This paper traces the dramatic proliferation of leadership roles in English primary and secondar schools, due mainly to central government education policy of the past two decades. This has transformed schools from relatively simple to highly complex organizations and has impacted on the working conditions of, and demands on, teachers, together with many aspects of schooling. These changes are illustrated with typical examples of schools' leadership structures and their functioning. Interview data provide teachers' views on, and reactions to, the changes (...) in school leadership. The paper also reviews the ways in which teacher education institutions have responded in terms of providing initial and in-service education and training to equip the profession for this new and developing challenge. It examines the reception of such programmes by teachers and the reported impact on schools' management and the role of leadership within it. (shrink)

Joshua Greene has argued that the empirical findings of cognitive science have implications for ethics. In particular, he has argued (1) that people’s deontological judgments in response to trolley problems are strongly influenced by at least one morally irrelevant factor, personal force, and are therefore at least somewhat unreliable, and (2) that we ought to trust our consequentialist judgments more than our deontological judgments when making decisions about unfamiliar moral problems. While many cognitive scientists have rejected Greene’s dual-process theory of (...) moral judgment on empirical grounds, philosophers have mostly taken issue with his normative assertions. For the most part, these two discussions have occurred separately. The current analysis aims to remedy this situation by philosophically analyzing the implications of moral dilemma research using the CNI model of moral decision-making – a formalized, mathematical model that decomposes three distinct aspects of moral-dilemma judgments. In particular, we show how research guided by the CNI model reveals significant conceptual, empirical, and theoretical problems with Greene’s dual-process theory, thereby questioning the foundations of his normative conclusions. (shrink)

When we founded Studies in Ethics, Law and Technology we wondered if we might, like Icarus, be trying to fly too close to the sun. Had we set ourselves an impossible task in seeking to create a new community of interdisciplinary scholars under the umbrella of the words ethics, law and technology? Would expert scholars in biotechnologies, nanotechnologies, neurotechnologies, information technologies, weapons and security technologies, energy and fuel technologies, space based technologies, and/or new media and communication technologies all come together (...) in one place? As we show in this editorial, the answer is yes. (shrink)

The recent upsurge in “brain-training and perceptual-cognitive-training", proposing to improve isolated processes such as brain function, visual perception and decision-making, has created significant interest in elite sports practitioners, seeking to create an ‘edge’ for athletes. The claims of these related 'performance-enhancing industries' can be considered together as part of a process training approach proposing enhanced cognitive and perceptual skills and brain capacity, to support performance in everyday life activities, including sport. For example, the 'process- (...) class='Hi'>training industry' promotes the idea that playing games not only makes you a better player, but also smarter, more alert, and a faster learner. In this position paper we critically evaluate the effectiveness of both types of process-training programmes in generalizing transfer to sport performance. These issues are addressed in three stages. First, we evaluate empirical evidence in support of perceptual-cognitive process training, and its application to enhancing sport performance. Second, we critically review putative modularised mechanisms underpinning this kind of training, addressing limitations and subsequent problems. Specifically, we consider merits of this highly specific form of training, which focuses on training of isolated processes such as cognitive processes (attention, memory, thinking) and visual perception processes, separately from performance behaviors and actions. We conclude that these approaches may, at best, may provide some 'general transfer' of underlying processes to specific sport environments, but lack 'specificity of transfer' to contextualize actual performance behaviors. A major weakness of process training methods is their focus on enhancing performance in body “modules” (e.g., eye, brain, memory, anticipatory sub-systems). What is lacking is evidence on how these isolated components are modified and subsequently interact with other process “modules”, which are considered to underlie sport performance. Finally, we propose how an ecological dynamics approach, aligned with an embodied framework of cognition undermines the rationale that modularised processes can enhance performance in competitive sport. An ecological dynamics perspective proposes that the body is a complex adaptive system, interacting with performance environments in a functionally integrated manner, emphasising that the inter-relation between motor processes, cognitive and perceptual functions and the constraints of a sport task is best understood at the performer-environment scale of analysis. (shrink)

