BackgroundThe introduction of low cost optical 3D motion tracking sensors provides new options for effective quantification of motor dysfunction.ObjectiveThe present study aimed to evaluate the Kinect V2 sensor against a gold standard motion capture system with respect to accuracy of tracked landmark movements and accuracy and repeatability of derived clinical parameters.MethodsNineteen healthy subjects were concurrently recorded with a Kinect V2 sensor and an optical motion tracking system (Vicon). Six different movement tasks were recorded with 3D full-body kinematics from both systems. Tasks included walking in different conditions, balance and adaptive postural control. After temporal and spatial alignment, agreement of movements signals was described by Pearson’s correlation coefficient and signal to noise ratios per dimension. From these movement signals, 45 clinical parameters were calculated, including ranges of motions, torso sway, movement velocities and cadence. Accuracy of parameters was described as absolute agreement, consistency agreement and limits of agreement. Intra-session reliability of 3 to 5 measurement repetitions was described as repeatability coefficient and standard error of measurement for each system.ResultsAccuracy of Kinect V2 landmark movements was moderate to excellent and depended on movement dimension, landmark location and performed task. Signal to noise ratio provided information about Kinect V2 landmark stability and indicated larger noise behaviour in feet and ankles. Most of the derived clinical parameters showed good to excellent absolute agreement (30 parameters showed ICC(3,1) > 0.7) and consistency (38 parameters showed r > 0.7) between both systems.ConclusionGiven that this system is low-cost, portable and does not require any sensors to be attached to the body, it could provide numerous advantages when compared to established marker- or wearable sensor based system. The Kinect V2 has the potential to be used as a reliable and valid clinical measurement tool.

Gilles de la Tourette syndrome is a multifaceted neurodevelopmental disorder characterized by multiple motor and vocal tics. Research in Tourette syndrome has traditionally focused on the motor system. However, there is increasing evidence that perceptual and cognitive processes play a crucial role as well. Against this background it has been reasoned that processes linking perception and action might be particularly affected in these patients with the strength of perception-action binding being increased. However, this has not yet been studied experimentally. Here, we investigated adult Tourette patients within the framework of the ‘Theory of Event Coding’ using an experimental approach allowing us to directly test the strength of perception-action binding. We included 24 adult patients with Tourette syndrome and n = 24 healthy control subjects using a previously established visual-motor event file task with four levels of feature overlap requiring repeating or alternating responses. Concomitant to behavioural testing, EEG was recorded and analysed using temporal signal decomposition and source localization methods. On a behavioural level, perception-action binding was increased in Tourette patients. Tic frequency correlated with performance in conditions where unbinding processes of previously established perception-action bindings were required with higher tic frequency being associated with stronger perception-action binding. This suggests that perception-action binding is intimately related to the occurrence of tics. Analysis of EEG data showed that behavioural changes cannot be explained based on simple perceptual or motor processes. Instead, cognitive processes linking perception to action in inferior parietal cortices are crucial. Our findings suggest that motor or sensory processes alone are less relevant for the understanding of Tourette syndrome than cognitive processes engaged in linking and restructuring of perception-action association. A broader cognitive framework encompassing perception and action appears well suited to opening new routes for the understanding of Tourette syndrome.

We investigated effects of concurrent cognitive task difficulty (n-back) on the regularity of whole-body movements during treadmill walking in women and men from 3 age groups (20 -30, 60 -70, and 70 -80 years old). Using principal component analysis of individual gait patterns, we separated main (regular) from residual (irregular) components of whole-body motion. Proportion of residual variance (RV) was used as an index of gait irregularity. The gait in all age groups became more regular (reduced RV) upon introduction of a simple cognitive task (1-back), relative to walking without a concurrent cognitive task. In contrast, parametrically increasing working memory load from 1-back to 4-back led to age-differential effects, with gait patterns becoming more regular in those 20 -30 years old, becoming less regular in those 70 -80 years old, and showing no significant effects in those 60 -70 years old. Our results support the dual-process account of sensorimotor-cognitive interactions (O. Huxhold, S.-C. Li, F. Schmiedek, and U. Lindenberger, 2006), with age-general effects of internal versus external attentional focus and age-specific effects of resource competition with increasing cognitive task difficulty.

Background: Currently, there is a marked increase of young people with sudden onset of tic-like behaviors (TLBs) resembling movements and vocalizations presented on social media videos as "Tourette's syndrome." Objective: To delineate clinical phenomenology of TLBs after social media exposure in comparison with clinical features of Tourette's syndrome. Methods: We compared demographic and clinical variables between 13 patients with TLBs and 13 ageand sex-related patients with Tourette's syndrome. Results: Patients with TLBs had several characteristics allowing to distinguish them from patients with Tourette's syndrome, some of which discriminated perfectly (ie, abrupt symptom onset, lack of spontaneous symptom fluctuations, symptom deterioration in the presence of others) and some nearly perfectly (ie, predominantly complex movements involving trunk/extremities). Also, symptom onset was significantly later. Conclusions: TLBs after social media consumption differ from tics in Tourette's syndrome, strongly suggesting that these phenomena are categorically different conditions.

