Behavioural Neurology The latest articles from Hindawi © 2017 , Hindawi Limited . All rights reserved. Spatial Navigation Impairment Is Associated with Alterations in Subcortical Intrinsic Activity in Mild Cognitive Impairment: A Resting-State fMRI Study Wed, 20 Sep 2017 00:00:00 +0000 Impairment of spatial navigation (SN) skills is one of the features of the Alzheimer’s disease (AD) already at the stage of mild cognitive impairment (MCI). We used a computer-based battery of spatial navigation tests to measure the SN performance in 22 MCI patients as well as 21 normal controls (NC). In order to evaluate intrinsic activity in the subcortical regions that may play a role in SN, we measured ALFF, fALFF, and ReHo derived within 14 subcortical regions. We observed reductions of intrinsic activity in MCI patients. We also demonstrated that the MCI versus NC group difference can modulate activity-behavior relationship, that is, the correlation slopes between ReHo and allocentric SN task total errors were significantly different between NC and MCI groups in the right hippocampus (interaction , ), pallidum (, ), and thalamus (, ), which were negative in NC (right hippocampus, ; right pallidum, ; right thalamus, ; all ) but absent in MCI (right hippocampus, ; right pallidum, ; right thalamus ; all ). These findings may provide a novel insight of the brain mechanism associated with SN impairment in MCI and indicated a stage specificity of brain-behavior correlation in dementia. This trial is registered with ChiCTR-BRC-17011316. Zhao Qing, Weiping Li, Zuzana Nedelska, Wenbo Wu, Fangfang Wang, Renyuan Liu, Hui Zhao, Weibo Chen, Queenie Chan, Bin Zhu, Yun Xu, Jakub Hort, and Bing Zhang Copyright © 2017 Zhao Qing et al. All rights reserved. Central Poststroke Pain: Its Profile among Stroke Survivors in Kano, Nigeria Tue, 19 Sep 2017 07:26:25 +0000 Background. Central poststroke pain (CPSP) caused by sensory dysfunction of central origin is a disabling condition that significantly affects the quality of life of stroke patients. Aim. The aim of this study is to determine the clinical profiles and pattern of CPSP among stroke patients in Kano, Nigeria. Methods. The study was a cross-sectional design involving stroke survivors who were ≥18 years old and with no significant cognitive impairment approved by the Research Ethics Committee of Aminu Kano Teaching Hospital. Participants were assessed using diagnostic criteria form, the douleur neuropathique 4 questions (DN4 questionnaire), and Leeds assessment of neuropathic symptoms and signs (LANNS). Results. A total of 120 stroke patients participated in the study, in which 6 (5%) were diagnosed with CPSP occurring within the first 3 months in 50% of the participants. The pain characteristics were mainly moderate (83.3%), burning (62.5%), and continuously experienced (66.7%). The frequently affected parts were extremities or occurring as hemisyndrome. Conclusion. Prevalence of CPSP following stroke is low. The clinical features are variable and can occur at a varied time and different intensities and locations. However, it majorly occurs within the first few months post stroke. Abdulbaki Halliru Bashir, Auwal Abdullahi, Muhammad Aliyu Abba, and Naziru Bashir Mukhtar Copyright © 2017 Abdulbaki Halliru Bashir et al. All rights reserved. Gesture Decoding Using ECoG Signals from Human Sensorimotor Cortex: A Pilot Study Tue, 05 Sep 2017 00:00:00 +0000 Electrocorticography (ECoG) has been demonstrated as a promising neural signal source for developing brain-machine interfaces (BMIs). However, many concerns about the disadvantages brought by large craniotomy for implanting the ECoG grid limit the clinical translation of ECoG-based BMIs. In this study, we collected clinical ECoG signals from the sensorimotor cortex of three epileptic participants when they performed hand gestures. The ECoG power spectrum in hybrid frequency bands was extracted to build a synchronous real-time BMI system. High decoding accuracy of the three gestures was achieved in both offline analysis (85.7%, 84.5%, and 69.7%) and online tests (80% and 82%, tested on two participants only). We found that the decoding performance was maintained even with a subset of channels selected by a greedy algorithm. More importantly, these selected channels were mostly distributed along the central sulcus and clustered in the area of 3 interelectrode squares. Our findings of the reduced and clustered distribution of ECoG channels further supported the feasibility of clinically implementing the ECoG-based BMI system for the control of hand gestures. Yue Li, Shaomin Zhang, Yile Jin, Bangyu Cai, Marco Controzzi, Junming Zhu, Jianmin Zhang, and Xiaoxiang Zheng Copyright © 2017 Yue Li et al. All rights reserved. Cognitive Impairment in Relapsing-Remitting Multiple Sclerosis Patients with Very Mild Clinical Disability Tue, 15 Aug 2017 00:00:00 +0000 Cognitive dysfunction affects 40–65% of multiple sclerosis (MS) patients and can occur in the early stages of the disease. This study aimed to explore cognitive functions by means of the Italian version of the minimal assessment of cognitive function in MS (MACFIMS) in relapsing-remitting MS (RRMS) patients with very mild clinical disability to identify the primarily involved cognitive functions. Ninety-two consecutive RRMS patients with Expanded Disability Status Scale (EDSS) scores ≤ 2.5 and forty-two healthy controls (HC) were investigated. Our results show that 51.1% of MS patients have cognitive dysfunction compared to HC. An impairment of verbal and visual memory, working memory, and executive functions was found in the RRMS group. After subgrouping RRMS by EDSS, group 1 (EDSS ≤ 1.5) showed