Primary Sensory and Motor Cortex Activities During Voluntary and Passive Ankle Mobilization by the SHADE Orthosis

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Disease-Modifying Therapies and Coronavirus Disease 2019 Severity in Multiple Sclerosis

Objective: This study was undertaken to assess the impact of immunosuppressive and immunomodulatory therapies on the severity of coronavirus disease 2019 (COVID-19) in people with multiple sclerosis (PwMS). Methods: We retrospectively collected data of PwMS with suspected or confirmed COVID-19. All the patients had complete follow-up to death or recovery. Severe COVID-19 was defined by a 3-level variable: mild disease not requiring hospitalization versus pneumonia or hospitalization versus intensive care unit (ICU) admission or death. We evaluated baseline characteristics and MS therapies associated with severe COVID-19 by multivariate and propensity score (PS)-weighted ordinal logistic models. Sensitivity analyses were run to confirm the results. Results: Of 844 PwMS with suspected (n = 565) or confirmed (n = 279) COVID-19, 13 (1.54%) died; 11 of them were in a progressive MS phase, and 8 were without any therapy. Thirty-eight (4.5%) were admitted to an ICU; 99 (11.7%) had radiologically documented pneumonia; 96 (11.4%) were hospitalized. After adjusting for region, age, sex, progressive MS course, Expanded Disability Status Scale, disease duration, body mass index, comorbidities, and recent methylprednisolone use, therapy with an anti-CD20 agent (ocrelizumab or rituximab) was significantly associated (odds ratio [OR] = 2.37, 95% confidence interval [CI] = 1.18-4.74, p = 0.015) with increased risk of severe COVID-19. Recent use (<1 month) of methylprednisolone was also associated with a worse outcome (OR = 5.24, 95% CI = 2.20-12.53, p = 0.001). Results were confirmed by the PS-weighted analysis and by all the sensitivity analyses. Interpretation: This study showed an acceptable level of safety of therapies with a broad array of mechanisms of action. However, some specific elements of risk emerged. These will need to be considered while the COVID-19 pandemic persists

Regional Personalized Electrodes to Select Transcranial Current Stimulation Target

Rationale Personalizing transcranial stimulations promises to enhance beneficial effects for individual patients.ObjectiveTo stimulate specific cortical regions by developing a procedure to bend and position custom shaped electrodes; to probe the effects on cortical excitability produced when the properly customized electrode is targeting different cortical areas.MethodAn ad-hoc neuronavigation procedure was developed to accurately shape and place the personalized electrodes on the basis of individual brain magnetic resonance images (MRI) on bilateral primary motor (M1) and somatosensory (S1) cortices. The transcranial alternating current stimulation (tACS) protocol published by Feurra and coll. (2011) was used to test the effects on cortical excitability of the personalized electrode when targeting S1 or M1.ResultsNeuronal excitability as evaluated by tACS was different when targeting M1 or S1, with the General Estimating Equation model indicating a clear tCS Effect (p < 0.001), and post-hoc comparisons showing solely M1 20Hz tACS to reduce M1 excitability with respect to baseline and other tACS conditions.ConclusionsThe present work indicates that specific cortical regions can be targeted by tCS properly shaping and positioning the stimulating electrode.SignificanceThrough multimodal brain investigations continuous efforts in understanding the neuronal changes related to specific neurological or psychiatric diseases become more relevant as our ability to build the compensating interventions improves. An important step forward on this path is the ability to target the specific cortical area of interest, as shown in the present pilot work

Environmental noise-exposed workers: Event-related potentials, neuropsychological and mood assessment

Prolonged environmental noise exposure can induce pathogenic effects on various physical and psychosocial responses. The first aim of this study was to investigate whether long-term occupational noise exposure could affect neurophysiological, neuropsychological and emotional statuses, with particular respect to attention and working memory. The second aim was to evaluate the effects on the tactile P300 of a specific stressor (background traffic noise) vs a non-specific stress inductor (Stroop test). The comparison between a group of noise-exposed workers (traffic police officers), and a control group (office employees) did not show marked differences in cognitive and emotional profiles. The amplitude of the baseline cognitive potential (P300), recorded during a tactile (electric) discrimination task, resulted higher in noise-exposed workers than in controls, and this enhancement was associated with a lower level of trait anxiety and better mood profiles. Moreover, we found a wider P300 amplitude reduction in traffic police officers than in controls, under noisy conditions due to traffic. The effect of the Stroop test as a stress inductor was negligible and similar in the two groups. The wider amplitude of the non-auditory P300 in traffic police officers in the baseline condition could be a sign of cross-modal cerebral plasticity enhancing attentive processes in the 'stress-free' sensory channel. In addition, noise-exposed workers presented a higher cerebral sensitivity to stress selectively when they were exposed to the habitual environmental stressor. © 2007 Elsevier B.V. All rights reserved

Fronto-parietal coupling of brain rhythms in mild cognitive impairment: a multicentric EEG study

Electroencephalographic (EEG) data were recorded in 69 normal elderly (Nold), 88 mild cognitive impairment (MCI), and 109 mild Alzheimer's disease (AD) subjects at rest condition, to test whether the fronto-parietal coupling of EEG rhythms is in line with the hypothesis that MCI can be considered as a pre-clinical stage of the disease at group level. Functional coupling was estimated by synchronization likelihood of Laplacian-transformed EEG data at electrode pairs, which accounts for linear and non-linear components of that coupling. Cortical rhythms of interest were delta (2-4Hz), theta (4-8Hz), alpha 1 (8-10.5Hz), alpha 2 (10.5-13Hz), beta 1 (13-20Hz), beta 2 (20-30Hz), and gamma (30-40Hz). Compared to the Nold subjects, the AD patients presented a marked reduction of the synchronization likelihood (delta to gamma) at both fronto-parietal and inter-hemispherical (delta to beta 2) electrodes. As a main result, alpha 1 synchronization likelihood progressively decreased across Nold, MCI, and mild AD subjects at midline (Fz-Pz) and right (F4-P4) fronto-parietal electrodes. The same was true for the delta synchronization likelihood at right fronto-parietal electrodes (F4-P4). For these EEG bands, the synchronization likelihood correlated with global cognitive status as measured by the Mini Mental State Evaluation. The present results suggest that at group level, fronto-parietal coupling of the delta and alpha rhythms progressively becomes abnormal though MCI and mild AD. Future longitudinal research should evaluate whether the present EEG approach is able to predict the cognitive decline in individual MCI subjects

FMD, shear rate FMD and VMR in diabetic and control groups.

<p>Legend: FMD (Flow-Mediated Dilation, %); shear rate FMD (%); VMR (Cerebral Vasomotor Reactivity, %), LF/HF ratio (Low Frequency/High Frequency ratio). Data are expressed as mean ± SD.</p