Brain rhythm treatment effectiveness: More complex multisensory synchronization may be better?

In IAP Research Report # 9 (Brain rhythm treatment efficacy:  Can we fine-tune our brain clocks), it was concluded (after reviewing 23 studies) that "rhythm-based mental-timing treatments have merit for clinical use and warrant increased clinical use and research attention."  Additionally, it was concluded that:

• Positive treatment outcomes were reported for four forms of rhythm-based treatment. Positive outcomes were also observed for normal subjects and, more importantly, across a variety of clinical disorders (e.g., aphasia, apraxia, coordination/movement disorders, TBI, CP, Parkinson’s disease, stroke/CVA, Down’s syndrome, ADHD)

• Most rhythm-based brain-based interventions (the RAS, AOS-RRT and SMT treatment studies) all employed some form of auditory-based metronome to pace or cue the subjects targeted rhythmic behavior.

• External metronome-based rhythm tools (tapping to a beat, metronome-based rhythmic pacing, rhythmic-cuing via timed pulses/beats) is a central tool to improving temporal processing and mental-timing.

In this context, I was excited to see the recent article by Wing, Doumas & Welchman (2010)--the abstract of the study which I posted this past week.  Wing is the Wing of the Wing-Kristofferson two-level model of rhythm-based synchronization.  Thus, although the current study only focused on n=8 subjects, the research questions, methodology, and quality of research is based on a lengthy program of research and theorizing by Wing and associates.  In this context, I find their findings worthy of this special blog post.  A copy of the article can be viewed by clicking here.

As we all know (from reading this blog), synchronization is a crucial aspect of many forms of skilled human performance.  In many everyday and complex behaviors our CNS is often bombarded by multiple forms of sensory stimuli from which our brain seeks information to fine tune synchronization of time-dependent behaviors.  The current Wing study focused on whether synchronization of behaviors occurs best under a single feedback modality (e.g., auditory cues only) or when the CNS must process similar timing feedback from two sensory modalities concurrently (e.g., auditory and visual; auditory and haptic). 

Common sense suggests that the performance would probably be best when the brain only needs to focus on one form of time-based synchronization feedback (e.g., auditory only).  But...research suggest this is not the case.  The literature reviewed in the article, as well as the specific study reported (looking at synchronization of behavior under single or multiple sensory feedback conditions), favors a cue combination model of synchronization.  Whether auditory+visual synchronization feedback or auditory+haptic feedback, the brain, although tending to favor and weight the importance of one modality over the other (e.g., auditory performance feedback tends to dominate over visual when provided concurrently), appears to benefit from having more than one form of feedback.  Apparently the CNS combines feedback from different senses in a differential weighting algorithm (i.e., pays attention to one form of feedback more and gives it more weight in adjusting performance) which increases the precision of synchronization of behaviors.

Although replication is needed, this study suggests that rhythm-based mental timing or synchronization treatments (e.g., Interactive Metronome;  see conflict of interest notice) may be most effective when multisensory feedback is provided to subjects...and not just a single form of feedback.  Of course, there will always be individual differences and some individuals may benefit more from a single form of feedback (e.g., auditory beeps only).  Research that would identify individuals who do not benefit from the advantages of multisensory feedback would be of interest.  My only criticism of this study is the failure of the authors to hypothesize what occurs at the neurological level when multisensory cue feedback is provided---i.e., why does it improve performance?

For now...it appears that "more is better."

Technorati Tags: psychology, educational psychology, school psychology, neuropsychology, neuroscience, neurotechnology, metronome, Interactive Metronome, brain rhythm, IQ brain clock, mental timing, temporal processing, temporal resolution hypothesis, multisensory synchronization, brain synchronization

On the road again--blogging lite at NASP (Chicago) - 3-1 to 3-7

I will be on the road again.  I will be attending and presenting at the National Association of School Psychologists (NASP) conference in Chicago.  I will be gone Monday thru Saturday of this coming week. 

I don't expect much time to blog...except for possible "push" type FYI posts re: content posted at other blogs.....or...mobile blogging (check out the link.....it is very cool...but, of course, I tend to be a tech nerd)......

