic time points after a stroke, longitudinal acute-to-chronic studies remain scarce. Taking advantage of recent advances in mapping brain disconnections, we predict motor outcomes in 62 patients assessed longitudinally two weeks, three months, and one year after their stroke. Results indicate that brain disconnection patterns accurately predict motor impairments. However, disconnection patterns leading to impairment differ between the three-time points and between left and right motor impairments. These results were cross-validated using resampling techniques. In sum, we demonstrated that while some neuroplasticity mechanisms exist changing the structure-function relationship, disconnection patterns prevail when predicting motor impairment at different time points after stroke.

Relationship between Oral Health Status and Oropharyngeal Dysphagia in Older People: A Systematic Review.

The purpose of this review is to investigate the relationship between oral health status and oropharyngeal dysphagia (OD) in older people and to collect a list of oral health indicators that can enable carers and health professionals to screen for risk of dysphagia in older people during oral examinations. A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P 2015) guidelines. The analysis methods and inclusion criteria were documented in a protocol published in the Prospective International Register of Systematic Reviews (PROSPERO) under the registration number CRD42020140458. A total of 19 articles published between 2002 and 2020 were retained by the search criteria for the qualitative synthesis. Eighteen studies demonstrated at least one positive association between an oral health component (dental, salivary and/or muscular) and dysphagia. This review highlights that oral health and OD are associated but was not able to determine causality. The lack of scientific evidence could be explained by the observational approach of the majority of the studies and the irrelevant choice of oral health indicators. A relationship may exist between oral health and dysphagia, but this review highlights the lack of valid and standardized oral health indicators that would be needed to assess the impact of oral health on the overall health status of individuals.

Adjustable Parameters and the Effectiveness of Adjunct Robot-Assisted Gait Training in Individuals with Chronic Stroke.

The aims of this study were (1) to compare the effect of robot-assisted gait orthosis (RAGO) plus conventional physiotherapy with the effect of conventional therapy alone on functional outcomes, including balance, walking ability, muscle strength, daily activity, and cognition, in chronic stroke patients, and (2) to determine the association of adjustable parameters of RAGO on functional outcomes. Adjustable parameters of RAGO included guidance force, treadmill speed, and body-weight support. This retrospective cohort study enrolled 32 patients with chronic stroke. Of these, 16 patients received RAGO plus conventional physiotherapy (RAGO group), and 16 patients received conventional physiotherapy alone (control group). Balance was assessed using the Berg Balance Scale, walking ability using the Functional Ambulation Category, muscle strength using the Motricity Index, daily activity using the Barthel Index, and cognition using the Mini-Mental State Examination. The scores were assessed before and after training. The Mini-Mental State Examination and the Berg Balance Scale increased significantly in both groups, whereas improvements in the Motricity Index and the Barthel Index were only observed in the RAGO group after intervention. During RAGO training, reducing guidance force and body-weight support assistance was associated with improvements in the Barthel Index, whereas higher treadmill walking speed was associated with improvements in the Berg Balance Scale. Our study found that RAGO combination therapy resulted in improvements in more functional outcomes than did conventional training alone. The adjustable parameters of the RAGO training were partly associated with training outcomes.

A Case Study of Upper Limb Robotic-Assisted Therapy Using the Track-Hold Device.

