A double-blind,sham-controlled,trial of home-administered rhythmic 10-Hz median nerve stimulation for the reduction of tics,and suppression of the urge-to-tic,in individuals with Tourette syndrome and chronic tic disorder

Tourette syndrome (TS) and chronic tic disorder (CTD) are neurological disorders of childhood onset characterized by the occurrence of tics; repetitive, purposeless, movements or vocalizations of short duration which can occur many times throughout a day. Currently, effective treatment for tic disorders is an area of considerable unmet clinical need. We aimed to evaluate the efficacy of a home-administered neuromodulation treatment for tics involving the delivery of rhythmic pulse trains of median nerve stimulation (MNS) delivered via a wearable ‘watch-like’ device worn at the wrist. We conducted a UK-wide parallel double-blind sham-controlled trial for the reduction of tics in individuals with tic disorder. The device was programmed to deliver rhythmic (10 Hz) trains of low-intensity (1–19 mA) electrical stimulation to the median nerve for a pre-determined duration each day, and was intended to be used by each participant in their home once each day, 5 days each week, for a period of 4 weeks. Between 18th March 2022 and 26th September 2022, 135 participants (45 per group) were initially allocated, using stratified randomization, to one of the following groups; active stimulation; sham stimulation or to a waitlist (i.e. treatment as usual) control group. Recruited participants were individuals with confirmed or suspected TS/CTD aged 12 years of age or upward with moderate to severe tics. Researchers involved in the collection or processing of measurement outcomes and assessing the outcomes, as well as participants in the active and sham groups and their legal guardians were all blind to the group allocation. The primary outcome measure used to assess the ‘offline’ or treatment effect of stimulation was the Yale Global Tic Severity Scale–Total Tic Severity Score (YGTSS–TTSS) assessed at the conclusion of 4 weeks of stimulation. The primary outcome measure used to assess the ‘online’ effects of stimulation was tic frequency, measured as the number of tics per minute (TPM) observed, based upon blind analysis of daily video recordings obtained while stimulation was delivered. The results demonstrated that after 4-week stimulation, tic severity (YGTSS-TTSS) had reduced by 7.1 points (35 percentile reduction) for the active stimulation group compared to 2.13/2.11 points for the sham stimulation and waitlist control groups. The reduction in YGTSS–TTSS for the active stimulation group was substantially larger, clinically meaningful (effect size = .5) and statistically significant (p = .02) compared to both the sham stimulation and waitlist control groups, which did not differ from one another (effect size = −.03). Furthermore, blind analyses of video recordings demonstrated that tic frequency (tics per minute) reduced substantially (−15.6 TPM) during active stimulation compared to sham stimulation (−7.7 TPM). This difference represents a statistically significant (p < .03) and clinically meaningful reduction in tic frequency (>25 percentile reduction: effect size = .3). These findings indicate that home-administered rhythmic MNS delivered through a wearable wrist-worn device has the potential to be an effective community-based treatment for tic disorders.     

菜单界面设计的认知工效学研究方法

菜单研究是人 -计算机交互研究的重要内容之一。本文以研究方法的发展过程为主线 ,回顾了菜单界面认知工效学研究的历程 ,分别讨论了传统实验方法、系统仿真方法和眼动追踪方法在菜单界面设计研究中的应用     

Responses to mirror-image stimulation in jungle crows (Corvus macrorhynchos)

Four jungle crows (Corvus macrorhynchos) were exposed to a mirror placed either vertically or horizontally. The most frequently observed behaviors were pecking at the mirror and wing flapping when looking toward the mirror. These behavior patterns, which were only rarely observed when the mirror was reversed, can be interpreted as aggressive behaviors against a conspecific. The vertical mirror evoked the behaviors more often than the horizontal mirror. The present results suggest that crows perceive their mirror image as an image of a conspecific, not as their own. Received: 16 December 1999 / Accepted after revision 29 January 2000     

