Daily Habits in Parkinson's Disease: Validation of the Daily Habit Scale

Objective: The objective of the study was to validate a new scale for assessing habitual behavior—the Daily Habit Scale in patients with Parkinson's disease. Background: Parkinson's disease patients are impaired in habit learning and skill acquisition. Despite repeated practice, they have difficulty developing habitual responses. Methods: One hundred seventy-nine patients (Median (Mdn) = 69 [64–76], 65 females) participated in the study. Corrected item-to-total correlations were calculated to assess the item-convergent and item discriminant validity. Confirmatory factor analysis and assessment of internal consistency were also carried out. Concurrent validity in respect to measures of anxiety and depression, apathy, impulsivity, personality, multidimensional health locus of control, and health-related quality of life was also calculated. To determine the test–retest reliability of the scale, 30 patients (Mdn = 69 [66–73], 9 females) completed a second copy of the scale 6 months after the first. Results: Twenty-nine items (76%) and 9 items (24%) of the 38-item scale, respectively, showed a very good and good convergent validity. All the items discriminated between their own factor and the other factors. The comparative fit index of 0.932 indicated an acceptable model fit of the data, whereas the root mean square error of approximation of 0.06 moderate model fit. The scale had a good internal consistency (Cronbach α = 0.792), and a moderate test–retest reliability (0.57). Females had higher scores on two factors compared to men (Factor 3: household activities and Factor 8: sleep-related activities). Conclusions: The Daily Habit Scale is a reliable and valid tool to measure daily habits in Parkinson's disease

In Parkinson's disease on a probabilistic Go/NoGo task deep brain stimulation of the subthalamic nucleus only interferes with withholding of the most prepotent responses

The evidence on the impact of subthalamic nucleus deep brain stimulation (STN-DBS) on action restraint on Go/NoGO reaction time (RT) tasks in Parkinson's disease (PD) is inconsistent; with some studies reporting no effect and others finding that STN stimulation interferes with withholding of responses and results in more commission errors relative to STN-DBS off. We used a task in which the probability of Go stimuli varied from 100 % (simple RT task) to 80, 50 and 20 % (probabilistic Go/NoGo RT task), thus altering the prepotency of the response and the difficulty in withholding it on NoGo trials. Twenty PD patients with STN-DBS, ten unoperated PD patients and ten healthy controls participated in the study. All participants were tested twice; the order of on versus off stimulation for STN-DBS PD patients was counterbalanced. Both STN-DBS and unoperated PD patients were tested on medication. The results indicated that STN-DBS selectively decreased discriminability when the response was most prepotent (high-80 %, as compared to low Go probability trials-50 and 20 %). Movement times were faster with STN stimulation than with DBS off across different Go probability levels. There was neither an overall nor a selective effect of STN-DBS on RTs depending on the level of Go probability. Furthermore, compared to healthy controls, both STN-DBS and unoperated PD patients were more prone to making anticipatory errors; which was not influenced by STN stimulation. The results provide evidence for 'load-dependent' effects of STN stimulation on action restraint as a function of the prepotency of the Go response

The Effects of Functional Therapy on Motor Development in Children with Cerebral Palsy

ObjectivesThe cause of rheumatoid arthritis (RA) as a chronic inflammatory autoimmune disease is still unknown. It appears that both genetic and environmental factors play a role in its pathogenesis. Recent studies reveal that in addition to the CNS, immune cells synthesis neurotransmitters so that these catecholamines can regulate immune functions. The aim of this study is to evaluate the dopamine receptor gene expression profiles on peripheral blood mononuclear cells of rheumatoid arthritis patients in comparison with normal individuals.Material & MethodsIn the present study, we investigated dopamine receptor gene expression in PBMCs of 40 RA patients and 40 healthy individuals using Real Time-PCR.The specificities of the obtained Real time PCR products for the respective dopamine receptors fragments were confirmed by sequenced analysis capillary systemResultsWe found that DRD1-DRD5 types of dopamine receptors genes expression profiles of rheumatoid arthritis patients differ compared to healthy individuals. Moreover, a significant difference of DR2 and DR4 gene expression was seen in rheumatoid arthritis patients.ConclusionThis study showed that some types of dopamine receptors genes expression profiles alter in rheumatoid arthritis patients with comparison to healthy individuals Moreover, this alteration possibly could result in dysfunction of dopaminergic system in immune cells and finally lead to rheumatoid arthritis

Continuous Theta Burst Stimulation Over the Dorsolateral Prefrontal Cortex and the Pre-SMA Alter Drift Rate and Response Thresholds Respectively During Perceptual Decision-Making

BACKGROUND: The speed-accuracy trade-off (SAT) refers to the balancing of speed versus accuracy during decision-making. SAT is very commonly investigated with perceptual decision-making tasks such as the moving dots task (MDT). The dorsolateral prefrontal cortex (DLPFC) and the pre-supplementary motor area (pre-SMA) are two brain regions considered to be involved in the control of SAT. OBJECTIVES/HYPOTHESES: The study tested whether the DLPFC and the pre-SMA play an essential role in the control of SAT. We hypothesized that continuous theta burst stimulation (cTBS) over the right DLPFC would primarily alter the rate of accumulation of evidence, whereas stimulation of the pre-SMA would influence the threshold for reaching a decision. METHODS: Fifteen (5 females; mean age = 30, SD =5.40) healthy volunteers participated in the study. We used two versions of the MDT and cTBS over the right DLPFC, pre-SMA and sham stimulation. The drift diffusion model was fit to the behavioural data (reaction time and error rate) in order to calculate the drift rate, boundary separation (threshold) and non-decision time. RESULTS: cTBS over the right DLPFC decreased the rate of accumulation of evidence (i.e. the drift rate from the diffusion model) in high (0.35 and 0.5) but not in low coherence trials. cTBS over the pre-SMA changed the boundary separation/threshold required to reach a decision on accuracy, but not on speed trials. CONCLUSIONS: The results suggest for the first time that both the DLPFC and the pre-SMA make essential but distinct contributions to the modulation of SAT

