Objective
To present the International Parkinson and Movement Disorder Society (MDS) Clinical Diagnostic Criteria for Parkinson9s disease.
Background
Although several diagnostic criteria for Parkinson9s disease have been proposed, none have been officially adopted by an official Parkinson society. Moreover, the commonest-used criteria, the UK brain bank, were created more than 25 years ago. In recognition of the lack of standard criteria, the MDS initiated a task force to design new diagnostic criteria for clinical Parkinson9s disease.
Methods/Results
The MDS-PD Criteria are intended for use in clinical research, but may also be used to guide clinical diagnosis. The benchmark is expert clinical diagnosis; the criteria aim to systematize the diagnostic process, to make it reproducible across centers and applicable by clinicians with less expertise. Although motor abnormalities remain central, there is increasing recognition of non-motor manifestations; these are incorporated into both the current criteria and particularly into separate criteria for prodromal PD. Similar to previous criteria, the MDS-PD Criteria retain motor parkinsonism as the core disease feature, defined as bradykinesia plus rest tremor and/or rigidity. Explicit instructions for defining these cardinal features are included. After documentation of parkinsonism, determination of PD as the cause of parkinsonism relies upon three categories of diagnostic features; absolute exclusion criteria (which rule out PD), red flags (which must be counterbalanced by additional supportive criteria to allow diagnosis of PD), and supportive criteria (positive features that increase confidence of PD diagnosis). Two levels of certainty are delineated: Clinically-established PD (maximizing specificity at the expense of reduced sensitivity), and Probable PD (which balances sensitivity and specificity).
Conclusion
The MDS criteria retain elements proven valuable in previous criteria and omit aspects that are no longer justified, thereby encapsulating diagnosis according to current knowledge. As understanding of PD expands, criteria will need continuous revision to accommodate these advances. Disclosure: Dr. Postuma has received personal compensation for activities with Roche Diagnostics Corporation and Biotie Therapies. Dr. Berg has received research support from Michael J. Fox Foundation, the Bundesministerium fur Bildung und Forschung (BMBF), the German Parkinson Association and Novartis GmbH.

MDS Clinical Diagnostic Criteria for Parkinson's Disease (S19.001)

Effective motor performance is important for surviving and thriving, and skilled movement is critical in many activities. Much theorizing over the past few decades has focused on how certain practice conditions affect the processing of task-related information to affect learning. Yet, existing theoretical perspectives do not accommodate significant recent lines of evidence demonstrating motivational and attentional effects on performance and learning. These include research on (a) conditions that enhance expectancies for future performance, (b) variables that influence learners' autonomy, and (c) an external focus of attention on the intended movement effect. We propose the OPTIMAL (Optimizing Performance through Intrinsic Motivation and Attention for Learning) theory of motor learning. We suggest that motivational and attentional factors contribute to performance and learning by strengthening the coupling of goals to actions. We provide explanations for the performance and learning advantages of these variables on psychological and neuroscientific grounds. We describe a plausible mechanism for expectancy effects rooted in responses of dopamine to the anticipation of positive experience and temporally associated with skill practice. Learner autonomy acts perhaps largely through an enhanced expectancy pathway. Furthermore, we consider the influence of an external focus for the establishment of efficient functional connections across brain networks that subserve skilled movement. We speculate that enhanced expectancies and an external focus propel performers' cognitive and motor systems in productive "forward" directions and prevent "backsliding" into self- and non-task focused states. Expected success presumably breeds further success and helps consolidate memories. We discuss practical implications and future research directions.

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Optimizing performance through intrinsic motivation and attention for learning: The OPTIMAL theory of motor learning

/pdf/the-oxford-handbook-of-stress-health-and-coping-1fdqzy5i7i.pdf

The Oxford Handbook of Stress, Health and Coping

Additive benefits of autonomy support and enhanced expectancies for motor learning.

The challenge to provide equitable opportunities for college students to succeed is a critical priority for the Association of American Colleges and Universities (AACU (https://unlv.col.qualtrics. com/jfe/form/SV_9GOYyMonDPOfrX7);* students' self-ratings of three important predictors of success: academic confidence, sense of belonging, and improved mastery of skills that employers value (measured by Transparency Survey questions 4-6,8-11,22,24-25,32,34-35);* direct assessment of students' work as indicated by scored student work samples, selected randomly (addressed elsewhere in this special issue of Peer Review)-, and* short-term retention rates.RationaleThese measures of success and the rationale for our intervention intentionally align with several important past studies. Multiple researchers have demonstrated that increases in college students' academic confidence and sense of belonging are directly correlated with higher GPAs and persistence and retention rates, especially for underserved students. …

