Empirical evidence indicates that cognitive consequences of cerebellar lesions tend to be mild and less important than the symptoms due to lesions to cerebral areas. By contrast, imaging studies consistently report strong cerebellar activity during tasks of action observation and action understanding. This has been interpreted as part of the automatic motor simulation process that takes place in the context of action observation. The function of the cerebellum as a sequencer during executed movements makes it a good candidate, within the framework of embodied cognition, for a pivotal role in understanding the timing of action sequences. Here, we investigated a cohort of eight patients with chronic, first-ever, isolated, ischemic lesions of the cerebellum. The experimental task consisted in identifying a plausible sequence of pictures from a randomly ordered group of still frames extracted from (a) a complex action performed by a human actor ("biological action" test) or (b) a complex physical event occurring to an inanimate object ("folk physics" test). A group of 16 healthy participants was used as control. The main result showed that cerebellar patients performed significantly worse than controls in both sequencing tasks, but performed much worse in the "biological action" test than in the "folk physics" test. The dissociation described here suggests that observed sequences of simple motor acts seem to be represented differentially from other sequences in the cerebellum.

BackgroundThe aims of the present multicenter pilot study were to examine the feasibility and usability of two different smartphone-based monitoring systems (the Pulso system and the Trilogis-Monsenso system) from two IT companies in patients with bipolar disorder, developed and selected to be testes as a part of a European Union funded Pre-Commercial Procurement (the NYMPHA-MD project).MethodsPatients with bipolar disorder (ICD-10), > 18 years of age during a remitted, partial remitted or mild to moderate depressive state (HDRS-17 < 25) from Italy, Spain and Denmark were included. Patients were randomized 1:1 to the use of one of two smartphone-based monitoring systems. The randomization was stratified according to study location (Italy, Spain, Denmark) and all patients were followed for a 4 weeks study period. Usability and feasibility were evaluated using the Computer System Usability Questionnaire, and the Usefulness, Satisfaction, and Ease of use Questionnaire.ResultsA total of 60 patients aged 18–69 years with bipolar disorder (ICD-10) recruited from Italy, Spain, Denmark were included—59 patients completed the study. In Denmark, the patients evaluated the Trilogis-Monsenso system with a statistically significant higher usability compared with the Pulso system. In Italy and Spain, the patients evaluated no statistically significant difference between the two systems in any of the categories, except for the usefulness category favoring the Trilogis-Monsenso system (z = 2.68, p < 0.01).ConclusionsBoth monitoring systems showed acceptable usability and feasibility. There were differences in patient-based evaluations of the two monitoring systems related to the country of the study. Studies investigating the usability and feasibility during longer follow-up periods could perhaps reveal different findings. Future randomized controlled trials investigating the possible positive and negative effects of smartphone-based monitoring systems are needed.