Effects of Functional Electrical Stimulation on Attention and Brain Activity in Healthy Participants Using Near-Infrared Spectroscopy: An Interventional Study.

Background Involuntary limb activation using functional electrical stimulation (FES) can improve unilateral spatial neglect. However, the impact of FES on brain activity related to spatial attention remains unclear. Thus, in this study, we aimed to examine the effects of FES on spatial attention. Methodology In this interventional study, 13 healthy right-handed participants were asked to perform the Posner task for six minutes both before and after either FES or sham stimulation during each set, resulting in a total of two sets. FES was applied to the left forearm extensor muscles, with a frequency of 25 Hz, a pulse width of 100 µs, and the intensity adjusted to reach the motor threshold. Both the energization and pause times were set to five seconds. The Posner task was used to measure reaction time to a target appearing on a computer screen. Brain activity, indicated by oxygenated hemoglobin values, was measured using near-infrared spectroscopy with 24 probes according to the International 10-20 system method. Results In the left hemisphere, oxygenated hemoglobin values in the premotor and supplementary motor areas, primary somatosensory cortex, and somatosensory association areas were significantly higher after FES than after sham stimulation. In the right hemisphere, oxygenated hemoglobin values were significantly increased in the premotor, primary, and supplementary motor areas; in the supramarginal gyrus; and in the somatosensory association areas after FES. Reaction times in the Posner task did not differ significantly between the FES and sham conditions. Conclusions Collectively, these results suggest that FES of the upper limbs can activate the ventral pathway of the visual attention network and improve stimulus-driven attention. Activation of stimulus-driven attentional function could potentially contribute to symptom improvement in patients with unilateral spatial neglect.

Intervention and assessment of executive dysfunction in patients with stroke: A scoping review.

Rehabilitation methods for executive dysfunction were focused on cognitive rehabilitation in patients with stroke and traumatic brain injury. However, no reviews have focused on the various rehabilitation methods and assessment of executive function in patients with only stroke and included various study designs. This study aimed to identify various interventions and assessments in patients with stroke and executive dysfunction via a scoping review. We searched for articles using the PubMed, Web of Science, and CINAHL databases. Two reviewers independently screened the articles based on the inclusion and exclusion criteria using the title, abstract, and full text. We subsequently determined the study design, sample size, time since stroke, intervention, and assessment. We extracted 1131 articles, of which 27 articles were selected. The study designs were randomized controlled trials (81.5%), pilot studies (11.1%), and feasibility studies (7.4%), with a total of 599 participants. Interventions varied from cognitive training (22.2%), virtual reality (22.2%), noninvasive brain stimulation (14.8%), and dual-task training (11.1%), with consistent results. The assessments used were the Trail Making Test Part B (70.4%), Stroop Color and Word Test (44.4%), Digit Symbol Test, Frontal Assessment Battery, and Tower of London test (11.1%). In conclusion, this scoping review provided various interventions and assessments in patients with stroke with executive dysfunction.

Differences in the early stages of motor learning between visual-motor illusion and action observation.

The visual-motor illusion (VMI) induces a kinesthetic illusion by watching one's physically-moving video while the body is at rest. It remains unclear whether the early stages (immediately to one hour later) of motor learning are promoted by VMI. This study investigated whether VMI changes the early stages of motor learning in healthy individuals. Thirty-six participants were randomly assigned to two groups: the VMI or action observation condition. Each condition was performed with the left hand for 20 min. The VMI condition induced a kinesthetic illusion by watching one's ball-rotation task video. The action observation condition involved watching the same video as the VMI condition but did not induce a kinesthetic illusion. The ball-rotation task and brain activity during the task were measured pre, post1 (immediately), and post2 (after 1 h) in both conditions, and brain activity was measured using functional near-infrared spectroscopy. The rate of the ball-rotation task improved significantly at post1 and post2 in the VMI condition than in the action observation condition. VMI condition lowers left dorsolateral prefrontal cortex and right premotor area activity from post1 to pre compared to the action observation condition. In conclusion, VMI effectively aids early stages of motor learning in healthy individuals.

