Effect of transcranial direct current stimulation in the initial weeks post-stroke: a pilot randomized study.

OBJECTIVE: This study aimed at assessing the alterations in upper limb motor impairment and connectivity between motor areas following the post-stroke delivery of cathodal transcranial direct current stimulation sessions. METHODS: Modifications in the Fugl-Meyer Assessment scores, connectivity between the primary motor cortex of the unaffected and affected hemispheres, and between the primary motor and premotor cortices of the unaffected hemisphere were compared prior to and following six sessions of cathodal transcranial direct current stimulation application in 13 patients (active = 6; sham = 7); this modality targets the primary motor cortex of the unaffected hemisphere early after a stroke. RESULTS: Clinically relevant distinctions in Fugl-Meyer Assessment scores (≥9 points) were observed more frequently in the Sham Group than in the Active Group. Between-group differences in the alterations in Fugl-Meyer Assessment scores were not statistically significant (Mann-Whitney test, p=0.133). ROI-to-ROI correlations between the primary motor cortices of the affected and unaffected hemispheres post-therapeutically increased in 5/6 and 2/7 participants in the Active and Sham Groups, respectively. Between-group differences in modifications in connectivity between the aforementioned areas were not statistically significant. Motor performance enhancements were more frequent in the Sham Group compared to the Active Group. CONCLUSION: The results of this hypothesis-generating investigation suggest that heightened connectivity may not translate into early clinical benefits following a stroke and will be crucial in designing larger cohort studies to explore mechanisms underlying the impacts of this intervention. ClinicalTrials.gov Identifier: NCT02455427.

Brain activation during fear extinction recall in unmedicated patients with obsessive-compulsive disorder.

Specific brain activation patterns during fear conditioning and the recall of previously extinguished fear responses have been associated with obsessive-compulsive disorder (OCD). However, further replication studies are necessary. We measured skin-conductance response and blood oxygenation level-dependent responses in unmedicated adult patients with OCD (n = 27) and healthy participants (n = 22) submitted to a two-day fear-conditioning experiment comprising fear conditioning, extinction (day 1) and extinction recall (day 2). During conditioning, groups differed regarding the skin conductance reactivity to the aversive stimulus (shock) and regarding the activation of the right opercular cortex, insular cortex, putamen, and lingual gyrus in response to conditioned stimuli. During extinction recall, patients with OCD had higher responses to stimuli and smaller differences between responses to conditioned and neutral stimuli. For the entire sample, the higher the response delta between conditioned and neutral stimuli, the greater the dACC activation for the same contrast during early extinction recall. While activation of the dACC predicted the average difference between responses to stimuli for the entire sample, groups did not differ regarding the activation of the dACC during extinction recall. Larger unmedicated samples might be necessary to replicate the previous findings reported in patients with OCD.

Group Synchronization during Collaborative Drawing using Functional Near-Infrared Spectroscopy.

Functional near-infrared spectroscopy (fNIRS) is a noninvasive method particularly suitable for measuring cerebral cortex activation in multiple subjects, which is relevant for studying group interpersonal interactions in ecological settings. Although many fNIRS systems technically offer the possibility to monitor more than two individuals simultaneously, establishing easy-to-implement setup procedures and reliable paradigms to track hemodynamic and behavioral responses in group interaction is still required. The present protocol combines fNIRS and video-based observation to measure interpersonal synchronization in quartets during a cooperative task.This protocol provides practical recommendations for data acquisition and paradigm design, as well as guiding principles for an illustrative data analysis example. The procedure is designed to assess differences in brain and behavior interpersonal responses between social and non-social conditions inspired by a well-known ice-breaker activity, the Collaborative Face Drawing Task. The described procedures can guide future studies to adapt group naturalistic social interaction activities to the fNIRS environment.

Baseline emotional state influences on the response to animated short films: A randomized online experiment.

Introduction: Considering the relevance of the emotional state, it is necessary to understand how daily stimuli can modulate the emotions. Animated short films are common stimuli, but it is unknown how they can modulate the emotional state. The study aimed to evaluate: how participants' emotional state changed after watching animated short films with positive or negative emotional valence in an online experiment; the relationship between participants' baseline score on an Emotional Intensity Scale and their potential change in the main emotion after watching the films; and the association between the initial main emotion valence and the potential change in this emotion with participants' sociodemographic information. Methods: A sample of 2,269 participants recruited during COVID-19 pandemic were randomly assigned to either watch a negative or positive animated short film. Results: The results showed that, after watching a film with negative valence, participants were in a more negative emotional state than at baseline and compared with those who watched the film with positive valence. Also, individuals who had a negative baseline emotion and maintained the same emotion after the film had presented higher baseline emotional state scores (more negative emotion) than those who changed their emotions. In addition, the individuals who kept the baseline emotion had an association with age, marital status, level of education and psychiatric disorders, use of medication, and emotional awareness, while the individuals who changed the baseline emotion had an association with age, gender, and following or not social distancing recommendations. Conclusion: Baseline emotional state may influence the response to animated short films and sociodemographic characteristics are associated with the initial main emotion valence and its potential change in this emotion.

