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1.
BMJ Open ; 14(3): e082927, 2024 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-38531572

RESUMO

INTRODUCTION: The non-intoxicating plant-derived cannabinoid, cannabidiol (CBD), has demonstrated therapeutic potential in a number of clinical conditions. Most successful clinical trials have used relatively high (≥300 mg) oral doses of CBD. Relatively few studies have investigated the efficacy of lower (<300 mg) oral doses, typical of those available in over-the-counter CBD products. METHODS: We present a protocol for a randomised, double-blind, placebo-controlled, parallel-group clinical trial investigating the effects of a low oral dose (150 mg) of CBD on acute psychosocial stress, situational anxiety, motion sickness and cybersickness in healthy individuals. Participants (n=74) will receive 150 mg of CBD or a matched placebo 90 min before completing three virtual reality (VR) challenges (tasks) designed to induce transient stress and motion sickness: (a) a 15 min 'Public Speaking' task; (b) a 5 min 'Walk the Plank' task (above a sheer drop); and (c) a 5 min 'Rollercoaster Ride' task. The primary outcomes will be self-reported stress and nausea measured on 100 mm Visual Analogue Scales. Secondary outcomes will include salivary cortisol concentrations, skin conductance, heart rate and vomiting episodes (if any). Statistical analyses will test the hypothesis that CBD reduces nausea and attenuates subjective, endocrine and physiological responses to stress compared with placebo. This study will indicate whether low-dose oral CBD has positive effects in reducing acute psychosocial stress, situational anxiety, motion sickness and cybersickness. ETHICS AND DISSEMINATION: The University of Sydney Human Research Ethics Committee has granted approval (2023/307, version 1.6, 16 February 2024). Study findings will be disseminated in a peer-reviewed journal and at academic conferences. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ACTRN12623000872639).


Assuntos
Canabidiol , Enjoo devido ao Movimento , Humanos , Canabidiol/uso terapêutico , Austrália , Ansiedade/tratamento farmacológico , Náusea/tratamento farmacológico , Método Duplo-Cego , Enjoo devido ao Movimento/tratamento farmacológico , Estresse Psicológico , Ensaios Clínicos Controlados Aleatórios como Assunto
2.
BMJ Open ; 13(6): e071080, 2023 06 13.
Artigo em Inglês | MEDLINE | ID: mdl-37311632

RESUMO

INTRODUCTION: Patient education is a critical component of healthcare delivery. However, medical information and knowledge are complex and can be difficult for patients and families to comprehend when delivered verbally. The use of virtual reality (VR) to convey medical information to patients may bridge this communication gap and lead to more effective patient education. It may be of increased value to those with low health literacy and levels of patient activation, in rural and regional settings. The objective of this randomised, single-centre pilot study is to examine the feasibility and preliminary effectiveness of VR as an education tool for people with cancer. The results will provide data to inform the feasibility of a future randomised controlled trial, including sample size calculations. METHODS AND ANALYSIS: Patients with cancer undergoing immunotherapy will be recruited. A total of 36 patients will be recruited and randomised to one of three trial arms. Participants will be randomised 1:1:1 to receive VR, a two-dimensional video or standard care (ie, verbal communication and information leaflets). Feasibility will be assessed by recruitment rate, practicality, acceptability, usability and related adverse events. The potential impact of VR on patient-reported outcomes (ie, perceived information provision quality, knowledge about immunotherapy and patient activation) will be assessed and stratified by information coping style (ie, monitors vs blunters) whenever statistical analyses are significant. The patient-reported outcomes will be measured at baseline, post-intervention and 2 weeks post-intervention. In addition, semistructured interviews will be conducted with health professionals and participants randomised to the VR trial arm, to further explore acceptability and feasibility. ETHICS AND DISSEMINATION: Ethics approval was obtained from the Greater Western Human Research Ethics Committee, New South Wales Local Health District (2022/ETH01760). Informed consent will be obtained from all participants. Findings will be disseminated via relevant conference presentations and publications in peer-reviewed journals. TRIAL REGISTRATION NUMBER: ACTRN12622001473752.


