Gait analysis in patients with idiopathic scoliosis

Introduction: The goal of this study was to observe scoliotic subjects during level walking to identify asymmetries—which may be related to a neurological dysfunction or the spinal deformity itself—and to correlate these to the severity of the scoliotic curve. Methods: We assessed the gait pattern of ten females (median age 14.4) with idiopathic scoliosis characterised by a left-lumbar and a right-thoracic curve component. Gait analysis consisted of 3D kinematic (VICON) and kinetic (Kistler force plates) measurements. The 3D-segment positions of the head, trunk and pelvis, as well as the individual joint angles of the upper and lower extremities, were computed during walking and static standing. Calculation of pertinent kinetic and kinematic parameters allowed statistical comparison. Results: All subjects walked at a normal velocity (median: 1.22m/s; range:1.08-1.30m/s; height-adjusted velocity: 0.75m/s; range: 0.62-0.88m/s). The timing of the individual gait phases was normal and symmetrical for the whole group. Sagittal plane hip, knee and ankle motion followed a physiological pattern. Significant asymmetry was observed in the trunk's rotational behaviour in the transverse plane. During gait, the pelvis and the head rotated symmetrically to the line of progression, whereas trunk rotation was asymmetric, with increased relative forward rotation of the right upper body in relation to the pelvis. This produced a torsional offset to the line of progression. Minimal torsion (at right heel strike) measured: median 1.0° (range: 5.1°-8.3°), and maximal torsion (at left heel strike) measured 11.4° (range 6.9°-17.9°). The magnitude of the torsional offset during gait correlated to the severity of the thoracic deformity and to the standing posture, whereas the range of the rotational movement was not affected by the severity of the deformity. The ground reaction forces revealed a significant asymmetry of [Msz], the free rotational moment around the vertical axis going through the point of equivalent force application. On the right side, the initial endo-rotational moment was lower, followed by a higher exo-rotational moment than on the left. All the other force parameters (vertical, medio-lateral, anterior-posterior), did not show a significant side difference for the whole group. The use of a brace stiffened torsional motion. However the torsional offset and the asymmetry of the free rotational moment remained unchanged. Conclusion: The most significant and marked asymmetry was seen in the transverse plane, denoted as a torsional offset of the upper trunk in relation to the symmetrically rotating pelvis. This motion pattern was reflected by a ground-reaction-force asymmetry of the free rotational moment. Further studies are needed to investigate whether this behaviour is solely an expression of the structural deformity or whether it could enhance the progression of the torsional deformit

Fat-pad impingement after total knee arthroplasty with the LCS A/P-Glide system

Early follow-up (15.8 months;1-48) of 230 knee replacements with an LCS A/P Glide component indicated an increased occurrence of anterior knee pain due to a fat-pad impingement, necessitating early revision surgery. Unsatisfactory results were observed in 28 knees (12.2%). Thirteen knees (5.7%) were revised on finding the fat-pad impingement, and four knees (1.7%) were scheduled for later revision surgery; the remaining 11 subjects (4.8%) had revision surgery for a different reason. Twenty-six subjects (11.3%) complained about milder but typical symptoms of a fat-pad impingement, and 22 subjects (9.6%) had unspecific mild symptoms. 151 knees (65.7%) were free of pain and demonstrated an excellent result. The total revision rate of 10.4% (24 knees) is higher than described for other implant systems. However, the revision needed to treat the fat-pad impingement (5.7%) consisted of minor surgery only, such as exchange of the mobile bearing or reduction of the fat pad by arthroscopy. The femoral and tibial components were able to be left untouched. Resection of the Hoffa's fat pad is recommended when such an implant system is used, and possible impingement should be investigated intraoperatively before closur

Cannabidiol enhances verbal episodic memory in healthy young participants: A randomized clinical trial