Evidence for experience-dependent structural brain change in adult humans is accumulating. However, its time course is not well understood, as intervention studies typically consist of only 2 imaging sessions (before vs. after training). We acquired up to 18 structural magnetic resonance images over a 7-week period while 15 right-handed participants practiced left-hand writing and drawing. After 4 weeks, we observed increases in gray matter of both left and right primary motor cortices relative to a control group; 3 weeks later, these differences were no longer reliable. Time-series analyses revealed that gray matter in the primary motor cortices expanded during the first 4 weeks and then partially renormalized, in particular in the right hemisphere, despite continued practice and increasing task proficiency. Similar patterns of expansion followed by partial renormalization are also found in synaptogenesis, cortical map plasticity, and maturation, and may qualify as a general principle of structural plasticity. Research on human brain plasticity needs to encompass more than 2 measurement occasions to capture expansion and potential renormalization processes over time.

Stringed instrument bowing is a complex sensorimotor skill, involving fine regulation of bow orientation and motion relative to the string. In this study, we characterize this skill in terms of stabilization of specific bow parameters as well as the underlying use and coordination of the degrees of freedom (DOF) of the right bowing arm. Age-matched samples of 10 advanced cellists and 10 cello novices took part in the study. Kinematic bow movement data were analyzed with respect to task variables suggested by the cello teaching literature: position and orientation of the bow relative to the string, bow velocity, and timing. Joint motion of the bowing arm was analyzed in terms of movement amplitude and inter-joint coordination (principal component analysis). As expected, novices showed poorer control of bowing parameters. In addition, novices differed markedly from advanced players in the use and coordination of the DOF of the bowing arm, with the elbow and wrist showing less overall movement and a reduced proportion of variance explained by the first principal component (PC1). In contrast, larger amounts of shoulder variance were explained by PC1 in novices compared to experts. Our findings support Bernstein's theory of graded skill acquisition, according to which early stages of motor skill learning are characterized by a ''freezing'' of movement DOF, while later learning stages exploit the DOF, possibly following a proximal-to-distal sequence, for improved task performance.

Depending upon its organization, movement variability may reflect poor or flexible control of a motor task. We studied adult age-related differences in the structure of postural variability in manual pointing using the uncontrolled manifold (UCM) method. Participants from 2 age groups (younger: 20 -30 years; older: 70 -80 years; 12 subjects per group) completed a total of 120 pointing trials to 2 different targets presented according to 3 schedules: blocked, alternating, and random. The age groups were similar with respect to basic kinematic variables, end point precision, as well as the accuracy of the biomechanical forward model of the arm. Following the uncontrolled manifold approach, goal-equivalent and nongoal-equivalent components of postural variability (goal-equivalent variability [GEV] and nongoal-equivalent variability [NGEV]) were determined for 5 time points of the movements (start, 10%, 50%, 90%, and end) and used to define a synergy index reflecting the flexibility/stability aspect of motor synergies. Toward the end of the movement, younger adults showed higher synergy indexes than older adults. Effects of target schedule were not reliable. We conclude that normal aging alters the organization of common multidegree-of-freedom movements, with older adults making less flexible use of motor abundance than younger adults.

The dual-process account of sensorimotor-cognitive interactions postulates that easy cognitive tasks can lead to performance improvements in the motor domain (e.g., an increased stability while walking or balancing) across the lifespan. However, cross-domain resource competition can lead to performance decrements in motor tasks when the concurrent cognitive task is very difficult, and older adults have shown performance decrements in their motor functioning under such circumstances. Resource limitations are particularly pronounced not only in old adulthood, but also in childhood. The current study investigates the relationship of walking speed and cognitive load on walking regularity in 7- and 9-year olds and young adults, with 18 participants in each group. Participants were walking on a treadmill at their preferred speed, and with speeds that were 30% faster and 30% slower than preferred. Regularity of lower-body coordination was operationalized as the residual variance of principal component analyses performed on the data of a motion analysis system. All age groups showed a more regular gait with increasing walking speed. Young adults' gait regularity was not influenced by cognitive load, whereas children showed a U-shaped relationship of cognitive load and walking regularity, with the highest regularity when performing an easy cognitive task. It can be concluded that children are also influenced by cross-domain resources competition in challenging cognitive-motor dual-task situations.