Frontiers in Human Neuroscience

Approximately 90% of individuals with limb amputation experience the persistent sensation of the missing extremity and up to 85% experience debilitating pain in the missing limb, a condition termed phantom limb pain (PLP). In this registered clinical trial (NCT05296265), we tested the efficacy of Virtual Reality (VR) treatment of phantom leg pain in a sample of transtibial and transfemoral amputees with PLP. Adaptive randomization was used to assign 36 participants (19 transfemoral, 17 transtibial) recruited across three study sites to eight sessions of an active or distractor VR treatment. The active VR treatment required leg movements and provided virtual visual feedback. The distractor treatment was a commercially available VR treatment for pain based on the principle of distraction. The primary outcome measures were the comparison of ratings of pain intensity and quality at baseline versus immediately post-treatment and at 1-week and 8-week follow up. The secondary outcome measure, obtained in each session, was average pain intensity since the last treatment. Pain on both intensity and quality measures was significantly reduced with moderate effect sizes for the active treatment only; intensity effects persisted at 1-week follow-up, and quality effects persisted at 8-weeks follow-up. Ratings of pain intensity since the last treatment showed a large effect size for the active treatment and was significant for both treatments. This clinical trial showed significant efficacy of VR treatment for PLP, particularly for an active treatment providing virtual visual feedback of the amputated limb.

Humanity has always admired and created artwork, but the neurocognitive mechanisms behind artistic experience are still elusive. Professional artists and their intimate relationship with their artworks provide a unique opportunity to study the nature of art experience due to their expertise in both art making and art appreciation. During two fMRI tasks, professional artists (N=20) made aesthetic judgments on their own and other artists paintings (aesthetic appreciation task); they also mentally reconstructed the moments when they conceived their artworks or, as a control condition, when they visited now-familiar places for the first time (reconstruction by imagery task). During art appreciation of their own (as compared to other artists) paintings, participants showed stronger recruitment of bilateral posterior parietal cortices, the left lateral occipitotemporal cortex, and the dorso-central sector of the right insula, that is, action-related brain regions also involved in encoding the emotional components of movements. The reconstruction of their own artistic creation (as compared to episodic memory retrieval) involved the left fronto-parietal network associated with motor cognition. Altogether, these results suggest that the mental representations of the actions involved in creating art are integral to the overall artistic experience of painters, supporting an embodied view of the artists experience of art.

BackgroundPain with movement is common in adults with knee osteoarthritis (OA), but the effect of movement-evoked pain on gait is not well understood. This relationship is vital to understand as gait mechanics are associated with OA initiation and progression. Our current understanding of acute changes in pain and gait stems from extended bouts of walking, however these bouts likely dont represent real-world behavior. Therefore, understanding how gait changes with shorter, more intense bouts of activity may provide valuable insight into the pain experience. MethodsAdults with (n=19) and without (n=19) knee OA wore inertial measurement units (IMUs) while completing bouts of walking before and after two bouts of stair navigation (two flights). We tested whether pain and gait (speed, stride length, and lower extremity joint ranges of motion (ROM)) changed differently between adults with and without knee OA in response to multiple bouts of stair activity. FindingsThere were no significant interactions between group and stair bouts for any variable. When stratifying the OA group by those who did and did not experience pain, those who experienced a change in pain also had a greater change in early stance knee ROM in response to bouts of stairs. InterpretationThe observed changes suggest that knee kinematics may be more sensitive to acute changes in pain than gait speed or stride length. These differences were detectable using IMUs and therefore our results support the use of IMUs to measure concurrent pain and gait mechanics in less controlled and real-world settings.

