Neurorehabilitation of the upper extremity - immersive virtual reality vs. electromechanically assisted training. A comparative study.

Background: Severe paresis of the contralesional upper extremity is one of the most common and debilitating post-stroke impairments. The need for cost-effective high-intensity training is driving the development of new technologies, which can complement and extent conventional therapies. Apart from established methods using electromechanical devices, immersive virtual reality (iVR) systems hold promise to provide cost-efficient high-intensity arm training.

Effort-based decision making and motivational deficits in stroke patients.

Motivational deficits in patients recovering from stroke are common and can reduce active participation in rehabilitation and thereby impede functional recovery. We investigated whether stroke patients with clinically reduced drive, initiation, and endurance during functional rehabilitative training (n = 30) display systematic alterations in effort-based decision making compared to age, sex, and severity-matched stroke patients (n = 30) whose drive appeared unaffected. Notably, the two groups did not differ in self-reported ratings of apathy and depression.

Cathodal high-definition transcranial direct current stimulation (HD-tDCS) of the left ventral prefrontal cortex (vPFC) interferes with conscious error correction.

Precise motor timing requires the ability to flexibly adapt one's own movements with respect to changes in the environment. Previous studies suggest that the correction of perceived as compared to non-perceived timing errors involves at least partially distinct brain networks. The dorsolateral prefrontal cortex (dPFC) has been linked to the correction of perceived timing errors and evidence for a contribution of the ventrolateral PFC (vPFC) specifically to the correction of non-perceived errors exists.

The Psychological Science Accelerator's COVID-19 rapid-response dataset.

In response to the COVID-19 pandemic, the Psychological Science Accelerator coordinated three large-scale psychological studies to examine the effects of loss-gain framing, cognitive reappraisals, and autonomy framing manipulations on behavioral intentions and affective measures. The data collected (April to October 2020) included specific measures for each experimental study, a general questionnaire examining health prevention behaviors and COVID-19 experience, geographical and cultural context characterization, and demographic information for each participant. Each participant started the study with the same general questions and then was randomized to complete either one longer experiment or two shorter experiments.

Age interferes with sensorimotor timing and error correction in the supra-second range.

Introduction: Precise motor timing including the ability to adjust movements after changes in the environment is fundamental to many daily activities. Sensorimotor timing in the sub-and supra-second range might rely on at least partially distinct brain networks, with the latter including the basal ganglia (BG) and the prefrontal cortex (PFC). Since both structures are particularly vulnerable to age-related decline, the present study investigated whether age might distinctively affect sensorimotor timing and error correction in the supra-second range.

Stress effects on memory retrieval of aversive and appetitive instrumental counterconditioning in men.

Extinction training creates a second inhibitory memory trace and effectively reduces conditioned responding. However, acute stress inhibits the retrieval of this extinction memory trace. It is not known whether this also applies to other forms of associative learning such as instrumental counterconditioning, where previously learned associations are reversed and paired with the opposite valence.

In COVID-19 Health Messaging, Loss Framing Increases Anxiety with Little-to-No Concomitant Benefits: Experimental Evidence from 84 Countries.

The COVID-19 pandemic (and its aftermath) highlights a critical need to communicate health information effectively to the global public. Given that subtle differences in information framing can have meaningful effects on behavior, behavioral science research highlights a pressing question: Is it more effective to frame COVID-19 health messages in terms of potential losses (e.g.

Anodal Transcranial Direct Current Stimulation (atDCS) of the Primary Motor Cortex (M1) Facilitates Nonconscious Error Correction of Negative Phase Shifts.

Accurate motor timing requires the temporally precise coupling between sensory input and motor output including the adjustment of movements with respect to changes in the environment. Such error correction has been related to a cerebello-thalamo-cortical network. At least partially distinct networks for the correction of perceived (i.

Altered social decision making in patients with chronic pain.

Background: Chronic pain affects up to 20% of the population, impairs quality of life and reduces social participation. Previous research reported that pain-related perceived injustice covaries with these negative consequences. The current study probed whether chronic pain patients responded more strongly to disadvantageous social inequity than healthy individuals.

Lesion Evidence for a Causal Role of the Insula in Aversion to Social Inequity.

Humans resist unequal distributions of goods in their social interactions, even if it requires foregoing personal gains. Functional neuroimaging studies implicate the insula in this aversion to social inequity and in fairness-related decisions, but a causal contribution has not yet been established. We compared the responses of 30 patients with lesions to the insula on a multiple-trial version of the one-shot Ultimatum Game, a neuroeconomic social exchange paradigm where a sum of money is split between two players, to those of 30 matched patients with brain injuries sparing the insula.

A decision-neuroscientific intervention to improve cognitive recovery after stroke.

Functional recovery after stroke is dose-dependent on the amount of rehabilitative training. However, rehabilitative training is subject to motivational hurdles. Decision neuroscience formalizes drivers and dampers of behaviour and provides strategies for tipping motivational trade-offs and behaviour change.

Illusion of control affects ERP amplitude reductions for auditory outcomes of self-generated actions.

The reduction of neural responses to self-generated stimuli compared to external stimuli is thought to result from the matching of motor-based sensory predictions and sensory reafferences and to serve the identification of changes in the environment as caused by oneself. The amplitude of the auditory event-related potential (ERP) component N1 seems to closely reflect this matching process, while the later positive component (P2/ P3a) has been associated with judgments of agency, which are also sensitive to contextual top-down information. In this study, we examined the effect of perceived control over sound production on the processing of self-generated and external stimuli, as reflected in these components.