Also, I may do some Tweeting from the conference via Twitter.  My Twitter ID is @iqmobile.  The hash tag for all people who may tweet from NASP is #nasp2010.

I shall return.

Technorati Tags: psychology, IQs Corner, Intelligence, travel

iPost: Brain Blogging # 49

http://brainblogger.com/2010/02/26/brain-blogging-forty-ninth-edition/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+GNIFBrainBlogger+%28Brain+Blogger%29&utm_content=Bloglines

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Re: iPost: More on metronome based timing and movementsynchronization

I probably should have been the patient one and waited until I had digested the article before sharing. :)

Kevin McGrew PhD

Educational/School Psych. 

IAP (www.iapsych.com)

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On Feb 25, 2010, at 1:42 PM, "Robert Ryan" <rryan@interactivemetronome.com> wrote:

Of course! Sorry for my impatience.

Sent from my Verizon Wireless BlackBerry

---

From: Kevin McGrew <iap@earthlink.net>

Date: Thu, 25 Feb 2010 13:41:05 -0600 (GMT-06:00)

To: Rob Ryan<rryan@interactivemetronome.com>; Blog Time Posts<wj3chc.timedoc@blogger.com>

Cc: Amy Vega<avega@interactivemetronome.com>; Matthew Wukasch<mwukasch@interactivemetronome.com>; Al Guerra<aguerra@interactivemetronome.com>

Subject: RE: iPost: More on metronome based timing and movement synchronization

Had planned to get to that once I found time to download and read entire article.  Will do shortly.

ksm

-----Original Message-----
From: Rob Ryan
Sent: Feb 25, 2010 12:42 PM
To: Earthlink , Blog Time Posts
Cc: Amy Vega , Matthew Wukasch , Al Guerra
Subject: RE: iPost: More on metronome based timing and movement synchronization

Kevin-

If you don't mind, what are the implications for us, in any, in this paper?

Thanks




-----Original Message-----
From: Earthlink [mailto:iap@earthlink.net]
Sent: Thu 2/25/2010 9:29 AM
To: Blog Time Posts
Cc: Amy Vega; Matthew Wukasch; Al Guerra; Rob Ryan
Subject: iPost: More on metronome based timing and movement synchronization

Experimental Brain Research, Vol. 200, Issue 3 - New Issue Alert

Research Note
Combining multisensory temporal information for movement synchronisation

Alan M. Wing1 , Michail Doumas1, 2 and Andrew E. Welchman1

(1)     Behavioural Brain Sciences Centre, School of Psychology, 
University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
(2)     Department of Psychology, K. U. Leuven, Tiensestraat 102, 300 
Leuven, Belgium
Received: 9 July 2009  Accepted:9 December 2009  Published online: 29 
December 2009

Abstract  The ability to synchronise actions with environmental events 
is a fundamental skill supporting a variety of group activities. In 
such situations, multiple sensory cues are usually available for 
synchronisation, yet previous studies have suggested that auditory 
cues dominate those from other modalities. We examine the control of 
rhythmic action on the basis of auditory and haptic cues and show that 
performance is sensitive to both sources of information for 
synchronisation. Participants were required to tap the dominant hand 
index finger in synchrony with a metronome defined by periodic 
auditory tones, imposed movements of the non-dominant index finger, or 
both cues together. Synchronisation was least variable with the 
bimodal metronome as predicted by a maximum likelihood estimation 
(MLE) model. However, increases in timing variability of the auditory 
cue resulted in some departures from the MLE model. Our findings 
indicate the need for further investigation of the MLE account of the 
integration of multisensory signals in the temporal control of action.



