Brain Sci., Volume 12, Issue 11 (November 2022) – 170 articles

The complex structure of the brain supports high-order cognition, which is crucial for mastering chess. Surface-based measures, including the fractional dimension (FD) and gyrification index (GI), may be more sensitive in detecting cortical changes relative to volumetric indexes. For this reason, structural magnetic resonance imaging data from 29 chess experts and 29 novice participants were analyzed using the CAT12 toolbox. FD and GI for each brain region were compared between the groups. A multivariate model was used to identify surface-based brain measures that can predict chess expertise. In chess experts, FD is increased in the left frontal operculum (p < 0.01), and this change correlates with the starting age of chess practice (ρ = −0.54, p < 0.01). FD is decreased in the right superior parietal lobule (p < 0.01). Chess expertise is predicted by the FD in a network of fronto-parieto-temporal regions and is associated with GI changes in the middle cingulate gyrus (p < 0.01) and the superior temporal sulcus (p < 0.01). Our findings add to the evidence that chess expertise is based on the complex properties of the brain surface of a network of transmodal association areas important for flexible high-level cognitive functions. Interestingly, these changes are associated with long-lasting practice, suggesting that neuroplastic effects develop over time. Full article

Introduction: Ischemic stroke is a leading cause of disability and mortality worldwide. As acute stroke patients often lose decision-making capacity, acute management is fraught with complicated decisions regarding life-sustaining treatment (LST). We aimed to explore (1) the perspectives and experiences of clinicians regarding the use of predictive scores for LST decision making in severe acute stroke, and (2) clinicians’ awareness of their own cognitive biases in this context. Methods: Four focus groups (FGs) were conducted with 21 physicians (13 residents and 8 attending physicians); two FGs in a university hospital and two in a regional hospital in French-speaking Switzerland. Discussions were audio-recorded and transcribed verbatim. Transcripts were analyzed thematically. Two of the four transcripts were double coded to establish coding framework consistency. Results: Participants reported that predictive tools were not routinely used after severe stroke, although most knew about such scores. Scores were reported as being useful in quantifying prognosis, advancing scientific evidence, and minimizing potential biases in decisions. Their use is, however, limited by the following barriers: perception of inaccuracy, general disbelief in scoring, fear of self-fulfilling prophecy, and preference for clinical judgement. Emotional and cognitive biases were common. Emotional biases distort clinicians’ knowledge and are notably: bias of personal values, negative experience, and cultural bias. Cognitive biases, such as availability, confirmation, and anchoring biases, that produce systematic deviations from rational thinking, were also identified. Conclusions: The results highlight opportunities to improve decision making in severe stroke through the promotion of predictive tools, strategies for communicating prognostic uncertainty, and minimizing cognitive biases among clinicians, in order to promote goal-concordant care. Full article

Sexualized substance use (SSU) is the practice of psychotropic substance use before or during sex to increase sexual pleasure. The growing use of SSU has a strong association with sexually transmitted infections (STIs). Community health mobilizers (CHMs) are agents who assist in decreasing the global burden of disease in the communities they serve. They work as unit managers, counselors, or field workers. The managers and counselors have a minimum of a bachelor’s degree, and field workers have a minimum of a higher secondary education. This study aimed to qualitatively assess the knowledge gaps regarding SSU among CHMs. In-depth interviews (IDIs) were conducted in New Delhi, India with nineteen CHMs. Majority of the CHMs were men (n = 9, 47%) followed by transgender (TG) persons (TG females n = 5, 26.3%; TG males n = 1, 5.2%), and women (n = 4, 21.1%). Knowledge gaps were identified among the CHMs regarding different types of sexualized substances, drug procurement, human immunodeficiency virus (HIV) infection prevention, and complex health issues associated with SSU. It suggested the need for periodic workshops and training for upgradation of existing knowledge and practices among the CHMs. This formative research may help social scientists to develop protocols for conducting multi-centric, community-based studies across the country for further validation and exploration. Full article

The present review aims to explore the use of Immersive Virtual Reality (IVR) in the treatment of visual perception in Unilateral Spatial Neglect (USN) after a stroke. PubMed, Scopus, Embase and Pedro databases were searched, from inception to 1 February 2022. All studies that investigated the effect of IVR on USN, such as outcome in the stroke population, have been included. The current comprehensive systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations and was registered in the PROSPERO database [CRD42022311284]. Methodological quality was assessed through JBI critical appraisal tool. A total of 436 articles were identified through the database searches. A total of 10 articles, with a heterogeneous study design, which involved 77 patients with USN with low-to-moderate methodological quality, have been selected. Five out the included studies tested usability of IVR for assessed or treated visual perception deficits in USN, comparing the results with 134 healthy subjects. In the rest of studies that tested IVR such as treatment, three showed statistical positive results (p < 0.05) in visual perception outcome. To date, the literature has suggested the potential benefits in the use of IVR for the treatment of visual perception disorders in USN. Interestingly, IVR motivates patients during the rehabilitation process improving compliance and interest. The heterogeneity in the studies’ design and in IVR treatments indicate the need of future investigations in the consideration of potentiality and low-cost of this technology. Full article

