EEG Amplitude Modulation Analysis across Mental Tasks: Towards Improved Active BCIs.

Brain-computer interface (BCI) technology has emerged as an influential communication tool with extensive applications across numerous fields, including entertainment, marketing, mental state monitoring, and particularly medical neurorehabilitation. Despite its immense potential, the reliability of BCI systems is challenged by the intricacies of data collection, environmental factors, and noisy interferences, making the interpretation of high-dimensional electroencephalogram (EEG) data a pressing issue. While the current trends in research have leant towards improving classification using deep learning-based models, our study proposes the use of new features based on EEG amplitude modulation (AM) dynamics. Experiments on an active BCI dataset comprised seven mental tasks to show the importance of the proposed features, as well as their complementarity to conventional power spectral features. Through combining the seven mental tasks, 21 binary classification tests were explored. In 17 of these 21 tests, the addition of the proposed features significantly improved classifier performance relative to using power spectral density (PSD) features only. Specifically, the average kappa score for these classifications increased from 0.57 to 0.62 using the combined feature set. An examination of the top-selected features showed the predominance of the AM-based measures, comprising over 77% of the top-ranked features. We conclude this paper with an in-depth analysis of these top-ranked features and discuss their potential for use in neurophysiology.

Virtual reality and non-invasive brain stimulation for rehabilitation applications: a systematic review.

The present article reports the results of a systematic review on the potential benefits of the combined use of virtual reality (VR) and non-invasive brain stimulation (NIBS) as a novel approach for rehabilitation. VR and NIBS are two rehabilitation techniques that have been consistently explored by health professionals, and in recent years there is strong evidence of the therapeutic benefits of their combined use. In this work, we reviewed research articles that report the combined use of VR and two common NIBS techniques, namely transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS). Relevant queries to six major bibliographic databases were performed to retrieve original research articles that reported the use of the combination VR-NIBS for rehabilitation applications. A total of 16 articles were identified and reviewed. The reviewed studies have significant differences in the goals, materials, methods, and outcomes. These differences are likely caused by the lack of guidelines and best practices on how to combine VR and NIBS techniques. Five therapeutic applications were identified: stroke, neuropathic pain, cerebral palsy, phobia and post-traumatic stress disorder, and multiple sclerosis rehabilitation. The majority of the reviewed studies reported positive effects of the use of VR-NIBS. However, further research is still needed to validate existing results on larger sample sizes and across different clinical conditions. For these reasons, in this review recommendations for future studies exploring the combined use of VR and NIBS are presented to facilitate the comparison among works.

Physical exercise and human adipose-derived mesenchymal stem cells ameliorate motor disturbances in a male rat model of Parkinson's disease.

Parkinson's disease (PD) is a disabling and highly costly neurodegenerative condition with worldwide prevalence. Despite advances in treatments that slow progression and minimize locomotor impairments, its clinical management is still a challenge. Previous preclinical studies, using mesenchymal stem cell (MSC) transplantation and isolated physical exercise (EX), reported beneficial results for treatment of PD. Therefore, this experimental randomized study aimed to elucidate the therapeutic potential of combined therapy using adipose-derived human MSCs (ADSCs) grafted into the striatum in conjunction with aerobic treadmill training, specifically in terms of locomotor performance in a unilateral PD rat model induced by 6-hydroxydopamine (6-OHDA). Forty-one male Wistar rats were categorized into five groups in accordance with the type of treatment to which they were subjected (Sham, 6-OHDA - injury, 6-OHDA + exercise, 6-OHDA + cells, and 6-OHDA + combined). Subsequently, dopaminergic depletion was assessed by the methylphenidate challenge and the specified therapeutic intervention was conducted in each group. The foot fault task was performed at the end of the experiment to serve as an assessment of motor skills. The results showed that despite disturbances in motor balance and coordination, locomotor dysfunction was ameliorated in all treatment categories in comparison to the injury group (sign test, p < 0.001, effect size: 0.71). The exercise alone and combined groups were the categories that exhibited the best recovery in terms of movement performance (p < 0.001). Overall, this study confirms that exercise is a powerful option to improve motor function and a promising adjuvant intervention for stem cell transplantation in the treatment of PD motor symptoms. OPEN PRACTICES: This article has been awarded Open Data. All materials and data are publicly accessible at https://figshare.com/s/18a543c101a17a1d5560. Learn more about the Open Practices badges from the Center for Open Science: https://osf.io/tvyxz/wiki.

