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1.
Soc Cogn Affect Neurosci ; 19(1)2024 Feb 28.
Article En | MEDLINE | ID: mdl-38537123

The cerebellum causally supports social processing by generating internal models of social events based on statistical learning of behavioral regularities. However, whether the cerebellum is only involved in forming or also in using internal models for the prediction of forthcoming actions is still unclear. We used cerebellar transcranial Direct Current Stimulation (ctDCS) to modulate the performance of healthy adults in using previously learned expectations in an action prediction task. In a first learning phase of this task, participants were exposed to different levels of associations between specific actions and contextual elements, to induce the formation of either strongly or moderately informative expectations. In a following testing phase, which assessed the use of these expectations for predicting ambiguous (i.e. temporally occluded) actions, we delivered ctDCS. Results showed that anodic, compared to sham, ctDCS boosted the prediction of actions embedded in moderately, but not strongly, informative contexts. Since ctDCS was delivered during the testing phase, that is after expectations were established, our findings suggest that the cerebellum is causally involved in using internal models (and not just in generating them). This encourages the exploration of the clinical effects of ctDCS to compensate poor use of predictive internal models for social perception.


Transcranial Direct Current Stimulation , Adult , Humans , Transcranial Direct Current Stimulation/methods , Cerebellum/physiology , Learning
2.
Neuroimage Clin ; 41: 103582, 2024.
Article En | MEDLINE | ID: mdl-38428326

BACKGROUND: Converging evidence points to impairments of the predictive function exerted by the cerebellum as one of the causes of the social cognition deficits observed in patients with cerebellar disorders. OBJECTIVE: We tested the neurorestorative effects of cerebellar transcranial direct current stimulation (ctDCS) on the use of contextual expectations to interpret actions occurring in ambiguous sensory sceneries in a sample of adolescents and young adults with congenital, non-progressive cerebellar malformation (CM). METHODS: We administered an action prediction task in which, in an implicit-learning phase, the probability of co-occurrence between actions and contextual elements was manipulated to form either strongly or moderately informative expectations. Subsequently, in a testing phase, we probed the use of these contextual expectations for predicting ambiguous (i.e., temporally occluded) actions. In a sham-controlled, within-subject design, participants received anodic or sham ctDCS during the task. RESULTS: Anodic ctDCS, compared to sham, improved patients' ability to use contextual expectations to predict the unfolding of actions embedded in moderately, but not strongly, informative contexts. CONCLUSIONS: These findings corroborate the role of the cerebellum in using previously learned contextual associations to predict social events and document the efficacy of ctDCS to boost social prediction in patients with congenital cerebellar malformation. The study encourages the further exploration of ctDCS as a neurorestorative tool for the neurorehabilitation of social cognition abilities in neurological, neuropsychiatric, and neurodevelopmental disorders featured by macro- or micro-structural alterations of the cerebellum.


Cerebellar Diseases , Transcranial Direct Current Stimulation , Humans , Young Adult , Adolescent , Cerebellum , Learning , Social Cognition
3.
Brain Commun ; 6(1): fcad350, 2024.
Article En | MEDLINE | ID: mdl-38162902

