Reducing the Soleus Stretch Reflex With Conditioning: Exploring Game- and Impedance-Based Biofeedback

People with spasticity, i.e., stretch hyperreflexia, have a limited functional independence and mobility. While a broad range of spasticity treatments is available, many treatments are invasive, non-specific, or temporary and might have negative side effects. Operant conditioning of the stretch reflex is a promising non-invasive paradigm with potential long-term sustained effects. Within this conditioning paradigm, seated participants have to reduce the mechanically elicited reflex response using biofeedback of reflex magnitude quantified using electromyography (EMG). Before clinical application of the conditioning paradigm, improvements are needed regarding the time-intensiveness and slow learning curve. Previous studies have shown that gamification of biofeedback can improve participant motivation and long-term engagement. Moreover, quantification of reflex magnitude for biofeedback using reflexive joint impedance may obtain similar effectiveness within fewer sessions. Nine healthy volunteers participated in the study, split in three groups. First, as a reference the “Conventional” group received EMG- and bar-based biofeedback similar to previous research. Second, we explored feasibility of game-based biofeedback with the “Gaming” group receiving EMG- and game-based biofeedback. Third, we explored feasibility of game- and impedance-based biofeedback with the “Impedance” group receiving impedance and game-based biofeedback. Participants completed five baseline sessions (without reflex biofeedback) and six conditioning sessions (with reflex biofeedback). Participants were instructed to reduce reflex magnitude without modulating background activity. The Conventional and Gaming groups showed feasibility of the protocol in 2 and 3 out of 3 participants, respectively. These participants achieved a significant Soleus short-latency (M1) within-session reduction in at least –15% in the 4th–6th conditioning session. None of the Impedance group participants showed any within-session decrease in Soleus reflex magnitude. The feasibility in the EMG- and game-based biofeedback calls for further research on gamification of the conditioning paradigm to obtain improved participant motivation and engagement, while achieving long-term conditioning effects. Before clinical application, the time-intensiveness and slow learning curve of the conditioning paradigm remain an open challenge.

Olfactory Learning Supports an Adaptive Sugar-Aversion Gustatory Phenotype in the German Cockroach

An association of food sources with odors prominently guides foraging behavior in animals. To understand the interaction of olfactory memory and food preferences, we used glucose-averse (GA) German cockroaches. Multiple populations of cockroaches evolved a gustatory polymorphism where glucose is perceived as a deterrent and enables GA cockroaches to avoid eating glucose-containing toxic baits. Comparative behavioral analysis using an operant conditioning paradigm revealed that learning and memory guide foraging decisions. Cockroaches learned to associate specific food odors with fructose (phagostimulant, reward) within only a 1 h conditioning session, and with caffeine (deterrent, punishment) after only three 1 h conditioning sessions. Glucose acted as reward in wild type (WT) cockroaches, but GA cockroaches learned to avoid an innately attractive odor that was associated with glucose. Olfactory memory was retained for at least 3 days after three 1 h conditioning sessions. Our results reveal that specific tastants can serve as potent reward or punishment in olfactory associative learning, which reinforces gustatory food preferences. Olfactory learning, therefore, reinforces behavioral resistance of GA cockroaches to sugar-containing toxic baits. Cockroaches may also generalize their olfactory learning to baits that contain the same or similar attractive odors even if they do not contain glucose.

Olfactory Learning Supports an Adaptive Sugar-Aversion Gustatory Phenotype in the German Cockroach

An association of food sources with odors prominently guides foraging behavior in animals. To understand the interaction of olfactory memory and food preferences, we used glucose-averse (GA) German cockroaches. Multiple populations of cockroaches evolved a gustatory polymorphism where glucose is perceived as a deterrent and enables GA cockroaches to avoid eating glucose-containing toxic baits. Comparative behavioral analysis using an operant conditioning paradigm revealed that learning and memory guide foraging decisions. Cockroaches learned to associate specific food odors with fructose (phagostimulant, reward) within only a 1 hr conditioning session, and with caffeine (deterrent, punishment) after only three 1 hr conditioning sessions. Glucose acted as reward in wild type (WT) cockroaches, but GA cockroaches learned to avoid an innately attractive odor that was associated with glucose. Olfactory memory was retained for at least 3 days after three 1 hr conditioning sessions. Our results reveal that specific tastants can serve as potent reward or punishment in olfactory associative learning, which reinforces gustatory food preferences. Olfactory learning therefore reinforces behavioral resistance of GA cockroaches to sugar-containing toxic baits. Cockroaches may also generalize their olfactory learning to baits that contain the same or similar attractive odors even if they do not contain glucose.

