PubMed HealthSearch

Biomedical subjects

P Clouston

Publications and source records attributed to P Clouston.

10 recordsLinked to original sources

Late components of the event-related potentials and their topography in Parkinson's disease.

Late components of the event-related potential (ERP; N100, P200, N200, and P300) were elicited using an auditory oddball paradigm (with a button-press response to target stimuli) in 15 Parkinson's disease (PD) patients and 50 normal control subjects. Compared with control subjects, PD subjects showed a significant decrease in N200 amplitude. Between-group topographical differences in N200 amplitude were evident at central (C3, Cz, C4) and temporal (T5, T3, T4, T6) regions. The results may reflect a deficit in response selection in PD possibly resulting from a dysfunction associated with the abnormalities in the central and temporal regions found to have a decreased N200 amplitude compared with normal control subjects in this study.

Acoustic Stimulation

Dysfunctions of automatic (P300a) and controlled (P300b) processing in Parkinson's disease.

P300 Event Related Potentials components (P300a and P300b) were investigated using an auditory oddball paradigm (with a button press response to target stimuli) in 15 Parkinson's disease patients and 50 normal controls whilst simultaneously measuring electrodermal activity. Cluster analysis showed that the first 10 target stimuli generated the largest skin conductance responses. The first 10 single-trial ERP epochs were therefore analysed as an ERP sub-average for each individual. The P300a component (associated with the automatic 'Orienting Reflex') was expected to be most prevalent in this sub-average (compared with sub-averages of subsequent blocks of 10 target stimuli). Twenty-nine out of 50 normal controls (58%) elicited a P300a in the first 10 target sub-average, compared with only 2 out of 15 Parkinson's disease subjects (13%). The conventional P300b component (associated with controlled processing) was found to be significantly delayed for all sub-averages for the Parkinson's disease group when compared with controls. These preliminary findings suggest a possible dysfunction in both automatic and controlled processing in this disorder.

Adult

Automatic processing dysfunction in Parkinson's disease.

Simultaneous measures of Event Related Potentials (ERP) and electrodermal activity (EDA) allow the delineation of ERPs that did, and did not, evoke an electrodermal 'Orienting Reflex' (OR). The OR is an automatic reflex invoked by novel or significant stimuli. Our group have developed a model to quantify electrodermal OR activity acquired in conventional late component ERP paradigms with short interstimulus intervals. Target late component (N100, P200, N200, P300) ERPs (acquired in an auditory oddball paradigm) and EDA was examined in 15 Parkinson's disease (PD) subjects and 50 normal controls. Single-trial target ERPs were averaged according to whether or not they elicited an electrodermal OR. Compared with controls, the PD group showed significantly decreased N100 and N200 amplitudes in the OR related ERPs ('Orienting ERPs'). These preliminary findings suggest that conventional late component ERPs can be delineated according to whether or not they evoked an OR. The 'orienting ERPs' in PD showed more significant disturbances compared with controls, than ERPs that did not evoke an OR.

Acoustic Stimulation

Assessment of cortical motor output: compound muscle action potential versus twitch force recording.

To determine whether motor evoked potential (MEP) amplitude and area are accurate measurements of the magnitude of response to magnetic cortical stimulation, we simultaneously recorded the twitch and MEP in the first dorsal interosseous muscle of 8 normal subjects. Consecutive stimuli were delivered at increasing stimulus intensities (SI) or with increasing levels of background voluntary muscle contraction (BVC). There was stimulus to stimulus variability in MEP amplitude, area and twitch force. At low SI and at low levels of background contraction, there was a good correlation between twitch amplitude and MEP amplitude and area (r = 0.6-0.96, P < 0.005). Increasing either variable caused the correlation to decrease significantly (r = 0.02-0.31, P > 0.01). With increasing SI, MEP amplitude and area plateaued but twitch force continued to increase. A similar pattern was observed with higher levels of background muscle contraction although in some subjects a second increase in MEP amplitude and area was seen. Collision experiments demonstrated that the amplitude of the EMG activity resulting from repetitive motoneuron firing increased as SI was increased. This is due to multiple descending volleys which result in repetitive firing of some spinal motoneurons. Rapid, repetitive firing of some motor units is likely to result in phase cancellation and, therefore, the MEP amplitude, and to a lesser extent area, do not accurately reflect the net motor output.