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 *************************************************************** Kevin S. McGrew, PhD. Educational/School Psychologist Director Institute for Applied Psychometrics (IAP) www.iapsych.com IQ's Corner Blog:  http://www.iqscorner.com IQ Brain Clock Blog: http://www.ticktockbraintalk.blogspot.com IQ and Death Penalty Blog:  http://www.atkinsmrdeathpenalty.com Mobile IQ (personal):  http://www.iqmobile.blogspot.com Twitter account name:  @iqmobile *************************************************************  

iPost: Brain structure and map info

harpersnotes: Neuroanatomical educational resources, "BrainInfo", now
at UC San Diego. http://www.braininfo.rprc.washington.edu/

Original Tweet: http://twitter.com/harpersnotes/status/9680011135

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iPost: How your brain organizes your lexicon

Interesting article at BRAIN BLOGGER link below

http://brainblogger.com/2010/02/25/how-your-brain-groups-words/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+GNIFBrainBlogger+%28Brain+Blogger%29&utm_content=Bloglines

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RE: iPost: More on metronome based timing and movement synchronization

Kevin-

If you don't mind, what are the implications for us, in any, in this paper?

Thanks




-----Original Message-----
From: Earthlink [mailto:iap@earthlink.net]
Sent: Thu 2/25/2010 9:29 AM
To: Blog Time Posts
Cc: Amy Vega; Matthew Wukasch; Al Guerra; Rob Ryan
Subject: iPost: More on metronome based timing and movement synchronization

Experimental Brain Research, Vol. 200, Issue 3 - New Issue Alert

Research Note
Combining multisensory temporal information for movement synchronisation

Alan M. Wing1 , Michail Doumas1, 2 and Andrew E. Welchman1

(1)     Behavioural Brain Sciences Centre, School of Psychology, 
University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
(2)     Department of Psychology, K. U. Leuven, Tiensestraat 102, 300 
Leuven, Belgium
Received: 9 July 2009  Accepted:9 December 2009  Published online: 29 
December 2009

Abstract  The ability to synchronise actions with environmental events 
is a fundamental skill supporting a variety of group activities. In 
such situations, multiple sensory cues are usually available for 
synchronisation, yet previous studies have suggested that auditory 
cues dominate those from other modalities. We examine the control of 
rhythmic action on the basis of auditory and haptic cues and show that 
performance is sensitive to both sources of information for 
synchronisation. Participants were required to tap the dominant hand 
index finger in synchrony with a metronome defined by periodic 
auditory tones, imposed movements of the non-dominant index finger, or 
both cues together. Synchronisation was least variable with the 
bimodal metronome as predicted by a maximum likelihood estimation 
(MLE) model. However, increases in timing variability of the auditory 
cue resulted in some departures from the MLE model. Our findings 
indicate the need for further investigation of the MLE account of the 
integration of multisensory signals in the temporal control of action.



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iPost: More on metronome based timing and movement synchronization

Experimental Brain Research, Vol. 200, Issue 3 - New Issue Alert

Research Note

Combining multisensory temporal information for movement synchronisation

Alan M. Wing¹ , Michail Doumas^{1, 2} and Andrew E. Welchman¹

(1)	Behavioural Brain Sciences Centre, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK

(2)	Department of Psychology, K. U. Leuven, Tiensestraat 102, 300 Leuven, Belgium

Received: 9 July 2009  Accepted:9 December 2009  Published online: 29 December 2009

Abstract  The ability to synchronise actions with environmental events is a fundamental skill supporting a variety of group activities. In such situations, multiple sensory cues are usually available for synchronisation, yet previous studies have suggested that auditory cues dominate those from other modalities. We examine the control of rhythmic action on the basis of auditory and haptic cues and show that performance is sensitive to both sources of information for synchronisation. Participants were required to tap the dominant hand index finger in synchrony with a metronome defined by periodic auditory tones, imposed movements of the non-dominant index finger, or both cues together. Synchronisation was least variable with the bimodal metronome as predicted by a maximum likelihood estimation (MLE) model. However, increases in timing variability of the auditory cue resulted in some departures from the MLE model. Our findings indicate the need for further investigation of the MLE account of the integration of multisensory signals in the temporal control of action.

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Neuroplasticity and clinical and educational interventions @ SharpBrains

Interesting post at Sharp Brains on clinical and educational interventions and neuroplasticity.

iPost: Rehabilitation Psychology--Vol 55, 1

 Rehabilitation Psychology - Volume 55, Issue 1

A new issue is available for the following Educational Publishing Foundation journal:

Rehabilitation Psychology

Volume 55, Issue 1

Psychopathology and resilience following traumatic injury: A latent growth mixture model analysis.