Objective: The aim of this study was to investigate the efficacy and safety of deep-brain stimulation (DBS) in the treatment of patients with Parkinson’s disease aged 75 years and older. Methods: From March 2013 to June 2021, 27 patients with Parkinson’s disease (≥75 years old) who underwent DBS surgery at the First Medical Center of the PLA General Hospital were selected. The Unified Parkinson’s Disease Rating Scale Part 3 (UPDRS-III), 39-item Parkinson’s Disease Questionnaire (PDQ-39), and Barthel Index for Activities of Daily Living (BI) scores were used to evaluate motor function and quality of life before surgery and during on and off periods of DBS at 1 year post operation and at the final follow-up. A series of non-motor scales were used to evaluate sleep, cognition, and mood, and the levodopa equivalent daily dose (LEDD) was also assessed. Adverse events related to surgery were noted. Results: The average follow-up time was 55.08 (21–108) months. Symptoms were significantly improved at 1 year post operation. The median UPDRS-III score decreased from 35 points (baseline) to 19 points (improvement of 45.7%) in the stimulation-on period at 1 year post operation (t = 19.230, p < 0.001) and to 32 points (improvement of 8.6%) at the final follow-up (t = 3.456, p = 0.002). In the stimulation-off period, the median score of UPDRS-III increased from 35 points to 39 points (deterioration of −11.4%) at 1 year post operation (Z = −4.030, p < 0.001) and 45 points (deterioration of −28.6%) at the final follow-up (Z = −4.207, p < 0.001). The PDQ-39 overall scores decreased from 88 points (baseline) to 55 points (improvement of 37.5%) in the stimulation-on period at 1 year post operation (t = 11.390, p < 0.001) and 81 points (improvement of 8.0%) at the final follow-up (t = 2.142, p = 0.044). In the stimulation-off period, the median PDQ-39 score increased from 88 points to 99 points (deterioration of −12.5%) at the final follow-up (Z = −2.801, p = 0.005). The ADL-Barthel Index score increased from 25 points (baseline) to 75 points (improvement of 66.7%) at 1 year post operation (Z = −4.205, p < 0.001) and to 35 points (improvement of 28.6%) at the final follow-up (Z = −4.034, p < 0.001). In the stimulation-off period, BI scores decreased from 25 points to 15 points (deterioration of −40%) at 1 year post operation (Z = −3.225, p = 0.01) and to 15 points (deterioration of −40%) at the final follow-up (Z = −3.959, p = 0.001). Sleep, cognition, and mood were slightly improved at 1 year post operation (p < 0.05), and LEDD was reduced from 650 mg (baseline) to 280 mg and 325 mg at 1 year post operation and the final follow-up, respectively (p < 0.05). One patient had a cortical hemorrhage in the puncture tract on day 2 after surgery, five patients had hallucinations in the acute stage after surgery, and one patient had an exposed left-brain electrode lead at 4 months post operation; there were no infections or death. Conclusion: DBS showed efficacy and safety in treating older patients (≥75 years old) with Parkinson’s disease. Motor function, quality of life, activities of daily living, LEDD, and sleep all showed long-term improvements with DBS; short-term improvements in emotional and cognitive function were also noted. Full article

Patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) seropositive for autoantibodies against nodal and paranodal proteins display distinct clinical presentations. In the latest study, CIDP with autoantibodies against paranodal proteins was defined as autoimmune nodopathy (AN). We herein present a case of 39-year-old male with anti- neurofascin (NF) 155 and NF186 IgG4 antibody with gait disturbance and tremor, who was followed up for 4 months and demonstrated clinical improvements after apparently effective rituximab therapy. In addition, a literature review was conducted to investigate the clinical characteristics of anti-NF155/NF186-positive AN. Full article

