Individual differences in rhythm perception modulate music-related motor learning: a neurobehavioral training study with children.

Rhythm and motor function are intrinsically linked to each other and to music, but the rhythm-motor interplay during music training, and the corresponding brain mechanisms, are underexplored. In a longitudinal training study with children, we examined the role of rhythm predisposition in the fine motor improvements arising from music training, and which brain regions would be implicated. Fifty-seven 8-year-olds were assigned to either a 6-month music training (n = 21), sports training (n = 18), or a control group (n = 18). They performed rhythm and motor tasks, and structural brain scans before and after training were collected. Better ability to perceive rhythm before training was related to less gray matter volume in regions of the cerebellum, fusiform gyrus, supramarginal gyrus, ventral diencephalon, amygdala, and inferior/middle temporal gyri. Music training improved motor performance, and greater improvements correlated with better pre-training rhythm discrimination. Music training also induced a loss of gray matter volume in the left cerebellum and fusiform gyrus, and volume loss correlated with higher motor gains. No such effects were found in the sports and control groups. In summary, children with finer-tuned rhythm perception abilities were prone to finer motor improvements through music training, and this rhythm-motor link was to some extent subserved by the left cerebellum and fusiform gyrus. These findings have implications for models on music-related plasticity and rhythm cognition, and for programs targeting motor function.

Subcortical brain anatomy as a potential biomarker of persistent pain after total knee replacement in osteoarthritis.

ABSTRACT: The neural mechanisms for the persistence of pain after a technically successful arthroplasty in osteoarthritis (OA) remain minimally studied, and direct evidence of the brain as a predisposing factor for pain chronicity in this setting has not been investigated. We undertook this study as a first effort to identify presurgical brain and clinical markers of postarthroplasty pain in knee OA. Patients with knee OA (n = 81) awaiting total arthroplasty underwent clinical and psychological assessment and brain magnetic resonance imagining. Postoperative pain scores were measured at 6 months after surgery. Brain subcortical anatomic properties (volume and shape) and clinical indices were studied as determinants of postoperative pain. We show that presurgical subcortical volumes (bilateral amygdala, thalamus, and left hippocampus), together with shape deformations of the right anterior hippocampus and right amygdala, associate with pain persistence 6 months after surgery in OA. Longer pain duration, higher levels of presurgical anxiety, and the neuropathic character of pain were also prognostic of postsurgical pain outcome. Brain and clinical indices accounted for unique influences on postoperative pain. Our study demonstrates the presence of presurgical subcortical brain factors that relate to postsurgical persistence of OA pain. These preliminary results challenge the current dominant view that mechanisms of OA pain predominantly underlie local joint mechanisms, implying novel clinical management and treatment strategies.

Non-Surgical Periodontal Treatment Impact on Subgingival Microbiome and Intra-Oral Halitosis.

The purpose of this study was to characterize and compare subgingival microbiome before and after periodontal treatment to learn if any changes of the subgingival microbiome were reflected in intra-oral halitosis. We tested the hypothesis that intra-oral halitosis (Volatile sulfur compounds levels) correlates with corresponding subgingival bacterial levels before and after periodontal treatment. Twenty patients with generalized periodontitis completed the study. Subgingival plaque samples were collected at baseline and 6-8 weeks after nonsurgical periodontal therapy. Full-mouth periodontal status assessed probing depth (PD), clinical attachment loss (CAL), gingival recession (REC), bleeding on probing (BoP), PISA and PESA. Halitosis assessment was made using a volatile sulfur compounds (VSC) detector device. Periodontal measures were regressed across VSC values using adjusted multivariate linear analysis. The subgingival microbiome was characterized by sequencing on an Illumina platform. From a sample of 20 patients referred to periodontal treatment, 70% were females (n = 14), with a mean age of 56.6 (±10.3) years; full-mouth records of PD, CAL, BOP (%) allowed to classify the stage and grade of periodontitis, with 45% (n = 9) of the sample having Periodontitis Stage IV grade C and 95% (n = 19) had generalized periodontitis. The correlation of bacterial variation with VSCs measured in the periodontal diagnosis and in the reassessment after treatment were evaluated. Fusobacterium nucleatum, Capnocytophaga gingivalis and Campylobacter showaei showed correlation with the reduction of VSC after periodontal treatment (p-value = 0.044; 0.047 and 0.004, respectively). Capnocytophaga sputigena had a significant reverse correlation between VSCs variation from diagnosis (baseline) and after treatment. Microbial diversity was high in the subgingival plaque on periodontitis and intra-oral halitosis participants of the study. Furthermore, there were correlations between subgingival plaque composition and VSC counting after periodontal treatment. The subgingival microbiome can offer important clues in the investigation of the pathogenesis and treatment of halitosis.