involvement of verbal memory and executive functions; moreover, group 2 (2 ≤ EDSS ≤ 2.5) patients were also impaired in information processing speed and visual memory. Our results show that utilizing a comprehensive neuropsychological assessment, approximately half of MS patients with very mild physical disability exhibit cognitive impairment with a primary involvement of prefrontal cognitive functions. Detecting impairment of executive functions at an early clinical stage of disease could be useful to promptly enroll MS patients in targeted rehabilitation. S. Migliore, A. Ghazaryan, I. Simonelli, P. Pasqualetti, F. Squitieri, G. Curcio, D. Landi, M. G. Palmieri, F. Moffa, M. M. Filippi, and F. Vernieri Copyright © 2017 S. Migliore et al. All rights reserved. LncRNA NONRATT021972 Was Associated with Neuropathic Pain Scoring in Patients with Type 2 Diabetes Tue, 08 Aug 2017 05:16:56 +0000 Background. Long noncoding RNAs were involved in the processes of diabetes. Our study was aimed to explore clinical potential of LncRNA NONRATT021972 in diabetic neuropathic pain and investigate detailed mechanisms. Methods. 154 patients with type 2 diabetes were enrolled as experimental group paired with control. Patients without diabetes but neuropathy were enrolled to explore exclusive role of LncRNA NONRATT021972 in neuropathy. Real-time PCR and ELISA were performed to examine expression of LncRNA and TNF-α in flood. Neuropathic pain scores were calculated with data from NPQ. Streptozotocin was used for SD adult male rats to establish diabetes for NONRATT021972 siRNA or saline treatment. Neuropathic pain behaviors and expression of TNF-α were assessed. Result. Patients with type 2 diabetes had a significantly higher concentration of LncRNA NONRATT021972 in blood and more severe symptoms of neuropathic pain. LncRNA NONRATT021972 was positively associated with neuropathic pain scores of type 2 diabetes. TNF-α level increased in patients with type 2 diabetes. Animal experiment showed that LncRNA NONRATT021972 siRNA attenuated inflammation via decreasing TNF-α and alleviated neuropathic pain. Conclusion. LncRNA NONRATT021972 increased in type 2 diabetes and was positively associated with neuropathic pain scoring in type 2 diabetes. LncRNA NONRATT021972 exacerbated neuropathic pain via TNF-α related pathways. Wei Yu, Guo-qing Zhao, Rang-juan Cao, Zhi-hua Zhu, and Kai Li Copyright © 2017 Wei Yu et al. All rights reserved. Functional Capacity and Motor Performance of Upper Limbs in Individuals with Cerebellar Disorders: A Pilot Study Tue, 08 Aug 2017 04:41:53 +0000 In simple daily activities carried out by the upper limbs, the cerebellum is responsible for the adaptations required for the accurate movement based on previous experiences and external references. This paper aims to characterize the performance of the upper limbs after a cerebellar disease. We evaluated the digital and handgrip strength, dexterity, and function of the upper limbs. The motor performance of the upper limbs was assessed through the use of a digitizing tablet by performing aiming movements with the upper limb most affected by cerebellar disease and the paired limb of the healthy group. The results showed differences between groups: the cerebellar group had higher latency to movement onset, was slower, and presented less smooth trajectories and higher initial direction errors. Moreover, the movement direction influenced the peak velocity and the smoothness for both groups (contralateral directions were slower and less smooth). We concluded that cerebellar disorder leads to movement planning impairment compromising the formulation of an internal model. Alterations on movement execution seem to be a consequence from disruptions in the anticipatory model, leading to more adaptations. These findings are compatible with the roles of the cerebellum on the control of voluntary movement. Vivian Farahte Giangiardi, Sandra Maria Sbeghen F. de Freitas, Flávia P. de Paiva Silva, Renata Morales Banjai, and Sandra Regina Alouche Copyright © 2017 Vivian Farahte Giangiardi et al. All rights reserved. Depression after Stroke in Sub-Saharan Africa: A Systematic Review and Meta-Analysis Thu, 27 Jul 2017 00:00:00 +0000 Objective. We aimed to conduct a systematic review and meta-analysis of prevalence and characteristics of poststroke depression (PSD) in sub-Saharan Africa (SSA). Methods. We searched Medline, PsycINFO, and African Journals OnLine using keywords for stroke and depression and the .mp. operator for all 54 SSA countries/regions. Further information was retrieved through a manual search of references from relevant published and unpublished articles. We included only peer-reviewed original studies with epidemiological or experimental designs, conducted random-effect meta-analysis, and identified the most commonly associated factors by weight (inverse of variance method). Results. Seventeen studies, comprising 1483 stroke survivors, met the criteria for syntheses. The pooled frequency of clinically diagnosed PSD was 31% (95% CI = 26%–36%), versus 13.9% in healthy control pairs. Prevalence did not vary much across healthcare settings but was affected by methods of depression ascertainment. PSD was significantly associated with low education, cognitive impairment, physical disability, poor quality of life, and divorced marital status. Conclusion. Almost 1 in 3 individuals with stroke in SSA has clinical depression. Despite limitations around quality of identified studies, results of the present systematic review overlap with findings in the global literature and highlight useful targets for the design and trial of tailored intervention for PSD in SSA. Akin Ojagbemi, Onoja