Charles-Etienne Benoit

Musically cued gait-training improves both perceptual and motor timing in Parkinson's disease.

It is well established that auditory cueing improves gait in patients with idiopathic Parkinson’s disease (IPD). Disease-related reductions in speed and step length can be improved by providing rhythmical auditory cues via a metronome or music. However, effects on cognitive aspects of motor control have yet to be thoroughly investigated. If synchronization of movement to an auditory cue relies on a supramodal timing system involved in perceptual, motor, and sensorimotor integration, auditory cueing can be expected to affect both motor and perceptual timing. Here, we tested this hypothesis by assessing perceptual and motor timing in 15 IPD patients before and after a 4-week music training program with rhythmic auditory cueing. Long-term effects were assessed 1 month after the end of the training. Perceptual and motor timing was evaluated with a battery for the assessment of auditory sensorimotor and timing abilities and compared to that of age-, gender-, and education-matched healthy controls. Prior to training, IPD patients exhibited impaired perceptual and motor timing. Training improved patients’ performance in tasks requiring synchronization with isochronous sequences, and enhanced their ability to adapt to durational changes in a sequence in hand tapping tasks. Benefits of cueing extended to time perception (duration discrimination and detection of misaligned beats in musical excerpts). The current results demonstrate that auditory cueing leads to benefits beyond gait and support the idea that coupling gait to rhythmic auditory cues in IPD patients relies on a neuronal network engaged in both perceptual and motor timing.

BAASTA: Battery for the Assessment of Auditory Sensorimotor and Timing Abilities

The Battery for the Assessment of Auditory Sensorimotor and Timing Abilities (BAASTA) is a new tool for the systematic assessment of perceptual and sensorimotor timing skills. It spans a broad range of timing skills aimed at differentiating individual timing profiles. BAASTA consists of sensitive time perception and production tasks. Perceptual tasks include duration discrimination, anisochrony detection (with tones and music), and a version of the Beat Alignment Task. Perceptual thresholds for duration discrimination and anisochrony detection are estimated with a maximum likelihood procedure (MLP) algorithm. Production tasks use finger tapping and include unpaced and paced tapping (with tones and music), synchronization-continuation, and adaptive tapping to a sequence with a tempo change. BAASTA was tested in a proof-of-concept study with 20 non-musicians (Experiment 1). To validate the results of the MLP procedure, less widespread than standard staircase methods, three perceptual tasks of the battery (duration discrimination, anisochrony detection with tones, and with music) were further tested in a second group of non-musicians using 2 down / 1 up and 3 down / 1 up staircase paradigms (n = 24) (Experiment 2). The results show that the timing profiles provided by BAASTA allow to detect cases of timing/rhythm disorders. In addition, perceptual thresholds yielded by the MLP algorithm, although generally comparable to the results provided by standard staircase, tend to be slightly lower. In sum, BAASTA provides a comprehensive battery to test perceptual and sensorimotor timing skills, and to detect timing/rhythm deficits.

Gait improvement via rhythmic stimulation in Parkinson’s disease is linked to rhythmic skills

Training based on rhythmic auditory stimulation (RAS) can improve gait in patients with idiopathic Parkinson’s disease (IPD). Patients typically walk faster and exhibit greater stride length after RAS. However, this effect is highly variable among patients, with some exhibiting little or no response to the intervention. These individual differences may depend on patients’ ability to synchronize their movements to a beat. To test this possibility, 14 IPD patients were submitted to RAS for four weeks, in which they walked to music with an embedded metronome. Before and after the training, patients’ synchronization was assessed with auditory paced hand tapping and walking to auditory cues. Patients increased gait speed and stride length in non-cued gait after training. However, individual differences were apparent as some patients showed a positive response to RAS and others, either no response, or a negative response. A positive response to RAS was predicted by the synchronization performance in hand tapping and gait tasks. More severe gait impairment, low synchronization variability, and a prompt response to a stimulation change foster a positive response to RAS training. Thus, sensorimotor timing skills underpinning the synchronization of steps to an auditory cue may allow predicting the success of RAS in IPD.

“Lost in time” but still moving to the beat

ABSTRACT Motor synchronization to the beat of an auditory sequence (e.g., a metronome or music) is widespread in humans. However, some individuals show poor synchronization and impoverished beat perception. This condition, termed “beat deafness”, has been linked to a perceptual deficit in beat tracking. Here we present single‐case evidence (L.A. and L.C.) that poor beat tracking does not have to entail poor synchronization. In a first Experiment, L.A., L.C., and a third case (L.V.) were submitted to the Battery for The Assessment of Auditory Sensorimotor and Timing Abilities (BAASTA), which includes both perceptual and sensorimotor tasks. Compared to a control group, L.A. and L.C. performed poorly on rhythm perception tasks, such as detecting time shifts in a regular sequence, or estimating whether a metronome is aligned to the beat of the music or not. Yet, they could tap to the beat of the same stimuli. L.V. showed impairments in both beat perception and tapping. In a second Experiment, we tested whether L.A., L.C., and L.V.s perceptual deficits extend to an implicit timing task, in which they had to respond as fast as possible to a different target pitch after a sequence of standard tones. The three beat‐deaf participants benefited similarly to controls from a regular temporal pattern in detecting the pitch target. The fact that synchronization to a beat can occur in the presence of poor perception shows that perception and action can dissociate in explicit timing tasks. Beat tracking afforded by implicit timing mechanisms is likely to support spared synchronization to the beat in some beat‐deaf participants. This finding suggests that separate pathways may subserve beat perception depending on the explicit/implicit nature of a task in a sample of beat‐deaf participants. HighlightsSome people cannot perceive the rhythm of music but can still move to its beat.They can process temporal regularity when they do not pay attention to the rhythm.Implicit perception of rhythm may support motor synchronization to the beat.