Motor inhibitory control, a core component of cognitive control, is impaired in Parkinson's disease, dramatically impacting patients' abilities to implement goal-oriented adaptive strategies. A progressive loss of the midbrain's dopamine neurons characterizes Parkinson's disease and causes motor features responsive to dopaminergic treatments. Although such treatments restore motor symptoms, their impact on response inhibition is controversial. Most studies failed to show any effect of dopaminergic medicaments, although three studies found that these drugs selectively improved inhibitory control in early-stage patients. Importantly, all previous studies assessed only one domain of motor inhibition, i.e. reactive inhibition (the ability to react to a stop signal). The other domain, i.e. proactive inhibition (the ability to modulate reactive inhibition pre-emptively according to the current context), was utterly neglected. To re-examine this issue, we recruited cognitively unimpaired Parkinson's patients under dopaminergic treatment in the early (Hoehn and Yahr, 1-1.5, n = 20), intermediate (Hoehn and Yahr 2, n = 20), and moderate/advanced (Hoehn and Yahr, 2.5-3, n = 20) stages of the disease. Using a cross-sectional study design, we compared their performance on a simple reaction-time task and a stop-signal task randomly performed twice on dopaminergic medication (ON) and after medication withdrawal (OFF). Normative data were collected on 30 healthy controls. Results suggest that medication effects are stage-dependent. In Hoehn and Yahr 1-1.5 patients, drugs selectively impair reactive inhibition, leaving proactive inhibition unaffected. In the ON state, Hoehn and Yahr two patients experienced impaired proactive inhibition, whereas reactive inhibition is no longer affected, as it deteriorates even during the OFF state. By contrast, Hoehn and Yahr 2.5-3 patients exhibited less efficient reactive and proactive inhibition in the OFF state, and medication slightly improved proactive inhibition. This evidence aligns with the dopamine overdose hypothesis, indicating that drug administration may overdose intact dopamine circuitry in the earliest stages, impairing associated cognitive functions. In later stages, the progressive degeneration of dopaminergic neurons prevents the overdose and can exert some beneficial effects. Thus, our findings suggest that inhibitory control assessment might help tailor pharmacological therapy across the disease stage to enhance Parkinson's disease patients' quality of life by minimizing the hampering of inhibitory control and maximizing the reduction of motor symptoms.

4.
Cerebellum ; 23(2): 579-588, 2024 Apr.
Article En | MEDLINE | ID: mdl-37351729

The neuropsychological characteristics of the cerebellar cognitive affective syndrome (CCAS) in congenital, non-progressive malformations of the cerebellum have been scarcely investigated, and even less is known for Joubert syndrome (JS), an inherited, non-progressive cerebellar ataxia characterized by the so-called molar tooth sign. The few studies on this topic reported inconsistent results about intellectual functioning and specific neuropsychological impairments. The aim of this research is to examine the neuropsychological profile of JS compared to other congenital cerebellar malformations (CM), considering individual variability of intellectual quotient (IQ) in the two groups. Fourteen patients with JS and 15 patients with CM aged 6-25 years were tested through a comprehensive, standardized neuropsychological battery. Their scores in the neuropsychological domains were inspected through descriptive analysis and compared by mean of MANOVA and ANOVA models, then replicated inserting IQ as covariate. The two groups showed a largely overlapping neuropsychological profile, consistent with CCAS. However, the JS group showed worse performance in visual-spatial memory compared to CM patients, although this difference was mitigated when considering IQ. These findings highlight a divergence between JS and other CM in visual-spatial memory, which might suggest a critical role of the cerebellum in recalling task-relevant memories and might inform rehabilitative interventions.


Abnormalities, Multiple , Cerebellar Diseases , Cerebellum/abnormalities , Eye Abnormalities , Kidney Diseases, Cystic , Retina/abnormalities , Humans , Abnormalities, Multiple/psychology , Kidney Diseases, Cystic/genetics , Kidney Diseases, Cystic/psychology , Eye Abnormalities/psychology
5.
J Clin Med ; 12(16)2023 Aug 21.
Article En | MEDLINE | ID: mdl-37629464

The Mild Behavioral Impairment (MBI) concept was developed to determine whether late-onset persistent neuropsychiatric symptoms (NPSs) may be early manifestations of cognitive decline. Our study aims to investigate the prevalence and differentiating features of MBI with respect to major neurocognitive disorders (MNDs) and primary psychiatric disorders (PPDs). A total of 144 elderly patients who were referred to our psychogeriatric outpatient service were recruited. The severity of mental illness was evaluated by means of the Clinical Global Impression Severity scale, the severity of psychopathology was evaluated by means of the Brief Psychiatric Rating Scale (BPRS), and overall functioning was evaluated by means of the Global Assessment of Functioning scale. The sample included 73 (50.6%) patients with PPDs, 40 (27.8%) patients with MBI, and 31 (21.5%) patients with MNDs. Patients with MNDs reported the greatest severity of mental illness, the highest BPRS Total, Psychosis, Activation, and Negative Symptom scores, and the lowest functioning. Patients with MBI and PPDs had comparable levels of severity of mental illness and overall functioning, but MBI patients reported higher BPRS Total and Negative Symptom scores than PPD patients. Patients with MBI frequently reported specific clinical features, including a higher severity of apathy and motor retardation. These features merit further investigation since they may help the differential diagnosis between MBI and PPDs.