Green Juice in Human Metabolism: A Randomized Trial.

OBJECTIVE: Fruits and vegetables contain many compounds presenting potential antioxidant activity. The objective of this study was to evaluate the effect of a green juice recipe in adult metabolism in order to identify new preventive dietary sources. METHOD: This was a single-blind randomized controlled clinical trial. Recruitment and data were, respectively, made and collected at the Universidade Federal de Ciências da Saúde de Porto Alegre. Individuals who met all the inclusion criteria during the period of recruitment were included. Green juice (experimental group) or placebo (control group) were consumed from Monday to Friday between 8 and 9 am, in the amount of 300 mL for 60 days (except Saturdays and Sundays). To verify the effect of green juice on metabolism, the following were evaluated: (a) glycemia, plasma lipid profile, renal and liver functions, redox profile, and antioxidant enzymes; (b) anthropometry; and (c) well-being and anxiety. RESULTS: This study included 14 participants in the test group (juice group) and 13 controls (placebo group), with mean ages of 31.07 and 30.15 years, respectively. We did not observe a significant difference between the treatments. Dietary properties of vegetable and fruit juices are an area of significant interest. CONCLUSIONS: Together with an analysis of previous works, we suggest that green juice did not cause an improvement in metabolic function and there is a need for further research on this issue, mainly through different interventions and other samples.

YOGA AND THE INTERPLAY BETWEEN ATTENTIONAL LOAD AND EMOTION INTERFERENCE.

This study compared 45 yoga practitioners (M age = 29.7 yr., SD = 6.4) and 45 matched controls (M age = 29.3 yr., SD = 6.2) on the performance of a behavioral task that assessed negative emotion interference during a high- and a low-attentional demand condition, as well as on state and trait anxiety scores. Outcomes were also compared between beginner and advanced practitioners. For the behavioral task, the final sample comprised 36 yoga and 38 control participants. The yoga group presented lower emotion interference in the high attentional condition, compared to the low attentional condition; rated emotional images as less unpleasant, compared to controls; and reported lower state and trait anxiety scores relative to controls. Also, emotion interference in the low attentional condition was lower among advanced practitioners and state anxiety was lower among practitioners attending more than two weekly yoga classes. The results suggested that yoga may help improve self-regulatory skills and lower anxiety. The psychological mechanisms underlying the relationship between yoga and emotion regulation should be further investigated in longitudinal studies.

Evaluation of the Usability of a Serious Game in Virtual Reality with a Focus on the Perception and Experience of Health Professionals for Motor Rehabilitation in Children with Cerebral Palsy.

Introduction: Cerebral palsy (CP) is a nonprogressive neuropathological condition that requires lifelong neurocognitive-motor rehabilitation. Evidences indicate that the use of new technologies to assist in rehabilitation processes, such as serious games in virtual reality (VR), have served as adjuncts to therapy and capable of promoting engagement, motivation, and motor activation for these patients. Objective: To investigate the usability of a serious game in VR to help with the stability and balance of the head and trunk of children with CP, focusing on the perception and experience of health professionals. Methods: The collection was carried out with health professionals, and the results were comprehensively evaluated through viability by means of the total score, number of correct answers, number of errors, and level of difficulty during the execution of the game, which were collected from the performance report generated by the application. System satisfaction was also verified by the System Usability Scale (SUS). Results: The mean obtained from the total score of the SUS was 82.10 ± 12.66 points, being considered of high usability for the suggested purpose. The professionals' opinion about the usability of the system did not change due to the performance during the game. Conclusion: The study demonstrated that the developed rehabilitation program has successfully delivered the experience to exercise the head control and trunk balance of subjects with CP.

Quantifying time perception during virtual reality gameplay using a multimodal biosensor-instrumented headset: a feasibility study.