The effects of levodopa in the spatiotemporal gait parameters are mediated by self-selected gait speed in Parkinson's disease.

In individuals with Parkinson's disease (PD), the medication induces different and inconsistent results in the spatiotemporal parameters of gait, making it difficult to understand its effects on gait. As spatiotemporal gait parameters have been reported to be affected by gait speed, it is essential to consider the gait speed when studying walking biomechanics to interpret the results better when comparing the gait pattern of different conditions. Since the medication alters the self-selected gait speed of individuals with PD, this study analysed whether the change in gait speed can explain the selective effects of l-DOPA on the spatiotemporal parameters of gait in individuals with PD. We analysed the spatiotemporal gait parameters at the self-selected speed of 22 individuals with PD under ON and OFF states of l-DOPA medication. Bayesian mediation analysis evaluated which gait variables were affected by the medication state and checked if those effects were mediated by speed changes induced by medication. The gait speed was significantly higher among ON compared with OFF medication. All the spatiotemporal parameters of the gait were mediated by speed, with proportions of mediation close to 1 (effect entirely explained by speed changes). Our results show that a change in gait speed better explains the changes in the spatiotemporal gait parameters than the ON-OFF phenomenon. As an implication for rehabilitation, our results suggest that it is possible to assess the effect of l-DOPA on improving motor symptoms related to gait disorders by measuring gait speed.

COVID-19 news valence effects on emotion and its modulation by a relaxation: A randomized online experiment during COVID-19 pandemic.

This study evaluated how news with positive and negative content about COVID-19, as well as a relaxation pause, affect the emotional state. We also investigated the association between emotional state and practicing meditation/yoga, physical activity or having a mental disease. For that, a sample of 717 participants, recruited through social media, were randomly assigned to listen to negative or positive news about COVID-19. After that, both groups were guided through a short relaxation pause. Their emotional state was measured before they listened to the audios and after each audio. Mixed linear models were used to evaluate the effects of news group, relaxation pause, mental health and well-being practices. Negative news worsened their emotional state, whereas positive news improved it. A brief relaxation pause improved the effects of negative news content and may mitigate the effects of this valence of information. Practicing physical activity, meditation/yoga was associated with better emotional responses.

Cerebral Responses to Stationary Emotional Stimuli Measured by fMRI in Women with Persistent Postural-Perceptual Dizziness

Abstract Introduction Persistent postural-perceptual dizziness (PPPD) is a functional vestibular disorder characterized by chronic dizziness, unsteadiness, and hypersensitivity to motion. Preexisting anxiety disorders and neurotic personality traits confer vulnerability to PPPD. High anxiety during acute vertigo or dizziness incites it. A functional magnetic resonance imaging (fMRI) study of chronic subjective dizziness found unexpectedly hypoactive responses to vestibular stimulation in cortical regions that integrate threat assessment and spatial perception. Objective This fMRI study used non-moving, but emotionally charged visual stimuli to investigate the brain's activity of PPPD patients and control subjects. Methods The participants included 16 women with PPPD and 16 age-matched women who recovered completely from acute episodes of vertigo or dizziness capable of triggering PPPD. Brain responses to positive, neutral, and negative figures from the International Affective Picture System were measured with fMRI and compared between the groups. Dizziness handicap, anxiety, and depression were assessed with validated questionnaires. Results Between group analyses: Participants with PPPD showed reduced activity in anterior cingulate cortex and increased activity in left angular gyrus in response to negative versus positive stimuli, which was not observed in recovered individuals. Within group analyses: Participants with PPPD had increased activity in visuospatial areas (parahippocampal gyrus, intraparietal sulcus) in negative versus positive and negative versus neutral contrasts, whereas recovered individuals had increased activity in anxiety regions (amygdala, orbitofrontal cortex). Conclusion Patients with PPPD may be more attuned to spatial elements than to the content of emotionally charged visual stimuli.

Cerebral Responses to Stationary Emotional Stimuli Measured by fMRI in Women with Persistent Postural-Perceptual Dizziness.