6.
Parkinsonism Relat Disord ; 108: 105288, 2023 03.
Article En | MEDLINE | ID: mdl-36724569

INTRODUCTION: The impairment of nigrostriatal dopaminergic network is a core feature of dementia with Lewy bodies (DLB). The involvement and reconfiguration of extranigrostriatal dopaminergic circuitries in the DLB continuum is still theme of debate. We aim to investigate in vivo the dynamic changes of local and long-distance dopaminergic networks across DLB continuum. METHODS: Forty-nine patients (including 29 with dementia and 20 prodromal cases) and fifty-two controls entered the study. Each subject underwent a standardized clinical and neurological examination and performed Brain SPECT to measuring brain dopamine transporter (DAT) density. Spatially normalized images underwent the occipital-adjusted specific binding to obtain parametric data. The ANCOVA was applied to assess 123I-FP-CIT differences between pDLB, overt-DLB and CG, considering age, gender, and motor impairment as variables of no interest. Between-nodes correlation analysis measured molecular connectivity within the ventral and dorsal dopaminergic networks. RESULTS: Prodromal DLB and DLB patients showed comparable nigrostriatal deficits in basal ganglia regions compared with CG. Molecular connectivity analyses revealed extensive connectivity losses, more in ventral than in dorsal dopaminergic network in DLB dementia. Conversely, the prodromal group showed increased connectivity compared to CG, mostly putamen-thalamus-cortical and striatal-cortical connectivity. CONCLUSIONS: This study indicates a comparable basal ganglia deficit in nigrostriatal projections in DLB continuum and supports a different reorganization of extra-striatal dopaminergic connectivity in the prodromal phases of DLB. The shift from an increased to a decreased bilateral putamen-thalamus-cortex connectivity might be a hallmark of transition from prodromal to dementia DLB stages.


Alzheimer Disease , Lewy Body Disease , Humans , Lewy Body Disease/metabolism , Basal Ganglia/metabolism , Corpus Striatum/metabolism , Brain/metabolism , Thalamus/metabolism , Tomography, Emission-Computed, Single-Photon/methods , Alzheimer Disease/metabolism
7.
J Autism Dev Disord ; 53(9): 3343-3355, 2023 Sep.
Article En | MEDLINE | ID: mdl-35729297

According to current accounts of social cognition, the emergence of verbal and non-verbal components of social perception might rely on the acquisition of different cognitive abilities. These components might be differently sensitive to the pattern of neuropsychological impairments in congenital neurodevelopmental disorders. Here, we explored the association between social and non-social cognitive domains by administering subtests of the NEPSY-II battery to 92 patients with Intellectual and Developmental Disability (IDD). Regardless the level of intellectual functioning and presence of congenital brain malformations, results revealed that visuospatial skills predicted emotion recognition and verbal component of Theory of Mind, whereas imitation predicted the non-verbal one. Future interventions might focus on spatial and sensorimotor abilities to boost the development of social cognition in IDD.


Autism Spectrum Disorder , Theory of Mind , Humans , Autism Spectrum Disorder/psychology , Cognition , Social Perception , Recognition, Psychology , Emotions , Neuropsychological Tests
8.
Qual Sociol ; 45(3): 413-431, 2022.
Article En | MEDLINE | ID: mdl-35966137

Activists have responded to the Covid-19 pandemic by organizing for mutual aid: creating collective action to meet people's material needs and build ties of solidarity. I examine the difficulties encountered by mutual aid activists during the pandemic through Alberto Melucci's notions of latency and collective identity. Through digital ethnographic observations of the Instagram accounts of mutual aid groups based in Philadelphia, USA, as well as interviews with the activists, I explore how mutual aid, conceptualized as latency work, was practiced by activists in the unprecedented conditions of the pandemic and how activists approached collective identity processes. I show that activists experienced a compression of latency and mobilization within the crisis context of the pandemic, which made it more difficult for them to pursue the construction of a collective identity. I also suggest that the effects of this compression were further exacerbated by the logic of immediacy that characterizes social network sites.