Do we really understand the role of the prefrontal cortex in placebo analgesia?

Several reviews have strongly implicated prefrontal cortical engagement in expectation-based placebo analgesia. We recently found a robust placebo analgesic response and associated decreases in pain-related cortical activations, without observable prefrontal engagement. We hypothesized our substantial conditioning and weak verbal instructions diminished expectation-related prefrontal activation. To test this, we examined the same subjects during a conditioning procedure, in which expectancy of pain relief was high. In two conditioning sessions, noxious heat was applied to a leg region treated with an ″analgesic″ cream and another treated with a ″moisturizing″ cream. In reality, both creams were inert, but the temperature applied to the moisturizing-cream area was 2°C higher than that applied to the analgesic-cream area. Functional MRI was acquired during the second conditioning session. Pain ratings were lower for the low heat than the high heat, with corresponding reduced activations in pain-related regions. Similar to previous studies with strong expectation for pain relief, we observed more prefrontal activations during the ″analgesic″ than the control condition. Nevertheless, contrary to the idea of active prefrontal engagement, the relative activation was based on differences in negative BOLD signals. A literature review revealed that only a few studies conclusively showed active engagement of prefrontal cortex, i.e. increased positive BOLD signal during high expectation compared to a control, with variable timing and spatial-specificity. We suggest that this variability is due to the heterogeneous influence of cognitive, emotional and motivational factors. Future studies should attempt to unravel the multiple contributions to placebo responsiveness in the prefrontal cortex.

Auditory fear conditioning alters neural gain in the cochlear nucleus: a wireless neural recording study in freely behaving rats

Anxiety disorders involve distorted perception of the world including increased saliency of stress-associated cues. However, plasticity in the initial sensory regions of the brain following a fearful experience has never been examined. The cochlear nucleus (CN) is the first station in the central auditory system, with heterogeneous collections of neurons that not only project to but also receive projections from cortico-limbic regions, suggesting a potential for experience-dependent plasticity. Using wireless neural recordings in freely behaving rats, we demonstrate for the first time that neural gain in the CN is significantly altered by fear conditioning to auditory sequences. Specifically, the ventral subnuclei significantly increased firing rate to the conditioned tone sequence, while the dorsal subnuclei significantly decreased firing rate during the conditioning session overall. These findings suggest subregion-specific changes in the balance of inhibition and excitation in the CN as a result of conditioning experience. Heart rate was measured as the conditioned response (CR), which showed that while pre-conditioned stimulus (CS) responding did not change across baseline and conditioning sessions, significant changes in heart rate were observed to the tone sequence followed by shock. Heart-rate findings support acquisition of conditioned fear. Taken together, the present study presents first evidence for potential experience-dependent changes in auditory perception that involve novel plasticity within the first site of processing auditory information in the brain.

Impact of an 11-Week Strength and Conditioning Program on Firefighter Trainee Fitness

Physical fitness is an important aspect of physical health and wellbeing. The aim of this study was to investigate the effects of 11-weeks of formal strength and conditioning training conducted during fire academy training on the physical fitness characteristics of firefighter trainees. Archived physical fitness data for 23 male fire academy trainees (age: 27.6 ± 4.3 y; height: 178.5 ± 6.9 cm; body mass [BM]: 83.9 ± 1.8 kg; BM index [BMI]: 26.8 ± 2.8 kg/m2) were analyzed for this study. These data included vertical jump height, maximum pull-up repetitions, hand grip strength, lower-body strength (3RM Hexbar) and aerobic fitness. Trainees performed three sessions per week (two resistance training sessions and one aerobic conditioning session) in addition to fire academy training. A repeated measures ANOVA revealed significant (p < 0.05) pre-post decreases in BM and BMI and significant increases in upper- and lower-body strength, and aerobic fitness. Strength and conditioning programs are beneficial for improving firefighter trainees’ physical fitness even when run concurrently with fire academy training and with limited space and equipment. This increased fitness may aid in mitigating known occupational injury risks to this population and improve task performance.

