Physiological Correlates of Working Memory Behavior for Cognitive Efficiency: implications for concussion management

Cognitive efficiency—characterized via robust behavioral and physiological response dynamics, may provide clinically meaningful information with respect to dynamic concussion injury response and return to play considerations. Moreover, a feasible and ecologically valid method to assess dynamic behavioral and physiological metrics is also needed to best characterize cognitive efficiency in athletes and soldiers at a greater risk for concussion. This project was designed to examine the clinical utility and feasibility of a cognitive efficiency assessment designed to be completed within a virtual reality environment, which may hold significant implications for improved concussion clinical management. As such, we aimed to first further understand the relationships between heart rate variability and pupillary response as physiological correlates of digit-span task behavior in the context of cognitive efficiency, then to examine the effects of prior concussion on these responses. Additionally, we applied innovative, reliably sound, and validated psychophysiological methods using a feasible instrumentation option (virtual reality headset with pupillometry and heart rate monitor watch and strap). We feel these methodological considerations allowed us to best address our study aims and inform future directions of this line of inquiry to have direct ecologically valid applications. Collegiate club sports athletes, (N=59; 40% with a concussion history; age = 20.48 ± 1.86 years; 58% male), completed a backwards digit-span task (20 trials) in a virtual reality environment while recording pupil size. Linear mixed effects models showed a significant effect of cognitive load (digit sequence-length) on pupillary response (F4,232=3.67, p=0.006). Negligible effects were seen in task performance, heart rate variability or concussion history p<0.05 Pupillary response shows potential in informing cognitive load and efficiency in applied settings, using VR and eye tracking technology. Future investigations should consider participants’ concussion history variability.Doctor of Philosoph

Determinants of paediatric asthma: a three-level approach

Tese de doutoramento em Ciências Biomédicas, apresentada ao Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto, 2021Orientador Professor André Moreira (Faculdade de Medicina da Universidade do Porto); Coorientadores: Professor Eduardo de Oliveira Fernandes (Faculdade de Engenharia da Universidade do Porto); Doutora Joana Madureira (Instituto de Saúde Pública da Universidade do Porto); Professora Idalina Beirão (Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto)During the 20th century, urbanization has increasing and represented a major demographic and environmental change in developed countries. Urban living may offer a greater possibility to better health care, education and social services, but is also associated with increased exposure to air pollution, outdoors and indoors, loss of natural environments and biodiversity and lifestyle changes. Furthermore, this ever-changing urban environment has an impact on diseases patterns and prevalence, namely on noncommunicable diseases, such as asthma and allergy, and poses many challenges to understand the relationship between the changing on the urban environment and the children health. The overall aim of this thesis was to study the role of the environmental determinants of paediatric asthma.Ao longo do último século observou-se uma tendência crescente e rápida na urbanização, representando uma grande mudança demográfica e ambiental, principalmente nos países desenvolvidos. Apesar das cidades poderem oferecer oportunidades de acesso aos serviços de saúde, educação e sociais, estão também associadas a um aumento da exposição à poluição do ar, no exterior e no interior, diminuição de ambientes naturais e da biodiversidade e alterações nos estilos de vida. A alteração crescente do meio ambiente está igualmente associada ao aumento da prevalência de algumas doenças, nomeadamente, de doenças crónicas como a asma e as alergias e, representando por isso diversos desafios na compreensão da relação entre as mudanças no ambiente na saúde das crianças. O objetivo da presente tese é investigar o papel dos determinantes ambientais da asma e da alergia pediátrica.This work was supported by Fundação para a Ciência e Tecnologia through the scholarship SFRH/BD/112269/2015 and by the Project NORTE-01-0145-FEDER-000010 – Health, Comfort and Energy in the Built Environment (HEBE), cofinanced by Programa Operacional Regional do Norte (NORTE2020), through Fundo Europeu de Desenvolvimento Regional (FEDER), EXALAR 21 project financed by FEDER/FNR and by Fundação para a Ciência e Tecnologia (EXALAR 21 02/SAICT/2017 - Project nº 30193) and by EAACI Research Fellowship 2018, “How indoor environment can shape human microbiome: culture-independent approaches”info:eu-repo/semantics/publishedVersio

Executive dysfunction following a sport-related concussion is independent of task-based symptom burden

