Hierarchical psychophysiological pathways subtend perceptual asymmetries in Neglect

Stroke patients with left Hemispatial Neglect (LHN) show deficits in perceiving left contralesional stimuli with biased visuospatial perception towards the right hemifield. However, very little is known about the functional organization of the visuospatial perceptual neural network and how this can account for the profound reorganization of space representation in LHN. In the present work, we aimed at (1) identifying EEG measures that discriminate LHN patients against controls and (2) devise a causative neurophysiological model between the discriminative EEG measures. To these aims, EEG was recorded during exposure to lateralized visual stimuli which allowed for pre-and post-stimulus activity investigation across three groups: LHN patients, lesioned controls, and healthy individuals. Moreover, all participants performed a standard behavioral test assessing the perceptual asymmetry index in detecting lateralized stimuli. The between-groups discriminative EEG patterns were entered into a Structural Equation Model for the identification of causative hierarchical associations (i.e., pathways) between EEG measures and the perceptual asymmetry index. The model identified two pathways. A first pathway showed that the combined contribution of pre-stimulus frontoparietal connectivity and individual-alpha-frequency predicts post-stimulus processing, as measured by visual-evoked N100, which, in turn, predicts the perceptual asymmetry index. A second pathway directly links the inter-hemispheric distribution of alpha-amplitude with the perceptual asymmetry index. The two pathways can collectively explain 83.1% of the variance in the perceptual asymmetry index. Using causative modeling, the present study identified how psychophysiological correlates of visuospatial perception are organized and predict the degree of behavioral asymmetry in LHN patients and controls

Robot-assisted upper limb training for patients with multiple sclerosis: an evidence-based review of clinical applications and effectiveness

Upper extremities limitation is a common functional impairment in patients with Multiple Sclerosis (PwMS). Novel technological devices are increasingly used in neurorehabilitation to support motor function improvement and the quantitative assessment of motor performance during training in patients with neurological diseases. In this review, we systematically report the evidence on clinical applications and robotic-assisted arm training (RAT) in functional recovery in PwMS. PubMed/MEDLINE, the Cochrane Library, and the Physiotherapy Evidence Database (PEDro) databases were systematically searched from inception to March 2021. The 10-item PEDro scale assessed the study quality for the RCT, and the AMSTAR-2 was used to assess the quality of the systematic review. The 5-item Oxford CEBM scale was used to rate the level of evidence. A total of 10 studies (161 subjects) were included. The selected studies included one systematic review, four RCTs, one randomized crossover, and four case series. The RCTs were scored as high-quality studies, while the systematic review was determined to be of low quality. Shoulder range of motion, handgrip strength, and proximal arm impairment improved after RAT. Manual dexterity, arm function, and use in daily life also ameliorated arm function. The high clinical heterogeneity of treatment programs and the variety of robot devices affects the generalizability of the study results; therefore, we emphasize the need to standardize the intervention type in future studies that evaluate the role of robotic-assisted training in PwMS. Robot-assisted treatment seems safe and useful to increase manual dexterity and the quality of movement execution in PwMS with moderate to severe disability. Additional studies with an adequate sample size and methodological rigour are warranted to drive definite conclusion

Upper limb robotic rehabilitation for patients with cervical spinal cord injury: a comprehensive review

The upper extremities limitation represents one of the essential functional impairments in patients with cervical spinal cord injury. Electromechanics assisted devices and robots are increasingly used in neurorehabilitation to help functional improvement in patients with neurological diseases. This review aimed to systematically report the evidence-based, state-of-art on clinical applications and robotic-assisted arm training (RAT) in motor and functional recovery in subjects affected by cervical spinal cord injury. The present study has been carried out within the framework of the Italian Consensus Conference on "Rehabilitation assisted by robotic and electromechanical devices for persons with disability of neurological origin" (CICERONE). PubMed/MEDLINE, Cochrane Library, and Physiotherapy Evidence Database (PEDro) databases were systematically searched from inception to September 2021. The 10-item PEDro scale assessed the study quality for the RCT and the AMSTAR-2 for the systematic review. Two different authors rated the studies included in this review. If consensus was not achieved after discussion, a third reviewer was interrogated. The five-item Oxford CEBM scale was used to rate the level of evidence. A total of 11 studies were included. The selected studies were: two systematic reviews, two RCTs, one parallel-group controlled trial, one longitudinal intervention study and five case series. One RCT was scored as a high-quality study, while the systematic review was of low quality. RAT was reported as feasible and safe. Initial positive effects of RAT were found for arm function and quality of movement in addition to conventional therapy. The high clinical heterogeneity of treatment programs and the variety of robot devices could severely affect the generalizability of the study results. Therefore, future studies are warranted to standardize the type of intervention and evaluate the role of robotic-assisted training in subjects affected by cervical spinal cord injury

Effects of robotic upper limb treatment after stroke on cognitive patterns: A systematic review

