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WashU weekly Neuroscience publications

“The assessment of resistance to antidepressant treatment: Rationale for the Antidepressant Treatment History Form: Short Form (ATHF-SF)” (2019) Journal of Psychiatric Research

The assessment of resistance to antidepressant treatment: Rationale for the Antidepressant Treatment History Form: Short Form (ATHF-SF)
(2019) Journal of Psychiatric Research, 113, pp. 125-136. 

Sackeim, H.A.a , Aaronson, S.T.b , Bunker, M.T.c , Conway, C.R.d , Demitrack, M.A.e , George, M.S.f , Prudic, J.g , Thase, M.E.h , Rushi, A.J.i j k

a Departments of Psychiatry and Radiology, Columbia University, New York, NY, United States
b Sheppard Pratt Health System and Department of Psychiatry, University of Maryland, Baltimore, MD, United States
c LivaNova PLC, Houston, TX, United States
d Department of Psychiatry, Washington University, St. Louis, MO, United States
e Trevena, Inc., Chesterbrook, PA, United States
f Departments of Psychiatry, Neurology, and Neuroscience, Medical University of South Carolina, Charleston, SC, United States
g New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York, NY, United States
h Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States
i Duke-NUS Medical School, Singapore
j Duke University, Durham, NC, United States
k Texas Tech University, Permian BasinTX, United States

Abstract
There is considerable diversity in how treatment-resistant depression (TRD) is defined. However, every definition incorporates the concept that patients with TRD have not benefited sufficiently from one or more adequate trials of antidepressant treatment. This review examines the issues fundamental to the systematic evaluation of antidepressant treatment adequacy and resistance. These issues include the domains of interventions deemed effective in treatment of major depressive episodes (e.g., pharmacotherapy, brain stimulation, and psychotherapy), the subgroups of patients for whom distinct adequacy criteria are needed (e.g., bipolar vs. unipolar depression, psychotic vs. nonpsychotic depression), whether trials should be rated dichotomously as adequate or inadequate or on a potency continuum, whether combination and augmentation strategies require specific consideration, and the criteria used to evaluate the adequacy of treatment delivery (e.g., dose, duration), trial adherence, and clinical outcome. This review also presents the Antidepressant Treatment History Form: Short-Form (ATHF-SF), a completely revised version of an earlier instrument, and details how these fundamental issues were addressed in the ATHF-SF. © 2019 The Authors

Author Keywords
Antidepressant treatment resistance;  Brain stimulation;  Major depressive episode;  Pharmacotherapy;  Psychotherapy;  Treatment-resistant depression

Document Type: Review
Publication Stage: Final
Source: Scopus
Access Type: Open Access

“Recovery from brain injury: a surprising new drug target” (2019) The Lancet Neurology

Recovery from brain injury: a surprising new drug target
(2019) The Lancet Neurology, 18 (5), pp. 421-422. 

Rosand, J.a b , Khatri, P.c , Lee, J.-M.d

a Henry and Allison McCance Center for Brain Health, Division of Neurocritical Care, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, United States
b Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, United States
c Department of Neurology, University of Cincinnati, Cincinnati, OH, United States
d Department of Neurology, Washington University School of Medicine, St Louis, MO, United States

Document Type: Note
Publication Stage: Final
Source: Scopus

“Mental health in spouses of U.S. Gulf War veterans” (2019) Psychiatry Research

Mental health in spouses of U.S. Gulf War veterans
(2019) Psychiatry Research, 275, pp. 287-295. 