The present work examined whether oculomotor deficits associated with a sport-related concussion (SRC) reflect an impairment to executive-based planning mechanisms or a task-based increase in concussion symptomology (e.g., headache, vertigo). Therefore, I employed a standardized measure of SRC symptom severity (SCAT-5), antisaccade performance and pupillometry metrics in persons with a SRC during early (i.e., initial assessment: ≤12 days post-SRC) and later (i.e., follow-up assessment: 14-30 days post-SRC) stages of recovery. In the initial assessment, the SRC group yielded longer reaction times (RT) (p=0.001), increased directional errors (p=0.002) and larger task-evoked pupil dilations (TEPD) (p=0.004) than the control group. The follow-up assessment indicated that RTs did not reliably vary between groups (p=0.155); however, the SRC group demonstrated more directional errors and larger TEPDs (p\u3c0.03). Moreover, SCAT-5 symptom severity indicated that the oculomotor assessment did not increase symptom burden (p=0.622). Accordingly, I propose that a SRC impairs executive-based oculomotor planning mechanisms

Will the Conscious–Subconscious Pacing Quagmire Help Elucidate the Mechanisms of Self-Paced Exercise? New Opportunities in Dual Process Theory and Process Tracing Methods

The extent to which athletic pacing decisions are made consciously or subconsciously is a prevailing issue. In this article we discuss why the one-dimensional conscious–subconscious debate that has reigned in the pacing literature has suppressed our understanding of the multidimensional processes that occur in pacing decisions. How do we make our decisions in real-life competitive situations? What information do we use and how do we respond to opponents? These are questions that need to be explored and better understood, using smartly designed experiments. The paper provides clarity about key conscious, preconscious, subconscious and unconscious concepts, terms that have previously been used in conflicting and confusing ways. The potential of dual process theory in articulating multidimensional aspects of intuitive and deliberative decision-making processes is discussed in the context of athletic pacing along with associated process-tracing research methods. In attempting to refine pacing models and improve training strategies and psychological skills for athletes, the dual-process framework could be used to gain a clearer understanding of (1) the situational conditions for which either intuitive or deliberative decisions are optimal; (2) how intuitive and deliberative decisions are biased by things such as perception, emotion and experience; and (3) the underlying cognitive mechanisms such as memory, attention allocation, problem solving and hypothetical thought

Applications of infrared thermography in sports. A review

La termografía infrarroja (TI) registra el calor irradiado de un cuerpo, que es emitido en un rango del espectro electromagnético que la visión humana no es capaz de identificar. La respuesta térmica depende de una serie de ajustes fisiológicos específicos como la homeostasis corporal y salud del deportista, lo cual permite establecer interesantes aplicaciones en el deporte. El objetivo de este trabajo ha sido revisar la literatura en torno a las aplicaciones de la TI en el ámbito del deporte, y proponer las características óptimas del registro en relación al evaluado, las condiciones ambientales y la cámara utilizada. Concluimos que la principal contribución de la TI en el ámbito del deporte es ayudar a identificar signos de lesión antes de que la lesión se produzca, permitiéndonos actuar de manera preventiva durante el proceso de entrenamientoInfrared thermography (IRT) records the radiant heat of a body, which is emitted in the range of the electromagnetic spectrum that human vision is not able to identify. The thermal response depends on a number of specific physiological adjustments as body homeostasis and athlete’s health, which allow us to establishing interesting applications in sport. The aim of this study was to review the literature on IRT applications in sports, and to propose the optimal characteristics of the register in terms of the subject, the environmental conditions and the camera used. We conclude that the main contribution of IRT in the field of sport is to help identify signs of injury before it occurs, allowing us to act proactively along the training proces

The impact of Alzheimer’s disease risk factors on the pupillary light response

Alzheimer’s disease (AD) is the leading cause of dementia, and its prevalence is increasing and is expected to continue to increase over the next few decades. Because of this, there is an urgent requirement to determine a way to diagnose the disease, and to target interventions to delay and ideally stop the onset of symptoms, specifically those impacting cognition and daily livelihood. The pupillary light response (PLR) is controlled by the sympathetic and parasympathetic branches of the autonomic nervous system, and impairments to the pupillary light response (PLR) have been related to AD. However, most of these studies that assess the PLR occur in patients who have already been diagnosed with AD, rather than those who are at a higher risk for the disease but without a diagnosis. Determining whether the PLR is similarly impaired in subjects before an AD diagnosis is made and before cognitive symptoms of the disease begin, is an important step before using the PLR as a diagnostic tool. Specifically, identifying whether the PLR is impaired in specific at-risk groups, considering both genetic and non-genetic risk factors, is imperative. It is possible that the PLR may be impaired in association with some risk factors but not others, potentially indicating different pathways to neurodegeneration that could be distinguished using PLR. In this work, we review the most common genetic and lifestyle-based risk factors for AD and identify established relationships between these risk factors and the PLR. The evidence here shows that many AD risk factors, including traumatic brain injury, ocular and intracranial hypertension, alcohol consumption, depression, and diabetes, are directly related to changes in the PLR. Other risk factors currently lack sufficient literature to make any conclusions relating directly to the PLR but have shown links to impairments in the parasympathetic nervous system; further research should be conducted in these risk factors and their relation to the PLR

