Neurologic music therapy combined with EEG-tDCS for upper motor extremity performance in patients with corticobasal syndrome: Study protocol for a novel approach.

BACKGROUND: Corticobasal syndrome (CBS) is an atypical parkinsonian disorder that involves degeneration of brain regions associated with motor coordination and sensory processing. Combining transcranial direct current stimulation (tDCS) with rehabilitation training has been shown to improve upper-limb performance in other disease models. Here, we describe the protocol investigating whether tDCS with neurologic music therapy (NMT) (patterned sensory enhancement and therapeutic instrumental music performance) enhances functional arm/hand performance in individuals with CBS. METHODS: Study participants are randomly assigned to six 30-min sessions (twice per week for 3 weeks) of NMT + either sham tDCS or active tDCS. We aim to stimulate the frontoparietal cortex, which is associated with movement execution/coordination and sensory processing. The hemisphere contralateral to the more affected arm is stimulated (total stimulation current of 2 mA from 5 dime-sized electrodes). Individualized NMT sessions designed to exercise the upper limb are provided. Participants undergo gross/fine motor, cognitive and emotional assessments at baseline and follow-up (one month after the final session). To investigate the immediate effects of tDCS and NMT training, gross /fine motor, affective level, and kinematic parameter measurements using motion sensors are collected before and after each session. Electroencephalography is used to collect electrical neurophysiological responses before, during, and after tDCS+NMT sessions. The study participants, neurologic music therapist and outcome assessor are blinded to whether participants are in the sham or active tDCS group. CONCLUSION: This noninvasive and patient-centered clinical trial for CBS may provide insight into rehabilitation options that are sorely lacking in this population.

Visual priming of two-step motion sequences.

Perception of an ambiguous apparent motion is influenced by the immediately preceding motion. In positive priming, when an observer is primed with a slow-pace (1-3 Hz) sequence of motion frames depicting unidirectional drift (e.g., Right-Right-Right-Right), subsequent sequences of ambiguous frames are often perceived to continue moving in the primed direction (illusory Right-Right …). Furthermore, priming an observer with a slow-pace sequence of rebounding apparent motion frames that alternate between opponently coded motion directions (e.g., Right-Left-Right-Left) leads to an illusory continuation of the two-step rebounding sequence in subsequent random frames. Here, we show that even more arbitrary two-step motion sequences can be primed; in particular, two-step motion sequences that alternate between non-opponently coded directions (e.g., Up-Right-Up-Right; staircase motion) can be primed to be illusorily perceived in subsequent random frames. We found that staircase sequences, but not drifting or rebounding sequences, were primed more effectively with four priming frames compared with two priming frames, suggesting the importance of repeating the sequence element for priming arbitrary two-step motion sequences. Moreover, we compared the effectiveness of motion primes to that of symbolic primes (arrows) and found that motion primes were significantly more effective at producing prime-consistent responses. Although it has been proposed that excitatory and rivalry-like mechanisms account for drifting and rebounding motion priming, current motion processing models cannot account for our observed priming of staircase motion. We argue that higher order processes involving the recruitment and interaction of both attention and visual working memory are required to account for the type of two-step motion priming reported here.

Smooth pursuit operates over perceived not physical positions of the double-drift stimulus.

The double-drift illusion produces a large deviation in perceived direction that strongly dissociates physical position from perceived position. Surprisingly, saccades do not seem to be affected by the illusion (Lisi & Cavanagh, 2015). When targeting a double-drift stimulus, the saccade system is driven by retinal rather than perceived position. Here, using paired double-drift targets, we test whether the smooth pursuit system is driven by perceived or physical position. Participants (n = 7) smoothly pursued the inferred midpoint (Steinbach, 1976) between two horizontally aligned Gabor patches that were separated by 20° and moving on parallel, oblique paths. On the first half of each trial, the Gabors' internal textures were static while both drifted obliquely downward. On the second half of each trial, while the envelope moved obliquely upward, the internal texture drifted orthogonally to the envelope's motion, producing a large perceived deviation from the downward path even though the upward and downward trajectories always followed the same physical path but in opposite directions. We find that smooth pursuit eye movements accurately followed the nonillusory downward path of the midpoint between the two Gabors, but then followed the illusory rather than the physical trajectory on the upward return. Thus, virtual targets for smooth pursuit are derived from perceived rather than retinal coordinates.

Effects of internal and external velocity on the perceived direction of the double-drift illusion.

In the double-drift illusion, the combination of the internal and external motion vectors produces large misperceptions of both position and direction of motion. Here, we investigate the role that speed plays in determining how these two sources of motion are combined to produce the double-drift illusion. To address this question, we measure the size of the illusion at seven internal speeds combined with six external speeds. We find that the illusion increases with increasing internal speed and decreases with increasing external speed. We model this by combining the external and internal vectors to produce the resulting, illusory direction (Tse & Hsieh, 2006). The relative effect of the two vectors is specified by a constant K in this model and the data reveal that K decreases linearly as external speed increases. This critical role of external speed in modulating the vector combination uncovers new details about how the visual system combines different sources of motion information to produce a global motion percept.

Object-based attention generalizes to multisurface objects.