Toomey, R.a , Alpern, R.b , Reda, D.J.b , Baker, D.G.c d , Vasterling, J.J.e f , Blanchard, M.g , Eisen, S.A.g

a Department of Psychological and Brain Sciences, College of Arts and Sciences, Boston University, 900 Commonwealth Ave., Boston, MA, United States
b Cooperative Study Program Coordinating Center, Edward Hines Jr. VA Hospital, Hines, IL, United States
c Center of Excellence for Stress and Mental Health and VA San Diego Healthcare SystemSan Diego, United States
d Department of Psychiatry, University of California San DiegoLa Jolla, United States
e National Center for PTSD and Psychology Service, VA Boston Healthcare System, Boston, MA, United States
f Department of Psychiatry, School of Medicine, Boston University, Boston, MA, United States
g School of Medicine, Washington University, St. Louis, MO, United States

Abstract
Veterans’ spouses are at risk for mental distress and substance use. We examined long term psychological functioning in spouses from a national cohort of 1991 Gulf War era veterans. From clinical interviews, spouses of deployed veterans (n = 488) did not have a greater prevalence of post-war mental disorders compared to spouses of non-deployed veterans (n = 536); however, in couples that were living together since the war, there was an increased risk of anxiety disorders or any one disorder. On questionnaires, the impact varied but was most consistently observed in more severe depression and greater functional impairment in spouses of deployed compared to non-deployed veterans. If a veteran developed post-war anxious/depressive disorders or any one mental disorder, the matched spouse was more likely to develop post-war anxious/depressive disorders or any one mental disorder, respectively. Veteran combat exposure did not similarly increase the risk of spouse post-war mental disorders. Greater spouse self-reported symptomatology was observed in spouses of veterans with anxious/depressive disorders even when controlling for deployment. In summary, the war conferred greater risk for spouse mental disorders and distress for spouses of veterans with mental health disorders, with some increased risk for spouses of deployed veterans, especially in couples together since the war. © 2019

Author Keywords
Anxiety;  Depression;  Mental disorder;  Military;  Military spouse;  PTSD

Document Type: Article
Publication Stage: Final
Source: Scopus

“Prevalence of behavioral disorders and attention deficit/hyperactive disorder among school going children in Southwestern Uganda” (2019) BMC Psychiatry

Prevalence of behavioral disorders and attention deficit/hyperactive disorder among school going children in Southwestern Uganda
(2019) BMC Psychiatry, 19 (1), art. no. 105, . 

Kivumbi, A.a , Byansi, W.b , Damulira, C.a , Namatovu, P.a , Mugisha, J.d , Sensoy Bahar, O.b , McKay, M.M.b , Hoagwood, K.c , Ssewamala, F.M.a b

a International Center for Child Health and Development Circular Rd, P.O. Box 1988, Masaka, Uganda
b Brown School, Washington University in St. Louis, St. Louis, United States
c New York University School of Medicine, New York, United States
d Kyambogo University, Kampala, Uganda

Abstract
Background: Disruptive Behavioral Disorders (DBDs) and Attention Deficit/Hyperactivity Disorder (ADHD) are chronic, impairing, and costly child and adolescent mental health challenges which, when untreated, can result in disruptions in school performance, friendships and family relations. Yet, there is dearth of prevalence data on child and adolescent behavioral challenges within sub-Saharan Africa, including Uganda. This study aims to estimate the prevalence rate of behavioral challenges and ADHD among young school going children and early adolescents (ages 8-13 at study enrollment), utilizing a school-based sample in southwest Uganda. Methods: We present screening results from a 5-year scale-up study titled SMART Africa-Uganda (2016-2021), set across 30 public primary schools located in the greater Masaka region in Uganda, a region heavily impacted by poverty and HIV/AIDS. Specifically, we draw on screening data from caregivers of 2434 children that used well-established standardized measures that had been pre-tested in the region. These were: 1) oppositional defiant disorder (ODD) and conduct disorder (CD) subscales of the Disruptive Behavior Disorders (DBD) scale; and 2) the Iowa Connors and Impairment scales. Slightly over half of the children in the sample were female (52%), with a mean age of 10.27 years. Results: Of the 2434 participants screened for disruptive behaviors: 1) 6% (n = 136) scored positive on ODD and 2% (n = 42) scored positive on CD subscales of the DBD scale; 2) 9.61% (n = 234), and 2.67% (n = 65) were reported to have elevated symptoms of ODD and ADHD on the Iowa Connors caregiver report scale respectively. Twenty-five percent (n = 586) of children were described by their caregivers as having experienced some form of impairment in at least four domains of the Impairment scale. Conclusion: The results indicate the presence of behavioral challenges and ADHD among school going children, aged 8-13 years, in Uganda. Given the negative outcomes associated with behavioral challenges as children transition to adolescence and adulthood, detecting these emerging behavioral challenges early is critical in developing appropriate interventions. School settings could be considered as one of the contextually-relevant, culturally-appropriate, and non-stigmatizing venues to implement screening procedures and to detect emerging behavioral challenges and to make necessary referrals. © 2019 The Author(s).