9.
J Alzheimers Dis ; 87(3): 991-997, 2022.
Article En | MEDLINE | ID: mdl-35404280

Plasma phosphorylated tau species have been recently proposed as peripheral markers of Alzheimer's disease (AD) pathology. In this cross-sectional study including 91 subjects, plasma and cerebrospinal fluid (CSF) p-tau181 and p-tau231 levels were elevated in the early symptomatic stages of AD. Plasma p-tau231 and p-tau181 were strongly related to CSF phosphorylated tau, total tau and amyloid and exhibited a high accuracy-close to CSF p-tau231 and p-tau181-to identify AD already in the early stage of the disease. The findings might support the use as diagnostic and prognostic peripheral AD biomarkers in both research and clinical settings.


Alzheimer Disease , Alzheimer Disease/cerebrospinal fluid , Amyloid beta-Peptides/cerebrospinal fluid , Biomarkers/cerebrospinal fluid , Cross-Sectional Studies , Humans , Phosphorylation , tau Proteins/cerebrospinal fluid
10.
J Alzheimers Dis ; 86(2): 579-588, 2022.
Article En | MEDLINE | ID: mdl-35094996

BACKGROUND: The neurophysiological correlates of cognitive and motor symptoms in prodromal and overt dementia with Lewy bodies (DLB) are still to be elucidated. OBJECTIVE: To evaluate if cognitive and motor features of patients with prodromal and overt DLB are associated with the impairment of specific neurotransmitter circuits, evaluated in vivo with transcranial magnetic stimulation (TMS). METHODS: Fifty-one patients with DLB (twenty-five prodromal; twenty-six with dementia) underwent neuropsychological and clinical evaluation, with twenty-five patients having at least one follow-up evaluation. All patients were assessed with TMS at baseline, with protocols assessing cholinergic circuits (short latency afferent inhibition, SAI), GABAergic circuits (short interval intracortical inhibition, SICI), and glutamatergic circuits (intracortical facilitation, ICF). RESULTS: Compared to HC, SICI, ICF, and SAI resulted significantly impaired in both prodromal and overt DLB, with the latter showing a reduced SICI and SAI also compared to prodromal DLB. There was a significant correlation between motor deficits, evaluated with the UPDRS-III, and the impairment of GABAergic (SICI) (r = 0.729, p < 0.001) and glutamatergic (ICF) (r -0.608, p < 0.001) circuits; global cognition, evaluated with the Mini-Mental State Examination, correlated with the impairment of cholinergic (SAI) circuits (r=-0.738, p < 0.001). Worsening of cognitive functions at follow-up was associated with reduced cholinergic functions at baseline (R2 = 0.53, p < 0.001). CONCLUSION: These results suggest that motor and cognitive dysfunctions in prodromal and overt DLB depend on specific and independent neurotransmitter circuits.


Cognitive Dysfunction , Lewy Body Disease , Cholinergic Agents , Evoked Potentials, Motor/physiology , Humans , Lewy Body Disease/psychology , Neural Inhibition/physiology , Neurophysiology , Transcranial Magnetic Stimulation/methods
11.
Neuropsychol Rev ; 32(2): 352-399, 2022 06.
Article En | MEDLINE | ID: mdl-33929656