Cathodal Transcranial Direct Current Stimulation (tDCS) Applied to the Left Premotor Cortex Interferes with Explicit Reproduction of a Motor Sequence.

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that allows the modulation of cortical excitability. TDCS effects can outlast the stimulation period presumably due to changes of GABA concentration which play a critical role in use-dependent plasticity. Consequently, tDCS and learning-related synaptic plasticity are assumed to share common mechanisms.

Second look Holter ECG in neurorehabilitation.

Background: Many stroke survivors suffer recurrent stroke because paroxysmal atrial fibrillation (AF) was missed and no preventive anticoagulation initiated. This prospective cohort study determined the added diagnostic yield of second-look 24-h electrocardiographic recording (ECG) in a population at high risk for AF: patients who suffered a stroke of such severity that they require inpatient neurorehabilitation.

Methods: We enrolled 508 patients with ischemic stroke admitted to post-acute inpatient neurorehabilitation and determined whether AF was detected during acute care at the referring hospital.

Frequency and nature of pain in patients undergoing neurorehabilitation.

Objective: This prospective study investigated the extent to which patients undergoing neurorehabilitation reported pain, how this pain developed during inpatient stay and whether patients were treated accordingly (using pain medication).

Methods: The extent of pain, performance in daily activities, with a focus on possible impairment from pain, and pain medication were assessed at the beginning and the end of neurorehabilitation treatment. Overall 584 patients, with various neurological diagnoses, such as stroke, intracerebral hemorrhage, polyneuropathy, etc.

The posterior parietal cortex mediates early offline-rather than online-motor sequence learning.

Learning of new motor skills occurs particularly during training on a task (i.e. online) but has been observed between training-blocks lasting up to days after the end of the training (i.

Inducing illusory control ensures persistence when rewards fade and when others outperform us.

Persisting even when the rewards of continued effort are fading is essential for achieving long-term goals, skills, and good health, alike. Yet, we often quit when things get hard. Here, we tested whether augmenting the feeling of control through external measures increases persistence under such discouraging circumstances.

Pre-stimulus beta power modulation during motor sequence learning is reduced in 'Parkinson's disease.

Beta oscillations within motor-cortical areas have been linked to sensorimotor function. In line with this, pathologically altered beta activity in cortico-basal ganglia pathways has been suggested to contribute to the pathophysiology of Parkinson's disease (PD), a neurodegenerative disorder primarily characterized by motor impairment. Although its precise function is still discussed, beta activity might subserve an anticipatory role in preparation of future actions.

Conquering the inner couch potato: precommitment is an effective strategy to enhance motivation for effortful actions.

Letting effort-free gratification derail us from effort-requiring goals is one reason why we fail to realize health-relevant intentions like 'exercise regularly'. We tested the effectiveness of the self-control strategy precommitment in such effort-related conflicts, using a novel laboratory choice paradigm, where participants could precommit to an effort-requiring large reward by pre-eliminating an effort-free small reward from their choice set. Our participants used precommitment frequently and effectively, such that they reached effort-requiring large rewards more often.

Quantitative Rapid Assessment of Leukoaraiosis in CT : Comparison to Gold Standard MRI.

Purpose: The severity of white matter lesions (WML) is a risk factor of hemorrhage and predictor of clinical outcome after ischemic stroke; however, in contrast to magnetic resonance imaging (MRI) reliable quantification for this surrogate marker is limited for computed tomography (CT), the leading stroke imaging technique. We aimed to present and evaluate a CT-based automated rater-independent method for quantification of microangiopathic white matter changes.

Methods: Patients with suspected minor stroke (National Institutes of Health Stroke scale, NIHSS < 4) were screened for the analysis of non-contrast computerized tomography (NCCT) at admission and compared to follow-up MRI.

Association of exposure to manganese and iron with relaxation rates R1 and R2*- magnetic resonance imaging results from the WELDOX II study.

Objective: Magnetic resonance imaging is a non-invasive method that allows the indirect quantification of manganese (Mn) and iron (Fe) accumulation in the brain due to their paramagnetic features. The WELDOX II study aimed to explore the influence of airborne and systemic exposure to Mn and Fe on the brain deposition using the relaxation rates R1 and R2* as biomarkers of metal accumulation in regions of interest in 161 men, including active and former welders.

Material And Methods: We obtained data on the relaxation rates R1 and R2* in regions that included structures within the globus pallidus (GP), substantia nigra (SN), and white matter of the frontal lobe (FL) of both hemispheres, as well as Mn in whole blood (MnB), and serum ferritin (SF).

Motivation: What have we learned and what is still missing?

This final chapter deliberates three overarching topics and conclusions of the research presented in this volume: the endurance of the concept of extrinsic vs intrinsic motivation, the importance of considering subjective costs of activities when aiming to understand and enhance motivation, and current knowledge of the neurobiological underpinnings of motivation. Furthermore, three topics for future motivation research are outlined, namely the assessment and determinants of intrinsic benefits, the reconciliation of activity-specific motivation models with generalized motivation impairments in clinical populations, and the motivational dynamics of groups.

Changing health behavior motivation from I-must to I-want.

In the past, medicine was dominated by acute diseases. Since treatments were unknown to patients they followed their medical doctors´ directives-at least for the duration of the disease. Behavior was thus largely motivated by avoiding expected costs associated with alternative behaviors (I-must).