Action Potentials

Crossed inhibition in the human motor system.

We used transcranial magnetic stimulation in humans to investigate the effect of focal unilateral stimulation of the motor cortex on the function of the contralateral motor cortex. Surface-recorded, rectified, averaged electromyography (EMG) showed relative silent periods in small hand muscles at 35-64 and 123-158 ms following ipsilateral cortical stimulation over the hand area. The first inhibitory phase started 11 ms after the minimum corticospinal conduction time from the contralateral cortex, appropriate for transcallosal conduction. Foot muscles (with focal stimulation over the ipsilateral hand area) also showed silent periods at 61-104 ms, indicating a marked spread of the inhibitory effect throughout the opposite motor cortex. H-reflex studies in the upper limb showed that this inhibitory effect was not mediated at the level of the alpha motoneuron. Single motor unit peristimulus time histogram studies in upper limb muscles showed inhibition similar to that seen in the surface recordings and no evidence of excitation following ipsilateral motor cortex stimulation. Transcranial magnetic stimulation performed with large circular coils centered at the vertex activates both excitatory and inhibitory processes bilaterally so that focal unilateral stimulation is preferable in detailed studies of motor system physiology.

Adult

Quantitative studies of F responses in Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy.

We examined F wave mean and minimum latency, mean and maximum amplitude, duration, persistence and chronodispersion in 241 nerves from 78 patients with Guillain-Barré syndrome (GBS) and 162 nerves from 43 patients with chronic inflammatory demyelinating polyneuropathy (CIDP). Results were compared with normal criteria derived from 72 median, 73 ulnar and 73 tibial control nerves, to determine the relative diagnostic sensitivity of the various F wave parameters. F wave abnormalities were found in 92% and 95% of nerves of patients with GBS and CIDP respectively. Absence of F responses or prolongation of minimum and mean latency were the most frequent abnormalities in both groups. Forty-five (11.2%) nerves overall had absent F responses with normal compound muscle action potential (CMAP) amplitudes and no significant fall between stimulus sites, consistent with isolated proximal conduction block. Forty-four nerves (23.7% of nerves in which F waves were present) fulfilled minimum F latency criteria for acquired demyelination . Eighty-one (20.1%) nerves had normal conventional motor nerve conduction studies and abnormal F responses, not all of which were identified by assessing only F absence or minimum latency. Severity of F wave abnormalities did not correlate with clinical outcome. Our findings confirm the high frequency of proximal nerve lesions in early GBS and CIDP, not all of which are associated with distal motor conduction abnormalities, and suggest that assessment of multiple F wave parameters, in particular chronodispersion, mean latency and mean amplitude (in addition to absence and minimum latency), increases the yield of F wave studies.

Adult

A novel antineuronal antibody in stiff-man syndrome.

Two-thirds of stiff-man syndrome (SMS) patients harbor an autoantibody specific for a 64-kD species of glutamic acid decarboxylase (GAD), the rate-limiting enzyme in GABA synthesis. We assayed SMS antisera from two patients with SMS for the presence of anti-GAD antibodies using Western blot, immunohistochemical, and enzymatic analyses. Both SMS antisera recognized an 80-kD antigen present in human and rat neuronal extracts, and failed to recognize the 64-kD GAD species. Immunohistochemistry demonstrated neuronal binding identical to that reported with anti-GAD antibodies. Both sera depleted GAD activity from brain extracts. Our analysis indicates that these SMS antisera differ from previously reported SMS antisera by recognizing a novel 80-kD antigen, and suggests that they contain antibodies directed against either a species of GAD different in size from the 64-kD enzyme, or a protein that co-immunoprecipitates with GAD.

Adult

Post-traumatic syringomyelia following uncomplicated spinal fracture.

Two cases of post-traumatic syringomyelia presenting 10 and 41 years after spinal injuries that had caused lumbar vertebral fractures but no lasting neurological deficits are reported. In both patients the caudal end of the syrinx cavities, as shown by MRI, corresponded to the level of the previous vertebral fractures. Patients presenting with post-traumatic syringomyelia after uncomplicated spinal fracture are very rare, and the significance of the past history of spinal trauma may be overlooked.

Drainage