Akpa, Fisayo Elugbadebo, Mayowa Owolabi, and Bruce Ovbiagele Copyright © 2017 Akin Ojagbemi et al. All rights reserved. Corrigendum to “Pediatric Traumatic Brain Injury and Autism: Elucidating Shared Mechanisms” Sun, 16 Jul 2017 07:30:28 +0000 Rahul Singh, Ryan C. Turner, Linda Nguyen, Kartik Motwani, Michelle Swatek, Brandon P. Lucke-Wold, and Rabia Qaiser Copyright © 2017 Rahul Singh et al. All rights reserved. Characterizing Patients with Unilateral Vestibular Hypofunction Using Kinematic Variability and Local Dynamic Stability during Treadmill Walking Thu, 13 Jul 2017 00:00:00 +0000 Here, we aimed to compare the unstable gait caused by unilateral vestibular hypofunction (UVH) with the normal gait. Twelve patients with UVH and twelve age-matched control subjects were enrolled in the study. Thirty-four markers were attached to anatomical positions of each participant, and a three-dimensional (3D) motion analysis system was used to capture marker coordinates as the participants walked on a treadmill. The mean standard deviation of the rotation angles was used to represent gait variability. To explore gait stability, local dynamic stability was calculated from the trunk trajectory. The UVH group had wider step width and greater variability of roll rotation at the hip than the control group (). Also, the UVH group had lower local dynamic stability in the medial-lateral (ML) direction than the control group (). By linear regression analysis, we identified a linear relationship between the short-term Lyapunov exponent and vestibular functional asymmetry. The result implies that UVH-induced asymmetry can increase posture variability and gait instability. This study demonstrates the potential for using kinematic parameters to quantitatively evaluate the severity of vestibular functional asymmetry. Further studies will be needed to explore the clinical effectiveness of such approaches. Peng Liu, Qiuhong Huang, Yongkang Ou, Ling Chen, Rong Song, and Yiqing Zheng Copyright © 2017 Peng Liu et al. All rights reserved. Effects of Robot-Assisted Training for the Unaffected Arm in Patients with Hemiparetic Cerebral Palsy: A Proof-of-Concept Pilot Study Thu, 06 Jul 2017 00:00:00 +0000 On a voluntary basis, 10 adolescents with hemiparesis due to cerebral palsy and 11 neurologically healthy control subjects participated in this proof-of-concept pilot study. The aim was to examine the effects of robot-assisted training for the unaffected arm in patients with hemiparetic cerebral palsy. Baseline comparison between the unaffected arm of the hemiparetic patients with cerebral palsy and the dominant arm of healthy control subjects showed significant differences on the Jebsen-Taylor Hand Function test and action planning ability tests. Within-group comparison after ten 30-minute sessions (five days a week for two consecutive weeks) of robot-assisted training for the unaffected arm showed significant improvements in patients with cerebral palsy on the Jebsen-Taylor Hand Function test (performed at both hands) and action planning ability test (evaluated at the unaffected arm). Our findings are in line with previous evidences of action planning deficits at the unaffected arm in patients with hemiparetic cerebral palsy and support the hypothesis that robot-assisted training for the unaffected arm may be useful to improve manual dexterity and action planning in patients with hemiparesis due to cerebral palsy. Alessandro Picelli, Elisabetta La Marchina, Antonella Vangelista, Elena Chemello, Angela Modenese, Marialuisa Gandolfi, Elisa Francesca Maria Ciceri, Alessandra Bucci, Giada Zoccatelli, Leopold Saltuari, Andreas Waldner, Alessio Baricich, Andrea Santamato, and Nicola Smania Copyright © 2017 Alessandro Picelli et al. All rights reserved. Social Cognition Deficits: Current Position and Future Directions for Neuropsychological Interventions in Cerebrovascular Disease Mon, 03 Jul 2017 06:41:31 +0000 Neuropsychological assessments of cognitive dysfunction in cerebrovascular illness commonly target basic cognitive functions involving aspects of memory, attention, language, praxis, and number processing. Here, I highlight the clinical importance of often-neglected social cognition functions. These functions recruit a widely distributed neural network, making them vulnerable in most cerebrovascular diseases. Sociocognitive deficits underlie most of the problematic social conduct observed in patients and are associated with more negative clinical outcomes (compared to nonsocial cognitive deficits). In clinical settings, social cognition deficits are normally gleaned from collateral information from caregivers or from indirect inferences made from patients’ performance on standard nonsocial cognitive tests. Information from these sources is however inadequate. I discuss key social cognition functions, focusing initially on deficits in emotion perception and theory of mind, two areas that have gained sizeable attention in neuroscientific research, and then extend the discussion into relatively new, less covered but crucial functions involving empathic behaviour, social awareness, social judgements, and social decision making. These functions are frequently impaired following neurological change. At present, a wide range of psychometrically robust social cognition tests is available, and this review also makes the case for their inclusion in neuropsychological assessments. Progress Njomboro Copyright © 2017 Progress Njomboro. All rights reserved. Corrigendum to “Clinical and Preclinical Cognitive Function Improvement after Oral Treatment of a Botanical Composition Composed of Extracts from Scutellaria baicalensis and Acacia catechu” Mon, 03 Jul 2017 