The Track-Hold System (THS) project, developed in a healthcare facility and therefore in a controlled and protected healthcare environment, contributes to the more general and broad context of Robotic-Assisted Therapy (RAT). RAT represents an advanced and innovative rehabilitation method, both motor and cognitive, and uses active, passive, and facilitating robotic devices. RAT devices can be equipped with sensors to detect and track voluntary and involuntary movements. They can work in synergy with multimedia protocols developed ad hoc to achieve the highest possible level of functional re-education. The THS is based on a passive robotic arm capable of recording and facilitating the movements of the upper limbs. An operational interface completes the device for its use in the clinical setting. In the form of a case study, the researchers conducted the experimentation in the former Tabarracci hospital (Viareggio, Italy). The case study develops a motor and cognitive rehabilitation protocol. The chosen subjects suffered from post-stroke outcomes affecting the right upper limb, including strength deficits, tremors, incoordination, and motor apraxia. During the first stage of the enrolment, the researchers worked with seven patients. The researchers completed the pilot with four patients because three of them got a stroke recurrence. The collaboration with four patients permitted the generation of an enlarged case report to collect preliminary data. The preliminary clinical results of the Track-Hold System Project demonstrated good compliance by patients with robotic-assisted rehabilitation; in particular, patients underwent a gradual path of functional recovery of the upper limb using the implemented interface.

Cerebellar and Striatal Implications in Autism Spectrum Disorders: From Clinical Observations to Animal Models.

Autism spectrum disorders (ASD) are complex conditions that stem from a combination of genetic, epigenetic and environmental influences during early pre- and postnatal childhood. The review focuses on the cerebellum and the striatum, two structures involved in motor, sensory, cognitive and social functions altered in ASD. We summarize clinical and fundamental studies highlighting the importance of these two structures in ASD. We further discuss the relation between cellular and molecular alterations with the observed behavior at the social, cognitive, motor and gait levels. Functional correlates regarding neuronal activity are also detailed wherever possible, and sexual dimorphism is explored pointing to the need to apprehend ASD in both sexes, as findings can be dramatically different at both quantitative and qualitative levels. The review focuses also on a set of three recent papers from our laboratory where we explored motor and gait function in various genetic and environmental ASD animal models. We report that motor and gait behaviors can constitute an early and quantitative window to the disease, as they often correlate with the severity of social impairments and loss of cerebellar Purkinje cells. The review ends with suggestions as to the main obstacles that need to be surpassed before an appropriate management of the disease can be proposed.

Chronic exposure to cyclohexane induces stereotypic circling, hyperlocomotion, and anxiety-like behavior associated with atypical c-Fos expression in motor- and anxiety-related brain regions.

Recreational abuse of solvents continues, despite cyclohexane (CHX) is used as a safe replacement in gasoline or adhesive formulations. Increasing evidence indicates that CHX inhalation affects brain functioning; however, scanty information is available about its effects on behavior and brain activity upon drug removal. In this study, we used CD1 adult mice to mimic an intoxication period of recreational drugs for 30 days. During the CHX exposure (~30,000 ppm), we analyzed exploratory and biphasic behaviors, stereotypic circling, and locomotion. After CHX removal (24 h or a month later), we assessed anxiety-like behaviors and quantified c-Fos cells in motor- and anxiety-related brain regions. Our findings indicate that the repeated inhalation of CHX produced steady hyperactivity and reduced ataxia, sedation, and seizures as the exposure to CHX progressed. Also, CHX decreased grooming and rearing behaviors. In the first week of CHX inhalation, a stereotypic circling behavior emerged, and locomotion increased gradually. One month after CHX withdrawal, mice showed low activity in the center zone of the open field and more buried marbles. Twenty-four hours after CHX removal, c-Fos expression was low in the dorsal striatum, ventral striatum, motor cortex, dorsomedial prefrontal cortex, basolateral amygdala, lateral hypothalamus, and ventral hippocampus. One month later, c-Fos expression remained low in the ventral striatum and lateral hypothalamus but increased in the dorsomedial prefrontal cortex and primary motor cortex. This study provides a comprehensive behavioral characterization and novel histological evidence of the CHX effects on the brain when is administered in a recreational-like mode.

Effects of neuromuscular training on psychomotor development and active joint position sense in school children.