A rare case of concomitant Lambert-Eaton myasthenic syndrome and syndrome of inappropriate antidiuretic hormone secretion in a patient with small cell lung carcinoma.

Small cell lung carcinoma (SCLC) is a neuroendocrine carcinoma with a poor prognosis and is a common cause of paraneoplastic syndromes. Paraneoplastic syndromes are characterized by neurological and endocrinological problems in patients with malignancy and are often associated with difficulty in induction of chemotherapy. Here we report the case of a patient with SCLC concomitant with two paraneoplastic syndromes, syndrome of inappropriate antidiuretic hormone secretion (SIADH) and Lambert-Eaton myasthenic syndrome (LEMS), who was treated with a platinum-doublet chemotherapy regimen. A 66-year-old male patient presented with a 1-month history of progressive proximal muscle weakness, ataxia gait and 5 kg of body weight loss. The laboratory tests revealed hyponatremia due to SIADH and the existence of antibodies against P/Q-type voltage-gated calcium channels. The nerve conduction study showed a low amplitude of compound muscle action potential (0.38 mv), a 34% decrement on 3-Hz stimulation, and a 1939% increment after maximum voluntary contraction in 10 seconds (7.75 mv). The endobronchial ultrasound transbronchial needle aspiration biopsy revealed the pathological findings of SCLC. A 2-cycle chemotherapy regimen of irinotecan plus cisplatin resulted in temporary tumor shrinkage that lasted 2 months, but the improvement of proximal muscle weakness and hyponatremia were maintained over the tumor re-progression period after chemotherapy. Although paraneoplastic syndromes accelerate the decrease in performance status, chemotherapy for SCLC may improve symptoms related to paraneoplastic syndromes and could be considered in similar cases.

Effects of Visual-Motor Illusion via Image Videos Showing Increased Exercise Intensity on the Tibial Anterior during Sit-to-Stand Movement: A Study of Healthy Participants.

Visual-motor illusion (VMI) elicits kinesthetic sensation from visual stimulation. We have previously performed ankle motion VMI with resistance applied to the ankle joint on the paralyzed side (power-VMI (P-VMI)) and ankle motion VMI without resistance (standard-VMI (S-VMI)) to activate the tibialis anterior (TA) muscle in stroke-paralyzed patients and compared sit-to-stand (STS) durations, but these studies did not measure TA activity during the STS movement. The purpose of this study was to evaluate the effects of different intensities of visual stimuli presented during VMI on TA and STS movement. Healthy right-footed adults (n = 18) observed two different VMI videos of ankle dorsiflexion, including S-VMI and P-VMI, with an observation time of 2 min each. STS movement was evaluated before and after watching each video. Each participant performed both S-VMI and P-VMI interventions on the same day. Only P-VMI enhanced the integrated electromyogram of the TA, increased the angular velocities of the trunk forward inclination and the ankle dorsiflexion, and shortened the STS duration. Our results indicate that P-VMI facilitates the activation of TA during STS, and we believe that we have clarified the intervention mechanism of VMI.

Met receptor is essential for MAVS-mediated antiviral innate immunity in epithelial cells independent of its kinase activity.

Epithelial tissue is at the forefront of innate immunity, playing a crucial role in the recognition and elimination of pathogens. Met is a receptor tyrosine kinase that is necessary for epithelial cell survival, proliferation, and regeneration. Here, we showed that Met is essential for the induction of cytokine production by cytosolic nonself double-stranded RNA through retinoic acid-inducible gene-I-like receptors (RLRs) in epithelial cells. Surprisingly, the tyrosine kinase activity of Met was dispensable for promoting cytokine production. Rather, the intracellular carboxy terminus of Met interacted with mitochondrial antiviral-signaling protein (MAVS) in RLR-mediated signaling to directly promote MAVS signalosome formation. These studies revealed a kinase activity-independent function of Met in the promotion of antiviral innate immune responses, defining dual roles of Met in both regeneration and immune responses in the epithelium.