04:01:05 +0000 Mesfin Yimam, Bruce P. Burnett, Lidia Brownell, and Qi Jia Copyright © 2017 Mesfin Yimam et al. All rights reserved. Cerebral Reorganization in Subacute Stroke Survivors after Virtual Reality-Based Training: A Preliminary Study Wed, 28 Jun 2017 10:37:57 +0000 Background. Functional magnetic resonance imaging (fMRI) is a promising method for quantifying brain recovery and investigating the intervention-induced changes in corticomotor excitability after stroke. This study aimed to evaluate cortical reorganization subsequent to virtual reality-enhanced treadmill (VRET) training in subacute stroke survivors. Methods. Eight participants with ischemic stroke underwent VRET for 5 sections per week and for 3 weeks. fMRI was conducted to quantify the activity of selected brain regions when the subject performed ankle dorsiflexion. Gait speed and clinical scales were also measured before and after intervention. Results. Increased activation in the primary sensorimotor cortex of the lesioned hemisphere and supplementary motor areas of both sides for the paretic foot () was observed postintervention. Statistically significant improvements were observed in gait velocity (). The change in voxel counts in the primary sensorimotor cortex of the lesioned hemisphere is significantly correlated with improvement of 10 m walk time after VRET (). Conclusions. We observed improved walking and increased activation in cortical regions of stroke survivors after VRET training. Moreover, the cortical recruitment was associated with better walking function. Our study suggests that cortical networks could be a site of plasticity, and their recruitment may be one mechanism of training-induced recovery of gait function in stroke. This trial is registered with ChiCTR-IOC-15006064. Xiang Xiao, Qiang Lin, Wai-Leung Lo, Yu-Rong Mao, Xin-chong Shi, Ryan S. Cates, Shu-Feng Zhou, Dong-Feng Huang, and Le Li Copyright © 2017 Xiang Xiao et al. All rights reserved. Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of First Stroke Attack in Ibadan, Nigeria Tue, 27 Jun 2017 09:31:19 +0000 Background and Purpose. Poststroke depression (PSD) is a common complication after stroke. There is no adequate treatment for PSD. This study examined efficacy of cognitive rehabilitation therapy (CRT) in the treatment of PSD among stroke survivors. Methods. An experimental design, 30 participants with poststroke depression were randomly assigned into 3 groups of cognitive rehabilitation therapy (CRT), psychoeducation (PE), and the control group (CG). CRT consisted of nine sessions with three-phased sessions focusing on activity stimulation, negative thoughts, and people contacts, PE consisted of nine sessions focusing on knowledge on stroke and poststroke depression, and the CG group was on the waiting list. The BDI scale was used for assessing PSD at posttest. Results. There was a significant difference in the efficacy of CRT, PE, and the CG on PSD, with CRT–CG mean difference of −9.4 ± 3.11 and PE–CG 1.0 ± 3.83. Furthermore, stress was not a confounding variable on the efficacy of CRT. The type of therapy significantly influenced PSD at posttest, with the CRT having greater mean reduction to CG (−11.1 ± 3.1) than PE to the CG (3.0 ± 3.8). Conclusions. Cognitive rehabilitation therapy significantly reduced poststroke depression. Hence, it should be integrated as an adjunct treatment of poststroke depression. Olugbemi Olukolade and Helen O. Osinowo Copyright © 2017 Olugbemi Olukolade and Helen O. Osinowo. All rights reserved. An Exploratory Study of Intensive Neurofeedback Training for Schizophrenia Wed, 21 Jun 2017 00:00:00 +0000 Schizophrenia is a chronic and devastating brain disorder with ongoing cognitive, behavioral, and emotional deteriorated functions. Neurofeedback training, which enables the individuals to regulate their brain activity using a real-time feedback loop, is increasingly investigated as a potential alternative intervention for schizophrenia. This study aimed to explore the effect of short but intensive neurofeedback training for schizophrenic patients with difficulty for long-time training. A middle-aged woman with chronic schizophrenia completed the intensive training of alpha/beta2 (20–30 Hz) in four consecutive days with a total training duration of 13.5 hours. The results showed that her alpha/beta2 increased over sessions, and her behavior performance including short-term memory, mood, and speech pattern was improved at the end of neurofeedback training. Importantly, a 22-month follow-up found a dramatic improvement in both positive and negative symptoms. These positive outcomes suggest that such intensive neurofeedback training may provide new insight into the treatment of schizophrenia and thus deserves further study to fully examine its scope. Wenya Nan, Feng Wan, Lanshin Chang, Sio Hang Pun, Mang I. Vai, and Agostinho Rosa Copyright © 2017 Wenya Nan et al. All rights reserved. The Difference of Neural Networks between Bimanual Antiphase and In-Phase Upper Limb Movements: A Preliminary Functional Magnetic Resonance Imaging Study Tue, 20 Jun 2017 07:01:21 +0000 Most daily movements require some degree of collaboration between the upper limbs. The neural mechanisms are bimanual-condition specific and therefore should be different between different activities. In this study, we aimed to explore intraregional activation and interregional connectivity during bimanual movement by functional magnetic resonance imaging (fMRI). Ten right-handed, normal subjects were recruited. The neural correlates of unimanual (right side) and bimanual (in-phase and antiphase) upper limb movements were investigated. Connectivity analyses were carried