Development and Validation of a Daily Habit Scale

Habits are defined as automatic behaviours triggered by cues and performed without awareness. They are difficult to control and mentally efficient, which contrasts with goal-directed behaviour, which is characterised by active thought, high computational effort, and the ability to modify this behaviour in response to a changing environment and contextual demands. Habits are not only defined by the frequency with which a behaviour is performed but represent a complex construct that also includes the strength and automaticity of the habitual behaviour. We report here the development and validation of a Daily Habit Scale (DHS) to assess the frequency, automaticity, and strength of daily habits in healthy individuals. Item reduction based on factor analysis resulted in a scale with 38 items grouped into eight factors explaining 52.91% of the variance. The DHS showed very good internal consistency (Cronbach alpha = 0.738) and test-retest reliability (Intraclass correlation coefficient = 0.892, p<0.001) as well as convergent and divergent reliability compared to other scales measuring habits. We found a significant effect of age, gender, anxiety, and depression on the DHS. Considering certain limitations of the DHS, such as not considering the context of performance of habits, and the absence of certain items, such as transportation use, the results of this study suggest that DHS is a reliable and valid measure of daily habits that can be used by both clinicians and researchers as a measure of daily habits

Two knots in an umbilical cord with seventy centimeter length: A case report

Our case was a newborn with two umbilical knots that delivered 39 weeks gastation and did not experience any developmental disruptions. The risk factors of fetus for true knot formation in the umbilical cord were gender and the umbilical cord size. © 2020 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd

Inhibitory Control on a Stop Signal Task in Tourette Syndrome before and after Deep Brain Stimulation of the Internal Segment of the Globus Pallidus

As part of the first randomized double-blind trial of deep brain stimulation (DBS) of the globus pallidus (GPi) in Tourette syndrome, we examined the effect of stimulation on response initiation and inhibition. A total of 14 patients with severe Tourette syndrome were recruited and tested on the stop signal task prior to and after GPi-DBS surgery and compared to eight age-matched healthy controls. Tics were significantly improved following GPi-DBS. The main measure of reactive inhibition, the stop signal reaction time did not change from before to after surgery and did not differ from that of healthy controls either before or after GPi-DBS surgery. This suggests that patients with Tourette syndrome have normal reactive inhibition which is not significantly altered by GPi-DBS

Subthalamic nucleus deep brain stimulation induces impulsive action when patients with Parkinson's disease act under speed pressure

The subthalamic nucleus (STN) is proposed to modulate response thresholds and speed-accuracy trade-offs. In situations of conflict, the STN is considered to raise response thresholds, allowing time for the accumulation of information to occur before a response is selected. Conversely, speed pressure is thought to reduce the activity of the STN and lower response thresholds, resulting in fast, errorful responses. In Parkinson's disease (PD), subthalamic nucleus deep brain stimulation (STN-DBS) reduces the activity of the nucleus and improves motor symptoms. We predicted that the combined effects of STN stimulation and speed pressure would lower STN activity and lead to fast, errorful responses, hence resulting in impulsive action. We used the motion discrimination 'moving-dots' task to assess speed-accuracy trade-offs, under both speed and accuracy instructions. We assessed 12 patients with PD and bilateral STN-DBS and 12 age-matched healthy controls. Participants completed the task twice, and the patients completed it once with STN-DBS on and once with STN-DBS off, with order counterbalanced. We found that STN stimulation was associated with significantly faster reaction times but more errors under speed instructions. Application of the drift diffusion model showed that stimulation resulted in lower response thresholds when acting under speed pressure. These findings support the involvement of the STN in the modulation of speed-accuracy trade-offs and establish for the first time that speed pressure alone, even in the absence of conflict, can result in STN stimulation inducing impulsive action in PD

Theta burst magnetic stimulation over the pre-supplementary motor area improves motor inhibition

BACKGROUND: Stopping an ongoing motor response or resolving conflict induced by conflicting stimuli are associated with activation of a right-lateralized network of inferior frontal gyrus (IFG), pre-supplementary motor area (pre-SMA) and subthalamic nucleus (STN). However, the roles of the right IFG and pre-SMA in stopping a movement and in conflict resolution remain unclear. We used continuous theta burst stimulation (cTBS) to examine the involvement of the right IFG and pre-SMA in inhibition and conflict resolution using the conditional stop signal task. METHODS: We measured stop signal reaction time (SSRT, measure of reactive inhibition), response delay effect (RDE, measure of proactive action restraint) and conflict induced slowing (CIS, measure of conflict resolution). RESULTS: Stimulation over the pre-SMA resulted in significantly shorter SSRTs (improved inhibition) compared to sham cTBS. This effect was not observed for CIS, RDE, or any other measures. cTBS over the right IFG had no effect on SSRT, CIS, RDE or on any other measure. CONCLUSIONS: The improvement of SSRT with cTBS over the pre-SMA suggests its critical contribution to stopping ongoing movements