Phasic and repetitive self-touch differ in hemodynamic response in the prefrontal cortex-An fNIRS study.

Introduction: Each individual touches the own body several 100 times a day. While some researchers propose a self-regulatory function of self-touch, others report that self-touching increases nervousness. This controversy appears to be caused by the fact that researchers did not define the kind of self-touch they examined and actually, referred to different types of self-touch. Thus, kinematically defining different types of self-touch, such as phasic (discrete), repetitive, and irregular, and exploring the neural correlates of the different types will provide insight into the neuropsychological function of self-touching behavior. Methods: To this aim, we assessed hemodynamic responses in prefrontal brain areas using functional near-infrared spectroscopy (fNIRS) and behavioral responses with NEUROGES®. Fifty-two participants were recorded during three specific kinematically types of self-touch (phasic, irregular, repetitive) that were to be performed on command. The recently developed toolbox Satori was used for the visualization of neuronal processes. Results: Behaviorally, the participants did not perform irregular self-touch reliably. Neurally, the comparison of phasic, irregular and repetitive self-touch revealed different activation patterns. Repetitive self-touch is associated with stronger hemodynamic responses in the left Orbitofrontal Cortex and the Dorsolateral Prefrontal Cortex than phasic self-touch. Discussion: These brain areas have been reported to be associated with self-regulatory processes. Furthermore, irregular self-touch appears to be primarily generated by implicit neural control. Thus, by distinguishing kinematically different types of self-touch, our findings shed light on the controverse discussion on the neuropsychological function of self-touch.

Post-concussion symptoms and clinical reaction time performance of athletes with a history of concussion.

BACKGROUND: The symptom presentation after sport-related concussion is highly subjective, while the clinical test of reaction time (RT) has been presented as an objective tool to the effects of sport-related concussion. A multimodal assessment approach supports concussion management; therefore, it is appropriate to explore the relationship between modals. The aim of the present study is to investigate the relationship of clinical RT and post-concussion symptom (PCS) score, number of experienced concussions, and time since concussion. METHODS: Based on retrospective concussion history, 53 athletes were selected for this study. Athletes were questioned using a standardized questionnaire to obtain concussion history data, such as number of cumulative concussions and date of most recent concussion. Symptom scores were gathered through Sport Concussion Assessment Tool. A clinical RT test was used to obtain RT data. RESULTS: A significant positive correlation was found between RT and the PCS score. A linear regression revealed that the PCS score but neither the cumulative number of experienced concussions, nor the time post-concussion significantly predicts increased RT. Reaction time positively correlates with the symptoms neck pain, dizziness, balance problems, light sensitivity, feeling slowed down, feeling like in a fog, do not feel right, drowsiness, and irritability. CONCLUSIONS: This study presents that the PCS score particularly predicts increased RT after sport-related concussions. Furthermore, a specific set of symptoms significantly impacts the RT of athletes. The results suggest that not a single symptom drives the relationship between PCS score and RT, highlighting the heterogeneity of this injury.

Impaired recognition of nonverbal expressions of emotions in depressed individuals.

INTRODUCTION: Depressive individuals are impaired in the recognition of emotions in others'. Recent research suggests that the recognition of nonverbal expressions of emotions in other people may depend on the analysis of bodily rather than facial expressions. Therefore, we investigated if an impaired recognition of emotions by depressed individuals is body part specific. METHODS: Clinically diagnosed depressed and healthy matched controls were instructed to identify nonverbal expressions of positive (happiness), neutral, and negative emotions (sadness) via the face, the body, or the body and face. RESULTS: Depressed participants responded significantly less correctly overall when compared to non-depressed individuals. The recognition of nonverbal expressions of happiness by the body negatively predicted the Beck Depression Inventory II (BDI-II) score. DISCUSSION: The data revealed that the impaired recognition of nonverbal expressions of emotions in others by depressed individuals is not body part specific. Nevertheless, depressive symptoms seem to be related to the recognition of bodily expressions of happiness. Future studies must address whether impairments of depressive individuals are related to nonverbal expressions of the whole body.