Page 1-11

deRoon-Cassini, Terri A.; Mancini, Anthony D.; Rusch, Mark D.; Bonanno, George A.

Resilience in the face of coping with a severe physical injury: A study of trajectories of adjustment in a rehabilitation setting.

Page 12-22

Quale, Anette Johansen; Schanke, Anne-Kristine

Resilience and indicators of adjustment during rehabilitation from a spinal cord injury.

Page 23-32

White, Brian; Driver, Simon; Warren, Ann Marie

Change in positive emotion and recovery of functional status following stroke.

Page 33-39

Seale, Gary S.; Berges, Ivonne-Marie; Ottenbacher, Kenneth J.; Ostir, Glenn V.

Positive psychological variables in the prediction of life satisfaction after spinal cord injury.

Page 40-47

Kortte, Kathleen B.; Gilbert, Mac; Gorman, Peter; Wegener, Stephen T.

Clinically significant behavior problems during the initial 18 months following early childhood traumatic brain injury.

Page 48-57

Chapman, Leah A.; Wade, Shari L.; Walz, Nicolay C.; Taylor, H. Gerry; Stancin, Terry; Yeates, Keith O.

Girls with spinal cord injury: Social and job-related participation and psychosocial outcomes.

Page 58-67

Gorzkowski, Julie A.; Kelly, Erin H.; Klaas, Sara J.; Vogel, Lawrence C.

Making those who cannot see look best: Effects of visual resume formatting on ratings of job applicants with blindness.

Page 68-73

Wang, Katie; Barron, Laura G.; Hebl, Michelle R.

Promoting self-determined motivation for exercise in cardiac rehabilitation: The role of autonomy support.

Page 74-80

Russell, Kelly L.; Bray, Steven R.

Psychosocial predictors of employment status among men living with spinal cord injury.

Page 81-90

Burns, Shaun Michael; Boyd, Briana L.; Hill, Justin; Hough, Sigmund

Cognitive appraisals and posttraumatic stress disorder symptoms in informal caregivers of stroke survivors.

Page 91-96

Carek, Victoria; Norman, Paul; Barton, Jane

---

iPost: New cognitive neuroscience journal from Elesiver

New Journal: Developmental Cognitive Neuroscience  Edited by Sarah-Jayne Blakemore (University College London), Ronald E. Dahl (University of Pittsburgh Medical Center), Uta Frith (University College London) and Daniel S. Pine (NIMH). The journal will publish theoretical and research papers on cognitive brain development, from infancy through childhood and adolescence to old age. It will cover neurocognitive development and neurocognitive processing in both typical and atypical development, including social and affective aspects. Appropriate methodologies for the journal will include, but are not limited to, functional neuroimaging (fMRI and MEG), electrophysiology (EEG and ERP), NIRS and transcranial magnetic stimulation, as well as other neuroscience approaches which are applied in animal studies, patient studies, case studies, post-mortem studies and pharmacological studies. Authors will be able to submit papers for review from early 2010.

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Join/follow "IQs Corner" at Facebook

I have no idea what this feature will evolve into, but I've added a Facebook badge/button to all three of my professional blogs.  If it works as intended, clicking on the badge/button should take you to the IQ's Corner Facebook Group.....which I hope it allows you to join (if you want).

Technorati Tags: psychology, neuropsychology, school psychology, educational psychology, criminal psychology, criminal justice, criminal defense, IQs Corner, IQ Brain Clock, Atkins cases, intelligence, CHC, Cattell-Horn-Carroll, IQs Corner Facebook

Research Bytes 2-13-10: Neural synchrony; optimal control theory of movement

Uhlhaas, P. Fre´de´ric, R., Rodriguez, E., Rotarska-Jagiela1,A. & Singer, W. (2010).  Neural synchrony and the development of cortical networks.  Trends in Cognitive Sciences, Vol.14 No.2, 72-80.