out using the psychophysiological interaction (PPI) model. The cerebellum was strongly activated in both unimanual and bimanual movements, and the cingulate motor area (CMA) was the most activated brain area in antiphase bimanual movement. Moreover, compared with unimanual movement, CMA activation was also observed in antiphase bimanual movement, but not in in-phase bimanual movement. In addition, we carried out the PPI model to study the differences of effective connectivity and found that the cerebellum was more connected with the CMA during antiphase bimanual movement than in-phase bimanual movement. Our findings elucidate the differences of the cerebellar-cerebral functional connectivity between antiphase and in-phase bimanual movements, which could be used to facilitate the development of a neuroscience perspective on bimanual movement control in patients with motor impairments. Qiang Lin, Hai Li, Yu-Rong Mao, Wai-Leung Lo, Jiang-Li Zhao, Ling Chen, Yan Leng, Dong-Feng Huang, and Le Li Copyright © 2017 Qiang Lin et al. All rights reserved. Robotics in Lower-Limb Rehabilitation after Stroke Thu, 08 Jun 2017 03:40:50 +0000 With the increase in the elderly, stroke has become a common disease, often leading to motor dysfunction and even permanent disability. Lower-limb rehabilitation robots can help patients to carry out reasonable and effective training to improve the motor function of paralyzed extremity. In this paper, the developments of lower-limb rehabilitation robots in the past decades are reviewed. Specifically, we provide a classification, a comparison, and a design overview of the driving modes, training paradigm, and control strategy of the lower-limb rehabilitation robots in the reviewed literature. A brief review on the gait detection technology of lower-limb rehabilitation robots is also presented. Finally, we discuss the future directions of the lower-limb rehabilitation robots. Xue Zhang, Zan Yue, and Jing Wang Copyright © 2017 Xue Zhang et al. All rights reserved. Different Cognitive Profiles of Patients with Severe Aphasia Mon, 29 May 2017 03:46:45 +0000 Cognitive dysfunction frequently occurs in aphasic patients and primarily compromises linguistic skills. However, patients suffering from severe aphasia show heterogeneous performance in basic cognition. Our aim was to characterize the cognitive profiles of patients with severe aphasia and to determine whether they also differ as to residual linguistic abilities. We examined 189 patients with severe aphasia with standard language tests and with the CoBaGA (Cognitive Test Battery for Global Aphasia), a battery of nonverbal tests that assesses a wide range of cognitive domains such as attention, executive functions, intelligence, memory, visual-auditory recognition, and visual-spatial abilities. Twenty patients were also followed longitudinally in order to assess their improvement in cognitive skills after speech therapy. Three different subgroups of patients with different types and severity of cognitive impairment were evidenced. Subgroups differed as to residual linguistic skills, in particular comprehension and reading-writing abilities. Attention, reasoning, and executive functions improved after language rehabilitation. This study highlights the importance of an extensive evaluation of cognitive functions in patients with severe aphasia. Chiara Valeria Marinelli, Simona Spaccavento, Angela Craca, Paola Marangolo, and Paola Angelelli Copyright © 2017 Chiara Valeria Marinelli et al. All rights reserved. The Relationship between Psychosocial Factors and Cognition in Multiple Sclerosis Thu, 18 May 2017 07:04:42 +0000 Introduction. Multiple sclerosis (MS) is a common disorder in some regions of the world, with over 2.3 million people diagnosed worldwide. Cognitive impairment is one of the earliest symptoms to present in the course of the disease and can cause significant morbidity. We proposed a study to explore the psychosocial predictors of cognitive impairment in MS patients in Saudi Arabia, a previously unexplored patient population. Methods. Demographic data, depression scale (PHQ9), symptom burden (PHQ15), anxiety (GAD7), disease duration, and Montreal Cognitive Assessment (MOCA) scores were collected from 195 patients in a neurology clinic in Ryiadh, Saudi Arabia. Univariate and multiple regression analyses were conducted to identify variables that are significantly associated with cognitive impairment. Results. Variables that were identified to be significantly associated with cognition, , were education level, disease duration, and family history. Discussion. Both education level and disease duration were variables identified in previous studies. We showed family history to be a significant variable, and no association was found with depression or anxiety, which is unique to our study population. Conclusions. We identified several psychosocial predictors that are associated with cognition in our patient population. It was also noted that a difference exists between patient populations, highlighting the need for further studies in specific geographical regions. Fahad D. Alosaimi, Alaa AlMulhem, Mario Moscovici, Hanan AlShalan, Mohammad Alqazlan, Abdulgader Aldaif, and Sanjeev Sockalingam Copyright © 2017 Fahad D. Alosaimi et al. All rights reserved. Assessing Cognitive Ability and Simulator-Based Driving Performance in Poststroke Adults Sun, 07 May 2017 00:00:00 +0000 Driving is an important activity of daily living, which is increasingly relied upon as the population ages. It has been well-established that cognitive processes decline following a stroke and these processes may influence driving performance. There is much debate on the use