Previous research reported significant relationship between Big Five personality traits and aggression in both adolescent’s and adult population. However, it is unclear about whether similar connection exist in early age. This study investigated how personality traits and family environment influence the development of aggression in school aged Saudi children. A sample of 315 school going children were recruited voluntarily to complete a set of measures examining Big Five personality factors, family environment and aggression. Correlation analysis were employed to evaluate association between Big Five personality traits, family environment and aggression. The results showed a significant relationship of Big Five personality factors and family environment factors to aggression. The findings of the study revealed that amongst the Big Five personality traits conscientiousness, agreeableness, and neuroticism were strongest antecedents of childhood aggression. Family environment characterized by family cohesion, expressiveness and conflict were appeared to be significant antecedents of aggressive behavior in children. This study expands our knowledge about the intervention strategies of aggression from Big Five traits and family environment perspectives. Full article

Events linked to post-traumatic stress disorder (PTSD) influence psychological and physical health through the generation, exacerbation, and maintenance of symptoms such as anxiety, hyperarousal, and avoidance. Depending upon circumstance, traumatic events may also contribute to the onset of tinnitus, post-traumatic headache, and memory problems. PTSD should be considered a psychological injury, andwhile tinnitus is a symptom, its onset and sound quality may be connected in memory to the injury, thereby evincingthe capacity to exacerbate the trauma’s effects. The myriad attributes, psychological and mechanistic, shared by tinnitus and PTSD offer tinnitus investigators the opportunity to draw from the rich and long-practiced strategies implemented for trauma counseling. Mechanisms and interventions understood through the lens of traumatic exposures may inform the clinical management of tinnitus disorder, and future studies may assess the effect of PTSD intervention on co-occurring conditions. This brief summary considered literature from both the hearing and trauma disciplines, with the goal of reviewing mechanisms shared between tinnitus and PTSD, as well as clinical reports supporting mutual reinforcement of both their symptoms and the effects of therapeutic approaches. Full article

The aim of this review is to draw attention to neurosurgical approaches for treating chronic and opioid-resistant pain. In a first chapter, an up-to-date overview of the main pathophysiological mechanisms of pain has been carried out, with special emphasis on the details in which the surgical treatment is based. In a second part, the principal indications and results of different surgical approaches are reviewed. Cordotomy, Myelotomy, DREZ lesions, Trigeminal Nucleotomy, Mesencephalotomy, and Cingulotomy are revisited. Ablative procedures have a limited role in the management of chronic non-cancer pain, but they continues to help patients with refractory cancer-related pain. Another ablation lesion has been named and excluded, due to lack of current relevance. Peripheral Nerve, Spine Cord, and the principal possibilities of Deep Brain and Motor Cortex Stimulation are also revisited. Regarding electrical neuromodulation, patient selection remains a challenge. Full article

The Zero-P spacer was primarily developed aiming to reduce the morbidity associated with the traditional anterior cervical plate. During the past decade, many authors have reported the use of Zero-P spacers for anterior cervical discectomy and fusion (ACDF) of one or two segments. Nevertheless, there is still a paucity of knowledge on the safety and feasibility of using Zero-P spacers for 3-level fixation. The objective of this study was to investigate the clinical and radiological outcomes, with a focus on the sagittal alignment reconstruction of 3-level ACDF surgery using Zero-P spacers versus those using a traditional plate and cage system. From Sep 2013 to Aug 2016, a total of 44 patients who received 3-level ACDF surgery due to cervical spondylotic myelopathy were recruited. The Zero-P spacer was used in 23 patients (group ZP) and the traditional plate and cage system in 21 (group PC). Clinical outcomes were analyzed by Neck Disability Index (NDI) and Japanese Orthopedic Association (JOA) scores, and dysphagia was evaluated using the Bazaz score. Radiological outcomes, including fusion rate, adjacent segment degeneration (ASD), and especially changes in cervical sagittal alignment, were analyzed. The NDI and JOA scores did not differ significantly between the two groups postoperatively (p > 0.05); however, there was significantly less dysphagia in patients using Zero-P spacers at the 3- and 6-month follow-up (p < 0.05). At the 24-month follow-up, the fusion rate and ASD were similar between the two groups (p > 0.05). Interestingly, patients using Zero-P spacers had a significantly lower postoperative C2-7 Cobb angle and fused segment Cobb angle, compared to those using a traditional plate and cage system (p < 0.05); meanwhile, the fused segment disc wedge was also found to be significantly smaller in patients using Zero-P spacers after surgery (p < 0.05). Moreover, we further divided patients into subgroups according to their cervical lordosis. In patients with a preoperative C2-7 Cobb angle ≤ 10°, significantly less cervical and local lordosis, as well as disc wedge, were seen in group ZP after surgery (p < 0.05), while in others with a preoperative C2-7 Cobb angle > 10°, no significant difference in postoperative changes of the cervical sagittal alignment was seen between group ZP and group PC (p > 0.05). Zero-P spacers used in 3-level ACDF surgery could provide equivalent clinical outcomes and a lower rate of postoperative dysphagia, compared to the traditional plate and cage system. However, our results showed that it was inferior to the cervical plate in terms of sagittal alignment reconstruction for 3-level fixation. We recommend applying Zero-P spacers for 3-level ACDF in patients with good preoperative cervical lordosis (C2-7 Cobb angle > 10°), in order to restore and maintain physiological curvature of the cervical spine postoperatively. Full article