Assuntos
Neoplasias , Educação de Pacientes como Assunto , Humanos , Estudos de Viabilidade , Projetos Piloto , Neoplasias/terapia , Imunoterapia , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Front Neurol ; 14: 1147253, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37114229

RESUMO

This paper is concerned mainly with the assumptions underpinning the actual testing procedure, measurement, and interpretation of the video head impulse test-vHIT. Other papers have reported in detail the artifacts which can interfere with obtaining accurate eye movement results, but here we focus not on artifacts, but on the basic questions about the assumptions and geometrical considerations by which vHIT works. These matters are crucial in understanding and appropriately interpreting the results obtained, especially as vHIT is now being applied to central disorders. The interpretation of the eye velocity responses relies on thorough knowledge of the factors which can affect the response-for example the orientation of the goggles on the head, the head pitch, and the contribution of vertical canals to the horizontal canal response. We highlight some of these issues and point to future developments and improvements. The paper assumes knowledge of how vHIT testing is conducted.

4.
ANZ J Surg ; 93(5): 1341-1347, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36792539

RESUMO

BACKGROUND: Digital surgical planning (DSP) has revolutionized the preparation and execution of the management of complex head and neck pathologies. The addition of virtual reality (VR) allows the surgeon to have a three-dimensional experience with six degrees of freedom for visualizing and manipulating objects. This pilot study describes the participants experience with the first head and neck reconstructive VR-DSP platform. METHODS: An original VR-DSP platform has been developed for planning the ablation and reconstruction of head and neck pathologies. A prospective trial utilizing this platform involving reconstructive surgeons was performed. Participants conducted a simulated VR-DSP planning session, pre- and post-questionnaire as well as audio recordings allowing for qualitative analysis. RESULTS: Thirteen consultant reconstructive surgeons representing three surgical backgrounds with varied experience were recruited. The majority of surgeons had no previous experience with VR. Based on the system usability score, the VR-DSP platform was found to have above average usability. The qualitative analysis demonstrated the majority had a positive experience. Participants identified some perceived barriers to implementing the VR-DSP platform. CONCLUSIONS: Virtual reality-digital surgical planning is usable and acceptable to reconstructive surgeons. Surgeons were able to perform the steps in an efficient time despite limited experience. The addition of VR offers additional benefits to current VSP platforms. Based on the results of this pilot study, it is likely that VR-DSP will be of benefit to the reconstructive surgeon.


Assuntos
Procedimentos de Cirurgia Plástica , Cirurgiões , Realidade Virtual , Humanos , Projetos Piloto , Estudos Prospectivos
5.
Intern Med J ; 53(8): 1356-1365, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-35762188

RESUMO

BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-limiting toxicity for people treated for cancer. Impaired balance and falls are functional consequences of CIPN. Virtual reality (VR) technology may be able to assess balance and identify patients at risk of falls. AIMS: To assess the impact of potentially neurotoxic chemotherapy on balance using VR, and explore associations between VR balance assessment, falls and CIPN. METHODS: This prospective, repeated measures longitudinal study was conducted at two Australian cancer centres. Eligible participants were commencing adjuvant chemotherapy containing a taxane for breast cancer, or oxaliplatin for colorectal cancer (CRC), per institutional guidelines. Balance assessments using VR were conducted at baseline, end of chemotherapy and 3 and 6 months after completion of chemotherapy. Participants also completed a comprehensive CIPN assessment comprising clinical and patient-reported outcomes, and recorded falls or near falls. RESULTS: Out of 34 participants consented, 24 (71%) had breast cancer and 10 (29%) had CRC. Compared to baseline, balance threshold was reduced in 10/28 (36%) evaluable participants assessed at the end of chemotherapy, and persistent in 7/22 (32%) at 6 months. CIPN was identified in 86% at end of chemotherapy and persisted to 6 months after chemotherapy completion in 73%. Falls or near falls were reported by 12/34 (35%) participants, and were associated with impaired VR balance threshold (P = 0.002). CONCLUSIONS: While VR balance assessment was no better at identifying CIPN than existing measures, it is a potential surrogate method to assess patients at risk of falls from CIPN.


