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Come together: human-avatar on-line interactions boost joint-action performance in apraxic patients.

ABSTRACT: Limb apraxia (LA) is a high-order motor disorder linked to left-hemisphere damage. It is characterized by defective execution of purposeful actions upon delayed imitation, or verbal command when the actions are performed in isolated, non-naturalistic, conditions. Whether interpersonal interactions provide social affordances that activate neural resources different from those requested by individual action execution, which may improve LA performance, is unknown. To fill this gap, we measured interaction performance, behavioral and kinematic indexes of left-brain damaged patients with/without LA in a social reach-to-grasp task involving two different degrees of spatio-temporal interactivity with an avatar. We found that LA patients' impairment in coordinating with the virtual partner was abolished in highly interactive conditions (where patients selected their actions on-line based on the behavior of the virtual partner) with respect to low interactive conditions (where actions were selected beforehand based on abstract instructions). Voxel-based-Lesion-Symptom-Mapping indicated that impairments in low-interactive conditions were underpinned by lesions of premotor, motor and insular areas, and of the basal ganglia. Our approach expands current understanding of the behavioral and neural correlates of interactive motor performance by highlighting the important role of social affordances, and provides novel, potentially important, views on rehabilitation of higher-order motor cognition disorders.

SUBMITTER: Candidi M

PROVIDER: S-EPMC5714226 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Come together: human-avatar on-line interactions boost joint-action performance in apraxic patients.

Candidi Matteo M Sacheli Lucia M LM Era Vanessa V Canzano Loredana L Tieri Gaetano G Aglioti Salvatore M SM

Social cognitive and affective neuroscience 20171101 11

Limb apraxia (LA) is a high-order motor disorder linked to left-hemisphere damage. It is characterized by defective execution of purposeful actions upon delayed imitation, or verbal command when the actions are performed in isolated, non-naturalistic, conditions. Whether interpersonal interactions provide social affordances that activate neural resources different from those requested by individual action execution, which may improve LA performance, is unknown. To fill this gap, we measured inte ...[more]

PMID: 29140533

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Project description:BackgroundAlthough coma is commonly encountered in critical care, worldwide variability exists in diagnosis and management practices. We aimed to assess variability in coma definitions, etiologies, treatment strategies, and attitudes toward prognosis.MethodsAs part of the Neurocritical Care Society Curing Coma Campaign, between September 2020 and January 2021, we conducted an anonymous, international, cross-sectional global survey of health care professionals caring for patients with coma and disorders of consciousness in the acute, subacute, or chronic setting. Survey responses were solicited by sequential emails distributed by international neuroscience societies and social media. Fleiss κ values were calculated to assess agreement among respondents.ResultsThe survey was completed by 258 health care professionals from 41 countries. Respondents predominantly were physicians (n = 213, 83%), were from the United States (n = 141, 55%), and represented academic centers (n = 231, 90%). Among eight predefined items, respondents identified the following cardinal features, in various combinations, that must be present to define coma: absence of wakefulness (81%, κ = 0.764); Glasgow Coma Score (GCS) ≤ 8 (64%, κ = 0.588); failure to respond purposefully to visual, verbal, or tactile stimuli (60%, κ = 0.552); and inability to follow commands (58%, κ = 0.529). Reported etiologies of coma encountered included medically induced coma (24%), traumatic brain injury (24%), intracerebral hemorrhage (21%), and cardiac arrest/hypoxic-ischemic encephalopathy (11%). The most common clinical assessment tools used for coma included the GCS (94%) and neurological examination (78%). Sixty-six percent of respondents routinely performed sedation interruption, in the absence of contraindications, for clinical coma assessments in the intensive care unit. Advanced neurological assessment techniques in comatose patients included quantitative electroencephalography (EEG)/connectivity analysis (16%), functional magnetic resonance imaging (7%), single-photon emission computerized tomography (6%), positron emission tomography (4%), invasive EEG (4%), and cerebral microdialysis (4%). The most commonly used neurostimulants included amantadine (51%), modafinil (37%), and methylphenidate (28%). The leading determinants for prognostication included etiology of coma, neurological examination findings, and neuroimaging. Fewer than 20% of respondents reported routine follow-up of coma survivors after hospital discharge; however, 86% indicated interest in future research initiatives that include postdischarge outcomes at six (85%) and 12 months (65%).ConclusionsThere is wide heterogeneity among health care professionals regarding the clinical definition of coma and limited routine use of advanced coma assessment techniques in acute care settings. Coma management practices vary across sites, and mechanisms for coordinated and sustained follow-up after acute treatment are inconsistent. There is an urgent need for the development of evidence-based guidelines and a collaborative, coordinated approach to advance both the science and the practice of coma management globally.

Project description:Central to the mechanistic understanding of the human mind is to clarify how cognitive functions arise from simpler sensory and motor functions. A longstanding assumption is that forward models used by sensorimotor control to anticipate actions also serve to incorporate other people's actions and intentions, and give rise to sensorimotor interactions between people, and even abstract forms of interactions. That is, forward models could aid core aspects of human social cognition. To test whether forward models can be used to coordinate interactions, here we measured the movements of pairs of participants in a novel joint action task. For the task they collaborated to lift an object, each of them using fingers of one hand to push against the object from opposite sides, just like a single person would use two hands to grasp the object bimanually. Perturbations of the object were applied randomly as they are known to impact grasp-specific movement components in common grasping tasks. We found that co-actors quickly learned to make grasp-like movements with grasp components that showed coordination on average based on action observation of peak deviation and velocity of their partner's trajectories. Our data suggest that co-actors adopted pre-existing bimanual grasp programs for their own body to use forward models of their partner's effectors. This is consistent with the long-held assumption that human higher-order cognitive functions may take advantage of sensorimotor forward models to plan social behavior. New and Noteworthy: Taking an approach of sensorimotor neuroscience, our work provides evidence for a long-held belief that the coordination of physical as well as abstract interactions between people originates from certain sensorimotor control processes that form mental representations of people's bodies and actions, called forward models. With a new joint action paradigm and several new analysis approaches we show that, indeed, people coordinate each other's interactions based on forward models and mutual action observation.

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Come together: human-avatar on-line interactions boost joint-action performance in apraxic patients.

Publications

Come together: human-avatar on-line interactions boost joint-action performance in apraxic patients.

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