The human brain shows neuroplastic adaptations induced by motor skill training. However, the description of the plastic architecture of the whole-brain network in resting-state is still limited. In the present study, we aimed to detect how motor training affected the density distribution of whole-brain resting-state functional connectivity (FC) brain in fast-ball student-athletes using resting-state functional magnetic resonance imaging (fMRI) data of student-athletes (SA), and non-athlete healthy controls (NC). The voxel-wise data-driven graph theory approach, namely (...) global functional connectivity density (gFCD) mapping was applied. The results showed that the SA group exhibited significantly decreased gFCD in brain regions centered at left triangular part of inferior frontal gyrus (IFG), extending to opercular part of left IFG and middle frontal gyrus (MFG) compared with NC group. The findings supported the idea of an increased neural efficiency of athletes’ brain in the brain regions associated with attentional-motor modulation and executive control. Furthermore, the behavioral results demonstrated that in the SA group, faster executive control reaction time was associated with smaller gFCD values in left IFG. The findings implied that the motor skill training would decrease the numbers of FC in IFG to accelerate the execution control with high attentional demands, and focus the attention to the target detection the athletes are interested in. (shrink)

This paper presents a gamified motor imagery brain-computer interface (MI-BCI) training in immersive virtual reality. Aim of the proposed training method is to increase engagement, attention, and motivation in co-adaptive event-driven MI-BCI training. This was achieved using gamification, progressive increase of the training pace, and virtual reality design reinforcing the body ownership transfer (embodiment) into the avatar. From the 20 healthy participants performing 6 runs of 2-class MI-BCI training (left/right hand), 19 were trained for (...) a basic level of MI-BCI operation, with average peak accuracy in the session equal to 75.84\%. This confirms the proposed training method succeeded in improvement of the MI-BCI skills; moreover, participants were leaving the session in high positive affect. Although the performance was not directly correlated to the degree of embodiment, subjective magnitude of the body ownership transfer illusion correlated with the abilities to modulate the sensorimotor rhythm. (shrink)

The information processing capacity of the human mind is limited, as is evidenced by the so-called ‘‘attentional-blink’’ deficit: When two targets (T1 and T2) embedded in a rapid stream of events are presented in close temporal proximity, the second target is often not seen. This deficit is believed to result from competition between the two targets for limited attentional resources. Here we show, using performance in an attentional-blink task and scalp-recorded brain potentials, that meditation, or mental training, affects (...) the distribution of limited brain resources. Three months of intensive mental training resulted in a smaller attentional blink and reduced brain-resource allocation to the first target, as reflected by a smaller T1-elicited P3b, a brain-potential index of resource allocation. Furthermore, those individuals that showed the largest decrease in brain-resource allocation to T1 generally showed the greatest reduction in attentional-blink size. These observations provide novel support for the view that the ability to accurately identify T2 depends upon the efficient deployment of resources to T1. The results also demonstrate that mental training can result in increased control over the distribution of limited brain resources. Our study supports the idea that plasticity in brain and mental function exists throughout life and illustrates the usefulness of systematic mental training in the study of the human mind. (shrink)

Background: The present study compared the effects of a traditional resistance training and resistance training combined with cognitive task on body composition, physical performance, cognitive function, and plasma brain-derived neurotrophic factor levels in older adults. Methods: Thirty community-dwelling older adults were randomized into TRT and RT+CT. Exercise groups performed a similar resistance training program, twice a week over 16 weeks. Cognitive Training involved performing verbal fluency simultaneously with RT. Exercise sessions were performed 2-3 sets, 8-15 (...) repetitions at 60-70% of 1-repetition maximum. Body composition, physical function, cognitive performance, and BDNF levels were assessed before and after intervention period. Results: The physical performance was similarly improved in response to both TRT and RT+CT. However, exclusive improvements on cognitive function and BDNF levels were observed only after RT+CT. Conclusion: The RT program associated with a cognitive task, improved physical and cognitive performance in healthy older adults. (shrink)

