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- Alm, Per A., 1963-
(författare)
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Stuttering : A Disorder of Energy Supply to Neurons?
- 2021
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Ingår i: Frontiers in Human Neuroscience. - : Frontiers Media S.A.. - 1662-5161. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Stuttering is a disorder characterized by intermittent loss of volitional control of speech movements. This hypothesis and theory article focuses on the proposal that stuttering may be related to an impairment of the energy supply to neurons. Findings from electroencephalography (EEG), brain imaging, genetics, and biochemistry are reviewed: (1) Analyses of the EEG spectra at rest have repeatedly reported reduced power in the beta band, which is compatible with indications of reduced metabolism. (2) Studies of the absolute level of regional cerebral blood flow (rCBF) show conflicting findings, with two studies reporting reduced rCBF in the frontal lobe, and two studies, based on a different method, reporting no group differences. This contradiction has not yet been resolved. (3) The pattern of reduction in the studies reporting reduced rCBF corresponds to the regional pattern of the glycolytic index (GI; Vaishnavi et al., 2010). High regional GI indicates high reliance on non-oxidative metabolism, i.e., glycolysis. (4) Variants of the gene ARNT2 have been associated with stuttering. This gene is primarily expressed in the brain, with a pattern roughly corresponding to the pattern of regional GI. A central function of the ARNT2 protein is to act as one part of a sensor system indicating low levels of oxygen in brain tissue and to activate appropriate responses, including activation of glycolysis. (5) It has been established that genes related to the functions of the lysosomes are implicated in some cases of stuttering. It is possible that these gene variants result in a reduced peak rate of energy supply to neurons. (6) Lastly, there are indications of interactions between the metabolic system and the dopamine system: for example, it is known that acute hypoxia results in an elevated tonic level of dopamine in the synapses. Will mild chronic limitations of energy supply also result in elevated levels of dopamine? The indications of such interaction effects suggest that the metabolic theory of stuttering should be explored in parallel with the exploration of the dopaminergic theory.
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| 3. |
- Alm, Per A., 1963-
(författare)
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The Dopamine System and Automatization of Movement Sequences : A Review With Relevance for Speech and Stuttering
- 2021
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Ingår i: Frontiers in Human Neuroscience. - : Frontiers Media S.A.. - 1662-5161. ; 15
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Forskningsöversikt (refereegranskat)abstract
- The last decades of research have gradually elucidated the complex functions of the dopamine system in the vertebrate brain. The multiple roles of dopamine in motor function, learning, attention, motivation, and the emotions have been difficult to reconcile. A broad and detailed understanding of the physiology of cerebral dopamine is of importance in understanding a range of human disorders. One of the core functions of dopamine involves the basal ganglia and the learning and execution of automatized sequences of movements. Speech is one of the most complex and highly automatized sequential motor behaviors, though the exact roles that the basal ganglia and dopamine play in speech have been difficult to determine. Stuttering is a speech disorder that has been hypothesized to be related to the functions of the basal ganglia and dopamine. The aim of this review was to provide an overview of the current understanding of the cerebral dopamine system, in particular the mechanisms related to motor learning and the execution of movement sequences. The primary aim was not to review research on speech and stuttering, but to provide a platform of neurophysiological mechanisms, which may be utilized for further research and theoretical development on speech, speech disorders, and other behavioral disorders. Stuttering and speech are discussed here only briefly. The review indicates that a primary mechanism for the automatization of movement sequences is the merging of isolated movements into chunks that can be executed as units. In turn, chunks can be utilized hierarchically, as building blocks of longer chunks. It is likely that these mechanisms apply also to speech, so that frequent syllables and words are produced as motor chunks. It is further indicated that the main learning principle for sequence learning is reinforcement learning, with the phasic release of dopamine as the primary teaching signal indicating successful sequences. It is proposed that the dynamics of the dopamine system constitute the main neural basis underlying the situational variability of stuttering.
