Cortical activity in patients with high-functioning ischemic stroke during the Purdue Pegboard Test:insights into bimanual coordinated fine motor skills with functional near-infrared spectroscopy

After stroke,even high-functioning individuals may experience compromised bimanual coordination and fine motor dexterity,leading to reduced functional independence.Bilateral arm training has been proposed as a promising intervention to address these deficits.However,the neural basis of the impairment of functional fine motor skills and their relationship to bimanual coordination performance in stroke patients remains unclear,limiting the development of more targeted interventions.To address this gap,our study employed functional near-infrared spectroscopy to investigate cortical responses in patients after stroke as they perform functional tasks that engage fine motor control and coordination.Twenty-four high-functioning patients with ischemic stroke(7 women,17 men;mean age 64.75±10.84 years)participated in this cross-sectional observational study and completed four subtasks from the Purdue Pegboard Test,which measures unimanual and bimanual finger and hand dexterity.We found significant bilateral activation of the sensorimotor cortices during all Purdue Pegboard Test subtasks,with bimanual tasks inducing higher cortical activation than the assembly subtask.Importantly,patients with better bimanual coordination exhibited lower cortical activation during the other three Purdue Pegboard Test subtasks.Notably,the observed neural response patterns varied depending on the specific subtask.In the unaffected hand task,the differences were primarily observed in the ipsilesional hemisphere.In contrast,the bilateral sensorimotor cortices and the contralesional hemisphere played a more prominent role in the bimanual task and assembly task,respectively.While significant correlations were found between cortical activation and unimanual tasks,no significant correlations were observed with bimanual tasks.This study provides insights into the neural basis of bimanual coordination and fine motor skills in high-functioning patients after stroke,highlighting task-dependent neural responses.The findings also suggest that patients who exhibit better bimanual performance demonstrate more efficient cortical activation.Therefore,incorporating bilateral arm training in post-stroke rehabilitation is important for better outcomes.The combination of functional near-infrared spectroscopy with functional motor paradigms is valuable for assessing skills and developing targeted interventions in stroke rehabilitation.

Health-related risky behaviors and their risk factors in adolescents with high-functioning autism

BACKGROUND Health-related risky behaviors generally refer to behaviors that have a negative impact on health and quality of life.Health-related risky behaviors in adolescents with high-functioning autism(HFA)have not been well understood so far.Adolescents with HFA may have more health-related risky behaviors than neurotypical adolescents.AIM To investigate health-related risky behaviors and their risk factors with HFA.METHODS This is an observational study.Our study enrolled 110 adolescents aged 12-19-years-old meeting Diagnostic and Statistical Manual of Mental Disorders 4th edition criteria for HFA.They were recruited from Peking University Sixth Hospital.There were also 110 age,sex and nationality matched controls enrolled who came from a public school in Beijing,China.Both groups completed the Adolescents Health-related Risky Behavior Inventory.Nonparametric tests were carried out for comparison of the Adolescents Health-related Risky Behavior Inventory scores between the two groups.Expression recognition,the Inventory of Subjective Life Quality for Child and Adolescent,Chinese Wechsler Intelligence Scale for Children,Wechsler Intelligence Scale for Adult-Chinese Revised,Theory of Mind test and Autism Spectrum Screening Questionnaire were assessed in the autism group to explore factors associated with health-related risky behaviors.Multivariate regression analysis was conducted to explore the risk factors of health-related risky behaviors in the HFA group.RESULTS The results showed that the total score of the Adolescents Health-related Risky Behavior Inventory and scores of“aggression and violence,”“suicide and selfinjury,”“health compromising behavior”and“unprotected sex”subscales in the HFA group were significantly higher than those in the control group(Z range-4.197 to-2.213,P<0.05).Among the associated factors,poor emotional experience(B=-0.268,P<0.001),depression(B=-0.321,P<0.001),low score of intelligence(B=-0.032,P=0.042),low score of Theory of Mind test(B=-1.321,P=0.003)and poor adaptation to school life(B=-0.152,P=0.006)were risk factors.These risky behaviors may promote the occurrence of health-related risky behaviors in adolescents with HFA.CONCLUSION This study showed that adolescents with HFA were more likely to be involved in health-related risky behaviors.Different health-related risky behaviors have different reasons.