When a part of an object is cued, targets presented in other locations on the same object are detected more rapidly and accurately than are targets on other objects. Often in object-based attention experiments, cues and targets appear not only on the same object but also on the same surface. In four psychophysical experiments, we examined whether the "object" of attentional selection was the entire object or one of its surfaces. In Experiment 1, facilitation effects were found for targets on uncued, adjacent surfaces on the same object, even when the cued and uncued surfaces were oriented differently in depth. This suggests that the "object-based" benefits of attention are not restricted to individual surfaces. Experiments 2a and 2b examined the interaction of perceptual grouping and object-based attention. In both experiments, cuing benefits extended across objects when the surfaces of those objects could be grouped, but the effects were not as strong as in Experiment 1, where the surfaces belonged to the same object. The cuing effect was strengthened in Experiment 3 by connecting the cued and target surfaces with an intermediate surface, making them appear to all belong to the same object. Together, the experiments suggest that the objects of attention do not necessarily map onto discrete physical objects defined by bounded surfaces. Instead, attentional selection can be allocated to perceptual groups of surfaces and objects in the same way as it can to a location or to groups of features that define a single object.

Primed and unprimed rebounding illusory apparent motion.

Although sequences of uncorrelated random dots can yield a wide range of illusorily coherent motion percepts (including translation, rotation, contraction, expansion, shear, and rebounding motion), past priming studies have relied on two-alternative forced choice tasks that only measure unidirectional (positive or negative) priming effects. In Experiment 1 we showed that when participants are primed with unidirectional motion and given an additional option to report bidirectional (rebounding) motion, they do so frequently, suggesting that unidirectional motion can "default" to a rebounding percept. Furthermore, rebounding percepts are more prevalent during trials with long frame durations, suggesting a role for attention in forming and maintaining these illusory percepts. In Experiment 2 we compared rebounding percepts that followed unidirectional, drifting primes with rebounding percepts that followed bidirectional, rebounding primes, and found that these two types of illusory rebounding motion percepts differ systematically in their temporal structures. We argue that rebounding percepts following drifting primes can be understood as a breakdown of positive priming into an underlying oscillatory state, whereas rebounding percepts following rebounding primes may be understood either as (1) the initialization of the same oscillatory process, or (2) the entrainment of a two-step motion pattern by a higher-order mechanism.

Dissociating Higher and Lower Order Visual Motion Systems by Priming Illusory Apparent Motion.

Motion processing is thought of as a hierarchical system composed of higher and lower order components. Past research has shown that these components can be dissociated using motion priming paradigms in which the lower order system produces negative priming while the higher order system produces positive priming. By manipulating various stimulus parameters, researchers have probed these two systems using bistable test stimuli that permit only two motion interpretations. Here we employ maximally ambiguous test stimuli composed of randomly refreshing pixels in a task that allows observers to report more than just two types of motion percepts. We show that even with such stimuli, motion priming can constrain the unstructured random pixel patterns into coherent percepts of positive or negative apparent motion. Moreover, we find that the higher order system is uniquely susceptible to cognitive influences, as evidenced by a significant suppression of positive priming in the presence of alternative response options.

Persistent illusory apparent motion in sequences of uncorrelated random dots.

We report a novel phenomenon in which long sequences of random dot arrays refreshing at 2.5 Hz lead to persistent illusory percepts of coherent apparent motion. We term this effect illusory apparent motion (IAM). To quantify this illusion, we devised a persistence task in which observers are primed with a particular motion pattern and must indicate when the motion pattern ends. In Experiment 1 (N = 119), we induced translational apparent motion patterns and show that both drifting motion (e.g., up-up-up-up) and rebounding motion (e.g., up-down-up-down) persists throughout many frames of uncorrelated random dots, although rebounding motion tends to persist for longer (a rebounding bias). In Experiment 2 (N = 60), we induced rotational IAM on an annulus-shaped display, and show that the topology of the display (whether the annulus is complete or has a gap) determines whether or not the rebounding bias is present. Based on our findings, we argue that IAM provides a powerful tool to study the mechanisms, constraints, and individual differences in the perception of illusory motion.

Attending to Race (or Gender) Does Not Increase Race (or Gender) Aftereffects.

Recent research has shown that attention can influence the strength of face aftereffects. For example, attending to changes in facial features increases the strength of identity and figural aftereffects relative to passive viewing (Rhodes et al., 2011). Here, we ask whether attending to a specific social dimension of a face (such as race or gender) influences the strength of face aftereffects along that dimension. Across three experiments, participants completed many single-shot face adaptation trials. In each trial, participants observed a computer-generated adapting face for 5 s while instructed to focus on either the race or gender of that adapting face. Adapting faces were either Asian and female or Caucasian and male. In Experiment 1, all trials included an intermediate question (IQ) following each adaptation period, soliciting a rating of the adapting face on the attended dimension (e.g., race). In Experiment 2, only half of the trials included this IQ, and in Experiment 3 only a quarter of the trials did. In all three experiments, participants were subsequently presented with a race- and gender-neutral face and asked to rate it on either the attended dimension (e.g., race, attention-congruent trials) or the unattended dimension (e.g., gender, attention-incongruent trials) using a seven-point scale. Overall, participants showed significant aftereffects in all conditions, manifesting as (i) higher Asian ratings of the neutral faces following Caucasian vs. Asian adapting faces and (ii) higher female ratings of neutral faces following male vs. female adapting faces. Intriguingly, although reaction times were shorter during attention-congruent vs. attention-incongruent trials, aftereffects were not stronger along attention-congruent than attention-incongruent dimensions. Our results suggest that attending to a facial dimension such as race or gender does not result in increased adaptation to that dimension.