Revisiting Standard and Novel Therapeutic Approaches in Halitosis: A Review.

Halitosis, or bad breath, is an oral health problem characterized by an unpleasant malodor emanating from the oral cavity. This condition can have different origins and causes a negative burden in social interactions, communication and quality of life, and can in uncommon cases be indicative of underlying non-oral non-communicable diseases. Most cases of halitosis are due to inadequate oral hygiene, periodontitis and tongue coating, yet the remaining proportion of cases are due to ear-nose-throat-associated (10%) or gastrointestinal/endocrine (5%) disorders. For this reason, the diagnosis, treatment and clinical management of halitosis often require a multidisciplinary team approach. This comprehensive review revisits the etiology of halitosis as well as standard and novel treatment that may contribute to higher clinical success.

Periodontitis, Halitosis and Oral-Health-Related Quality of Life-A Cross-Sectional Study.

We aimed to explore the association between volatile sulfurous compounds (VSCs) and periodontal epithelial surface area (PESA) and periodontal inflamed surface area (PISA) on a cohort of periodontitis patients. Consecutive patients were assessed for periodontitis and halitosis. A full-mouth periodontal status assessment tested probing depth (PD), clinical attachment loss (CAL), gingival recession (REC), bleeding on probing (BoP), PISA and PESA. A halitosis assessment was made using a VSC detector device. Periodontal measures were regressed across VSC values using adjusted multivariate linear analysis. From a total of seventy-two patients (37 females/35 males), the PESA of posterior-lower regions was found to be significantly higher in halitosis cases than their non-halitosis counterparts (p = 0.031). Considering all patients, the PESA of the posterior-lower region (B = 1.3, 95% CI: 0.2-2.3, p = 0.026) and age (B = -1.6, 95% CI: -3.1-0.2, p = 0.026) showed significant association with VSCs. In halitosis patients, the PESA of the posterior-lower region (B = 0.1, 95% CI: 0.0-0.1, p = 0.001), PISA Total (B = -0.1, 95% CI: -0.1-0.0, p = 0.008) and the OHIP-14 domain of physical disability (B = -2.1, 95% CI:-4.1-0.1, p = 0.040) were the most significant variables in this model. The PESA from the posterior-lower region may be associated with VSCs when other causes of extra-oral halitosis are excluded. Further intervention studies are needed to confirm this association.

Gray matter correlates of reading fluency deficits: SES matters, IQ does not.

Brain correlates of reading ability have been intensely investigated. Most studies have focused on single-word reading and phonological processing, but the brain basis of reading fluency remains poorly explored to date. Here, in a voxel-based morphometry study with 8-year-old children, we compared fluent readers (n = 18; seven boys) with dysfluent readers with normal IQ (n = 18; six boys) and with low IQ (n = 18; ten boys). Relative to dysfluent readers, fluent readers had larger gray matter volume in the right superior temporal gyrus and the two subgroups of dysfluent readers did not differ from each other, as shown in frequentist and Bayesian analyses. Pairwise comparisons showed that dysfluent readers of normal and low IQ did not differ in core reading regions and that both subgroups had less gray matter volume than fluent readers in occipito-temporal, parieto-temporal and fusiform areas. We also examined gray matter volume in matched subgroups of dysfluent readers differing only in socioeconomic status (SES): lower-SES (n = 14; seven boys) vs. higher-SES (n = 14; seven boys). Higher-SES dysfluent readers had larger gray matter volume in the right angular gyrus than their lower-SES peers, and the volume of this cluster correlated positively with lexico-semantic fluency. Age, sex, IQ, and gray matter volume of the right angular cluster explained 68% of the variance in the reading fluency of higher-SES dysfluent readers. In sum, this study shows that gray matter correlates of dysfluent reading are independent of IQ, and suggests that SES modulates areas sub-serving lexico-semantic processes in dysfluent readers-two findings that may be useful to inform language/reading remediation programs.

