One Week of Motor Adaptation Induces Structural Changes in Primary Motor Cortex That Predict Long-Term Memory One Year Later

The neural bases of motor adaptation have been extensively explored in human and non-human primates. A network including the cerebellum, primary motor and the posterior parietal cortex appears to be crucial for this type of learning. Yet, to date, it is unclear whether these regions contribute directly or indirectly to the formation of motor memories. Here we trained subjects on a complex visuomotor rotation associated with long-term memory (in the order of months) to identify potential sites of structural plasticity induced by adaptation. One week of training led to i) an increment in local gray-matter concentration over the hand area of the contralateral primary motor cortex and ii) an increase in fractional anisotropy in an area underneath this region that correlated with the speed of learning. Moreover, the change in gray matter concentration measured immediately after training predicted improvements in the speed of learning during re-adaptation one year later. Our study suggests that motor adaptation induces structural plasticity in primary motor circuits. In addition, it provides the first piece of evidence indicating that early structural changes induced by motor learning may impact on behavior up to one year after training.Fil: Landi, Sofía Mariana. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Ciencias Fisiológicas. Cátedra de Fisiologia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; ArgentinaFil: Baguear, Miguel Federico. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Ciencias Fisiológicas. Cátedra de Fisiologia; ArgentinaFil: Della Maggiore, Valeria Monica. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Ciencias Fisiológicas. Cátedra de Fisiologia; Argentin

Visuomotor Adaptation Modulates the Clustering of Sleep Spindles Into Trains

Sleep spindles are thought to promote memory consolidation. Recently, we have shown that visuomotor adaptation (VMA) learning increases the density of spindles and promotes the coupling between spindles and slow oscillations, locally, with the level of spindle-SO synchrony predicting overnight memory retention. Yet, growing evidence suggests that the rhythmicity in spindle occurrence may also influence the stabilization of declarative and procedural memories. Here, we examined if VMA learning promotes the temporal organization of sleep spindles into trains. We found that VMA increased the proportion of spindles and spindle-SO couplings in trains. In agreement with our previous work, this modulation was observed over the contralateral hemisphere to the trained hand, and predicted overnight memory retention. Interestingly, spindles grouped in a cluster showed greater amplitude and duration than isolated spindles. The fact that these features increased as a function of train length, provides evidence supporting a biological advantage of this temporal arrangement. Our work opens the possibility that the periodicity of NREM oscillations may be relevant in the stabilization of procedural memories.Fil: Solano, Agustín Benjamín Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaFil: Riquelme, Luis Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaFil: Pérez Chada, Daniel. Universidad Austral; ArgentinaFil: Della Maggiore, Valeria Monica. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; Argentin

Motor Learning Promotes the Coupling between Fast Spindles and Slow Oscillations Locally over the Contralateral Motor Network

Recent studies from us and others suggest that traditionally declarative structures mediate some aspects of the encoding and consolidation of procedural memories. This evidence points to the existence of converging physiological pathways across memory systems. Here, we examined whether the coupling between slow oscillations (SO) and spindles, a mechanism well established in the consolidation of declarative memories, is relevant for the stabilization of human motor memories. To this aim, we conducted an electroencephalography study in which we quantified various parameters of these oscillations during a night of sleep that took place immediately after learning a visuomotor adaptation (VMA) task. We found that VMA increased the overall density of fast (≥12 Hz), but not slow (<12 Hz), spindles during nonrapid eye movement sleep, stage 3 (NREM3). This modulation occurred rather locally over the hemisphere contralateral to the trained hand. Although adaptation learning did not affect the density of SOs, it substantially enhanced the number of fast spindles locked to the active phase of SOs. The fact that only coupled spindles predicted overnight memory retention points to the relevance of this association in motor memory consolidation. Our work provides evidence in favor of a common mechanism at the basis of the stabilization of declarative and motor memories.Fil: Solano, Agustín Benjamín Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaFil: Riquelme, Luis Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaFil: Pérez Chada, Daniel. Universidad Austral. Hospital Universitario Austral. Departamento de Medicina Interna. Servicio de Neumonologia.; ArgentinaFil: Della Maggiore, Valeria Monica. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; Argentin

Direct mapping rather than motor prediction subserves modulation of corticospinal excitability during observation of actions in real time

Motor facilitation refersto the specific increment in corticospinal excitability (CSE)elicited by the observation of actions performed by others. To date,the precise nature of the mechanism at the basis of this phenomenonis unknown. One possibility is that motor facilitation is driven by apredictive process reminiscent of the role of forward models in motorcontrol. Alternatively, motor facilitation may result from a model-freemechanism by which the basic elements of the observed action aredirectly mapped onto their cortical representations. Our study wasdesigned to discern these alternatives. To this aim, we recorded thetime course of CSE for the first dorsal interosseous (FDI) and theabductor digiti minimi (ADM) during observation of three graspingactions in real time, two of which strongly diverged in kinematicsfrom their natural (invariant) form. Although artificially slow movementsused in most action observation studies might enhance theobserver?s discrimination performance, the use of videos in real timeis crucial to maintain the time course of CSE within the physiologicalrange of daily actions. CSE was measured at 4 time points within a240-ms window that best captured the kinematic divergence from theinvariant form. Our results show that CSE of the FDI, not the ADM,closely follows the functional role of the muscle despite the mismatchbetween the natural and the divergent kinematics. We propose thatmotor facilitation during observation of actions performed in real timereflects the model-free coding of perceived movement following adirect mapping mechanism.Fil: Gueugneau, Nicolas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaFil: Mc Cabe, Sofia Ines. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaFil: Villalta, Jorge Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaFil: Grafton, Scott T.. University of California. Department of Psychology; Estados UnidosFil: Della Maggiore, Valeria Monica. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay; Argentin

