• Introduction: The differentiation of voluntary and involuntary movements represents a crucial challenge for observers, particularly providers who face the behaviors in an emergency.
• Methods: An algorithm is developed to classify movements as voluntary or involuntary are identified. Red flags to identify movements that require treatment or restraint are presented.

• Results and Discussion:

Involuntary movements include the broad class of movement disorders, including (A) movement disorders with identified pathophysiology and (B) functional movement disorders, a wide variety of movements that may or may not resemble movement disorders with identified pathophysiology.

Voluntary movements include (A) motions deliberately performed by persons to express exuberance such as applause and zaghrouta and (B) motions deliberately performed by persons to deceive others, such as (A) malingering, the fabrication of actions in order to avoid jail, work, school, and to obtain financial and other rewards, and (B) Münchausen syndrome, the fabrication of symptoms and signs to seek medical attention and treatment. Identification of functional movement disorders and fabricated voluntary movements is crucial to avoid providing inappropriate interventions, such as medications and surgeries with significant risks and no beneficial effects.

Electrophysiological and motion measurements may facilitate the identification of voluntary movements. For example, a Bereitschaftspotential, a surface-negative electrical brain potential identified on electroencephalograph (EGG), can identify self-initiated voluntary acts.

• Conclusions

Neuroscientists can benefit from the proposed algorithm to differentiate voluntary and involuntary movements particularly in emergent situations to determine when interventions are required and contraindicated.

The imbalance between the speed and accuracy of cognitive-motor operations can lead to the formation of abnormal behavioral programs fraught with serious negative consequences for the individual. For successful correction and prevention of social disadaptation in adolescents with nervous and mental diseases and functional disorders in mental sphere in general education schools, the peculiarities of their psychomotor activity should be taken into account.

We measured some parameters of psychomotor coordination in adolescents, students of a specialized school for psychiatric patients in remission. Based on their medical records, these students were divided into two groups: adolescents with neuropsychiatric diagnoses and sequelae of organic brain damage (n = 37) and adolescents with mental disorders without organic brain damage (n = 28). The control group consisted of healthy adolescents from a secondary school (n = 70). During simple motor tests, the trajectory of horizontal movement of the arm "from elbow to fingers" was recorded. During cyclic (right – left) movements of the lever within the range marked by external light markers, adolescents with mental disorders from both groups showed higher speed, but poorer accuracy and smoothness of movements than healthy participants. The latencies of the sensorimotor response to light and acoustic stimuli in adolescents with mental disorders without organic brain damage were longer than in the control group. These results are included in a comprehensive database for large-scale health monitoring in schoolchildren.

Background

Intraoperative ultrasound (ioUS) images of brain tumors contain information that has not yet been exploited. The present work aims to analyze images in both B-mode and strain-elastography using techniques based on artificial intelligence and radiomics. We pretend to assess the capacity for differentiating glioblastomas (GBM) from solitary brain metastases (SBM) and also to assess the ability to predict the overall survival (OS) in GBM.

Methods

We performed a retrospective analysis of patients who underwent craniotomy between March 2018 to June 2020 with GBM and SBM diagnoses. Cases with an ioUS study were included. In the first group of patients, an analysis based on deep learning was performed. An existing neural network (Inception V3) was used to classify tumors into GBM and SBM. The models were evaluated using the area under the curve (AUC), classification accuracy, and precision. In the second group, radiomic features from the tumor region were extracted. Radiomic features associated with OS were selected employing univariate correlations. Then, a survival analysis was conducted using Cox regression.

Results

For the classification task, a total of 36 patients were included. 26 GBM and 10 SBM. Models were built using a total of 812 ultrasound images. For B-mode, AUC and accuracy values of the classification algorithms ranged from 0.790 to 0.943 and from 72 to 89 % respectively. For elastography, AUC and accuracy values ranged from 0.847 to 0.985 and from 79 to 95 % respectively. Sixteen patients were available for the survival analysis. A total of 52 radiomic features were extracted. Two texture features from B-mode (Conventional mean and GLZLM_SZLGE) and one texture feature from strain-elastography (GLZLM_LZHGE) were significantly associated with OS.

Conclusion

Automated processing of ioUS images through deep learning can generate high-precision classification algorithms. Radiomic tumor region features in B-mode and elastography appear to be significantly associated with OS in GBM.

In Arabic, two-digit numbers are read from right to left, i.e. the unit digit precedes the decade digit (24 = four and twenty) in accordance to the text reading and writing direction but opposite to the math direction (left-to-right).

The current study investigated the effect of the syntactic representation of numbers in Arabic on the task of transcoding two-digit numbers from dictation. The study participants were primary, junior-high and high school pupils in addition to higher education students with Arabic as their first language. They performed transcoding task, namely writing two-digit numbers from dictation. Units first\decades first writing patterns were collected depending on the differential syntactics structure evident in the two-digit number dictated (Teens numbers-units first, Identical units and decades- units first, Whole tens- decades firs, the rest remaining two-digit numbers-units first).