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| 4. |
- Alm, Per, 1963-
(författare)
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Streptococcal infection as a major historical cause of stuttering : data, mechanisms, and current importance
- 2020
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Ingår i: Frontiers in Human Neuroscience. - : Frontiers Media SA. - 1662-5161. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Stuttering is one of the most well-known speech disorders, but the underlying neurological mechanisms are debated. In addition to genetic factors, there are also major non-genetic contributions. It is here proposed that infection with group A beta-hemolytic streptococcus (GAS) was a major underlying cause of stuttering until the mid-1900s when penicillin was introduced in 1943. The main mechanism proposed is an autoimmune reaction from tonsillitis, targeting specific molecules, for example within the basal ganglia. It is here also proposed that GAS infections may have continued to cause stuttering to some extent, to the present date, though more rarely. If so, early diagnosis of such cases would be of importance. Childhood cases with sudden onset of stuttering after throat infection may be particularly important to assess for possible GAS infection. The support for this hypothesis primarily comes from three lines of argument. First, medical record data from the 1930s strongly indicates that there was one type of medical event in particular that preceded the onset of childhood stuttering with unexpected frequency: diseases related to GAS throat infections. In particular, this included tonsillitis and scarlet fever, but also rheumatic fever. Rheumatic fever is a childhood autoimmune sequela of GAS infection, which was a relatively widespread medical problem until the early 1960s. Second, available reports of changes of the childhood prevalence of stuttering indicate striking parallels between stuttering and the incidence of rheumatic fever, with: (1) decline from the early 1900s; (2) marked decline from the introduction of penicillin in the mid 1940s; and (3) reaching a more stable level in the 1960s. The correlations between the data for stuttering and rheumatic fever after the introduction of penicillin are very high, at about 0.95. Third, there are established biological mechanisms linking GAS tonsillitis to immunological effects on the brain. Also, a small number of more recent case reports have provided further support for the hypothesis linking stuttering to GAS infection. Overall, it is proposed that the available data provides strong evidence for the hypothesis that GAS infection was a major cause of stuttering until the mid-1900s, interacting with genetic predisposition.
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- Alotaibi, N, et al.
(författare)
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Cognitive Outcome Prediction in Infants With Neonatal Hypoxic-Ischemic Encephalopathy Based on Functional Connectivity and Complexity of the Electroencephalography Signal
- 2022
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Ingår i: Frontiers in human neuroscience. - : Frontiers Media SA. - 1662-5161. ; 15, s. 795006-
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Tidskriftsartikel (refereegranskat)abstract
- Impaired neurodevelopmental outcome, in particular cognitive impairment, after neonatal hypoxic-ischemic encephalopathy is a major concern for parents, clinicians, and society. This study aims to investigate the potential benefits of using advanced quantitative electroencephalography analysis (qEEG) for early prediction of cognitive outcomes, assessed here at 2 years of age. EEG data were recorded within the first week after birth from a cohort of twenty infants with neonatal hypoxic-ischemic encephalopathy (HIE). A proposed regression framework was based on two different sets of features, namely graph-theoretical features derived from the weighted phase-lag index (WPLI) and entropies metrics represented by sample entropy (SampEn), permutation entropy (PEn), and spectral entropy (SpEn). Both sets of features were calculated within the noise-assisted multivariate empirical mode decomposition (NA-MEMD) domain. Correlation analysis showed a significant association in the delta band between the proposed features, graph attributes (radius, transitivity, global efficiency, and characteristic path length) and entropy features (Pen and SpEn) from the neonatal EEG data and the cognitive development at age two years. These features were used to train and test the tree ensemble (boosted and bagged) regression models. The highest prediction performance was reached to 14.27 root mean square error (RMSE), 12.07 mean absolute error (MAE), and 0.45 R-squared using the entropy features with a boosted tree regression model. Thus, the results demonstrate that the proposed qEEG features show the state of brain function at an early stage; hence, they could serve as predictive biomarkers of later cognitive impairment, which could facilitate identifying those who might benefit from early targeted intervention.
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- Andersson, Jan, 1965-, et al.
(författare)
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Self-Perception and the Relation to Actual Driving Abilities for Individuals With Visual Field Loss
- 2022
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Ingår i: Frontiers in Human Neuroscience. - : Frontiers Media SA. - 1662-5161. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn Sweden, individuals with visual field loss (VFL) have their driving license withdrawn. The literature clearly indicates that individuals with VFL are unsafe drivers on a group level. However, many drivers with VFL can be safe on an individual level. The literature also suggests that self-perception, beliefs, and insights of one's own capabilities are related to driving performance. This study had three aims: (1) To investigate self-perceived driving capability ratings for individuals with VFL; (2) to compare these ratings between groups with different medical conditions associated with VFL (stroke, glaucoma, and diabetes); and (3) to relate the self-perception ratings to actual driving performance in an advanced driving simulator. MethodsParticipants comprised 723 individuals whose driver's license had been withdrawn because of VFL and 92 normally sighted elderly individuals. All participants completed a background survey, rated difficulties with different traffic situations, rated their strengths and weaknesses as drivers, and rated aspects that were important for causing traffic accidents. Of the VFL group participants, 264 also completed a simulator-based driving test that they knew could lead to renewal of their driving license. VFL participants and normally sighted was at the same age when they completed the simulator driving test. ResultsOverall, individuals with VFL rated their capabilities as high on all instruments and scales used, even higher than the elderly normally sighted control group. The only VFL etiology group that rated lower than other groups was the diabetes group. Safety orientation and internal control orientation values were best at discriminating between VFL participants in terms of self-perception of driving performance. Participants categorized as "high" in terms of safety skills and internal control were more modest in their ratings. Finally, participants who passed the simulated driving test did not differ from those who failed, in any of the self-perception measures. ConclusionSelf-perception ratings among individuals with VFL were higher than those of normally sighted elderly individuals. Self-assessed skills did not predict driving performance. Groups with different VFL etiologies rated similarly. Self-ratings of driving abilities cannot be used to assess actual driving performance. Actual driving tests (on road or in the simulator) are necessary to discriminate between safe and unsafe drivers with VFL.
