Impairment of Auditory-Motor Timing and Compensatory Reorganization after Ventral Premotor Cortex Stimulation

Integrating auditory and motor information often requires precise timing as in speech and music. In humans, the position of the ventral premotor cortex (PMv) in the dorsal auditory stream renders this area a node for auditory-motor integration. Yet, it remains unknown whether the PMv is critical for auditory-motor timing and which activity increases help to preserve task performance following its disruption. 16 healthy volunteers participated in two sessions with fMRI measured at baseline and following rTMS (rTMS) of either the left PMv or a control region. Subjects synchronized left or right finger tapping to sub-second beat rates of auditory rhythms in the experimental task, and produced self-paced tapping during spectrally matched auditory stimuli in the control task. Left PMv rTMS impaired auditory-motor synchronization accuracy in the first sub-block following stimulation (p<0.01, Bonferroni corrected), but spared motor timing and attention to task. Task-related activity increased in the homologue right PMv, but did not predict the behavioral effect of rTMS. In contrast, anterior midline cerebellum revealed most pronounced activity increase in less impaired subjects. The present findings suggest a critical role of the left PMv in feed-forward computations enabling accurate auditory-motor timing, which can be compensated by activity modulations in the cerebellum, but not in the homologue region contralateral to stimulation

Clinical Complications Due to Combined Therapy of Narcoleptics

Proceedings of the 9th International Multidisciplinary Conference «Stress and Behavior» Saint-Petersburg, Russia, 16–19 May 2005.Agranulocytosis is a well known life-threatening side effect connected to clozapine treatment. Other dopamine blockers, typical and atypical, have been reported to induce neutropenia and agranulocytosis during treatment in adults and children. Three reports have described a decrease in white blood cells during treatment by neuroleptics other then clozapine, following clozapine-induced agranulocytosis. We report a 44-year-old woman with a previous course of clozapine treatment who developed neutropenia on combined treatment with clozapine and sulpiride, which was then followed by neutropenia on amisulpride treatment and pancytopenia on chlorpromazine treatment. Following treatment by a combination ECT and haloperidol, her condition improved without any signs of blood dyscrasia. The etiology of clozapine-induced agranulocytosis remains unknown. Leading hypothesis include an immune mechanism that is possibly complement- or drug- dependent and a toxic effect. We consider cross-sensitization of the immune system, triggered by the combination of clozapine and sulpiride and then expanded to include amisulpride and chlorpromazine, as a possible explanation of the event. The previous clozapine treatment might have been an additional risk factor. Clinicians should consider this possible complication in everyday practice when prescribing combined therapy

Effects of Acute Aerobic Exercise, Mindfulness Training and Combined Mindfulness and Exercise on Cognitive Performance

Physical activity (PA) and mindfulness are independently associated with improved cognitive function; however, the effects of their combination on cognitive function are unknown. The purpose of this study was to examine the effects of an acute bout of PA, mindfulness training, and combined PA and mindfulness training on changes in cognitive function and perceived cognitive ability. Using a repeated measures within-subjects design, adults (N = 29, Mage = 28.6) completed three 20-minute counterbalanced conditions: a) mindfulness training (MIND); b) moderate-intensity walking (PA), and c) moderate-intensity walking while listening to PA-specific mindfulness training (PAMIND). Participants completed the NIH Toolbox Cognitive Battery and PROMIS Applied Cognition Short Form before and after each condition. Within-subjects repeated measures ANOVAs revealed inhibitory control, working memory, task shifting, processing speed and the fluid composite score ( P &lt; .01 for all) improved from pre-to post-condition for all conditions. Perceived cognitive ability declined across all conditions pre- to post-condition ( P &lt; .001); decreases were largest in the MIND condition. Cognitive performance improved following acute bouts of general mindfulness, PA, and the combination of the two, but perceived cognitive ability declined. Future work is warranted to examine effects in other populations and as a result of different PA and mindfulness doses and interventions. </jats:sec

Effect of the Fit2Thrive Intervention on Patient-reported Outcomes in Breast Cancer Survivors: A Randomized Full Factorial Trial

Moderate to vigorous physical activity (MVPA) interventions improve patient-reported outcomes (PROs) of physical and psychological health among breast cancer survivors (BCS); however, the effects of specific intervention components on PROs are unknown. To use the Multiphase Optimization Strategy (MOST) to examine overall effects of the Fit2Thrive MVPA promotion intervention on PROs in BCS and explore whether there are intervention component-specific effects on PROs. Physically inactive BCS [n = 269; Mage = 52.5 (SD = 9.9)] received a core intervention (Fitbit + Fit2Thrive smartphone app) and were randomly assigned to one of 32 conditions in a full factorial experiment of five components ("on" vs. "off"): (i) support calls, (ii) deluxe app, (iii) text messages, (iv) online gym, and (v) buddy. Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires assessed anxiety, depression, fatigue, physical functioning, sleep disturbance and sleep-related impairment at baseline, post-intervention (12-week), and 24-week follow-up. Main effects for all components at each time point were examined using an intention to treat mixed-effects model. All PROMIS measures except sleep disturbance significantly improved (p's < .008 for all) from baseline to 12-weeks. Effects were maintained at 24-weeks. The "on" level of each component did not result in significantly greater improvements on any PROMIS measure compared to the "off" level. Participation in Fit2Thrive was associated with improved PROs in BCS, but improvements did not differ for "on" vs. "off" levels for any component tested. The low-resource Fit2Thrive core intervention is a potential strategy to improve PROs among BCS. Future studies should test the core in an RCT and examine various intervention component effects in BCS with clinically elevated PROs