The findings reveal that in general Arabic speakers adopt decades first writing pattern of two-digit numbers especially when it is consistent with syntactic structure of two-digit numbers as in whole tens. This first decade writing pattern becomes more evident in junior-high school, high school and higher education since the proficiency and skills in math, second and third languages improves. However, this pattern is modulated depending on a complexity of the units and decades structure that requires more working memory capacity. This complexity is more pronounced in two-digit numbers, where the numerical syntactic structure is more evident than in numbers with a less prominent numerical syntactic structure (numbers 19-12) or in identical units and decades numbers compared to the remaining two-digit numbers category (with an evident syntactic structure of units and decades). Additionally, influences were claimed because of the consistency or inconsistency between the reading direction of text (Right-to-Left), two-digit numbers reading (Right-to-Left) in Arabic and math writing direction taught (Left-to-Right) placing less or more load on working memory.

The basement of the vertebrate motor system is flexor reflex whilst the extensor thrust supposed to be an optional factor for the stepping. But different forms of stepping (in opposite directions) could be differently depending upon it, since the sensory input is crucial for the stepping. The most investigated is forward stepping (FW) being the most “learned” in both phylogeny and ontogeny. In opposite, the backward (BW) stepping is associated with mostly the specific forms of behavioral activity. We compared an EMG activity of several hindlimb muscles moved the hip (iliopsoas, IP, sartorius (SR), adductor magnus (AM), biceps femoris posterior (BFP)), knee (rectus femoris (RF), vastus medialis (VM)), and ankle (tibialis anterior (TA), gastrocnemius medialis (GM), soleus (SL)) joints, in decerebrate cats stepped under epidural electrical stimulation. For most cats, an activity of hip flexors (IP, SR) was lower, hip extensors (AM, BFP) – higher, knee extensors (RF and VM) – lower, ankle flexor (TA) – lower, ankle extensor (GM) – higher for BW stepping than for FW stepping. For all muscles but SR (with minimal sample size) differences were statistically significant (Wilcoxon test). Only in SL, no clear predominance for any stepping mode was obtained. These data point out to different balance in flexion and extension during stepping in opposite directions.

The renin–angiotensin system (RAS) not only plays an important role in controlling blood pressure but also participates in almost every process to maintain homeostasis in mammals. The occurrence of RAS in the basal ganglia suggests that the system may be targeted to improve the therapy of neurodegenerative diseases. We found heteromers formed by Mas and angiotensin receptors and addressed their functionality in neurons and microglia. Novel interactions formed by MAS/AT₁R and MAS/AT₂R were discovered by using resonance energy transfer techniques. In the heterologous system, we showed that the three receptors—MasR, AT₁R, and AT₂R—can interact to form heterotrimers. The functionality of individual and interacting receptors was assayed by measuring levels of the second messengers cAMP and Ca²⁺ in transfected human embryonic kidney cells (HEK-293T) and primary cultures of striatal cells. Functionality and expression were assayed in parallel in primary cultures of microglia treated or not with lipopolysaccharide and interferon-γ (IFN-γ) to simulate neuroinflammation conditions. The proximity ligation assay (PLA) was used to assess heteromer expression in parkinsonian and dyskinetic conditions. In all cases, agonist-induced signaling was reduced upon coactivation, and in some cases just by coexpression. Also, the blockade of signaling of two receptors in a complex by the action of a given (selective) receptor antagonist (cross-antagonism) was often observed. The negative modulation of calcium mobilization (mediated by AT₁R activation), the multiplicity of possibilities on RAS affecting the MAPK pathway, and the disbalanced expression of heteromers in dyskinesia yield new insight into the operation of the RAS system, how it becomes unbalanced, and how a disbalanced RAS can be rebalanced. Furthermore, RAS components in activated microglia warrant attention in drug-development approaches to address neurodegeneration.

Parkinson's disease dementia (PDD) is frequently found in patients with Parkinson’s disease (PD). Identifying early stage of Parkinson's disease dementia is an important primary goal of dementia treatment because it is possible to delay the progression of dementia when dementia is detected and treated in an early stage. However, the sociodemographic and neuropsychological characteristics of early stage PDD are less known than those of Alzheimer's dementia or vascular dementia. The objectives of this study were to develop a PDD prediction model considering environmental factors, health behaviors, physical functions, depression, medical history, and cognitive functions (eg. neuropsychological profile) by using the “Parkinson’s Dementia registry Data​​​​​​​,” a nationwide survey. This study analyzed 289 Parkinson patients (110 PDD patients and 179 PD-MCI), young than 65 years. The PDD prediction model was developed using a optimal scaling regression (It is also called categorical regression with optimal scaling). The results presented the optimization scale as an ordinal spline (graph). In addition, the quantification index (HAYASI I score) of each neuropsychological test for optimal prediction of PDD was presented. Based on this study, it will be needed to develop a customized screening test that can early detect PDD using medical big data.