Hyperactive movement behaviour of athletes with post-concussion symptoms.

OBJECTIVE: Observations of hyperactive (/restless, agitated) behaviour as a consequence of mild traumatic brain injuries (mTBI) in sports are inconclusive as reduced or slowed movement behaviour is also commonly described post-concussion. This might be grounded in the fact that the movement behaviour of athletes has not been systematically investigated during standardized settings and with objective methods of nonverbal movement analysis. Thus, we investigate whether symptoms after mTBI in sports are characterized by a hyper- or hypoactive movement behaviour experimentally. METHODS: Three matched groups of 40 athletes were investigated: 14 symptomatic and 14 asymptomatic athletes with a mTBI; and 12 non-concussed athletes. Four certified raters analysed with a standard analysis system for nonverbal behaviour each athlete's hand movement activity, hand movement contacts, and resting positions that were displayed during a videotaped standardized anamnesis protocol. RESULTS: Symptomatic athletes spend significantly more time with act apart hand movements and less time with closed rest positions when compared to non-concussed athletes. Post-concussion symptom (PCS) scores positively correlate with act apart hand movements. A linear regression analysis revealed that act apart hand movements significantly predict the PCS score. CONCLUSIONS: Athletes with increased symptoms after mTBI move their hands in a hyperactive and restless manner. Increased act apart hand movements, i.e., when both hands move simultaneously without touching each other, indicate a motoric destabilization in symptomatic athletes' behaviour that might be related to impaired inhibitory motor control systems. Future diagnoses should concern the systematic analysis of the nonverbal movement behaviour as a potential behavioural marker of symptoms after mTBI.

Nonverbal Hand Movement Durations Indicate Post-Concussion Symptoms of Athletes.

Methods of post-concussion diagnosis are still under debate with regard to sensitivity, objectivity, reliability, and costs. Spontaneous displays of nonverbal hand movement behavior during interaction are indicative of psychopathology and are relatively simple to record and analyze. Increased continuous (irregular) body-focused hand movement activity in particular indicates psychopathologies that overlap in symptomatology with those of sport-related concussions (SRCs). We therefore hypothesized that the duration of "irregular," "on body," and "act on each other" hand movements is increased in athletes with SRC who suffer from post-concussion symptoms. Three matched groups of 40 athletes were investigated: 14 symptomatic athletes with a concussion, 14 asymptomatic athletes with a concussion, and 12 non-concussed athletes. Using the Neuropsychological Gesture (NEUROGES)-Elan analysis system, four certified raters analyzed all nonverbal hand movements that were displayed during a videotaped standardized anamnesis about concussion history, incidence, course of action, and post-concussion symptoms. The duration of irregular Structure units among symptomatic athletes was significantly longer compared with asymptomatic athletes. Irregular, on body, and act on each other hand movement durations correlated with post-concussion symptoms. Whereas the duration of irregular units significantly predicted the post-concussion symptom score, working memory performances showed only marginal effects. Increased duration of irregular hand movement units indicates post-concussion symptoms in athletes with SRC. Because the recording of spontaneous displays of nonverbal hand movement behavior is relatively simple and cost efficient, we suggest using the neuropsychological analysis of hand movement behavior as a future diagnostic parameter of concussion management protocols.

Not just contact sports: significant numbers of sports-related concussions in cycling.