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| 7. |
- Andreou, Dimitrios, et al.
(författare)
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Maltreatment, the Oxytocin Receptor Gene, and Conduct Problems Among Male and Female Teenagers
- 2018
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Ingår i: Frontiers in Human Neuroscience. - : FRONTIERS MEDIA SA. - 1662-5161. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- The oxytocin receptor gene (OXTR) influences human behavior. The G allele of OXTR rs53576 has been associated with both prosocial and maladaptive behaviors but few studies have taken account of environmental factors. The present study determined whether the association of childhood maltreatment with conduct problems was modified by OXTR rs53576 genotypes. In a general population sample of 1591 teenagers, conduct problems as well as maltreatment were measured by self-report. DNA was extracted from saliva samples. In males, there was a significant positive association between maltreatment and conduct problems independent of the genotype. In females, among G allele carriers, the level of conduct problems was significantly higher among those who had been maltreated as compared to those not maltreated. By contrast, among female AA carriers, conduct problems did not vary between those who were, and who were not, maltreated. The results indicate that OXTR rs53576 plays a role in antisocial behavior in females such that the G allele confers vulnerability for antisocial behavior if they experience maltreatment, whereas the A allele has a protective effect.
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| 8. |
- Armstrong, Irene T, et al.
(författare)
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Waiting for a hand : saccadic reaction time increases in proportion to hand reaction time when reaching under a visuomotor reversal
- 2013
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Ingår i: Frontiers in Human Neuroscience. - : Frontiers Media SA. - 1662-5161. ; 7, s. 319-
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Tidskriftsartikel (refereegranskat)abstract
- Although eye movement onset typically precedes hand movement onset when reaching to targets presented in peripheral vision, arm motor commands appear to be issued at around the same time, and possibly in advance, of eye motor commands. A fundamental question, therefore, is whether eye movement initiation is linked or yoked to hand movement. We addressed this issue by having participants reach to targets after adapting to a visuomotor reversal (or 180° rotation) between the position of the unseen hand and the position of a cursor controlled by the hand. We asked whether this reversal, which we expected to increase hand reaction time (HRT), would also increase saccadic reaction time (SRT). As predicted, when moving the cursor to targets under the reversal, HRT increased in all participants. SRT also increased in all but one participant, even though the task for the eyes-shifting gaze to the target-was unaltered by the reversal of hand position feedback. Moreover, the effects of the reversal on SRT and HRT were positively correlated across participants; those who exhibited the greatest increases in HRT also showed the greatest increases in SRT. These results indicate that the mechanisms underlying the initiation of eye and hand movements are linked. In particular, the results suggest that the initiation of an eye movement to a manual target depends, at least in part, on the specification of hand movement.
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| 9. |
- Bartfai, Aniko, et al.
(författare)
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Predicting Outcome for Early Attention Training After Acquired Brain Injury
- 2022
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Ingår i: Frontiers in Human Neuroscience. - : FRONTIERS MEDIA SA. - 1662-5161. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe training of impaired attention after acquired brain injury is central for successful reintegration in daily living, social, and working life. Using statistical process control, we found different improvement trajectories following attention training in a group of relatively homogeneous patients early after acquired brain injury (ABI). ObjectiveTo examine the contribution of pre-injury factors and clinical characteristics to differences in outcome after early attention training. Materials and MethodsData collected in a clinical trial comparing systematic attention training (APT) with activity-based attention training (ABAT) early after brain injury were reanalyzed. ResultsStroke patients (p = 0.004) with unifocal (p = 0.002) and right hemisphere lesions (p = 0.045), and those with higher mental flexibility (TMT 4) (p = 0.048) benefitted most from APT training. Cognitive reserve (p = 0.030) was associated with CHANGE and APT as the sole pre-injury factor. For TBI patients, there was no statistical difference between the two treatments. ConclusionOur study identifies indiscernible factors predicting improvement after early attention training. APT is beneficial for patients with right-hemispheric stroke in an early recovery phase. Knowledge of prognostic factors, including the level of attention deficit, diagnosis, and injury characteristics, is vital to maximizing the efficiency of resource allocation and the effectiveness of rehabilitative interventions to enhance outcomes following stroke and TBI.
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