空间导航的脑网络基础和调控机制

空间导航在生活中时刻发生,空间能力衰退是阿尔兹海默症的重要早期表现。早期关于空间导航神经机制的研究主要关注单个脑区的特异性功能,但这些脑区如何交互以整合不同模态的信息支持复杂导航行为尚不清楚。脑成像技术、脑网络建模方法和神经调控手段的发展,为在脑网络水平理解人类空间导航的认知神经机制提供了重要研究手段。本研究试图融合空间导航认知神经机制研究的最新进展,借助脑网络建模、大数据分析、微电流刺激等前沿研究手段,研究空间导航脑网络的关键拓扑属性特征(如模块化、核心节点等),探寻该功能特异性神经网络的重要影响因素和调控机制,并构建空间导航的脑网络理论模型。研究成果将有利于理解人类复杂导航行为的脑网络基础,为阿尔兹海默症等相关认知障碍脑疾病的筛查和诊断提供重要参考。     

Attempted induction of signalled lucid dreaming by transcranial alternating current stimulation

Neurophysiological correlates of self-awareness during sleep (‘lucid dreaming’) remain unclear despite their importance for clarifying the neural underpinnings of consciousness. Transcranial direct (tDC) and alternating (tAC) current stimulation during sleep have been shown to increase dream self-awareness, but these studies’ methodological weaknesses prompted us to undertake additional study. tAC stimulation was associated with signal-verified and self-rated lucid dreams—but so was the sham procedure. Situational factors may be crucial to inducing self-awareness during sleep.     

Centrally elicited aggressive behavior: A model system for the study of episodic neurobehavioral pathologies?

Studies in which the predatory-like attack of a cat upon a rat has been elicited by electrical brain stimulation have been briefly reviewed with an emphasis on the question of where within the central nervous system such brain stimulation is producing its behaviorally meaningful effects. Two opposing but by no means mutually exclusive views are considered. The first is that brain stimulation elicits this behavior pattern primarily because it affects a specific motivated behavior system that is organized discretely in the midbrain and pons. The second is that forebrain neural activity is modulated in behaviorally significant ways by brainstem stimulation, which elicits predatory-like aggressive behavior in the cat. The possibility that further research on the altered state of central nervous system activity, induced by brain stimulation which elicits aggressive behavior in the cat, may lead to a further understanding of the altered states of central nervous system activity that underlie the aggressive dyscontrol syndrome and other episodic state disorders is discussed.     

A preliminary analysis of self-control with aversive events: the effects of task magnitude and delay on the choices of children with autism

When faced with a choice between two aversive events, a person exhibits self-control by choosing a smaller, more immediate aversive event over a larger, delayed aversive event. Task demands are often aversive to children with autism and other developmental disabilities. The purpose of this study was to evaluate behavioral sensitivity to differences in the amount and delay of tasks as part of a preliminary study on self-control. Participants were 2 children with autism who engaged in problem behavior maintained by escape. Results indicated a lack of self-control with respect to choosing between two aversive tasks and suggested potential strategies for increasing self-control (i.e., choosing a small immediate task over a large delayed task).     

Transcranial magnetic stimulation as a tool for cognitive studies

Transcranial Magnetic Stimulation (TMS) is a tool for the non-invasive stimulation of the human brain. It allows the activation of arbitrary sites of the superficial cortex and, combined with other brain-imaging techniques such as EEG, PET, and fMRI, it can be used to evaluate cortical excitability and connectivity. This is of major importance in, for example, the study of cognitive processes such as language, learning, memory and self-representation, which are thought to be represented in multiple brain areas. The mechanisms of action of TMS are known on a basic level, but its effect on the activation state of brain tissue is still poorly understood. Clinical applications of TMS have also been proposed and guidelines for its safe use drafted.     

Safe periods both explain and need explaining.

Dinsmoor's (2001) stress on the response‐produced safe period as a reinforcer for avoidance behavior is a positive contribution, even though several questions about such safe periods remain to be answered.     

Optokinetic stimulation affects temporal estimation in healthy humans

The representation of time and space are closely linked in the cognitive system. Optokinetic stimulation modulates spatial attention in healthy subjects and patients with spatial neglect. In order to evaluate whether optokinetic stimulation could influence time perception, a group of healthy subjects performed "time-comparison" tasks of sub- and supra-second intervals before and after leftward or rightward optokinetic stimulation. Subjective time perception was biased by the direction of optokinetic stimulation. Rightward optokinetic stimulation induced an overestimation of time perception compared with baseline and leftward optokinetic stimulation. These results indicate a directional bias in time perception induced by manipulation of spatial attention and could argue for a mental linear representation of time intervals.