As psychomotor development occurs in a specific social context, the environment in which a child is reared is important. The randomized study involved forty-five school children between 8 and 10 years. They were assigned to a control group (n = 23) and a neuromuscular training group (n = 22). A neuromuscular intervention for six weeks, on two nonconsecutive days, and in a circuit with 30-second stations was performed. The psychomotor development was evaluated through a psychomotor battery and the active joint position sense through the positional error. In the control group, the positional error decreased significantly in the shoulder (p < 0.001) and hip (p < 0.001), while the scores of motor function increased significantly which included balance (p < 0.001), spatio-temporal structuring (p = 0.022), global praxia (p = 0.002), and fine praxia (p = 0.003). In the neuromuscular training group, the positional error decreased significantly in the shoulder (p = 0.015), elbow (p = 0.015), wrist (p < 0.001), hip (p < 0.001), knee (p < 0.001), and ankle (p < 0.001), while the motor function scores increased significantly which included tonicity (p < 0.001), balance (p < 0.001), notion of the body (p < 0.001), spatio-temporal structuring (p < 0.001), global praxia (p < 0.001), and fine praxia (p < 0.001). A six-week neuromuscular training improved active joint position sense and psychomotor development in children.

Effect of physical therapy on 7- to 10-year-old children with autism spectrum disorder: A retrospective study in a university day hospital.

More than half of children who have autism spectrum disorder (ASD) suffer from motor impairment. In a retrospective study, the authors investigated the effect of a body-mediated workshop with dance movement therapy (DMT) on the motor skills and social skills of children with ASD by comparing 10 autistic children aged 7 to 10 years who benefited from DMT with 10 autistic children in a control group. Scores on the Movement Assessment Battery for Children and the Vineland Adaptive Behavior Scale were compared. The body-mediated workshop had significant benefits for motricity, especially manual dexterity, and for relational skills. A body-mediated workshop may have a multimodal effect and requires transmodal training. Regarding the mechanisms that explain the benefits and the cascading effect, the roles of imitation and multimodal connections are important.

Ultrassonografia dos movimentos de língua na avaliação e terapia do ceceio anterior: um estudo de caso / Ultrasonography of tongue movements in the assessment and therapy of anterior lisp: a case study / Ecografía de los movimientos de la lengua en la evaluación y la terapia del ceceo anterior: un estudio de caso

Introdução: O ceceio é um tipo de transtorno dos sons da fala decorrente de alterações nas estruturas orofaciais. Os métodos perceptivo-auditivos de avaliação fonoaudiológica podem gerar dúvidas quanto à natureza do transtorno e, portanto, as avaliações instrumentais são recomendadas para obter um diagnóstico mais preciso e completo. A ultrassonografia dos movimentos de língua permite a visualização em tempo real do movimento da língua durante a fala podendo contribuir na fonoterapia como biofeedback visual ultrassonográfico (BVU). Objetivos: Descrever os gestos articulatórios das fricativas /s/, /z/, /ʃ/ e /Æ·/ pré e pós-terapia fonoaudiológica com BVU em uma criança com ceceio anterior. Métodos: Foram avaliados diversos aspectos da fala de uma menina de oito anos com ceceio anterior, e coletadas imagens ultrassonográficas antes e após cinco sessões de terapia utilizando BVU. Foram comparadas as imagens da língua na produção dos sons /s, z, ʃ, Æ·/ pré e pós a intervenção fonoaudiológica com BVU. Resultados: Antes do tratamento, a paciente anteriorizava sem elevar a ponta de língua em /s/ e /z/; e em /ʃ/ e /Æ·/ também havia anteriorização de ponto articulatório, mas sem interposição. Após a fonoterapia, houve ajuste do ponto articulatório e aquisição da elevação de ponta de língua em /s/ e /z/ resultando em maior constrição de língua em /ʃ/ e /Æ·/. Conclusão: A ultrassonografia mostrou-se importante para a caracterização e descrição do ceceio anterior, e o seu uso como BVU permitiu melhora expressiva na produção articulatória por proporcionar automonitoramento durante a fala, num curto período de atendimento.