Attention-Deficit/Hyperactivity Disorder in Adults with High-Functioning Pervasive Developmental Disorders in Japan

Aims: This study was designed to verify the proportion of Japanese adults with pervasive developmental disorder (PDD) who met the diagnostic criteria (other than E) for attention-deficit/hyperactivity disorder (ADHD) in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Furthermore, we examined to what extent adults with PDD think that they exhibit ADHD symptoms. Methods: We developed an original Japanese self-report questionnaire to determine the presence or absence of 18 symptoms from the diagnostic criteria for ADHD in the DSM-IV-TR. We administered the questionnaire to 64 adults with high-functioning PDD (45 men and 19 women) and 21 adults with ADHD (10 men and 11 women), aged 18 to 59 years, with a full-scale intelligence quotient ≥75. Target patients were evaluated for ADHD by their psychiatrists. Results: Twenty-nine (45.3%) adults with PDD also had ADHD. The percentage of these adults who had over six perceived inattention symptoms from the DSM-IV-TR was 96.6%. The percentage of these adults who had over six perceived hyperactivity-impulsivity symptoms was 65.5%. Thirty-five (55.6%) adults with PDD responded that they were aware of having ADHD symptoms at the level of the relevant diagnostic criteria. Conclusions: The present study is the first to examine the frequency of objective and perceived ADHD symptoms in adults with PDD in Japan. Our results show that both objective and perceived ADHD symptoms frequently appear in a large number of adults with PDD. This suggests that it is necessary to attend to concomitant ADHD symptoms in the medical care of adults with PDD.

Abnormal Linguistic Lateralization and Sensory Processing in High Functioning Children with Autism Spectrum Conditions

Brain lateralization for language in high-functioning children with autism spectrum conditions (ASC) and sensory processing were explored as a part of a neuropsychological profile. A dichotic listening test and the Luria laterality subtest were administered to all participants (including controls) and the sensory profile test only to the ASC group. The usual right ear advantage was not exhibited by children with ASC and anomalies in auditory filtering were found. The sensory profile of 60% of the sample was characterized by hypersensitivity to auditory stimuli, hyposensitivity to vestibular information, high emotional reactions to sensory experiences, poor psychosocial coping strategies, high distractibility and inability to interpret body and facial language. Hyper-responsiveness to environmental auditory stimuli was significantly associated with impaired attention. Similarly, non-adaptive responses to sensory quotidian experiences were strongly connected to poor coping strategies. Our results, although preliminary, contribute to emphasizing the importance of including additional assessment methods such as the dichotic listening and the sensory profile questionnaire in the evaluation of cognitive profile in high-functioning children with ASC to plan an individualized psycho-educative intervention.

Comparison of adults with attention-deficit/hyperactivity disorder versus Asperger’s disorder using the WAIS-R

Objective: The present study compared results on the Wechsler Adult Intelligence Scale-Revised (WAIS-R) among adult patients with attention-deficit/hyperactivity disorder (AD/HD) and those with Asperger’s disorder (AD). Method: WAIS-R results were compared between 16 adults with AD/HD (8 men and 8 women;mean age, 33.81 years;mean full-scale IQ, 101.5) and 15 adults with AD (12 men and 3 women;mean age, 30.93 years;mean full-scale IQ, 104.6). Results: Verbal IQ was significantly higher than performance IQ in the AD group. Among various subtests, scores were the highest for similarities in the AD/HD group and for block design in the AD group. Picture completion test scores were the lowest scores obtained in both groups. A comparison of subtest scores between the AD/HD and AD groups showed scores for information to be significantly higher in the AD group than in the AD/HD group. Conclusions: Our results suggest that there are no differences in verbal IQ, performance IQ, and full-scale IQ scores (except for scores on the information subtest) among adult patients with AD/HD compared with adult patients with AD.