Assuntos
Antineoplásicos , Neoplasias da Mama , Doenças do Sistema Nervoso Periférico , Humanos , Feminino , Estudos Longitudinais , Estudos Prospectivos , Austrália/epidemiologia , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Doenças do Sistema Nervoso Periférico/diagnóstico , Doenças do Sistema Nervoso Periférico/tratamento farmacológico , Neoplasias da Mama/tratamento farmacológico
6.
NPJ Microgravity ; 8(1): 27, 2022 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-35858981

RESUMO

Otoliths are the primary gravity sensors of the vestibular system and are responsible for the ocular counter-roll (OCR). This compensatory eye torsion ensures gaze stabilization and is sensitive to a head roll with respect to gravity and the Gravito-Inertial Acceleration vector during, e.g., centrifugation. To measure the effect of prolonged spaceflight on the otoliths, we quantified the OCR induced by off-axis centrifugation in a group of 27 cosmonauts in an upright position before and after their 6-month space mission to the International Space Station. We observed a significant decrease in OCR early postflight, larger for first-time compared to experienced flyers. We also found a significantly larger torsion for the inner eye, the eye closest to the rotation axis. Our results suggest that experienced cosmonauts have acquired the ability to adapt faster after G-transitions. These data provide a scientific basis for sending experienced cosmonauts on challenging missions that include multiple g-level transitions.

7.
Gait Posture ; 95: 70-75, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35453086

RESUMO

BACKGROUND: Previous research has established that anxiety is associated with freezing of gait (FOG) in Parkinson's disease (PD). Although providing body-related visual feedback has been previously suggested to improve FOG, it remains unclear whether anxiety-induced FOG might be improved. RESEARCH QUESTION: The current study aimed to evaluate whether body-related visual feedback (VF) improves FOG consistently across low and high threat conditions. METHODS: Sixteen PD patients with FOG were instructed to walk across a plank in a virtual environment that was either located on the ground (low threat) or elevated above a deep pit (high threat). Additionally, visual feedback (VF) was either provided (+) or omitted (-) using an avatar that was synchronised in real-time with the participants movements. RESULTS: revealed that in the low threat condition (i.e., ground), %FOG was significantly reduced when VF was provided (VF+) compared to when VF was absent (VF-). In contrast, during the elevated high threat condition, there were no differences in %FOG regardless of whether VF was provided or not. SIGNIFICANCE: These findings confirm that although VF can aid in the reduction of FOG, anxiety may interfere with freezers' ability to use sensory feedback to improve FOG and hence, in high threat conditions, VF was unable to aid in the reduction of FOG. Future studies should direct efforts towards the treatment of anxiety to determine whether better management of anxiety may improve FOG.


Assuntos
Transtornos Neurológicos da Marcha , Doença de Parkinson , Ansiedade/etiologia , Retroalimentação Sensorial , Marcha , Transtornos Neurológicos da Marcha/etiologia , Humanos , Doença de Parkinson/complicações
8.
Patient Educ Couns ; 105(7): 1928-1942, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35168856

RESUMO

OBJECTIVE: To explore what is currently known about the use of virtual reality (VR) as a patient education tool in healthcare. METHODS: Arksey and O'Malley's scoping review method and the PRISMA-ScR Checklist were employed. Four peer-reviewed databases were searched (Medline, Embase, PsychINFO, the Cochrane library). Pre-defined selection criteria identified 18 studies for inclusion. Results were synthesized using a narrative approach. RESULTS: VR as an educational tool in healthcare is feasible and acceptable, and may improve patient's knowledge about their illness and satisfaction with treatment. Most studies used the Oculus VR glasses or headset, educated patients though the use of 3D 360° VR anatomical models, and were conducted with people affected with cancer. Opportunities exist for exploring unintended consequences, and the role of VR in educating populations with lower health literacy. CONCLUSION: VR could assist in communicating medical information and knowledge to patients, but more research is needed, particularly to identify for whom and in what situations this method is most useful and to improve understanding about the potential unintended consequences. PRACTICE IMPLICATIONS: Health professionals should consider using VR to educate their patients, and researchers can use this as a road map on how to address knowledge gaps in this field.


