Subtraction Task Research Articles

Characterizing exact arithmetic abilities before formal schooling

Children appear to have some arithmetic abilities before formal instruction in school, but the extent of these abilities as well as the mechanisms underlying them are poorly understood. Over two studies, an initial exploratory study of preschool children in the U.S. (N = 207; Age = 2.89–4.30 years) and a pre-registered replication of preschool children in Italy (N = 130; Age = 3–6.33 years), we documented some basic behavioral signatures of exact arithmetic using a non-symbolic subtraction task. Furthermore, we investigated the underlying mechanisms by analyzing the relationship between individual differences in exact subtraction and assessments of other numerical and non-numerical abilities. Across both studies, children performed above chance on the exact non-symbolic arithmetic task, generally showing better performance on problems involving smaller quantities compared to those involving larger quantities. Furthermore, individual differences in non-verbal approximate numerical abilities and exact cardinal number knowledge were related to different aspects of subtraction performance. Specifically, non-verbal approximate numerical abilities were related to subtraction performance in older but not younger children. Across both studies we found evidence that cardinal number knowledge was related to performance on subtraction problems where the answer was zero (i.e., subtractive negation problems). Moreover, subtractive negation problems were only solved above chance by children who had a basic understanding of cardinality. Together these finding suggest that core non-verbal numerical abilities, as well as emerging knowledge of symbolic numbers provide a basis for some, albeit limited, exact arithmetic abilities before formal schooling.

Mapping and decoding cortical engagement during motor imagery, mental arithmetic, and silent word generation using MEG

Accurate quantification of cortical engagement during mental imagery tasks remains a challenging brain-imaging problem with immediate relevance to developing brain-computer interfaces. We analyzed magnetoencephalography (MEG) data from 18 individuals completing cued motor imagery, mental arithmetic, and silent word generation tasks. Participants imagined movements of both hands (HANDS) and both feet (FEET), subtracted two numbers (SUB), and silently generated words (WORD). The task-related cortical engagement was inferred from beta band (17-25 Hz) power decrements estimated using a frequency-resolved beamforming method. In the hands and feet motor imagery tasks, beta power consistently decreased in premotor and motor areas. In the word and subtraction tasks, beta-power decrements showed engagements in language and arithmetic processing within the temporal, parietal, and inferior frontal regions. A support vector machine classification of beta power decrements yielded high accuracy rates of 74 and 68% for classifying motor-imagery (HANDS vs. FEET) and cognitive (WORD vs. SUB) tasks, respectively. From the motor-versus-nonmotor contrasts, excellent accuracy rates of 85 and 80% were observed for hands-versus-word and hands-versus-sub, respectively. A multivariate Gaussian-process classifier provided an accuracy rate of 60% for the four-way (HANDS-FEET-WORD-SUB) classification problem. Individual task performance was revealed by within-subject correlations of beta-decrements. Beta-power decrements are helpful metrics for mapping and decoding cortical engagement during mental processes in the absence of sensory stimuli or overt behavioral outputs. Markers derived based on beta decrements may be suitable for rehabilitation purposes, to characterize motor or cognitive impairments, or to treat patients recovering from a cerebral stroke.

Does GERAS DANCE improve gait in older adults?

BackgroundOlder adults at increased fall risk walk slower with less rhythm and coordination. This study explored the effect of dance on spatiotemporal gait parameters in older adults. MethodsParticipants (N = 23) in a single-arm trial were enrolled in the 12-week GERAS DANCE program (total dose of 36 h). Gait was assessed at baseline and 12-weeks under two experimental conditions: normal walking or walking while performing serial subtraction by 3. Outcome measures were gait speed, stride length time, double support time, stride length and stride width. Separate two-way repeated measures ANOVAs were used to determine estimates of the magnitude of effect of GERAS DANCE on spatiotemporal gait parameters and a paired t-test was used to examine differences in cognitive performance before and after dance. ResultsOlder adults (72.50 ± 7.13 years; 75% female) had excellent attendance (82.73% adherence). GERAS DANCE resulted in increased gait speed (p<0.001), reduced stride length time (p = 0.034), reduced double support time (p = 0.001), increased stride length (p = 0.003) and marginally reduced stride width (p = 0.064), regardless of the experimental condition. Improvements in walking performance were observed with sustained performance on the serial subtraction task before and after GERAS DANCE. ConclusionsGERAS DANCE may be a safe and feasible program to help improve spatiotemporal gait parameters in older adults with early memory or mobility impairments. Next steps include testing the efficacy for fall prevention to help inform clinical practice guidelines and virtual intervention implementation.