Estimation of minimal detectable change in the 10-meter walking test for patients with stroke: a study stratified by gait speed.

Objective: This study aimed to classify and calculate the minimal detectable changes (MDC) in gait time and gait speed in a 10-meter walking test (10MWT) in patients with stroke classified according to their gait speed. Methods: The participants were 84 patients with stroke. Their gait times were measured twice each at their comfortable gait speed (CGS) and maximum gait speed (MGS) on a 10-meter straight track, and gait speed was calculated using gait time. Participants were assigned to three speed groups based on their CGS: low-speed (<0.4 m/s; n = 19); moderate-speed (0.4-0.8 m/s; n = 29); and high-speed (>0.8 m/s; n = 36). For each group, first and second retest reliability and MDC of CGS and MGS were calculated using gait time and gait speed in the 10MWT. Results: MDCs in the 10MWT at CGS were: low-speed group, gait time 5.25 s, gait speed 0.05 m/s; moderate-speed group, gait time 2.83 s, gait speed 0.11 m/s; and high-speed group, gait time 1.58 s, gait speed 0.21 m/s. MDCs in the 10MWT at MGS were: low-speed group, gait time 7.26 s, gait speed 0.04 m/s; moderate-speed group, gait time 2.48 s, gait speed 0.12 m/s; and high-speed group, gait time 1.28 s, gait speed 0.19 m/s. Conclusion: Since the MDC of gait speed and gait time differ depending on the participant's gait speed, it is necessary to interpret the results according to the participant's gait speed when judging the effectiveness of therapeutic interventions.

Longitudinal Changes in Motor Estimation Error and Motor Function in Patients with Parkinson's Disease: A Case Report.

BACKGROUND AND OBJECTIVES: This report described two cases with clear longitudinal changes in motor estimation error (difference between the motor imagery and motor execution) and their progression and motor and activities of daily living (ADL) function changes in patients with PD. MATERIALS AND METHODS: Patient 1 was a 68-year-old man (Hoehn and Yahr [H and Y] stage: IV, diagnosed with PD for 11.8 years) and patient 2 was a 68-year-old woman (H and Y stage: II, diagnosed with PD for 9.6 years). Imagined two-step test (iTST), two-step test (TST), and PD-related assessments (Unified Parkinson's Disease Rating Scale [UPDRS], and Freezing of Gait Questionnaire [FOGQ]) were assessed at baseline and after 6 months. Motor estimation error was calculated as the iTST distance minus TST distance. RESULTS: In patient 1, motor estimation error was greater after 6 months (baseline: 5.7 [4.8%]/after 6 months: 25.7 cm [26.1%]). Moreover, UPDRS and FOGQ total scores deteriorated after 6 months (UPDRS total: 29/34 point, and FOGQ: 9/16 point). Conversely, in patient 2, motor estimation error did not change notably (-3.6 [7.6%]/-2.5 cm [7.0%]), while UPDRS and FOGQ total scores improved after 6 months (UPDRS total: 17/12 point, and FOGQ: 6/1 point). CONCLUSIONS: This report indicated that greater motor estimation error may be associated with declining motor and ADL function and disease progression in patients with PD.

Estimation Error Consisting of Motor Imagery and Motor Execution in Patients with Stroke.

Previous studies demonstrate that the difference between motor imagery and actual tasks (estimation error) is related to cognitive and physical functions and that a large estimation error (LE) is related to motor imagery ability, including cognitive and physical functions in healthy subjects. The purpose of this study investigated whether estimation error is related to physical and cognitive function in patients with stroke. The study included 60 patients with stroke. The Timed Up and Go Test (TUGT) was employed to assess estimation error. First, the imagined TUGT (iTUGT) was performed; thereafter, the actual TUGT was performed. The estimation error was calculated by subtracting TUGT from iTUGT, with conversion to the absolute value. The patients were classified into the small estimation error (SE) and LE groups, with comparisons of various clinical scores (Mini-Mental State Examination, Berg Balance Scale, 10-m walking speed, Brunnstrom Recovery Stage, and Functional Independence Measure). As a result, the estimation error was significantly larger in the LE group than in the SE group. Cognitive function and balance ability were significantly lower in the LE group than in the SE group. In conclusion, the estimation error was related to physical and cognitive functions in patients with stroke.