Assuntos
Educação de Pacientes como Assunto , Realidade Virtual , Atenção à Saúde , Pessoal de Saúde/educação , Humanos
9.
J Vestib Res ; 32(3): 295-304, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34459428

RESUMO

BACKGROUND: Dizziness is a common perioperative complication after cochlear implantation (CI). To date, the exact cause behind this phenomenon remains unclear. There is recent evidence to suggest that otolith function, specifically utricular, may be affected shortly after CI surgery, however whether these changes are related to patient symptoms has not yet been investigated. OBJECTIVE: To determine whether CI surgery and perioperative dizziness is associated with changes in utricular function. METHODS: We performed an observational study on patients undergoing routine CI surgery. Utricular function was assessed using the Subjective Visual Vertical (SVV), and perioperative dizziness was determined using a questionnaire. The study followed patients before surgery and then again 1-day, 1-week and 6-weeks after implantation. RESULTS: Forty-one adult CI recipients participated in the study. The SVV deviated away from the operated ear by an average of 2.17° a day after implantation, 0.889° 1 week and -0.25° 6 weeks after surgery. Dizziness contributed to a tilt of 0.5° away from the implanted ear. These deviations were statistically significant. CONCLUSIONS: CI surgery causes utricular hyperfunction in the operated ear that resolves over 6 weeks. SVV tilts were greater in participants experiencing dizziness, suggesting that utricular hyperfunction may contribute to the dizziness.


Assuntos
Implante Coclear , Implantes Cocleares , Adulto , Implante Coclear/efeitos adversos , Implantes Cocleares/efeitos adversos , Tontura/etiologia , Humanos , Membrana dos Otólitos , Vertigem/complicações
10.
J Vestib Res ; 32(3): 261-269, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34151877

RESUMO

BACKGROUND: Parkinson's disease (PD) is a common multi-system neurodegenerative disorder with possible vestibular system dysfunction, but prior vestibular function test findings are equivocal. OBJECTIVE: To report and compare vestibulo-ocular reflex (VOR) gain as measured by the video head impulse test (vHIT) in participants with PD, including tremor dominant and postural instability/gait dysfunction phenotypes, with healthy controls (HC). METHODS: Forty participants with PD and 40 age- and gender-matched HC had their vestibular function assessed. Lateral and vertical semicircular canal VOR gains were measured with vHIT. VOR canal gains between PD participants and HC were compared with independent samples t-tests. Two distinct PD phenotypes were compared to HC using Tukey's ANOVA. The relationship of VOR gain with PD duration, phenotype, severity and age were investigated using logistic regression. RESULTS: There were no significant differences between groups in vHIT VOR gain for lateral or vertical canals. There was no evidence of an effect of PD severity, phenotype or age on VOR gains in the PD group. CONCLUSION: The impulsive angular VOR pathways are not significantly affected by the pathophysiological changes associated with mild to moderate PD.


Assuntos
Doença de Parkinson , Vestíbulo do Labirinto , Teste do Impulso da Cabeça , Humanos , Doença de Parkinson/diagnóstico , Reflexo Vestíbulo-Ocular/fisiologia , Canais Semicirculares/fisiologia
11.
JMIR Form Res ; 5(11): e28315, 2021 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-34730537