Using synchronized eye movements to assess attentional engagement.

The gradual emergence of online education in China in recent years requires new means of real-time monitoring and timely feedback to students. This research examines the effectiveness of synchronized eye movement assessment of attention engagement through two experiments. The first experiment used 24 university students in school as participants and made them watch the same video in high and low attentional engagement states (serial subtraction task) to compare the Inter-Subject Correlation (ISC) of participants' eye movements in different conditions. The results showed that the ISC of eye movements was significantly higher for participants in a high attentional engagement state than for participants in a low attentional engagement state. The second experiment had 26 university students in school as participants, as part of which they were made to watch video materials under the condition of having eye movement modeling examples. The results showed that the ISC of eye movements was significantly lower for participants in the group with eye movement modeling examples than those without eye movement modeling examples. However, overall test scores were significantly higher in the former than the latter. The first experiment showed that the eye movement trajectories of participants with high attentional engagement were more consistent than of those with low attentional engagement. Therefore, the ISC of participants' eye movements could be used as an objective indicator to assess and predict students' attentional conditions during online education. The second experiment showed that the eye movement modeling examples interfered with the participants' attention distribution to some extent; nevertheless, they positively affected the improvement in teaching effectiveness. Overall, the studies showed that the Inter-Subject Correlation is reliable to assess attentional engagement status in domestic online education.

Sex differences in perceptions of sleep inertia following nighttime awakenings.

The influence of biological sex on sleep inertia symptoms is currently unknown. We investigated the role of sex differences in the subjective experience and objective cognitive manifestation of sleep inertia following nighttime awakenings. Thirty-two healthy adults (16 female, 25.91 ± 5.63 years) completed a 1-week at-home study with one experimental night during which sleep was measured by polysomnography and participants were awakened during their habitual sleep time. Participants completed a psychomotor vigilance task, Karolinska Sleepiness Scale (KSS), visual analog mood scales, and a descending subtraction task (DST) prior to sleep (baseline) and at 2, 12, 22, and 32 min after awakening. A series of mixed-effects models with Bonferroni-corrected post hoc tests were used to examine the main effects of test bout and sex, and their interaction, with a random effect of participant, and order of wake-up and sleep history as covariates. All outcomes except for percent correct on the DST showed a significant main effect of test bout, with worse performance after waking compared to baseline (all ps < .003). Significant effects of sex (p = .002) and sex × test bout (p = .01; R2M = 0.49, R2C = 0.69) were observed for KSS, with females reporting a greater increase in sleepiness from baseline to after waking compared to males. These results suggest that while females reported feeling sleepier than males following nighttime awakenings, their cognitive performance was comparable. Future research is needed to determine whether perceptions of sleepiness influence decision-making during the transition from sleep to wakefulness.

Students' learning growth in mental addition and subtraction: Results from a learning progress monitoring approach.