of off-road neurological assessments and driving simulators as tools to predict driving performance; however, the majority of research uses unlicensed poststroke drivers, making the comparability of poststroke adults to that of a control group difficult. It stands to reason that in order to determine whether simulators and cognitive assessments can accurately assess driving performance, the baseline should be set by licenced drivers. Therefore, the aim of this study was to assess differences in cognitive ability and driving simulator performance in licensed community-dwelling poststroke drivers and controls. Two groups of licensed drivers (37 poststroke and 43 controls) were assessed using several cognitive tasks and using a driving simulator. The poststroke adults exhibited poorer cognitive ability; however, there were no differences in simulator performance between groups except that the poststroke drivers demonstrated less variability in driver headway. The application of these results as a prescreening toolbox for poststroke drivers is discussed. Alison Blane, Hoe C. Lee, Torbjörn Falkmer, and Tania Dukic Willstrand Copyright © 2017 Alison Blane et al. All rights reserved. The Effect of Dopaminergic Medication on Joint Kinematics during Haptic Movements in Individuals with Parkinson’s Disease Wed, 19 Apr 2017 00:00:00 +0000 This study examined whether altered joint angular motion during haptic exploration could account for a decline in haptic sensitivity in individuals with PD by analyzing joint position data during haptic exploration of a curved contour. Each participant’s hand was passively moved by a robotic arm along the edges of a virtual box (5 cm × 15 cm) with a curved left wall. After each trial, participants indicated whether the contour was curved or straight. Visual, auditory, and tactile cues were occluded, and an electrogoniometer recorded shoulder and elbow joint angles during each trial. The PD group in the OFF state had a higher mean detection threshold (4.67 m−1) than the control group (3.06 m−1). Individuals with PD in the OFF state also had a significantly greater magnitude of shoulder abduction than those in the ON state () and a smaller magnitude of elbow flexion than those in the ON state or compared to the control group (both ). These findings suggest that individuals with PD employ joint configurations that may contribute to haptic insensitivity. Dopamine replacement therapy improved joint configurations during haptic exploration in patients with PD, suggesting a role for dopaminergic dysfunction in PD-related haptic insensitivity. Kuan-yi Li, Pei-yi Chu, and Kristen A. Pickett Copyright © 2017 Kuan-yi Li et al. All rights reserved. Prior Knowledge of Target Direction and Intended Movement Selection Improves Indirect Reaching Movement Decoding Thu, 13 Apr 2017 00:00:00 +0000 Objective. Previous studies have demonstrated that target direction information presented by the dorsal premotor cortex (PMd) during movement planning could be incorporated into neural decoder for achieving better decoding performance. It is still unknown whether the neural decoder combined with only target direction could work in more complex tasks where obstacles impeded direct reaching paths. Methods. In this study, spike activities were collected from the PMd of two monkeys when performing a delayed obstacle-avoidance task. We examined how target direction and intended movement selection were encoded in neuron population activities of the PMd during movement planning. The decoding performances of movement trajectory were compared for three neural decoders with no prior knowledge, or only target direction, or both target direction and intended movement selection integrated into a mixture of trajectory model (MTM). Results. We found that not only target direction but also intended movement selection was presented in neural activities of the PMd during movement planning. It was further confirmed by quantitative analysis. Combined with prior knowledge, the trajectory decoder achieved the best performance among three decoders. Conclusion. Recruiting prior knowledge about target direction and intended movement selection extracted from the PMd could enhance the decoding performance of hand trajectory in indirect reaching movement. Hongbao Li, Yaoyao Hao, Shaomin Zhang, Yiwen Wang, Weidong Chen, and Xiaoxiang Zheng Copyright © 2017 Hongbao Li et al. All rights reserved. Apathy and Reduced Speed of Processing Underlie Decline in Verbal Fluency following DBS Mon, 20 Mar 2017 00:00:00 +0000 Objective. Reduced verbal fluency is a strikingly uniform finding following deep brain stimulation (DBS) for Parkinson’s disease (PD). The precise cognitive mechanism underlying this reduction remains unclear, but theories have suggested reduced motivation, linguistic skill, and/or executive function. It is of note, however, that previous reports have failed to consider the potential role of any changes in speed of processing. Thus, the aim of this study was to examine verbal fluency changes with a particular focus on the role of cognitive speed. Method. In this study, 28 patients with PD completed measures of verbal fluency, motivation, language, executive functioning, and speed of processing, before and after DBS. Results. As expected, there was a marked decline in verbal fluency but also in a timed test of executive functions and two measures of speed of processing. Verbal fluency decline was associated with markers of linguistic and executive functioning, but not after speed of processing was statistically controlled for. In contrast, greater decline in verbal fluency was associated with higher levels of apathy at baseline, which