RESUMO

BACKGROUND: Despite optimal medical and surgical intervention, freezing of gait commonly occurs in people with Parkinson disease. Action observation via video self-modeling, combined with physical practice, has potential as a noninvasive intervention to reduce freezing of gait. OBJECTIVE: The aim of this study is to determine the feasibility and acceptability of a home-based, personalized video self-modeling intervention delivered via a virtual reality head-mounted display (HMD) to reduce freezing of gait in people with Parkinson disease. The secondary aim is to investigate the potential effect of this intervention on freezing of gait, mobility, and anxiety. METHODS: The study was a single-group pre-post mixed methods pilot trial for which 10 participants with Parkinson disease and freezing of gait were recruited. A physiotherapist assessed the participants in their homes to identify person-specific triggers of freezing and developed individualized movement strategies to overcome freezing of gait. 180° videos of the participants successfully performing their movement strategies were created. Participants watched their videos using a virtual reality HMD, followed by physical practice of their strategies in their own homes over a 6-week intervention period. The primary outcome measures included the feasibility and acceptability of the intervention. Secondary outcome measures included freezing of gait physical tests and questionnaires, including the Timed Up and Go Test, 10-meter walk test, Goal Attainment Scale, and Parkinson Anxiety Scale. RESULTS: The recruitment rate was 24% (10/42), and the retention rate was 90% (9/10). Adherence to the intervention was high, with participants completing a mean of 84% (SD 49%) for the prescribed video viewing and a mean of 100% (SD 56%) for the prescribed physical practice. One participant used the virtual reality HMD for 1 week and completed the rest of the intervention using a flat-screen device because of a gradual worsening of his motion sickness. No other adverse events occurred during the intervention or assessment. Most of the participants found using the HMD to view their videos interesting and enjoyable and would choose to use this intervention to manage their freezing of gait in the future. Five themes were constructed from the interview data: reflections when seeing myself, my experience of using the virtual reality system, the role of the virtual reality system in supporting my learning, developing a deeper understanding of how to manage my freezing of gait, and the impact of the intervention on my daily activities. Overall, there were minimal changes to the freezing of gait, mobility, or anxiety measures from baseline to postintervention, although there was substantial variability between participants. The intervention showed potential in reducing anxiety in participants with high levels of anxiety. CONCLUSIONS: Video self-modeling using an immersive virtual reality HMD plus physical practice of personalized movement strategies is a feasible and acceptable method of addressing freezing of gait in people with Parkinson disease.

12.
J Parkinsons Dis ; 11(3): 1443-1454, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34057098

RESUMO

BACKGROUND: Although prior research has established that freezing of gait (FOG) in Parkinson's disease (PD) is associated with anxiety, only one study to date has directly manipulated anxiety levels to induce FOG. OBJECTIVE: The current study aimed to replicate these previous findings and evaluate whether a seated version of a 'threat' virtual reality (VR) paradigm could induce anxiety and provoke FOG. METHODS: Twenty-four PD patients with FOG were assessed across various threat conditions in both a walking VR paradigm (Experiment 1) and a seated VR paradigm (Experiment 2). Both paradigms manipulated the height (i.e., elevated vs ground) and width (wide vs narrow) of the planks participants were instructed to walk across. RESULTS: Across both experiments, the Elevated + Narrow condition provoked significantly greater number of freezing episodes compared to all other conditions. Higher levels of self-reported anxiety were reported during the Elevated+Narrow condition compared to all other conditions in Experiment 1, and compared to the Ground condition in Experiment 2. CONCLUSION: These findings confirm that anxiety contributes to FOG and validates the use of a seated VR threat paradigm for provoking anxiety-related freezing. This enables future studies to combine this paradigm with functional MRI to explore the neural correlates underlying the role of anxiety in FOG.


Assuntos
Ansiedade , Transtornos Neurológicos da Marcha , Doença de Parkinson , Realidade Virtual , Ansiedade/etiologia , Transtornos Neurológicos da Marcha/etiologia , Humanos , Doença de Parkinson/complicações
13.
Exp Brain Res ; 239(6): 1853-1862, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33846841

RESUMO

The suppression head impulse test paradigm (SHIMP) is a newly described indicator of vestibular function which yields two measures: vestibulo-ocular reflex (VOR) gain and a saccadic response. It is an alternative and complementary test to the head impulse test paradigm (HIMP). Parkinson's disease (PD) has known saccadic and central vestibular pathway dysfunction. This paper is the first description of SHIMP VOR gain and saccade characteristic in this population. This prospective observational study measured the SHIMP VOR gain and saccade characteristics in 39 participants with idiopathic PD and compared this to 40 healthy controls (HC). The effect of group, demographic variables and SHIMP characteristics were evaluated. SHIMP VOR gains were not significantly different between groups (p = 0.10). Compared to HC, the PD group mean SHIMP peak saccade velocity was significantly reduced by an average of 77.07°/sec (p < 0.001), and SHIMP saccade response latency was longer, with an average delay of 23.5 ms (p = 0.003). SHIMP saccade peak velocity was also associated with both head impulse velocity (p = 0.002) and SHIMP VOR gain (p = 0.004) variables, but there was no significant influence of these variables when SHIMP saccade peak velocity was considered as a predictor of PD (p = 0.52-0.91). VOR gains were unaffected by PD. PD-specific saccadic dysfunction, namely reduced peak saccade velocities and prolonged response latencies, were observed in the SHIMP-induced saccade responses. VOR gain using slow phase eye velocity is preferred as the indicator of vestibular function in the SHIMPs paradigm as non-vestibular factors affected saccade peak velocity.


