Born to speak and sing: musical predictors of language development in pre-schoolers

The relationship between musical and linguistic skills has received particular attention in infants and school-aged children. However, very little is known about pre-schoolers. This leaves a gap in our understanding of the concurrent development of these skills during development. Moreover, attention has been focused on the effects of formal musical training, while neglecting the influence of informal musical activities at home. To address these gaps, in Study 1, 3- and 4-year-old children (n = 40) performed novel musical tasks (perception and production) adapted for young children in order to examine the link between musical skills and the development of key language capacities, namely grammar and phonological awareness. In Study 2 we investigated the influence of informal musical experience at home on musical and linguistic skills of young pre-schoolers, using the same evaluation tools. We found systematic associations between distinct musical and linguistic skills. Rhythm perception and production were the best predictors of phonological awareness, while melody perception was the best predictor of grammar acquisition, a novel association not previously observed in developmental research. These associations could not be explained by variability in general cognitive functioning, such as verbal memory and non-verbal abilities. Thus, selective music-related auditory and motor skills are likely to underpin different aspects of language development and can be dissociated in pre-schoolers. We also found that informal musical experience at home contributes to the development of grammar. An effect of musical skills on both phonological awareness and language grammar is mediated by home musical experience. These findings pave the way for the development of dedicated musical activities for pre-schoolers to support specific areas of language development

Entrainment: A domain general cognitive timing mechanism?

From an early age onwards we tend to synchronize to temporally regular and rhythmic stimuli, such as the beat in music, which inevitably leads to movement. Recently, such basic mapping of temporally regular sound and motor behavior has been critically discussed and the four speakers of this symposium will address extensions of a basic sensorimotor conceptualization of entrainment in their talks. M. Henry and colleagues discuss oscillatory entrainment in perception only, while E. Large puts to test whether oscillatory entrainment simply mirrors stimulus frequency when movement is coupled with syncopated rhythm. J. Grahn explores whether non-beat related factors impact synchronization in movement, while S. Dalla-Bella confers how stimulus complexity affects people's capacity to synchronize finger tapping but also perception. The symposium will be discussed by V. Penhune

Side and time variability of intraepidermal nerve fiber density

Objective: To assess the right-to-left and short-term variability of intraepidermal nerve fiber density (IENFD) at the distal site of the leg. Methods: Patients with possible or probable small fiber neuropathy (SFN) and healthy volunteers (HVs) underwent skin biopsies at the right and left distal leg. A subgroup of participants underwent follow-up biopsies 20 days later. Biopsies were immunostained by polyclonal anti-protein gene product 9.5 antibodies, and IENFD was quantified in nonconsecutive sections following published guidelines by operators blinded to the participants' condition (diagnosis, side, and time of biopsy). Findings were referred to sex- and age-adjusted normative values. Results: Forty patients and 17 HVs underwent bilateral skin biopsies; 15 patients and 8 HVs underwent follow-up skin biopsies. Sural nerve and dorsal sural nerve conduction studies were normal in all participants. Interside IENFD did not differ both in patients (median 2.45 IENF/mm +/- 1.45 SD right; 2.2 IENF/mm +/- 1.32 SD left) and HVs (median 6.3 IENF/mm +/- 2.81 right; 6.2 IENF/mm +/- 2.3 SD left). The right-to-left correlation coefficients were excellent (Pearson 0.95 in SFN and 0.97 in HVs). The analysis of IENFD at 20-day follow-up biopsy showed no difference between sides in both groups and yielded excellent correlation coefficients. Conclusions: The diagnosis of SFN can be reliably ascertained by unilateral skin biopsy at the distal site of the leg, and IENFD is not expected to vary within 3 weeks

Cognitive Syndromes and C9orf72 Mutation Are Not Related to Cerebellar Degeneration in Amyotrophic Lateral Sclerosis