Author Keywords
Adolescents;  Attention deficit/hyperactive disorder;  Conduct disorders;  Disruptive behavior disorders;  Oppositional defiant disorder;  Prevalence

Document Type: Article
Publication Stage: Final
Source: Scopus
Access Type: Open Access

“Suicidal Ideation in First-Episode Psychosis (FEP): Examination of Symptoms of Depression and Psychosis Among Individuals in an Early Phase of Treatment” (2019) Suicide and Life-Threatening Behavior

Suicidal Ideation in First-Episode Psychosis (FEP): Examination of Symptoms of Depression and Psychosis Among Individuals in an Early Phase of Treatment
(2019) Suicide and Life-Threatening Behavior, 49 (2), pp. 423-431. Cited 1 time.

Bornheimer, L.A.

Postdoctoral Research Associate, Brown School, Washington University in St. Louis, St. Louis, MO, United States

Abstract
First-episode psychosis (FEP) is a particularly high-risk period for suicide, in which risk elevates by 60% within a first year of treatment as compared to later stages of illness. To date, much of the literature has focused on individuals with a longer duration of psychosis; thus, there is an urgency for research to examine suicide risk among individuals in FEP in the beginning stage of treatment. This study aimed to identify the relationships between demographic characteristics, symptoms of depression, psychosis (particularly positive symptoms of psychosis), and suicidal ideation among individuals in FEP. Secondary data were obtained from National Institute of Mental Health’s Early Treatment Program of the Recovery After an Initial Schizophrenia Episode project (N = 404). Consistent with prior research, participants who experienced suicidal ideation during the study period reported having a longer duration of untreated psychosis and greater symptoms of depression. Further, positive symptoms of psychosis, namely hallucinations and delusions, were found to increase the odds of experiencing suicidal ideation. Findings point toward the implication that depression and positive symptoms of psychosis relate to the experience of suicidal ideation among individuals with a FEP and should be evaluated for and treated in the early stages of treatment. © 2018 The American Association of Suicidology

Document Type: Article
Publication Stage: Final
Source: Scopus

“Tau PET in autosomal dominant Alzheimer’s disease: relationship with cognition, dementia and other biomarkers” (2019) Brain : a journal of neurology

Tau PET in autosomal dominant Alzheimer’s disease: relationship with cognition, dementia and other biomarkers
(2019) Brain : a journal of neurology, 142 (4), pp. 1063-1076. Cited 1 time.

Gordon, B.A.a b c d , Blazey, T.M.a , Christensen, J.a , Dincer, A.a , Flores, S.a , Keefe, S.a , Chen, C.a , Su, Y.e , McDade, E.M.b f , Wang, G.f , Li, Y.f , Hassenstab, J.b d f , Aschenbrenner, A.b f , Hornbeck, R.a , Jack, C.R.g , Ances, B.M.b c f , Berman, S.B.h , Brosch, J.R.i , Galasko, D.j , Gauthier, S.k , Lah, J.J.l , Masellis, M.m , van Dyck, C.H.n , Mintun, M.A.o , Klein, G.p , Ristic, S.q , Cairns, N.J.b c f , Marcus, D.S.a , Xiong, C.b r , Holtzman, D.M.b c f , Raichle, M.E.a c f , Morris, J.C.b f , Bateman, R.J.b c f , Benzinger, T.L.S.a b