Recreational drug intake may be associated with a range of medical untoward consequences, including male infertility. However, as the related evidence is still limited, the main outcome of this review is to provide a better understanding of the existence of any association between recreational drug misuse and male fertility levels’ decline. Whilst searching the MEDLINE/PubMed, a comprehensive overview of the literature regarding male infertility and substances of abuse (e.g., phytocannabinoids, opiates/opioids, stimulants, ‘herbal highs’, psychedelics, and ‘novel psychoactive substances) was here undertaken. Due to the paucity of robust, high-quality, empirical, human studies, a narrative strategy was here preferred over a systematic approach. Relevant data are qualitatively analyzed and presented in a table. Although most available evidence is in support of a detrimental role of cannabis on human spermatogenesis, a few remaining studies failed to document any effect of this drug on seminal quality, and it is not clear to which extent this drug impacts fertility rates/time to pregnancy. The current understanding of the impact of opiate-, cocaine- and amphetamine/stimulant-misuse on human reproduction is widely unknown, and most studies dealing with this matter represent only an extrapolation of data derived from specific clinical circumstances. Although the message of ‘no smoking, no alcohol and no street drugs’ should always be offered as good health advice to all patients seeking medical help for fertility issues, robust scientific clinical evidence in support of a direct detrimental impact of recreational drugs on spermatogenesis is scant to date. Full article

Inhibition of reaching and grasping actions as an element of cognitive control and executive function is a vital component of sensorimotor behaviour that is often impaired in patients who have lost sensorimotor function following a stroke. To date, there are few kinematic studies detailing the fine spatial and temporal upper limb movements associated with the millisecond temporal trajectory of correct and incorrect responses to visually driven Go/No-Go reaching and grasping tasks. Therefore, we aimed to refine the behavioural measurement of correct and incorrect inhibitory motor responses in a Go/No-Go task for future quantification and personalized rehabilitation in older populations and those with acquired motor disorders, such as stroke. An exploratory study mapping the kinematic profiles of hand movements in neurotypical participants utilizing such a task was conducted using high-speed biological motion capture cameras, revealing both within and between subject differences in a sample of healthy participants. These kinematic profiles and differences are discussed in the context of better assessment of sensorimotor function impairment in stroke survivors. Full article

Objective: This study aimed to investigate the association between high-mobility-group box 1 (HMGB1) and stroke-associated pneumonia (SAP) in acute ischemic stroke (AIS) patients. Methods: AIS patients were enrolled in two centers. The serum samples were collected within the first 24 h after admission, and HMGB1 levels were measured by enzyme-linked immunosorbent assay. Logistic regression models were used to calculate the odds ratio (OR) and 95% confidence interval (95% CI) of SAP for HMGB1 concentrations. Restricted cubic splines (RCS) were performed to explore the shapes of the association between HMGB1 concentrations and SAP. Results: From January 2022 to May 2022, a total of 420 AIS patients were enrolled. Ninety-six (22.9%) patients develop SAP. The levels of HMGB1 in the SAP group were higher than those in the non-SAP group (p < 0.001). Using the first quartile of HMGB1 group as a reference, patients in the fourth quartile of HMGB1 group had the highest likelihood of experiencing SAP in the unadjusted model (OR = 3.687; 95% CI: 1.851–7.344), age- and sex-adjusted model (OR = 3.511; 95% CI: 1.725–7.147), and multivariable-adjusted model (OR = 2.701; 95% CI: 1.045–6.981). HMGB1 was also independently associated with SAP as a continuous variable in the unadjusted model (OR = 1.132; 95% CI: 1.069–1.199), age- and sex-adjusted model (OR = 1.131; 95% CI: 1.066–1.200), and multivariable-adjusted model (OR = 1.096; 95% CI: 1.011–1.188). RCS showed a linear association between HMGB1 and SAP (p for linear trend = 0.008) Conclusions: HMGB1 might be able to act as a potential biomarker of SAP in AIS patients. Full article