Objective: The notion that cerebellar pathology may contribute to cognitive impairment in ALS, especially in patients with C9orf72 repeated expansion, has been inconsistently reported. This study aimed exploring the relationship between cerebellar involvement, cognitive impairment and C9orf72 repeated expansion of patients with ALS. Methods: Quantitative in vivo assessment of cerebellar lobules has been investigated in 66 non-demented patients with ALS and 28 healthy controls (HCs). Pathologic C9orf72 repeated expansion was found in 13 patients. Mild cognitive and/or behavioral impairment was diagnosed in 22 C9orf72 negative ALS patients. Measures of cortical volume (CV} and cortical thickness (CT) of cerebellar lobules of all participants were used for Principal Component Analysis (PCA) to identify clusters of lobular measures highly correlated with each other. PCA outcomes were used for between group comparisons and correlation analyses with neuropsychological and clinical features. Results: Disease severity measured with ALS functional rating scale and index of disease progression rate significantly correlated with CV reduction of the second PCA cluster loading CV measures of anterior lobules. In all patients, cognitive impairment, measured with verbal fluency, was related to CV reduction of the third cluster comprising posterior lobules. No specific cortical thinning or volume reduction of cerebellar clustering patterns could be detected in ALS subgroups. Conclusion: Our data show that specific patterns of subregional cerebellar involvement are associated with physical disability or cognitive impairment in ALS, in line with the topographic organization of the cerebellum. However, there was no specific correlation between cerebellar degeneration and cognitive syndromes or C9orf72 mutations

Acquired and congenital disorders of sung performance: A review.

Many believe that the majority of people are unable to carry a tune. Yet, this widespread idea underestimates the singing abilities of the layman. Most occasional singers can sing in tune and in time, provided that they perform at a slow tempo. Here we characterize proficient singing in the general population and identify its neuronal underpinnings by reviewing behavioral and neuroimaging studies. In addition, poor singing resulting from a brain injury or neurogenetic disorder (i.e., tone deafness or congenital amusia) is examined. Different lines of evidence converge in indicating that poor singing is not a monolithic deficit. A variety of poor-singing "phenotypes" are described, with or without concurrent perceptual deficits. In addition, particular attention is paid to the dissociations between specific abilities in poor singers (e.g., production of absolute vs. relative pitch, pitch vs. time accuracy). Such diversity of impairments in poor singers can be traced to different faulty mechanisms within the vocal sensorimotor loop, such as pitch perception and sensorimotor integration

Rapamycin treatment for amyotrophic lateral sclerosis protocol for a phase II randomized, double-blind, placebo-controlled, multicenter, clinical trial (RAP-ALS trial)

Introduction: Misfolded aggregated proteins and neuroinflammation significantly contribute to amyotrophic lateral sclerosis (ALS) pathogenesis, hence representing therapeutic targets to modify disease expression. Rapamycin inhibits mechanistic target of Rapamycin (mTOR) pathway and enhances autophagy with demonstrated beneficial effects in neurodegeneration in cell line and animal models, improving phenotype in SQSTM1 zebrafish, in Drosophila model of ALS-TDP, and in the TDP43 mouse model, in which it reduced neuronal loss and TDP43 inclusions. Rapamycin also expands regulatory T lymphocytes (Treg) and increased Treg levels are associated with slow progression in ALS patients. Therefore, we planned a randomized clinical trial testing Rapamycin treatment in ALS patients. Methods: RAP-ALS is a phase II randomized, double-blind, placebo-controlled, multicenter (8 ALS centers in Italy), clinical trial. The primary aim is to assess whether Rapamycin administration increases Tregs number in treated patients compared with control arm. Secondary aims include the assessment of safety and tolerability of Rapamycin in patients with ALS; the minimum dosage to have Rapamycin in cerebrospinal fluid; changes in immunological (activation and homing of T, B, NK cell subpopulations) and inflammatory markers, and on mTOR downstream pathway (S6RP phosphorylation); clinical activity (ALS Functional Rating Scale-Revised, survival, forced vital capacity); and quality of life (ALSAQ40 scale). Discussion: Rapamycin potentially targets mechanisms at play in ALS (i.e., autophagy and neuroinflammation), with promising preclinical studies. It is an already approved drug, with known pharmacokinetics, already available and therefore with significant possibility of rapid translation to daily clinics. Findings will provide reliable data for further potential trials. Ethics and dissemination: The study protocol was approved by the Ethics Committee of Azienda Ospedaliero Universitaria of Modena and by the Ethics Committees of participating centers (Eudract n. 2016-002399-28) based on the Helsinki declaration

