The effects of direct current stimulation on exercise performance, pacing and perception in temperate and hot environments

Background. Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulatory technique and has previously been shown to enhance submaximal exercise by reducing rating of perceived exertion (RPE). The present study examined the effects of tDCS on high-intensity self-paced exercise in temperate conditions and fixed followed by maximal exercise in the heat; it was hypothesised performance and RPE would be altered. Methods. Two separate studies were undertaken in which exercise was preceded by 20-minutes of sham tDCS (SHAM), or anodal tDCS (TDCS). Study 1: six males completed a 20-km cycling time trial, on two occasions. Power output (PO), RPE, O2 pulse, and heart rate (HR) were measured throughout. Study 2: eight males completed fixed intensity cycling exercise at 55% of a pre-determined maximal power output (PMax) for 25-minutes before undertaking a time to exhaustion test (TTE; 75% PMax) in hot conditions (33°C), on two occasions. Test duration, heart rate, thermal and perceptual responses were measured. Study specific and combined statistical analyses was undertaken and effect sizes established.. Results. Study 1: mean PO was not improved with the tDCS (197 ± 20 W) compared to SHAM (197 ± 12 W) and there were no differences in pacing profile HR, O2 pulse or RPE (p > .05). Study 2: TTE duration (SHAM 314 ± 334 s cf 237 ± 362 s tDCS), thermal, heart rate and perceptual responses were unchanged by tDCS compared to SHAM (p > .05). When combined, performance in the SHAM trial tended to better than the tDCS. Conclusion. tDCS did not influence cycling performance (study 1) exercise tolerance (study 2) or perception (studies 1&2). tDCS does not appear to facilitate high intensity exercise performance or exercise performance in the heat

A new MRI rating scale for progressive supranuclear palsy and multiple system atrophy: validity and reliability

AIM To evaluate a standardised MRI acquisition protocol and a new image rating scale for disease severity in patients with progressive supranuclear palsy (PSP) and multiple systems atrophy (MSA) in a large multicentre study. METHODS The MRI protocol consisted of two-dimensional sagittal and axial T1, axial PD, and axial and coronal T2 weighted acquisitions. The 32 item ordinal scale evaluated abnormalities within the basal ganglia and posterior fossa, blind to diagnosis. Among 760 patients in the study population (PSP = 362, MSA = 398), 627 had per protocol images (PSP = 297, MSA = 330). Intra-rater (n = 60) and inter-rater (n = 555) reliability were assessed through Cohen's statistic, and scale structure through principal component analysis (PCA) (n = 441). Internal consistency and reliability were checked. Discriminant and predictive validity of extracted factors and total scores were tested for disease severity as per clinical diagnosis. RESULTS Intra-rater and inter-rater reliability were acceptable for 25 (78%) of the items scored (≥ 0.41). PCA revealed four meaningful clusters of covarying parameters (factor (F) F1: brainstem and cerebellum; F2: midbrain; F3: putamen; F4: other basal ganglia) with good to excellent internal consistency (Cronbach α 0.75-0.93) and moderate to excellent reliability (intraclass coefficient: F1: 0.92; F2: 0.79; F3: 0.71; F4: 0.49). The total score significantly discriminated for disease severity or diagnosis; factorial scores differentially discriminated for disease severity according to diagnosis (PSP: F1-F2; MSA: F2-F3). The total score was significantly related to survival in PSP (p<0.0007) or MSA (p<0.0005), indicating good predictive validity. CONCLUSIONS The scale is suitable for use in the context of multicentre studies and can reliably and consistently measure MRI abnormalities in PSP and MSA. Clinical Trial Registration Number The study protocol was filed in the open clinical trial registry (http://www.clinicaltrials.gov) with ID No NCT00211224

Pain in the neurodegenerating brain: insights into pharmacotherapy for Alzheimer disease and Parkinson disease

This is the final version. Available on open access from Lippincott, Williams & Wilkins via the DOI in this recordNational Institute for Health Research (NIHR)European Union Horizon 202

ORATIONVM || SCHOLAE ME-||LANCHTHONIANAE,|| QVAE AB ANNO M.D.LXXI.|| vs[que] ad Annum M.D.LXXIIII.|| in Academia Vuitebergensi || scriptae et recitatae || sunt.|| TOMVS SEPTIMVS.||

Vorlageform des Erscheinungsvermerks: SERVESTAE,|| Excudebat Bonauentura Faber.|| ANNO || M.D.LXXXVI.|

Chronologia || Scriptorum || PHILIPPI ME=||LANCHTHONIS.||

Vorlageform des Erscheinungsvermerks: GORLICII || Excusum typis Ambrosij Fritschij.|| Anno || M.D.LXXXII.|

Germaniae Qvatvor Circa Rhenvm Circvlorvm, Rhenani Svperioris, Rhenani Inferioris, Westphalici Et Bvrgvndici, Brevis Conspectvs Historicvs, Res Ibidem Gestas

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Development of a Textile Integrated, Two-State Controlled Tremor Suppression Orthosis for the Wrist

Tremor is one of the most common movement disorders with the highest prevalence in the upper limb. Apart from medication or surgery, the mechanical suppression of the involuntary movement with an orthosis can be used as alternative treatment. Here we propose a controlled energy dissipating suppression orthosis using a mechanical brake. For this approach, we focused on improved wearability with voluntary movement preservation and ergonomics while providing tremor suppression. The novelty of this orthosis is the decentralization of the tremor suppression mechanism and the integration of textiles in the orthosis structure. We performed computational and test bench simulations of a controlled two-state brake with a 1D human model to optimize the brake duration and timing. The objective was to optimize the trade-off between tremor suppression and voluntary movement suppression. The textile-integrated prototype, with the optimized parameter, was validated in a proof-of-concept case study with a tremor-affected person performing activities of daily living. With the optimized parameters, we achieved a tremor suppression of 78.8%, 66.5%, and 40.8% for the simulation, test bench, and case study, respectively as measured by the change in power spectral density (PSD) at the tremor frequency peak. While minimizing the voluntary movement suppression in the simulation and test bench by introducing the trajectory distance as new validation method (23.7% and 31.2%), no voluntary movements suppression was measured in the case study using PSD analysis. Our new orthosis has the potential to become a daily wearable device that can improve the quality of life for tremor-affected people.ISSN:2576-320