Walking Ability Associated with Executive Dysfunction in Patients with Stroke: A Cross-Sectional Study.

Previous studies have shown an association between executive dysfunction and walking ability. However, it remains unclear whether the degree of executive dysfunction is associated with differences in walking ability in patients with stroke. The aim of this study was to investigate whether there are differences in walking ability according to executive dysfunction in patients with stroke. A total of 51 patients with stroke were enrolled in this study. Executive function was measured using the Trail Making Test (TMT) Part B, and walking ability was assessed using the 10 m walk test and the Timed Up and Go Test (TUGT). Cluster analysis was performed using the TMT Part B and compared within each cluster. TMT Part B was categorized into three groups (cluster 1: n = 20, cluster 2: n = 24, and cluster 3: n = 7). Cluster 1 was significantly better than clusters 2 and 3, and cluster 2 was significantly better than cluster 3. The 10 m walk time and TUGT of cluster 1 were significantly better than those of cluster 3. However, the 10 m walk time and TUGT of clusters 1 and 2 did not differ significantly. In conclusion, these findings may indicate differences in walking ability according to executive dysfunction.

Effects of a treatment program based on constraint-induced movement therapy for the lower extremities on gait and balance in chronic stroke: a 6-month follow-up pilot study.

Constraint-induced movement therapy (CIMT) for the lower extremities CIMT (LE-CIMT) has been shown feasible and promising but the long-term outcomes remain uncertain. In this pilot study, we recruited eight participants with chronic stroke from our facility for persons with disabilities to determine changes in gait and balance throughout an extended treatment program based on the principles of LE-CIMT. The program consisted of a run-in phase (3 weeks), LE-CIMT phase (3 weeks), and maintenance phase (6 months). In the LE-CIMT phase (3.5 h/day, 5 days/week, 3 weeks), the participants received task-oriented training (3 h) and transfer package training (30 min). The maintenance phase (30 min/day, 2-3 times/week, 6 months) included a transfer package and conventional training. The assessments were performed in the beginning and after each phase using the Fugl-Meyer Assessment, 6-min walk test (6MWT), Berg Balance Scale (BBS), and 10-m walk test from which walking speed, cadence, and stride length were derived. Overall, 6MWT, BBS, walking speed, and cadence improved significantly over time (analysis of variance P  < 0.001). When comparing the results from before to after the LE-CIMT phase, 6MWT, BBS, walking speed, and cadence improved significantly ( P  = 0.002 to 0.022). At the end of the 6-month maintenance phase, further improvements relative to the after LE-CIMT phase were found for 6MWT, walking speed, and cadence ( P  = 0.002 to 0.034). These pilot results suggest that an extended treatment program based on the principles of LE-CIMT can improve balance and more so walking in the chronic phase of stroke.

Overestimation associated with walking and balance function in individuals diagnosed with a stroke.