BACKGROUND: Although sports-related concussions (SRCs)/mild traumatic brain injuries in contact sports have recently received much attention, investigation of SRCs in cycling - a sport yielding some of the highest percentages of SRC - remains strikingly limited. In particular, rates of incidence, cycling-specific causes, and potential long-term effects of SRC have not been examined in this sport. Here, a retrospective online survey was used to investigate the incidence and potential long-term effects of SRCs among cyclists. METHODS: A cycling-specific questionnaire was developed and administered to 2792 cyclists via an online survey. First, participants were asked about their acute symptomatology, and secondly, cycling-specific items and concussion history were addressed. RESULTS: Of the 999 cyclists whom completed the questionnaire, 23.8% had experienced a concussion. Incidence of concussion was significantly higher in cyclists who were club members, who cycled more than 200 kilometers per week, and who wore a helmet. Cyclists with a history of concussion complained significantly more often about headaches, pressure in the head, sensitivity to light, confusion, and irritability. CONCLUSIONS: Concussions in cycling are a serious injury with a high incidence relative to other sports. Although wearing a helmet reduces the risk of severe brain injury, interesting, the present results show a relation between helmet use, participation in cycling clubs, and increased concussion incidence. These data are in line with the growing number of findings showing that athletes with a history of concussion report more symptoms.

Game-specific characteristics of sport-related concussions.

BACKGROUND: Concussions are common incidences in sports. However, game-specific characteristics such as tactics, field positions, etc. might positively/negatively contribute to the occurrence of mild traumatic brain injuries (mTBI) in various sports such as soccer, volleyball, handball, or basketball. Thus, the intention of this study was to analyze game-specific characteristics of concussive incidents in active players from the perspective of different sportive disciplines. METHODS: Four sport-specific questionnaires for soccer, handball, volleyball and basketball were established using an online survey tool. RESULTS: A total of 3001 participants completed the questionnaires. 18% of the participants answered that they had experienced a concussion which significantly differed depending on the sport practiced (χ2(3)=56.868, P<0.001; soccer 25%, handball 24%, volleyball 13%, basketball 15%). Whereas handball and soccer players experienced most concussions on the amateur level, volleyball players experienced most on the professional level and basketball players during leisure play (χ2(9)=112.667, P<0.001). Soccer players experienced most concussions by a collision with another player, volleyball players instead experienced most concussions by hits from the ball (χ2(6)=211.260, P<0.001). In soccer, goalkeepers and defensive midfield players showed most concussive incidences (χ2(7)=19.638, P<0.01); in volleyball, the libero position and outside positions showed to be significantly affected from sport-related concussions (χ2(6)=13.617, P<0.05). CONCLUSIONS: The present results showed that factors critically contributing to the occurrence of concussions are sport-specific and particularly concern amateurs. This indicates that most concussions in ball games appear in situations, where medical care units are not necessarily present. Preventive measures should therefore especially address amateurs in ball sports.

Neural Control of Posture in Individuals with Persisting Postconcussion Symptoms.

INTRODUCTION: Postural instability has been shown to characterize individuals who suffered from long-term symptoms after mild traumatic brain injury. However, recordings of neural processes during postural control are difficult to realize with standard neuroimaging techniques. Thus, we used functional nearinfrared spectroscopy to investigate brain oxygenation of individuals with persistent postconcussion symptoms (pPCS) during postural control in altered environments. METHODS: We compared brain oxygenation and postural sway during balance control in three groups: individuals suffering from pPCS, individuals with a history of mild traumatic brain injury but without pPCS, and healthy controls. Individuals were investigated during postural control tasks with six different conditions: i) eyes opened, ii) eyes closed, and iii) blurred visual input, each while standing a) on a stable and b) an unstable surface. RESULTS: In all groups, during the eyes closed/unstable surface condition as compared with the other conditions, the postural sway increased as well as the brain oxygenation in frontal brain cortices. In the most difficult balance condition, as compared with the other two groups, subjects with pPCS applied more force over time to keep balance as measured by the force plate system with a significantly greater activation in frontopolar/orbitofrontal areas of the right hemisphere. CONCLUSIONS: As subjects with pPCS applied more force over time to control balance, we propose that with regard to cognitive processes, the increase of cerebral activation in these individuals indicates an increase of attention-demanding processes during postural control in altered environments.

Physical activity interventions in schools for improving lifestyle in European countries.

