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BACKGROUND: Several studies have continuously investigated FFRs using binaural beat (BB) stimulations and their related effects. However, only a few studies have investigated the differences in BB stimulation effects according to basic demographic characteristics, such as gender and age. OBJECTIVE: This study aimed to determine the alpha wave activity after a 10-Hz BB stimulation and subsequently identify differences according to gender across all brain areas (frontal, central, parietal, temporal, and occipital areas). METHODS: A total of 23 healthy adults (11 male and 12 female), aged 20–29, participated in the study. For the 10-Hz BB stimulation, pure tone auditory stimuli of 250 and 260 Hz were given to the left and right ear, respectively. Through a power spectrum analysis of the phase-excluding BBs (non-BBs) and phase-including 10-Hz BBs (α-BBs), the alpha power at each brain area was estimated. These values were compared using a mixed-design ANOVA. RESULTS: With the exception of the temporal area, all other brain areas showed a significant increase in alpha power for α-BBs compared to those of non-BBs. However, the difference according to gender was not significant. CONCLUSION: The results indicated the lack of gender effects in alpha wave generation through a 10-Hz BB stimulation.

Background Binaural beats (BB) are a form of auditory beat stimulation that produces sounds and can induce a specific state of brain wave based on the difference in the frequency of auditory stimulation. This study aimed at investigating the effects of inaudible BB on visuospatial memory at 18,000 Hz reference and 10 Hz difference frequencies. Methods Eighteen adult subjects in their twenties were enrolled, including 12 males (mean age: 23.8 ± 1.2) and six females (mean age: 22.8 ± 0.8). An auditory stimulator that could provide 10 Hz BB stimulation via 18,000 Hz to the left and 18,010 Hz to the right ears was used. The experiment consisted of two 5-minute phases, the rest and task phases. The task phase involved two conditions: task performance without BB stimulation (Task-only) and with BB stimulation (Task + BB). A 3-back task was used to measure visuospatial memory. Throughout the experiment, brain waves were measured at a 500 Hz sampling rate. Cognitive ability as measured by task performance (accuracy and reaction time) with and without BB, as well as variations in alpha power across different brain domains were compared using paired t-tests. Results The results show that, compared to the Task-only condition, the Task + BB condition had significantly higher accuracy and significantly shorter reaction time. The electroencephalogram (EEG) analysis showed that a reduction level in alpha power for the task performance under the Task + BB condition was significantly lower in all brain areas except the frontal, compared to that under the Task-only condition. Conclusion The significance of this study lies in having verified the independent effects of BB stimulation without any auditory influence, based on visuospatial memory.

Sonogenetics refers to the use of genetically encoded, ultrasound-responsive mediators for noninvasive and selective control of neural activity. It is a promising tool for studying neural circuits. However, due to its infancy, basic studies and developments are still underway, including gauging key in vivo performance metrics such as spatiotemporal resolution, selectivity, specificity, and safety. In this paper, we summarize recent findings on sonogenetics to highlight technical hurdles that have been cleared, challenges that remain, and future directions for optimization.

BACKGROUND: A system that comprehensively analyzes a complex perceptual-motor behavior such as driving, by measuring changes in the central and autonomic nervous systems integrated with measurement of changes in vehicle operation, is lacking. OBJECTIVE: We aimed to develop a functional magnetic resonance imaging (fMRI)-compatible driving simulator to enable simultaneous measurement of physiological, kinematic, and brain activations. METHODS: The system mainly comprises a driving simulator and physiological/kinematic measurement. The driving simulator comprises a steering wheel, an accelerator, a brake pedal, and a virtual-reality optical system. The physiological system comprises a skin-conductance-level and a photoplethysmographic meter. The kinematic system comprises a 3-axis accelerometer and a 2-axis gyroscope attached to the accelerator foot. To evaluate the influence of the MR system on the MMSD, physiological and kinematic signals were measured. RESULTS: The system did not blur or deform the MR image. Moreover, the main magnetic field, the gradient magnetic field, and the RF pulse of the MR system did not introduce noise into the physiological or kinematic signals. CONCLUSION: This system can enable a comprehensive evaluation of cognitively complex behaviors such as driving, by quantitatively measuring and analyzing concurrent brain activity, autonomic nervous system activity, and human movement during simulated driving.