BACKGROUND: An estimation error is the difference between motor imagery and actual motor time. Previous studies have reported that overestimation (motor imagery time < actual motor time) is related to physical functions in healthy individuals. However, this finding is unclear among individuals diagnosed with a stroke. OBJECTIVE: We investigated whether overestimation is related to physical function in individuals diagnosed with a stroke. METHODS: This study included 71 individuals diagnosed with a stroke (mean age, 67.2 ± 13.4 years; mean time since stroke, 68.4 ± 44.7 days). Imagined timed up and go test (iTUGT) was performed to assess the estimation error. First, the iTUGT was performed; subsequently, the TUGT was performed. The estimation error was calculated by subtracting the TUGT from the iTUGT, with two standard deviations (2 SDs) being calculated. Furthermore, patients were classified into appropriate estimation (AE, within ±2 SD) and overestimation (OE, over -2 SD) groups. Both groups were tested using the estimation error, iTUGT, TUGT, Berg Balance Scale (BBS), and Brunnstrom Recovery Stage (BRS). Subsequently, a correlation analysis was performed. RESULTS: The OE group had a significantly higher estimation error than the AE group (OE: -7.08 ± 6.87 s, AE: -0.29 ± 1.53 s, P < .001). Moreover, the OE group had significantly lower TUGT and BBS than the AE group. The estimation error was correlated with the TUGT, BBS, and lower-limb BRS (ρ = -0.454, 0.431, 0.291, respectively; P < .05). CONCLUSIONS: Overestimation was associated with TUGT and balance function in individuals diagnosed with a stroke.

Designing receptor agonists with enhanced pharmacokinetics by grafting macrocyclic peptides into fragment crystallizable regions.

Short half-lives in circulation and poor transport across the blood-brain barrier limit the utility of cytokines and growth factors acting as receptor agonists. Here we show that surrogate receptor agonists with longer half-lives in circulation and enhanced transport rates across the blood-brain barrier can be generated by genetically inserting macrocyclic peptide pharmacophores into the structural loops of the fragment crystallizable (Fc) region of a human immunoglobulin. We used such 'lasso-grafting' approach, which preserves the expression levels of the Fc region and its affinity for the neonatal Fc receptor, to generate Fc-based protein scaffolds with macrocyclic peptides binding to the receptor tyrosine protein kinase Met. The Met agonists dimerized Met, inducing biological responses that were similar to those induced by its natural ligand. Moreover, lasso-grafting of the Fc region of the mouse anti-transferrin-receptor antibody with Met-binding macrocyclic peptides enhanced the accumulation of the resulting Met agonists in brain parenchyma in mice. Lasso-grafting may allow for designer protein therapeutics with enhanced stability and pharmacokinetics.

Effects of visual-motor illusions with different visual stimuli on the sit-to-stand of people with hemiplegia following stroke: A randomized crossover controlled trial.

BACKGROUND: The objective of this study was to determine the effects of different visual stimuli during visual-motor illusion on sit-to-stand in people with hemiplegia following stroke. METHODS: This was a randomized crossover controlled trial. Twenty people with hemiplegia following stroke were randomly divided into groups. The video images used for visual-motor illusion were ankle dorsiflexion without resistance (standard visual-motor illusion [standard illusion]) and maximum effort dorsiflexion with resistance (power visual-motor illusion [power illusion]). People with hemiplegia following stroke underwent both illusion interventions with a 1-week washout period in between; group A started with the standard illusion intervention and group B started with the power illusion intervention. Outcomes included the sit-to-stand duration, maximum weight-bearing value, trunk movement during sit-to-stand, ankle joint movement during sit-to-stand, and active ankle dorsiflexion movement on the paralyzed side. RESULTS: The angular velocity of the trunk and ankle joints increased significantly during sit-to-stand, and sit-to-stand duration decreased significantly in response only to power illusion. In addition, the change in angular velocity of active ankle dorsiflexion was significantly greater in response to power illusion than was the change in response to standard illusion. CONCLUSION: Power illusion induces a greater improvement in paralyzed ankle dorsiflexion function than standard illusion, resulting in shorter sit-to-stand duration.

Effects of visual-motor illusion in stroke hemiplegic patients with left-side personal neglect: A report of two cases.