Observing touch activates brain regions similar to those activated by experiencing actual touch, suggesting that visual information can cross-modally influence tactile perception. In this electroencephalography (EEG) study, we investigated how viewing visual displays of an arm being touched may affect the perception and processing of digitally rendered touch patterns designed to resemble either stroking or tapping. Thirty-one participants experienced touch patterns delivered to their left forearm via a wearable sleeve while viewing either a photo of an arm or spatiotemporally aligned videos of an arm being touched in synchrony with either of the two touch patterns. Continuity and pleasantness ratings of touch stimuli were higher for stroking than for tapping. Correlations between continuity and pleasantness ratings were stronger when touch was accompanied by videos of touch than by the photo of an arm. Analysis of evoked brain responses revealed visual modulation of touch processing at centroparietal electrodes beginning at around 0.9 s, with the cross-modal effects diverging between stroking and tapping at about 1.6 s. Furthermore, the interaction effects of cross-modal influences between stroking and tapping at the neural level positively correlated with the visual modulation of pleasantness ratings in two right frontal clusters at around 1.4 s and 1.8 s. These results suggest that observing touch influences the perception and processing of touch through initial sensory integration at centroparietal sites, followed by later frontal valuation processes. This extends previous findings on affective touch by demonstrating that visual inputs can cross-modally shape the hedonic evaluation of digitally actuated touch.

Prolonged esports play induces cognitive fatigue that is not fully captured by subjective awareness, motivating practical, non-stimulant nutritional strategies supported by objective physiological markers. We here tested whether acute milk protein intake attenuates fatigue-related physiological responses during prolonged esports play and supports subjective state, executive control, and in-game performance. In a randomized, single-blind (assessor-blind), energy-matched controlled crossover study, 15 healthy young adults with esports experience completed two sessions in which they consumed either a milk protein drink or an energy-matched apple juice control before a 3-h virtual soccer task. Physiological measures included pupillometry during gameplay, salivary cortisol, continuous interstitial glucose monitoring, and heart rate. Subjective ratings (VAS) and executive function (flanker task) were assessed across post-ingestion time points, and in-game performance metrics were aggregated within hourly gameplay blocks. Milk protein intake was associated with a coherent pattern of physiological advantages, including larger pupil diameter during gameplay, smoother interstitial glucose dynamics, and lower salivary cortisol, while heart rate showed time-dependent changes without a clear condition effect. These physiological changes co-occurred with higher enjoyment and lower hunger, improved flanker performance, and condition-dependent improvements in in-game performance, most notably higher shot success rate. Additionally, pupil diameter during gameplay was associated with inhibitory-control efficiency on the flanker task. These findings suggest that acute milk protein intake may serve as a practical, non-stimulant nutritional strategy to sustain physiological state and cognitive-behavioral performance during prolonged esports (virtual soccer) play. Highlights- Prolonged esports play models modern digital cognitive activity and cognitive fatigue. - Acute milk protein intake increases pupil diameter during prolonged esports play. - Interstitial glucose dynamics are smoother and salivary cortisol is lower with milk protein. - Enjoyment increases and hunger decreases during 3 h of virtual soccer play. - Executive function and in-game performance improve, most notably shot success rate.

Chronic low back pain (CLBP) is persistent and refractory, affecting 20-30% of population worldwide. Neurofeedback has been explored as a potential non-pharmacological intervention for chronic pain, although evidence in CLBP remains limited. This study evaluated PainWaive, a consumer-grade digitally-delivered neurofeedback intervention targeting multiple pain-related frequency bands recorded over the sensorimotor cortex in individuals with CLBP. In a multiple-baseline experimental design, four participants completed daily assessments of pain severity and pain interference during randomly-assigned baseline phases of 7, 10, 14, and 20 days, followed by 20 sessions of the PainWaive intervention over four weeks. Daily pain assessments continued during the post-intervention and follow-up phases. Participants rated PainWaive's usability and acceptability at post-intervention. Anxiety, depression, wellbeing, and sleep disturbance were assessed at three timepoints. Aggregated Tau-U analyses indicated a large effect (-0.67) on pain severity from baseline to intervention and very large from baseline to post-intervention (-0.92) and follow-up (-0.92) phases. Large effects (-0.63, -0.62, and -0.70) were also observed for pain interference. Individual-level analyses showed significant reductions across all participants, with visual inspection confirming progressive decreases over time. The intervention was rated usable and acceptable by all participants, while psychological outcomes were mixed and varied across participants. The findings provide promising evidence that the PainWaive neurofeedback intervention may reduce pain severity and pain interference in some individuals with CLBP. By prioritising accessibility, usability, and self-administration, PainWaive supports a foundation for more patient-centred, technology-enabled approaches to chronic pain management. Further evaluation of this approach in randomised trials is required to establish efficacy.