Background: Migraine is one of the most prevalent neurological disorders worldwide. A large number of studies suggest that migraines are associated with the mental state of the patients, and specially with negative emotions. One option to regulate negative emotions or the negative affective state in chronic migraine patients is by using visual feedback techniques that may induce visually induced analgesia. In fact, it is known that the observation of facial expressions effectively modulates pain perception during social interaction.

Aim: To investigate whether the exposure to different visual feedback conditions (facial expressions) may modulate pain perception assessed by the 1 to 100 cm visual analogue scale in chronic migraine patients.

Methods: To this aim 38 female chronic migraine patients were recruited at the IRCCS C. Mondino Foundation. Participants were exposed to a 1x4 within-subject study design, where they had to observe different visual stimuli (positive face, neutral face, negative face, and control (white screen)), presented 3 times in a randomized order (each condition lasted 40 seconds). After the observation of each visual condition pain ratings with a 0 to 100 VAS and identification scores in a Likert scale from -3 (not identification at all) to 3 (total identification) were assessed.

Results: The results show a significant difference in pain ratings between the positive (32.44±31) and the negative (38.61±29.74) (z=-4.46, p<0.0001), and the neutral facial expression (37.15±28.36) (z=3.41, p<0.001). Participants felt more identified with the neutral face condition compared to the negative face condition (z=3.32, p<0.05). Overall, the patients felt more identified with the three emotional face conditions than with the white screen control condition.

Conclusions: A positive emotional face feedback is a stimulus strong enough to modulate pain perception via the mediation of emotion regulation for positive emotions. This study paves the way to the integration of new cognitive-behavioural training based on the adoption of visual placebo analgesia to further control pain perception in chronic migraine patients.

Background: Assessment of the impact of lipid profile on the effects of rehabilitation in individuals with stroke at a chronic stage of recovery, relative to the type of stroke, sex and BMI.

Methods: The study was conducted in a spa facility and involved 24 patients with chronic stroke, aged over 50 years. The patients were divided into two groups, comprising those with normal and with elevated lipid profile values. All the patients received spa therapy in course of a three-week rehabilitation program at a health resort. The examinations were carried out twice: Exam I upon admission to and Exam II on the day of discharge from the spa facility. The study assessed the lipid panel values in relation to the effectiveness of the rehabilitation program, as reflected by scores in Barthel scale, Berg scale, and Rankin scale.

Results: The present study showed a statistically significant relationship in the short-term exam with Rankin scale in patients with ischemic stroke (p=0.047). It was also observed that both the short-term and the long-term effect measured with Berg scale tended to decrease with higher LDL (rho= -0.738) and with higher total cholesterol (rho= -0.740) in patients with obesity.

Conclusions: The present study showed a difference in the effects of rehabilitation in patients with normal lipid profile values versus those with high lipid profile values relative to the type of stroke. Better effects of rehabilitation were observed in patients with ischemic stroke. Furthermore, effectiveness of the rehabilitation program according to Berg scale was lower in patients with obesity and with higher LDL and CH. However, the current findings must be treated as preliminary due to the small size of the study group. Further research should take into account a larger population of patients at a chronic stage of recovery post-stroke.

Introduction

　During static muscle contractions, there are two load types: maintenance of a joint angle against internal and external forces (position-control task) and maintenance of a constant force against a rigid resistance (force-control task). Previous studies have reported that heteronymous monosynaptic Ia facilitation was greater while homonymous inhibition was smaller in the position-control task as compared to the force-control task, even though a similar net torque was generated in both tasks. However, a difference in afferent cutaneous processing between these two tasks has not been fully understood. The aim of this study was to determine whether cutaneous stimulus registration and information processing differ between these two tasks by investigating the amplitude of cutaneomuscular reflex (CMR) and the gating of somatosensory evoked potentials (SEPs).

Methods

Eighteen healthy participants performed position- and force-control tasks with matched loads (20 % maximum voluntary contraction) with the right index finger. During each task, electrical stimulation was applied to the right index finger, and CMR and SEPs were recorded from the right first dorsal interosseous muscle and C3’ of the International 10–20 system, respectively.

Results

The E2 amplitude of CMR and the reduction of N33 amplitude of SEPs were greater in force-control than position-control task.

Conclusions

These results suggest that processing of cutaneous sensation is enhanced in force-control than position-control task, and, together with the previous study demonstrating the greater proprioceptive sensory processing in the position-control task, this study may contribute to the development of rehabilitation exercise programs.