Personal neglect is the neglect of self-body space, which often occurs in patients with unilateral spatial neglect (USN), but lacks a dedicated rehabilitation. The purpose of this study was to investigate the effects of visual-motor illusion (VMI) on two-stroke hemiplegic patients with left-side personal neglect. Case 1 was a 53-year-old man diagnosed with a right lenticulostriate artery infarction. Case 2 was a 76-year-old woman diagnosed with a right middle cerebral artery infarction. USN symptoms were not observed in either patient in the desk USN assessment, but personal neglect and USN symptoms in daily life were observed in both patients. Intervention effects were verified using an ABA design, comprising a 5-day three-phase (A1, B, A2). In phase B, VMI was performed on the paralyzed upper limb for 10 min in addition to conventional physical therapy. Outcomes measures were the Fluff test, Catherine Bergego Scale (CBS), Fugl-Meyer Assessment (FMA), and Functional Independence Measure (FIM). In both patients, no improvements were noted in FMA, but improvements were observed in the Fluff test, CBS, and FIM in phase B; these effects were retained in phase A2. Therefore, VMI may have contributed to improvements in Personal neglect and USN symptoms in daily life.

A feedback loop between lamellipodial extension and HGF-ERK signaling specifies leader cells during collective cell migration.

Upon the initiation of collective cell migration, the cells at the free edge are specified as leader cells; however, the mechanism underlying the leader cell specification remains elusive. Here, we show that lamellipodial extension after the release from mechanical confinement causes sustained extracellular signal-regulated kinase (ERK) activation and underlies the leader cell specification. Live-imaging of Madin-Darby canine kidney (MDCK) cells and mouse epidermis through the use of Förster resonance energy transfer (FRET)-based biosensors showed that leader cells exhibit sustained ERK activation in a hepatocyte growth factor (HGF)-dependent manner. Meanwhile, follower cells exhibit oscillatory ERK activation waves in an epidermal growth factor (EGF) signaling-dependent manner. Lamellipodial extension at the free edge increases the cellular sensitivity to HGF. The HGF-dependent ERK activation, in turn, promotes lamellipodial extension, thereby forming a positive feedback loop between cell extension and ERK activation and specifying the cells at the free edge as the leader cells. Our findings show that the integration of physical and biochemical cues underlies the leader cell specification during collective cell migration.

Effects and Adaptation of Visual-Motor Illusion Using Different Visual Stimuli on Improving Ankle Joint Paralysis of Stroke Survivors-A Randomized Crossover Controlled Trial.

Visual-motor illusion (VMI) is an intervention to induce kinesthetic sensation from visual stimuli. We aimed to compare the effects of VMI of different visual stimuli on the paralyzed side ankle joint of stroke hemiplegic patients (hemiplegic patients) and to clarify their indication. We applied two types of VMI images of ankle dorsiflexion: ankle dorsiflexion without resistance (standard VMI (S-VMI)) and maximum effort dorsiflexion with resistance (power VMI (P-VMI)). Twenty-two hemiplegic patients were divided into two groups: Group A, which received S-VMI first and P-VMI one week later (n = 11), and Group B, which received P-VMI first and S-VMI one week later (n = 11). Immediate effects were evaluated. Outcomes were the dorsiflexion angle and angular velocity, degree of sense of agency (SoA), and sense of ownership. Patient's characteristics of cognitive flexibility were assessed using the Trail making test-B (TMT-B). Fugl-Meyer assessment and the Composite-Spasticity-Scale were also assessed. P-VMI was significantly higher than S-VMI in SoA and dorsiflexion angular velocity. Additionally, the degree of improvement in dorsiflexion function with P-VMI was related to TMT-B and degree of muscle tone. Therefore, P-VMI improves ankle function in hemiplegic patients more than S-VMI but should be performed with cognitive flexibility and degree of muscle tone in mind.

Brain and muscle activation patterns during postural control affect static postural control.