Introduction: lisping is a type of speech disorder resulting from changes in orofacial structures. The auditory-perceptual methods of speech-language assessment can raise doubts as to the nature of the disorder and, therefore, instrumental assessments are recommended to obtain a more accurate diagnosis. Ultrasonography of tongue movements allows real-time visualization of tongue movement during speech and may contribute to speech therapy as visual biofeedback. Objectives: To describe the articulatory gestures of fricatives /s/, /z/, /ʃ/ e /Ʒ/ before and after speech therapy with visual ultrasound biofeedback in a child with anterior lisp. Methods: Several aspects of the speech of an eight-year-old girl with previous lisp were evaluated, and ultrasound images were collected before and after 05 therapy sessions using ultrasound as instrumental biofeedback. The images of the tongue in the production of sounds /s, z, ʃ, Ʒ/ were compared before and after the speech therapy intervention. Results: Before treatment, the patient anteriorized without raising the tip of the tongue in /s/ and /z/; in /ʃ/ and /Ʒ/ there was anteriorization of the articulation point, but without interposition. After speech therapy, he adjusted the articulation point and acquired tongue tip elevation in /s/ and /z/ and presented greater tongue constriction in /ʃ/ and /Ʒ/. Conclusion: Ultrasonography proved to be important for the diagnosis and description of the previous lisp, and its use as biofeedback allowed a significant improvement in articulatory production due to its self-monitoring during speech, in a short period of care.

Introducción: el ceceo es un tipo de trastorno del habla resultante de cambios en las estructuras orofaciales. Los métodos auditivo-perceptivos de evaluación del habla y el lenguaje pueden generar dudas sobre la naturaleza del trastorno y, por lo tanto, se recomiendan evaluaciones instrumentales para obtener un diagnóstico más preciso. La ecografía de los movimientos de la lengua permite la visualización en tiempo real del movimiento de la lengua durante el habla y puede contribuir a la terapia del habla como biorretroalimentación visual. Objetivos: Describir los gestos articulatorios involucrados en la producción del habla de un niño con ceceo previo y compararlos antes y después de la logopedia con biofeedback visual por ultrasonido. Métodos: Se evaluaron varios aspectos del habla de una niña de ocho años con ceceo previo, y se recolectaron imágenes de ultrasonido antes y después de 05 sesiones de terapia utilizando ultrasonido como biofeedback instrumental. Se compararon las imágenes de la lengua en la producción de sonidos /s, z, ʃ, Æ·/ antes y después de la intervención logopédica. Resultados: antes del tratamiento, el paciente realizó una anteriorización sin levantar la punta de la lengua en /s/ y /z/; en /ʃ/ y /Æ·/ hubo anteriorización del punto de articulación, pero sin interposición. Después de la logopedia, ajustó el punto de articulación y adquirió elevación de la punta de la lengua en /s/ y /z/ y presentó mayor constricción de la lengua en /ʃ/ y /Æ·/. Conclusión: La ecografía demostró ser importante para el diagnóstico y descripción del ceceo previo, y su uso como biofeedback permitió una mejora significativa en la producción articulatoria debido a su autocontrol durante el habla, en un corto período de atención.

Infant Gut Microbiota Associated with Fine Motor Skills.