Neural mechanisms underlying handedness remain poorly understood. We used functional magnetic resonance imaging (fMRI) to study performance of a visually guided drawing task with each hand. We hypothesized that the left superior parietal lobule supports drawing with either hand, and individuals with chroninc peripheral nerve injury (PNI) to the dominant hand use the same mechanism as healthy adults. Methods33 right-handed adults (23 healthy, 10 patients) underwent fMRI while performing a precision drawing task, alternating between the right hand (RH) and left hand (LH). 20 regions of interest (12 a priori and 8 post-hoc) were examined for LH>RH effects on BOLD magnitude and on functional connectivity (FC) modulation via generalized psychophysiological interaction. ResultsDuring LH drawing, contralateral primary motor cortex (M1) had lower magnitude, and greater FC with two networks of equal-or-greater magnitude: left M1-dorsal premotor, and intrahemispheric parieto-temporal network. Contralateral M1 also had reduced interhemispheric FC with inferior parietal lobule, which exhibited lower magnitude. Patient group did not interact with these effects. ConclusionsThree neural mechanisms differentiate LH from RH drawing. First, a left hemisphere bimanual control network engages intrahemispherically (directly) during RH drawing and interhemispherically (indirectly) during LH drawing. Second, LH drawing increases engagement of a contralateral network that may reflect increased task demands. Third, RH drawing increases engagement of an interhemispheric tool use network. The first and third networks may explain the dominant hands performance advantages. PNI patients use the same mechanisms, highlighting their potential as a neuromodulatory target to enhance LH performance after RH impairment.

Cognitive dysfunction is increasingly recognized as an important feature of chronic pain (CP). However, subjective cognitive complaints and objectively measured cognitive performance frequently diverge. Whether and how these two aspects of cognitive functioning differentially relate to the broad symptomatology and brain function in CP remains unclear. Here, 114 individuals with CP completed patient-reported outcome measures on cognitive functioning and multidimensional CP symptoms, as well as a visuospatial working memory task, and resting-state EEG. Bayesian correlations, network analyses, and Bayesian regression models examined how subjective and objective cognitive functioning relate to multidimensional CP symptoms and EEG activity/connectivity, while controlling for age and sex. Additional models tested whether EEG associations were independent of broader symptom burden. Results indicated that subjective and objective cognitive functioning were uncorrelated. Subjective cognitive functioning was strongly associated with psychosocial symptoms, whereas objective cognitive functioning was largely independent of broader symptom burden. EEG revealed associations between subjective cognitive functioning and bilateral frontotemporal beta connectivity; however, these relationships were substantially attenuated after accounting for broader CP symptom burden. Objective cognitive functioning showed no robust associations with EEG. These findings indicate a dissociation between subjective cognitive complaints and objective cognitive performance in CP. Subjective cognitive complaints were primarily associated with psychosocial symptom burden and beta-band hypoconnectivity. In contrast, objective cognitive performance was unrelated to the broader symptomatology of CP and EEG measures. This dissociation may inform more targeted interventions, optimize the allocation of cognitive assessment resources, and ultimately improve long-term functional outcomes in CP.

Flow, as defined by Mihalyi Csikszentmihalyi (1975), is a holistic sensation experienced when individuals are fully immersed in an activity, resulting in a mental state characterized by a diminished sense of self and altered perception of time. To investigate the global neural dynamics underlying flow, we employed EEG microstate analysis to capture the spatial and temporal properties of dominant transient global brain states (Lehmann et al., 1998). In a study involving 43 participants playing the video game Thumper for 25 minutes, we extracted three four-minute EEG segments from each session corresponding to reported experiences of flow, boredom, and frustration, as determined by self-reports and performance metrics. Across conditions, six distinct microstate topographies (A-F) accounted for most of the global variance. Given that reduced self-referential processing is a key feature of flow, we hypothesized that flow would modulate the properties of microstates C and E, which have been associated with brain regions resembling the default mode network (DMN). Compared to boredom and frustration, the flow condition showed significantly decreased global explained variance, mean duration, time coverage, and occurrence frequency of microstate E, as well as reduced mean duration and time coverage of microstate C. These findings suggest that microstates associated with self-referential processing are shorter and less frequent during flow than during boredom and frustration. This supports the notion that the flow experience modulates global brain dynamics, particularly within the DMN. Furthermore, our results align with previous research reporting reduced DMN activity during meditative and psychedelic states, reinforcing the idea of diminished self-awareness in such conditions.