Assuntos
Doença de Parkinson , Vestíbulo do Labirinto , Teste do Impulso da Cabeça , Humanos , Doença de Parkinson/complicações , Reflexo Vestíbulo-Ocular , Movimentos Sacádicos
14.
Pain ; 162(7): 2110-2119, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33769370

RESUMO

ABSTRACT: Psychological models of chronic pain (CP) highlight cognitive-processing biases (ie, attentional biases, interpretation biases, and attentional control) as pivotal processes that uniquely and synergistically impact the development and maintenance of CP. Very few studies explore multiple cognitive biases, and no studies have examined these 3 processes together in a CP sample. Furthermore, there is a lack of research investigating the relationship between these cognitive processes and pain-relevant variables (eg, pain intensity and pain catastrophising). The current study aimed to (1) compare attentional biases, interpretation biases, and attentional control in people with and without CP, (2) explore their interrelationships, and (3) explore their association with pain-related variables. Seventy-four participants with CP and 66 without pain volunteered. Participants completed a visual scanning task with eye tracking, a recognition task, and a flanker task. Traditional and Bayesian analysis indicated no effect of pain status on cognitive-processing biases. All participants, regardless of pain status, demonstrated attentional biases towards pain on some indices of early and late attention, but not interpretation bias or attentional control. There was weak evidence of associations between attentional biases, interpretation biases, and attentional control. Pain intensity was significantly correlated with interpretation biases, and follow-up analyses revealed people with high pain intensity demonstrated an interpretation bias towards pain significantly more than those with low pain intensity. Findings suggest that attentional biases towards pain are ubiquitous, but for people with moderate-to-severe pain, interpretation biases may have a role worthy of further research.


Assuntos
Viés de Atenção , Dor Crônica , Atenção , Teorema de Bayes , Viés , Humanos
15.
Accid Anal Prev ; 154: 106093, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33770719

RESUMO

Applications of neuroimaging methods have substantially contributed to the scientific understanding of human factors during driving by providing a deeper insight into the neuro-cognitive aspects of driver brain. This has been achieved by conducting simulated (and occasionally, field) driving experiments while collecting driver brain signals of various types. Here, this sector of studies is comprehensively reviewed at both macro and micro scales. At the macro scale, bibliometric aspects of these studies are analysed. At the micro scale, different themes of neuroimaging driving behaviour research are identified and the findings within each theme are synthesised. The surveyed literature has reported on applications of four major brain imaging methods. These include Functional Magnetic Resonance Imaging (fMRI), Electroencephalography (EEG), Functional Near-Infrared Spectroscopy (fNIRS) and Magnetoencephalography (MEG), with the first two being the most common methods in this domain. While collecting driver fMRI signal has been particularly instrumental in studying neural correlates of intoxicated driving (e.g. alcohol or cannabis) or distracted driving, the EEG method has been predominantly utilised in relation to the efforts aiming at development of automatic fatigue/drowsiness detection systems, a topic to which the literature on neuro-ergonomics of driving particularly has shown a spike of interest within the last few years. The survey also reveals that topics such as driver brain activity in semi-automated settings or neural activity of drivers with brain injuries or chronic neurological conditions have by contrast been investigated to a very limited extent. Potential topics in driving behaviour research are identified that could benefit from the adoption of neuroimaging methods in future studies. In terms of practicality, while fMRI and MEG experiments have proven rather invasive and technologically challenging for adoption in driving behaviour research, EEG and fNIRS applications have been more diverse. They have even been tested beyond simulated driving settings, in field driving experiments. Advantages and limitations of each of these four neuroimaging methods in the context of driving behaviour experiments are outlined in the paper.