Parkinson’s disease (PD) is a neurodegenerative disorder often associated with pre-motor symptoms involving both gastrointestinal and olfactory tissues. PD patients frequently suffer from hyposmia, hyposalivation, dysphagia and gastrointestinal dysfunctions. During the last few years it has been speculated that microbial agents could play a crucial role in PD. In particular, alterations of the microbiota composition (dysbiosis) might contribute to the formation of misfolded α-synuclein, which is believed to be the leading cause of PD. However, while several findings confirmed that there might be an important link between intestinal microbiota alterations and PD onset, little is known about the potential contribution of the nasal microbiota. Here, we describe the latest findings on this topic by considering that more than 80% of patients with PD develop remarkable olfactory deficits in their prodromal disease stage. Therefore, the nasal microbiota might contribute to PD, eventually boosting the gut microbiota in promoting disease onset. Finally, we present the applications of the seed amplification assays to the study of the gut and olfactory mucosa of PD patients, and how they could be exploited to investigate whether pathogenic bacteria present in the gut and the nose might promote α-synuclein misfolding and aggregation. Full article

Neuroprostheses are neuroengineering devices that have an interface with the nervous system and supplement or substitute functionality in people with disabilities. In the collective imagination, neuroprostheses are mostly used to restore sensory or motor capabilities, but in recent years, new devices directly acting at the brain level have been proposed. In order to design the next-generation of neuroprosthetic devices for brain repair, we foresee the increasing exploitation of closed-loop systems enabled with neuromorphic elements due to their intrinsic energy efficiency, their capability to perform real-time data processing, and of mimicking neurobiological computation for an improved synergy between the technological and biological counterparts. In this manuscript, after providing definitions of key concepts, we reviewed the first exploitation of a real-time hardware neuromorphic prosthesis to restore the bidirectional communication between two neuronal populations in vitro. Starting from that ‘case-study’, we provide perspectives on the technological improvements for real-time interfacing and processing of neural signals and their potential usage for novel in vitro and in vivo experimental designs. The development of innovative neuroprosthetics for translational purposes is also presented and discussed. In our understanding, the pursuit of neuromorphic-based closed-loop neuroprostheses may spur the development of novel powerful technologies, such as ‘brain-prostheses’, capable of rewiring and/or substituting the injured nervous system. Full article

Engaging in musical activities throughout the lifespan may protect against age-related cognitive decline and modify structural and functional connectivity in the brain. Prior research suggests that musical experience modulates brain regions that integrate different modalities of sensory information, such as the insula. Most of this research has been performed in individuals classified as professional musicians; however, general musical experiences across the lifespan may also confer beneficial effects on brain health in older adults. The current study investigated whether general musical experience, characterized using the Goldsmith Music Sophistication Index (Gold-MSI), was associated with functional connectivity in older adults (age = 65.7 ± 4.4, n = 69). We tested whether Gold-MSI was associated with individual differences in the functional connectivity of three a priori hypothesis-defined seed regions in the insula (i.e., dorsal anterior, ventral anterior, and posterior insula). We found that older adults with more musical experience showed greater functional connectivity between the dorsal anterior insula and the precentral and postcentral gyrus, and between the ventral anterior insula and diverse brain regions, including the insula and prefrontal cortex, and decreased functional connectivity between the ventral anterior insula and thalamus (voxel p < 0.01, cluster FWE p < 0.05). Follow-up correlation analyses showed that the singing ability subscale score was key in driving the association between functional connectivity differences and musical experience. Overall, our findings suggest that musical experience, even among non-professional musicians, is related to functional brain reorganization in older adults. Full article

Objective: Higher fasting glucose is thought to be associated with adverse outcome in patients receiving endovascular treatment (EVT), while the effect of glycosylated hemoglobin (HbA_1c) on outcome is controversial. We combined fasting blood glucose (FBG) with HbA_1c and evaluated their relationship with the three-month functional outcome in patients who underwent EVT. Methods: Data from 739 consecutive ischemic stroke patients who underwent EVT from April 2015 to August 2021 were retrospectively reviewed. HbA_1c was used to estimate the chronic glucose level according to the following formula: chronic glucose level (mg/dL) = 28.7 × HbA_1c (%) − 6.7. Patients were split into two groups in accordance with the three-month modified Rankin Scale (mRS). Univariate and multivariate analyses were utilized to investigate the association of outcome with blood glucose and to identify other predictors of prognosis. Results: Patients with poor outcome had significantly higher FBG, chronic glycemia, FBG/chronic glycemic ratio, and difference between FBG and chronic glycemia (Δ_A-C). FBG, the FBG/chronic glycemic ratio, and Δ_A-C remained to be associated with poor outcome after adjustment. We then established a glycemia-based nomogram with a concordance index of 0.841, and it showed favorable clinical utility according to decision curve analysis. Conclusions: Glycemia after EVT was connected with the functional outcome and a nomogram based on glycemia may be used to predict prognosis in stroke patients treated with EVT. Full article