BACKGROUND: In the last decades, children's and adolescents' obesity and overweight have increased in European Countries. Unhealthy eating habits and sedentary lifestyle have been recognized to determine such an epidemic. Schools represent an ideal setting to modify harmful behaviors, and physical activity could be regarded as a potential way to avoid the metabolic risks related to obesity. Methods : A systematic review of the literature was carried out to summarize the evidence of school-based interventions aimed to promote, enhance and implement physical activity in European schools. Only randomized controlled trials were included, carried out in Europe from January 2000 to April 2014, universally delivered and targeting pupils aged between 3 and 18 years old. Results : Forty-seven studies were retrieved based either on multicomponent interventions or solely physical activity programs. Most aimed to prevent obesity and cardiovascular risks among youths. While few studies showed a decrease in BMI, positive results were achieved on other outcomes, such as metabolic parameters and physical fitness. Conclusion : Physical activity in schools should be regarded as a simple, non-expensive and enjoyable way to reach all the children and adolescents with adequate doses of moderate to vigorous physical activity.

Brain oxygenation patterns during the execution of tool use demonstration, tool use pantomime, and body-part-as-object tool use.

Divergent findings exist whether left and right hemispheric pre- and postcentral cortices contribute to the production of tool use related hand movements. In order to clarify the neural substrates of tool use demonstrations with tool in hand, tool use pantomimes without tool in hand, and body-part-as-object presentations of tool use (BPO) in a naturalistic mode of execution, we applied functional Near InfraRed Spectroscopy (fNIRS) in twenty-three right-handed participants. Functional NIRS techniques allow for the investigation of brain oxygenation during the execution of complex hand movements with an unlimited movement range. Brain oxygenation patterns were retrieved from 16 channels of measurement above pre- and postcentral cortices of each hemisphere. The results showed that tool use demonstration with tool in hand leads to increased oxygenation as compared to tool use pantomimes in the left hemispheric somatosensory gyrus. Left hand executions of the demonstration of tool use, pantomime of tool use, and BPO of tool use led to increased oxygenation in the premotor and somatosensory cortices of the left hemisphere as compared to right hand executions of either condition. The results indicate that the premotor and somatosensory cortices of the left hemisphere constitute relevant brain structures for tool related hand movement production when using the left hand, whereas the somatosensory cortex of the left hemisphere seems to provide specific mental representations when performing tool use demonstrations with the tool in hand.

Persistent Postconcussive Symptoms Are Accompanied by Decreased Functional Brain Oxygenation.

Diagnostic methods are considered a major concern in the determination of mild traumatic brain injury. The authors examined brain oxygenation patterns in subjects with severe and minor persistent postconcussive difficulties and a healthy control group during working memory tasks in prefrontal brain regions using functional near-infrared spectroscopy. The results demonstrated decreased working memory performances among concussed subjects with severe postconcussive symptoms that were accompanied by decreased brain oxygenation patterns. An association appears to exist between decreased brain oxygenation, poor performance of working memory tasks, and increased symptom severity scores in subjects suffering from persistent postconcussive symptoms.

Effects of exercise on anxiety and depression disorders: review of meta- analyses and neurobiological mechanisms.

Anxiety and depression are the most frequently diagnosed psychological diseases showing a high co-morbidity. They have a severe impact on the lives of the persons concerned. Many meta-analytical studies suggested a positive anxiolytic and depression-reducing effect of exercise programs. The aim of the present article is to synthesize metaanalyses on the effects of exercise on anxiety and depression and to describe average effect sizes. For this purpose 37 meta-analyses were included reporting 50 effect sizes for anxiety scores of 42,264 participants and depression scores of 48,207 persons. The average documented anxiolytic effect of exercise in these reviews was small, 0.34. In contrast, the effect of exercise on depression was significantly higher and at a moderate level, 0.56. Data of randomized controlled trials suggest higher sizes for the effect of exercise on anxiety and depression leading to increases up to moderate and large effects, respectively. Additionally, exercise seems to be more beneficial for patients compared to participants within a non-clinical, normal range of psychological disease. Especially for the effect of exercise on anxiety, more high quality meta-analyses of randomized controlled trials are needed. Finally, possible neurobiological explanations are suggested for the positive effect of exercise on psychological disorders like anxiety and depression.

