Lidia Yágüez

Representations of graphomotor trajectories in the human parietal cortex: Evidence for controlled processing and automatic performance

The aim of this study was to identify the cerebral areas activated during kinematic processing of movement trajectories. We measured regional cerebral blood flow (rCBF) during learning, performance and imagery of right‐hand writing in eight right‐handed volunteers. Compared with viewing the writing space, increases in rCBF were observed in the left motor, premotor and frontomesial cortex, and in the right anterior cerebellum in all movement conditions, and the increases were related to mean tangential writing velocity. No rCBF increases occurred in these areas during imagery. Early learning of new ideomotor trajectories and deliberately exact writing of letters both induced rCBF increases in the cortex lining the right intraparietal sulcus. In contrast, during fast writing of overlearned trajectories and in the later phase of learning new ideograms the rCBF increased bilaterally in the posterior parietal cortex. Imagery of ideograms that had not been practised previously activated the anterior and posterior parietal areas simultaneously. Our results provide evidence suggesting that the kinematic representations of graphomotor trajectories are multiply represented in the human parietal cortex. It is concluded that different parietal subsystems may subserve attentive sensory movement control and whole‐field visuospatial processing during automatic performance.

The effects on cognitive functions of a movement-based intervention in patients with Alzheimer's type dementia: a pilot study

To explore the effect of a non‐aerobic movement based activity on cognition in people with Alzheimers type dementia (AD).

Cognitive Modulation of the Cerebral Processing of Human Oesophageal Sensation using Functional Magnetic Resonance Imaging

Background: While cortical processing of visceral sensation has been described, the role that cognitive factors play in modulating this processing remains unclear. Aim: To investigate how selective and divided attention modulate the cerebral processing of oesophageal sensation. Methods: In seven healthy volunteers (six males, mean age 33 years; ranging from 24 to 41 years old) from the general community, phasic visual and oesophageal (non-painful balloon distension) stimuli were presented simultaneously. During the selective attention task, subjects were instructed to press a button either to a change in frequency of oesophageal or visual stimuli. During a divided attention task, subjects received simultaneous visual and oesophageal stimuli and were instructed to press a button in response to a change in frequency of both stimuli. Results: Selectively focussing attention on oesophageal stimuli activated the visceral sensory and cognitive neural networks (primary and secondary sensory cortices and anterior cingulate cortex respectively) while selective attention to visual stimuli primarily activated the visual cortex. When attention was divided between the two sensory modalities, more brain regions in the sensory and cognitive domains were utilised to process oesophageal stimuli in comparison to those employed to process visual stimuli (p = 0.003). Conclusion: Selective and divided attention to visceral stimuli recruits more neural resources in both the sensory and cognitive domains than attention to visual stimuli. We provide neurobiological evidence that demonstrates the biological importance placed on visceral sensations and demonstrate the influence of cognitive factors such as attention on the cerebral processing of visceral sensation.

Effects of attention on visceral stimulus intensity encoding in the male human brain.

BACKGROUND & AIMS Hypervigilance is considered important in pain perception in functional gastrointestinal disorders. Nonetheless, a comprehensive assessment of the influence of attention on brain processing of visceral sensation has not been performed. We investigated the effects of attention on esophageal pain perception and brain activity. METHODS Twelve healthy male volunteers (age range, 21-32 years) underwent 4 functional magnetic resonance imaging scans incorporating 4 levels of esophageal stimulation (ES), ranging from nonpainful to painful, during which they completed a task aimed at distracting them from the esophageal stimulus. The volunteers were then scanned a fifth time, during painful stimulation without distraction. RESULTS Following ES during distraction, there was a significant linear trend (P < .05) in which the intensity of cerebral activation in the primary somatosensory cortex (SI) (bilateral) and left mid-anterior cingulate cortex (ACC) increased with stimulation intensity. When pain was delivered during distraction, there was a significant reduction in pain ratings, accompanied by significant decreases (P < .05) in brain activity in the right ACC and right prefrontal cortex. There was no effect of distraction on SI activity (P < .05). CONCLUSIONS Our results suggest that the SI is involved in processing sensory-discriminative aspects of visceral sensation. In contrast, activity in the mid-ACC suggests that this region is multifunctional because it appears to be involved in sensory and cognitive appraisal of visceral pain; the right prefrontal cortex seems to be involved in only cognitive responses to pain.

Motor learning by imagery is differentially affected in Parkinson's and Huntington's diseases.

Studies of motor imagery and motor learning have thus far been concerned only with its effects on healthy subjects. Therefore, in order to investigate the possible involvement of the basal ganglia, the effectiveness of motor imagery in the acquisition of motor constants in a graphomotor trajectorial learning task was examined in 11 non-demented mildly affected Huntingtons disease (HD) patients and 12 non-demented Parkinsons disease (PD) patients. The patients received, after baseline, 10 min of motor imagery training, followed by a motor practice phase. Additionally, a test battery for visual imagery abilities was administered in order to investigate possible relations between visual and motor imagery. The results showed that imagery training alone enabled the HD patients to achieve a significant approach to movement isochrony, whereas the PD patients showed no marked improvements, either with motor imagery or with motor practice. Furthermore, the PD patients had more difficulties than the HD patients in solving the visual imagery tasks. Subsequent correlational analysis revealed significant relationships between the degree of caudate atrophy in the HD patients and their performance in the visual imagery tasks. However, there were no substantial correlations between the performance on the visual imagery tasks and the improvement of motor performance through motor imagery, which indicates that visual and motor imagery are independent processes. It is suggested that the dopaminergic input to the basal ganglia plays an important role in the translation of motor representations into motor performance, whereas the caudate nucleus atrophy of the HD patients does not seem to affect motor imagery, but only the visual imagery process. Furthermore, the deficits found in PD patients might also be related to their limited attentional resources and difficulties in employing predictive motor strategies.