Visual problems associated with traumatic brain injury:Vision with traumatic brain injury

Traumatic brain injury (TBI) and its associated concussion are major causes of disability and death. All ages can be affected but children, young adults and the elderly are particularly susceptible. A decline in mortality has resulted in many more individuals living with a disability caused by TBI including those affecting vision. This review describes: (1) the major clinical and pathological features of TBI; (2) the visual signs and symptoms associated with the disorder; and (3) discusses the assessment of quality of life and visual rehabilitation of the patient. Defects in primary vision such as visual acuity and visual fields, eye movement including vergence, saccadic and smooth pursuit movements, and in more complex aspects of vision involving visual perception, motion vision (‘akinopsia’), and visuo-spatial function have all been reported in TBI. Eye movement dysfunction may be an early sign of TBI. Hence, TBI can result in a variety of visual problems, many patients exhibiting multiple visual defects in combination with a decline in overall health. Patients with chronic dysfunction following TBI may require occupational, vestibular, cognitive and other forms of physical therapy. Such patients may also benefit from visual rehabilitation, including reading-related oculomotor training and the prescribing of spectacles with a variety of tints and prism combinations

Fusion, 2018

https://hsrc.himmelfarb.gwu.edu/smhs_fusion/1010/thumbnail.jp

Determinants of paediatric asthma: a three-level approach

Tese de doutoramento em Ciências Biomédicas, apresentada ao Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto, 2021Orientador Professor André Moreira (Faculdade de Medicina da Universidade do Porto); Coorientadores: Professor Eduardo de Oliveira Fernandes (Faculdade de Engenharia da Universidade do Porto); Doutora Joana Madureira (Instituto de Saúde Pública da Universidade do Porto); Professora Idalina Beirão (Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto)During the 20th century, urbanization has increasing and represented a major demographic and environmental change in developed countries. Urban living may offer a greater possibility to better health care, education and social services, but is also associated with increased exposure to air pollution, outdoors and indoors, loss of natural environments and biodiversity and lifestyle changes. Furthermore, this ever-changing urban environment has an impact on diseases patterns and prevalence, namely on noncommunicable diseases, such as asthma and allergy, and poses many challenges to understand the relationship between the changing on the urban environment and the children health. The overall aim of this thesis was to study the role of the environmental determinants of paediatric asthma.Ao longo do último século observou-se uma tendência crescente e rápida na urbanização, representando uma grande mudança demográfica e ambiental, principalmente nos países desenvolvidos. Apesar das cidades poderem oferecer oportunidades de acesso aos serviços de saúde, educação e sociais, estão também associadas a um aumento da exposição à poluição do ar, no exterior e no interior, diminuição de ambientes naturais e da biodiversidade e alterações nos estilos de vida. A alteração crescente do meio ambiente está igualmente associada ao aumento da prevalência de algumas doenças, nomeadamente, de doenças crónicas como a asma e as alergias e, representando por isso diversos desafios na compreensão da relação entre as mudanças no ambiente na saúde das crianças. O objetivo da presente tese é investigar o papel dos determinantes ambientais da asma e da alergia pediátrica.This work was supported by Fundação para a Ciência e Tecnologia through the scholarship SFRH/BD/112269/2015 and by the Project NORTE-01-0145-FEDER-000010 – Health, Comfort and Energy in the Built Environment (HEBE), cofinanced by Programa Operacional Regional do Norte (NORTE2020), through Fundo Europeu de Desenvolvimento Regional (FEDER), EXALAR 21 project financed by FEDER/FNR and by Fundação para a Ciência e Tecnologia (EXALAR 21 02/SAICT/2017 - Project nº 30193) and by EAACI Research Fellowship 2018, “How indoor environment can shape human microbiome: culture-independent approaches”info:eu-repo/semantics/publishedVersio