Abstract

Recent data indicate that the synchronisation of oscillatory activity is relevant for the development of cortical circuits as demonstrated by the involvement of neural synchrony in synaptic plasticity and changes in the frequency and synchronisation of neural oscillations during development. Analyses of resting-state and task-related neural synchrony indicate that gamma-oscillations emerge during early childhood and precise temporal coordination through neural synchrony continues to mature until early adulthood. The late maturation of neural synchrony is compatible with changes in the myelination of cortico-cortical connections and with late development of GABAergic neurotransmission. These findings highlight the role of neural synchrony for normal brain development as well as its potential importance for understanding neurodevelopmental disorders, such as autism spectrum disorders (ASDs) and schizophrenia.

Article Outline

Function and mechanisms of neural synchrony in cortical networks
Resting-state oscillations: development of frequency, amplitude and synchronisation
Maturation of steady-state responses
Development of task-related oscillations during motor, cognitive and perceptual processes
Neural synchrony during development: relationship to anatomy and physiology
Neural synchrony during development: implications for psychopathology
Concluding remarks
Acknowledgements
References

Diedrichsen, J., Shadmehr, R., & Ivry, R. B. (2010). The coordination of movement: optimal feedback control and
beyond. Trends in Cognitive Sciences, 14(1), 31-39.

Abstract

Optimal control theory and its more recent extension, optimal feedback control theory, provide valuable insights into the flexible and task-dependent control of movements. Here, we focus on the problem of coordination, defined as movements that involve multiple effectors (muscles, joints or limbs). Optimal control theory makes quantitative predictions concerning the distribution of work across multiple effectors. Optimal feedback control theory further predicts variation in feedback control with changes in task demands and the correlation structure between different effectors. We highlight two crucial areas of research, hierarchical control and the problem of movement initiation, that need to be developed for an optimal feedback control theory framework to characterise movement coordination more fully and to serve as a basis for studying the neural mechanisms involved in voluntary motor control.

Article Outline

The problem of coordination
Optimal (feedback) control theory
Distribution of work across multiple effectors
Task-dependent feedback control
Structure of movement variability
Initial gating mechanism
Coordination through high-level state estimates
Current limitations and outlook
Acknowledgements
Glossary
References

Technorati Tags: psychology, educational psychology, school psychology, cognition, motor movements, coordination, neural oscillations, neuroscience, neuropsychology, brain clock, IQ brain clock

iPost: SharpBrains on iPad as brain fitness tool

AlvaroF: Apple iPad Thumbs-Up: Brain Fitness Value, and Limitations:
In a previous article for SharpBrains, I asked whethe... http://bit.ly/coiOwQ
Original Tweet: http://twitter.com/AlvaroF/status/8988897919

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iPost: APA book review of "A frontal approach to the brain"

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A frontal approach to the brain.

Corballis, Michael C.

PsycCRITIQUES. Vol 55(6),2010, No Pagination Specified.

Reviews the book, The new executive brain: Frontal lobes in a complex world by Elkhonon Goldberg (see record 2009-12340-000). This book reflects Goldberg's primary interest in executive function and the role of the frontal lobes in decision making. A pervading theme is the distinction between what he terms veridical decision making, which depends on discovering facts (such as the state of one's bank account), and actor-centered decision making, which is a matter of determining one's preference (such as how to spend whatever is left in the bank account). Veridical decisions depend primarily on the posterior cortex and actor-centered ones on the frontal lobes. Another theme derives from his criticism of the notion, still popular in some circles, that the mind is composed of independent modules, each dedicated to some specific subtask. He prefers instead the notion of cognitive gradients, whereby one cognitive function blends into another across the cortical surface. A third theme is hemispheric specialization. Such broad themes allow Goldberg to develop insights into a variety of conditions and dispositions, including specific brain injuries, drug effects, sex differences, schizophrenia, attention-deficit/hyperactivity disorder, and more. This is a ruminative book, sometimes rambling and speculative but often laced with revealing anecdotes. Goldberg's Russian experience and long tenure as a neuropsychologist in the United States provide a valuable historical perspective, and most of the ideas in the book are ones that he has previously developed. 