Introduction Persistent postural-perceptual dizziness (PPPD) is a functional vestibular disorder characterized by chronic dizziness, unsteadiness, and hypersensitivity to motion. Preexisting anxiety disorders and neurotic personality traits confer vulnerability to PPPD. High anxiety during acute vertigo or dizziness incites it. A functional magnetic resonance imaging (fMRI) study of chronic subjective dizziness found unexpectedly hypoactive responses to vestibular stimulation in cortical regions that integrate threat assessment and spatial perception. Objective This fMRI study used non-moving, but emotionally charged visual stimuli to investigate the brain's activity of PPPD patients and control subjects. Methods The participants included 16 women with PPPD and 16 age-matched women who recovered completely from acute episodes of vertigo or dizziness capable of triggering PPPD. Brain responses to positive, neutral, and negative figures from the International Affective Picture System were measured with fMRI and compared between the groups. Dizziness handicap, anxiety, and depression were assessed with validated questionnaires. Results Between group analyses: Participants with PPPD showed reduced activity in anterior cingulate cortex and increased activity in left angular gyrus in response to negative versus positive stimuli, which was not observed in recovered individuals. Within group analyses: Participants with PPPD had increased activity in visuospatial areas (parahippocampal gyrus, intraparietal sulcus) in negative versus positive and negative versus neutral contrasts, whereas recovered individuals had increased activity in anxiety regions (amygdala, orbitofrontal cortex). Conclusion Patients with PPPD may be more attuned to spatial elements than to the content of emotionally charged visual stimuli.

Can news with positive or negative content affect and a relaxation pause improve the emotional state of health care professionals? A randomized online experiment during COVID-19 pandemic.

A cause of mental distress during the COVID-19 pandemic is media exposure, which can impact health care professionals (HCPs) who must keep up to date with the statistics and procedures to fight the outbreak. This study aimed to evaluate the effects of listening to negative and positive news about COVID-19 pandemic and a relaxation pause audio. For that, we measured the emotional state through Likert items in a scale developed to assess how anxious, stressed, hopeful, conscious about emotions, irritated, despondent, joyful, optimistic, and preoccupied, he or she was feeling in the moment of evaluation. In an online experiment, an HCPs sample of 245 participants were randomly assigned to either listen to negative or positive news contents about COVID-19. After that, both groups were guided by a relaxation pause activity in which they paid attention to the body and breath. They were assessed before and after listening to each audio. After listening to negative news, participants entered in a more negative emotional state than at baseline (p < 0.001) and compared with participants who listened to positive news (p < 0.001). Both groups improved their emotional state after performing the proposed brief relaxation (p < 0.001). These results show the importance of HCPs being aware and controlling the content of consumed news. A brief relaxation practice can mitigate the negative effects of consuming information with negative content.

Frontal Hemodynamic Response During Step Initiation Under Cognitive Conflict in Older and Young Healthy People.

Gait initiation is a daily challenge even for healthy individuals as it requires the timely coupling between the automatic anticipatory postural adjustment (APA) and the voluntary step according to the context. Modulation of this motor event has been thought to involve higher level brain control, including cognitive inhibitory circuitries. Despite the known participation of the supplementary motor area (SMA) in the modulation of some parameters of APA, the participation of areas controlling inhibition during gait initiation still needs to be investigated. In this study, the hemodynamic responses of the SMA and dorsolateral prefrontal cortex (DLPFC) were assessed using functional near-infrared spectroscopy (fNIRS) during a gait initiation task under cognitive conflict to select the foot to step (congruent [CON] and incongruent [INC] conditions). The older group (OG) showed worse inhibitory control than the young group (YG) along with more impairments in APA parameters. OG also had a lower amplitude of hemodynamic responses in both areas than YG in the INC. The INC increased the correlation between SMA and DLPFC only in the YG. Aging seems to impair the interaction between the hemodynamic responses of SMA and DLPFC, which influences APA performance in gait initiation under cognitive conflict.

COVID-19 information exposure in digital media and implications for employees in the health care sector: findings from an online survey.