a Mallinckrodt Institute of Radiology, Washington University in St. LouisMO, United States
b Knight Alzheimer’s Disease Research Center, Washington University in St. Louis MO, United States
c Hope Center for Neurological Disorders, St. Louis, MO, United States
d Department of Psychological and Brain Sciences, Washington University in St. Louis MO, United States
e Banner Health, United States
f Department of Neurology, Washington University in St. Louis MO, United States
g Department of Radiology, Mayo Clinic, Rochester, MN, United States
h Department of Neurology, University of Pittsburgh, Pittsburgh, PA, United States
i Department of Neurology, Indiana University, Indianapolis, IN, United States
j Department of Neurosciences, University of California, San Diego, CA, United States
k Departments of Psychiatry, Neurology and Neurosurgery, Medicine, McGill University, Montreal, Canada
l Department of Neurology, Emory University, Atlanta, GA, United States
m Division of Neurology, Sunnybrook Health Sciences Centre; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute; Department of Medicine, University of Toronto, Toronto, ON, Canada
n Alzheimer’s Disease Research Unit, Yale University School of Medicine, New HavenCT, United States
o Avid Radiopharmaceuticals (A Wholly Owned Subsidiary of Eli Lilly and Company), Philadelphia, PA, United States
p Roche Pharma Research and Early Development, Basel, Switzerland
q Roche/Genentech Product Development, Neuroscience, Basel, Switzerland
r Department of Biostatistics, Washington University in St. LouisMO, United States

Abstract
Tauopathy is a hallmark pathology of Alzheimer’s disease with a strong relationship with cognitive impairment. As such, understanding tau may be a key to clinical interventions. In vivo tauopathy has been measured using cerebrospinal fluid assays, but these do not provide information about where pathology is in the brain. The introduction of PET ligands that bind to paired helical filaments provides the ability to measure the amount and distribution of tau pathology. The heritability of the age of dementia onset tied to the specific mutations found in autosomal dominant Alzheimer’s disease families provides an elegant model to study the spread of tau across the course of the disease as well as the cross-modal relationship between tau and other biomarkers. To better understand the pathobiology of Alzheimer’s disease we measured levels of tau PET binding in individuals with dominantly inherited Alzheimer’s disease using data from the Dominantly Inherited Alzheimer Network (DIAN). We examined cross-sectional measures of amyloid-β, tau, glucose metabolism, and grey matter degeneration in 15 cognitively normal mutation non-carriers, 20 asymptomatic carriers, and 15 symptomatic mutation carriers. Linear models examined the association of pathology with group, estimated years to symptom onset, as well as cross-modal relationships. For comparison, tau PET was acquired on 17 older adults with sporadic, late onset Alzheimer disease. Tau PET binding was starkly elevated in symptomatic DIAN individuals throughout the cortex. The brain areas demonstrating elevated tau PET binding overlapped with those seen in sporadic Alzheimer’s disease, but with a greater cortical involvement and greater levels of binding despite similar cognitive impairment. Tau PET binding was elevated in the temporal lobe, but the most prominent loci of pathology were in the precuneus and lateral parietal regions. Symptomatic mutation carriers also demonstrated elevated tau PET binding in the basal ganglia, consistent with prior work with amyloid-β. The degree of tau tracer binding in symptomatic individuals was correlated to other biomarkers, particularly markers of neurodegeneration. In addition to the differences seen with tau, amyloid-β was increased in both asymptomatic and symptomatic groups relative to non-carriers. Glucose metabolism showed decline primarily in the symptomatic group. MRI indicated structural degeneration in both asymptomatic and symptomatic cohorts. We demonstrate that tau PET binding is elevated in symptomatic individuals with dominantly inherited Alzheimer’s disease. Tau PET uptake was tied to the onset of cognitive dysfunction, and there was a higher amount, and different regional pattern of binding compared to late onset, non-familial Alzheimer’s disease. © The Author(s) (2019). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Author Keywords
Alzheimer’s;  amyloid;  FDG;  flortaucipir;  MRI

Document Type: Article
Publication Stage: Final
Source: Scopus

“Cognitive, Emotional, and Physical Functioning as Predictors of Paid Employment in People With Stroke, Traumatic Brain Injury, and Spinal Cord Injury” (2019) The American journal of occupational therapy : official publication of the American Occupational Therapy Association

Cognitive, Emotional, and Physical Functioning as Predictors of Paid Employment in People With Stroke, Traumatic Brain Injury, and Spinal Cord Injury
(2019) The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 73 (2), pp. 7302205010p1-7302205010p15. 

