Playing a musical instrument demands the integration of sensory and perceptual information with motor processes in order to produce a harmonic musical piece. The diversity of brain mechanisms involved and the joyful character of playing an instrument make musical instrument training a potential vehicle for neurorehabilitation of motor skills in patients with cerebral palsy (CP). This clinical condition is characterized by motor impairments that can affect, among others, manual function, and limit severely the execution of basic daily activities. In this study, adolescents and adult patients with CP, as well as a group of typically developing children learned to play piano for 4 consecutive weeks, having completed a total of 8 hours of training. For ten of the participants, learning was supported by a special technical system aimed at helping people with sensorimotor deficits to better discriminate fingers and orient themselves along the piano keyboard. Potential effects of piano training were assessed with tests of finger tapping at the piano and tests of perception of vibratory stimulation of fingers, and by measuring neuronal correlates of motor learning in the absence of and after piano training. Results were highly variable especially among participants with CP. Nevertheless, a significant effect of training on the ability to perceive the localization of vibrations over fingers was found. No effects of training on the performance of simple finger tapping sequences at the piano or on motor-associated brain responses were registered. Longer periods of training are likely required to produce detectable changes.
Impaired cerebral autoregulation leads to fluctuations in cerebral blood flow, which can be especially dangerous for immature brain of preterm newborns. In this paper, two mathematical models of cerebral autoregulation are discussed. The first one is an enhancement of a vascular model proposed by Piechnik et al. We extend this model by adding a polynomial dependence of the vascular radius on the arterial blood pressure and adjusting the polynomial coefficients to experimental data to gain the autoregulation behavior. Moreover, the inclusion of a Preisach hysteresis operator, simulating a hysteretic dependence of the cerebral blood flow on the arterial pressure, is tested. The second model couples the blood vessel system model by Piechnik et al. with an ordinary differential equation model of cerebral autoregulation by Ursino and Lodi. An optimal control setting is proposed for a simplified variant of this coupled model. The objective of the control is the maintenance of the autoregulatory function for a wider range of the arterial pressure. The control can be interpreted as the effect of a medicament changing the cerebral blood flow by, for example, dilation of blood vessels. Advanced numerical methods developed by the authors are applied for the numerical treatment of the control problem.
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