We have all experienced the sense of time slowing down when we are bored or speeding up when we are focused, engaged, or excited about a task. In virtual reality (VR), perception of time can be a key aspect related to flow, immersion, engagement, and ultimately, to overall quality of experience. While several studies have explored changes in time perception using questionnaires, limited studies have attempted to characterize them objectively. In this paper, we propose the use of a multimodal biosensor-embedded VR headset capable of measuring electroencephalography (EEG), electrooculography (EOG), electrocardiography (ECG), and head movement data while the user is immersed in a virtual environment. Eight gamers were recruited to play a commercial action game comprised of puzzle-solving tasks and first-person shooting and combat. After gameplay, ratings were given across multiple dimensions, including (1) the perception of time flowing differently than usual and (2) the gamers losing sense of time. Several features were extracted from the biosignals, ranked based on a two-step feature selection procedure, and then mapped to a predicted time perception rating using a Gaussian process regressor. Top features were found to come from the four signal modalities and the two regressors, one for each time perception scale, were shown to achieve results significantly better than chance. An in-depth analysis of the top features is presented with the hope that the insights can be used to inform the design of more engaging and immersive VR experiences.

Immersive media experience: a survey of existing methods and tools for human influential factors assessment.

Virtual reality (VR) applications, especially those where the user is untethered to a computer, are becoming more prevalent as new hardware is developed, computational power and artificial intelligence algorithms are available, and wireless communication networks are becoming more reliable, fast, and providing higher reliability. In fact, recent projections show that by 2022 the number of VR users will double, suggesting the sector was not negatively affected by the worldwide COVID-19 pandemic. The success of any immersive communication system is heavily dependent on the user experience it delivers, thus now more than ever has it become crucial to develop reliable models of immersive media experience (IMEx). In this paper, we survey the literature for existing methods and tools to assess human influential factors (HIFs) related to IMEx. In particular, subjective, behavioural, and psycho-physiological methods are covered. We describe tools available to monitor these HIFs, including the user's sense of presence and immersion, cybersickness, and mental/affective states, as well as their role in overall experience. Special focus is placed on psycho-physiological methods, as it was found that such in-depth evaluation was lacking from the existing literature. We conclude by touching on emerging applications involving multiple-sensorial immersive media and provide suggestions for future research directions to fill existing gaps. It is hoped that this survey will be useful for researchers interested in building new immersive (adaptive) applications that maximize user experience.

Speech and swallowing characteristics in patients with facioscapulohumeral muscular dystrophy.

BACKGROUND: Although facial muscle weakness is common in patients with Facioscapulohumeral Muscular Dystrophy (FSHD), the literature is scarce on the speech and swallowing aspects. OBJECTIVE: To investigate speech and swallowing patterns in FSHD and assess the correlation with clinical data. METHODS: A cross-sectional study was conducted. Patients with clinical confirmation of FSHD and aged above 18 years were included and paired with healthy control individuals by age and gender. Individuals who had neurological conditions that could interfere with test results were excluded. The following assessments were applied: speech tests (acoustic and auditory-perceptual analysis); swallowing tests with the Northwestern Dysphagia Patient Check Sheet (NDPCS), the Eat Assessment Tool (EAT-10), the Speech Therapy Protocol for Dysphagia Risk (PARD), and the Functional Oral Intake Scale (FOIS); disease staging using the modified Gardner-Medwin-Walton scale (GMWS); and quality of life with the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The correlation between test results and clinical data was verified by non-parametric statistics. RESULTS: Thirteen individuals with FSHD and 10 healthy controls were evaluated. The groups presented significant differences in the motor bases of phonation and breathing. Regarding swallowing, two (15%) individuals presented mild dysphagia and seven (53.8%) showed reduced facial muscles strength. These results were not correlated with duration of the disease, age at symptoms onset, and quality of life. Dysphagia was related to worsening disease severity. CONCLUSIONS: FSHD patients presented mild dysarthria and dysphagia. Frequent monitoring of these symptoms could be an important way to provide early rehabilitation and better quality of life.

The hydrolysis of striatal adenine- and guanine-based purines in a 6-hydroxydopamine rat model of Parkinson's disease.

