Precision of a pointing movement performed with either the dominant or non-dominant hand is linked to the timing of anticipatory postural adjustments

Introduction: It is a common experience to feel motor awkwardness when performing a pointing movement with the non-preferred limb, which is known to be associated to less precise movements. Here we provide evidence that this last behaviour partly stems from changes in the temporal organization of the Anticipatory Postural Adjustments (APAs) in the non-preferred side. Materials and methods: We investigated the effect of lateralization on APAs in Biceps Brachii, Triceps Brachii and Anterior Deltoid, which stabilize the arm when performing a pen-pointing movement (prime mover Flexor Carpi Radialis). Moreover, we analysed the elbow and wrist kinematics as well as the precision of the pointing movement. Results: The mean kinematics of wrist movement and its latency, with respect to prime mover recruitment, were similar in the two sides, while APAs in Triceps Brachii, Biceps Brachii and Anterior Deltoid were less anticipated when movements were performed with the non-dominant (20\u201330 ms) versus dominant hand (60\u201370 ms). APAs in the non-dominant limb were associated with an altered fixation of the elbow, which showed a higher excursion, and with a more scattered pointing error (non-dominant: 16.3 \ub1 1.7 mm versus dominant: 10.1 \ub1 0.8 mm). Discussion: By securing the dynamics of the more proximal joints, an appropriate timing of the intra-limb APAs seems necessary for refining the voluntary movement precision. The linkage between APAs, elbow fixation and movement accuracy also agrees with the recent suggestion that APAs and prime mover recruitment are driven by a shared motor command, which strives to obtain an accurate pointing

Anticipatory Postural Adjustments associated with reaching movements are programmed according to the availability of visual information

During goal-directed arm movements, the eyes, head, and arm are coordinated to look at and reach the target. We examined whether the expectancy of visual information about the target modifies Anticipatory Postural Adjustments (APAs). Ten standing subjects had to (1) move the eyes, head and arm, so as to reach, with both gaze and index-finger, a target of known position placed outside their visual field (Gaze-Reach); (2) look at the target while reaching it (Reach in Full Vision); (3) keep the gaze away until having touched it (Reach then Gaze) and (4) just Gaze without Reach the target. We recorded eye, head, right arm, and acromion kinematics, EMGs from upper- and lower-limb muscles, and forces exerted on the ground. In Gaze-Reach, two coordination strategies were found: when gaze preceded arm muscle recruitment (Gaze-first) and when the opposite occurred (Reach-first). APAs in acromion kinematics, leg muscles, and ground forces started significantly earlier in Gaze-first vs. Reach-first (mean time advance: 44.3 \ub1 8.9 ms), as it was in Reach in Full Vision vs. Reach then Gaze (39.5 \ub1 7.9 ms). The Gaze-first to Reach-first time-shift was similar to that between Reach in Full Vision and Reach then Gaze (p = 0.58). Moreover, Gaze without Reach data witnessed that the head-induced postural actions did not affect the APA onset in Gaze-first and Reach-first. In conclusion, in Gaze-first, the central control of posture considers visual information while planning the movement, like in Reach in Full Vision; while Reach-first is more similar to Reach then Gaze, where vision is not required

Intended rather than actual movement velocity determines the latency of anticipatory postural adjustments

The literature reports that anticipatory postural adjustments (APAs) are programmed according to movement velocity. However, the linkage between APAs and velocity has been highlighted within single subjects who were asked to voluntarily change movement velocity; therefore, till now, it has been impossible to discern whether the key factor determining APA latency was the intended movement velocity or the actual one. Aim of this study was to distinguish between these two factors. We analyzed the APA chain that stabilizes the arm during a brisk index finger flexion in two groups of subjects: (1) 29 who composed our database from previous experiments and were asked to "go-as-fast-as-possible" (go-fast), but actually performed the movement with different speeds (238-1180\ub0/s), and (2) ten new subjects who performed the go-fast movement at more than 500\ub0/s and were then asked to go-slow at about 50 % of their initial velocity, thus moving at 300-800\ub0/s. No correlation between APA latency and actual movement speed was observed when all subjects had to go-fast (p > 0.50), while delayed APAs were found in the ten new subjects when they had to go-slow (p < 0.001). Moreover, in the speed range between 300 and 800\ub0/s, the APA latency depended only on movement instruction: subjects going fast showed earlier APAs than those going slow (p < 0.001). These data suggest a stronger role of the intended movement velocity versus the actual one in modifying the timing of postural muscles recruitment with respect to the prime mover. These results also strengthen the idea of a shared postural and voluntary command within the same motor act

Solitary fibrous tumour of the supraglottic larynx.

Solitary fibrous tumour (SFT) is a rare, benign, mesenchymal neoplasm that usually arises in the pleura, but rarely involves other sites outside the serosal space (mediastinum, lung, liver, thyroid gland); larynx involvement is very rare with only sporadic cases reported in the literature. We report a case of SFT in a 41-year-old woman with supraglottic laryngeal invovlement; symptoms included dysphonia and mild odynophagia lasting 2 years, and fibre-optic laryngeal evaluation showed a sub-mucosal mass involving the left supraglottis and medial wall of the pyriform sinus. MRI represents the gold standard tool for differential diagnosis (with schwannoma, paraganglioma and haemangioma) and correct staging, while immunohistochemical and cytomorphologic analysis (bcl-2 and CD34 positivity in 90% of cases) is needed for definitive diagnosis. Surgery is the main treatment (endoscopic and open conservative technique), and its goal is a balance between safe oncological resection and good preservation of laryngeal functions; in this particular case an open laryngeal approach was scheduled due to the size of the tumour. Prognosis is good and in only a few cases (especially in pleural SFT) does the biological behaviour take a malignant course