The perception of physical exertion is the cognitive sensation of work demands associated with voluntary muscular actions. Measurements of exerted force are crucial for avoiding the risk of overexertion and understanding human physical capability. For this purpose, various physiological measures have been used; however, the state-of-the-art in-force exertion evaluation lacks assessments of underlying neurophysiological signals. The current study applied a graph theoretical approach to investigate the topological changes in the functional brain network induced by predefined force exertion levels for twelve female participants during an isometric arm task and rated their perceived physical comfort levels. The functional connectivity under predefined force exertion levels was assessed using the coherence method for 84 anatomical brain regions of interest at the electroencephalogram (EEG) source level. Then, graph measures were calculated to quantify the network topology for two frequency bands. The results showed that high-level force exertions are associated with brain networks characterized by more significant clustering coefficients (6%), greater modularity (5%), higher global efficiency (9%), and less distance synchronization (25%) under alpha coherence. This study on the neurophysiological basis of physical exertions with various force levels suggests that brain regions communicate and cooperate higher when muscle force exertions increase to meet the demands of physically challenging tasks. Full article

Many contradictory theories regarding epileptogenesis in idiopathic generalized epilepsy have been proposed. This study aims to define the network that takes part in the formation of the spike-wave discharges in patients with generalized tonic–clonic seizures alone (GTCSa) and elucidate the network characteristics. Furthermore, we intend to define the most influential brain areas and clarify the connectivity pattern among them. The data were collected from 23 patients with GTCSa utilizing low-density electroencephalogram (EEG). The source localization of generalized spike-wave discharges (GSWDs) was conducted using the Standardized low-resolution brain electromagnetic tomography (sLORETA) methodology. Cortical connectivity was calculated utilizing the imaginary part of coherence. The network characteristics were investigated through small-world propensity and the integrated value of influence (IVI). Source localization analysis estimated that most sources of GSWDs were in the superior frontal gyrus and anterior cingulate. Graph theory analysis revealed that epileptic sources created a network that tended to be regularized during generalized spike-wave activity. The IVI analysis concluded that the most influential nodes were the left insular gyrus and the left inferior parietal gyrus at 3 and 4 Hz, respectively. In conclusion, some nodes acted mainly as generators of GSWDs and others as influential ones across the whole network. Full article

According to the shallow structure hypothesis (SSH), adult L2 learners rely more on lexical-semantic and pragmatic information but less so on syntactic information in online language processing, ending up with shallower syntactic representation. To test the SSH, we conducted an eye-tracking experiment on L1-Korean L2-Chinese learners with native Chinese speakers as the baseline, investigating their processing of Chinese base-generated-topic sentences (BGT). The results show that both the intermediate and advanced Korean learners of Chinese are sensitive to and can make use of syntactic information, but only the advanced learners are sensitive to the semantic constraint when processing Chinese BGT sentences, providing evidence against the SSH. Full article

Aims: This intervention study evaluates the effect of a virtual reality cognition training system (VRCTS) on improving cognitive function and clinical symptoms in Han Chinese patients with schizophrenia in the remission stage. Methods: Sixty-eight patients with schizophrenia in the remission stage were recruited for this study and were randomly allocated to either the virtual reality training (VRT) group or the treatment-as-usual (TAU) group. For the VRT group, patients received training with the VRCTS for two weeks and antipsychotic treatment as usual, while the TAU group only received antipsychotic treatment as usual. Cognitive function and clinical symptoms before and after the two-week treatment were assessed by the MATRICS consensus cognitive battery (MCCB), positive and negative syndrome scale (PANSS), and personal and social performance scale (PSP). Results: The results showed that (1) VRCTS could improve MCCB composite scores and scores on 2 out of 7 cognitive domains: visual learning as well as reasoning and problem solving. It was also observed that (2) VRCTS could alleviate general psychopathology symptoms of PANSS, but did not exert effects on positive and negative symptoms among patients with schizophrenia in the remission stage. Conclusions: A therapeutic effect of VRCTS was observed in patients with schizophrenia in the remission stage. This may improve cognitive function and general psychopathological symptoms. Trial registration: China Clinical Trial Registry, ChiVTR1800016121. Full article