Parkinson's disease (PD) is characterized by a progressive neurodegeneration in the substantia nigra and a striatal dopamine decrease. Striatal extracellular adenosine and ATP modulate the dopaminergic neurotransmission whereas guanosine has a protective role in the brain. Therefore, the regulation of their levels by enzymatic activity may be relevant to the clinical feature of PD. Here it was evaluated the extracellular nucleotide hydrolysis from striatal slices 4 weeks after a unilateral infusion with 6-OHDA into the medial forebrain bundle. This infusion increased ADP, AMP, and GTP hydrolysis by 15, 25, and 41%, respectively, and decreased GDP hydrolysis by 60%. There was no change in NTPDases1, 2, 3, 5, 6, and 5'-nucleotidase transcription. Dopamine depletion changes nucleotide hydrolysis and, therefore, alters the regulation of striatal nucleotide levels. These changes observed in 6-OHDA-lesioned animals may contribute to the symptoms observed in the model and provide evidence to indicate that extracellular purine hydrolysis is a key factor in understanding PD, giving hints for new therapies.

Cognitive profile of patients with facioscapulohumeral muscular dystrophy.

Although it is predominantly a muscular disease, impairments in the central nervous system in patients with facioscapulohumeral muscular dystrophy (FSHD) have been described in the literature. Objective: To describe the cognitive profile of patients with FSHD and to correlate the impairments found with clinical variables and quality of life. Methods: Cross-sectional and case-control study that evaluated FSHD patients using a series of cognitive assessments (Mini-Mental State Examination - MMSE, Montreal Cognitive Assessment - MoCA, verbal fluency with phonological restriction - FAS, categorical verbal fluency - FAS-cat, trail-making test - TMT, and Rey's Verbal Auditory Learning Test); a neurological severity scale (Gardner-Medwin-Walton - GMWS); and a quality of life measurement tool (Medical Outcomes Study 36-Item Short-Form Health Survey). Results: Individuals with FSHD (13) and healthy controls (26) were paired by gender and age. Significant differences between case and control groups were found in MMSE, TMT A, and A7 (p≤0.05) and MOCA (p≤0.001) performances. A positive correlation was verified in long-term memory impairments and the age in which symptoms appear (r=-0.593, p=0.033). Regarding quality of life assessment, the emotional domain correlated to MEEM (r=0.657, p=0.015), TMT A (r=-0.601, p=0.030), and A7 (r=0.617, p=0.025) performances. Conclusions: Individuals with FSHD presented mild impairments in the performance of tasks that involve attention, planning, and long-term memory functions. Those impairments were associated neither with the disease duration nor with its neurological severity.

Embora seja uma doença predominantemente muscular, alterações no sistema nervoso central em pacientes com Distrofia Facioescapuloumeral (FSHD) têm sido descritas na literatura. Objetivo: Caracterizar o perfil cognitivo de pacientes com FSHD e correlacionar as alterações encontradas com variáveis clínicas e qualidade de vida. Métodos: Estudo transversal, caso-controle que avaliou pacientes com FSHD por meio de uma série de avaliações cognitivas (Mini Exame do Estado Mental ­ MEEM; Montreal Cognitive Assessment ­ MoCA; fluência verbal com restrição fonológica ­ FAS; fluência verbal categórica ­ FAS-cat; Trail Making Test ­ TMT; e Rey's Verbal Auditory Learning Test ­ RAVLT); uma escala de gravidade neurológica (Gardner-Medwin-Walton ­ GMWS); e um questionário (Medical Outcomes Study 36-Item Short-Form Health Survey ­ SF-36). Resultados: A amostra foi composta por 13 indivíduos com FSHD e 26 controles saudáveis, pareados por sexo e idade. A análise comparativa entre os grupos FSHD e controle mostrou diferenças significativas no desempenho cognitivo dos testes MEEM, TMT A e A7 (p≤0.05) e no MoCA (p≤0,001). Verificou-se uma correlação positiva com a idade de início dos sintomas e o prejuízo na memória de longo prazo (r=-0,593, p=0,033). Em relação à qualidade de vida, observou-se uma correlação entre o domínio de limitação emocional e os testes MEEM (r=0,657, p=0,015), TMT A (r=-0,601, p=0,030) e A7 (r=0,617, p=0,025). Conclusões: Pacientes com FSHD apresentaram alterações leves na realização de tarefas que envolvem as funções de atenção, planejamento e memória de longo prazo. Essas alterações não tiveram associação com o tempo de doença nem com sua gravidade neurológica.

