Functional Magnetic Resonance Imaging Neurofeedback and Motor training for Parkinson’s Disease: Randomised Trial

Objective: Real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback (NF) uses feedback of the patient’s own brain activity to self-regulate brain networks which in turn could lead to a change in behaviour and clinical symptoms. The objective was to determine the effect of neurofeedback and motor training and motor training (MOT) alone on motor and non-motor functions in Parkinson’s disease (PD) in a 10-week small Phase I randomised controlled trial. Methods: 30 patients with PD (Hoehn & Yahr I-III) and no significant comorbidity took part in the trial with random allocation to two groups. Group 1 (NF: 15 patients) received rt-fMRI-NF with motor training. Group 2 (MOT: 15 patients) received motor training alone. The primary outcome measure was the Movement Disorder Society – Unified Parkinson’s Disease Rating Scale-Motor scale (MDS-UPDRS-MS), administered pre- and post-intervention ‘off-medication’. The secondary outcome measures were the ‘on-medication’ MDS-UPDRS, the Parkinson’s disease Questionnaire-39, and quantitative motor assessments after 4 and 10 weeks. Results: Patients in the NF group were able to upregulate activity in the supplementary motor area by using motor imagery. They improved by an average of 4.5 points on the MDS-UPDRS-MS in the ‘off-medication’ state (95% confidence interval: -2.5 to -6.6), whereas the MOT group improved only by 1.9 points (95% confidence interval +3.2 to -6.8). However, the improvement did not differ significantly between the groups. No adverse events were reported in either group. Interpretation: This Phase I study suggests that NF combined with motor training is safe and improves motor symptoms immediately after treatment, but larger trials are needed to explore its superiority over active control conditions. Clinical Trial website : Unique Identifier: NCT01867827 URL: https://clinicaltrials.gov/ct2/show/NCT01867827?term=NCT01867827&rank=1

The autobiographical you: letters in the gendered politics of the labour movement.

In this article, I consider the importance of epistolary narratives in the interface of autobiography and politics. In doing this, I read the letters of Fannia Mary Cohn, a Jewish immigrant worker, trade union activist and ardent labour organizer in the garment industry in the USA in the first half of the twentieth century. Cohn was a prolific writer and political activist and left a rich body of labour literature, but never wrote an autobiography or a diary or journal. It is in her letters to her comrades and friends in the labour movement that short autobiographical stories erupt and it is on such stories across her correspondence that this article focuses. The analysis is informed by Hannah Arendt’s theorization of narratives in their interrelation with politics and history. Drawing on a rich body of feminist literature around the relational self, what I argue is that an Arendtian reading of epistolary narratives is a useful analytical tool in understanding gendered politics in the diverse histories of the labour movement.