The lateralized effects of Parkinson's Disease on motor imagery: Evidence from mental chronometry.

Alterations to the content of action representations may contribute to the movement challenges that characterize Parkinson's Disease (PD). One way to investigate action representations is through motor imagery. As PD motor symptoms typically have a unilateral onset, disease-related deficits related to action representations may follow a similarly lateralized pattern. The present study examined if temporal accuracy of motor imagery in individuals with PD differed according to the side of the body involved in the task. Thirty-eight participants with PD completed a mental chronometry task using their more affected and less affected side. Participants had significantly shorter mental versus physical movement times for the more affected. Higher imagery vividness in the kinaesthetic domain predicted shorter mental versus physical movement times for the more affected side, as did lower imagery vividness in the visual domain and poorer cognitive function. These results indicate that people with PD imagine movements differently when the target actions their more affected versus less affected side. It is additionally possible that side-specific deficits in the accurate processing of kinaesthetic information lead to an increased reliance on visual processes and cognitive resources to successfully execute motor imagery involving the more affected side.

Mental health differences in medical students based on curriculum and gender.

BACKGROUND: The prevalence of mental health struggles among students in medical school is widely reported; however, little is known about how it is impacted by the medical school curriculum. This study aimed to evaluate differences in anxiety, depression, and emotional exhaustion in medical students based on gender, class year, and curriculum. METHODS: An anonymous online survey consisting of questions from established, validated questionnaires about demographics, anxiety, depression, emotional exhaustion, and personal health behaviors was sent to 817 medical students who attended Rowan-Virtua School of Osteopathic Medicine during the Spring of 2021. When applying to this school, each of these students had the option to choose either the problem-based learning (PBL) or lecture-based learning (LBL) curriculum track. RESULTS: The survey was completed by 222 students. Females experienced higher levels of anxiety, depression, and emotional exhaustion than males. Students in the PBL had lower levels of emotional exhaustion than their peers in the LBL. Increase in emotional exhaustion was most pronounced between 1st and 2nd year students. Emotional exhaustion was inversely correlated with sleep and exercise. CONCLUSIONS: On average, students who were either male or in the PBL curriculum experienced less mental distress in the form of anxiety, depression, and emotional exhaustion than their peers. While gender continues to be an established factor in how mental distress is experienced, the reduced levels of emotional exhaustion in PBL students is a novel finding that can potentially shed light on how to better optimize medical education. Despite the inherent selection bias and lower number of PBL students, to our knowledge, this is the first study comparing two different curricula within a single institution. This finding along with a focus on good sleep and exercise habits may provide a path for improving mental health in medical students.

Handedness effects on imagery of dominant- versus non-dominant-hand movements: An electroencephalographic investigation.

Mental representations of our bodies are thought to influence how we interact with our surroundings. We can examine these mental representations through motor imagery, the imagination of movement using scalp EEG recordings. The visual modality of motor imagery emphasises 'seeing' the imagined movement and is associated with increased activity in the alpha rhythm (8-14 Hz) measured over the occipital regions. The kinaesthetic modality emphasises 'feeling' the movement and is associated with decreased activity in the mu rhythm (8-14 Hz) measured over the sensorimotor cortices. These two modalities can be engaged in isolation or together. We recorded EEG activity while 37 participants (17 left-hand dominant) completed an objective hand motor imagery task. Left-handers exhibited significant activity differences between occipital and motor regions only during imagery of right-hand (non-dominant-hand) movements. This difference was primarily driven by less oscillatory activity in the mu rhythm, which may reflect a shift in imagery strategy wherein participants placed more effort into generating the kinaesthetic sensations of non-dominant-hand imagery. Spatial features of 8-14 Hz activity generated from principal component analysis (PCA) provide further support for a strategy shift. Right-handers also exhibited significant differences between alpha and mu activity during imagery of non-dominant movements. However, this difference was not primarily driven by either rhythm, and no differences were observed in the group's PCA results. Together, these findings indicate that individuals imagine movement differently when it involves their dominant versus non-dominant hand, and left-handers may be more flexible in their motor imagery strategies.

Concurrent Inhibition of ERK and Farnesyltransferase Suppresses the Growth of HRAS Mutant Head and Neck Squamous Cell Carcinoma.

Human papilloma virus (HPV)-negative head and neck squamous cell carcinoma (HNSCC) is a common cancer worldwide with an unmet need for more effective, less toxic treatments. Currently, both the disease and the treatment of HNSCC cause significant mortality and morbidity. Targeted therapies hold new promise for patients with HPV-negative status whose tumors harbor oncogenic HRAS mutations. Recent promising clinical results have renewed interest in the development of farnesyltransferase inhibitors (FTIs) as a therapeutic strategy for HRAS-mutant cancers. With the advent of clinical evaluation of the FTI tipifarnib for the treatment of HRAS-mutant HNSCC, we investigated the activity of tipifarnib and inhibitors of HRAS effector signaling in HRAS-mutant HNSCC cell lines. First, we validated that HRAS is a cancer driver in HRAS-mutant HNSCC lines. Second, we showed that treatment with the FTI tipifarnib largely phenocopied HRAS silencing, supporting HRAS as a key target of FTI antitumor activity. Third, we performed reverse-phase protein array analyses to profile FTI treatment-induced changes in global signaling, and conducted CRISPR/Cas9 genetic loss-of-function screens to identify previously unreported genes and pathways that modulate sensitivity to tipifarnib. Fourth, we determined that concurrent inhibition of HRAS effector signaling (ERK, PI3K, mTORC1) increased sensitivity to tipifarnib treatment, in part by overcoming tipifarnib-induced compensatory signaling. We also determined that ERK inhibition could block tipifarnib-induced epithelial-to-mesenchymal transition, providing a potential basis for the effectiveness of this combination. Our results support future investigations of these and other combination treatments for HRAS mutant HNSCC.