The footfault test as a screening tool in the 6-hydroxydopamine rat model of Parkinson's disease.

The administration of 6-hydroxydopamine (6-OHDA) into the nigrostriatal pathway is a rat model of Parkinson's disease (PD). The footfault test is a behavioural task in which rodents have their motor functions assessed. Here, we observed that unilaterally 6-OHDA-lesioned animals show a context-induced ipsilateral rotational behaviour when placed on the footfault apparatus for 3 min and this may be used as index to detect lesioned animals. Our results showed a sensitivity and specificity of 100% for lesions higher than 94% and 64%, respectively (ROC curve: AUC=0.988). A binary logistic regression model showed an expB=1.116 (95% CI, 1.007-1.236) and C=-9.081+/-4.554 (p=0.046) using the nigral tyrosine hidroxylase immunocontent as standard (each unit represents a 10%-lesion extension). Additionally, the footfault test was more sensitive than apomorphine challenging at 1mg/kg when these tests were carried out days apart and it was less sensitive than methylphenidate at 40 mg/kg (sign test, p<0.05). Therefore, the footfault test may be very useful in the PD animal model for screening animals since it is fast and simple and it does not require a drug to induce rotational activity.

The effect of noise on attention and performance in reading and writing tasks.

PURPOSE: This study investigated the effects of two levels of noise on the performance of young students of three educational levels and tested their ability to maintain attentional focus in reading and writing tasks. METHODS: 162 school children in the third, fourth and fifth grades were placed in three groups according to their educational level: Control Group (CG), Experimental Group A (GEA) and Experimental Group B (GEB). All groups were submitted to a Sustained Attention Test, Reading Assessment and Isolated Words Test and Writing Dictation Sub-test (part of the International Dyslexia Test). The GEA and GEB performed the tests in a noisy environment: 20dB and 40dB, respectively. The CG was assessed in the usual school environmental noise at the same time of the day. The data was submitted to an ANOVA, the Kruskal-Wallis test and Spearman correlation test. RESULTS: The higher the score on the Sustained Attention Test, the shorter the time spent reading and fewer errors in the dictation task. There were no differences across the three grades within the GEA (lower levels of noise) with regard to the effect of noise on attention and in the reading and writing task performance. The higher levels of noise for the GEB, however, decreased the attention levels, therefore increasing mistakes on the dictation test. Comparing the performance across educational levels on the reading tasks, the fourth grade presented decreased reading time, while the third and fifth grades spent more time reading. CONCLUSION: Auditory interference can influence the ability to focus attention as well as worsen performance in reading and writing tasks at more intense noise levels.

Mesenchymal stem cell transplantation and aerobic exercise for Parkinson's disease: therapeutic assets beyond the motor domain.

Parkinson's disease (PD) is a very common neurodegenerative condition in which both motor and nonmotor deficits evolve throughout the course of the disease. Normally characterized as a movement disorder, PD has been broadly studied from a motor perspective. However, mild to moderate cognitive deficits began to appear in the early phases of the disease, even before motor disturbances actually manifest, and continue to progress relentlessly. These nonmotor manifestations are also a source of detriment to the patients' already strained functionality and quality of life, and pose a therapeutic challenge seeing that replacing therapies have had conflicting results. Considering that the currently approved therapies can hardly be considered curative, efforts to find therapeutic approaches with an actual disease-modifying quality and capable of addressing not only motor but also cognitive dysfunctions are clearly needed. Among possible alternatives with such attribute, mesenchymal stem cell transplantation and exercise are worth highlighting given their common neuroprotective, neuroplastic, and immunomodulatory properties. In this paper, we will summarize the existent literature on the topic, focusing on the mechanisms of action through which these two approaches might beget therapeutic benefits for PD beyond the commonly assessed motor dysfunctions, alluding, at the same time, toward a potential synergic association of both therapies as an optimized approach for PD.

