Rancho Los Amigos National Rehabilitation Center

About: Rancho Los Amigos National Rehabilitation Center is a healthcare organization based out in Downey, California, United States. It is known for research contribution in the topics: Spinal cord injury & Population. The organization has 285 authors who have published 411 publications receiving 16198 citations. The organization is also known as: Rancho Los Amigos.

Subcortical ischaemic vascular dementia

Abstract: Summary Vascular dementia is the second most common type of dementia. The subcortical ischaemic form (SIVD) frequently causes cognitive impairment and dementia in elderly people. SIVD results from small-vessel disease, which produces either arteriolar occlusion and lacunes or widespread incomplete infarction of white matter due to critical stenosis of medullary arterioles and hypoperfusion (Binswanger's disease). Symptoms include motor and cognitive dysexecutive slowing, forgetfulness, dysarthria, mood changes, urinary symptoms, and short-stepped gait. These manifestations probably result from ischaemic interruption of parallel circuits from the prefrontal cortex to the basal ganglia and corresponding thalamocortical connections. Brain imaging (computed tomography and magnetic resonance imaging) is essential for correct diagnosis. The main risk factors are advanced age, hypertension, diabetes, smoking, hyperhomocysteinaemia, hyperfibrinogenaemia, and other conditions that can cause brain hypoperfusion such as obstructive sleep apnoea, congestive heart failure, cardiac arrhythmias, and orthostatic hypotension. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL) and some forms of cerebral amyloid angiopathy have a genetic basis. Treatment is symptomatic and prevention requires control of treatable risk factors.

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

Abstract: 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.

Head injury and the risk of AD in the MIRAGE study

Abstract: Objectives: It has been suggested in some studies that head injury is a risk factor for AD, and that this risk is heightened among carriers of the APOE -e4 allele. We examined the effects of head injury and APOE genotype on AD risk in a large family study. Subjects: A total of 2,233 probands who met criteria for probable or definite AD and their 14,668 first-degree family members (4,465 parents, 7,694 siblings, and 2,509 spouses) were ascertained at 13 centers in the United States, Canada, and Germany participating in the MIRAGE (Multi-Institutional Research in Alzheimer Genetic Epidemiology) project. Information on head injury was collected by interview of multiple informants and review of medical records. Nondemented relatives and spouses served as control subjects for this study. Methods: Odds of AD for head trauma with or without loss of consciousness were computed by comparing probands with unaffected spouses using conditional logistic regression analysis. To account for the unique biologic relationship between probands and their parents and siblings, odds of AD were computed using a generalized estimating equation (GEE) Poisson regression approach. GEE logistic regression was used to examine the joint effects of APOE genotype and head injury on the odds of AD in probands and a control group comprised of unaffected siblings and spouses. Results: Comparison of probands with their unaffected spouses yielded odds ratios for AD of 9.9 (95% CI, 6.5 to 15.1) for head injury with loss of consciousness and 3.1 (2.3 to 4.0) for head injury without loss of consciousness. The corresponding odds derived from the comparison of probands with their parents and sibs were 4.0 (2.9 to 5.5) for head injury with loss of consciousness and 2.0 (1.5 to 2.7) for head injury without loss of consciousness. Head injury without loss of consciousness did not significantly increase the risk of AD in spouses (OR = 1.3; 95% CI, 0.4 to 4.1). The joint effects of head injury and APOE genotype were evaluated in a subsample of 942 probands and 327 controls (spouses and siblings). Head injury increased the odds of AD to a greater extent among those lacking e4 (OR = 3.3) than among e4 heterozygotes (OR = 1.8) or homozygotes (OR = 1.3). Conclusion: Head injury is a risk factor for AD. The magnitude of the risk is proportional to severity and heightened among first-degree relatives of AD patients. The influence of head injury on the risk of AD appears to be greater among persons lacking APOE -e4 compared with those having one or two e4 alleles, suggesting that these risk factors may have a common biologic underpinning.

Decoding motor imagery from the posterior parietal cortex of a tetraplegic human

Abstract: Nonhuman primate and human studies have suggested that populations of neurons in the posterior parietal cortex (PPC) may represent high-level aspects of action planning that can be used to control external devices as part of a brain-machine interface. However, there is no direct neuron-recording evidence that human PPC is involved in action planning, and the suitability of these signals for neuroprosthetic control has not been tested. We recorded neural population activity with arrays of microelectrodes implanted in the PPC of a tetraplegic subject. Motor imagery could be decoded from these neural populations, including imagined goals, trajectories, and types of movement. These findings indicate that the PPC of humans represents high-level, cognitive aspects of action and that the PPC can be a rich source for cognitive control signals for neural prosthetics that assist paralyzed patients.