Reorganization of functional brain network architecture in chronic osteoarthritis pain.

Osteoarthritis (OA) manifests with chronic pain, motor impairment, and proprioceptive changes. However, the role of the brain in the disease is largely unknown. Here, we studied brain networks using the mathematical properties of graphs in a large sample of knee and hip OA (KOA, n = 91; HOA, n = 23) patients. We used a robust validation strategy by subdividing the KOA data into discovery and testing groups and tested the generalizability of our findings in HOA. Despite brain global topological properties being conserved in OA, we show there is a network wide pattern of reorganization that can be captured at the subject-level by a single measure, the hub disruption index. We localized reorganization patterns and uncovered a shift in the hierarchy of network hubs in OA: primary sensory and motor regions and parahippocampal gyrus behave as hubs and insular cortex loses its central placement. At an intermediate level of network structure, frontoparietal and cingulo-opercular modules showed preferential reorganization. We examined the association between network properties and clinical correlates: global disruption indices and isolated degree properties did not reflect clinical parameters; however, by modeling whole brain nodal degree properties, we identified a distributed set of regions that reliably predicted pain intensity in KOA and generalized to hip OA. Together, our findings reveal that while conserving global topological properties, brain network architecture reorganizes in OA, at both global and local scale. Network connectivity related to OA pain intensity is dissociated from the major hub disruptions, challenging the extent of dependence of OA pain on nociceptive signaling.

Brain gray matter abnormalities in osteoarthritis pain: a cross-sectional evaluation.

ABSTRACT: The interaction between osteoarthritis (OA) pain and brain properties remains minimally understood, although anatomical and functional neuroimaging studies suggest that OA, similar to other chronic pain conditions, may impact as well as partly be determined by brain properties. Here, we studied brain gray matter (GM) properties in OA patients scheduled to undergo total joint replacement surgery. We tested the hypothesis that brain regional GM volume is distinct between hip OA (HOA) and knee OA (KOA) patients, relative to healthy controls and moreover, that these properties are related to OA pain. Voxel-based morphometry group contrasts showed lower anterior cingulate GM volume only in HOA. When we reoriented the brains (flipped) to examine the hemisphere contralateral to OA pain, precentral GM volume was lower in KOA and HOA, and 5 additional brain regions showed distortions between groups. These GM changes, however, did not reflect clinical parameters. Next, we subdivided the brain into larger regions, approximating Brodmann areas, and performed univariable and machine learning-based multivariable contrasts. The univariable analyses approximated voxel-based morphometry results. Our multivariable model distinguished between KOA and controls, was validated in a KOA hold-out sample, and generalized to HOA. The multivariable model in KOA, but not HOA, was related to neuropathic OA pain. These results were mapped into term space (using Neurosynth), providing a meta-analytic summary of brain anatomical distortions in OA. Our results indicate more subtle cortical anatomical differences in OA than previously reported and also emphasize the interaction between OA pain, namely its neuropathic component, and OA brain anatomy.

Consensus Recommendations of the Multiple Sclerosis Study Group and the Portuguese Neuroradiological Society for the Use of Magnetic Resonance Imaging in Multiple Sclerosis in Clinical Practice: Part 2.