Stem Cell Transplantation and Physical Exercise in Parkinson's Disease, a Literature Review of Human and Animal Studies.

The absence of effective and satisfactory treatments that contribute to repairing the dopaminergic damage caused by Parkinson's Disease (PD) and the limited recovery capacity of the nervous system are troubling issues and the focus of many research and clinical domains. Recent advances in the treatment of PD through stem cell (SC) therapy have recognized their promising restorative and neuroprotective effects that are implicated in the potentiation of endogenous mechanisms of repair and contribute to functional locomotor improvement. Physical exercise (PE) has been considered an adjuvant intervention that by itself induces beneficial effects in patients and animal models with Parkinsonism. In this sense, the combination of both therapies could provide synergic or superior effects for motor recovery, in contrast with their individual use. This review aims to provide an update on recent progress and the potential effectiveness of SC transplantation and PE for the treatment of locomotor deficits in PD. It has reviewed the neuropathological pathways involved in the classical motor symptoms of this condition and the mechanisms of action described in experimental studies that are associated with locomotor enhancement through exercise, cellular transplantation, and their union in some neurodegenerative conditions.

Association of GPX1 and GPX4 polymorphisms with episodic memory and Alzheimer's disease.

It is well established that healthy aging, mild cognitive impairment (MCI), and Alzheimer's disease (AD) are associated with substantial declines in episodic memory. However, there is still debate about the roles of GPX1 and GPX4 polymorphisms. The aim of this study was to investigate the association of rs1050450 and rs713041 polymorphisms with memory. This research was composed of a cross-sectional study (334 subjects) and a case-control study (108 healthy controls and 103 with AD-NINCDS/ARDA, DSM-IV-TR criteria). For the association of the genetic polymorphisms with memory or cognitive loss, the phenotypes were analyzed as follows: 1) each memory as a quantitative trait; 2) presence of deficit on a specific memory; 3) presence of MCI; 4) presence of AD. To assess verbal learning and the ability to store new information, we used the Rey Verbal Learning Test. Scores were recorded as a function of age as in the WMS-R testing battery. DNA was obtained from whole blood, and genotypes for GPX1 (rs1050450) and GPX4 (rs713041) were detected by allelic discrimination assay using TaqMan® MGB probes on a real-time PCR system. GPX1 TT homozygotes had lower long-term visual memory scores than CC/CT group (-0.28 ±â€¯1.03 vs. 0.13 ±â€¯1.03, respectively, p = 0.017). For the GPX4 rs713041, the frequency of the TT genotype was higher in the group with normal scores than in the group with long-term visual memory deficits (p = 0.025). In a multivariate logistic regression, GPX1 CC homozygotes had a 2.85 higher chance of developing AD (OR = 2.85, CI95% = 1.04-7.78, p = 0.041) in comparison to the reference genotype. No significant differences were observed regarding the MCI group between genetic variants. This study is one of the first to show that polymorphisms in GPX1 and GPX4 are significantly associated with episodic memory and AD in a South Brazilian population.

Motor Improvement Using Motion Sensing Game Devices for Cerebral Palsy Rehabilitation.

The authors aimed to investigate the effects of an intervention based on interactive game set with the movement sensor Kinect on children with cerebral palsy (CP). Twenty-eight participants were recruited. Their age was between 3 and 12 years old, and rated as level I, II, or III on the Gross Motor Function Classification System. They played two games from the Xbox 360 Kinect system and were evaluated using the Gross Motor Function Measure (GMFM) after a period of 8 weeks. The intervention led to significant motor function improvement as increase of the global scores on the GMFM (p < .001). Rehabilitation interventions using the Xbox 360 Kinect interactive games may represent useful tools for children with CP.