High-impact chronic pain (HICP), defined as persistent pain that substantially limits daily activities, affects millions of adults and poses a public health challenge. Yet relatively little is known about how HICP manifests in people's daily lives. To address this gap, this study used the comprehensive Ecological Momentary Assessment of pain (cEMAp) to assess pain-related experiences four times per day over 7 days in individuals with chronic low back pain. Based on the classification using the Graded Chronic Pain Scale-Revised, we compared individuals with HICP (n = 66) with those in the next most severe pain category, bothersome chronic pain (n = 41), defined as having similar pain frequency but less frequent interference with daily activities. On each prompt, participants completed 2-hour assessments of pain intensity, interference, catastrophizing, behaviors, coping strategies, and pain characteristics. In line with prior research, both groups reported similar pain intensity levels, but the HICP group reported more frequent interference with physical, mental, and social activities. There were no group differences in daily mood or catastrophizing. Exploratory analyses suggested that many daily experiences were similar across groups, with differences observed in selected pain qualities, coping strategies, and pain behaviors. Additional analyses of response distributions showed some similarity across groups in many experiences. Overall, although individuals with HICP on average experience higher pain interference in daily life, levels of many day-to-day experiences are similar between the two groups. Data obtained with cEMAp complement traditional retrospective assessment by providing a detailed view of chronic pain in everyday life.

Facial perception is a central feature of everyday social encounters and a rich source of emotional information. Classic functional magnetic resonance imaging (fMRI) studies of emotional facial processing used static photos emotional expression to identify regions of the brain showing univariate differences in response magnitudes between different emotional categories. However, there has been much less work identifying how the brain represents dynamic emotional facial expression and the factors that drive the similarity among these representations. In the current study, incorporated dynamic facial expression stimuli and representational similarity analysis to compare three competing hypothesized models of similarity of each of the stimuli presented: action being made, valence of the expression, and the identity of the person being perceived. Participants were shown short videos of fourteen volunteer actors making positive or negative facial expressions directed either toward or away from the camera. Activation patterns were compared against competing models on a trial-by-trial basis using a full multilevel modeling approach. Results showed that the identity of the person in the video was a greater predictor of brain responses similarity than the action or valence across widely distributed brain systems, particularly in the default mode network and lower-level visual processing regions. This suggests that the specific identity of the stimulus being perceived is a central driver of neural response similarity during perceptual encoding in dynamic facial processing.

ObjectiveAdults with knee osteoarthritis often experience movement-evoked pain (MEP), and that pain has the potential to alter gait mechanics and influence disease progression. However, the associations between MEP and gait biomechanics have only been assessed in typical lab settings. Gait mechanics differ in the lab compared to in the real-world, thus it is unknown whether these associations between pain and gait translate to real-world settings. Therefore, this study aimed to measure concurrent changes in MEP and gait mechanics across three days of typical real-world activity. DesignSeventeen participants with self-reported physician-diagnosed symptomatic knee osteoarthritis wore inertial measurement units on their more symptomatic limbs thigh and shank, as well as on both feet for three days of typical activity. Participants were sent 5 automated text messages a day and were instructed to complete a short 3-5 minute walk and self-report their MEP via a Numeric Rating Scale (0-10) during each of the walks. A random coefficients model was used to determine how gait speed, stride length, and knee and ankle range of motion was related to changes in pain intensity. ResultsThe average MEP experienced during the instructed walks was 1.4 {+/-} 1.3 with individual participant average pain intensities ranging from 0 to 4.8. Greater MEP was associated with a 2.7{degrees} decrease in knee range of motion per unit increase in pain (95% CI [-4.8 -0.5], p = 0.02). Seven of the seventeen participants never reported a pain level of 0. Speed, stride length, and ankle range of motion did not differ by pain intensity. ConclusionsIncreases in MEP were associated with decreases in knee range of motion. A 2.7{degrees} decrease in knee range of motion in response to a 1-unit change in pain is meaningful as 5{degrees} is generally considered the threshold for a meaningful difference in joint angles. With a change in pain intensity of 2 being common with daily activity, individuals may be experiencing meaningful changes in knee joint angles regularly. With gait mechanics being associated with disease progression, these daily acute fluctuations in pain may be influencing disease progression rates.