Wong, A.W.K.a , Chen, C.b , Baum, M.C.c , Heaton, R.K.d , Goodman, B.e , Heinemann, A.W.f

a Alex W. K. Wong, PhD, DPhil, is Assistant Professor, Program in Occupational Therapy and Department of Neurology, Washington University School of Medicine, St. Louis, MO;
b Saw Swee Hock School of Public Health, National University of Singapore, is Assistant Professor, Singapore
c M. Carolyn Baum, OTR/L, Program in Occupational Therapy, Washington University School of Medicine, is Professor and Elias Michael Executive Director, St. Louis, MO, United States
d Department of Psychiatry, University of California, is Professor, San Diego, United States
e BA, Program in Occupational Therapy, Washington University School of Medicine, is Master of Science in Occupational Therapy Student, St. Louis, MO, United States
f Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Director, Center for Rehabilitation Outcomes Research, Allen W. Heinemann ,is Professor, Chicago, United States

Abstract
OBJECTIVE: Our objective was to examine demographic, cognitive, emotional, and physical factors that predict return to paid employment for people after neurological injury. METHOD: Four hundred eighty adults with stroke (n = 149), traumatic brain injury (n = 155), and spinal cord injury (n = 176) completed an occupational outcome questionnaire and physical, emotional, and cognitive assessments at three rehabilitation facilities. RESULTS: Odds of employment were predicted by being married or partnered, having more education, requiring fewer prompts for task sequencing, and having higher inhibitory control (but were not predicted by specific type of injury). Participants who returned to work within 3 mo were more likely to work with the same employer and to take a full-time position than those who returned later. CONCLUSION: Executive functioning, in particular sequencing and inhibitory control, strongly predicts employment and highlights the importance of cognitive strategy training during occupational therapy with people who have sustained neurological injuries. Copyright © 2019 by the American Occupational Therapy Association, Inc.

Document Type: Article
Publication Stage: Final
Source: Scopus

“Differences in cognitive impairment in primary age-related tauopathy versus Alzheimer disease” (2019) Journal of Neuropathology and Experimental Neurology

Differences in cognitive impairment in primary age-related tauopathy versus Alzheimer disease
(2019) Journal of Neuropathology and Experimental Neurology, 78 (3), pp. 219-228. 

Besser, L.M.a , Mock, C.b , Teylan, M.A.b , Hassenstab, J.c d , Kukull, W.A.b , Crary, J.F.e

a School of Urban and Regional Planning, Institute for Healthy Aging and Lifespan Studies, Florida Atlantic University, Boca Raton, FL, United States
b Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA, United States
c Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, United States
d Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States
e Department of Pathology, Fishberg Department of Neuroscience, Friedman Brain Institute, Ronald M. Loeb Center for Alzheimer’s Disease, Icahn School of Medicine at Mount Sinai, New York, NY, United States

Abstract
This study examined differences in neuropsychological test scores between individuals with primary age-related tauopathy (PART) and Alzheimer disease (AD) using cross-sectional data from the National Alzheimer’s Coordinating Center. Linear regression tested for differences in 4 cognitive domains stratified by cognitive status (global Clinical Dementia Rating [CDR]). The sample included 240 participants with no neuritic plaques (NP) (definite PART), 186 with sparse NP (possible PART), and 510 with moderate/frequent NP (AD). Four cognitive domain z-score outcome variables (memory, attention, executive function, and semantic memory/language) were calculated using 12 neuropsychological tests. Definite PART participants had a sparing of semantic memory/language compared to those with AD, with a mean adjusted z-score difference of 0.37 (95% confidence interval [CI]: 0.16-0.58) for those with CDR ¼ 0.5 or 1 and of 0.92 (CI: 0.22-1.63) for those with CDR ¼ 2 or 3. Compared to participants with AD, definite PART participants with CDR ¼ 0.5 or 1 had sparing of memory (adjusted z-score difference: 0.61; CI: 0.39-0.84) and definite PART participants with CDR ¼ 2 or 3 had sparing of attention (adjusted z-score difference: 0.76: CI: 0.09-1.43). Patterns of cognitive impairment differed between definite PART and AD, suggesting significant differences in clinical presentation between individuals from these 2 groups. © 2019 American Association of Neuropathologists, Inc. All rights reserved.