Individuals with acquired brain injury (ABI) commonly present with impairments in cognitive abilities. As these competencies seem to be predictive of patients' abilities to reintegrate into the everyday settings, it is crucial to assess them properly. However, previous research has indicated that patients may perform relatively well on standard tests of cognitive functioning, but may nonetheless encounter significant difficulties in organizing and executing everyday tasks. In order to overcome this issue, virtual reality (VR) methods have been introduced in clinical practice with the aim of creating assessments that simulate real-world activities and thus, provide a clearer picture of patients' functioning in everyday settings. This review offers an overview of VR assessment tools described in the scientific literature between 2010 and 2019. Overall, 38 relevant records describing 31 different tools were found. Among these tools, 16 assessed executive functions and prospective memory, while the other 15 assessed visuo-spatial abilities. Although promising results have been reported, our analysis indicated that about half of the tools deliver tasks that differ from everyday activities, thus limiting the generalizability of patients' performance to the real-world. Moreover, a variety of methodological shortfalls related to study Internal and External Validity have been highlighted, which hamper the possibility of drawing definite recommendations on tool choice. These limitations suggest the importance of putting considerable efforts into the improvement or development of VR tools for patients with ABI for both research and clinical purposes, considering the great potential of this form of assessment.


Brain Injuries , Virtual Reality , Adult , Brain Injuries/complications , Cognition , Executive Function , Humans , Neuropsychological Tests
12.
Proc Inst Mech Eng H ; 235(12): 1471-1478, 2021 Dec.
Article En | MEDLINE | ID: mdl-34281446

Total hip arthroplasty procedures are physically demanding for surgeons. Repetitive mallet swings to impact a surgical handle (impactions), can lead to muscle fatigue, discomfort, and injuries. The use of an automated surgical hammer may reduce fatigue and increase surgical efficiency. The aim of this study was to compare the effect of repeated manual and automated impactions on the user's muscle activation, by means of surface electromyography. Surface electromyography signals were recorded from eight muscles of seven (n = 7) orthopedic surgeons during repetitions of manual and automated impactions, to reach the same surgical outcome (broaching depth). Qualitative data was also captured to track the perceived fatigue and preferences of impaction modalities after completion of impaction tasks. Time to complete tasks, muscle activation, and muscle fatigue were quantified. Results showed a significant decrease in time required to reach the same broaching depth for the automated method compared to manual impactions (p = 0.001). A reduction in muscle fatigue and activation of right Brachioradialis muscle was observed during automated impactions (p = 0.018). A significant difference in fatigue was observed, with lower level of fatigue during automated impactions (p = 0.001). These results suggest that an automated surgical workflow might reduce the exposure to the impaction task and, therefore, muscle fatigue, with a reduced activation of the most engaged muscles. The study suggests that the burden on the user can be reduced by a change in the surgical methodology to perform broaching in total hip arthroplasty, which could potentially benefit surgical efficiency and reduce the risk of fatigue-based errors during a procedure.


Arthroplasty, Replacement, Hip , Orthopedic Surgeons , Arthroplasty, Replacement, Hip/adverse effects , Electromyography , Humans , Muscle Fatigue , Muscle, Skeletal
13.
Brain Struct Funct ; 226(3): 671-684, 2021 Apr.
Article En | MEDLINE | ID: mdl-33426567

Congenital or acquired cerebellum alterations are associated with a complex pattern of motor, cognitive and social disorders. These disturbances may reflect the involvement of the cerebellum in generating and updating the internal models that sub-serve-the prediction of sensory events. Here, we tested whether the cerebellar involvement in using contextual expectations to interpret ambiguous sensory sceneries is specific for social actions or also extends to physical events. We applied anodic, cathodic and sham cerebellar transcranial Direct Current Stimulation (ctDCS) to modulate the performance of an adult sample in two tasks requiring the prediction of social actions or moving shapes. For both tasks, in an earlier implicit-learning phase (familiarization), we manipulated the probability of co-occurrence between a particular action/shape and contextual elements, which could provide either strongly or moderately informative expectations. The use of these expectations was then tested when participants had to predict the unfolding of temporally occluded videos, in situations of perceptual uncertainty (testing). Results showed that in the testing, but not in the familiarization phase, cathodic as compared to anodic and sham ctDCS hindered participants' sensitivity in predicting actions embedded in strongly, but not moderately, informative contexts. Conversely, anodic as compared to sham ctDCS boosted the prediction of actions embedded in moderately, but not strongly, informative contexts. We observed no ctDCS effects for the shape prediction task, thus pointing to a specific involvement of the cerebellum in forming expectations related to social events. Our results encourage the exploration of rehabilitative effects of ctDCS in patients with social perception deficits.