Significant variation in performance in motor imagery tasks impedes their wide adoption for brain-computer interface applications. Previous researchers have found that resting-state alpha-band power is positively correlated with MI-BCI performance. In this study, we designed a neurofeedback training protocol based on the up-regulation of the alpha band relative power to investigate its effect on MI-BCI performance. The principal finding of this study is that alpha NFT could successfully help subjects increase alpha-rhythm power and improve their MI-BCI performance. An (...) individual difference was also found in this study in that subjects who increased alpha power more had a better performance improvement. Additionally, the functional connectivity of the frontal-parietal network was found to be enhanced after alpha NFT. However, the enhancement failed to reach a significant level after multiple comparisons correction. These findings contribute to a better understanding of the neurophysiological mechanism of cognitive control through alpha regulation. (shrink)

Neurofeedback is a complex learning scenario, as the task consists of trying out mental strategies while processing a feedback signal that signifies activation in the brain area to be self-regulated and acts as a potential reward signal. In an attempt to dissect these subcomponents, we obtained whole-brain networks associated with efficient self-regulation in two paradigms: parallel, where the task was performed concurrently, combining feedback with strategy execution; and serial, where the task was performed consecutively, separating feedback processing from (...) strategy execution. Twenty participants attempted to control their anterior midcingulate cortex using functional magnetic resonance imaging NF in 18 sessions over 2 weeks, using cognitive and emotional mental strategies. We analyzed whole-brain fMRI activations in the NF training runs with the largest aMCC activation for the serial and parallel paradigms. The equal length of the strategy execution and the feedback processing periods in the serial paradigm allows a description of the two task subcomponents with equal power. The resulting activation maps were spatially correlated with functionally annotated intrinsic connectivity brain maps. Brain activation in the parallel condition correlates with the basal ganglia network, the cingulo-opercular network, and the frontoparietal control network ; brain activation in the serial strategy execution condition with the default mode network, the FPCN, and the visual processing network; while brain activation in the serial feedback processing condition predominantly with the CON, the DMN, and the FPCN. Additional comparisons indicate that BG activation is characteristic to the parallel paradigm, while supramarginal gyrus and superior temporal gyrus activations are characteristic to the serial paradigm. The multifaceted view of the subcomponents allows describing the cognitive processes associated with strategy execution and feedback processing independently in the serial feedback task and as combined processes in the multitasking scenario of the conventional parallel feedback task. (shrink)

Given the discovery of a distributed language and motor functional network, surprisingly few studies have explored whether language processing is related to motor skill training. To address this issue, the present study used functional magnetic resonance imaging to compare whole-brain activation between nonexperts and experts in table tennis, an open skill sport in which players make rapid decisions in response to an ever-changing environment. Whole-brain activation was assessed in 30 expert table tennis players with more than 7 (...) years’ experience and 35 age-matched nonexpert college students while they performed both a size and a semantic judgment task of words presented on a monitor. Compared with nonexperts, expert table tennis players showed greater activation in the left middle occipital gyrus and right precuneus while judging the size of the words versus during baseline fixation. They also showed greater activation in the left lingual gyrus during the semantic judgment task versus during baseline fixation. Our findings indicate that the visual regions engaged in language processing are associated with open motor skill training. (shrink)

Mario Villena-González Laboratorio de Neurodinámica Básica y Aplicada, Pontificia Universidad Católica de Chile, Chile When our attention is internally oriented … Read More →.

O'Brien & Opie believe that some mental representations are evoked by stimuli to which a person is attending, and other mental representations are evoked by stimuli to which attention was not paid. I argue that this is the classical view of consciousness; yet this is the view which they wish to challenge.