Neural correlates of visuospatial imagery.

We studied changes in regional cerebral blood flow (rCBF) in 10 healthy right-handed subjects during a visuospatial imagery task. The subjects task consisted of drawing imagined lines connecting encircled numbers in ascending order and estimating the number of lines crossing. Compared with a control task in which there were no crossed lines, there were significant rCBF increases in the cingulate gyrus, the adjacent superior frontal gyrus and in the left inferior parietal cortex. The rCBF changes of the latter area correlated with task performance time. Since these activation areas are close to those in imagery of movement trajectories, we concluded that they appear to be a subsystem for processing mental visuospatial images.

Hemispheric dissociation of visual-pattern processing and visual rotation

We aimed at investigating whether on-line and delayed visual pattern processing activated different areas in human prefrontal and parietal cortex. For this purpose we measured the regional cerebral blood flow (rCBF) during simultaneous and successive visual matrix processing in 10 right-handed subjects. Delayed matching to sample activated predominantly left hemispheric ventrolateral prefrontal cortex, Brocas area and parts of the parietal cortex. In contrast, visuospatial matrix rotation showed activation of the right dorsolateral prefrontal cortex and parietal lobe. The present results suggest a hemispheric dissociation of fronto-parietal circuits with a left dominance for visual pattern processing like storage and a right dominance for visuospatial processing.

Cognitive predictors of cognitive change following bilateral subthalamic nucleus deep brain stimulation in Parkinson’s disease

The beneficial effects of deep brain stimulation (DBS) of the subthalamic nucleus (STN) for the motor symptoms in advanced Parkinsons disease (PD) are well established. Early in PD, mild cognitive impairment is present in a proportion of patients. Hence, it can also be present in PD patients considered for DBS. The potential impact of even a modest decline post-surgically is a concern because it could result in impaired cognitive function. Therefore, attempts to determine which pre-operative cognitive measures predict post-operative cognitive change warrant further attention. We report our findings in a cohort of 30 routinely operated non-demented patients who underwent detailed neuropsychological assessments on average 7.1 months before and 9.4 months after STN DBS. We report the individual and group differences pre- and post-DBS. Stepwise regression analysis was used to analyse the best cognitive predictors of post-operative cognitive changes. We describe our data in relation to published normative data. Post-STN DBS, the immediate story recall component of verbal memory was the most affected cognitive function showing a significant decline in its group mean with a large effect size. The best predictors for this change were pre-surgical list learning and Full Scale Intelligence Quotient. These results suggest that non-demented patients, with even mild impairments in both general intellectual functions and list learning, may be at greater risk of decline in other aspects of verbal memory after STN DBS. Pre-existing mild executive dysfunction was not influenced post-operatively. These findings may help selection and consent for STN DBS.

Factors associated with multiple re-admission to a psychiatric hospital

Background: Previous studies have attempted to identify various demographic and associated factors which place psychiatric service users at risk of re-admission to a psychiatric hospital following discharge. Aims: To conduct a 2-year follow-up of a group of patients who had been admitted to a psychiatric ward and to investigate possible variables that could determine readmission to hospital. Method: A cross sectional and a two year longitudinal design were used. Results: “Revolving-door” service users were more likely to be taking medication, were younger at age of first contact with services, and had been using services for longer. They were also more likely to be living in council housing, which is, housing provided by and subsidised by local government, and have a diagnosis of affective disorder. There were no differences between the previous cohort and the current sample in terms of demographics, and history of contact with services. A larger proportion of service users met the “revolving-door” criteria during the present study as compared to our previous study. There were some differences between the current and previous study in terms of accommodation at discharge, diagnosis, and social living status. Conclusions: Several variables were shown to predict membership in the “revolving-door” group and findings replicate Langdon et al. (), although there were differences. “Revolving-door” patients may have more enduring and chronic mental illnesses, but were similar to their “non-revolving door” counterparts on some variables. Research of this nature is difficult given the cross-sectional nature of studies, and a lack of a clear consensus within the literature as to which factors are associated with “revolving-door” service users remains. Declaration of interest: None.

Differential effect of Huntington's and Parkinson's diseases in programming motor sequences of varied lengths

AbstractBackgroundParkinsons disease (PD) and Huntingtons disease (HD) patients have difficulties executing sequential movements. Attention control and short–term memory probably play an important role in programming sequential movements. To investigate the contribution of these cognitive factors to programming and executing visuomotor sequences in HD and PD patients a computerized version of the Corsi Block Tapping–Test was employed.Methodsthe performance of 11 patients with early stage PD, 11 HD patients with borderline to mild caudate atrophy and 20 healthy subjects was compared. The task was a reaction time task where targets were illuminated in groups of sequences increasing from 2 items to 5 items. Subjects reproduced the sequence (pressing the illuminated target) in the same order of appearance. Reaction Times and movement times were recorded.ResultsPD patients had increasing difficulties in programming and executing series greater than three components. HD patients did not differ significantly from the controls, although they showed a tendency to lose accuracy in the longer series. Both patient groups did not differ in their attention span.ConclusionsIn PD although the spatial information may be well stored, they have difficulty accessing it when their attention is overloaded, leading to poor encoding and slow information processing. This process interferes with programming and execution of movement sequences. HD patients in the early stages of the illness seem to have more attention resources than PD patients, so that they start to show more problems in executing visuomotor sequences with longer movement sequences than PD patients.