Cerebellum/physiology , Cognition/physiology , Social Interaction , Transcranial Direct Current Stimulation , Humans , Learning/physiology , Male , Predictive Value of Tests , Transcranial Direct Current Stimulation/methods , Young Adult
14.
Med Eng Phys ; 76: 13-19, 2020 02.
Article En | MEDLINE | ID: mdl-31889620

Total hip arthroplasty (THA) broaching involves impacting a broach handle with a mallet, facilitating force transmission to progress broaches into the femoral medullary canal. Limited surgical access during direct anterior THAs increases off-axis forces, potentially contributing to tissue damage. The aim was to characterise impactions during broaching. In a cadaver lab, movement of handle, femur and instrumented mallet was tracked during direct-anterior approach (DAA) and posterior approach (PA). Mallet velocity, broach displacement and input energy were calculated. Following the cadaver lab, different impaction strategies were investigated using bone simulants for a simulated DAA. The effects of reduced mallet velocity inputs and the influence of different impaction locations on the broach handle strike plate were investigated. To seat the broach in cadaveric bone, lower impaction energy (-59%) and number of strikes (-53%) were observed during PA compared to DAA. Suboptimal broach progression was reached in bone simulant at low mallet velocities (3.1 ± 0.3 m/s). Impacting the strike plate's upper part caused larger deflections (p < 0.001) of the Sawbones femur which suggested that higher off axis forces occurred. Awareness of reduced load transmission during DAA broaching using off-axis broach handles, compared to the traditional PA, could help promoting a more efficient and careful impaction strategy in surgeries.


Arthroplasty, Replacement, Hip/methods , Femur , Mechanical Phenomena , Arthroplasty, Replacement, Hip/instrumentation , Biomechanical Phenomena , Female , Femur/physiology , Humans , Middle Aged , Weight-Bearing
15.
Behav Brain Res ; 378: 112248, 2020 01 27.
Article En | MEDLINE | ID: mdl-31614184

Action execution is prone to errors and, while engaged in interaction, our brain is tuned to detect deviations from what one expects from other's action. Prior research has shown that Event-Related-Potentials (ERPs) are specifically modulated by the observation of action mistakes interfering with goal achievement. However, in complex and modular actions, embedded motor errors do not necessarily produce an immediate effect on the global goal. Here we dissociate embedded motor goals from global action goals by asking subjects to observe familiar but untrained knotting actions. During knotting an embedded motor error (i.e. the rope is inserted top-down instead of bottom-up during the formation of a loop) while not producing any immediate mistake, may strongly affect the final result. We found that embedded errors elicit in the observer specific early fronto-central negativity (120-180 ms). In a second experiment, we online administered exicitatory transcranial magnetic stimulation (TMS) over central (C3) or occipital (Oz) scalp locations, at the timing of the ERP components observed in the first experiment. C3 stimulation produced a significant improvement in embedded error discrimination performance. These results show that sensorimotor areas are instrumental in the early detection of embedded motor errors. We conclude that others' embedded errors provide fundamental cues which, inserted within a complex hierarchical action plan, might be used by the observer to anticipate whether an action will eventually fail.


