ABSTRACT Objective This study aimed at assessing the alterations in upper limb motor impairment and connectivity between motor areas following the post-stroke delivery of cathodal transcranial direct current stimulation sessions. Methods Modifications in the Fugl-Meyer Assessment scores, connectivity between the primary motor cortex of the unaffected and affected hemispheres, and between the primary motor and premotor cortices of the unaffected hemisphere were compared prior to and following six sessions of cathodal transcranial direct current stimulation application in 13 patients (active = 6; sham = 7); this modality targets the primary motor cortex of the unaffected hemisphere early after a stroke. Results Clinically relevant distinctions in Fugl-Meyer Assessment scores (≥9 points) were observed more frequently in the Sham Group than in the Active Group. Between-group differences in the alterations in Fugl-Meyer Assessment scores were not statistically significant (Mann-Whitney test, p=0.133). ROI-to-ROI correlations between the primary motor cortices of the affected and unaffected hemispheres post-therapeutically increased in 5/6 and 2/7 participants in the Active and Sham Groups, respectively. Between-group differences in modifications in connectivity between the aforementioned areas were not statistically significant. Motor performance enhancements were more frequent in the Sham Group compared to the Active Group. Conclusion The results of this hypothesis-generating investigation suggest that heightened connectivity may not translate into early clinical benefits following a stroke and will be crucial in designing larger cohort studies to explore mechanisms underlying the impacts of this intervention. ClinicalTrials.gov Identifier: NCT02455427. poststroke post FuglMeyer Fugl Meyer 1 active 6 7 7) ≥9 9 (≥ points Betweengroup Between group MannWhitney Mann Whitney test p=0.133. p0133 p p=0.133 . 0 133 p=0.133) ROItoROI ROI posttherapeutically therapeutically 56 5 5/ 27 2 2/ Groups respectively hypothesisgenerating hypothesis generating intervention ClinicalTrialsgov ClinicalTrials gov Identifier NCT02455427 NCT ≥ ( p013 p=0.13 NCT0245542 p01 p=0.1 NCT024554 p0 p=0. NCT02455 p=0 NCT0245 p= NCT024 NCT02 NCT0

Abstract Introduction Persistent postural-perceptual dizziness (PPPD) is a functional vestibular disorder characterized by chronic dizziness, unsteadiness, and hypersensitivity to motion. Preexisting anxiety disorders and neurotic personality traits confer vulnerability to PPPD. High anxiety during acute vertigo or dizziness incites it. A functional magnetic resonance imaging (fMRI) study of chronic subjective dizziness found unexpectedly hypoactive responses to vestibular stimulation in cortical regions that integrate threat assessment and spatial perception. Objective This fMRI study used non-moving, but emotionally charged visual stimuli to investigate the brain's activity of PPPD patients and control subjects. Methods The participants included 16 women with PPPD and 16 age-matched women who recovered completely from acute episodes of vertigo or dizziness capable of triggering PPPD. Brain responses to positive, neutral, and negative figures from the International Affective Picture System were measured with fMRI and compared between the groups. Dizziness handicap, anxiety, and depression were assessed with validated questionnaires. Results Between group analyses: Participants with PPPD showed reduced activity in anterior cingulate cortex and increased activity in left angular gyrus in response to negative versus positive stimuli, which was not observed in recovered individuals. Within group analyses: Participants with PPPD had increased activity in visuospatial areas (parahippocampal gyrus, intraparietal sulcus) in negative versus positive and negative versus neutral contrasts, whereas recovered individuals had increased activity in anxiety regions (amygdala, orbitofrontal cortex). Conclusion Patients with PPPD may be more attuned to spatial elements than to the content of emotionally charged visual stimuli.

RESUMO Objetivo: Estimar o consumo de informações relacionadas com doença do novo coronavírus e seus efeitos em profissionais do setor da saúde durante a pandemia. Métodos: Um questionário on-line foi distribuído para funcionários de uma instituição de saúde em São Paulo, Brasil, entre 3 e 10 de abril de 2020. Os dados foram analisados com estatísticas descritivas. Resultados: Foram incluídos nas análises 2.646 participantes. A maioria (44,4%) reportou ter acessado uma quantidade excessiva ou próxima de excessiva sobre o novo coronavírus, e 67,6% reportaram ter aumentado seu tempo médio em mídias sociais. Quando perguntados se era fácil determinar o que era informação confiável, 43,2% responderam “às vezes”, comparados com 14,6% que responderam “sempre”. Sobre os possíveis sinais de sobrecarga de informação associada com a pandemia, 31% sempre ou quase todos os dias se sentiram estressados com a quantidade de informações que tinham que acompanhar. Entre os respondentes, 80,0% reportaram sentir pelo menos um sintoma como dor de cabeça, espasmos oculares, inquietação ou dificuldade para dormir. Participantes com um estilo mais negativo de lidar com muitas informações também reportaram maior proporção de sintomas que os participantes com estilo positivo. De forma semelhante, participantes que aumentaram seu acesso a mídias sociais reportaram maior proporção de sintomas do que os que diminuíram seu acesso durante a pandemia. Conclusão: Nossa pesquisa fornece uma descrição de como os indivíduos consomem informações relacionadas com a doença do novo coronavirus durante a pandemia e sugere que a exposição a uma quantidade excessiva de informações e as elevadas demandas podem impor sofrimento psicológico e afetar a saúde mental.