An Overview of 3-D Printing for Medical Applications.

PURPOSE: To review the basics of 3-D printing and discuss the future of 3-D printing and its place in medical imaging. METHODS: A literature search was conducted using EBSCO, JSTOR, ProQuest, and Google Scholar. Recent publications that provided robust and current information were preferred, but older articles were used, if needed. RESULTS: 3-D printing began by converting a computer-aided design into a physical model. Also referred to as additive manufacturing, 3-D printing was developed as an alternative to the more costly process of subtractive manufacturing. The construction, application, and implementation of 3-D product designs has allowed for 3-D printing in various environments, from manufacturing to medicine. DISCUSSION: Since its beginning, the purpose and applicability of 3-D printing have shifted from the simple production of visual prototypes to the provision of innovative solutions to problems. 3-D printing has allowed for greater creativity in medicine and is increasing the popularity of medical imaging because of its suitability for anatomic modeling, teaching, and patient education. CONCLUSION: Radiology departments are becoming vital components of 3-D printing in health care by providing computed tomography or magnetic resonance imaging data sets to designate anatomical structures for 3-D fabrication. 3-D medical printing programs in hospital settings might be limited to larger facilities because of associated start-up costs. However, as competition in the 3-D market increases, costs are expected to decline, which will help reduce barriers to 3-D printing across the health care community.

Mu oscillations and motor imagery performance: A reflection of intra-individual success, not inter-individual ability.

Mu oscillations (8-13 Hz), recorded over the human motor cortex, have been shown to consistently suppress during both the imagination and performance of movements; however, its functional significance in the imagery process is currently unclear. Here we examined human electroencephalographic (EEG) oscillations in the context of motor imagery performance as measured by imagery success within participants and imagery ability between participants. We recorded continuous EEG activity while participants performed the Test of Ability in Movement Imagery (TAMI), an objective test of motor imagery task. Results demonstrated that mu oscillatory activity significantly decreased during successful as compared to unsuccessful imagery trials. However, the extent of reduction in mu oscillations did not correlate with overall imagery ability as measured by the total TAMI score. These findings provide further support for the involvement of mu oscillations in indexing motor imagery performance and suggest that mu oscillations may reflect important processes related to imagery accuracy, processes likely related to those underlying overt motor production and motor understanding.

First-time sports-related concussion recovery revisited: management changes and impact on recovery.

CONTEXT: Concussion is among the most common injuries in athletes. Over the past 10 years, concussion knowledge has expanded, and guidelines for management have changed. Recent changes include recommendations against strict mental and physical rest after sustaining a concussion, a better recognition of preexisting conditions predisposing protracted concussion recovery, and the addition of preliminary patient counseling and education about the expected course of concussion recovery. OBJECTIVE: To assess the impact of changes in concussion management on the duration of symptoms in middle school and high school athletes after sustaining a first-time, sports-related concussion. METHODS: A retrospective review was performed of medical records of athletes who sustained a concussion between 2016 and 2018 and were treated by the same primary care physician (J.M.N) using the revised approach to concussion management described. Patients were included if they were 11 to 18 years old and had a diagnosis of first-time concussion sustained while playing organized sports. Athletes who sustained a concomitant injury or sustained a concussion outside of organized sports were excluded from the study; athletes lost to follow-up or with incomplete forms were also excluded. Each athlete's length of symptomatic time from his or her concussion was calculated. This data was then compared with a previously-published data set of athletes who sustained a concussion between 2011 and 2013, with the same inclusion criteria but a different approach to concussion management. RESULTS: A total of 110 male and 72 female athletes (N=182) met the study's eligibility criteria. Collectively, athletes of both sexes from the 2016-2018 data set reported a higher incidence of preexisting conditions associated with prolonged concussion recovery compared with the data set of 2011-2013 athletes. However, both sexes from the 2016-2018 data set also reported a shorter median duration of concussion symptoms compared with the 2011-2013 athletes (median duration 5 vs. 11 days for male athletes and 7 vs. 28 days for female athletes, respectively; p<0.001). CONCLUSION: Recent changes in concussion management have led to decreased duration of symptoms among 11- to 18-year-old athletes with first-time, sports-related concussions. These management changes include advocating for early activity, recognizing preexisting conditions, and educating athletes about the realities of concussion recovery.