The relative influence of goal and kinematics on corticospinal excitability depends on the information provided to the observer

Viewing a person perform an action activates the observer's motor system. Whether this phenomenon reflects the action's kinematics or its final goal remains a matter of debate. One alternative to this apparent controversy is that the relative influence of goal and kinematics depends on the information available to the observer. Here, we addressed this possibility. For this purpose, we measured corticospinal excitability (CSE) while subjects viewed 3 different grasping actions with 2 goals: a large and a small object. Actions were directed to the large object, the small object, or corrected online in which case the goal switched during the movement. We first determined the kinematics and dynamics of the 3 actions during execution. This information was used in 2 other experiments to measure CSE while observers viewed videos of the same actions. CSE was recorded prior to movement onset and at 3 time points during the observed action. To discern between goal and kinematics, information about the goal was manipulated across experiments. We found that the goal influenced CSE only when its identity was known before movement onset. In contrast, a kinematic modulation of CSE was observed whether or not information regarding the goal was provided.Fil: Mc Cabe, Sofia Ines. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Ciencias Fisiológicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Villalta, Jorge Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaFil: Saunier, Ghislain. Universidade Federal do Estado do Rio de Janeiro; BrasilFil: Grafton, Scott T.. University of California; Estados UnidosFil: Della Maggiore, Valeria Monica. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; Argentin

The origins of anterograde interference in visuomotor adaptation

Anterograde interference refers to the negative impact of prior learning on the propensity for future learning. There is currently no consensus on whether this phenomenon is transient or long lasting, with studies pointing to an effect in the time scale of hours to days. These inconsistencies might be caused by the method employed to quantify performance, which often confounds changes in learning rate and retention. Here, we aimed to unveil the time course of anterograde interference by tracking its impact on visuomotor adaptation at different intervals throughout a 24-h period. Our empirical and model-based approaches allowed us to measure the capacity for new learning separately from the influence of a previous memory. In agreement with previous reports, we found that prior learning persistently impaired the initial level of performance upon revisiting the task. However, despite this strong initial bias, learning capacity was impaired only when conflicting information was learned up to 1 h apart, recovering thereafter with passage of time. These findings suggest that when adapting to conflicting perturbations, impairments in performance are driven by two distinct mechanisms: a long-lasting bias that acts as a prior and hinders initial performance and a short-lasting anterograde interference that originates from a reduction in error sensitivity.Fil: Lerner, Gonzalo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaFil: Albert, Scott. Johns Hopkins School of Medicine; Estados UnidosFil: Caffaro, Pedro Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaFil: Villalta, Jorge Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaFil: Jacobacci, Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaFil: Shadmehr, Reza. Johns Hopkins School of Medicine; Estados UnidosFil: Della Maggiore, Valeria Monica. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; Argentin

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81&nbsp;years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Motor resonance may originate from sensorimotor experience

In humans, the motor system can be activated by passive observation of actions or static pictures with implied action. The origin of this facilitation is of major interest to the field of motor control. Recently it has been shown that sensorimotor learning can reconfigure the motor system during action observation. Here we tested directly the hypothesis that motor resonance arises from sensorimotor contingencies by measuring corticospinal excitability in response to abstract non-action cues previously associated with an action. Motor evoked potentials were measured from the first dorsal interosseus (FDI) while human subjects observed colored stimuli that had been visually or motorically associated with a finger movement (index or little finger abduction). Corticospinal excitability was higher during the observation of a colored cue that preceded a movement involving the recorded muscle than during the observation of a different colored cue that preceded a movement involving a different muscle. Crucially this facilitation was only observed when the cue was associated with an executed movement but not when it was associated with an observed movement. Our findings provide solid evidence in support of the sensorimotor hypothesis of action observation and further suggest that the physical nature of the observed stimulus mediating this phenomenon may in fact be irrelevant.Fil: Petroni, Agustin. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Baguear, Federico. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Della Maggiore, Valeria Monica. Universidad de Buenos Aires. Facultad de Medicina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Functional Evidence for Memory Stabilization in Sensorimotor Adaptation: A 24-h Resting-State fMRI Study

Adaptation learning is crucial to maintain precise motor control in face of environmental perturbations. Although much progress has been made in understanding the psychophysics and neurophysiology of sensorimotor adaptation (SA), the time course of memory consolidation remains elusive. The lack of a reproducible gradient of memory resistance using protocols of retrograde interference has even led to the proposal that memories produced through SA do not consolidate. Here, we pursued an alternative approach using resting-state fMRI to track changes in functional connectivity (FC) induced by learning. Given that consolidation leads to long-term memory, we hypothesized that a change in FC that predicted long-term memory but not short-term memory would provide indirect evidence for memory stabilization. Six scans were acquired before, 15 min, 1, 3, 5.5, and 24 h after training on a center-out task under veridical or distorted visual feedback. The experimental group showed an increment in FC of a network including motor, premotor, posterior parietal cortex, cerebellum, and putamen that peaked at 5.5 h. Crucially, the strengthening of this network correlated positively with long-term retention but negatively with short-term retention. Our work provides evidence, suggesting that adaptation memories stabilize within a 6-h window, and points to different mechanisms subserving short- and long-term memory.Fil: Della Maggiore, Valeria Monica. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaFil: Villalta, Jorge Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaFil: Kovacevic, Natasa. University of Toronto; CanadáFil: McIntosh, Anthony Randal. University of Toronto; Canad