INTRODUCTION: Magnetic resonance imaging is recognized as the most important diagnostic test in the diagnosis of multiple sclerosis, differential diagnosis and evaluation of progression/therapeutic response. However, to make optimal use of magnetic resonance imaging in multiple sclerosis, the use of a standard, reproducible and comparable imaging protocol is of uttermost importance. In this context, the Portuguese Society of Neuroradiology and the Group of Studies of Multiple Sclerosis, after a joint discussion, appointed a committee of experts to create recommendations adapted to the national reality on the use of magnetic resonance imaging in multiple sclerosis. This document represents the second part of the first Portuguese consensus recommendations on the use of magnetic resonance imaging in multiple sclerosis in clinical practice. MATERIAL AND METHODS: The Portuguese Society of Neuroradiology and the Group of Studies of Multiple Sclerosis, after discussing the topic in national meetings and after a working group meeting held in Figueira da Foz, May 2017, appointed a committee of experts that have developed several standard protocols on the use of magnetic resonance imaging on multiple sclerosis by consensus. The document obtained was based on the best scientific evidence and expert opinion. Portuguese multiple sclerosis consultants and departments of neuroradiology scrutinized and reviewed the consensus paper; comments and suggestions were considered. Standardized strategies of magnetic resonance imaging referral in clinical practice for diagnosis and follow-up of multiple sclerosis were published in the first part of this paper. RESULTS: We provide magnetic resonance imaging acquisition protocols regarding multiple sclerosis diagnostic and monitoring and the information to be included in the report for application across Portuguese healthcare institutions. CONCLUSION: We hope that these first Portuguese magnetic resonance imaging guidelines will contribute to optimize multiple sclerosis management and improve patient care in Portugal.

Introdução: A ressonância magnética é considerada o exame complementar mais importante para o diagnóstico de esclerose múltipla, seus diagnósticos diferenciais e avaliação da sua progressão/resposta terapêutica. No entanto, para um uso ótimo desta ferramenta na esclerose múltipla, é essencial a aplicação de um protocolo de imagem padronizado, reprodutível e comparável. Neste contexto, o Grupo de Estudos de Esclerose Múltipla e a Sociedade Portuguesa de Neurorradiologia, após discussão conjunta, designaram um comité de peritos para a criação de recomendações adaptadas à realidade nacional sobre a utilização da ressonância magnética na esclerose múltipla. Este documento corresponde à segunda parte das primeiras recomendações de consenso portuguesas sobre a utilização da ressonância magnética na esclerose múltipla na prática clínica. Material e Métodos: O Grupo de Estudos de Esclerose Múltipla e a Sociedade Portuguesa de Neurorradiologia após discussão do tema em reuniões de âmbito nacional e de uma reunião do grupo de trabalho que teve lugar na Figueira da Foz em maio de 2017, designaram um comité de peritos que elaboraram por método de consenso protocolos padronizados sobre o uso da ressonância magnética na esclerose múltipla. O documento teve como base a melhor evidência científica e a opinião dos peritos. Posteriormente, o documento foi enviado para escrutínio à maioria dos responsáveis de consulta de esclerose múltipla e dos departamentos de neurorradiologia; tendo sido considerados os seus comentários e sugestões. As estratégias padronizadas de referenciação imagiológica na prática clínica para o diagnóstico e seguimento da esclerose múltipla foram publicadas na primeira parte deste artigo. Resultados: Neste artigo são propostos os protocolos de aquisição de ressonância magnética adequados para o diagnóstico e monitorização da esclerose múltipla, bem como a informação a constar do relatório imagiológico, tendo em vista a sua aplicação nas várias instituições de saúde portuguesas. Conclusão: Os autores esperam que estas primeiras orientações portuguesas sobre a utilização da ressonância magnética na esclerose múltipla na prática clínica contribuam para otimizar a gestão desta patologia e melhorar o tratamento destes doentes em Portugal.

Resting-state connectivity reveals a role for sensorimotor systems in vocal emotional processing in children.