Cannabis contains a multitude of different compounds. One of them, cannabidiol - a non-psychoactive substance - might counteract negative effects of Δ-9-Tetrahydrocannabinol on hippocampus-dependent memory impairment. The aim of the present study was to investigate the effect of vaping cannabidiol on verbal episodic memory in healthy young subjects. We used a double-blind, placebo-controlled, randomized crossover trial in 39 healthy young subjects. Participants received once a single dose of cannabidiol e-liquid (0.25 ml, 5% cannabidiol, 12.5 mg cannabidiol) and once placebo for vaping after learning 15 unrelated nouns. The primary outcome measure was the short delay verbal memory performance (number of correctly free recalled nouns) 20 min after learning. 34 participants (mean age: 22.26 [3.04]) completed all visits and entered analyses (17 received cannabidiol and 17 received placebo first). Cannabidiol enhanced verbal episodic memory performance (placebo: 7.03 [2.34]; cannabidiol 7.71 [2.48]; adjusted group difference 0.68, 95% CI 0.01 to 1.35; R; 2β; = .028, p = .048). Importantly, we did not detect medication effects on secondary outcome measures attention or working memory performance, suggesting that CBD has no negative impact on these basic cognitive functions. The results are in line with the idea that vaping cannabidiol interacts with the central endocannabinoid system and is capable to modulate memory processes, a phenomenon with possible therapeutic potential. Further studies are needed to investigate optimal dose-response and time-response relationships

Introducing COSMOS: a Web Platform for Multimodal Game-Based Psychological Assessment Geared Towards Open Science Practice

We have established the COgnitive Science Metrics Online Survey (COSMOS) platform that contains a digital psychometrics toolset in the guise of applied games measuring a wide range of cognitive functions. Here, we are outlining this online research endeavor designed for automatized psychometric data collection and scalable assessment: once set up, the low costs and expenditure associated with individual psychometric testing allow substantially increased study cohorts and thus contribute to enhancing study outcome reliability. We are leveraging gamification of the data acquisition method to make the tests suitable for online administration. By putting a strong focus on entertainment and individually tailored feedback, we aim to maximize subjects’ incentives for repeated and continued participation. The objective of measuring repeatedly is obtaining more revealing multitrial average scores and measures from various operationalizations of the same psychological construct instead of relying on single-shot measurements. COSMOS is set up to acquire an automatically and continuously growing dataset that can be used to answer a wide variety of research questions. Following the principles of the open science movement, this data set will also be made accessible to other publicly funded researchers, given that all precautions for individual data protection are fulfilled. We have developed a secure hosting platform and a series of digital gamified testing instruments that can measure theory of mind, attention, working memory, episodic long- and short-term memory, spatial memory, reaction times, eye-hand coordination, impulsivity, humor appreciation, altruism, fairness, strategic thinking, decision-making, and risk-taking behavior. Furthermore, some of the game-based testing instruments also offer the possibility of using classical questionnaire items. A subset of these gamified tests is already implemented in the COSMOS platform, publicly accessible and currently undergoing evaluation and calibration as normative data is being collected. In summary, our approach can be used to accomplish a detailed and reliable psychometric characterization of thousands of individuals to supply various studies with large-scale neurocognitive phenotypes. Our game-based online testing strategy can also guide recruitment for studies as they allow very efficient screening and sample composition. Finally, this setup also allows to evaluate potential cognitive training effects and whether improvements are merely task specific or if generalization effects occur in or even across cognitive domains

Lack of cortisol response in patients with posttraumatic stress disorder (PTSD) undergoing a diagnostic interview

Background: According to DSM-IV, the diagnosis of posttraumatic stress disorder (PTSD) requires the experience of a traumatic event during which the person's response involved intense fear, helplessness, or horror. In order to diagnose PTSD, clinicians must interview the person in depth about his/her previous experiences and determine whether the individual has been traumatized by a specific event or events. However, asking questions about traumatic experiences can be stressful for the traumatized individual and it has been cautioned that subsequent "re-traumatization" could occur. This study investigated the cortisol response in traumatized refugees with PTSD during a detailed and standardized interview about their personal war and torture experiences. Methods: Participants were male refugees with severe PTSD who solicited an expert opinion in the Psychological Research Clinic for Refugees of the University of Konstanz. 17 patients were administered the Vivo Checklist of War, Detention, and Torture Events, a standardized interview about traumatic experiences, and 16 subjects were interviewed about absorption behavior. Self-reported measures of affect and arousal, as well as saliva cortisol were collected at four points. Before and after the experimental intervention, subjects performed a Delayed Matching-to-Sample (DMS) task for distraction. They also rated the severity of selected PTSD symptoms, as well as the level of intrusiveness of traumatic memories at that time. Results: Cortisol excretion diminished in the course of the interview and showed the same pattern for both groups. No specific response was detectable after the supposed stressor. Correspondingly, ratings of subjective well-being, memories of the most traumatic event(s) and PTSD symptoms did not show any significant difference between groups. Those in the presumed stress condition did not perform worse than persons in the control condition after the stressor. However, both groups performed poorly in the DMS task, which is consistent with memory and concentration problems demonstrated in patients with PTSD. Conclusion: A comprehensive diagnostic interview including questions about traumatic events does not trigger an HPA-axis based alarm response or changes in psychological measures, even for persons with severe PTSD, such as survivors of torture. Thus, addressing traumatic experiences within a safe and empathic environment appears to impose no unacceptable additional load to the patient