The purpose of this study was to measure and describe students' learning development in mental computation of mixed addition and subtraction tasks up to 100. We used a learning progress monitoring (LPM) approach with multiple repeated measurements to examine the learning curves of second-and third-grade primary school students in mental computation over a period of 17 biweekly measurement intervals in the school year 2020/2021. Moreover, we investigated how homogeneous students' learning curves were and how sociodemographic variables (gender, grade level, the assignment of special educational needs) affected students' learning growth. Therefore, 348 German students from six schools and 20 classes (10.9% students with special educational needs) worked on systematically, but randomly mixed addition and subtraction tasks at regular intervals with an online LPM tool. We collected learning progress data for 12 measurement intervals during the survey period that was impacted by the COVID-19 pandemic. Technical results show that the employed LPM tool for mental computation met the criteria of LPM research stages 1 and 2. Focusing on the learning curves, results from latent growth curve modeling showed significant differences in the intercept and in the slope based on the background variables. The results illustrate that one-size-fits-all instruction is not appropriate, thus highlighting the value of LPM or other means that allow individualized, adaptive teaching. The study provides a first quantitative overview over the learning curves for mental computation in second and third grade. Furthermore, it offers a validated tool for the empirical analysis of learning curves regarding mental computation and strong reference data against which individual learning growth can be compared to identify students with unfavorable learning curves and provide targeted support as part of an adaptive, evidence-based teaching approach. Implications for further research and school practice are discussed.

The influence of price location on reference-price ads

PurposeResearch has shown that when the original and the sale prices were displayed in a horizontal direction, with the sale price to the right (“Original price of $349.99/Sale price $239.99”), consumers are more likely to initiate a subtraction task to calculate the amount of the discount; and this subtraction effect would lead to better consumer value perception than if the sale price was to the left. However, fewer scholars have questioned whether the subtraction effect would still operate if the reference-price ads line up in a vertical direction? The aim of this research is to understand how different formations of reference-price ads may affect consumers' price perception and buying intention. Interestingly, positive effects on buying intention and value perceptions disappeared when buyers were shown a dollars-saved cue, rather than the lineup of original and sale prices.Design/methodology/approachThree experiments were conducted to test the hypotheses.FindingsThe results of the experiments demonstrate that when the sale price is displayed above the original price, consumers' price perception and buying intention are higher than what is placed below it.Research limitations/implicationsWhen written horizontally, Mandarin and Japanese language text are almost always written left-to-right, with multiple rows progressing downward, as in standard English text. Notably, the right-to-left written form for Mandarin and Japanese language only happens by writing in a vertically and multiple-columned context. In particular, the format of reference-price ads in our research is considered to be a generally single column text only. Therefore, its writing system has almost no difference from the English one. However, our hypothesis does not apply to the Arabic world due to the right-to-left nature of the Arabic writing system.Practical implicationsOur results may inform consumers whether their cognition, which influences them not to make irrational decisions, is in turn influenced by sale price display location. Consumers should be reminded that next time they see the smaller number (sale price) they should not be too excited and forget to properly consider the original price. They should think more and consider the distance to the shop or the quality of the product before buying anything. If a product is sold in two different shops and the farther one displays the sale price above the original price but the nearer one displays the sale price below the original price, prolonging the decision time enables consumers to decrease their buying costs, such as the cost of fuel.Originality/valueThis is one of the first studies to discuss the influence of the price location in a vertical direction on price perception and buying intention.

Dividing attention during the Timed Up and Go enhances associations of several subtask performances with MCI and cognition.

We tested the hypothesis that dividing attention would strengthen the ability to detect mild cognitive impairment (MCI) and specific cognitive abilities from Timed Up and Go (TUG) performance in the community setting. While wearing a belt-worn sensor, 757 dementia-free older adults completed TUG during two conditions, with and without a concurrent verbal serial subtraction task. We segmented TUG into its four subtasks (i.e., walking, turning, and two postural transitions), and extracted 18 measures that were summarized into nine validated sensor metrics. Participants also underwent a detailed cognitive assessment during the same visit. We then employed a series of regression models to determine the combinations of subtask sensor metrics most strongly associated with MCI and specific cognitive abilities for each condition. We also compared subtask performances with and without dividing attention to determine whether the costs of divided attention were associated with cognition. While slower TUG walking and turning were associated with higher odds of MCI under normal conditions, these and other subtask associations became more strongly linked to MCI when TUG was performed under divided attention. Walking and turns were also most strongly associated with executive function and attention, particularly under divided attention. These differential associations with cognition were mirrored by performance costs. However, since several TUG subtasks were more strongly associated with MCI and cognitive abilities when performed under divided attention, future work is needed to determine how instrumented dual-task TUG testing can more accurately estimate risk for late-life cognitive impairment in older adults.

