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Changes in corticospinal drive to spinal motoneurones following tablet-based practice of manual dexterity.

ABSTRACT: The use of touch screens, which require a high level of manual dexterity, has exploded since the development of smartphone and tablet technology. Manual dexterity relies on effective corticospinal control of finger muscles, and we therefore hypothesized that corticospinal drive to finger muscles can be optimized by tablet-based motor practice. To investigate this, sixteen able-bodied females practiced a tablet-based game (3 × 10 min) with their nondominant hand requiring incrementally fast and precise pinching movements involving the thumb and index fingers. The study was designed as a semirandomized crossover study where the participants attended one practice- and one control session. Before and after each session electrophysiological recordings were obtained during three blocks of 50 precision pinch movements in a standardized setup resembling the practiced task. Data recorded during movements included electroencephalographic (EEG) activity from primary motor cortex and electromyographic (EMG) activity from first dorsal interosseous (FDI) and abductor pollicis brevis (APB) muscles. Changes in the corticospinal drive were evaluated from coupling in the frequency domain (coherence) between EEG-EMG and EMG-EMG activity. Following motor practice performance improved significantly and a significant increase in EEG-EMGAPB and EMGAPB-EMGFDI coherence in the beta band (15-30 Hz) was observed. No changes were observed after the control session. Our results show that tablet-based motor practice is associated with changes in the common corticospinal drive to spinal motoneurons involved in manual dexterity. Tablet-based motor practice may be a motivating training tool for stroke patients who struggle with loss of dexterity.

SUBMITTER: Larsen LH

PROVIDER: S-EPMC4760389 | biostudies-other | 2016 Feb

REPOSITORIES: biostudies-other

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Project description:There is a limited understanding of the neurological adaptations responsible for changes in strength following shortening and lengthening resistance training and subsequent detraining. The aim of the study was to investigate differences in corticospinal and spinal responses to resistance training of the tibialis anterior muscle between shortening or lengthening muscle contractions for 4 weeks and after 2 weeks of detraining. Thirty-one untrained individuals were assigned to either shortening or lengthening isokinetic resistance training (4 weeks, 3 days/weeks) or a non-training control group. Transcranial magnetic stimulation and peripheral nerve stimulation (PNS) were used to assess corticospinal and spinal changes, respectively, at pre-, mid-, post-resistance training and post detraining. Greater increases changes (P < 0.01) in MVC were found from the respective muscle contraction training. Motor evoked potentials (expressed relative to background EMG) significantly increased in lengthening resistance training group under contraction intensities ranging from 25 to 80% of the shortening and lengthening contraction intensity (P < 0.01). In the shortening resistance training group increases were only seen at 50 and 80% of both contraction type. Volitional drive (V-wave) showed a greater increase following lengthening resistance training (57%) during maximal lengthening contractions compared to maximal shortening contractions following shortening resistance training (23%; P < 0.001). During the detraining period MVC and V-wave did not change (P > 0.05), although MEP amplitude decreased during the detraining period (P < 0.01). No changes in H-reflex were found pre to post resistance training or post detraining. Modulation in V-wave appeared to be contraction specific, whereby greatest increases occurred following lengthening resistance training. Strength and volitional drive is maintained following 2 weeks detraining, however corticospinal excitability appears to decrease when the training stimulus is withdrawn.

Project description:BackgroundWe performed a pilot study on whether tablet-based measures of manual dexterity can provide behavioral markers for detection of first-episode psychosis (FEP), and whether cortical excitability/inhibition was altered in FEP.MethodsBehavioral and neurophysiological testing was undertaken in persons diagnosed with FEP (N = 20), schizophrenia (SCZ, N = 20), autism spectrum disorder (ASD, N = 20), and in healthy control subjects (N = 20). Five tablet tasks assessed different motor and cognitive functions: Finger Recognition for effector (finger) selection and mental rotation, Rhythm Tapping for temporal control, Sequence Tapping for control/memorization of motor sequences, Multi Finger Tapping for finger individuation, and Line Tracking for visuomotor control. Discrimination of FEP (from other groups) based on tablet-based measures was compared to discrimination through clinical neurological soft signs (NSS). Cortical excitability/inhibition, and cerebellar brain inhibition were assessed with transcranial magnetic stimulation.ResultsCompared to controls, FEP patients showed slower reaction times and higher errors in Finger Recognition, and more variability in Rhythm Tapping. Variability in Rhythm Tapping showed highest specificity for the identification of FEP patients compared to all other groups (FEP vs. ASD/SCZ/Controls; 75% sensitivity, 90% specificity, AUC = 0.83) compared to clinical NSS (95% sensitivity, 22% specificity, AUC = 0.49). Random Forest analysis confirmed FEP discrimination vs. other groups based on dexterity variables (100% sensitivity, 85% specificity, balanced accuracy = 92%). The FEP group had reduced short-latency intra-cortical inhibition (but similar excitability) compared to controls, SCZ, and ASD. Cerebellar inhibition showed a non-significant tendency to be weaker in FEP.ConclusionFEP patients show a distinctive pattern of dexterity impairments and weaker cortical inhibition. Easy-to-use tablet-based measures of manual dexterity capture neurological deficits in FEP and are promising markers for detection of FEP in clinical practice.

Project description:BackgroundAccurate immunosuppression is of critical importance in preventing rejection, while avoiding toxicity following lung transplantation. The mainstay immunosuppressants are calcineurin inhibitors, which require regular monitoring due to interactions with other medications and diet. Adherence to immunosuppression and patient knowledge is vital and can be improved through patient education. Education using tablet-computers was investigated.ObjectiveTo compare tablet-PC education and conventional education in improving immunosuppression trough levels in target range 6 months after a single education. Secondary parameters were ratio of immunosuppression level measurements divided by per protocol recommended measurements, time and patient satisfaction regarding education.DesignSingle-centre, open labelled randomised controlled trial.ParticipantsPatients >6 months after lung-transplantation with <50% of calcineurin inhibitor trough levels in target range.InterventionTablet-pc education versus personal, nurse-led education.MeasurementsCalcineurin inhibitor levels in target range 6 months after education, level variability, interval adherence, knowledge and adherence was studied. As outcome parameter, renal function was measured and adverse events registered.ResultsSixty-four patients were 1:1 randomised for either intervention. Levels of immunosuppression 6 months after education were equal (tablet-PC 58% vs. conventional 48%, p = 0.27), both groups improved in achieving a CNI trough level within target range by either education method (delta tablet-PC 29% vs. conventional 20%). In all patients, level variability decreased (-20.4%), whereas interval adherence remained unchanged. Knowledge about immunosuppression improved by 7% and compliance tests demonstrated universal improvements with no significant difference between groups.ConclusionEducation is a simple, effective tool in improving adherence to immunosuppression. Tablet-PC education was non-inferior to conventional education.Trial registrationClinicalTrials.gov NCT01398488 http://clinicaltrials.gov/ct2/show/NCT01398488? term=gottlieb+tablet+pc+education&rank=1.

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Changes in corticospinal drive to spinal motoneurones following tablet-based practice of manual dexterity.

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