Background: Robotic therapy (RT) has been internationally recognized for the motor rehabilitation of the upper limb. Although it seems that RT can stimulate and promote neuroplasticity, the effectiveness of robotics in restoring cognitive deficits has been considered only in a few recent studies. Objective: To verify whether, in the current state of the literature, cognitive measures are used as inclusion or exclusion criteria and/or outcomes measures in robotic upper limb rehabilitation in stroke patients. Methods: The systematic review was conducted according to PRISMA guidelines. Studies eligible were identified through PubMed/MEDLINE and Web of Science from inception to March 2021. Results: Eighty-one studies were considered in this systematic review. Seventy-three studies have at least a cognitive inclusion or exclusion criteria, while only seven studies assessed cognitive outcomes. Conclusion: Despite the high presence of cognitive instruments used for inclusion/exclusion criteria their heterogeneity did not allow the identification of a guideline for the evaluation of patients in different stroke stages. Therefore, although the heterogeneity and the low percentage of studies that included cognitive outcomes, seemed that the latter were positively influenced by RT in post-stroke rehabilitation. Future larger RCTs are needed to outline which cognitive scales are most suitable and their cut-off, as well as what cognitive outcome measures to use in the various stages of post-stroke rehabilitation

Behavioural and electrophysiological effects of tDCS to prefrontal cortex in patients with disorders of consciousness

9noOBJECTIVES: Left dorsolateral prefrontal cortex anodal transcranial direct current stimulation (tDCS) was applied in a group of patients with disorders of consciousness to determine the effects of modulation of spontaneous oscillatory brain activity. METHODS: 12 patients in an unresponsive wakefulness syndrome (UWS) and 12 in a minimally conscious state (MCS) underwent 2-weeks active and 2-weeks sham tDCS. Neurophysiological assessment was performed with EEG power spectra and coherence analysis directly before and after each session. RESULTS: An increase of power and coherence of the frontal and parietal alpha and beta frequency bands and significant clinical improvements were seen after the active tDCS in MCS patients. In contrast, UWS patients showed some local frontal changes in the slow frequencies. No treatment effect was observed after sham. CONCLUSIONS: tDCS could induce changes in cortical EEG oscillations, modulating the travel of alpha and beta waves between anterior and posterior brain areas when some cognitive functions were preserved. This plays an important role in consciousness by integrating cognitive-emotional processing with the state of arousal. In unresponsive people, brain integration seems to be lost. SIGNIFICANCE: Our results further support the critical role of long-range fronto-parietal connections in consciousness and show the potential therapeutic utility of tDCS.reservedmixedCavinato M.; Genna C.; Formaggio E.; Gregorio C.; Storti S.F.; Manganotti P.; Casanova E.; Piperno R.; Piccione F.Cavinato, M.; Genna, C.; Formaggio, E.; Gregorio, C.; Storti, S. F.; Manganotti, P.; Casanova, E.; Piperno, R.; Piccione, F

Arthrobacter agilis and rosy discoloration in “Terme del Foro” (Pompeii, Italy)

Pink patinas and rosy discolorations on stones and mural paintings are often of biological origin, although they are frequently ascribed to chemical causes. This work represents the first report of this kind of biodeterioration in Pompeii, where we found a pink dusty patina in the “Terme del Foro”. Non-invasive sampling was performed to identify the aetiology of the discoloration. Interestingly, the pink pigmented bacterial species Arthrobacter agilis was found associated to the patina, pointing to a role of this bacterial species in rosy discoloration. Both morphology of the isolate and 16S rDNA analysis were consistent with identification as A. agilis. Raman spectroscopy was carried out to compare the pigments from the pink patina with those associated with A. agilis isolates, and the reference strain A. agilis DSM 20550. A spectroscopically identical carotenoid-like pigment was identified in all the three types of sample, arguing for a biological origin of the patina. Observations of pink patina distribution suggest that low-lighting and salinity are likely to play a role in patina development

A polychrome Mukozuke (1624–1644) porcelain offers a new hypothesis on the introduction of European enameling technology in Japan

This study was carried out in an attempt to resolve the issue of the introduction of overglaze enameling in Japan through non-destructive analysis of the overglaze enamels that decorate the only known polychrome mukozuke dish (to be used in the tea ceremony) bearing the early Japanese date mark ‘Kan'ei Nen Sei’ (made in the Kan'ei period) (1624–1644). The investigation focused specifically on the overglaze yellow enamel and the underglaze blue pigment, for they could provide valuable information on the production workshop and geographical area of origin. Owing to the extraordinary importance and extreme rarity of this newly-discovered dish, it was mandatory not to sample it. Therefore, Energy-Dispersive X-Ray Fluorescence (ED-XRF) and Raman spectroscopy were used to obtain, in a non-destructive way, both elemental and molecular information about the coloring agent present in the yellow overglaze enamel. The underglaze-blue pigment at the base mark was also investigated. Besides a detailed literature research, a comparison was made with the chemical composition of fully identified and dated polychrome decorated Chinese and Japanese porcelains, and the results are reported in this work. The obtained analytical evidence has proved to be crucial in identifying the first use of Naples Yellow in Japan, and in resolving the issue of the origin of overglaze enameling, providing the missing step that actually led to the first development of the technique in Arita in the 1630s. Furthermore, it has shown that the Raman shift of the Pb mode of the A2O’ lattice is greatly affected by the firing temperature for enamel decoration, and that this specific characteristic of Naples Yellow, along with its elemental composition, can help determine its area of origin and period of manufacture

Autoantibodies against type I IFNs in patients with Ph-negative myeloproliferative neoplasms

Autoantibodies against type I IFNs in patients with Ph-negative myeloproliferative neoplasm