Malnutrition is common, morbid, and often correctable, but subject to missed and delayed diagnosis. Better screening and prediction could improve clinical, functional, and economic outcomes. This study aimed to assess the predictability of malnutrition from longitudinal patient records, and the external generalizability of a predictive model. Predictive models were developed and validated on statewide emergency department (ED) and hospital admission databases for California, Florida and New York, including visits from October 1, 2015 to December 31, 2018. Visit features included patient demographics, diagnosis codes, and procedure categories. Models included long short-term memory (LSTM) recurrent neural networks trained on longitudinal trajectories, and gradient-boosted tree and logistic regression models trained on cross-sectional patient data. The dataset used for model training and internal validation (California and Florida) included 62,811 patient trajectories (266,951 visits). Test sets included 63,997 (California), 63,112 (Florida), and 62,472 (New York) trajectories, such that each cohort’s composition was proportional to the prevalence of malnutrition in that state. Trajectories contained seven patient characteristics and up to 2,008 diagnosis categories. Area under the receiver-operating characteristic (AUROC) and precision-recall curves (AUPRC) were used to characterize prediction of first malnutrition diagnoses in the test sets. Data analysis was performed from September 2020 to May 2021. Between 4.0% (New York) and 6.2% (California) of patients received malnutrition diagnoses. The longitudinal LSTM model produced the most accurate predictions of malnutrition, with comparable predictive performance in California (AUROC 0.854, AUPRC 0.258), Florida (AUROC 0.869, AUPRC 0.234), and New York (AUROC 0.869, AUPRC 0.190). Deep learning models can reliably predict malnutrition from existing longitudinal patient records, with better predictive performance and lower data-collection requirements than existing instruments. This approach may facilitate early nutritional intervention via automated screening at the point of care.

Ewing’s sarcoma (EWS) is a bone cancer arising predominantly in young children. EWSR1 (Ewing Sarcoma breakpoint region 1/EWS RNA binding protein 1) gene is ubiquitously expressed in most cell types, indicating it has diverse roles in various cellular processes and organ development. Recently, several studies have shown that missense mutations of EWSR1 genes are known to be associated with central nervous system disorders such as amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). Otherwise, EWSR1 plays epigenetic roles in gene expression, RNA processing, and cellular signal transduction. Interestingly, EWSR1 controls micro RNA (miRNA) levels via Drosha, leading to autophagy dysfunction and impaired dermal development. Ewsr1 deficiency also leads to premature senescence of blood cells and gamete cells with a high rate of apoptosis due to the abnormal meiosis. Despite these roles of EWSR1 in various cellular functions, the exact mechanisms are not yet understood. In this context, the current review overviews a large body of evidence and discusses on what EWSR1 genetic mutations are associated with brain diseases and on how EWSR1 modulates cellular function via the epigenetic pathway. This will provide a better understanding of bona fide roles of EWSR1 in aging and its association with brain disorders.

This study aimed to determine the level of brain activation in separate regions, including the lobes, cerebellum, and limbic system, depending on the weight of an object during elbow flexion and extension exercise using functional magnetic resonance imaging (fMRI). The study was conducted on ten male undergraduates (22.4 ± 1.2 years). The functional images of the brain were obtained using the 3T MRI. The participants performed upper limb flexion and extension exercise at a constant speed and as the weight of the object for lifting was varied (0 g and 1000 g). The experiment consisted of four blocks that constituted 8 minutes. Each block was designed to comprise a rest phase (1 minute) and a lifting phase (1 minute). The results showed that, in the parietal lobe, the activation was higher for the 0 g-motion condition than for the 1000 g-motion condition; however, in the occipital lobe, cerebellum, sub-lobar, and limbic system, the activation was higher for the 1000 g-motion condition than for the 0 g-motion condition. The brain region for the perception of object weight was identified as the ventral area (occipital, temporal, and frontal lobe), and the activation of the ventral pathway is suggested to have increased as the object came into vision and as its shape, size, and weight were perceived. For holding an object in hand, compared to not holding it, the exercise load was greater for controlling the motion to maintain the posture (arm angle at 90°), controlling the speed to repeat the motion at a constant speed, and producing an accurate posing. Therefore, to maintain such varied conditions, the activation level increased in the regions associated with control and regulation through the motion coordination from vision to arm movements (control of muscles). A characteristic reduced activation was observed in the regions associated with visuo-vestibular interaction and voluntary movement when the exercise involved lifting a 1000-g object compared to the exercise without object lifting.