The potential for the misdiagnosis of giftedness as attention deficit/hyperactivity disorder (ADHD) has been well documented, as has the clinical diagnostic profile of individuals with both giftedness and ADHD. This study aimed to examine parents’ and teachers’ responses to the Conners 3 behavioral rating scale of gifted students with ADHD compared to gifted students without ADHD and non-gifted students with ADHD. Ninety-two children aged 6 to 16 years were included in the study. On the basis of clinical assessments utilizing the K-SADS, the WISC-V, and other neurocognitive tests, the students were split into three groups: gifted/ADHD (n = 35), ADHD (n = 35), and gifted (n = 22). The results revealed that mothers’, fathers’, and teachers’ responses to the Conners 3 rating scale distinguished well between the gifted group and the other two groups, but not between the gifted/ADHD and ADHD groups. The learning difficulties observed by teachers was the most significant element that distinguished gifted/ADHD students from non-gifted ADHD students. Other results indicated that mothers and fathers reported more inattention problems in their gifted/ADHD children than teachers. Additionally, mothers tended to observe more learning and executive function problems in their gifted/ADHD children than teachers did. These findings highlight the importance of multiple informants complementing each other in the assessment process for ADHD in a gifted context to counteract the masking effect between giftedness and ADHD. Full article

Background: Sleep is considered an essential component related to physiological and psychological recovery in athletes and particularly in basketball, given the impact of condensed travel and game schedules on player health and performance. Objective: The aim of this systematic review is to examine studies published to date on sleep and basketball performance. Methodology: All scientific articles that reported a relationship between sleep and its possible impact on performance in basketball are included. The research processes followed the PRISMA criteria, and the relevant articles were extracted (PubMed, WOS, Scopus) as of December 31, 2021. Results: Twenty-eight articles were selected for inclusion and data extraction, with 27 demonstrating that sleep is a vital component in the recovery of basketball players and their corresponding on-court performance. Three central themes that we identified: (1) the quality and extension of sleep (the better quality and more extension of sleep, better performance and lower probability of injury); (2) influence of the players circadian rhythm (travel and game scheduling do not currently facilitate or take this into account); and (3) higher training loads and/or increased stress may jeopardize a subsequent good night’s sleep, which should be taken into account when scheduling practices and workouts. Conclusion: The current systematic review regarding sleep and basketball performance and highlights that there is a strong relationship between both variables. Collectively, the evidence supports the critical influence of sleep on player recovery and basketball performance and risk for injury. Full article

Transcranial direct current stimulation (TDCS) on the primary motor cortex (M1) has been reported to be effective in fibromyalgia (FM). Our previous works have shown hypometabolism of motor networks in FM using Functional Near Infrared Spectroscopy (fNIRS), which could contribute to pain symptoms. To investigate if a single Transcranial Direct Current Stimulation (TDCS) session can restore the reduced metabolism expected in FM patients, we compared metabolic activity in FM patients and controls during a finger-tapping task in basal condition, sham condition, and under anodal TDCS on M1. During the finger tapping task, a continuous wave 20 channel fNIRS system was placed across the bilateral central-frontal areas in 22 healthy controls and 54 FM patients. Subjects were randomly assigned to real TDCS or sham stimulation. The finger-tapping slowness did not change after real and sham stimulation. After real TDCS stimulation, FM patients showed an increased activation of cortical motor regions (t-statistic = −2.5246, p-value = 0.0125 for the stimulated hemisphere and t-statistic = −4.6638, p-value = 0.0001 for the non-stimulated hemisphere). The basal differences between FM and controls reverted after real TDCS, while this effect was not observed for sham stimulation. A single TDCS session of the cortical motor network seemed able to restore basic cortical hypometabolism in FM patients. Further studies could clarify the long-term effect of M1 stimulation on cortical metabolism, and its relevance in pain processing and clinical features. Full article

Children and youth with Autism Spectrum Disorder (ASD) display difficulties recognizing and interacting with behavioral expressions of emotion, a deficit that makes social interaction problematic. Social skills training is foundational to the treatment of ASD, yet this intervention is costly, time-consuming, lacks objectivity, and is difficult to deliver in real-world settings. This pilot project investigated the use of an immersive virtual reality (IVR) headset to simulate real-world social interactions for children/youth with ASD. The primary objective was to describe gaze fixation and visual search behaviors during the simulated activity. Ten participants were enrolled and completed one social-skills training session in the IVR. The results demonstrate differential patterns between participants with mild, moderate, and severe ASD in the location and duration of gaze fixation as well as the patterns of visual searching. Although the results are preliminary, these differences may shed light on phenotypes within the continuum of ASD. Additionally, there may be value in quantifying gaze and visual search behaviors as an objective metric of interventional effectiveness for social-skills training therapy. Full article