Voices are a primary source of emotional information in everyday interactions. Being able to process non-verbal vocal emotional cues, namely those embedded in speech prosody, impacts on our behaviour and communication. Extant research has delineated the role of temporal and inferior frontal brain regions for vocal emotional processing. A growing number of studies also suggest the involvement of the motor system, but little is known about such potential involvement. Using resting-state fMRI, we ask if the patterns of motor system intrinsic connectivity play a role in emotional prosody recognition in children. Fifty-five 8-year-old children completed an emotional prosody recognition task and a resting-state scan. Better performance in emotion recognition was predicted by a stronger connectivity between the inferior frontal gyrus (IFG) and motor regions including primary motor, lateral premotor and supplementary motor sites. This is mostly driven by the IFG pars triangularis and cannot be explained by differences in domain-general cognitive abilities. These findings indicate that individual differences in the engagement of sensorimotor systems, and in its coupling with inferior frontal regions, underpin variation in children's emotional speech perception skills. They suggest that sensorimotor and higher-order evaluative processes interact to aid emotion recognition, and have implications for models of vocal emotional communication.

Does auriculotherapy have therapeutic effectiveness? An overview of systematic reviews.

BACKGROUND AND PURPOSE: Auriculotherapy is a therapeutic technique used for a wide variety of conditions. Nevertheless, similarly to any health related intervention, the clinical use of this therapy requires scientific evidence of effectiveness in order to support its rational use. The main goal of this article is to critically analyze published literature on auriculotherapy and to provide an overview of the effectiveness of this technique in the management of health disorders. METHODS: The inventory of published reviews on this subject was carried out in November 2017, by assessing the following computerized databases: PubMed, MEDLINE, PsycINFO, EBMR, Cochrane Database of Systematic Reviews, CINAHL Plus NRC and Science Direct. Were only considered the systematic reviews based on meta-analysis with high methodological quality described according to AMSTAR (Assessment of Multiple Systematic Reviews). The eligible articles were systematically reviewed to find out in which health conditions auriculotherapy can be used with effectiveness. RESULTS: A total of 14 reviews were eligible according to the inclusion and exclusion criterions. Those reviews were focused on the management of insomnia, smoking cessation and pain, within the clinical scope of Neurology, Orthopaedics and Rheumatology. CONCLUSIONS: Auriculotherapy has shown to have positive effects while associated to conventional treatments of insomnia, chronic and acute pain. Further well designed studies are required to evaluate the effectiveness of this technique in the treatment of other health conditions.

[Medical error in diagnostic imaging, performance and CAD systems]. / Erro médico em imagiologia: performance e sistemas de detecção computorizada.

Error occurs in medical practice. Perception error is particularly prevalent in Radiology. The studies in this area of knowledge are vital to understand the importance of perceptual factors in diagnostic imaging and consequently providing information allowing the development of computerized aided detection systems (CAD systems), that can help to reduce the number of false-negatives.

[Functional neuroanatomy. Cortical mapping in usual paradigm in functional magnetic resonance imaging]. / Neuroanatomia funcional. Anatomia das áreas activáveis nos usuais paradigmas em ressonância magnética funcional.

Using cases of their own experience, the authors describe the cortical mapping related with the main brain functions they had investigated by Functional Magnetic Resonance Imaging (fMRI).

Cortical remapping in amputees and dysmelic patients: a functional MRI study.

OBJECTIVES: To investigate motor cortex function in upper and lower limb amputees and dysmelic patients using fMRI. MATERIAL AND METHODS: Five amputees and two dysmelic patients were examined. Motor and imagery tasks were defined according to each patient limb deficiency. Cortical activation patterns were analysed for each patient and compared between groups, integrating patients clinical data. RESULTS: There is a consistent pattern of cortical reorganization in all amputees: predominance of activation in the ipsilateral motor cortex and extension to premotor and sensory areas of the contralateral cortex. On the contrary, cortical maps of dysmelic patients were similar to those of healthy volunteers, predominantly with activation of contralateral primary motor cortex areas. CONCLUSIONS: fMRI discloses specific patterns of cortical reorganization on amputees and dysmelic patients, suggesting influence by prosthesis adaptation or stump use with dexterity. These findings could be further applied in influencing neurorehabilitation and development of prosthetic devices.