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Isao Mizukura

Publications and source records attributed to Isao Mizukura.

3 recordsLinked to original sources

Intralimb incoordination in patients with ataxia.

Intralimb incoordination needs to be distinguished from interlimb incoordination, which is observed in Parkinson's disease (PD). With this aim, intra and inter-limb coordination impairment in the lower limbs were measured in 13 patients with cerebellar ataxia during pedaling of an ergometer with left and right pedals that can be rotated independently. Intralimb incoordination in patients with cerebellar ataxia was compared with interlimb incoordiation in patients with PD. We concluded that impairment of intralimb coordination in ataxia patients leads to inability to maintain pedaling amplitude and speed, but unlike in PD, right and left coordination was roughly preserved. Our method may be useful for assessing the severity of ataxia and detecting hidden parkinsonism in ataxic patients.

Adult↗

Classifying lower limb dynamics in Parkinson's disease.

To classify lower limb dynamics in patients with Parkinson's disease (PD), we conducted a clinical study by using pedaling exercise.Twenty-seven patients with idiopathic PD were included in this study. We measured rotational velocities of pedals during pedaling movements with a newly developed ergometer. The velocity waveforms exhibited different characteristics among patients, which could be categorized into four different clusters. In cluster 1, the amplitude on each side was constant and the relative phase was locked at 180 degrees. The pattern was the same as seen in normal subjects. In cluster 2, the amplitude on each side was constant, but the relative phase was locked at 90 degrees. In cluster 3, the amplitude on each side was modulated, and the relative phase drifted monotonously from 0 to 360 degrees during pedaling cycles. In cluster 4, the amplitude on each side was synchronously and irregularly modulated, and the relative phase fluctuated with intermittent spike-like decrement. In order to evaluate, the correlation between pattern and severity of PD, we divided 13 patients, who underwent measurement of pedaling patterns more than three times, into three groups, and found that the abnormal coordination pattern correlated with the presence of freezing phenomenon in patients with PD. Our clinical analysis may contribute in analyzing and classifying the dynamics of PD.

Adult↗

A coupled oscillator model of disordered interlimb coordination in patients with Parkinson's disease.

Coordination between the left and right limbs during cyclic movements, which can be characterized by the amplitude of each limb's oscillatory movement and relative phase, is impaired in patients with Parkinson's disease (PD). A pedaling exercise on an ergometer in a recent clinical study revealed several types of coordination disorder in PD patients. These include an irregular and burst-like amplitude modulation with intermittent changes in its relative phase, a typical sign of chaotic behavior in nonlinear dynamical systems. This clinical observation leads us to hypothesize that emergence of the rhythmic motor behaviors might be concerned with nonlinearity of an underlying dynamical system. In order to gain insight into this hypothesis, we consider a simple hard-wired central pattern generator model consisting of two identical oscillators connected by reciprocal inhibition. In the model, each oscillator acts as a neural half-center controlling movement of a single limb, either left or right, and receives a control input modeling a flow of descending signals from higher motor centers. When these two control inputs are tonic-constant and identical, the model has left-right symmetry and basically exhibits ordered coordination with an alternating periodic oscillation. We show that, depending on the intensities of these two control inputs and on the difference between them that introduces asymmetry into the model, the model can reproduce several behaviors observed in the clinical study. Bifurcation analysis of the model clarifies two possible mechanisms for the generation of disordered coordination in the model: one is the spontaneous symmetry-breaking bifurcation in the model with the left-right symmetry. The other is related to the degree of asymmetry reflecting the difference between the two control inputs. Finally, clinical implications by the model's dynamics are briefly discussed.

Ataxia↗