•Both action observation and execution activate shared cortical and cerebellar areas.•Type of grip is processed in several parietal, premotor and cerebellar regions.•The inferior parietal cortex ...plays a key role in encoding final action goal.•Multivariate pattern analysis allows to decode subtle features from observed actions.•Both grip type and final action goal are decoded within the mirror neuron system.
During execution and observation of reaching-grasping actions, the brain must encode, at the same time, the final action goal and the type of grip necessary to achieve it. Recently, it has been proposed that the Mirror Neuron System (MNS) is involved not only in coding the final goal of the observed action, but also the type of grip used to grasp the object. However, the specific contribution of the different areas of the MNS, at both cortical and subcortical level, in disentangling action goal and grip type is still unclear. Here, twenty human volunteers participated in an fMRI study in which they performed two tasks: (a) observation of four different types of actions, consisting in reaching-to-grasp a box handle with two possible grips (precision, hook) and two possible goals (open, close); (b) action execution, in which participants performed grasping actions similar to those presented during the observation task. A conjunction analysis revealed the presence of shared activated voxels for both action observation and execution within several cortical areas including dorsal and ventral premotor cortex, inferior and superior parietal cortex, intraparietal sulcus, primary somatosensory cortex, and cerebellar lobules VI and VIII. ROI analyses showed a main effect for grip type in several premotor and parietal areas and cerebellar lobule VI, with higher BOLD activation during observation of precision vs hook actions. A grip x goal interaction was also present in the left inferior parietal cortex, with higher BOLD activity during precision-to-close actions. A multivariate pattern analysis (MVPA) revealed a significant accuracy for the grip model in all ROIs, while for the action goal model, significant accuracy was observed only for left inferior parietal cortex ROI. These findings indicate that a large network involving cortical and cerebellar areas is involved in the processing of type of grip, while final action goal appears to be mainly processed within the inferior parietal region, suggesting a differential contribution of the areas activated in this study.
Humans and monkey studies showed that specific sectors of cerebellum and basal ganglia activate not only during execution but also during observation of hand actions. However, it is unknown whether, ...and how, these structures are engaged during the observation of actions performed by effectors different from the hand. To address this issue, in the present fMRI study, healthy human participants were required to execute or to observe grasping acts performed with different effectors, namely mouth, hand, and foot. As control, participants executed and observed simple movements performed with the same effectors. The results show that: (1) execution of goal-directed actions elicited somatotopically organized activations not only in the cerebral cortex but also in the cerebellum, basal ganglia, and thalamus; (2) action observation evoked cortical, cerebellar and subcortical activations, lacking a clear somatotopic organization; (3) in the territories displaying shared activations between execution and observation, a rough somatotopy could be revealed in both cortical, cerebellar and subcortical structures. The present study confirms previous findings that action observation, beyond the cerebral cortex, also activates specific sectors of cerebellum and subcortical structures and it shows, for the first time, that these latter are engaged not only during hand actions observation but also during the observation of mouth and foot actions. We suggest that each of the activated structures processes specific aspects of the observed action, such as performing internal simulation (cerebellum) or recruiting/inhibiting the overt execution of the observed action (basal ganglia and sensory-motor thalamus).
•Grasping actions require the integration of visual information and motor signals.•Grasping activates both dorso-dorsal and dorso-ventral parieto-frontal circuits.•Manipulative actions are based on ...somatomotor transformations.•Manipulation relies on partially segregated functional circuits with respect to grasping.•Both grasping and manipulation involve basal ganglia and cerebellum.
Neurophysiological and neuroimaging evidence suggests a significant contribution of several brain areas, including subdivisions of the parietal and the premotor cortex, during the processing of different components of hand and arm movements. Many investigations improved our knowledge about the neural processes underlying the execution of reaching and grasping actions, while few studies have directly investigated object manipulation. Most studies on the latter topic concern the use of tools to achieve specific goals. Yet, there are very few studies on pure manipulation performed in order to explore and recognize objects, as well as on manipulation performed with a high level of manual dexterity. Another dimension that is quite neglected by the available studies on grasping and manipulation is, on the one hand, the contribution of the subcortical nodes, first of all the basal ganglia and cerebellum, to these functions, and, on the other hand, recurrent connections of these structures with cortical areas. In the first part, we have reviewed the parieto-premotor and subcortical circuits underlying reaching and grasping in humans, with a focus on functional neuroimaging data. Then, we have described the main structures recruited during object manipulation. We have also reported the contribution of recent structural connectivity techniques whereby the cortico-cortical and cortico-subcortical connections of grasping-related and manipulation-related areas in the human brain can be determined. Based on our review, we have concluded that studies on cortical and subcortical circuits involved in grasping and manipulation might be promising to provide new insights about motor learning and brain plasticity in patients with motor disorders.
Introduction
Restless Legs Syndrome (RLS) is a widely prevalent and complex neurological disorder. Despite notable advancements in managing RLS, the disorder continues to face challenges related to ...its recognition and management.
Objective
This study seeks to gain comprehensive insights into the knowledge and clinical practices among Italian neurologists regarding RLS diagnosis, management, and treatment, comparing approaches among general neurologists, movement disorder specialists, and sleep experts.
Methods
Members of the Italian Society of Neurology, the Italian Society of Parkinson and Movement Disorders, and the Italian Association of Sleep Medicine were invited to participate in a 19-question online survey.
Results
Among the 343 surveyed neurologists, 60% categorized RLS as a “sleep-related movement disorder.” Forty% indicated managing 5–15 RLS patients annually, with sleep specialists handling the highest patient volume. Of note, only 34% adhered strictly to all five essential diagnostic criteria. The majority (69%) favored low-dosage dopamine agonists as their first-line treatment, with movement disorder specialists predominantly endorsing this approach, while sleep experts preferred iron supplementation. Regular screening for iron levels was widespread (91%), with supplementation typically guided by serum iron alterations. In cases of ineffective initial treatments, escalating dopamine agonist dosage was the preferred strategy (40%).
Conclusions
These findings underscore a lack of a clear conceptualization of RLS, with a widespread misconception of the disorder as solely a movement disorder significantly influencing treatment approaches. Disparities in RLS understanding across neurology subspecialties underscore the necessity for improved diagnostic accuracy, targeted educational initiatives, and management guidelines to ensure consistent and effective RLS management.
Background
Restless legs syndrome (RLS) is a complex sensorimotor disorder occurring with a typical circadian fashion. Association with additional features, like alexithymia and nocturnal compulsive ...behaviors further complicates the framework.
Objectives
To assess interoception in RLS.
Methods
A total of 25 RLS patients and 28 controls underwent the heartbeat tracking task (interoceptive accuracy IAC). RLS symptoms’ frequency, disturbance and duration, nocturnal behaviors, interoceptive awareness (IAW), alexithymia, depressive and anxiety symptoms were also collected.
Results
RLS patients showed significant lower IAC (P = 0.0003) and IAW (P = 0.012), and reported more nocturnal eating behaviors (P < 0.001). IAC positively correlated with IAW (R = 0.32), and negatively correlated with age (R = −0.58). Nocturnal eating behavior negatively correlated with IAC (R = −0.44) and IAW (R = −0.50).
Conclusions
RLS patients presented reduced interoceptive abilities correlating with higher nocturnal eating behaviors. Future studies are needed to explore the role of interoception in RLS pathophysiology, also in relation to other sensorimotor aspects.
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