Electrical brain activity modulation in terms of changes in its intensity and spatial distribution is a function of age and task demand. However, the dynamics of brain modulation is unknown when it depends on external factors such as training. The aim of this research is to verify the effect of deductive reasoning training on the modulation in the brain activity of healthy younger and older adults ( (mean age of 21 ± 3.39) and (mean age (...) of 68.92 ± 5.72)). The analysis reveals the benefits of training, showing that it lowers cerebral activation while increasing the number of correct responses in the trained reasoning task (). The brain source generators were identified by time-averaging low-resolution brain electromagnetic tomography (sLORETA) current density images. In both groups, a bilateral overactivation associated with the task and not with age was identified. However, while the profile of bilateral activation in younger adults was symmetrical in anterior areas, in the older ones, the profile was located asymmetrically in anterior and posterior areas. Consequently, bilaterality may be a marker of how the brain adapts to maintain cognitive function in demanding tasks in both age groups. However, the differential bilateral locations across age groups indicate that the tendency to brain modulation is determined by age. (shrink)

The phenomenon of eSports is omnipresent today. International championships and their competitive athletes thrill millions of spectators who watch eSports athletes and their teams try to improve and outperform each other. In order to achieve the necessary cognitive and physical top form and to counteract general health problems caused by several hours of training in front of the PC or console, eSports athletes need optimal cognitive, physical and mental training. However, a gap exists in eSports specific health management, (...) including prevention of health issues and training of these functions. To contribute to this topic, we present in this mini review possible avenues for holistic training approaches for cognitively, physically and mentally fitter and more powerful eSports athletes based on interdisciplinary findings. Furthermore, we discuss exergames as a motivating and promising complementary training approach for eSports athletes, which simultaneously combines physical and cognitive stimulation and challenges in an attractive gaming environment. Exergames have the high potential to penetrate new applications and thus influence the growing eSports research and development community. (shrink)

Traumatic brain injury is a major cause of death and disability in Western society, and often results in functional and neuropsychological abnormalities. Memory impairment is one of the most significant cognitive implications after TBI. In the current study we investigated procedural memory acquisition by observational training in TBI patients. It was previously found that while practicing a new motor skill, patients engage in all three phases of skill learning–fast acquisition, between-session consolidation, and long-term retention, though their pattern of (...) learning is atypical compared to healthy participants. A different set of studies showed that training by observing a motor task, generally prompted effective acquisition and consolidation of procedural knowledge in healthy participants. The aim of our study was to evaluate the potential benefit of action observation in TBI patients. Examine the possibility of general improvement in performance between the first and second stage of the study. Investigate the link between patients’ ability to benefit from observational learning and common measures of injury.Materials and methodsPatients hospitalized after moderate to severe TBI, were trained by observation for the finger opposition sequence motor task. They were then tested for the observation-trained sequence and a similar control sequence, at two different time-points.Results revealed a significant difference in performance between the trained and untrained sequences, in favor of the trained sequence. An increase in performance for both sequences A and B toward the second session. The advantage for sequence A was stable and preserved also in the second session. Participants with lower moderate Functional Independence Measure scores gained more from observational-procedural learning, compared with patients with higher functional abilities.ConclusionOverall, these findings support the notion that TBI patients may achieve procedural memory consolidation and retention through observational learning. Moreover, different functional traits may predict the outcomes of observational training in different patients. These findings may have significant practical implications in the future, regarding skill acquisition methods in TBI patients. (shrink)