OBJECTIVE: To estimate coronavirus disease 2019-related information consumption and related implications for health care professionals (medical and nonmedical personnel) during the pandemic. METHODS: A cross-sectional on-line survey was distributed to employees of a major health care institution located in São Paulo, Brazil between April 3 and April 10, 2020. Data were analyzed using descriptive statistics. RESULTS: The sample comprised 2,646 respondents. Most participants (44.4%) reported excessive or almost excessive access to information about the novel coronavirus and 67.6% reported having increased their average time spent on social media. When asked how frequently they consider it was easy to determine the reliability of information, "sometimes" corresponded to 43.2% of the answers in contrast to 14.6% responding "always". Answers related to potential signs of information overload associated with the pandemic indicated that 31% of respondents felt stressed by the amount of information they had to keep up with almost every day or always. Overall, 80.0% of respondents reported having experienced at least one of the following symptoms: headache, eye twitching, restlessness or sleeping difficulty. The frequency of symptoms was higher among participants with a more negative information processing style regarding when dealing with large volumes of information relative to those with a positive information processing style. Likewise, symptoms were more frequently reported by participants who had increased their social media access relative to those reporting reduced access during the pandemic. CONCLUSION: Our survey provides a description of how health professionals consume COVID-19 related information during the pandemic, and suggests that excessive information exposure and high processing demands may impose psychological distress and affect mental health.

COVID-19 information exposure in digital media and implications for employees in the health care sector: findings from an online survey / Exposição às informações sobre COVID-19 em mídias digitais e suas implicações para funcionários do setor de saúde: resultados de uma pesquisa on-line

ABSTRACT Objective: To estimate coronavirus disease 2019-related information consumption and related implications for health care professionals (medical and nonmedical personnel) during the pandemic. Methods: A cross-sectional on-line survey was distributed to employees of a major health care institution located in São Paulo, Brazil between April 3 and April 10, 2020. Data were analyzed using descriptive statistics. Results: The sample comprised 2,646 respondents. Most participants (44.4%) reported excessive or almost excessive access to information about the novel coronavirus and 67.6% reported having increased their average time spent on social media. When asked how frequently they consider it was easy to determine the reliability of information, "sometimes" corresponded to 43.2% of the answers in contrast to 14.6% responding "always". Answers related to potential signs of information overload associated with the pandemic indicated that 31% of respondents felt stressed by the amount of information they had to keep up with almost every day or always. Overall, 80.0% of respondents reported having experienced at least one of the following symptoms: headache, eye twitching, restlessness or sleeping difficulty. The frequency of symptoms was higher among participants with a more negative information processing style regarding when dealing with large volumes of information relative to those with a positive information processing style. Likewise, symptoms were more frequently reported by participants who had increased their social media access relative to those reporting reduced access during the pandemic. Conclusion: Our survey provides a description of how health professionals consume COVID-19 related information during the pandemic, and suggests that excessive information exposure and high processing demands may impose psychological distress and affect mental health.

RESUMO Objetivo: Estimar o consumo de informações relacionadas com doença do novo coronavírus e seus efeitos em profissionais do setor da saúde durante a pandemia. Métodos: Um questionário on-line foi distribuído para funcionários de uma instituição de saúde em São Paulo, Brasil, entre 3 e 10 de abril de 2020. Os dados foram analisados com estatísticas descritivas. Resultados: Foram incluídos nas análises 2.646 participantes. A maioria (44,4%) reportou ter acessado uma quantidade excessiva ou próxima de excessiva sobre o novo coronavírus, e 67,6% reportaram ter aumentado seu tempo médio em mídias sociais. Quando perguntados se era fácil determinar o que era informação confiável, 43,2% responderam "às vezes", comparados com 14,6% que responderam "sempre". Sobre os possíveis sinais de sobrecarga de informação associada com a pandemia, 31% sempre ou quase todos os dias se sentiram estressados com a quantidade de informações que tinham que acompanhar. Entre os respondentes, 80,0% reportaram sentir pelo menos um sintoma como dor de cabeça, espasmos oculares, inquietação ou dificuldade para dormir. Participantes com um estilo mais negativo de lidar com muitas informações também reportaram maior proporção de sintomas que os participantes com estilo positivo. De forma semelhante, participantes que aumentaram seu acesso a mídias sociais reportaram maior proporção de sintomas do que os que diminuíram seu acesso durante a pandemia. Conclusão: Nossa pesquisa fornece uma descrição de como os indivíduos consomem informações relacionadas com a doença do novo coronavirus durante a pandemia e sugere que a exposição a uma quantidade excessiva de informações e as elevadas demandas podem impor sofrimento psicológico e afetar a saúde mental.

Extrinsic functional connectivity of the default mode network in crack-cocaine users.