The Posterior Insular Cortex is Necessary for the Consolidation of Tone Fear Conditioning

ABSTRACTThe insular cortex (IC) is notably implicated in emotional and cognitive processing; however, little is known regarding to what extent its two main subregions play functionally distinct roles on memory consolidation of conditioned fear tasks. Here we verified the effects of temporary functional inactivation of the anterior (aIC) and posterior IC (pIC) on contextual and tone fear memory. Rats received post-training bilateral infusions of the GABAA receptor agonist muscimol into either the aIC or pIC and were tested 48 and 72 hours after the conditioning session to assess contextual (CFC) and tone (TFC) fear conditioning, respectively. Inactivation of the aIC during memory consolidation did not affect fear memory for CFC or TFC. On the other hand, post-training inactivation of the pIC impaired TFC but not CFC. Our findings indicate that the pIC is a necessary part of the neural circuitry related to the consolidation of cued-fear memories.HighlightsWe studied the role of the anterior (aIC) and posterior (pIC) insula in fear memoryPost-training inactivation of aIC and pIC did not impact contextual fear conditioningThe pIC but not aIC is necessary for the consolidation of tone fear conditioning

Nontraumatic Exertional Fatalities in Football Players, Part 2: Excess in Conditioning Kills

Background: The incidence of nontraumatic fatalities in high school (HS) and National Collegiate Athletic Association (NCAA) football players has continued at a constant rate since the 1960s. Purpose: To describe the causes of nontraumatic fatalities in HS and NCAA football players and provide prevention strategies. Study Design: Descriptive epidemiology study. Methods: We reviewed 187 fatalities in HS and NCAA nontraumatic football players catalogued by the National Registry of Catastrophic Sports Injuries during a 20-year period between July 1998 and June 2018. Results: The majority (n = 162; 86.6%) of fatalities occurred during a practice or conditioning session. Most fatalities, when timing was known, (n = 126; 70.6%) occurred outside of the regular playing season, with the highest incidence in the August preseason (n = 64; 34.2%). All documented conditioning sessions were supervised by a coach (n = 92) or strength and conditioning coach (n = 40). The exercise regimen at the time of the fatality involved high-intensity aerobic training in 94.7%. Punishment was identified as the intent in 36 fatalities. The average body mass index of the athletes was 32.6 kg/m2. For athletes who died due to exertional heat stroke, the average body mass index was 36.4 kg/m2, and 97.1% were linemen. Conclusion: Most nontraumatic fatalities in HS and NCAA football players occurred during coach-supervised conditioning sessions. The primary cause of exertion-related fatalities was high-intensity aerobic workouts that might have been intended as punishment and/or excess repetitions. Exertion-related fatalities are potentially preventable by applying standards in workout design, holding coaches accountable, and ensuring compliance with the athlete’s health and current welfare policies.

Sweat Characteristics of Cramp-Prone and Cramp-Resistant Athletes

Exercise-associated muscle cramps (EAMCs) are thought to be caused by dehydration and/or electrolyte losses. In this multicenter, cross-sectional study, the authors determined whether sweat rates (SRs), sweat electrolyte concentrations, or sweat electrolyte content differed in athletes with (i.e., crampers) and without (i.e., noncrampers) a history of EAMCs and whether these variables could predict EAMC-prone athletes. Male and female collegiate athletes (N = 350) from 11 sports with (n = 245) and without (n = 105) a self-reported history of EAMCs completed a typical exercise or conditioning session. SRs, calculated from body mass, and posterior forearm sweat were analyzed for sweat sodium concentration ([Na+]sw), sweat potassium concentration ([K+]sw), and sweat chloride concentration ([Cl−]sw). The authors used SRs and sweat electrolyte concentrations to calculate sweat electrolyte content lost. Within each gender, no differences in SRs (204 males, p = .92; 146 females, p = .24); [Na+]sw (191 males, p = .55; 126 females, p = .55); Na+sw content (191 males, p = .59; 126 females, p = .20); [K+]sw (192 males, p = .57; 126 females, p = .87); K+sw content (192 males, p = .49; 126 females, p = .03); [Cl−]sw (192 males, p = .94; 77 females, p = .57); and Cl−sw content (192 males, p = .55; 77 females, p = .34) occurred between crampers and noncrampers. Receiver operating characteristic curve analysis revealed that sweat electrolyte content and SRs were predictive of EAMC-prone athletes in American football (area under curve = 0.65–0.72, p ≤ .005), but not in any other sport. EAMCs may not be solely caused by fluid or electrolyte losses in most athletes. Fluid and electrolyte replacement may help American footballers. Clinicians should individualize fluid and electrolyte replacement and understand different etiologies for EAMCs.