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Falls are the second most frequent cause of injury in the elderly. Physiological processes associated with aging affect the elderly’s ability to respond to unexpected balance perturbations, leading to increased fall risk. Every year, approximately 30% of adults, 65 years and older, experiences at least one fall. Investigating the neurophysiological mechanisms underlying the control of static and dynamic balance in the elderly is an emerging research area. The study aimed to identify cortical and muscular correlates during static and dynamic balance tests in a cohort of young and old healthy adults. We recorded cortical and muscular activity in nine elderly and eight younger healthy participants during an upright stance task in static and dynamic (core board) conditions. To simulate real-life dual-task postural control conditions, the second set of experiments incorporated an oddball visual task. We observed higher electroencephalographic (EEG) delta rhythm over the anterior cortex in the elderly and more diffused fast rhythms (i.e., alpha, beta, gamma) in younger participants during the static balance tests. When adding a visual oddball, the elderly displayed an increase in theta activation over the sensorimotor and occipital cortices. During the dynamic balance tests, the elderly showed the recruitment of sensorimotor areas and increased muscle activity level, suggesting a preferential motor strategy for postural control. This strategy was even more prominent during the oddball task. Younger participants showed reduced cortical and muscular activity compared to the elderly, with the noteworthy difference of a preferential activation of occipital areas that increased during the oddball task. These results support the hypothesis that different strategies are used by the elderly compared to younger adults during postural tasks, particularly when postural and cognitive tasks are combined. The knowledge gained in this study could inform the development of age-specific rehabilitative and assistive interventions.

Dravet syndrome (DS) is a rare severe epilepsy syndrome associated with slowed psychomotor development and behavioral disorders from the second year onward in a previously seemingly normal child. Among cognitive impairments, visuospatial, sensorimotor integration, and expressive language deficits are consistently reported. There have been independent hypotheses to deconstruct the typical cognitive development in DS (dorsal stream vulnerability, cerebellar‐like pattern, sensorimotor integration deficit), but an encompassing framework is still lacking. We performed a scoping review of existing evidence to map the current understanding of DS cognitive and behavioral developmental profiles and to summarize the evidence on suggested frameworks. We searched PubMed, Scopus, PsycInfo, and MEDLINE to identify reports focusing on cognitive deficits and/or behavioral abnormalities in DS published between 1978 and March 15, 2020. We followed the Preferred Reporting Items for Systematic reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR) guidelines. Twenty‐one reports were selected and tabulated by three independent reviewers based on predefined data extraction and eligibility forms. Eighteen reports provided assessments of global intelligence quotients with variable degrees of cognitive impairment. Eleven reports analyzed single subitems contribution to global cognitive scores: these reports showed consistently larger impairment in performance scales compared to verbal ones. Studies assessing specific cognitive functions demonstrated deterioration of early visual processing, fine and gross motor abilities, visuomotor and auditory‐motor integration, spatial processing, visuo‐attentive abilities, executive functions, and expressive language. Behavioral abnormalities, reported from 14 studies, highlighted autistic‐like traits and attention and hyperactivity disorders, slightly improving with age. The cognitive profile in DS and some behavioral and motor abnormalities may be enclosed within a unified theoretical framework of the three main hypotheses advanced: a pervasive sensorimotor integration deficit, encompassing an occipito‐parietofrontal circuit (dorsal stream) dysfunction and a coexistent cerebellar deficit.