OBJECTIVE: This study aimed to explore the functional connectivity of the default mode network (DMN) in crack-cocaine users, in comparison with that observed in age-matched non-drug-using controls. MATERIALS AND METHODS: Inpatient crack-cocaine users who had been abstinent for at least four weeks and age-matched non-drug-using controls underwent resting state functional magnetic resonance imaging. Images were acquired while the subjects rested with their eyes closed. After data preprocessing, DMNs were defined by spatial independent component analysis and seed-based correlation analysis, by chosen regions of interest centered in the ventral anterior cingulate cortex and in the posterior cingulate cortex. RESULTS: The functional connectivity of the DMN determined by independent component analysis did not differ between the crack-cocaine users and the controls. However, the seed-based correlation analysis seeking a single metric of functional connectivity between specific brain regions showed that the negative connectivity between the ventral anterior cingulate cortex and the left superior parietal lobule was significantly greater in the crack-cocaine users than in the controls. CONCLUSION: The results suggest that selective extrinsic network connectivity of the DMN related to motor and executive function is impaired during crack-cocaine addiction.

Extrinsic functional connectivity of the default mode network in crack-cocaine users / A conectividade funcional extrínseca da rede de modo padrão em usuários de crack-cocaína

Abstract Objective: This study aimed to explore the functional connectivity of the default mode network (DMN) in crack-cocaine users, in comparison with that observed in age-matched non-drug-using controls. Materials and Methods: Inpatient crack-cocaine users who had been abstinent for at least four weeks and age-matched non-drug-using controls underwent resting state functional magnetic resonance imaging. Images were acquired while the subjects rested with their eyes closed. After data preprocessing, DMNs were defined by spatial independent component analysis and seed-based correlation analysis, by chosen regions of interest centered in the ventral anterior cingulate cortex and in the posterior cingulate cortex. Results: The functional connectivity of the DMN determined by independent component analysis did not differ between the crack-cocaine users and the controls. However, the seed-based correlation analysis seeking a single metric of functional connectivity between specific brain regions showed that the negative connectivity between the ventral anterior cingulate cortex and the left superior parietal lobule was significantly greater in the crack-cocaine users than in the controls. Conclusion: The results suggest that selective extrinsic network connectivity of the DMN related to motor and executive function is impaired during crack-cocaine addiction.

Resumo Objetivo: Este estudo teve como objetivo explorar a conectividade funcional da rede de modo padrão em usuários de crack-cocaína comparando-a a controles não usuários da mesma faixa etária. Materiais e Métodos: Usuários de crack-cocaína internados em abstinência por pelo menos quatro semanas e controles não usuários pareados por idade foram submetidos a ressonância magnética funcional em estado de repouso, enquanto descansavam com os olhos fechados. Depois do pré-processamento de dados, a rede de modo padrão foi definida por análise espacial de componentes independentes e análise de correlação baseada em sementes, por regiões de interesse centradas no córtex cingulado anterior ventral e no córtex cingulado posterior. Resultados: A conectividade funcional analisada por componentes independentes não foi diferente entre os usuários de crack- cocaína e os controles pareados por idade. No entanto, a análise de correlação baseada em sementes à procura de uma conectividade funcional métrica única entre regiões específicas do cérebro mostrou uma negatividade significativamente maior da conectividade entre o córtex cingulado anterior ventral e o lóbulo parietal superior esquerdo, quando comparada a controles pareados por idade. Conclusão: Os resultados sugerem que conectividades extrínsecas seletivas da rede de modo padrão relacionadas a funções motoras e executivas podem estar comprometidas na dependência de crack-cocaína.

Motor Readiness Increases Brain Connectivity Between Default-Mode Network and Motor Cortex: Impact on Sampling Resting Periods from fMRI Event-Related Studies.

The default-mode network (DMN) has been implicated in many conditions. One particular function relates to its role in motor preparation. However, the possibly complex relationship between DMN activity and motor preparation has not been fully explored. Dynamic interactions between default mode and motor networks may compromise the ability to evaluate intrinsic connectivity using resting period data extracted from task-based experiments. In this study, we investigated alterations in connectivity between the DMN and the motor network that are associated with motor readiness during the intervals between motor task trials. fMRI data from 20 normal subjects were acquired under three conditions: pure resting state; resting state interleaved with brief, cued right-hand movements at constant intervals (lower readiness); and resting state interleaved with the same movements at unpredictable intervals (higher readiness). The functional connectivity between regions of motor and DMNs was assessed separately for movement periods and intertask intervals. We found a negative relationship between the DMN and the left sensorimotor cortex during the task periods for both motor conditions. Furthermore, during the intertask intervals of the unpredictable condition, the DMN showed a positive relationship with right sensorimotor cortex and a negative relation with the left sensorimotor cortex. These findings indicate a specific modulation on motor processing according to the state of motor readiness. Therefore, connectivity studies using task-based fMRI to probe DMN should consider the influence of motor system modulation when interpreting the results.