BACKGROUND: During early life, dynamic gut colonization and brain development co-occur with potential cross-talk mechanisms affecting behaviour. METHODS: We used 16S rRNA gene sequencing to examine the associations between gut microbiota and neurodevelopmental outcomes assessed by the Bayley Scales of Infant Development III in 71 full-term healthy infants at 18 months of age. We hypothesized that children would differ in gut microbial diversity, enterotypes obtained by Dirichlet multinomial mixture analysis and specific taxa based on their behavioural characteristics. RESULTS: In children dichotomized by behavioural trait performance in above- and below-median groups, weighted Unifrac b-diversity exhibited significant differences in fine motor (FM) activity. Dirichlet multinomial mixture modelling identified two enterotypes strongly associated with FM outcomes. When controlling for maternal pre-gestational BMI and breastfeeding for up to 3 months, the examination of signature taxa in FM groups showed that Turicibacter and Parabacteroides were highly abundant in the below-median FM group, while Collinsella, Coprococcus, Enterococcus, Fusobacterium, Holdemanella, Propionibacterium, Roseburia, Veillonella, an unassigned genus within Veillonellaceae and, interestingly, probiotic Bifidobacterium and Lactobacillus were more abundant in the above-median FM group. CONCLUSIONS: Our results suggest an association between enterotypes and specific genera with FM activity and may represent an opportunity for probiotic interventions relevant to treatment for motor disorders.

Physical Activity Level and Motor Aptitude: Motor Domains and Identification Capacity of Brazilian Insufficiently Active Older Adults.

BACKGROUND: A decrease in the physical activity level in old age is common, which results in an increase in the number of falls and chronic conditions. Associated with that occurs the decline in motor skills as a result of the deficit in the interaction of cognitive and motor processes. Physical activity levels can be associated differently with each motor domain. ; Objective: We analyzed the relationship between physical activity level and motor aptitude and to identify which motor domains were most sensitive to detect insufficiently active level in older adults. ; Methods: 385 elderly people of both sexes participated in the study. For the evaluation of the subjects, the International Questionnaire on Physical Activity and the Motor Scale for Older Adults were adopted. ; Results: The majority of the elderly were active. In comparing motor aptitude between active and insufficiently active (IAC) elders a significant difference was found in the Global Coordination, Balance, Body Scheme and General Motor Aptitude. From the analysis of the Area Under the Curve (AUC), we verified that these domains also were the ones that presented adequate diagnostic accuracy to identify IAC elderly. Besides that, active elderly have presented the General Motor Aptitude classified within normality while the IAC below the normal. ; Conclusion: Our data suggest that IAC older adults present lower motor aptitude than the active elderly, especially in the domains of Global Coordination, Balance, Body Scheme and General Motor Aptitude, and that these domains were sensitive to indicate IAC older adults.

New insights into the neural foundations mediating movement/language interactions gained from intrasurgical direct electrostimulations.

Interactions between language and motricity have been a topic of interest in brain development as well as in pathological models. The role of the motor system in language has been investigated through neuroimaging and non-invasive brain stimulation methods. However, little is known about the neural basis that might be involved in such interactions. Meanwhile, brain direct electrostimulations (DES) have provided essential knowledges about the connectomic organization of both motor and language systems. We propose here to review the literature about DES from the outlook of interactions between language and motricity and to investigate common cortico-subcortical structures shared by both networks. Then we will report an experimental study about the spatial distribution of DES eliciting simultaneous speech and contralateral upper limb negative motor response in a series of 100 patients operated on under awake condition for a low-grade glioma. From the probabilistic map obtained, a structural connectivity analysis was performed to reveal the cortico-subcortical networks involved in language and motricity interactions. The embodiment suggested by these results takes place in parallel and distributed bilateral fronto-temporo-parietal networks rather than in a single and somatopically well defined organization as previously suggested.

International Health Practices: A Multidisciplinary Approach to Therapeutic Mediations With an Artistic Medium Based on the Model of Play.

