Motor imagery helps updating internal models during microgravity exposure.

Skilled movements result from a mixture of feedforward and feedback mechanisms conceptualized by internal models. These mechanisms subserve both motor execution and motor imagery. Current research suggests that imagery allows updating feedforward mechanisms, leading to better performance in familiar contexts. Does this still hold in radically new contexts? Here, we test this ability by asking participants to imagine swinging arm movements around shoulder in normal gravity condition and in microgravity in which studies showed that movements slow down. We timed several cycles of actual and imagined arm pendular movements in three groups of subjects during parabolic flight campaign. The first, control, group remained on the ground. The second group was exposed to microgravity but did not imagine movements inflight. The third group was exposed to microgravity and imagined movements inflight. All groups performed and imagined the movements before and after the flight. We predicted that a mere exposure to microgravity would induce changes in imagined movement duration. We found this held true for the group who imagined the movements, suggesting an update of internal representations of gravity. However, we did not find a similar effect in the group exposed to microgravity despite the fact that the participants lived the same gravitational variations as the first group. Overall, these results suggest that motor imagery contributes to update internal representations of the considered movement in unfamiliar environments, while a mere exposure proved to be insufficient.NEW & NOTEWORTHY Gravity strongly affects the way movements are performed. How internal models process this information to adapt behavior to novel contexts is still unknown. The microgravity environment itself does not provide enough information to optimally adjust the period of natural arm swinging movements to microgravity. However, motor imagery of the task while immersed in microgravity was sufficient to update internal models. These results show that actually executing a task is not necessary to update graviception.

Neuromagnetic signatures of the spatiotemporal transformation for manual pointing.

Movement planning involves transforming the sensory signals into a command in motor coordinates. Surprisingly, the real-time dynamics of sensorimotor transformations at the whole brain level remain unknown, in part due to the spatiotemporal limitations of fMRI and neurophysiological recordings. Here, we used magnetoencephalography (MEG) during pro-/anti-wrist pointing to determine (1) the cortical areas involved in transforming visual signals into appropriate hand motor commands, and (2) how this transformation occurs in real time, both within and across the regions involved. We computed sensory, motor, and sensorimotor indices in 16 bilateral brain regions for direction coding based on hemispherically lateralized de/synchronization in the α (7-15 Hz) and ß (15-35 Hz) bands. We found a visuomotor progression, from pure sensory codes in 'early' occipital-parietal areas, to a temporal transition from sensory to motor coding in the majority of parietal-frontal sensorimotor areas, to a pure motor code, in both the α and ß bands. Further, the timing of these transformations revealed a top-down pro/anti cue influence that propagated 'backwards' from frontal through posterior cortical areas. These data directly demonstrate a progressive, real-time transformation both within and across the entire occipital-parietal-frontal network that follows specific rules of spatial distribution and temporal order.

Cutaneous features of Zika virus infection: a clinicopathological overview.

Zika virus (ZIKV) is an emerging mosquito-borne flavivirus transmitted mainly by Aedes species of mosquitos. Although the infection is usually mild and self-limiting, it is emerging as a public health challenge in tropical and subtropical countries owing to its unprecedented pathogenicity and increased risk for fetal malformations and neurological symptoms. Cutaneous manifestations as for other mosquito-borne viruses remain a hallmark of the disease. This article provides a detailed overview on ZIKV infection, including its varied cutaneous clinical manifestations and diagnostic aspects, and also provides detailed insights into its pathogenesis in human skin.

Generalized pustular psoriasis triggered by Zika virus infection.

Zika virus is an emerging arbovirus, which is expanding in epidemic proportions through tropical and subtropical areas of the world. Although Zika is linked to a number of congenital and neurological complications, there is scarce knowledge on the impact of ZIKV infection in human skin. We report the case of a 68-year old woman who presented with generalized pustular psoriasis after a preceding and otherwise uneventful episode of ZIKV infection. Based on recent experimental data on the biology of ZIKV infection in the cutaneous environment, we speculate that ZIKV may have directly triggered the development of generalized pustular psoriasis by stimulation of keratinocyte-derived mediators of inflammation and a polyfunctional T-cell driven immune reaction in the cutaneous milieu.

The Attentional Fields of Visual Search in Simultanagnosia and Healthy Individuals: How Object and Space Attention Interact.

Simultanagnosia is a deficit in which patients are unable to perceive multiple objects simultaneously. To date, it remains disputed whether this deficit results from disrupted object or space perception. We asked both healthy participants as well as a patient with simultanagnosia to perform different visual search tasks of variable difficulty. We also modulated the number of objects (target and distracters) presented. For healthy participants, we found that each visual search task was performed with a specific "attentional field" depending on the difficulty of visual object processing but not on the number of objects falling within this "working space." This was demonstrated by measuring the cost in reaction times using different gaze-contingent visible window sizes. We found that bilateral damage to the superior parietal lobule impairs the spatial integration of separable features (within-object processing), shrinking the attentional field in which a target can be detected, but causing no deficit in processing multiple objects per se.

Saccadic compensation for smooth eye and head movements during head-unrestrained two-dimensional tracking.