Author Keywords
AD;  Alzheimer disease;  Cognition;  Cognitive;  Neuropathology;  PART;  Primary age-related tauopathy

Document Type: Article
Publication Stage: Final
Source: Scopus

“Public Health Implications of Rising Marijuana Use in Pregnancy in an Age of Increasing Legalization – Reply” (2019) JAMA Pediatrics

Public Health Implications of Rising Marijuana Use in Pregnancy in an Age of Increasing Legalization – Reply
(2019) JAMA Pediatrics, . 

Agrawal, A., Grucza, R.A., Rogers, C.E.

Department of Psychiatry, Washington University, School of Medicine in St Louis, St Louis, MO, United States

Document Type: Letter
Publication Stage: Article in Press
Source: Scopus

“Benefits of Imaging in Children for Unilateral Sensorineural Hearing Loss and the Eye of the Beholder” (2019) JAMA Otolaryngology – Head and Neck Surgery

Benefits of Imaging in Children for Unilateral Sensorineural Hearing Loss and the Eye of the Beholder
(2019) JAMA Otolaryngology – Head and Neck Surgery, . 

Lieu, J.E.C., Gantz, J.A.

Department of Otolaryngology-Head and Neck Surgery, Washington University in St Louis School of Medicine, St Louis, MO, United States

Document Type: Note
Publication Stage: Article in Press
Source: Scopus

“Dose of remote limb ischemic conditioning for enhancing learning in healthy young adults” (2019) Experimental Brain Research

Dose of remote limb ischemic conditioning for enhancing learning in healthy young adults
(2019) Experimental Brain Research, . 

Mattlage, A.E.a , Sutter, E.N.a , Bland, M.D.a b c , Surkar, S.M.a , Gidday, J.M.d e f , Lee, J.-M.b , Hershey, T.g h , Chen, L.i , Lang, C.E.a b c

a Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO, United States
b Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
c Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, United States
d Department of Ophthalmology, Louisiana State University Health Sciences Center, New Orleans, LA, United States
e Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, LA, United States
f Department of Neuroscience, Louisiana State University Health Sciences Center, New Orleans, LA, United States
g Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
h Department of Radiology, Washington University School of Medicine, St. Louis, MO, United States
i Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, United States

Abstract
Remote limb ischemic conditioning (RLIC) is a technique in which tissues distant from the target organ are exposed to brief, sub-lethal bouts of ischemia. The effects of remotely applied ischemic conditioning are systemically transferred to the target organ, and typically manifested as protection from subsequent ischemic injury. Previous studies in our lab have found and confirmed that RLIC enhances learning and retention during motor training on a balance task. The current study tested the effect of RLIC dose (number of cycles) on learning enhancement in young, healthy adults. Forty healthy participants age 18–40 years were randomized to receive 5 cycles of sham conditioning (n = 9), 3 cycles of RLIC (n = 11), 4 cycles of RLIC (n = 10), or 5 cycles of RLIC (n = 10) using a blood pressure cuff around the upper arm once a day for 7 consecutive weekdays (Days 1–7). Participants concurrently trained on a balance task, bimanual cup stacking task, and a discrete sequence production task on Days 3–7. Change in performance on each of the three tasks was compared across groups. Participants in all four groups improved their performance on each of the three tasks over time. However, RLIC at any dose did not enhance learning on any of the three tasks. While RLIC is safe, inexpensive, and clinically feasible, reproducibility may be challenged by unidentified factors, raising critical challenges to the straightforward translation of RLIC for improving rehabilitation outcomes in individuals recovering from neurological injury. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.

Author Keywords
Ischemic conditioning;  Motor learning;  Psychomotor performance

Document Type: Article
Publication Stage: Article in Press
Source: Scopus