was not associated with changes in cognitive speed. Discussion. Reduced generativity and processing speed may account for the marked reduction in verbal fluency commonly observed following DBS. Jennifer A. Foley, Tom Foltynie, Ludvic Zrinzo, Jonathan A. Hyam, Patricia Limousin, and Lisa Cipolotti Copyright © 2017 Jennifer A. Foley et al. All rights reserved. Neuroprotective and Antiamnesic Effects of Mitragyna inermis Willd (Rubiaceae) on Scopolamine-Induced Memory Impairment in Mice Sun, 12 Mar 2017 08:44:40 +0000 Aim. To assess memory improvement and neuroprotective and antioxidant effects of Mitragyna inermis (M. inermis) leaf decoction on the central nervous system. Methodology. Leaf decoction of M. inermis was tested on learning and memory in normal and scopolamine-induced cognitive impairment in mice using memory behavioral tests such as the Morris water maze, object recognition task, and elevated plus maze. Oxidative stress enzymes—catalase, superoxide dismutase, and the thiobarbituric acid reactive substance, a product of lipid peroxidation—were quantified. In each test, mice 18 to 25 g were divided into groups of 5. Results. The extract reversed the effects of scopolamine in mice. The extract significantly increased discrimination index in the object recognition task test and inflexion ratio in the elevated plus maze test. The times spent in target quadrant in MWM increased while the transfer latency decreased in mice treated by M. inermis at the dose of 196.5 mg/kg. The activity levels of superoxide dismutase and catalase were significantly increased, whereas the thiobarbituric acid reactive substance was significantly decreased after 8 consecutive days of treatment with M. inermis at the dose of 393 mg/kg. Conclusion. These results suggest that M. inermis leaf extract possess potential antiamnesic effects. David Bougolla Pahaye, Elisabeth Ngo Bum, Germain Sotoing Taïwé, Gwladys Temkou Ngoupaye, Neteydji Sidiki, Fleur Clarisse Okomolo Moto, Nadège Kouemou, Stephanie Jacqueline Kameni Njapdounke, Gisele Nkantchoua, Antoine Kandeda, Jean Pierre Omam Omam, Veronique Mairaira, and Josiane Lucie Ojong Copyright © 2017 David Bougolla Pahaye et al. All rights reserved. Vascular Cognitive Impairment through the Looking Glass of Transcranial Magnetic Stimulation Sun, 26 Feb 2017 06:57:41 +0000 In the last years, there has been a significant growth in the literature exploiting transcranial magnetic stimulation (TMS) with the aim at gaining further insights into the electrophysiological and neurochemical basis underlying vascular cognitive impairment (VCI). Overall, TMS points at enhanced brain cortical excitability and synaptic plasticity in VCI, especially in patients with overt dementia, and neurophysiological changes seem to correlate with disease process and progress. These findings have been interpreted as part of a glutamate-mediated compensatory effect in response to vascular lesions. Although a single TMS parameter owns low specificity, a panel of measures can support the VCI diagnosis, predict progression, and possibly identify early markers of “brain at risk” for future dementia, thus making VCI a potentially preventable cause of both vascular and degenerative dementia in late life. Moreover, TMS can be also exploited to select and evaluate the responders to specific drugs, as well as to become an innovative rehabilitative tool in the attempt to restore impaired neural plasticity. The present review provides a perspective of the different TMS techniques by further understanding the cortical electrophysiology and the role of distinctive neurotransmission pathways and networks involved in the pathogenesis and pathophysiology of VCI and its subtypes. Giuseppe Lanza, Placido Bramanti, Mariagiovanna Cantone, Manuela Pennisi, Giovanni Pennisi, and Rita Bella Copyright © 2017 Giuseppe Lanza et al. All rights reserved. Peptide Selank Enhances the Effect of Diazepam in Reducing Anxiety in Unpredictable Chronic Mild Stress Conditions in Rats Thu, 09 Feb 2017 07:28:01 +0000 It was shown that the anxiolytic effect of Selank is comparable to that of classical benzodiazepine drugs and that the basis of their mechanism of action may be similar. These data suggest that the presence of Selank may change the action of classical benzodiazepine drugs. To test this hypothesis, we evaluated the anxiolytic activity of Selank and diazepam in rats both under conditions of unpredictable chronic mild stress and in its absence, after the individual and combined administration of these compounds using the elevated plus maze test. We found that, even in the absence of chronic stress, the administration of a course of test substances changed anxiety indicators toward their deterioration, but the changes after the administration of a course of Selank were less pronounced. In conditions of chronic stress, anxiety indicator values after the simultaneous use of diazepam and Selank did not differ from the respective values observed before chronic stress exposure. The data obtained indicate that the individual administration of Selank was the most effective in reducing elevated levels of anxiety, induced by the administration of a course of test substances, whereas the combination of diazepam with Selank was the most effective in reducing anxiety in unpredictable chronic mild stress conditions. Anastasiya Kasian, Timur Kolomin, Lyudmila Andreeva, Elena Bondarenko, Nikolay Myasoedov, Petr Slominsky, and Maria Shadrina Copyright © 2017 Anastasiya Kasian et al. All rights reserved. Optimizing Neuropsychological Assessments for Cognitive, Behavioral, and Functional Impairment Classification: A Machine Learning Study Tue, 31 Jan 2017 14:13:29 +0000 