Endoscopic ultrasonic curette-assisted removal of frontal osteomas

Indications for endoscopic resection of fronto-ethmoidal osteomas have been progressively expanded thanks to optimization of surgical exposure and the development of dedicated instruments. Curved cutting drills are still suboptimal to treat hard osseous neoplasms of the frontal sinus. We present two patients affected by frontal osteoma treated with an endoscopic procedure using an ultrasonic bone curette. The ultrasonic bone curette may be considered an effective tool to reduce soft tissue manipulation, optimize surgical time and accelerate the healing process. However, the technique requires significant shape innovations to reach the lateral recesses and to manage pure intrasinusal lesions

Transcranial direct current stimulation of SMA modulates anticipatory postural adjustments without affecting the primary movement

Recent works provide evidences that anticipatory postural adjustments (APAs) are programmed with the prime mover recruitment as a shared posturo-focal command. However the ability of the CNS to adjust APAs to changes in the postural context implies that the postural and voluntary components should take different pathways before reaching the representation of single muscles in the primary motor cortex. Here we test if such bifurcation takes place at the level of the supplementary motor area (SMA). TDCS was applied over the SMA in 14 subjects, who produced a brisk index-finger flexion. This activity is preceded by inhibitory APAs, carved in the tonic activity of Biceps Brachii and Anterior Deltoid, and by an excitatory APA in Triceps Brachii. Subjects performed a series of 30 flexions before, during and after 20min of tDCS in CATHODAL, ANODAL or SHAM configuration. The inhibitory APA in Biceps and the excitatory APA in Triceps were both greater in ANODAL than in SHAM and CATHODAL configurations, while no difference was found among the latter two (ANODAL vs. SHAM: biceps +26.5%, triceps +66%; ANODAL vs. CATHODAL: biceps +20.5%, triceps: +63.4%; for both muscles, ANOVA p<0.02, Tukey p<0.05). Instead, the APA in anterior deltoid was unchanged in all configurations. No changes were observed in prime mover recruitment and index-finger kinematics. Results show that the SMA is involved in modulating APAs amplitude. Moreover, the differential effect of tDCS observed on postural and voluntary commands suggests that these two components of the motor program are already separated before entering SMA

Overview of the cerebellar function in anticipatory postural adjustments and of the compensatory mechanisms developing in neural dysfunctions

This review aims to highlight the important contribution of the cerebellum in the Anticipatory Postural Adjustments (APAs). These are unconscious muscular activities, accompanying every voluntary movement, which are crucial for optimizing motor performance by contrasting any destabilization of the whole body and of each single segment. Moreover, APAs are deeply involved in initiating the displacement of the center of mass in whole-body reaching movements or when starting gait. Here we present literature that illustrates how the peculiar abilities of the cerebellum (i) to predict, and contrast in advance, the upcoming mechanical events; (ii) to adapt motor outputs to the mechanical context, and (iii) to control the temporal relationship between task-relevant events, are all exploited in the APA control. Moreover, recent papers are discussed which underline the key role of cerebellum ontogenesis in the correct maturation of APAs. Finally, on the basis of a survey of animal and human studies about cortical and subcortical compensatory processes that follow brain lesions, we propose a candidate neural network that could compensate for cerebellar deficits and suggest how to verify such a hypothesis

Direct-current stimulation of posterior tibial nerve modulates the Soleus H-reflex amplitude

Introduction: Several studies demonstrated that transcranial direct current stimulation (tDCs) is a promising non-invasive tool able to modulate the excitability of several CNS structures. Its effect is usually facilitatory when using anodal polarity and inhibitory for the cathodal one. In most studies, DC stimulation was applied on cortical or spinal structures, while little is known about its effect on peripheral nerves fibres. This research aims at highlighting such effect. Methods: In twenty subjects, electrical stimulation of the posterior tibial nerve (1 ms current pulses, 1 shock every 9 s) was used to elicit the H-re\ufb02ex in the Soleus muscle. Once the H-re\ufb02ex amplitude was stable for at least 15 min, DCs (either cathodal or anodal) was applied proximally to the same nerve for 10 min, looking for changes in re\ufb02ex amplitude. Then, the H-re\ufb02ex was measured for 30 further minutes, looking for after-effects. Results: Cathodal DCs induced a significant increase of the H-re\ufb02ex amplitude (about +35%) with respect to the control value. In this configuration the after-effect lasted about 25 min. Anodal DCs induced instead a significant decrease (about -25%) of the re\ufb02ex amplitude. A significant after-effect was observed for just about 5 min. Discussion: This study shows that DCs applied to a peripheral nerve is able to elicit neuromodulation. Its polarity dependence suggests a local change in the excitability of nerve fibres rather than a central modulation of the spinal re\ufb02ex circuit. Moreover it is worth to note that the polarity dependence was opposite to what found for tDCS

La realcalinización y la extracción electroquímica de los cloruros en las construcciones de hormigón armado

Realkalisation and electrochemical chloride removal techniques, developed for rehabiliting carbonated and chloride-containing structures, are presented. Electrolysis and electromigration mechanisms and consequences as well as electrochemical conditions at the reinforcement surface are discussed and compared with cathodic protection ones. Furthermore, possible side effects are commented