Strategies informed by various ways of experiencing number relations in subtraction tasks

The aim of this paper is to develop greater understanding of how the way students experience a task is related to which, and how, number relations are discerned. We study how 42 Grade 1 students solved a word problem in a number range that was new to them: 32–25 = __. The variation theory of learning has informed our analysis, opening for thorough analyses of what constitutes differences in the students’ acts in solving the arithmetic word problem and how they experience the task. Observations of their strategies and ways of reasoning revealed that how the students discern the semantic structure and number relations relates to their ways of encountering the task and consequently their success in solving it. The study offers a complementary approach to understanding arithmetic skills that contribute knowledge as to why some students develop powerful ways of solving arithmetic tasks while others get stuck in cumbersome strategies.

Math Skills: a New Look from Functional Data Analysis.

Mental calculations involve various areas of the brain. The frontal, parietal and temporal lobes of the left hemisphere have a principal role in the completion of this typology of tasks. Their level of activation varies based on the mathematical competence and attentiveness of the subject under examination and the perceived difficulty of the task. Recent literature often investigates patterns of cerebral activity through fMRI, which is an expensive technique. In this scenario, EEGs represent a more straightforward and cheaper way to collect information regarding brain activity. In this work, we propose an EEG based method to detect differences in the cerebral activation level of people characterized by different abilities in carrying out the same arithmetical task. Our approach consists in the extraction of the activation level of a given region starting from the EEG acquired during resting state and during the completion of a subtraction task. We then analyze these data through Functional Data Analysis, a statistical technique that allows operating on biomedical signals as if they were functions. The application of this technique allowed for the detection of distinct cerebral patterns among the two groups and, more specifically, highlighted the presence of higher levels of activation in the parietal lobe in the population characterized by a lower performance.

Prefrontal Cortex Brain Activation During Texting and Walking: A Functional Near-Infrared Spectroscopy Feasibility Study

Texting while walking is an increasingly common, potentially dangerous task but its functional brain correlates have yet to be reported. Therefore, we evaluated prefrontal cortex (PFC) activation patterns during single- and dual-task texting and walking in healthy adults. Thirteen participants (29-49years) walked under single- and dual-task conditions involving mobile phone texting or a serial-7s subtraction task, while measuring PFC activation (functional near-infrared spectroscopy) and behavioral task performance (inertial sensors, mobile application). Head lowering during texting increased PFC activation. Texting further increased PFC activation, and decreased gait performance similarly to serial-7 subtraction. Our results support the key role of executive control in texting while walking.

Comparison of Wuqinxi Qigong with Stretching on Single- and Dual-Task Gait, Motor Symptoms and Quality of Life in Parkinson's Disease: A Preliminary Randomized Control Study.

The objective of this study was to investigate the therapeutic effect of Wuqinxi Qigong vs. stretching on single- and dual-task gait, motor symptoms, and quality of life in people with mild and moderate Parkinson’s disease (PD). This single-blind, randomized control trial included 40 participants with idiopathic PD who were randomized into the Wuqinxi Qigong (WQ) group or stretching group. Participants completed 12 weeks (two sessions/week) of intervention. The primary outcomes were gait parameters when performing single-task (comfortable pace) and dual-task (obstacle crossing, serial-3 subtraction and backward digit span) walking, including gait speed, stride length, and double support percentage. The secondary outcomes were ratings from the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), results of the timed-up-and-go test (TUGT), results of the Mini-Balance Evaluation Systems Test (MiniBESTest), and responses from the 39-item Parkinson’s Disease Questionnaire (PDQ-39). All measures were assessed pre- and post-intervention. The WQ group demonstrated increased gait speed (p = 0.000) during the single task, and increased stride length (p = 0.001, p = 0.021) during the single-task and serial-3 subtraction task. Double support percentage significantly decreased (p = 0.004) in the WQ group during the obstacle crossing task, and also decreased (p = 0.045) in the stretching group during the single-task. TUGT (p = 0.005), MiniBESTest (p = 0.023) and PDQ-39 (p = 0.043) in the WQ group significantly improved, and both groups showed significant improvement in MDS-UPDRS after intervention. Wuqinxi Qigong is an effective method to improve single- and dual-task gait. While both exercises improve motor symptoms, Wuqinxi Qigong results in better mobility, balance and quality of life compared to stretching alone.