Assuntos
Acidentes de Trânsito , Encéfalo , Eletroencefalografia , Humanos , Magnetoencefalografia , Neuroimagem
16.
Acta Otolaryngol ; 141(5): 471-475, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33641579

RESUMO

BACKGROUND: Superior Canal Dehiscence is classically diagnosed with typical abnormalities on Vestibular Evoked Myogenic Potentials (VEMPs) and Computed Tomography (CT) scans. AIM: This paper discusses the utility of the video Head Impulse Test (vHIT) in SCD. METHODS: Data from 11 ears (8 patients) with SCD were retrospectively reviewed. Results from vHIT, VEMPs and CT and when possible, MRI scans were correlated. An audit of 300 vHIT from patients undergoing routine testing for any neurotological complaint was also conducted to look at the incidence of isolated abnormal superior canal function. RESULTS: 82% of patients (9 ears) with SCD showed abnormal vHIT (reduced gain and catch-up saccades) isolated to the affected superior semicircular canal. CONCLUSION: Correlation of the CT and VEMPs are important in forming a diagnosis of SCD. However, if isolated superior canal vHIT abnormalities are demonstrated, it is suggestive of SCD and such patients should be referred for further investigations.


Assuntos
Teste do Impulso da Cabeça , Deiscência do Canal Semicircular/diagnóstico , Canais Semicirculares/diagnóstico por imagem , Adulto , Idoso de 80 Anos ou mais , Feminino , Teste do Impulso da Cabeça/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Reflexo Vestíbulo-Ocular , Estudos Retrospectivos , Deiscência do Canal Semicircular/diagnóstico por imagem , Deiscência do Canal Semicircular/fisiopatologia , Tomografia Computadorizada por Raios X , Potenciais Evocados Miogênicos Vestibulares
17.
J Parkinsons Dis ; 11(1): 271-282, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33074191

RESUMO

BACKGROUND: Freezing of gait (FOG) in Parkinson's disease (PD) has been shown to be more frequent in stressful situations, implicating anxiety. Heart rate (HR) has been shown to increase prior to a FOG episode supporting the notion that elevated stress levels may trigger FOG. However, no studies to date have investigated whether elevated HR precedes all subtypes of FOG or only those episodes that are driven by anxiety. OBJECTIVE: The present study sought to investigate whether 1) HR increases prior to FOG episodes in nonspecific environments (Experiment 1), and if 2) HR increases prior to FOG when provoked in high but not low threat environments using a virtual reality paradigm (Experiment 2). METHODS: In Experiment 1, 10 of 19 participants with PD and FOG (PD + FOG) experienced FOG during a series of walking trials. In Experiment 2, 12 of 23 participants with PD + FOG experienced FOG while walking across an elevated and ground level narrow plank in virtual reality. HR was collected throughout the duration of both experiments, while FOG was quantified by experts using video review and tagging. RESULTS: HR significantly increased 2-3 seconds prior to a FOG episode during Experiment 1. In Experiment 2, HR significantly increased 4-6 seconds prior to a FOG episode, specifically while navigating the elevated plank. However, there were no significant increases in HR prior to FOG episodes when participants navigated the ground plank. CONCLUSION: This study extends previous work further demonstrating that increases in HR prior to FOG episodes appear linked to elevated anxiety levels.


Assuntos
Ansiedade/fisiopatologia , Medo/fisiologia , Transtornos Neurológicos da Marcha/fisiopatologia , Frequência Cardíaca/fisiologia , Doença de Parkinson/fisiopatologia , Idoso , Eletrocardiografia , Feminino , Transtornos Neurológicos da Marcha/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Desempenho Psicomotor/fisiologia , Realidade Virtual
18.
Eur Arch Otorhinolaryngol ; 278(6): 2057-2065, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33112983