A non-contact tactile stimulation system using a time-varying magnetic field was developed. The system comprises a control unit, power unit, output unit, and actuator. The control unit adjusts stimulation parameters, particularly the signal intensity and frequency. The power unit produces high voltages for generating the magnetic field, whereas the output unit transmits the energy generated according to the signal from the control unit to the actuator. A spiral coil actuator generates the magnetic field. To validate the effectiveness of the system, preliminary experiments on 10 male adults without neurological disorders (23.2 ± 3.05 years) were conducted. Magnetic field stimuli were presented to the right palm of the subjects at three different frequencies (10, 30, and 50 Hz), and corresponding electroencephalogram (EEG) signals were measured simultaneously. Event-related potential (ERP) analysis showed that N100 and P300 components were identified in somatosensory areas. Subjective evaluations revealed that feelings such as “tingling,” “trembling,” “tapping,” and “percussing” were induced. Moreover, as the stimulus frequency changes, differences may occur in induced feeling. The system uses a time-varying magnetic field, which not only induces tactile stimulation without contact but also has trans-object characteristics that can present tactile sensations, even when there is an obstacle between an actuator and skin.

This study aimed to compare the cognitive performance and event-related potential (ERP) patterns between females who have given birth (parous) and those who have not (nulliparous). A total of 50 female participants, including 27 who were parous (33.2 ± 3.2 years) and 23 who were nulliparous (30.8 ± 2.3 years), were recruited. Only parous females who were ≤36 months postpartum (17.7 ± 8.1 months) were included. To compare the cognitive performance between the two groups, we presented the 3-back task (a working memory task) and compared the accuracy rate (%) and reaction time (ms) between the groups. Electroencephalogram (EEG) signals were simultaneously recorded and the ERP patterns at Fz, Cz, and Pz, which are highly associated with the 3-back task, were analyzed. From the ERP patterns, we extracted N100, P300, P600, P300 peak-to-peak (P300p_p), and P600 peak-to-peak (P600p_p). There were no significant between-group differences in terms of accuracy rate, reaction time, or ERP components (N100, P300, P600, P300p_p, or P600p_p) at the three sites (Fz, Cz, and Pz). Since this study, using meaningful objective data, did not show that parity was significantly correlated with cognitive performance ability and ERP patterns, childbirth does not appear to influence cognitive decline.

In this study, we attempted to observe changes in cognitive characteristics according to 3 intensity changes (Level 1: 0.25 gravity, Level 2: 0.38 gravity, Level 3: 1.3 gravity) at 8 vibration frequencies (10, 50, 100, 150, 200, 225, 250, 300 Hz). The subjects were twelve male (22.1 ± 0.6 years old) and twelve female (21.5 ± 0.8 years old) healthy, right-handed adults with normal cognitive abilities. An experimental trial consisted of a stimulation phase (0.1 sec) in which a vibration stimulus was presented and a rest phase (6 sec) in which no vibration stimulus was presented. A selected stimulus was presented on the first knuckle of the right index finger 5 times (trials). Cognitive characteristics scores according to changes in intensity at each frequency were sampled using a subjective assessment sheet consisting of eighteen items (“ticklish,” “shivery,” “push,” “convex,” “thick,” “numb,” “slow,” “fast,” “shallow,” “strike,” “weak,” “strong,” “dense,” “blunt,” “heavy,” “light,” “stab”, “no stimulus”). To identify the cognitive characteristics according to intensity changes by frequency, the 3 intensities were designated as variables, and a curve estimation regression analysis was performed. At 10 Hz, cognitive characteristics of ’blunt’ increased with the intensity, and ’weak’ decreased. In 100 and 225 Hz, increase or decrease in intensity led to opposite cognitive characteristics (‘weak-strong’ in 100 and 225 Hz, ‘light-heavy’ in 225 Hz). In 100 and 225 Hz, as the intensity increased, expressions on the sense of surface such as ’blunt’ were superior, and the shape of an object (thick) and dynamics (push) differed with the change in intensity. In addition, in 225 Hz, decrease in intensity led to increase in cognitive characteristics such as ’light’ and 'shallow. ’Fast’ was unique in that it only appeared as the intensity increased at 300 Hz.

