Electroencephalography (EEG) is useful to objectively diagnose/grade hepatic encephalopathy (HE) across its spectrum of severity. However, it requires expensive equipment, and hepatogastroenterologists are generally unfamiliar with its acquisition/interpretation. Recent technological advances have led to the development of low‐cost, user‐friendly EEG systems, allowing EEG acquisition also in settings with limited neurophysiological experience. The aim of this study was to assess the relationship between EEG parameters obtained from a standard‐EEG system and from a commercial, low‐cost wireless headset (light‐EEG) in patients with cirrhosis and varying degrees of HE. Seventy‐two patients (58 males, 61 ± 9 years) underwent clinical evaluation, the Psychometric Hepatic Encephalopathy Score (PHES), and EEG recording with both systems. Automated EEG parameters were calculated on two derivations. Strong correlations were observed between automated parameters obtained from the two EEG systems. Bland and Altman analysis indicated that the two systems provided comparable automated parameters, and agreement between classifications (normal versus abnormal EEG) based on standard‐EEG and light‐EEG was good (0.6 < κ < 0.8). Automated parameters such as the mean dominant frequency obtained from the light‐EEG correlated significantly with the Model for End‐Stage Liver Disease score (r = −0.39, P < 0.05), fasting venous ammonia levels (r = −0.41, P < 0.01), and PHES (r = −0.49, P < 0.001). Finally, significant differences in light‐EEG parameters were observed in patients with varying degrees of HE. Conclusion: Reliable EEG parameters for HE diagnosing/grading can be obtained from a cheap, commercial, wireless headset; this may lead to more widespread use of this patient‐independent tool both in routine liver practice and in the research setting. (Hepatology 2016;63:1651‐1659)

Past selection experience greatly affects the deployment of attention such that targets are more readily selected if their features or locations were more frequently selected in the past. Crucially, recent studies have shown similar experience-dependent effects also for salient task irrelevant stimuli: distractors exerted less interference if they appeared at a location where they were presented more often, relatively to other possible locations. Here we investigated the effects of such suppression history on the immediate behavioural correlates of attentional deployment, i.e., eye movements. Participants were to make saccadic eye movements to a target stimulus, while ignoring a highly distracting irrelevant visual onset appearing abruptly on the screen in a proportion of trials. Crucially, this irrelevant onset occurred more frequently in two locations on the visual display and our results showed that, relatively to distractors elsewhere, onsets presented at these locations became easier to ignore, giving rise to reduced oculomotor capture. Consistent with the notion that experience can alter attentional deployment towards spatial locations, these findings indicate that, through learning, the priority of high frequency locations becomes suppressed, attenuating the intrinsic saliency of distractors appearing therein. Traces left by individual events of attentional suppression decrease the processing priority of coordinates within topographic maps of the visual space.

Visually guided grasping is a fundamental building block of animal behavior, the specific neural mechanisms of which remain poorly documented in the human brain. We have mapped the causal contribution of different brain parts to grasping behavior by studying the kinematic parameters of 33 patients with brain tumors, engaged in actions directed toward objects of different sizes. Using motion capture techniques, we analyzed the dynamics of grip aperture and wrist transport. Voxel-based lesion-symptom mapping analysis was applied to correlate lesion volumes with specific behavioral deficits. Results showed that lesions in the anterior and lateral bank of the intraparietal sulcus produced impaired finger scaling related to object size. Conversely, impaired velocity of finger aperture was associated with lesions in the dorsal premotor cortex (PMd). Grip aperture deficits following dominant hemisphere lesions were bilateral and were unilateral when following nondominant hemisphere lesions. Impaired wrist transport during reaching was associated with lesions in the first segment of the superior longitudinal fasciculus. Our work highlights an architecture of the grasping network in humans, with unique species-specific features. We hypothesize a model of human neural architecture in which object geometry for hand preshaping is first coded in the left anterior intraparietal cortex and then shared with the right hemisphere. Execution of the motor program of hand preshaping is then performed by the PMd on the corresponding side.

In recent years, the use of implicit mechanisms based on statistical learning (SL) has emerged as a strong factor in biasing visuospatial attention, so that target selection is improved at frequently attended locations and distractor filtering is facilitated at frequently suppressed locations. Although these mechanisms have been consistently described in younger adults, similar evidence in healthy aging is scarce. Therefore, we studied the learning and persistence of SL of target selection and distractor suppression in younger and older adults in visual search tasks where the frequency of target (Experiment 1) or distractor (Experiment 2) was biased across spatial locations. The results show that SL of target selection was preserved in the older adults so, similar to their younger counterparts, they showed a strong and persistent advantage in target selection at locations more frequently attended. However, unlike young adults, they did not benefit from implicit SL of distractor suppression, so that distractor interference was maintained throughout the experiment independently of the contingencies associated with distractor locations. Taken together, these results provide novel evidence of distinct developmental patterns for SL of task-relevant and task-irrelevant visual information, likely reflecting differences in the implementation of proactive suppression attentional mechanisms between younger and older adults. Public Significance StatementHumans can use regularities in visual scenes to improve performance in finding relevant objects (targets) and inhibiting responses to irrelevant objects (distractors). The present study demonstrates that older adults can learn and exploit target-related but not distractor-related spatial regularities. This finding sheds further light on how the ability to use prior experience to guide attention may change in aging, with potential consequences for daily activities characterized by irrelevant distractors (e.g., driving).

(1) Background: Degenerative cervical myelopathy is one of the main causes of disability in the elderly. The treatment of choice in patients with clear symptomatology and radiological correlation is surgical decompression. The application of navigated transcranial magnetic stimulation (nTMS) techniques has the potential to provide additional insights into the cortical and corticospinal behavior of the myelopathic cord and to better characterize the possible extent of clinical recovery. The objective of our study was to use nTMS to evaluate the effect of surgical decompression on neurophysiological properties at the cortical and corticospinal level and to better characterize the extent of possible clinical recovery. (2) Methods: We conducted a longitudinal study in which we assessed and compared nTMS neurophysiological indexes and clinical parameters (modified Japanese Orthopedic Association score and nine-hole pegboard test) before surgery, at 6 months, and at 12 months’ follow-up in a population of 15 patients. (3) Results: We found a significant reduction in resting motor threshold (RMT; average 7%), cortical silent period (CSP; average 15%), and motor area (average 25%) at both 6 months and 12 months. A statistically significant linear correlation emerged between recruitment curve (RC) values obtained at follow-up appointments and at baseline (r = 0.95 at 6 months, r = 0.98 at 12 months). A concomitant improvement in the mJOA score and in the nine-hole pegboard task was observed after surgery. (4) Conclusions: Our results suggest that surgical decompression of the myelopathic spinal cord improves the neurophysiological balance at the cortical and corticospinal level, resulting in clinically significant recovery. Such findings contribute to the existing evidence characterizing the brain and the spinal cord as a dynamic system capable of functional and reversible plasticity and provide useful clinical insights to be used for patient counseling.