Using the arousal and mood hypothesis as a theoretical framework, we examined whether community-dwelling older adults (N = 132) exhibited cognitive benefits after listening to music. Participants listened to shorter (≈2.5 min) or longer (≈8 min) excerpts from recordings of happy- or sad-sounding music or from a spoken-word recording. Before and after listening, they completed tasks measuring visuospatial working memory (WM), cognitive flexibility and speed, verbal fluency, and mathematical ability, as well as measures of arousal and mood. In general, older adults improved from pre- to post-test on the cognitive tasks. For the test of WM, the increase was greater for participants who heard happy-sounding music compared to those in the other two groups. The happy-sounding group also exhibited larger increases in arousal and mood, although improvements in mood were evident only for the long-duration condition. At the individual level, however, improvements in WM were unrelated to changes in arousal or mood. In short, the results were partially consistent with the arousal and mood hypothesis. For older adults, listening to happy-sounding music may optimize arousal levels and mood, and improve performance on some cognitive tasks (i.e., WM), even though there is no direct link between changes in arousal/mood and changes in WM. Full article

Conflicts between groups are difficult to resolve, partly because humans tend to be biased in judging outgroup members. The aim of the current article is to review findings on the link between creativity and conflict-related biases and to offer a model that views creative cognition as an ability that may contribute to overcoming conflict-related biases. Our proposed model conforms to the twofold model of creativity. According to this model, creativity involves a generation phase and an evaluation phase, and these phases correspond to the neural mechanisms that underlie conflict-related biases. Specifically, we contend that the generation phase of creativity affects conflict-related biases by exerting an influence on stereotypes and prejudice, outgroup-targeted emotions, and ingroup empathy biases, all of which rely on the default mode network. Conversely, the evaluation phase of creativity, which is usually associated with activation in the executive control network and action-observation system, may be related to herding behaviors. Building on the shared mechanisms of creativity and conflicts, we propose that studies examining creativity-based interventions may be effective in promoting reconciliation. Full article

This article evaluates an educational experience that uses art to develop empathy. The artistic educational project is called “stepping into others’ shoes” and is carried out with 71 students enrolled in the Early Childhood Education and Primary Education degree programs of the University of Vigo. The main objective is to analyze the students’ experiences in processes of empathic pedagogical relationships that allow empowerment dynamics of oneself and others. An ethnographic approach is used to evaluate the experience through a group case study design with different qualitative instruments: analysis of artistic production, field diary and life stories. The main results indicate that when art is used for the construction of an empathic identity, the participants of these creative dynamics find it difficult to express their feelings and emotions. However, these processes favor social relationships and mutual recognition, as well as self-knowledge. It facilitates the creation of alternative meeting spaces and the promotion of creativity. Based on these results and their discussion, lines of action are suggested which should allow using art as a resource to develop empathy and promote increased motivation in the classroom. Full article

The correct use of punctuation marks in secondary-school students is essential for the comprehension of written texts and, therefore, for the students’ academic success. However, the examination of this issue has often been overlooked in the literature. In the present study, we focused on the progression of comma usage (i.e., a punctuation mark that is often challenging to master) and examined its relation to reading comprehension. A sample of first- and fourth-year secondary-education students from Spain (N = 115) punctuated brief texts in which commas had been previously omitted. The original texts included various types of mandatory commas in Spanish. We also obtained a reading comprehension score from a standardized reading test. Results show that secondary-education students often did not correctly place the commas, with first-year secondary-education students only succeeding in the correct placement of commas 54.5% of the time in (Year 8 in the UK system). This figure increased to 80.9% in fourth-year secondary-education students (Year 11 in the UK system). As a control, this figure rose to 91.5% in first-year university students. Critically, better comprehenders were the ones with better use of punctuation marks (r = 0.33). These results are useful for developing teaching methods to improve writing/reading skills in secondary-school students. Full article

Background: Drug addiction may play an important role in chronic migraine (CM) with medication-overuse headache (MOH). Psychiatric diseases are associated with CM, but data regarding obsessive–compulsive disorder (OCD) are lacking. We aimed to establish the prevalence of OCD traits in CM patients with MOH and the impact on onabotulinum toxin A (OBT-A) treatment. Methods: A total of 75 patients with CM and MOH undergoing treatment with OBT-A in our Headache Centre were evaluated. At baseline and after four injection sessions, we assessed the migraine burden and the presence of OCD traits with the Obsessive–Compulsive Inventory—Revised (OCI-R) test. Results: At baseline, 28% of patients had OCI-R scores compatible with borderline OCD aspects, while 22.7% were pathological. An improvement in headache was significantly associated with an increase in the number of subjects with a normal OCI-R score at T0 and T1, whereas patients with a pathological OCI-R score at T0 showed a significantly higher prevalence of CM at T1. Conclusions: Our data showed a significant rate of OCD traits at baseline, which could strengthen the hypothesis of an addictive disorder underlying CM with MOH. OCD traits seem to influence the OBT-A response. An OCD assessment could be useful in improving patients’ selections before starting treatments. Full article