This study aimed to determine the effects of the binaural beat (BB) on brainwave induction using an inaudible baseline frequency outside the audible frequency range. Experiments were conducted on 18 subjects (11 males [mean age: 25.7 ± 1.6 years] and 7 females [mean age: 24.0 ± 0.6 years]). A BB stimulation of 10 Hz was exerted by presenting frequencies of 18,000 Hz and 18,010 Hz to the left and right ears, respectively. A power spectrum analysis was performed to estimate the mean of the absolute power of the alpha frequency range (8-13 Hz). The variation in the mean alpha power during the rest and stimulation phases in each brain area was compared using the Wilcoxon signed-rank test. Compared to the rest phase, the stimulation phase with BB showed an increasing trend in the mean alpha power across all 5 brain areas. Notably, a significant increase was found in the frontal, central, and temporal areas. This is a significant study in that it determines the effects of only BB without the influence of auditory perception, which has been overlooked in previous studies.

BACKGROUND: Variations or malformation of the internal carotid artery (ICA) and basilar artery (BA) can be risk factors during simple surgery. So medically the focus has been on information about the positional relationship between the blood vessels based on the distance and angle between the ICA and BA. OBJECTIVE: This study measured the distance and angle between the ICA and BA in 188 healthy Korean male and female subjects in their 20s and 40s and analyzed the differences in terms of age and gender. METHODS: Magnetic resonance images were obtained; the distance between the right ICA and BA was defined as R1 [cm], the distance between the left ICA and BA was defined as L2 [cm], and the distance between the right ICA and left ICA was defined as M3 [cm]. The angles between the right and left ICA and BA were defined as AR1 [degree] and AR2 [degree], respectively. RESULTS: With increasing age, R1 and M3 became shorter in both men and women, and L2 became shorter only in women. CONCLUSION: The results of this study provide data on the average distance and angle between the ICA and BA of healthy Korean men and women in their 20s and 40s, which may later be used to support the diagnosis of relevant brain diseases and simple routine surgical procedures.

The melanocortin-4 receptor (MC4R) belongs to the G protein-coupled receptor (GPCR) family and plays an essential role in the control of energy homeostasis. Here, we identified a novel MC4R-interacting protein, glucose-regulated protein 78 (GRP78), from a pulldown assay using hypothalamic protein extracts and the third intracellular loop of MC4R. We found that MC4R interacted with GRP78 in both the cytosol and at the cell surface and that this interaction increased when MC4R was internalized in the presence of the agonist melanotan-II (MTII). Downregulation of GRP78 using a short interfering RNA approach attenuated MTII-mediated receptor internalization. Reduction in GRP78 expression during tunicamycin-induced endoplasmic reticulum stress also suppressed MTII-mediated internalization of MC4R and cAMP-mediated transcriptional activity. Furthermore, lentiviral-mediated short hairpin RNA knockdown of endogenous GRP78 in the paraventricular nucleus (PVN) of the hypothalamus resulted in an increase in body weight in mice fed a high-fat diet. These results suggest that GRP78 in the PVN binds to MC4R and may have a chaperone-like role in the regulation of MC4R trafficking and signaling.

Misfolded polypeptides are rapidly cleared from cells via the ubiquitin–proteasome system (UPS). However, when the UPS is impaired, misfolded polypeptides form small cytoplasmic aggregates, which are sequestered into an aggresome and ultimately degraded by aggrephagy. Despite the relevance of the aggresome to neurodegenerative proteinopathies, the molecular mechanisms underlying aggresome formation remain unclear. Here we show that the CTIF–eEF1A1–DCTN1 (CED) complex functions in the surveillance of either pre-existing or newly synthesized polypeptides by linking two molecular events: selective recognition and aggresomal targeting of misfolded polypeptides. These events are accompanied by CTIF sequestration into the aggresome, preventing the additional synthesis of misfolded polypeptides from mRNAs bound by nuclear cap-binding complex. These events render cells more resistant to apoptosis induced by proteotoxic stresses. Collectively, our data provide compelling evidence for a previously unappreciated protein surveillance pathway and a regulatory gene expression network for coping with misfolded polypeptides.

This study aims to use functional magnetic resonance imaging (fMRI) to assess the effective connectivity between the regions of the brain activated when driving and performing a secondary task (addition task). The subjects used an MR-compatible driving simulator ㅊ to manipulate the driving wheel with both hands and control the pedals (accelerator and brake) with their right foot as if they were driving in an actual environment. Effective connectivity analysis was performed for three regions of the right and the left hemispheres with the highest z-scores, and six of the regions of the entire brain (right and left hemisphere) activated during driving by dynamic causal modeling (DCM). In the right hemisphere, a motor control pathway related to movement control for driving performance was discovered, in the left hemisphere, the pathways in the regions related to movement control for driving performance, starting with the region associated with the secondary task, were discovered. In the whole brain, connectivity was discovered in each of the right and left hemispheres. The motor network of declarative memory, which is the connectivity of the right thalamus, left lingual gyrus, and right precentral gyrus, was worth noting. These results seem meaningful, as they demonstrate the connectivity associated with the control of voluntary movement related to memory from human experience, although limited to driving tasks.