Influence of serial subtraction tasks on transient characteristics of postural control

Influence of serial subtraction tasks on transient characteristics of postural control

Influence of serial subtraction tasks on transient characteristics of postural control.

We sought to better understand the influence of cognitive perturbations on transient aspects of postural control. Twenty healthy, younger adults had their postural control assessed during eyes open quiet stance. Participants completed three different conditions that either had no cognitive perturbation present, an easy cognitive perturbation (i.e., serial subtraction by ones), or a more difficult cognitive perturbation (i.e., serial subtraction by sevens). All trials finished with 60s of undisturbed eyes open quiet stance, which was the focus of the balance assessment. 95% confidence ellipse area (EA) was calculated for 5-s epochs throughout the trial. The difference in EA from the first epoch after participants started (onset) or stopped (offset) the cognitive task to the last epoch of the trial (i.e., 55-60s after perturbation) was used to characterize transient postural control behavior. Functional near-infrared spectroscopy was also used to quantify changes in prefrontal cortex activation during the counting tasks to support interpretation of the transient balance findings. There was a significant effect of condition for transient balance characteristics following a cognitive perturbation (P<0.001), with greater transient increases in postural sway for both difficult (Cohen's d=0.40, P<0.001) and easier (Cohen's d=0.29, P=0.013) cognitive perturbations relative to no cognitive perturbation. The onset of cognitive tasks was also associated with greater transient increases in postural sway than the offset of the cognitive tasks (Cohen's d=0.24, P=0.019). The functional near-infrared spectroscopy data indicated that a significant decrease in deoxygenated hemoglobin was observed for left Brodmann area 46 for both the subtraction by ones (T=-3.97; Benjamini-Hochberg significance value (q)=0.008) and subtraction by sevens (T=-3.11; q=0.036) conditions relative to the baseline condition. The subtraction by sevens condition was also associated with a relative increase in deoxygenated hemoglobin for the right Brodmann area 9 (T=3.36; q=0.026) compared to the subtraction by ones condition. In conclusion, serial subtraction can elicit transient increases in postural sway, with more difficult tasks and the onset of the cognitive-motor challenge exhibiting magnified effects. Additionally, even the cessation of a cognitive task (i.e., serial subtraction) can be associated with lingering perturbing effects on balance control.