iPost: PEBS neuroethics roundup

Always good stuff. Click link below

http://kolber.typepad.com/ethics_law_blog/2010/02/pebs-neuroethics-roundup-from-jhu-guest-blogger-1.html

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iAbstract: Taste and Go (olfactory) abilities may help diagnose Alzheimers

	Taste in mild cognitive impairment and Alzheimer's disease Journal Journal of Neurology Publisher Steinkopff ISSN 0340-5354 (Print) 1432-1459 (Online) Issue Volume 257, Number 2 / February, 2010 Category Original Communication DOI 10.1007/s00415-009-5300-6 Pages 238-246 Subject Collection Medicine SpringerLink Date Thursday, September 03, 2009	Add to marked items Add to shopping cart Add to saved items Permissions & Reprints Recommend this article

Silke Steinbach¹ , Walter Hundt², Andreas Vaitl³, Petra Heinrich⁴, Stefan Förster³, Katharina Bürger⁵ and Thomas Zahnert¹

(1)	Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University, Fetscherstr. 74, 01307 Dresden, Germany

(2)	Department of Clinical Radiology, Ludwig-Maximilians-University, Munich, Germany

(3)	Department of Nuclear Medicine, Ludwig-Maximilians-University, Munich, Germany

(4)	Department of Medical Statistics and Epidemiology, Institut für medizinische Statistik und Epidemiologie, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany

(5)	Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany

Received: 15 February 2009  Revised:27 July 2009  Accepted: 14 August 2009  Published online: 1 September 2009

Abstract  In this prospective study we investigated the quantitative and qualitative taste function of patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). 29 healthy, elderly subjects, 29 MCI and 30 AD patients were tested using a validated taste test, the "taste strips". Additionally, odor identification, odor discrimination, odor threshold, the mini-mental state examination (MMSE) and Apo E epsilon 4 status were examined. Regarding taste, there was a significant reduction of total taste scores and also the score for individual tastes on either side of the tongue between controls and MCI/AD patients. There was no significant difference in the taste scores between MCI and AD patients. A taste test may be a useful procedure for differentiating between healthy subjects and patients with MCI/AD in a clinical context. For diagnosing MCI versus AD, further tests such as smell test, MMSE, Apo E epsilon 4 status, FDG-PET and MRI appear to be useful.

Keywords  Mild cognitive impairment - Alzheimer's disease - Taste

S. Steinbach and W. Hundt have contributed equally to this work.

---

Silke Steinbach Email: Silkesteinbach@hotmail.com

iPost: Eureka brain special

At MIND HACKS via URL below

http://www.mindhacks.com/blog/2010/02/eureka_brain_special.html

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Efficacy of Interactive Metronome treatment study (Cosper, 2009): An example of a "non-example" of IM efficacy research

As a member of the Interactive Metronome Scientific Advisory Board I am often asked to review published research studies that have investigated the IM method.

Recently, a investigation of the effectiveness IM (which is a mental timing-based intervnetion) with children with attention deficit disorder and developmental coordination disorders was published in the International Journal of Rehabilitation Research. The citation and abstract for the article are reproduced below.

• Cosper, S., Lee, G., Peters, S & Bishop, E. (2009).  Interactive Metronome training in children with attention deficit and developmental coordination disorders, Internal Journal of Rehabilitation Research, 32 (4), 331-336.  (click here to view)

Abstract: The objective of this study was to examine the efficacy of Interactive Metronome (Interactive Metronome, Sunrise, Florida, USA) training in a group of children with mixed attentional and motor coordination disorders to further explore which subcomponents of attentional control and motor functioning the training influences. Twelve children who had been diagnosed with attention deficit hyperactivity disorder, in conjunction with either developmental coordination disorder (n=10) or pervasive developmental disorder (n=2), underwent 15 1-h sessions of Interactive Metronome training over a 15-week period. Each child was assessed before and after the treatment using measures of attention, coordination, and motor control to determine the efficacy of training on these cognitive and behavioral realms. As a group, the children made significant improvements in complex visual choice reaction time and visuomotor control after the training. There were, however, no significant changes in sustained attention or inhibitory control over inappropriate motor responses after treatment. These results suggest Interactive Metronome training may address deficits in visuomotor control and speed, but appears to have little effect on sustained attention or motor inhibition.