This article, corresponding to a part of the restitution of a financed international research project between France, Brazil, Canada, Italy and Belgium, aims to offer a modelisation and qualitative evaluation of mediation care settings based on an original methodological tool that involves identifying the typical games at the foundations of creativity, following a multidisciplinary perspective. Therapeutic mediations are settings or devices organized around a "pliable medium," often artistic, like painting, modeling, writing and theater, which are very widespread in institutional practices, both in France and abroad. The scientific objectives of this research consist in a multi-disciplinary exploration (anthropology, criminology, neuroscience, clinical psychology) of the process of creative symbolization understood as a process of transformation involving play. According to this orientation, play can be defined as a psychic process whereby a subjective experience can be explored with pleasure, and consequently symbolized and appropriated. Our fundamental and original hypothesis is that play is at the source of the creative process, conceived as a work of metabolization by the psyche of playful experiences during the different stages of life. The review of the understanding of play in psychoanalysis, anthropology, criminology and neuroscience emphasizes the richness of this model and the importance of reflecting on the typical games in the field of psychic care. A clinical example of treatment in a pictorial therapeutic mediation setting of a child with psychotic disorders makes it possible to identify a number of typical games as well as the modalities of interpretation of the therapists through play. These multidisciplinary studies lead to the presentation of a general table of typical games, and these first results highlight the richness of identifying typical games in clinical settings. Ultimately, the multidisciplinary approach shows the interest of the model of play in the evaluation of therapeutic mediation settings, with a convergence of the different disciplines emphasizing the pertinence of this model. The scientific impact of this research overlaps with its societal impact, through the development of innovative tools for evaluating therapeutic mediations, in order to take account of the evolution of the different forms of social expression of psychic suffering.

Motoric cognitive risk syndrome, incident cognitive impairment and morphological brain abnormalities: Systematic review and meta-analysis.

BACKGROUND: Motoric cognitive risk syndrome (MCR) is a pre-dementia stage, which associates slow walking speed with subjective cognitive impairment (SCI). MCR's clinical utility for the prediction of dementia and its pathophysiology are unclear. The aim of this systematic review and meta-analysis is to examine the association of MCR with incident cognitive impairment, cognitive performance and brain structures. METHODS: A systematic search was conducted using the Medical Subject Heading terms "Walking" and "Cognition disorders" combined with the terms "Subjective cognitive impairment", "Subjective cognitive decline" and "Motoric cognitive risk". A total of 11 studies were included in the systematic review and meta-analysis: 3 studies had dementia as the outcome, 3 studies had cognitive performance as the outcome, 4 studies had brain structures as the outcome and one study examined the incidence of both major neurocognitive disorders and cognitive impairment. RESULTS: MCR was found to be associated with incident cognitive impairment (pooled hazard ratio (HR) = 1.70, 95% CI, 1.46-1.98 with P-value <0.001) and dementia (pooled HR = 2.50, 95% CI, 1.75-2.39 with P-value <0.001). MCR was also found to be associated with low grey matter volume involving the premotor and the prefrontal cortex, and lacunar lesions in the frontal lobe. No significant association was found with white matter abnormalities. CONCLUSION: MCR predicts cognitive impairment and dementia, suggesting that it may be used as a screening syndrome for dementia in a primary care setting. Its significant association with both low grey matter volume and lacunar lesions makes its pathophysiology unclear and suggests multiple pathways.

Brain Gray Matter Volume Associations With Abnormal Gait Imagery in Patients With Mild Cognitive Impairment: Results of a Cross-Sectional Study.

Individuals with mild cognitive impairment (MCI) have worse gait performance compared to cognitive healthy individuals (CHI). The discrepancy between imagined and performed timed up and go test (TUG), known as the TUG delta time, is a marker of brain gait control impairment in individuals with MCI. The study aims to examine the association between the TUG delta time and brain gray matter (GM) volumes in CHI and individuals with MCI. A total of 326 participants, 156 CHI and 170 MCI, with TUG delta time and a brain T1-weighted magnetic resonance imaging (MRI) were selected in this cross-sectional study. Individuals with MCI were older and had greater (i.e., worst performance) performed TUG and TUG delta time compared to CHI. The GM volume association with TUG delta time was examined in CHI and MCI assuming that increased TUG delta time would be associated with locally decreased GM volumes. No significant association was found in CHI, whereas TUG delta time was negatively associated with the GM volume of the right medial temporal lobe in individuals with MCI.