Dance is a core form of human-environment interaction and a powerful medium for emotional expression, yet dancers are routinely exposed to environmental affective cues that may shape their movement. We tested whether a negative emotional context induced immediately before improvisation alters dance biomechanics. Twenty professional dancers performed two 3-min improvised dances. Between dances, they viewed either Neutral or Negatively valenced pictures from the International Affective Picture System (IAPS; 2 min 40 s, 5 s per image). Eye tracking verified attention to the visual stream. Mood was assessed at four time points (PT1-PT4) using the Brazilian Mood Scale (BRAMS), and full-body, three-dimensional kinematics were captured at 300 Hz using a 9-camera optoelectronic system (Qualisys) and processed to measure global movement amplitude and expansion. Negative IAPS exposure increased tension, depression, fatigue, and decreased vigor from PT2 to PT3. Biomechanically, the Negative Stimulus dancers showed a significant reduction in global movement amplitude after negative IAPS exposure, with reduced movement amplitude of the body extremities. In contrast, global movement expansion remained unchanged; that is, the extremities were not positioned closer or farther from the pelvis. Neutral images produced no mood change and no measurable modulation of movement amplitude or expansion. Together, these results support the hypothesis that improvised dance carries biomechanical signatures of the dancers current affective state, beyond the intended expressive content, and provide an automated motion-capture workflow for studying emotion-movement coupling in spontaneous dance. HighlightsNegative visual context shifted dancers mood toward negative affect Negative images reduced movement amplitude in improvised dance Movement expansion remained stable despite mood induction Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=113 SRC="FIGDIR/small/711707v1_ufig1.gif" ALT="Figure 1"> View larger version (19K): org.highwire.dtl.DTLVardef@aeaacdorg.highwire.dtl.DTLVardef@14f9bf5org.highwire.dtl.DTLVardef@18805fcorg.highwire.dtl.DTLVardef@1411256_HPS_FORMAT_FIGEXP M_FIG C_FIG

Elite athletes exhibit sport-specific neural adaptations, yet it remains unclear whether such changes reflect general effects of training or the unique demands of individual sports. Skiing requires postural control and whole-body coordination under dynamically unstable environments, placing high demands on somatosensory processing and sensorimotor integration. The present study aimed to identify structural brain characteristics specific to elite skiers by comparing them with athletes from other sports disciplines and non-athletes. T1-weighted MRI data were analyzed using voxel-based morphometry in 13 skiers, 23 non-ski control athletes and 25 non-athletes. Whole-brain analysis comparing skiers with non-ski athletes revealed a significant cluster showing greater gray matter volume in skiers compared with non-ski athletes in the left postcentral gyrus, extending into the superior parietal lobule. The identified cluster primarily encompassed cytoarchitectonic Areas 2 and 5L. These regions are involved in higher-order somatosensory processing and multisensory integration. Importantly, region-of-interest analysis demonstrated that gray matter volume within this cluster was greater in skiers compared with non-ski athletes and non-athletes, with no difference between non-ski athletes and non-athletes. These findings highlight the relative prominence of structural adaptations within somatosensory-parietal networks, reflecting the unique integration of proprioceptive and other sensory information required for elite skiing. Overall, these findings provide evidence for sport-specific structural brain differences in elite athletes and highlight the importance of somatosensory and parietal regions in sensorimotor integration relevant to skiing. These findings may have implications for understanding neural markers of expertise and may inform future approaches to training and performance evaluation in skiing.