A Teaching Intervention That Increases Underserved College Students' Success

The numerous negative health impacts of COVID-19, which include expected changes to psychiatric illness and physical activity (PA), are disproportionately distributed in the United States. Mental illnesses and physical inactivity are prevalent among U.S. college students. This study examined whether there was a change in minutes of PA and depression scores after a stay-at-home order and examined predictors of these changes. An online survey was sent to all undergraduate and graduate students attending a large, diverse university via an electronic newsletter. The survey requested information about demographic and academic data, cardiorespiratory fitness, and depression symptoms. Paired t-tests and logistic regression were employed. Our sample (n = 194) was predominantly female (73%), young (mean age of 25), not a sexual minority (82%), and had a mean 3.4 GPA. Students reported worse depression scores (p < 0.01) and fewer minutes of PA (p = 0.01) after the stay-at-home order. There was a small but significant (p = 0.04) correlation between changes in total minutes of PA and depression scores. Senior (p = 0.05) and Hispanic (p = 0.03) students were less likely to report worsening depression scores than freshmen and white students, respectively. Asian students were significantly more likely than white students to report decreased PA. This study suggests that COVID-19 and its consequences may be contributing to reduced PA and greater depression symptoms in college students and that sub-groups have been affected differently. Targeted interventions to promote PA and support mental health may bolster the ability for resilience of college students.

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Changes in Depression and Physical Activity Among College Students on a Diverse Campus After a COVID-19 Stay-at-Home Order.

Benefits (some unexpected) of Transparently Designed Assignments

The present study examined whether motor skill learning could be enhanced through a hypnotic intervention. The task involved throwing a tennis ball overhand at a target. Participants were assigned to either a hypnosis or control group. Both groups first completed a pre-test of 20 throws. Prior to the second block of 20 throws (post-test), the hypnosis group received a 10-minute hypnotic intervention. The theme of the hypnosis session was to focus on the target while throwing. Participants were aroused from the hypnotic state prior to the throwing task. The control group was asked to relax in the same environment for the same length of time. Control group participants were told that focusing on the target had been shown to increase accuracy. On the post-test, as well as on a retention test (20 throws), conducted 5-8 days after the post-test, the hypnosis group showed an increase in throwing accuracy relative to the pre-test and more effective performance than the control group whose performance was similar to that on the pre-test. These findings show that hypnosis can have a positive impact on motor learning. Potential mechanisms for this effect are discussed.

Brief Hypnotic Intervention Increases Throwing Accuracy

Depression is a serious but treatable health issue that affects college students at an alarming rate. Improved cardiorespiratory fitness (CRF) decreases depression risk and severity but this relationship has not been fully evaluated in the college student population. Non-exercise estimated CRF (eCRF) could be used to identify students at risk for or suffering from depression. This study investigated the associations of depression and eCRF in college students. Participants (N = 437) completed a survey which included demographic and student-status questions, eCRF variables, and a validated depression instrument. Descriptive, chi-square, t-test, regression, and odds ratio analyses were employed. Depression was associated with low-fitness (X2 = 4.660, P = 0.031) and eCRF below age-predicted CRF (t = 3.28, P < 0.001). Predictors of increased depression included low-fitness, sexual orientation, current depression treatment, and GPA (R2= 0.145-0.159; Adj R2= 0.135-0.149). Odd ratio analyses determined that low-fitness increased the risk of reporting depression ( s=2.39, P = 0.017, 95% CI=1.17-4.872) which remained significant when adjusted (s=2.478, P=0.017, 95% CI=1.175-5.229). Adjusted odds ratio analyses also indicated increased risk of reporting depression for those in a sexual minority (s=2.582, P=0.001, 95% CI=1.44,4.629) and undergoing current depression treatment (s=2.393, P < 0.001, 95% CI=2.393-13.043). High levels of fitness did not reduce the odds of reporting depression compared to age predicted CRF. A simple eCRF algorithm can be used to identify college student depression.

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Estimated Cardiorespiratory Fitness Is Associated With Reported Depression in College Students.

Transcranial direct current stimulation of the cerebellum (c-tDCS) improves motor performance in young and old adults. Based on the cerebellar involvement in Parkinson's disease (PD), c-tDCS could have potential to improve motor function in PD. The purpose was to determine the effects of c-tDCS on motor performance in PD while participants were on medications. The study was a randomized, double-blind, SHAM-controlled, between-subjects design. Twenty-two participants with PD were allocated to either a c-tDCS group or a SHAM group. All participants completed one experimental session and performed two motor tasks with their most affected hand in a Baseline condition (no stimulation) and an Experimental condition. The motor tasks were a visuomotor isometric precision grip task (PGT) and a rapid arm movement task (AMT). The primary dependent variables were force error and endpoint error in the PGT and AMT, respectively. There were no significant differences in force error or endpoint error in the Experimental condition between the c-tDCS and SHAM groups. These results indicate that an acute application of c-tDCS does not enhance motor performance in hand and arm tasks in PD. Longer-term c-tDCS application over multiple days may be needed to enhance motor function in PD.

/pdf/an-acute-application-of-cerebellar-transcranial-direct-3s8vxq5kaa.pdf

Sharon Jalene

Papers

Changes in Depression and Physical Activity Among College Students on a Diverse Campus After a COVID-19 Stay-at-Home Order.

Benefits (some unexpected) of Transparently Designed Assignments

Brief Hypnotic Intervention Increases Throwing Accuracy

Estimated Cardiorespiratory Fitness Is Associated With Reported Depression in College Students.

An Acute Application of Cerebellar Transcranial Direct Current Stimulation Does Not Improve Motor Performance in Parkinson's Disease