Fibromyalgia syndrome (FMS) is a complex pain disorder, characterized by diffuse pain and cognitive disturbances. Abnormal cortical oscillatory activity may be a promising biomarker, encouraging non-invasive neurostimulation techniques as a treatment. We aimed to modulate abnormal slow cortical oscillations by delivering transcranial alternating current stimulation (tACS) and physiotherapy to reduce pain and cognitive symptoms. This was a double-blinded, randomized, crossover trial conducted between February and September 2018 at the Rehabilitation Unit of a teaching Hospital (NCT03221413). Participants were randomly assigned to tACS or random noise stimulation (RNS), 5 days/week for 2 weeks followed by ad hoc physiotherapy. Clinical and cognitive assessments were performed at T0 (baseline), T1 (after stimulation), T2 (1 month after stimulation). Electroencephalogram (EEG) spectral topographies recorded from 15 participants confirmed slow-rhythm prevalence and provided tACS tailored stimulation parameters and electrode sites. Following tACS, EEG alpha1 ([8–10] Hz) activity increased at T1 (p = 0.024) compared to RNS, pain symptoms assessed by Visual Analog Scale decreased at T1 (T1 vs T0p = 0.010), self-reported cognitive skills and neuropsychological scores improved both at T1 and T2 (Patient-Reported Outcomes in Cognitive Impairment, T0–T2, p = 0.024; Everyday memory questionnaire, T1 compared to RNS, p = 0.012; Montréal Cognitive Assessment, T0 vs T1, p = 0.048 and T0 vs T2, p = 0.009; Trail Making Test B T0–T2, p = 0.034). Psychopathological scales and other neuropsychological scores (Trail Making Test-A; Total Phonemic Fluency; Hopkins Verbal Learning Test-Revised; Rey–Osterrieth Complex Figure) improved both after tACS and RNS but earlier improvements (T1) were registered only after tACS. These results support tACS coupled with physiotherapy in treating FMS cognitive symptoms, pain and subclinical psychopathology.

Alterations in body representations (i.e., body image and body schema) are increasingly getting attention in clinical practice. Adolescents affected by idiopathic scoliosis experience body image dissatisfaction, and alterations in body schema have been suggested to be a consequence of the disease development. Although research has recognized the predisposing role of body representation disorders to psychopathologies, these aspects have been largely overlooked in this clinical population. This scoping review aims to establish the state of the art on the widely neglected aspects of body image and body schema disorders in adolescents affected by idiopathic scoliosis. PubMed, Scopus, PsycInfo, and MEDLINE were consulted to select articles published between 2000 and 2021. Three independent reviewers identified 27 articles by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review guidelines. Body image was assessed in 24 of the 27 studies. Body image disorders were reported, with more severe scoliosis cases showing higher body image dissatisfaction. Surgery seems to be the best approach to improve body image outcomes, but studies did not reveal clear associations between clinical measures of scoliosis severity (e.g., Cobb angle, hump height) and body image. Disorders of body schema have been reported, but the finding might have been biased by the paucity of studies on this aspect of body representations (4/27). This review highlighted the wide prevalence of psychological distress and body schema alterations among adolescents affected by idiopathic scoliosis; but it also revealed that both are disregarded and not properly evaluated.

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Falls are the second leading cause of injury for the elderly worldwide. Physiological aging processes alter the ability to address unexpected balance perturbations and increase the probability of falling. Indeed, approximately 30% of adults older than 65 years experiences up to one fall/year. Investigating the neurophysiological patterns of static and dynamic balance in the elderly is an emerging area of research. This knowledge will provide a mechanistic basis to implement novel rehabilitation strategies and assistive devices to eventually reduce the risk of falls. Our aim was to identify cortical and muscular correlates of static and dynamic balance in a cohort of younger and old healthy adults. We quantified cortical and muscular activation in 9 elderly and 8 younger healthy participants during a task of upright stance in static and dynamic (core board) conditions. To simulate real-life double-tasking while maintaining posture, a second set of experiments incorporated a visual oddball task. During static balance, we observed high electroencephalographic (EEG) delta rhythm over the anterior cortex in the elderly and more diffused fast rhythms (i.e., alpha, beta, gamma band) in younger participants. By adding a visual oddball, the elderly increased theta activation over sensorimotor and occipital cortices. During dynamic balance, the elderly recruited sensorimotor areas and increased muscle co-contraction, suggesting a preferen- tial motor strategy to maintain posture. This strategy was exasperated during the oddball task. The younger participants showed an overall reduced cortical and muscular activation compared to the elderly, with the noteworthy difference of a preferential activation of occipital areas reinforced during the oddball task, hinting to a likely visual strategy to maintain dynamic balance. These results support the hypothesis of a different strategy during the life-span in addressing postural tasks as cognitive load increases. This knowledge will aid in tailoring age-specific rehabilitative and assistive interventions.

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