After reading thie manuscript, I decided to make this formal blog post in an effort to educate readers on a few critical issues related to intervention research. After a thorough read of the study, and despite the fact that it reported positive findings in the area of motor coordination improvement (but not in attention), it is my professional opinion that there are enough major methodological flaws which make the study an invalid study of the effectiveness of the IM treatment program.

Below are the major concerns I have about the study. I will only focus on my major concerns and will not highlight other minor concerns I noted during my review of manuscript.

Treatment integrity/fidelity/validity:  The most serious (fatal) flaw  is the lack of treatment integrity or validity. As described in the methods section, the treatment consisted of one hour sessions (per week) of IM treatment over a period of 15 weeks. To readers unfamiliar with the IM program, the standard treatment protocol is for three hourly sessions per week.  The use of only one hourly session per week (versus the recommended three hourly sessions per week) is a clear example of poor treatment integrity as defined below.

Treatment integrity (also known as treatment fidelity) refers to the degree to which intervention is implemented as intended. Interpretations of the obtained results require some assurance that treatment was carried our as it was designed or, in other words, that treatment was implemented with high levels of integrity. Compromised integrity has serious implications for inferences drawn about the relationship between treatment and outcome. Indeed, the obtained results are related not to the intended intervention (i.e., treatment as designed) but to the implemented intervention (i.e., treatment as delivered by treatment agents). [Click here for more information]

This violation of the IM treatment protocol would be analogous to the following:

• Being prescribed three weekly sessions of physical therapy for back pain but only doing one session a week.
• Being prescribed 300 mg/day of some form of medication to treat a condition, but only taking 100 mg/day.
• Having a reading disabled student who is recommended to receive three hourly sessions of reading-focused special education services a week only receive one hourly session per week.

The bottom line is that this this study should not be considered a valid study of the efficacy of the IM treatment program as it was not implemented as per the prescribed IM treatment protocol (poor treatment integrity/fidelity).  This major methodological flaw in itself disqualifies this study as a valid study of the IM treatment program.

Confounding of IM treatment with pharmacological treatments. The sample consisted of 12 subjects with various diagnoses, but whom all shared a diagnosis of ADHD.  As described by the authors, half of the subjects were taking some form of medication during the study. More importantly, "no medication changes occurred over the course of the study". This introduces a potential intervention confound. It is very possible that the medications received by half of the sample were already impacting the ability of these children to attend and concentrate at their maximal levels. As a result, no non-pharmacological intervention would have a chance to prove its effectiveness as these six subjects were already being "treated " via medication (and might already be near or at their optimal level of functioning). When it can be ethically designed, the efficacy of nondrug (or new drug) effectiveness is typically investigated by having subjects on a  current medication regime discontinue their medication for a rescribed period of time to establish a nondrug baseline performance level. Then the new treatment (or new drug) is introduced and performance measured to evaluate effectiveness. This was not done in the current study for half of the subjects.   It can be easily argued that  at least half of the subjects were already receiving treatment or intervention (medication) which confoundes the ability to detect effectiveness for any new treatment (e.g.,  IM). 

Statistical and design analysis: It is well known in the research methodology literature that the simple analysis of change scores (from a pre- post-test design) is a less than optimal research design. The most critical issue is the fact that the reliability of the change or difference score is a function of the reliability of the pre-and post test scores and the correlation between the two. The reliability of change scores is always much lower than the reliability of individual measures. In addition, possible differences in the subjects as they entered the study should be controlled for in the analysis via some form of statistical control (e.g., analysis of covariance, repeated measures designs, etc.). Simple pre-/post-test change score research designs suffer from serious methodological flaws.  This has been recognized for decades.  The results are of questionable value. Click here for additional background information.  Furthermore, the study does not include a control group or the random assignment of subjects to treatment and control groups.