Evoked Potentials/physiology , Goals , Motor Activity/physiology , Psychomotor Performance/physiology , Sensorimotor Cortex/physiology , Visual Perception/physiology , Adult , Anticipation, Psychological , Cues , Electroencephalography , Female , Humans , Male , Transcranial Magnetic Stimulation , Young Adult
16.
Behav Neurol ; 2019: 1346987, 2019.
Article En | MEDLINE | ID: mdl-31467613

INTRODUCTION: Multidisciplinary rehabilitation interventions are considered to be a need for children with acquired brain injury (ABI), in order to remediate the important sequelae and promote adjustment. Technology-based treatments represent a promising field inside the rehabilitation area, as they allow delivering interventions in ecological settings and creating amusing exercises that may favor engagement. In this work, we present an overview of remote technology-based training programs (TP) addressing cognitive and behavioral issues delivered to children with ABI and complement it with the results of a meta-analytic exploration. EVIDENCE ACQUISITION: We performed the review process between January and February 2019. 32 studies were included in the review, of which 14 were further selected to be included in the meta-analysis on TP efficacy. EVIDENCE SYNTHESIS: Based on the review process, the majority of TP addressing cognitive issues and all TP focusing on behavioral issues were found to be effective. Two meta-analytic models examining the means of either cognitive TP outcomes or behavioral TP outcomes as input outcome yielded a nonsignificant effect size for cognitive TP and a low-moderate effect size for behavioral TP. Additional models on outcomes reflecting the greatest beneficial effects of TP yielded significant moderate effect sizes for both types of TP. Nevertheless, consistent methodological heterogeneity was observed, pointing to cautious interpretation of findings. A subgroup analysis on visuospatial skill outcomes showed a smaller yet significant effect size of cognitive TP, with low heterogeneity, providing a more reliable estimation of overall cognitive TP effects. CONCLUSIONS: Promising results on remote cognitive and behavioral TP efficacy emerged both at the review process and at the meta-analytic investigation. Nevertheless, the high heterogeneity that emerged across studies prevents us from drawing definite conclusions. Further research is needed to identify whether specific training characteristics and population subgroups are more likely to be associated with greater training efficacy.


Brain Injuries/rehabilitation , Brain Injuries/therapy , Telerehabilitation/methods , Child , Female , Humans , Male
17.
J Neuroeng Rehabil ; 16(1): 108, 2019 08 28.
Article En | MEDLINE | ID: mdl-31462262

BACKGROUND: The estimation of relative distance is a perceptual task used extensively in everyday life. This important skill suffers from biases that may be more pronounced when estimation is based on haptics. This is especially true for the blind and visually impaired, for which haptic estimation of distances is paramount but not systematically trained. We investigated whether a programmable tactile display, used autonomously, can improve distance discrimination ability in blind and severely visually impaired youngsters between 7 and 22 years-old. METHODS: Training consisted of four weekly sessions in which participants were asked to haptically find, on the programmable tactile display, the pairs of squares which were separated by the shortest and longest distance in tactile images with multiple squares. A battery of haptic tests with raised-line drawings was administered before and after training, and scores were compared to those of a control group that did only the haptic battery, without doing the distance discrimination training on the tactile display. RESULTS: Both blind and severely impaired youngsters became more accurate and faster at the task during training. In haptic battery results, blind and severely impaired youngsters who used the programmable display improved in three and two tests, respectively. In contrast, in the control groups, the blind control group improved in only one test, and the severely visually impaired in no tests. CONCLUSIONS: Distance discrimination skills can be trained equally well in both blind and severely impaired participants. More importantly, autonomous training with the programmable tactile display had generalized effects beyond the trained task. Participants improved not only in the size discrimination test but also in memory span tests. Our study shows that tactile stimulation training that requires minimal human assistance can effectively improve generic spatial skills.


Distance Perception , Space Perception , Vision Disorders/rehabilitation , Adolescent , Blindness/rehabilitation , Case-Control Studies , Child , Female , Humans , Learning , Male , Memory , Psychomotor Performance , Reaction Time , Size Perception , Touch , Young Adult
18.
Micromachines (Basel) ; 9(7)2018 Jul 14.
Article En | MEDLINE | ID: mdl-30424284