BACKGROUND: Previous studies have reported existence of coordinated brain and muscle activity patterns that affect postural control. However, differences in these activity patterns that affect postural control are still unclear. The purpose of this study was to clarify brain and muscle activity pattern affecting postural control. RESEARCH QUESTION: Does the difference in brain and muscle activity patterns during postural control affect postural control ability? METHOD: Nineteen healthy men (mean age: 24.8 ± 4.1 years, height: 171.8 ± 5.5 cm, and weight: 63.5 ± 12.5 kg) performed a postural control task on a balance board, and their brain and muscle activities and body sway during the task were measured using functional near-infrared spectroscopy, surface electromyography, and three-dimensional accelerometry. Hierarchical cluster analysis was conducted to extract subgroups based on brain and muscle activities and postural control, and correlation analysis was performed to investigate the relationship between brain activity, muscle activity, and postural control. RESULTS: Two subgroups were found. Subgroup 1 (n = 9) showed higher brain activity in the supplementary motor area (p = 0.04), primary motor cortex (p = 0.04) and stable postural control in the mediolateral (p < 0.01) planes, and subgroup 2 (n = 10) showed higher muscle activity in the tibialis anterior (p < 0.01), a higher shank muscles co-contraction (p = 0.02) and unstable postural control. Furthermore, the supplementary motor area activity is negatively correlated with body sway of mediolateral plane (r = -0.51, p = 0.02), and tibialis anterior activity is positively correlated with body sway on the mediolateral plane (r = 0.62, p = 0.004). SIGNIFICANCE: Higher brain activity in motor-related areas, lower activity in the lower limb muscles and lower co-contraction of shank muscles were observed in stable postural control. These results will facilitate the planning of new rehabilitation methods for improving postural control ability.

Relationship between the vividness of motor imagery and physical function in patients with subacute hemiplegic stroke: a cross-sectional preliminary study.

PURPOSE: The study aimed to clarify whether the vividness of motor imagery is related to lower limb function and walking ability in patients with hemiplegic stroke. MATERIALS AND METHODS: The study was a cross-sectional preliminary study. The subjects were 15 patients with hemiplegic stroke. The vividness of motor imagery was assessed using the kinesthetic and visual imagery questionnaire. The kinesthetic imagery (KI) involves the sensation of one's own movement, whereas the visual imagery (VI) involves the imagination of a third-person performing the self-movement. Their physical functions were assessed using the Brunnstrom recovery stage, stroke impairment assessment set, 10-m maximum walking speed test, and functional independence measure. KI and VI were compared using the t test. Correlation analysis was performed between KI or VI and various variables as well as between the motor imagery gap (difference between KI and VI) and various variables. RESULTS: KI was significantly lower than VI (p < .01). KI was correlated not only with lower limb function (r = 0.68) but also with walking speed (r = -0.64). The motor imagery gap was correlated with hip joint function (r = -0.53). CONCLUSIONS: KI and motor imagery gap were associated with lower limb function and walking ability.

Liver-expressed antimicrobial peptide 2 functions independently of growth hormone secretagogue receptor in calorie-restricted mice.

Ghrelin is a gastric-derived peptide that stimulates feeding, blood glucose elevation, body temperature reduction, and growth hormone (GH) secretion. Liver-expressed antimicrobial peptide 2 (LEAP2) is an endogenous antagonist of the ghrelin receptor, also called growth hormone secretagogue receptor (GHSR). We studied the effects of LEAP2 administration on feeding, body weight, glycemia, body temperature, and inflammation-related genes in the liver in C57BL/6 J mice and Ghsr-knockout (Ghsr-KO) mice. We found that a single administration of LEAP2 did not abolish fasting-induced food intake in 24-h fasted C57BL/6 J mice or Ghsr-KO mice. Moreover, continuous LEAP2 administration to mice fed ad libitum for 6 days did not affect feeding, body temperature, plasma ghrelin, or blood glucose. By contrast, continuous LEAP2 administration to calorie-restricted C57BL/6 J mice and Ghsr-KO mice induced body weight loss, hypoglycemia, body temperature reduction, and upregulation of Il-6 and Il-1ß mRNAs in the liver. Our findings suggest that LEAP2 functions independently of GHSR, implying that LEAP2 affects physiology beyond the ghrelin-GHSR system.