Faculty Bibliography

BACKGROUND:Traumatic spinal cord injury (TSCI) is one of the most devastating injuries that has a physical impact on patients. The CHORDATA® method involves suspension and pendulous exercises and has been clinically used to treat patients with TSCI. Although empirically used to treat neurological patients, there is no scientific evidence of the efficacy of this method. PURPOSE/OBJECTIVE:To evaluate the chronic effects of CHORDATA® method on torque, muscle activation, muscle thickness, and functionality in patients with traumatic spinal cord injury. METHODS:Twenty-six male patients with medullar thoracic injury were randomly categorised into two groups: intervention group (n = 14) and control group (n = 12). Rehabilitation program comprised of 16 sessions of body suspension and pendulum exercises (twice/week). The maximal voluntary isometric trunk flexion and extension torques, muscle activation and thickness (external and internal oblique, rectus and transversus abdominis, longissimus, and multifidus muscles), and functionality (adapted reach test) were evaluated before and after of rehabilitation program. FINDINGS/RESULTS:A significant increase was observed in maximal voluntary isometric torque (flexion, 58%; extension, 76%), muscle activation of the rectus abdominis muscle, and muscle thickness of all intervention group muscles, without changes in the control group. Compared to the pre-intervention period, the intervention group also showed improvement in functionality at post-intervention, but no such differences were noted in the control group. INTERPRETATION/CONCLUSIONS:The corporal suspension and pendulum exercises training improved rectus abdominis muscle activation, trunk muscles structure and strength, and reaching capacity in medullar thoracic injury patients.

The goal of the present study was to investigate intrinsic and reading-related brain function associated with dyslexia and typical readers in monolingual Brazilian children. Two fMRI studies were carried out: a resting-state and a word-reading study. The results show (a) underconnectivity between the occipitotemporal region (visual word form area) and the brain's default-mode network in dyslexic readers and (b) more activation of the anterior cingulate cortex for typical readers relative to dyslexic readers. The findings provide evidence for brain connectivity and function differences in an underrepresented population in fMRI studies of dyslexia; the results suggest atypical intrinsic function, and differences in directed attention processes in dyslexia.

PURPOSE/OBJECTIVE:To estimate the effect size of a serious game for cardiopulmonary resuscitation (CPR) training in comparison with a video-based on-line course in terms of learning outcomes among medical students before simulation-based CPR using a manikin. METHODS:Participants were 45 first-year medical students randomly assigned to CPR self-training using either a video-based Apple Keynote presentation (n = 22) or a serious game developed in a 3D learning environment (n = 23) for up to 20 min. Each participant was evaluated on a written, multiple-choice test (theoretical test) and then on a scenario of cardiac arrest (practical test) before and after exposure to the self-learning methods. The primary endpoint was change in theoretical and practical baseline scores during simulated CPR. This study was conducted in 2017. RESULTS:Both groups improved scores after exposure. The video group had superior performance in both the theoretical test (7.56±0.21 vs 6.51±0.21 for the game group; p = 0.001) and the practical test (9.67±0.21 vs 8.40±0.21 for the game group; p < 0.001). However, students showed a preference for using games, as suggested by the longer time they remained interested in the method (18.57±0.66 min for the game group vs 7.41±0.43 for the video group; p < 0.001). CONCLUSIONS:The self-training modality using a serious game, after a short period of exposure, resulted in inferior students' performance in both theoretical and practical CPR tests compared to the video-based self-training modality. However, students showed a clear preference for using games rather than videos as a form of self-training.

BACKGROUND:There has been a growing amount of evidence indicating that excess visceral fat is associated with alterations in brain structure and function, including brain cortical thinning in adults. OBJECTIVES:This study aims to investigate the relationship between brain cortical thickness with obesity assessments, in adolescents. METHODS:In this study, we measured three different obesity assessments within an adolescent population (aged 15 - 18 years): body mass index (BMI), visceral fat ratio measured with an MRI and hepatorenal gradient measured with an ultrasound. Volunteers also underwent an MRI scan to measure brain structure. RESULTS:Results indicated that there was no relationship of BMI or hepatorenal gradient with brain cortical dimensions. However, there was a significant association between visceral fat ratio and an increase of cortical thickness throughout the brain. CONCLUSIONS:These results suggest that visceral fat, but not BMI, is correlated with cortical thickening in adolescence.

With resting-state functional MRI (rs-fMRI) there are a variety of post-processing methods that can be used to quantify the human brain connectome. However, there is also a choice of which preprocessing steps will be used prior to calculating the functional connectivity of the brain. In this manuscript, we have tested seven different preprocessing schemes and assessed the reliability between and reproducibility within the various strategies by means of graph theoretical measures. Different preprocessing schemes were tested on a publicly available dataset, which includes rs-fMRI data of healthy controls. The brain was parcellated into 190 nodes and four graph theoretical (GT) measures were calculated; global efficiency (GEFF), characteristic path length (CPL), average clustering coefficient (ACC), and average local efficiency (ALE). Our findings indicate that results can significantly differ based on which preprocessing steps are selected. We also found dependence between motion and GT measurements in most preprocessing strategies. We conclude that by using censoring based on outliers within the functional time-series as a processing, results indicate an increase in reliability of GT measurements with a reduction of the dependency of head motion.

Diffusion tensor imaging (DTI) has been used to evaluate white matter (WM) integrity in major depressive disorder (MDD), with several studies reporting differences between depressed patients and controls. However, these findings are variable and taken from relatively small studies often using suboptimal analytic approaches. The presented DTI study examined WM integrity in large samples of medication-free MDD patients (n=134) and healthy controls (n=54) using voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) approaches, and rigorous statistical thresholds. Compared with health control subjects, MDD patients show no significant differences in fractional anisotropy, radial diffusivity, mean diffusivity, and axonal diffusivity with either the VBM or the TBSS approach. Our findings suggest that disrupted WM integrity does not have a major role in the neurobiology of MDD in this relatively large study using optimal imaging acquisition and analysis; however, this does not eliminate the possibility that certain patient subgroups show WM disruption associated with depression.