BACKGROUND: Dual task walking requires simultaneous management of cognitive and motor demands and is associated with changes in gait and cortical activation. However, the relationship between task related cortical recruitment and dual task related gait adjustments in healthy young adults remains unclear. This study aimed to investigate the effects of dual tasking on gait performance and cortical activation, and to examine the association between changes in cortical activity and dual-task costs. METHODS: This cross sectional study included 33 healthy young adults. Participants performed three conditions: single task walking, cognitive single task (verbal fluency), and dual task walking. Each condition was repeated 10 times using a repeated short block design with randomized trial presentation. Gait performance was assessed using an instrumented walkway, and cortical activation was measured using functional near infrared spectroscopy. Dual task costs were calculated for gait and cognitive outcomes. Statistical analysis included repeated measures analysis of variance (ANOVA) and Wilcoxon signed rank tests, with false discovery rate correction for multiple comparisons. Associations between changes in cortical activation and dual task costs were examined using correlation analyses. RESULTS: Dual task walking resulted in significant changes in gait, including reduced speed, step and stride length, and increased base of support, stance, and double support (all p < 0.05), while cognitive performance remained unchanged. Dual tasking was associated with increased cortical activation in left prefrontal and motor related regions. Greater increases in cortical activation were associated with lower dual task costs across most gait parameters, with significant correlations observed in the left dorsolateral prefrontal cortex (r {approx} 0.42 to 0.47 for speed and stride length; p < 0.05). Double support showed a distinct pattern, suggesting a specific temporal adjustment within the gait cycle. CONCLUSIONS: Dual task walking in young adults is associated with coordinated behavioral and cortical adaptations. Increased cortical recruitment is linked to reduced motor interference, suggesting that broader engagement of cortical networks may contribute to performance under cognitive motor load.

Biomechanics studies using traditional optical motion capture have been limited by small, homogeneous sample sizes and a focus on single movements, restricting the ability to capture clinically relevant adaptations across daily tasks. These limitations are particularly consequential in heterogeneous musculoskeletal conditions such as knee osteoarthritis (OA), where variability in demographic and clinical characteristics necessitates large, representative samples to identify patient-specific biomechanical intervention targets. Markerless motion capture enables faster, high-throughput data collection and offers the potential for community-based assessments; however, its feasibility of use in clinical populations across diverse tasks remains unclear. This study evaluated the feasibility of community-based, high-throughput markerless biomechanics data collection in individuals with knee OA. Participants (n = 85) completed a series of activities of daily living using a portable markerless motion capture system deployed across two community-based and two on-campus sites. Feasibility was assessed using timing metrics related to research operations (transit, setup, calibration, breakdown), participant workflow (consent, questionnaires, motion capture), and task-specific durations. No significant differences in timing metrics were observed across sites despite logistical and operational challenges. These findings support the feasibility of using high-throughput, community-based markerless motion capture and suggest a viable pathway for addressing long-standing limitations in sample size and representativeness through scalable data collection workflows in biomechanics studies.

The most prominent signature associated with motor execution and motor imagery is the event-related desynchronisation and synchronisation (ERD/S) in the mu and beta bands (8-30 Hz). In the context of brain-computer interfaces (BCI), this ERD/S signature is helpful for binary decisions, such as left vs. right imagery, but it is not a robust biomarker for continuous prediction, such as precisely decoding different levels of force application. This is essential for developing better BCI applications with precise dynamic force outputs. Recent studies have revealed that sensorimotor beta bursts have a stronger relationship with motor control, even at a single-trial level, than beta band power. We, therefore, investigated whether the transient nature of beta bursts provide an alternative, but robust biomarker for BCI force decoding. Here, we designed an experiment where human participants (N = 16) performed both motor execution (ME) at four force levels (10%, 25%, 50%, and 75% of maximum voluntary contraction) and imagined exerting the same, i.e. a motor imagery (MI) task, as their electroencephalogram was recorded. We observed a clear and classical ERD pattern in the motor cortex during the ME task, whereas it was less pronounced during the MI task. After extracting sensorimotor beta bursts, we observed differences in spectral burst features between motor execution and imagery including burst amplitude, spectral width, and temporal width. Moreover, different force levels were correlated with changes in the burst amplitude and burst spectral width, specifically during motor execution. Interestingly, we found that different beta burst waveforms are associated with the different force levels and conditions. This suggests that the bursts-level features could be driven by changes in the underlying beta burst waveforms. Overall, our study shows that sensorimotor beta burst can be an important piece of the puzzle to implementing precise force control in brain-computer interface-based prosthetics.