Autonomous navigation in novel environments still represents a challenge for people with visual impairment (VI). Pin array matrices (PAM) are an effective way to display spatial information to VI people in educative/rehabilitative contexts, as they provide high flexibility and versatility. Here, we tested the effectiveness of a PAM in VI participants in an orientation and mobility task. They haptically explored a map showing a scaled representation of a real room on the PAM. The map further included a symbol indicating a virtual target position. Then, participants entered the room and attempted to reach the target three times. While a control group only reviewed the same, unchanged map on the PAM between trials, an experimental group also received an updated map representing, in addition, the position they previously reached in the room. The experimental group significantly improved across trials by having both reduced self-location errors and reduced completion time, unlike the control group. We found that learning spatial layouts through updated tactile feedback on programmable displays outperforms conventional procedures on static tactile maps. This could represent a powerful tool for navigation, both in rehabilitation and everyday life contexts, improving spatial abilities and promoting independent living for VI people.

19.
PLoS One ; 13(11): e0207476, 2018.
Article En | MEDLINE | ID: mdl-30440042

Observing others' actions desynchronizes electroencephalographic (EEG) rhythms and modulates corticospinal excitability as assessed by transcranial magnetic stimulation (TMS). However, it remains unclear if these measures reflect similar neurofunctional mechanisms at the individual level. In the present study, a within-subject experiment was designed to assess these two neurophysiological indexes and to quantify their mutual correlation. Participants observed reach-to-grasp actions directed towards a small (precision grip) or a large object (power grip). We focused on two specific time points for both EEG and TMS. The first time point (t1) coincided with the maximum hand aperture, i.e. the moment at which a significant modulation of corticospinal excitability is expected. The second (t2), coincided with the EEG resynchronization occurring at the end of the action, i.e. the moment at which a hypothetic minimum for action observation effect is expected. Results showed a Mu rhythm bilateral desynchronization at t1 with differential resynchronization at t2 in the two hemispheres. Beta rhythm was more desynchronized in the left hemisphere at both time points. These EEG differences, however, were not influenced by grip type. Conversely, motor potentials evoked by TMS in an intrinsic hand muscle revealed an interaction effect of grip and time. No significant correlations between Mu/Beta rhythms and motor evoked potentials were found. These findings are discussed considering the spatial and temporal resolution of the two investigated techniques and argue over two alternative explanations: i. each technique provides different measures of the same process or ii. they describe complementary features of the action observation network in humans.


Brain Waves/physiology , Cortical Excitability/physiology , Fingers/physiology , Hand/physiopathology , Adult , Biomechanical Phenomena , Brain Mapping , Electroencephalography , Electromyography , Female , Humans , Male , Nails/physiology , Transcranial Magnetic Stimulation
20.
IEEE Trans Haptics ; 11(1): 30-38, 2018.
Article En | MEDLINE | ID: mdl-29611811

We present a fully latching and scalable 4 × 4 haptic display with 4 mm pitch, 5 s refresh time, 400 mN holding force, and 650 µm displacement per taxel. The display serves to convey dynamic graphical information to blind and visually impaired users. Combining significant holding force with high taxel density and large amplitude motion in a very compact overall form factor was made possible by exploiting the reversible, fast, hundred-fold change in the stiffness of a thin shape memory polymer (SMP) membrane when heated above its glass transition temperature. Local heating is produced using an addressable array of 3 mm in diameter stretchable microheaters patterned on the SMP. Each taxel is selectively and independently actuated by synchronizing the local Joule heating with a single pressure supply. Switching off the heating locks each taxel into its position (up or down), enabling holding any array configuration with zero power consumption. A 3D-printed pin array is mounted over the SMP membrane, providing the user with a smooth and room temperature array of movable pins to explore by touch. Perception tests were carried out with 24 blind users resulting in 70 percent correct pattern recognition over a 12-word tactile dictionary.


Blindness/psychology , Man-Machine Systems , Pattern Recognition, Physiological , Touch Perception , Touch , User-Computer Interface , Visually Impaired Persons/psychology , Adolescent , Adult , Discrimination, Psychological , Equipment Design , Female , Humans , Male , Middle Aged , Physical Stimulation , Polymers , Young Adult
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