Use of colistin in adult patients: A cross-sectional study

Objectives: The aim of this study was to assess colistin use in a country endemic for multidrug-resistant Gram-negative bacteria (MDR-GNB). Methods: Colistin prescription patterns were evaluated in 22 Italian centres. Factors associated with use of colistin in combination with other anti-MDR-GNB agents were also assessed. Results: A total of 221 adults receiving colistin were included in the study. Their median age was 64 years (interquartile range 52\u201373 years) and 134 (61%) were male. Colistin was mostly administered intravenously (203/221; 92%) and mainly for targeted therapy (168/221; 76%). The most frequent indications for colistin therapy were bloodstream infection and lower respiratory tract infection. Intravenous colistin was administered in combination with at least another anti-MDR-GNB agent in 80% of cases (163/203). A loading dose of 9 MU of colistimethate was administered in 79% of patients receiving i.v. colistin and adequate maintenance doses in 85%. In multivariable analysis, empirical therapy [odds ratio (OR) = 3.25, 95% confidence interval (CI) 1.24\u20138.53;P = 0.017] and targeted therapy for carbapenem-resistant Enterobacterales infection (OR = 4.76, 95% CI 1.69\u201313.43; P = 0.003) were associated with use of colistin in combination with other agents, whilst chronic renal failure (OR = 0.39, 95% CI 0.17\u20130.88; P = 0.024) was associated with use of colistin monotherapy. Conclusion: Colistin remains an important option for severe MDR-GNB infections when other treatments are not available. Despite inherent difficulties in optimising its use owing to peculiar pharmacokinetic/pharmacodynamic characteristics, colistin was mostly used appropriately in a country endemic for MDR-GNB

Rate Effects on Timing, Key Velocity, and Finger Kinematics in Piano Performance

We examined the effect of rate on finger kinematics in goal-directed actions of pianists. In addition, we evaluated whether movement kinematics can be treated as an indicator of personal identity. Pianists' finger movements were recorded with a motion capture system while they performed melodies from memory at different rates. Pianists' peak finger heights above the keys preceding keystrokes increased as tempo increased, and were attained about one tone before keypress. These rate effects were not simply due to a strategy to increase key velocity (associated with tone intensity) of the corresponding keystroke. Greater finger heights may compensate via greater tactile feedback for a speed-accuracy tradeoff that underlies the tendency toward larger temporal variability at faster tempi. This would allow pianists to maintain high temporal accuracy when playing at fast rates. In addition, finger velocity and accelerations as pianists' fingers approached keys were sufficiently unique to allow pianists' identification with a neural-network classifier. Classification success was higher in pianists with more extensive musical training. Pianists' movement “signatures” may reflect unique goal-directed movement kinematic patterns, leading to individualistic sound

Development and Validation of the Computerised Adaptive Beat Alignment Test (CA-BAT)

Beat perception is increasingly being recognised as a fundamental musical ability. A number of psychometric instruments have been developed to assess this ability, but these tests do not take advantage of modern psychometric techniques, and rarely receive systematic validation. The present research addresses this gap in the literature by developing and validating a new test, the Computerised Adaptive Beat Alignment Test (CA-BAT), a variant of the Beat Alignment Test (BAT) that leverages recent advances in psychometric theory, including item response theory, adaptive testing, and automatic item generation. The test is constructed and validated in four empirical studies. The results support the reliability and validity of the CA-BAT for laboratory testing, but suggest that the test is not well-suited to online testing, owing to its reliance on fne perceptual discrimination