[Purpose] Stroke survivors exhibit abnormal pelvic motion and significantly deteriorated gait performance. Although the gait of stroke survivors has been evaluated at the primary level pertaining to ankle, knee, and hip motions, secondary deviations involving the pelvic motions are strongly related to the primary level. Therefore, the aim of this study was to identify the kinematic differences of the primary and secondary joints and to identify mechanism differences that alter the gait performance of stroke survivors. [Subjects and Methods] Five healthy subjects and five stroke survivors were recruited. All the subjects were instructed to walk at a self-selected speed. The joint kinematics and gait parameters were calculated. [Results] For the stroke survivors, the range of motion of the primary-joint motions were significantly reduced, and the secondary-joint motions were significantly increased. Additionally, for the healthy subjects, the primary joint kinematics were the main factors ensuring gait performance, whereas for the stoke survivors, the secondary-joint motions were the main factors. [Conclusion] The results indicate that while increasing the range of motion of primary-joint movements is the main target to achieve, there is a strong need to constrain and support pelvic motions in order to improve the outcome of gait rehabilitation.

In this study, we measured neuronal activation in the primary somatosensory area (S1) and Brodmann area 3 (BA3) using 3T functional magnetic resonance imaging (fMRI) while presenting a 250-Hz high-frequency vibrational stimulus to each of three phalanges (distal, intermediate, and proximal) of four fingers of the right hand (index, middle, ring, and little). We compared the nerve activation area between each finger and each phalange. Ten healthy male college students (26.6 &plusmn, 2.5 years old) participated in this study. One session consisted of three blocks: a rest (30 s), stimulation (30 s), and response phase (9 s). In the rest phase, the vibrational stimulus was not presented. In the stimulation phase, the vibrational stimulation was presented at any one of the three phalanges of the selected finger. In the response phase, subjects were instructed to press a button corresponding to the phalange that they thought had received the vibration. The subtraction method was used to extract the activation area. The activation area in the S1 was the largest when the little finger was stimulated (for the finger comparison), and largest when the second phalange was stimulated (for the phalange comparison). The BA3 showed similar trends, and there was no statistically significant difference.

The goal of this study was to develop a wearable olfactory augmentation device (Fig. 1) that provides an intuitive and objective delivery of complex olfactory information via haptic feedback, in the form of cutaneous vibrotactile stimuli, in order to enhance environmental awareness of odor signals. The hypothesis is that displaying olfactory information through the skin enables intuitive and prompt identification of potentially hazardous chemicals and odors before they pose actual threats to the human body. In this work, an olfactory augmentation prototype is designed and manufactured, and experiments are conducted to assess the performance of device components and to improve the functionality of the device.

Dopaminergic systems play a major role in reward-related behavior and dysregulation of dopamine (DA) systems can cause several mental disorders, including depression. We previously reported that dopamine D2 receptor knockout (D2R

The purpose of this study was to examine the actual state of injuries experience and safety accident prevention in dental hygienists. This study surveyed the actual state of injuries experience caused by apparatus and materials through a self-administered survey of 366 dental hygienists. Statistical analysis was performed using PASW Statistics 18.0. Frequency, chi-square test, t-test, one-way ANOVA were applied in this analysis. The results were as follows: Out of the 307 subjects (83.9%) experienced injuries in the last 6 months, and 294 subjects (80.3%) chose the stab as the most frequent type of injuries experience and it was followed by incised wound, scratch and burn. In relation to the differences in injuries experience depending on general characteristics, there were significant differences depending on the age, career, position, dental treatment (p< 0.001) and the education (p

Dopaminergic systems play a major role in reward-related behavior and dysregulation of dopamine (DA) systems can cause several mental disorders, including depression. We previously reported that dopamine D2 receptor knockout (D2R−/−) mice display increased anxiety and depression-like behaviors upon chronic stress. Here, we observed that chronic stress caused myelin loss in wild-type (WT) mice, while the myelin level in D2R−/− mice, which was already lower than that in WT mice, was not affected upon stress. Fewer mature oligodendrocytes (OLs) were observed in the corpus callosum of stressed WT mice, while in D2R−/− mice, both the control and stressed group displayed a decrease in the number of mature OLs. We observed a decrease in the number of active β-catenin (ABC)-expressing and TCF4-expressing cells among OL lineage cells in the corpus callosum of stressed WT mice, while such regulation was not found in D2R−/− mice. Administration of lithium normalized the behavioral impairments and myelin damage induced by chronic stress in WT mice, and restored the number of ABC-positive and TCF4-positive OLs, while such effect was not found in D2R−/− mice. Together, our findings indicate that chronic stress induces myelin loss through the Wnt/β-catenin signaling pathway in association with DA signaling through D2R.