RESUMO

PURPOSE: Parkinson's disease (PD) is a neurodegenerative disorder with possible vestibular system dysfunction. This study reports the transient and sustained functions of the otoliths and their reflex pathways in PD compared to healthy controls (HC) and determines if otolith function relates to previous fall history. METHODS: Forty participants with PD and 40 HC had their otolith function assessed. Transient saccular and utricular-mediated reflexes were assessed by cervical and ocular vestibular evoked myogenic potentials (cVEMPs and oVEMPs, respectively) elicited by air-conducted stimulus (clicks) and bone-conducted vibration (light tendon hammer taps). Static otolith function was assessed by the Curator Subjective Visual Vertical (SVV) test. RESULTS: Compared to HC, the PD group had significantly more absent cVEMP responses to both clicks (47.5% vs. 30%, respectively, p = 0.03) and taps (21.8% vs. 5%, respectively, p = 0.002). Only the PD group had bilaterally absent tap cVEMPs, this was related to previous falls history (p < 0. 001). In both groups, click oVEMPs were predominantly absent, and tap oVEMPs were predominantly present. The PD group had smaller tap oVEMP amplitudes (p = 0.03) and recorded more abnormal SVV responses (p = 0.01) and greater error on SVV compared to HC, p < 0.001. SVV had no relationship with VEMP responses (p = 0.14). CONCLUSIONS: PD impacts on cVEMP reflex pathways but not tap oVEMP reflex pathways. Bone-conducted otolith stimuli (taps) are more robust than air-conducted sound stimuli (clicks) for both o and cVEMPs. A lack of association between SVV and VEMP responses suggest that static and dynamic otolith functions are differentially affected in PD.


Assuntos
Doença de Parkinson , Potenciais Evocados Miogênicos Vestibulares , Estimulação Acústica , Humanos , Membrana dos Otólitos , Reflexo
19.
PLoS One ; 15(12): e0243226, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33326467

RESUMO

Body-worn video is increasingly relied upon in the criminal justice system, however it is unclear how viewing chest-mounted video may affect a police officer's statement about an event. In the present study, we asked whether reviewing footage from an experienced event could shape an individual's statement, and if so, whether reporting before reviewing may preserve an officer's original experience. Student participants (n = 97) were equipped with chest-mounted cameras as they viewed a simulated theft in virtual reality. One week later, half of the participants recalled the event in an initial statement while the other half did not. Participants then viewed either their body-worn video or a control video. Finally, participants provided their statement (no initial statement condition) or were given the opportunity to amend their original account (initial statement condition). Results revealed that viewing body-worn video enhanced the completeness and accuracy of individuals' free recall statements. However, whilst reviewing footage enabled individuals to exclude errors they had written in their initial statements, they also excluded true details that were uncorroborated by the camera footage (i.e., details which individuals experienced, but that their camera did not record). Such camera conformity is discussed in light of the debate on when an officer should access their body-worn video during an investigation and the influence of post-event information on memory.


Assuntos
Rememoração Mental , Polícia , Gravação em Vídeo , Adulto , Crime , Feminino , Humanos , Masculino , Memória , Roubo , Adulto Jovem
20.
Sci Rep ; 10(1): 18739, 2020 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-33127963

RESUMO

Short-term deprivation (2.5 h) of an eye has been shown to boost its relative ocular dominance in young adults. Here, we show that a much shorter deprivation period (3-6 min) produces a similar paradoxical boost that is retinotopic and reduces spatial inhibition on neighbouring, non-deprived areas. Partial deprivation was conducted in the left hemifield, central vision or in an annular region, later assessed with a binocular rivalry tracking procedure. Post-deprivation, dominance of the deprived eye increased when rivalling images were within the deprived retinotopic region, but not within neighbouring, non-deprived areas where dominance was dependent on the correspondence between the orientation content of the stimuli presented in the deprived and that of the stimuli presented in non-deprived areas. Together, these results accord with other deprivation studies showing V1 activity changes and reduced GABAergic inhibition.


Assuntos
Dominância Ocular/fisiologia , Privação Sensorial/fisiologia , Visão Monocular/fisiologia , Adulto , Feminino , Humanos , Masculino , Neurociências , Córtex Visual/fisiologia , Percepção Visual/fisiologia
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