Incomplete literature review:  In the introduction the authors state that "there are only two peer-reviewed studies comparing pretreatment and posttreatment effects that include a control group, and one of these found that the Interactive Metronome improved golf swings in healthy normal individuals."  The authors failed to mention one of the largest and best designed IM efficacy studies (random assigment of subjects to treatment and control groups;  analysis that controlled for initial pret-test scores) by Taub et al.  (2007).  Furthermore, the above quote conveys the implicit assumption that a study of the effectiveness of IM on golf swings is not relevant to the current research. This reflects a narrow understanding of the potential causal mechanisms of the IM program. As discussed in the Taub et al article, and in a recent review of the efficacy of various brain rhythm treatments, a review of theoretical and empirical research (from a diverse range of disciplines) suggests the hypothesis that the effectiveness of IM is due to its impact on a "domain-general" cognitive mechanism. If a treatment programs efficacy is believed to be based on the modification of a domain general cognitive/brain-based mechanism, one would expect it to have generalized treatment effects across a wide variety of human performance domains. This is discussed in greater detail in the Taub et al paper. [Conflict of interest note - I am a coauthor on this paper].

In conclusion, it is my professional opinion that the Cosper et al (2009) IM efficacy study suffers from major methodological flaws which make the study an invalid study of the effectiveness of the IM treatment program.

Technorati Tags: psychology, neurotechnology, neuroscience, Interactive Metronome, mental time keeping, IQ brain clock, interval timing, brain clock, brain rhythm, rhythm perception, rhythm production

Cognitive fluency hot topic---Emailing tweet from: PsychScience (APS)

Easy = True - fascinating article on cognitive fluency "one of the
hottest topics in psychology today" http://ow.ly/13pcW
Original Tweet: http://twitter.com/PsychScience/status/8591179370

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iPost: PEBS neuro roundup

http://kolber.typepad.com/ethics_law_blog/2010/02/pebs-neuroethics-roundup-from-jhu-guest-blogger.html

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Can music training alter your brain

Story at MIND HACKS link below

http://mindblog.dericbownds.net/2010/02/music-training-induces-plasticity-in.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+Mindblog+%28MindBlog%29&utm_content=Bloglines

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The Blue Brain Project

At MIND HACKS link below

http://www.mindhacks.com/blog/2010/02/blue_brain_year_one.html

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Brain injury: Recover and rehabilitattion review article

Wiley Interdisciplinary Reviews: Cognitive Science

Volume 1, Issue 1, Pages 108-118

Advanced Review

Brain injury: recovery and rehabilitation

Barbara A. Wilson *

MRC Cognition and Brain Sciences Unit, 15 Chaucer Rd, Cambridge, CB2 7EF, England, United Kingdom

email: Barbara A. Wilson (barbara.wilson@mrc-cbu.cam.ac.uk)

^*Correspondence to Barbara A. Wilson, MRC Cognition and Brain Sciences Unit, 15 Chaucer Rd, Cambridge, CB2 7EF, England, United Kingdom

Abstract

This paper discusses contributing factors relating to recovery and rehabilitation among patients who have sustained nonprogressive brain injury. Following a brief description of conditions observed in people with brain damage and their incidence and prevalence, the paper then focuses on survivors of traumatic brain injury (TBI), concentrating particularly on recovery and rehabilitation within this group. As recovery means different things to different people, the term is used here to mean partial recovery of function together with substitution of function.[1] Consideration is given to factors influencing recovery from TBI, particularly age, gender, and cognitive reserve. Mechanisms of recovery are also examined, particularly regeneration, diaschisis, and plasticity. Attention is then focused on rehabilitation, a process whereby survivors of brain injury are helped to attain their optimum level of functioning and return to their own most appropriate environments. Cognitive rehabilitation is typically aimed at helping people compensate for their difficulties. The need to treat cognitive, emotional, and psychosocial consequences of brain injury is recognized, and different approaches to rehabilitation are described together with the main changes seen in the past few years. Finally, evidence for the success of neuropsychological rehabilitation is presented

psychology, neuropsychology, neuroscience, brain injury, neurorehabilitation