The fascination with brain research is widespread, and school teachers are no exception. This growing interest, usually noticed by the increased supply of short-term training or books on how to turn the brain more efficient, leads us to think about their basic training and outreach resources available. Little is known about what the official Initial Teacher Training offers concerning the brain literature and if it meets scientific standards. Also, what are the science communication materials (...) that teachers can access to learn about the developing brain remain undiscussed. First, we examined the ITT courses taught in Portuguese Higher Education, both in public and private institutions, to identify the syllabus with updated neuroscientific knowledge. Second, we searched for the neuroscience-related books published in the last 6 years through the National Library of Portugal database. Thirty ITT courses and 35 outreach publications were reviewed through a rapid review methodology. Our results showed an absence of curricular units indicating in their programs that brain research, and its relationship with learning, would be taught in a representative and updated way. In contrast, the number of brain-related books for educators increased in Portugal, corroborating the demand for this field of study by these professionals. Based on the literature that shows how misunderstandings about the brain have increased in school contexts, our discussion recognizes that science outreach could be a way to increase the scientific literacy of school teachers with the research community working more in this direction, but, since a previous problem seems to be unsolved, there is an urgent need for specialized attention to the development of training curricula for future kindergarten and elementary school teachers. (shrink)

Traditional rehabilitation strategies become difficult in the chronic phase stage of stroke prognosis. Brain–computer interface combined with external devices may improve motor function in chronic stroke patients, but it lacks comprehensive assessments of neurological changes regarding functional rehabilitation. This study aimed to comprehensively and quantitatively investigate the changes in brain activity induced by BCI–FES training in patients with chronic stroke. We analyzed the EEG of two groups of patients with chronic stroke, one group received functional electrical stimulation (...) rehabilitation training and the other group received BCI combined with FES training. We constructed functional networks in both groups of patients based on direct directed transfer function and assessed the changes in brain activity using graph theory analysis. The results of this study can be summarized as follows: after rehabilitation training, the Fugl–Meyer assessment scale score was significantly improved in the BCI–FES group, and there was no significant difference in the FES group. Both the global and local graph theory measures of the brain network of patients with chronic stroke in the BCI–FES group were improved after rehabilitation training. The node strength in the contralesional hemisphere and central region of patients in the BCI–FES group was significantly higher than that in the FES group after the intervention, and a significant increase in the node strength of C4 in the contralesional sensorimotor cortex region could be observed in the BCI–FES group. These results suggest that BCI–FES rehabilitation training can induce clinically significant improvements in motor function of patients with chronic stroke. It can improve the functional integration and functional separation of brain networks and boost compensatory activity in the contralesional hemisphere to a certain extent. The findings of our study may provide new insights into understanding the plastic changes of brain activity in patients with chronic stroke induced by BCI–FES rehabilitation training. (shrink)

Behavioral interventions have shown promising neuroprotective effects, but the cascade of molecular, brain and behavioral changes involved in these benefits remains poorly understood. Projecte Moviment is a 12-week multi-domain, single-blind, proof-of-concept randomized controlled trial examining the cognitive effect and underlying mechanisms of an aerobic exercise, computerized cognitive training and a combined groups compared to a waitlist control group. Adherence was > 80% for 82/109 participants recruited. In this study we report intervention-related changes in plasma biomarkers and structural-MRI and (...) how they related to changes in physical activity and individual variables and their potential role as mediators in the cognitive changes. Our results show that although there were no significant changes in molecular biomarker concentrations in any intervention group, changes in ICAM-1 and SDF1-α were negatively associated with changes in physical activity outcomes in AE and COMB groups. Brain volume changes were found in the CCT showing a significant increase in precuneus volume. Sex moderated the brain volume change in the AE and COMB groups, suggesting that men may benefit more than women. Changes in molecular biomarkers and brain volumes did not significantly mediate the cognitive-related benefits found previously for any group. This study shows crucial initial molecular and brain volume changes related to lifestyle interventions at early stages and highlights the value of examining activity parameters, individual difference characteristics and using a multi-level analysis approach to address these questions. (shrink)