Speech and swallowing characteristics in patients with facioscapulohumeral muscular dystrophy / Caracterização da fala e da deglutição em pacientes com distrofia muscular facioescapuloumeral

ABSTRACT Background: Although facial muscle weakness is common in patients with Facioscapulohumeral Muscular Dystrophy (FSHD), the literature is scarce on the speech and swallowing aspects. Objective: To investigate speech and swallowing patterns in FSHD and assess the correlation with clinical data. Methods: A cross-sectional study was conducted. Patients with clinical confirmation of FSHD and aged above 18 years were included and paired with healthy control individuals by age and gender. Individuals who had neurological conditions that could interfere with test results were excluded. The following assessments were applied: speech tests (acoustic and auditory-perceptual analysis); swallowing tests with the Northwestern Dysphagia Patient Check Sheet (NDPCS), the Eat Assessment Tool (EAT-10), the Speech Therapy Protocol for Dysphagia Risk (PARD), and the Functional Oral Intake Scale (FOIS); disease staging using the modified Gardner-Medwin-Walton scale (GMWS); and quality of life with the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The correlation between test results and clinical data was verified by non-parametric statistics. Results: Thirteen individuals with FSHD and 10 healthy controls were evaluated. The groups presented significant differences in the motor bases of phonation and breathing. Regarding swallowing, two (15%) individuals presented mild dysphagia and seven (53.8%) showed reduced facial muscles strength. These results were not correlated with duration of the disease, age at symptoms onset, and quality of life. Dysphagia was related to worsening disease severity. Conclusions: FSHD patients presented mild dysarthria and dysphagia. Frequent monitoring of these symptoms could be an important way to provide early rehabilitation and better quality of life.

RESUMO Antecedentes: Embora haja predomínio de fraqueza muscular facial na distrofia facioescapuloumeral (FSHD), é escassa a literatura sobre aspectos de fala e deglutição. Objetivo: Investigar os padrões de fala e deglutição na FSHD e correlacioná-los com dados clínicos da doença. Métodos: Estudo transversal. Pacientes com confirmação clínica de FSHD e idade acima de 18 anos foram incluídos e pareados por idade e sexo com controles saudáveis. Foram excluídos indivíduos que apresentassem condições neurológicas que pudessem interferir nos resultados dos testes. Aplicaram-se as seguintes avaliações: fala (análise acústica e perceptivo-auditiva); deglutição, por meio do Northwestern Dysphagia Patient Check Sheet (NDPCS), Eat Assessment Tool (EAT-10), Protocolo de Avaliação para Risco de Disfagia (PARD) e Functional Oral Intake Scale (FOIS); estadiamento da doença, por meio da Gardner-Medwin-Walton scale (GMWS); e qualidade de vida, com o Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Resultados de fala e deglutição foram correlacionados com dados clínicos da doença por teste não paramétrico. Resultados: Foram avaliados 13 indivíduos com FSHD e dez controles saudáveis. Houve diferença significativa entre os grupos nas bases motoras fonação e respiração. Na deglutição, dois (15%) indivíduos apresentaram disfagia leve e sete (53,8%), força reduzida da musculatura da face. Esses resultados não foram correlacionados com tempo de doença, idade de início dos sintomas e qualidade de vida. A disfagia esteve relacionada com a gravidade da doença. Conclusões: Pacientes com FSHD apresentaram disartria e disfagia leves. O monitoramento frequente desses sintomas pode ser uma forma importante de proporcionar reabilitação precoce e melhor qualidade de vida.

Cognitive profile of patients with facioscapulohumeral muscular dystrophy / Perfil cognitivo de pacientes com distrofia muscular facioescapuloumeral

ABSTRACT Although it is predominantly a muscular disease, impairments in the central nervous system in patients with facioscapulohumeral muscular dystrophy (FSHD) have been described in the literature. Objective: To describe the cognitive profile of patients with FSHD and to correlate the impairments found with clinical variables and quality of life. Methods: Cross-sectional and case-control study that evaluated FSHD patients using a series of cognitive assessments (Mini-Mental State Examination — MMSE, Montreal Cognitive Assessment — MoCA, verbal fluency with phonological restriction — FAS, categorical verbal fluency — FAS-cat, trail-making test — TMT, and Rey's Verbal Auditory Learning Test); a neurological severity scale (Gardner-Medwin-Walton — GMWS); and a quality of life measurement tool (Medical Outcomes Study 36-Item Short-Form Health Survey). Results: Individuals with FSHD (13) and healthy controls (26) were paired by gender and age. Significant differences between case and control groups were found in MMSE, TMT A, and A7 (p≤0.05) and MOCA (p≤0.001) performances. A positive correlation was verified in long-term memory impairments and the age in which symptoms appear (r=-0.593, p=0.033). Regarding quality of life assessment, the emotional domain correlated to MEEM (r=0.657, p=0.015), TMT A (r=-0.601, p=0.030), and A7 (r=0.617, p=0.025) performances. Conclusions: Individuals with FSHD presented mild impairments in the performance of tasks that involve attention, planning, and long-term memory functions. Those impairments were associated neither with the disease duration nor with its neurological severity.