The prion gene is associated with human long-term memory

Human cognitive processes are highly variable across individuals and are influenced by both genetic and environmental factors. Although genetic variations affect short-term memory in humans, it is unknown whether genetic variability has also an impact on long-term memory. Because prion-like conformational changes may be involved in the induction of long-lasting synaptic plasticity, we examined the impact of single-nucleotide polymorphisms (SNPs) of the prion protein gene (PRNP) on long-term memory in healthy young humans. SNPs in the genomic region of PRNP were associated with better long-term memory performance in two independent populations with different educational background. Among the examined PRNP SNPs, the common Met129Val polymorphism yielded the highest effect size. Twenty-four hours after a word list-learning task, carriers of either the 129MM or the 129MV genotype recalled 17% more information than 129VV carriers, but short-term memory was unaffected. These results suggest a role for the prion protein in the formation of long-term memory in human

CPEB3 is Associated with Human Episodic Memory

Cytoplasmic polyadenylation element-binding (CPEB) proteins are crucial for synaptic plasticity and memory in model organisms. A highly conserved, mammalian-specific short intronic sequence within CPEB3 has been identified as a ribozyme with self-cleavage properties. In humans, the ribozyme sequence is polymorphic and harbors a single nucleotide polymorphism that influences cleavage activity of the ribozyme. Here we show that this variation is related to performance in an episodic memory task and that the effect of the variation depends on the emotional valence of the presented material. Our data suggest a role for human CPEB3 in human episodic memory

Recognition memory performance can be estimated based on brain activation networks

Recognition memory is an essential ability for functioning in everyday life. Establishing robust brain networks linked to recognition memory performance can help to understand the neural basis of recognition memory itself and the interindividual differences in recognition memory performance.; We analysed behavioural and whole-brain fMRI data from 1'410 healthy young adults during the testing phase of a picture-recognition task. Using independent component analysis (ICA), we decomposed the fMRI contrast for previously seen vs. new (old-new) pictures into networks of brain activity. This was done in two independent samples (training sample: N = 645, replication sample: N = 665). Next, we investigated the relationship between the identified brain networks and interindividual differences in recognition memory performance by conducting a prediction analysis. We estimated the prediction accuracy in a third independent sample (test sample: N = 100).; We identified 12 robust and replicable brain networks using two independent samples. Based on the activity of those networks we could successfully estimate interindividual differences in recognition memory performance with high accuracy in a third independent sample (r = 0.5, p = 1.29 × 10; -07; ).; Given the robustness of the ICA decomposition as well as the high prediction estimate, the identified brain networks may be considered as potential biomarkers of recognition memory performance in healthy young adults and can be further investigated in the context of health and disease

Effectiveness of a stand-alone, smartphone-based virtual reality exposure app to reduce fear of heights in real-life: a randomized trial

Smartphone-based virtual reality (VR) applications (apps) might help to counter low utilization rates of available treatments for fear of heights. Demonstration of effectiveness in real-life situations of such apps is crucial, but lacking so far. Objective of this study was to develop a stand-alone, smartphone-based VR exposure app-Easy Heights-and to test its effectiveness in a real-life situation. We performed a single-blind, parallel group, randomized controlled trial. We recruited 70 participants with fear of heights, aged 18-60 years. Primary outcome was performance in a real-life Behavioral Avoidance Test (BAT) on a lookout tower after a single 1-h app use (phase 1) and after additional repeated (6 × 30 min) app use at home (phase 2). After phase 2, but not phase 1, participants in the Easy Heights condition showed significantly higher BAT scores compared to participants in the control condition (Cohen's d = 1.3, p = 0.0001). Repeated use of our stand-alone, smartphone-based VR exposure app reduces avoidance behavior and fear, providing a low-threshold treatment for fear of heights