Subjects with Alzheimer’s disease (AD) show loss of cognitive functions and change in behavioral and functional state affecting the quality of their daily life and that of their families and caregivers. A neuropsychological assessment plays a crucial role in detecting such changes from normal conditions. However, despite the existence of clinical measures that are used to classify and diagnose AD, a large amount of subjectivity continues to exist. Our aim was to assess the potential of machine learning in quantifying this process and optimizing or even reducing the amount of neuropsychological tests used to classify AD patients, also at an early stage of impairment. We investigated the role of twelve state-of-the-art neuropsychological tests in the automatic classification of subjects with none, mild, or severe impairment as measured by the clinical dementia rating (CDR). Data were obtained from the ADNI database. In the groups of measures used as features, we included measures of both cognitive domains and subdomains. Our findings show that some tests are more frequently best predictors for the automatic classification, namely, LM, ADAS-Cog, AVLT, and FAQ, with a major role of the ADAS-Cog measures of delayed and immediate memory and the FAQ measure of financial competency. Petronilla Battista, Christian Salvatore, and Isabella Castiglioni Copyright © 2017 Petronilla Battista et al. All rights reserved. Mice with Catalytically Inactive Cathepsin A Display Neurobehavioral Alterations Wed, 04 Jan 2017 09:01:17 +0000 The lysosomal carboxypeptidase A, Cathepsin A (CathA), is a serine protease with two distinct functions. CathA protects β-galactosidase and sialidase Neu1 against proteolytic degradation by forming a multienzyme complex and activates sialidase Neu1. CathA deficiency causes the lysosomal storage disease, galactosialidosis. These patients present with a broad range of clinical phenotypes, including growth retardation, and neurological deterioration along with the accumulation of the vasoactive peptide, endothelin-1, in the brain. Previous in vitro studies have shown that CathA has specific activity against vasoactive peptides and neuropeptides, including endothelin-1 and oxytocin. A mutant mouse with catalytically inactive CathA enzyme () shows increased levels of endothelin-1. In the present study, we elucidated the involvement of CathA in learning and long-term memory in 3-, 6-, and 12-month-old mice. Hippocampal endothelin-1 and oxytocin accumulated in mice, which showed learning impairments as well as long-term and spatial memory deficits compared with wild-type littermates, suggesting that CathA plays a significant role in learning and in memory consolidation through its regulatory role in vasoactive peptide processing. O. Y. Calhan and V. Seyrantepe Copyright © 2017 O. Y. Calhan and V. Seyrantepe. All rights reserved. Vestibular Migraine: Clinical Challenges and Opportunities for Multidisciplinarity Mon, 19 Dec 2016 14:22:59 +0000 Migraine and vertigo are two very prevalent conditions in general population. The coexistence of both in the same subject is a significant clinical challenge, since it is not always possible to understand whether they are causally related or associated by chance, requiring different diagnostic and therapeutic approaches. In this review we analyze and summarize the actual knowledge about vestibular migraine (VM), focusing on the new concepts proposed by the International Classification of Headache Disorders 3-beta and by the Bárány Society and also addressing the former concepts, which are still present in clinical practice. We conclude that clinical studies using a multidisciplinary approach are crucial in this field, since different specialists observe the same pathology with different eyes. Clinical presentation of VM is variable in what concerns vestibular symptoms temporal relation with migraine headache, as well as in their accompanying manifestations. Biomarkers, either genomics or functional, and molecular imaging techniques will be helpful to clarify many aspects of the complexity of this entity, helping to define to what extent can VM be considered a separate and independent clinical entity. Isabel Luzeiro, Leonel Luís, Freire Gonçalves, and Isabel Pavão Martins Copyright © 2016 Isabel Luzeiro et al. All rights reserved. Pediatric Traumatic Brain Injury and Autism: Elucidating Shared Mechanisms Thu, 15 Dec 2016 12:42:11 +0000 Pediatric traumatic brain injury (TBI) and autism spectrum disorder (ASD) are two serious conditions that affect youth. Recent data, both preclinical and clinical, show that pediatric TBI and ASD share not only similar symptoms but also some of the same biologic mechanisms that cause these symptoms. Prominent symptoms for both disorders include gastrointestinal problems, learning difficulties, seizures, and sensory processing disruption. In this review, we highlight some of these shared mechanisms in order to discuss potential treatment options that might be applied for each condition. We discuss potential therapeutic and pharmacologic options as well as potential novel drug targets. Furthermore, we highlight advances in understanding of brain circuitry that is being propelled by improved imaging modalities. Going forward, advanced imaging will help in diagnosis and treatment planning strategies for pediatric patients. Lessons from each field can be applied to design better and more rigorous trials that can be used to improve guidelines for pediatric patients suffering from TBI or ASD. Rahul Singh, Ryan C. Turner, Linda Nguyen, Kartik Motwani, Michelle Swatek, and Brandon P. Lucke-Wold Copyright © 2016 Rahul Singh et al. All rights reserved.