ABSTRACT Objective: To estimate coronavirus disease 2019-related information consumption and related implications for health care professionals (medical and nonmedical personnel) during the pandemic. Methods: A cross-sectional on-line survey was distributed to employees of a major health care institution located in São Paulo, Brazil between April 3 and April 10, 2020. Data were analyzed using descriptive statistics. Results: The sample comprised 2,646 respondents. Most participants (44.4%) reported excessive or almost excessive access to information about the novel coronavirus and 67.6% reported having increased their average time spent on social media. When asked how frequently they consider it was easy to determine the reliability of information, “sometimes” corresponded to 43.2% of the answers in contrast to 14.6% responding “always”. Answers related to potential signs of information overload associated with the pandemic indicated that 31% of respondents felt stressed by the amount of information they had to keep up with almost every day or always. Overall, 80.0% of respondents reported having experienced at least one of the following symptoms: headache, eye twitching, restlessness or sleeping difficulty. The frequency of symptoms was higher among participants with a more negative information processing style regarding when dealing with large volumes of information relative to those with a positive information processing style. Likewise, symptoms were more frequently reported by participants who had increased their social media access relative to those reporting reduced access during the pandemic. Conclusion: Our survey provides a description of how health professionals consume COVID-19 related information during the pandemic, and suggests that excessive information exposure and high processing demands may impose psychological distress and affect mental health.

Resumo Objetivo: Este estudo teve como objetivo explorar a conectividade funcional da rede de modo padrão em usuários de crack-cocaína comparando-a a controles não usuários da mesma faixa etária. Materiais e Métodos: Usuários de crack-cocaína internados em abstinência por pelo menos quatro semanas e controles não usuários pareados por idade foram submetidos a ressonância magnética funcional em estado de repouso, enquanto descansavam com os olhos fechados. Depois do pré-processamento de dados, a rede de modo padrão foi definida por análise espacial de componentes independentes e análise de correlação baseada em sementes, por regiões de interesse centradas no córtex cingulado anterior ventral e no córtex cingulado posterior. Resultados: A conectividade funcional analisada por componentes independentes não foi diferente entre os usuários de crack- cocaína e os controles pareados por idade. No entanto, a análise de correlação baseada em sementes à procura de uma conectividade funcional métrica única entre regiões específicas do cérebro mostrou uma negatividade significativamente maior da conectividade entre o córtex cingulado anterior ventral e o lóbulo parietal superior esquerdo, quando comparada a controles pareados por idade. Conclusão: Os resultados sugerem que conectividades extrínsecas seletivas da rede de modo padrão relacionadas a funções motoras e executivas podem estar comprometidas na dependência de crack-cocaína.

Abstract Objective: This study aimed to explore the functional connectivity of the default mode network (DMN) in crack-cocaine users, in comparison with that observed in age-matched non-drug-using controls. Materials and Methods: Inpatient crack-cocaine users who had been abstinent for at least four weeks and age-matched non-drug-using controls underwent resting state functional magnetic resonance imaging. Images were acquired while the subjects rested with their eyes closed. After data preprocessing, DMNs were defined by spatial independent component analysis and seed-based correlation analysis, by chosen regions of interest centered in the ventral anterior cingulate cortex and in the posterior cingulate cortex. Results: The functional connectivity of the DMN determined by independent component analysis did not differ between the crack-cocaine users and the controls. However, the seed-based correlation analysis seeking a single metric of functional connectivity between specific brain regions showed that the negative connectivity between the ventral anterior cingulate cortex and the left superior parietal lobule was significantly greater in the crack-cocaine users than in the controls. Conclusion: The results suggest that selective extrinsic network connectivity of the DMN related to motor and executive function is impaired during crack-cocaine addiction.