Cognitive task avoidance correlates with fatigue-induced performance decrement but not with subjective fatigue

&NA; Mentally demanding tasks feel effortful and are usually avoided. Furthermore, prolonged cognitive engagement leads to mental fatigue, consisting of subjective feeling of exhaustion and decline in performance. Despite the intuitive characterization of fatigue as an increase in subjective effort perception, the effect of fatigue on effort cost has never been tested experimentally. To this end, sixty participants in 2 separate experiments underwent a forced‐choice working memory task following either a fatigue‐inducing (i.e. cognitive task involving working memory, conflict and switch costs) or a control manipulation. We measured fatigue in terms of subjective feeling and performance decrement and assessed effort in terms of subjective perception and task avoidance. Subjects exhibited only weak avoidance of the working memory task, with stronger influence of reward than task difficulty on their decisions. In addition, we found that task avoidance did not systematically change following the fatigue manipulation but that variations in task avoidance correlated with fatigue‐induced performance decline. The other measures of fatigue and effort were unrelated to each other. Our findings suggest that subjective fatigue may develop independently of task avoidance and suggest an “anticipatory regulation” model in which fatigue urges subjects to stop in anticipation of possible, future adverse consequences.

Test-retest reliability of the Battery for the Assessment of Auditory Sensorimotor and Timing Abilities (BAASTA)

Perceptual and sensorimotor timing skills can be thoroughly assessed with the Battery for the Assessment of Auditory Sensorimotor and Timing Abilities (BAASTA). The battery has been used for testing rhythmic skills in healthy adults and patient populations (e.g., with Parkinson disease), showing sensitivity to timing and rhythm deficits. Here we assessed the test-retest reliability of the BAASTA in 20 healthy adults. Participants were tested twice with the BAASTA, implemented on a tablet interface, with a 2-week interval. They completed 4 perceptual tasks, namely, duration discrimination, anisochrony detection with tones and music, and the Beat Alignment Test (BAT). Moreover, they completed motor tasks via finger tapping, including unpaced and paced tapping with tones and music, synchronization-continuation, and adaptive tapping to a sequence with a tempo change. Despite high variability among individuals, the results showed good test-retest reliability in most tasks. A slight but significant improvement from test to retest was found in tapping with music, which may reflect a learning effect. In general, the BAASTA was found a reliable tool for evaluating timing and rhythm skills.

Locus Coeruleus atrophy doesn’t relate to fatigue in Parkinson’s disease

Fatigue is a frequent complaint among healthy population and one of the earliest and most debilitating symptoms in Parkinson’s disease (PD). Earlier studies have examined the role of dopamine and serotonin in pathogenesis of fatigue, but the plausible role of noradrenalin (NA) remains underexplored. We investigated the relationship between fatigue in Parkinsonian patients and the extent of degeneration of Locus Coeruleus (LC), the main source of NA in the brain. We quantified LC and Substantia Nigra (SN) atrophy using neuromelanin-sensitive imaging, analyzed with a novel, fully automated algorithm. We also assessed patients’ fatigue, depression, sleep disturbance and vigilance. We found that LC degeneration correlated with the levels of depression and vigilance but not with fatigue, while fatigue correlated weakly with atrophy of SN. These results indicate that LC degeneration in Parkinson’s disease is unlikely to cause fatigue, but may be involved in mood and vigilance alterations.

Objective but not subjective fatigue increases cognitive task avoidance

Mentally demanding tasks feel effortful and are usually avoided. Furthermore, prolonged cognitive engagement leads to mental fatigue, consisting of subjective feeling of exhaustion and decline in performance. Despite the intuitive characterization of fatigue as an increase in subjective effort perception, the effect of fatigue on effort cost has never been tested experimentally. To this end, sixty participants in 2 separate experiments underwent a forced-choice working memory task following either a fatigue-inducing (i.e. Stroop task) or a control manipulation. We measured subjective fatigue and effort as well as their objective behavioral signatures: performance decline and task avoidance, respectively. We found that fatigue-induced performance decline was correlated with task avoidance, while the feelings of fatigue and effort were unrelated to each other. Our findings highlight the discrepancy between subjective and objective manifestations of fatigue and effort, and provide valuable evidence feeding the ongoing theoretical debate on the nature of these constructs.