How skill expertise shapes the brain functional architecture: an fMRI study of visuo-spatial and motor processing in professional racing-car and naïve drivers

The present study was designed to investigate the brain functional architecture that subserves visuo-spatial and motor processing in highly skilled individuals. By using functional magnetic resonance imaging (fMRI), we measured brain activity while eleven Formula racing-car drivers and eleven ‘naïve’ volunteers performed a motor reaction and a visuo-spatial task. Tasks were set at a relatively low level of difficulty such to ensure a similar performance in the two groups and thus avoid any potential confounding effects on brain activity due to discrepancies in task execution. The brain functional organization was analyzed in terms of regional brain response, inter-regional interactions and blood oxygen level dependent (BOLD) signal variability. While performance levels were equal in the two groups, as compared to naïve drivers, professional drivers showed a smaller volume recruitment of task-related regions, stronger connections among task-related areas, and an increased information integration as reflected by a higher signal temporal variability. In conclusion, our results demonstrate that, as compared to naïve subjects, the brain functional architecture sustaining visuo-motor processing in professional racing-car drivers, trained to perform at the highest levels under extremely demanding conditions, undergoes both ‘quantitative’ and ‘qualitative’ modifications that are evident even when the brain is engaged in relatively simple, non-demanding tasks. These results provide novel evidence in favor of an increased ‘neural efficiency’ in the brain of highly skilled individuals

Treatment-Emergent Mania/Hypomania in unipolar patients

8sireservedObjective: The aim of this study was to estimate the incidence of treatment-emergent mania/hypomania (TEMH) and to describe the clinical characteristics of patients with major depression experiencing this event during treatment with a selective serotonin reuptake inhibitor (SSRI) and/or interpersonal psychotherapy (IPT). Methods: Following an algorithm-based protocol, 344 patients with major depression confirmed with the Structured Clinical Interview for DSM-IV disorders were treated with an SSRI, interpersonal psychotherapy, or their combination for ninemonths. The emergence of mania/hypomania was carefully monitored throughout the study using the Young Mania Rating Scale and clinical assessment. Results: Overall, eight patients experienced TEMH. The incidence of this event was 3.0% in patients treated with an SSRI and 0.9% in patients treated with IPT alone. Among patients treated with an SSRI, the difference between sites was higher than expected by chance alone (6.8% at Pisa and 0% at Pittsburgh, p = 0.002). Despite the adoption of an identical protocol at the two sites, some demographic and clinical characteristics of participants may account for this unexpected result. Alternatively, the greater number of episodes and earlier age of onset at the Pittsburgh site suggests that the unipolar course of illness was more clearly established prior to study entry. Conclusions: TEMH is an infrequent event, occurring in 2.3% of patients treated for major depression. Nevertheless, its consequences are clinically relevant and require prompt and appropriate therapeutic interventions. For this reason, recognising those patients at risk for such an event is of paramount clinical significance. The observed difference in the incidence of TEMH between the two sites requires further investigation. © 2008 The Authors Journal compilation © 2008 Blackwell Munksgaard.mixedBENVENUTI, A.; RUCCI, P.; MINIATI, M.; PAPASOGLI, A.; FAGIOLINI, A.; CASSANO, G.B.; SWARTZ, H.; FRANK, E.Benvenuti, A.; Rucci, P.; Miniati, M.; Papasogli, A.; Fagiolini, A.; Cassano, G. B.; Swartz, H.; Frank, E

MSSD Group Comparisons.

<p>MSSD contrast maps for motor reaction (a) and visuo-spatial (b) task. Yellow/red regions indicate significantly (<i>p</i> < 0.05, whole brain corrected) greater BOLD variability in professional as compared to naïve drivers. No regions showed significantly greater MSSD in naïve drivers.</p

Behavioural results.

<p>Behavioural performance of professional (red) and naïve (blue) drivers during the motor reaction task (a) and the visuo-spatial task (b). Average reaction time and mean error rate (± SE) are shown in the graphs. No significant differences between the two groups have been observed. </p

Connectivity Group Comparisons.

<p>Statistical map of between group comparisons derived from path coefficients and t-statistics obtained using multivariate autoregressive analysis (MAR) during (a) the motor reaction and (b) the visuo-spatial task. Red and blue arrows respectively indicate significantly greater positive and negative influence on target regions for which a within group effect was also present (<i>p</i> < 0.05). Here are shown connections that were significantly stronger in professional as compared to naïve drivers (we observed no stronger connections in this latter group).</p

Brain activation results.

<p>(a) Brain activations in left (top) and right (bottom) hemispheres of professional (blue/yellow scale) and naive (gray shadow) drivers during motor reaction (1st column) and visuo-spatial (2nd column) tasks computed at whole brain corrected <i>p</i> < 0.05. (b) Left (top) and right (bottom) hemispheres activation contrast maps for the two tasks, where blue color corresponds to regions significantly more activated in naive as compared to professional drivers, while red color corresponds to regions significantly more activated in the professional drivers group (<i>p</i> < 0.05, whole brain corrected).</p