0006 An At-Home Evaluation of a Light Intervention to Mitigate Sleep Inertia Symptoms

Abstract Introduction Sleep inertia symptoms typically occur after waking from nocturnal sleep. Under laboratory settings, light exposure upon waking has been shown to improve alertness, mood, and vigilant attention. We investigated whether a field-deployable light-emitting device would help to improve alertness and working memory in a real-world setting. Methods Thirty-five participants (18 female; 26.4 ± 6.0 y) completed an at-home, within-subject, randomized crossover study. Participants wore actiwatches during their normal sleep-wake schedule for five nights ahead of the adaptation and experimental nights. On the experimental night, participants performed baseline testing before their self-selected bedtime. Forty-five minutes after bedtime, participants received a phone call and were instructed to perform test bouts while wearing light-emitting glasses with the light either on (light condition) or off (control). A 3-minute descending subtraction task (DST) and the Karolinska Sleepiness Scale (KSS) were performed at +7, +17, +27, and +37 minutes after the call. Participants were then instructed to go back to sleep and were called 45 minutes after lights out to repeat the test bouts in the opposite condition. A series of mixed-effects models were performed with fixed effects of condition, test bout, and their interaction, and a random effect of participant. Condition order, sex, and baseline were included as covariates. Results There was a significant effect of test bout for DST total responses (χ2 [3] = 17.42; p &amp;lt; .001) and total correct (χ2 [3] = 21.29; p &amp;lt; .001) with improved performance at +27 and +37 minutes compared to +7 minutes. Sex was a significant predictor for KSS (F1,30 = 10.26; p = .003), with females (8.20 ± 0.23) rating higher sleepiness than males (7.10 ± 0.25). There were no other significant effects for DST or KSS outcomes (p &amp;gt; .05). Conclusion These results suggest that the intervention was not able to improve working memory or alertness under naturalistic at-home settings. Further analysis is needed to determine whether these results are applicable to other cognitive performance domains. Support (If Any) Funded by the Naval Postgraduate School, via the Naval Medical Research Center's Naval Advanced Medical Development Department (MIPR N3239820WXHN007), with support from the NASA Airspace Operations and Safety Program, System-Wide Safety.

Patterns of Children's Relationships With Parents and Teachers in Grade 1: Links to Task Persistence and Performance.

Our study aimed to investigate the patterns of children’s relationships with their parents and teachers, the development of these relationships during Grade 1, and respective links to children’s learning (in task persistence and performance). Parents of 350 children answered questionnaires about the quality of their relationships with their children; 25 teachers answered questions about children’s task persistence at school and the quality of their relationships with their students; 350 children completed literacy and math performance tests; and six testers evaluated children’s task persistence when completing those tests. All measures were administered twice: at the start and end of Grade 1. Latent profile analyses found two meaningful child profiles that were similar at the beginning and end of Grade 1: average relationship (89% at T1, 85% at T2) and conflictual relationship (11% at T1, 15% at T2) with parents and teachers. These profiles were highly stable throughout Grade 1, except for 15 children who moved from an average relationship to a conflictual relationship profile. This declining trajectory can be characterized by poor relationships with teachers and low task persistence at the end of Grade 1, although they did not perform any worse than other children. Finally, children exhibiting conflictual relationships with their parents and teachers at the beginning of Grade 1 performed worse on spelling and subtraction tasks and demonstrated lower task-persistent behavior at the end of Grade 1 than those with average (good) relationships with parents and teachers.

A Novel Way of Measuring Dual-Task Interference: The Reliability and Construct Validity of the Dual-Task Effect Battery in Neurodegenerative Disease

Background. Decreased automaticity is common among individuals with neurodegenerative disease and is often assessed using dual-task (DT) paradigms. However, the best methods for assessing performance changes related to DT demands remain inconclusive. Objective. To investigate the reliability and validity of a novel battery of DT measures (DT Effect—Battery (DTE-B)) encompassing three domains: task-specific interference, task prioritization, and automaticity. Methods. Data for this retrospective cross-sectional study included 125 participants with Parkinson’s disease (PD), 127 participants with Alzheimer’s disease (AD), and 84 healthy older adults. Reliability analyses were conducted using a subset of each population. DTE-B measures were calculated from single and DT performance on the Timed Up and Go test and a serial subtraction task. Construct validity was evaluated via associations within the DTE-B and with theoretically supported measures as well as known-groups validity analyses. Results. Good to excellent reliability was found for DTE-B measures of task interference (motor and cognitive DT effects) (ICCs≥.658) and automaticity (combined DT effect (cDTE)) (ICCs≥.938). Evidence for convergent validity was found with associations within the hypothesized constructs. Known-groups validity analyses revealed differences in the DTE-B among the healthy group and PD and AD groups (ps≤.001), excepting task prioritization (ps≥.061). Conclusions. This study provides evidence to support the DTE-B as a reliable measure of multiple constructs pertinent to DT performance. The cDTE demonstrated evidence to support its validity as a measure of automaticity. Further investigation of the utility of the DTE-B in both PD and AD, as well as other populations, is warranted.