Age-related changes in prefrontal activity during walking in dual-task situations: a fNIRS study.

BACKGROUND: Previous studies suggest that the human gait is under control of higher-order cognitive processes, located in the frontal lobes, such that an age-related degradation of cognitive capabilities has a negative impact on gait. METHODS: Using functional Near-Infrared-Spectroscopy (fNIRS) we investigate the frontocortical hemodynamic correlates of dual-task walking in two conditions. 15 young and 10 older individuals walked on a treadmill while completing concurrent tasks that had either visual (checking) or verbal-memory (alphabet recall) demands. We compared subjects' motor performance, as well as their prefrontal activity in single- and dual-task walking. RESULTS: Our behavioral data partly confirm previous accounts on higher dual-task costs in stepping parameters (i.e., decreased step duration) in old age, particularly with a visual task and negative dual-task cost (i.e., improved performance) during the verbal task in young adults. Functional imaging data revealed little change of prefrontal activation from single- to dual-task walking in young individuals. In the elderly, however, prefrontal activation substantially decreased during dual-task walking with a complex visual task. CONCLUSION: We interpret these findings as evidence for a shift of processing resources from the prefrontal cortex to other brain regions when seniors face the challenge of walking and concurrently executing a visually demanding task.

Hemispheric differences of motor execution: a near-infrared spectroscopy study.

Distal movements of the limbs are predominantly controlled by the contralateral hemisphere. However, functional neuroimaging studies do not unequivocally demonstrate a lateralization of the cerebral activation during hand movements. While some studies show a predominant activation of the contralateral hemisphere, other studies provide evidence for a symmetrically distributed bihemispheric activation. However, the divergent results may also be due to methodological shortcomings. Therefore, the present study using functional near-infrared spectroscopy examines cerebral activation in both hemispheres during motor actions of the right and left hands. Twenty participants performed a flexion/extension task with the right- or left-hand thumb. Cerebral oxygenation changes were recorded from 48 channels over the primary motor, pre-motor, supplementary motor, primary somatosensory cortex, subcentral area, and the supramarginal gyrus of each hemisphere. A consistent increase of cerebral oxygenation was found for oxygenated and for total hemoglobin in the hemisphere contralateral to the moving hand, regardless of the laterality. These findings are in line with previous data from localization [1-3] and brain imaging studies [4-6]. The present data support the proposition that there is no hemispheric specialization for simple distal motor tasks. Both hemispheres are equally activated during movement of the contralateral upper limb.

Neurobiological alterations induced by exercise and their impact on depressive disorders [corrected].

BACKGROUND: The impact of physical activity on brain metabolic functions has been investigated in different studies and there is growing evidence that exercise can be used as a preventive and rehabilitative intervention in the treatment of depressive disorders. However, the exact neuronal mechanisms underlying the latter phenomenon have not been clearly elucidated. The present article summarises key results derived from studies that focussed on the neurobiological impact of exercise on brain metabolic functions associated with depressive disorders. Since major depressive disorder (MDD) is a life threatening disease it is of great significance to find reliable strategies to prevent or to cure this illness. Therefore, the aim of this paper is to review (1) the physiological relationship between physical activity and depressive disorders and (2) the potential neurobiological alterations induced by exercise that might lead to the relief of mental disorders like depression. METHODS: We searched electronic databases for literature concerning the relationship between exercise and depression from 1963 until 2009. RESULTS: The data suggests an association between physical inactivity and higher levels of depressive symptoms. Properly designed studies could show that exercise training can be as effective as antidepressive medications. CONCLUSION: The exact mechanisms how exercise affects the brain are not fully understood and the literature lacks of well designed studies concerning the effects of exercise training on depressive disorders. But the observed antidepressant actions of exercise are strong enough that it already can be used as an alternative to current medications in the treatment of depressive disorders.