While issues of efficacy and specificity are crucial for the future of neurofeedback training, there may be alternative designs and control analyses to circumvent the methodological and ethical problems associated with double-blind placebo studies. Surprisingly, most NF studies do not report the most immediate result of their NF training, i.e. whether or not children with ADHD gain control over their brain activity during the training sessions. For the investigation of specificity, however, it seems essential to analyze (...) the learning and adaptation processes that take place in the course of the training and to relate improvements in self-regulated brain activity across training sessions to behavioral, neuropsychological and electrophysiological outcomes. To this aim, a review of studies on neurofeedback training with ADHD patients, which include the analysis of learning across training sessions or relate training performance to outcome, is presented. Methods on how to evaluate and quantify learning of EEG regulation over time are discussed. “Non-learning” has been reported in a small number of ADHD-studies, but has not been a focus of general methodological discussion so far. For this reason, selected results from the brain-computer interface (BCI) research on the so-called “brain-computer illiteracy”, the inability to gain control over one’s brain activity, are also included. It is concluded that in the discussion on specificity, more attention should be devoted to the analysis of EEG regulation performance in the course of the training and its impact on clinical outcome. It is necessary to improve the knowledge on characteristic cross-session and within-session learning trajectories in ADHD and to provide the best conditions for learning. (shrink)

Hand function improvement in stroke survivors in the chronic stage usually plateaus by 6 months. Brain-computer interface (BCI)-guided robot-assisted training has been shown to be effective for facilitating upper-limb motor function recovery in chronic stroke. However, the underlying neuroplasticity change is not well understood. This study aimed to investigate the whole-brain neuroplasticity changes after 20-session BCI-guided robot hand training, and whether the changes could be maintained at the 6-month follow-up. Therefore, the clinical improvement and the neurological (...) changes before, immediately after, and 6 months after training were explored in 14 chronic stroke subjects. The upper-limb motor function was assessed by Action Research Arm Test (ARAT) and Fugl-Meyer Assessment for Upper-Limb (FMA), and the neurological changes were assessed using resting-state functional magnetic resonance imaging. Repeated-measure ANOVAs indicated that long-term motor improvement was found by both FMA (F[2,26]= 6.367,p= 0.006) and ARAT (F[2,26]= 7.230,p= 0.003). Seed-based functional connectivity analysis exhibited that significantly modulated FC was observed between ipsilesional motor regions (primary motor cortex and supplementary motor area) and contralesional areas (supplementary motor area, premotor cortex, and superior parietal lobule), and the effects were sustained after 6 months. The fALFF analysis showed that local neuronal activities significantly increased in central, frontal and parietal regions, and the effects were also sustained after 6 months. Consistent results in FC and fALFF analyses demonstrated the increase of neural activities in sensorimotor and fronto-parietal regions, which were highly involved in the BCI-guided training.Clinical Trial Registration:This study has been registered atClinicalTrials.govwith clinical trial registration number NCT02323061. (shrink)

Entropy-based algorithms have been suggested as robust estimators of electroencephalography (EEG) predictability or regularity. This study aimed to examine possible disturbances in EEG complexity as a means to elucidate the pathophysiological mechanisms in chronic stroke, before and after a brain computer interface (BCI)-motor observation intervention. Eleven chronic stroke subjects and nine unimpaired subjects were recruited to examine the differences in their EEG complexity. The BCI-motor observation intervention was designed to promote functional recovery of the hand in stroke subjects. Fuzzy (...) approximate entropy (fApEn), a novel entropy-based algorithm designed to evaluate complexity in physiological systems, was applied to assess the EEG signals acquired from unimpaired subjects and stroke subjects, both before and after training. The results showed that stroke subjects had significantly lower EEG fApEn than unimpaired subjects (p < 0.05) in the motor cortex area of the brain (C3, C4, FC3, FC4, CP3, CP4) in both hemispheres before training. After training, motor function of the paretic upper limb, assessed by the Fugl-Meyer Assessment-Upper Limb (FMA-UL), Action Research Arm Test (ARAT), and Wolf Motor Function Test (WMFT) improved significantly (p < 0.05). Furthermore, the EEG fApEn in stroke subjects increased considerably in the central area of the contralesional hemisphere after training (p < 0.05). A significant correlation was noted between clinical scales (FMA-UL, ARAT, and WMFT) and EEG fApEn in C3/C4 in the contralesional hemisphere (p < 0.05). This finding suggests that the increase in EEG fApEn could be an estimator of the variance in upper limb motor function improvement. In summary, fApEn can be used to identify abnormal EEG complexity in chronic stroke, when used with BCI-motor observation training. Moreover, these findings based on the fApEn of EEG signals also expand the existing interpretation of training-induced functional improvement in stroke subjects. Entropy-based analysis might serve as a novel approach to understanding the abnormal cortical dynamics of stroke and the neurological changes induced by rehabilitation training. (shrink)