STPNet: A Spatial-Temporal Propagation Network for Background Subtraction

In background subtraction tasks, spatial and temporal contexts are beneficial in detecting moving objects. The methods based on Deep Neural Networks in this task has explored different topologies, which are composed of the conventional operations of convolutional neural networks, such as Convolutional Long-short Term Memory layer (ConvLSTM), 2D convolutional layer, or 3D convolutional layer, to capture these contexts. In this work, we propose a new background subtraction algorithm named spatial–temporal propagation network. An end-to-end network with novel layers, whose process of operation is equivalent to that the feature maps multiply with affinity matrices, is proposed to capture the spatial–temporal correlation in video sequences and aggregate the deep features from the consecutive frames. Experimental results on CDnet-2014 and LASIESTA datasets show that this novel layer provides an alternative way for our network to aggregate multiscale spatial–temporal features. Meanwhile, the proposed network achieves state-of-the-art performance and is generalizable to unseen videos.

Cardiovascular reactivity, stress, and personal emotional salience: Choose your tasks carefully.

Both greater cardiovascular reactivity and lesser reactivity ("blunting") to laboratory stressors are linked to poor health outcomes, including among people who have a history of traumatic experiences. In a sample of recently separated and divorced adults (N=96), this study examined whether differences in cardiovascular reactivity might be explained by differences in the personal emotional salience of the tasks and trauma history. Participants were assessed for trauma history, current distress related to their marital dissolution, and cardiovascular reactivity during two tasks, a serial subtraction math stressor task and a divorce-recall task. Participants with a greater trauma history evidenced less blood pressure reactivity to the serial subtraction task (a low personal emotional salience task) when compared to participants with less trauma history. In contrast, participants with a greater trauma history evidenced higher blood pressure reactivity to the divorce-recall task, but only if they also reported more divorce-related distress (high personal emotional salience). These associations were not significant for heart rate reactivity. Among people with a history of more traumatic experiences, a task with low personal salience was associated with a lower blood pressure response, whereas a task with higher personal emotional salience was associated with a higher blood pressure response. Future studies examining cardiovascular reactivity would benefit from determining the personal emotional salience of tasks, particularly for groups that have experienced stressful life events or trauma.

Additive Effect of Dopaminergic Medication on Gait Under Single and Dual-Tasking Is Greater Than of Deep Brain Stimulation in Advanced Parkinson Disease With Long-Duration Deep Brain Stimulation

IntroductionPatients with advanced Parkinson disease (PD) often experience problems with mobility, including walking under single- (ST) and dual-tasking (DT) conditions. The effects of deep brain stimulation in the subthalamic nucleus (DBS) versus dopaminergic medication (Med) on these conditions are not well investigated. Materials and MethodsWe used two ST and two DT-gait paradigms to evaluate the effect of DBS and dopaminergic medication on gait parameters in 14 PD patients (mean age 66 ± 8 years) under DBSOFF/MedON, DBSON/MedOFF, and DBSON/MedON conditions. They performed standardized 20-meter walks with convenient and fast speed. To test DT capabilities, they performed a checking-boxes and a subtraction task during fast-paced walking. Quantitative gait analysis was performed using a tri-axial accelerometer (Dynaport, McRoberts, The Netherlands). Dual-task costs (DTC) of gait parameters and secondary task performance were compared intraindividually between DBSOFF/MedON vs DBSON/MedON, and DBSON/MedOFF vs DBSON/MedON to estimate responsiveness. ResultsDopaminergic medication increased gait speed and cadence at convenient speed. It increased cadence and decreased number of steps at fast speed, and improved DTC of cadence during the checking boxes and DTC of cadence and number of steps during the subtraction tasks. DBS only improved DTC of cadence during the checking boxes and DTC of gait speed during the subtraction task. ConclusionDopaminergic medication showed larger additional effects on temporal gait parameters under ST and DT conditions in advanced PD than DBS. These results, after confirmation in independent studies, should be considered in the medical management of advanced PD patients with gait and DT deficits.