RESUMO Embora seja uma doença predominantemente muscular, alterações no sistema nervoso central em pacientes com Distrofia Facioescapuloumeral (FSHD) têm sido descritas na literatura. Objetivo: Caracterizar o perfil cognitivo de pacientes com FSHD e correlacionar as alterações encontradas com variáveis clínicas e qualidade de vida. Métodos: Estudo transversal, caso-controle que avaliou pacientes com FSHD por meio de uma série de avaliações cognitivas (Mini Exame do Estado Mental — MEEM; Montreal Cognitive Assessment — MoCA; fluência verbal com restrição fonológica — FAS; fluência verbal categórica — FAS-cat; Trail Making Test — TMT; e Rey's Verbal Auditory Learning Test — RAVLT); uma escala de gravidade neurológica (Gardner-Medwin-Walton — GMWS); e um questionário (Medical Outcomes Study 36-Item Short-Form Health Survey — SF-36). Resultados: A amostra foi composta por 13 indivíduos com FSHD e 26 controles saudáveis, pareados por sexo e idade. A análise comparativa entre os grupos FSHD e controle mostrou diferenças significativas no desempenho cognitivo dos testes MEEM, TMT A e A7 (p≤0.05) e no MoCA (p≤0,001). Verificou-se uma correlação positiva com a idade de início dos sintomas e o prejuízo na memória de longo prazo (r=-0,593, p=0,033). Em relação à qualidade de vida, observou-se uma correlação entre o domínio de limitação emocional e os testes MEEM (r=0,657, p=0,015), TMT A (r=-0,601, p=0,030) e A7 (r=0,617, p=0,025). Conclusões: Pacientes com FSHD apresentaram alterações leves na realização de tarefas que envolvem as funções de atenção, planejamento e memória de longo prazo. Essas alterações não tiveram associação com o tempo de doença nem com sua gravidade neurológica.

Effects of musical improvisation as a cognitive and motor intervention for the elderly / Efeitos da improvisação musical como intervenção cognitiva e motora para idosos

Music has been debated as a positive factor for the health of elderly people. In a randomized study, the researchers compared an intervention based on percussion and musical improvisation with a choir activity. The objective was to investigate whether improvisation would influence the executive functioning and motor skills of healthy elderly people. A set of instruments for psychological and motor assessment was used before and after the procedure. Differences were found in the performance of the participants of the improvisation group in the Clock Drawing Test suggesting possible gains in executive function. There were gains, regardless of the group, in part A of the Trail Making Test, which indicates a sustained attention. No evidence of motor effects was found in this study. The results suggest that musical activities can contribute to the prevention of cognitive decline caused by aging.

A música tem sido discutida como fator promotor da saúde do idoso. Em um estudo randomizado, uma intervenção baseada em exercícios de percussão e improvisação foi comparada a uma atividade de canto coral. O objetivo foi investigar os efeitos sobre o funcionamento executivo e motor de idosos saudáveis. Um conjunto de instrumentos de avaliação psicológica e motora foi aplicado antes e depois da intervenção. Foram encontradas diferenças no desempenho do grupo de improvisação no Teste de Desenho do Relógio sugerindo possíveis ganhos executivos. Houve ganhos independentes de grupo na parte A do Teste de Trilhas, que avalia a atenção sustentada. Não foram verificadas evidências de efeitos motores. Os resultados indicam que atividades musicais podem contribuir na prevenção do declínio cognitivo decorrente do envelhecimento.