Spatial updating is the ability to keep track of the position of world-fixed objects while we move. In the case of vision, this phenomenon is called spatial constancy and has been studied in head-restraint conditions. During head-restrained smooth pursuit, it has been shown that the saccadic system has access to extraretinal information from the pursuit system to update the objects' position in the surrounding environment. However, during head-unrestrained smooth pursuit, the saccadic system needs to keep track of three different motor commands: the ocular smooth pursuit command, the vestibuloocular reflex (VOR), and the head movement command. The question then arises whether saccades compensate for these movements. To address this question, we briefly presented a target during sinusoidal head-unrestrained smooth pursuit in darkness. Subjects were instructed to look at the flash as soon as they saw it. We observed that subjects were able to orient their gaze to the memorized (and spatially updated) position of the flashed target generally using one to three successive saccades. Similar to the behavior in the head-restrained condition, we found that the longer the gaze saccade latency, the better the compensation for intervening smooth gaze displacements; after about 400 ms, 62% of the smooth gaze displacement had been compensated for. This compensation depended on two independent parameters: the latency of the saccade and the eye contribution to the gaze displacement during this latency period. Separating gaze into eye and head contributions, we show that the larger the eye contribution to the gaze displacement, the better the overall compensation. Finally, we found that the compensation was a function of the head oscillation frequency and we suggest that this relationship is linked to the modulation of VOR gain. We conclude that the general mechanisms of compensation for smooth gaze displacements are similar to those observed in the head-restrained condition.

Comparing limb proprioception and oculomotor signals during hand-guided saccades.

We previously showed that saccades tend to overshoot briefly flashed targets that were manually displaced in the dark (Ren et al. 2006). However it was not clear if the overshoot originated from a sensory error in measuring hand displacement or from a premotor error in saccade programming, because gaze and hand position started at the same central position. Here, we tested between these hypotheses by dissociating the initial eye and hand position. Five hand/target positions (center, far, near, right, left) on a frontally-placed horizontal surface were used in four paradigms: Center or Peripheral Eye-hand Association (CA or PA, both gaze and right hand started from the center or a same peripheral location) and Hand or Eye Dissociation (HD or ED, hand or gaze started from one of three non-target peripheral locations). Subjects never received any visual feedback about the final target location and the subjects' hand displacement. In the CA paradigm, subjects showed the same overshoot that we showed previously. However, changing both initial eye and hand positions relative to the final target (PA) affected the pattern, significantly altering the directions of overshoots. Changing only the initial position of hand (HD) did not have this effect, whereas changing only initial eye position (ED) had the same effect as the PA condition (CA approximately HD, PA approximately ED). Furthermore, multiple regression analysis showed that the direction of the ideal saccade contributed significantly to the endpoint direction error, not the direction of the hand path. These results suggest that these errors do not primarily arise from misestimates of the hand trajectory, but rather from a process of comparing the initial eye position and the limb proprioceptive signal during saccade programming.

Proprioceptive guidance of saccades in eye-hand coordination.

The saccade generator updates memorized target representations for saccades during eye and head movements. Here, we tested if proprioceptive feedback from the arm can also update handheld object locations for saccades, and what intrinsic coordinate system(s) is used in this transformation. We measured radial saccades beginning from a central light-emitting diode to 16 target locations arranged peripherally in eight directions and two eccentricities on a horizontal plane in front of subjects. Target locations were either indicated 1) by a visual flash, 2) by the subject actively moving the handheld central target to a peripheral location, 3) by the experimenter passively moving the subject's hand, or 4) through a combination of the above proprioceptive and visual stimuli. Saccade direction was relatively accurate, but subjects showed task-dependent systematic overshoots and variable errors in radial amplitude. Visually guided saccades showed the smallest overshoot, followed by saccades guided by both vision and proprioception, whereas proprioceptively guided saccades showed the largest overshoot. In most tasks, the overall distribution of saccade endpoints was shifted and expanded in a gaze- or head-centered cardinal coordinate system. However, the active proprioception task produced a tilted pattern of errors, apparently weighted toward a limb-centered coordinate system. This suggests the saccade generator receives an efference copy of the arm movement command but fails to compensate for the arm's inertia-related directional anisotropy. Thus the saccade system is able to transform hand-centered somatosensory signals into oculomotor coordinates and combine somatosensory signals with visual inputs, but it seems to have a poorly calibrated internal model of limb properties.

[Thrombolytic therapy with ultra-high doses of streptokinase]. / Thrombolytische Therapie mit ultrahohen Streptokinasedosen.

Two pilot studies were carried out in patients suffering from acute myocardial infarction. They received high doses of streptokinase and acylated streptokinase-plasminogen activator complex intravenously as a bolus injection. Furthermore, the possibility of using streptokinase bolus therapy was examined in patients with acute vascular occlusion. Due to the limited number and the heterogenicity of cases the results obtained in patients with acute myocardial infarction are to evaluate with some reservation. In patients with acute vascular occlusion streptokinase bolus therapy at high doses proved to be a promising alternative to the conventional therapy.