The purpose of this study was to determine the levels of trace metals in the blood of the general Korean population. A total of 258 healthy individuals, according to their regular medical check-ups, (119 males and 139 females, age ranging from 12 to 78 years old) were enrolled from December 2014 to December 2016. Levels of 10 trace elements were determined using inductively coupled plasma mass spectrometry (ICP-MS). The geometric mean (GM) levels for lead, arsenic, cesium, mercury, aluminum, cadmium, copper, manganese, selenium, and zinc were 15.97 μg/L, 7.19 μg/L, 2.39 μg/L, 3.41 μg/L, 10.57 μg/L, 0.78 μg/L, 979.8 μg/L, 11.06 μg/L, 111.37 μg/L, and 872.7 μg/L, respectively. There were significant gender-related differences in the levels of several metals; male individuals had higher Pb, As, Cs, Hg, and Se than females, while females had higher Cd, Cu, and Mn than males. We noticed remarkably high blood levels of Hg, As and Al in the Korean population. The element concentrations reported represent a new contribution to the knowledge of the blood chemistry for the Korea population. The data can be used to assess the clinical health of this population.

In this study, we developed a tactile stimulator capable of administering either puff- or suction-type stimuli. The system is composed of three parts: a control unit, an air-handling unit, and a stimulation unit. The control unit controls the type, intensity, and time of stimulation. The air-handling unit delivers the stimulation power quantitatively to the stimulation unit, as commanded by the control unit. The stimulation unit stably administers either type of pressure to the skin, without any change of the tactor. Although the design of the stimulator is simple, it allows for five levels of control of the stimulation intensity (2-6 psi) and 0.1-s steps of control of the stimulation time, as we confirmed by tests. Preliminary electroencephalographic and event-related potential (ERP) studies of our system in humans confirmed the presence of N100 and P300 waves at standard electrode position C3, which are related to perception and cognition, respectively, in the somatosensory area of the brain. In addition, different stimulation types (puff and suction) and intensities (2 and 6 psi) were reflected in different peak-to-peak amplitudes and slopes of the mean ERP signal. The system developed in this study is expected to contribute to human tactile studies by providing the ability to administer puff- or suction-type stimuli interchangeably.

Background Several studies have used functional magnetic resonance imaging (fMRI) to show that neural activity is associated with driving. fMRI studies have also elucidated the brain responses associated with driving while performing sub-tasks. It is important to note that these studies used computer mouses, trackballs, or joysticks to simulate driving and, thus, were not comparable to real driving situations. In order to overcome these limitations, we used a driving wheel and pedal equipped with an MR-compatible driving simulator (80 km/h). The subjects drove while performing sub-tasks, and we attempted to observe differences in neuronal activation. Methods The experiments consisted of three blocks and each block consisted of both a control phase (1 min) and a driving phase (2 min). During the control phase, the drivers were instructed to look at the stop screen and to not perform driving tasks. During the driving phase, the drivers either drove (driving only condition) or drove while performing an additional sub-task (driving with sub-task condition) at 80 km/h. Results Compared to when the drivers were focused only on driving, when the drivers drove while performing a sub-task, the number of activation voxels greatly decreased in the parietal area, which is responsible for spatial perception. Task-performing areas, such as the inferior frontal gyrus and the superior temporal gyrus, showed increased activation. Performing a sub-task simultaneously while driving had affected the driver’s driving. The cingulate gyrus and the sub-lobar region (lentiform nucleus, caudate, insula, and thalamus), which are responsible for error monitoring and control of unnecessary movements (e.g., wheel and pedal movements), showed increased activation during driving with sub-task condition compared to driving only condition. Conclusions Unlike simple driving simulators (joysticks, computer mouses, or trackballs) used in previous research, the addition of a driving wheel and pedals (accelerator and brake) to the driving simulator used in this study closely represents real driving. Thus, the number of processed movements was increased, which led to an increased number of unnecessary movements that needed to be controlled. This in turn increased activation in the corresponding brain regions.