Pleasurable urge to move to music is often referred to as groove. Although previous studies have shown an association between the supplementary motor area (SMA) and the groove experience, its causal role remains unclear. Here, we investigated whether the SMA is causally involved in groove experience during music listening using repetitive transcranial magnetic stimulation. Fifteen healthy participants completed three sessions on separate days: excitatory stimulation (intermittent theta burst stimulation; iTBS) over the SMA, inhibitory stimulation (continuous theta burst stimulation; cTBS) over the SMA, and sham stimulation (iTBS or cTBS) over the vertex. After each stimulation session, participants listened to five high-groove and five low-groove musical excerpts and rated urge-to-move and pleasure on a 0-100 scale. Heart rate was additionally recorded as an exploratory physiological measure during music listening. Linear mixed-effects models (LMM) showed that pleasure ratings, but not urge-to-move ratings, were higher following both iTBS and cTBS compared with sham stimulation. In exploratory LMMs, reduced log-transformed heart rate variability (HRV) significantly predicted higher pleasure ratings. These findings suggest that SMA stimulation modulates the pleasurable component of the groove experience, likely via network-level mechanisms rather than a simple linear relationship between SMA excitability and pleasure. They also raise the possibility that reduced parasympathetic activity, reflected by lower HRV, mediates the stimulation-related increase in musical pleasure. Future studies should investigate the causal roles of other brain regions as well as clarify the directionality between autonomic changes and the groove experience.

We investigated whether multimodal sensing that combines functional near-infrared spectroscopy (fNIRS) with peripheral physiological signals can improve subject-independent classification of arousal and valence, the fundamental affective dimensions in Russells circumplex model. We developed Japanese emotion-inducing music-video stimuli (60 seconds each) and recorded subjects central nervous system activity using fNIRS, alongside peripheral physiological measures, specifically electrodermal activity (EDA) and photoplethysmography (PPG), during video viewing. To prioritize reproducibility and methodological transparency, we extracted simple, easily computed features from each modality and performed binary (high vs. low) classification separately for arousal and valence using a support vector machine. The combination of fNIRS and EDA yielded the highest performance, with a macro-averaged F1 score of 0.73 for arousal and 0.64 for valence. These findings underscore the utility of integrating fNIRS with peripheral physiological signals for subject-independent emotion classification.

Chronic pelvic pain (CPP) affects up to 26% of women worldwide. While its pathophysiology is poorly understood, disturbances in body perception have been identified in various similar chronic musculoskeletal disorders. The Fremantle Perineal Awareness Questionnaire (FrePAQ) is a novel tool designed to specifically assess disturbed body perception in the pelvic region, but its structural validity and reliability require formal evaluation. Methods: Patient partners with lived experience contributed to study design. Participants with (n=417 and without (n=277) chronic pelvic pain completed the FrePAQ at baseline, as well as one week later. We assessed the validity and reliability of the FrePAQ following COSMIN guidelines for Classical Test Theory. Results: The validated FrePAQ comprises a two factor model, with a six item Distress & Disconnection (D&D) subscale and a two item Size & Shape (S&S) subscale. Confirmatory analysis showed excellent fit (CFI = .988; RMSEA = .048) and measurement invariance between diagnostic groups. Internal consistency was high (cronbach alpha = .838 CPP, .819 controls). Test retest reliability was high for D&D (ICC = .863) and acceptable for S&S (ICC = .695). FrePAQ scores showed a weak to moderate correlation with pain scores (r = .234 to .255), psychological distress (r = .226 to .443), and functional impact (r = .172 to .295), particularly for the D&D subscale. Conclusion: The FrePAQ is a reliable and valid instrument to measure perineal perceptual disturbances in CPP. Future research will evaluate the tools potential to support phenotyping and guide individualised interventions. Improved understanding of body perception disturbance in CPP can enhance diagnosis and treatment precision.