We investigated if emotion regulation can be improved through self-regulation training on non-emotional brain regions, as well as how to change the brain networks implicated in this process. During the training period, the participants were instructed to up-regulate their right dorsolateral prefrontal cortex activity according to real-time functional near-infrared spectroscopy neurofeedback signals, and there was no emotional element. The results showed that the training significantly increased emotion regulation, resting-state functional connectivity within the emotion regulation network (...) and frontoparietal network, and rsFC between the ERN and amygdala; however, training did not influence the rsFC between the FPN and the amygdala. However, self-regulation training on rDLPFC significantly improved emotion regulation and generally increased the rsFCs within the networks; the rsFC between the ERN and amygdala was also selectively increased. The present study also described a safe approach that may improve emotion regulation through self-regulation training on non-emotional brain regions. (shrink)

In Parkinson’s disease, the fronto-striatal network is involved in motor and cognitive symptoms. Working memory updating training engages this network in healthy populations, as observed by improved cognitive performance and increased striatal BOLD signal. This two-part study aimed to assess the feasibility of WM updating training in PD and measure change in cognition, movement and functional brain response in one individual with PD after WM updating training. A feasibility and single-subject study were performed in which patients (...) with PD completed computerized WM updating training. The outcome measures were the pre-post changes in criterion and transfer cognitive tests; cognitive complaints; psychological health; movement kinematics; and task-related BOLD signal. Participants in the feasibility study showed improvements on the criterion tests at post-test. FL displayed the largest improvements on the criterion tests and smaller improvements on transfer tests. Furthermore, FL reported improved cognitive performance in everyday life. A shorter onset latency and smoother upper-limb goal-directed movements were measured at post-test, as well as increased activation within the striatum and decreased activation throughout the fronto-parietal WM network. This two-part study demonstrated that WM updating training is feasible to complete for PD patients and that change occurred in FL at post-test in the domains of cognition, movement and functional brain response. (shrink)

Objective:This study aimed to investigate the effect of robot-assisted gait training therapy combined with non-invasive brain stimulation on lower limb function in patients with stroke and spinal cord injury.Data sourcesPubMed, Cochrane Central Register of Controlled Trials, Ovid MEDLINE, and Web of Science were searched.Study selectionRandomized controlled trials published as of 3 March 2021. RCTs evaluating RAGT combined with NIBS, such as transcranial direct current stimulation and repetitive transcranial magnetic stimulation, for lower limb function and activities in patients with (...) stroke and SCI were included.Data extractionTwo reviewers independently screened the records, extracted the data, and assessed the risk of bias.Data synthesisA meta-analysis of five studies and risk of bias were conducted. Pooled estimates demonstrated that RAGT combined with NIBS significantly improved lower limb function [standardized mean difference = 0.52; 95% confidence interval = 0.06–0.99] but not lower limb activities. Subgroup analyses also failed to find a greater improvement in lower limb function of RAGT with tDCS compared to sham stimulation. No significant differences between participant characteristics or types of NIBS were observed.ConclusionThis meta-analysis demonstrated that RAGT therapy in combination with NIBS was effective in patients with stroke and SCI. However, a greater improvement in lower limb function and activities were not observed using RAGT with tDCS compared to sham stimulation. (shrink)