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[Impairment of the restoration of motor function after delayed nerve suture].

Motor restitution was studied after severance and microsurgical suture of 75 rabbit peroneal nerves by functional, electromyographic and morphological methods. Maximal pre-suture denervation lasted 12 months. Concerning the nerve distal to the suture site, individual variations in the degree of neurotization were more obvious than increasing changes with later nerve suture. But yet motor recovery was worse in this animal group with long lasting pre-suture denervation intervals. It therefore is concluded that changes within the muscle cells and the motor endplates probably are of outstanding importance for the poor motor recovery. Morphological findings in muscle and endplates support the conclusion. Especially after late nerve sutures the arrival of axons within the muscle is by no means necessarily followed by a sufficient recurrence of its function.

Animals

Enhancement of voluntary motor function following spinal cord stimulation--case study.

One patient with an incomplete traumatic myelopathy underwent epidural spinal cord stimulation for the management of severe intractable spasms, which were abolished by the stimulation. After several months of stimulation, the patient regained some voluntary motor function in the lower extremities. Voluntary motor control of the left quadriceps was present only when spinal cord stimulation was activated and stopped immediately after it was turned off. The effects could be consistently reproduced. EMG polygraphic recordings confirmed the results.

Adult

Influence of bolus temperature on human esophageal motor function.

Hot and cold water, in comparison to room temperature water, ingested by normal young men, profoundly alters esophageal motor function. Cold water slows or abolishes esophageal peristalsis, prolongs the contraction wave in the distal esophagus, produces a delayed but prolonged relaxation of the lower esophageal sphincter, and regularly causes a lower esophageal sphincteric contraction of increased amplitude. It does not, however, diminish the frequency of response of the lower esophageal sphincter even when the peristaltic wave above is abolished. Hot water, on the other hand, accelerates the response of the esophagus to the swallow; this change is reflected by increased speed of wave propagation, waves of shorter duration, a more brief relaxation of the lower esophageal sphincter, and a lower esophageal sphincter contraction of less amplitude. Hot water may even increase the frequency of peristalsis at least in the proximal esophagus. In spite of these changes, however, neither extreme of temperature altered the rapid passage of the water swallows through the more proximal portions of the esophagus. Hot water tended to traverse the lower esophageal sphincter more rapidly than did room temperature water, but cold water was often delayed in entering the stomach and tended to pool in the distal esophagus even though sphincteric relaxation was manometrically complete and prolonged.

Deglutition

[Relation between features of the recovery of motor functions in patients with ischemic strokes and the site and extent of lesion focus].

The nature and degree of motor disorders, the degree and rate of recovery were shown to be more dependent on the localization than on the size of the cerebral infarction specified by computer-aided tomography of the drain. Localization of infarct in the posterior femur of the internal capsule proved the least favourable with regard to the recovery of motor functions.

Brain

[The effect of hyperbaric oxygenation on the secretory, motor function and microcirculation of the stomach and duodenal walls in patients with duodenal ulcers].

A total of 22 patients with duodenal ulcer were examined for secretory and motor functions, microcirculation of the gastroduodenal wall and changes in the stomach-duodenum interrelations under the influence of hyperbaric oxygenation. Of these, group I included 9 patients with active ulcer; group II 13 persons with a healing ulcer. To assess gastric and duodenal functions, use was made of pH-metry combined with the measurement of intraluminal pressure by "open catheters". Microcirculation of the gastroduodenal wall was estimated by the radiation method. The studies have shown that the patients with active ulcer treated by hyperbaric oxygenation manifested a decrease of motor activity of both stomach and duodenum, an improvement of acid-neutralizing function of the stomach, a reduction of the duration of duodenum acidification, a greater normalization of microcirculation in the duodenal wall than in the gastric wall. In the patients with healing ulcers, the duodenal motility returned to normal, the initially elevated gastric motility fell to normal, the acidification of the duodenal bulb declined, and the regional blood flow returned to normal. It may thus be concluded that the positive impact of hyperbaric oxygenation on gastroduodenal function was more pronounced in the patients with healing ulcers where a more considerable decrease of motor activity was not accompanied by duodenal motility suppression.

Adult

Effect of disuse of hand for recovery of motor function following dorsal column section in the monkey.

A question of whether use or disuse of the hand affects the recovery of motor function following dorsal column (DC) section was examined in monkeys. The hand was immobilized by a cast for 16 and 18 days after the section. When the cast was removed, the motor deficit was severer than that observed immediately after the DC section in control animals clearly indicating that the usage of the hand was necessary for the recovery. However, the impairment was not permanent. The hand skill started improving following the removal of the cast and reached the same level as the control although it took longer than for control animals. Neuronal mechanisms for the recovery are discussed in relation to the formation of new synapses.

Afferent Pathways

Impairment and recovery profiles of sensory-motor function following stroke: single-case graphical analysis techniques.

Graphical analysis procedures have been developed to improve interpretation of sensory-motor tests from individual subjects following acute brain damage. The procedures have been applied to 11 unilateral stroke patients assessed serially over 12 months on a computerized quantitative sensory-motor test battery of which grip strength, arm speed, and tracking have been chosen for illustrative purposes. The results indicate that four graphs are necessary to fully demonstrate neurologic impairment and recovery of each sensory-motor function, although fewer graphs would be satisfactory in some applications. Such analyses have proven valuable in the display of serial performance of individual patients but demonstration of impairment and recovery is much more difficult than for group analyses.

Activities of Daily Living

Cerebellar nitric oxide synthase, cGMP and motor function in two lines of cerebellar mutant mice, Staggerer and Wriggle Mouse Sagami.

We investigated the hypothesis that nitric oxide (NO) is involved in the cerebellar motor function, by measuring nitric oxide synthase (NOS) activities and cGMP in the cerebellum using two lines of mutant mice having motor dysfunction, Staggerer (SG) and Wriggle Mouse Sagami (WMS). In SG, the NOS activity per cerebellum was reduced to 5.8% of that of the controls, while no significant change was observed in WMS. The cerebellar cGMP in SG was reduced to 3.3% of that of the controls and to 43% in WMS. In contrast with these neurochemical markers of NO, the locomotor dysfunction and the number of falls were greater in WMS than in SG. The reductions of the neurochemical markers of NO are consistent with the results of the previous neuropathological studies in SG and WMS whereas the cerebellar motor dysfunction was independent of these neurochemical and neuropathological changes.

Amino Acid Oxidoreductases

[Recovery of motor function disorders in patients of different ages with infarct foci in the cerebral hemispheres (clinico-computer-tomographic correlation)].

To determine the possible role of age in motor rehabilitation, the authors compared the degree of restoration of impaired motor functions in patients of different age groups with infarction foci in the large hemispheres of the brain. Localization and size of post-ischemic changes in the cerebral substance were assessed by computer-aided tomography. By the end of the late rehabilitative period. (12 months after the development of infarction), there were no statistically significant differences between the degree of recovery of impaired motor possibilities. Most important for recovery seems to be an intactness of functionally significant structures, especially of the posterior femur of the internal capsule.

Adult

Effects of hemodialysis on the cognitive and sensory-motor functioning of the adult chronic hemodialysis patient.

Twenty chronically dialyzed adults were administered a repeatable battery of 14 cognitive and sensory-motor tests on 3 consecutive days: immediately prior to their midweek dialysis, approximately 20 hr after their midweek dialysis, and again immediately prior to their end-of-the week dialysis. Serum electrolyte and methylamine analyses were performed at each test session. When compared to established norms, these patients scored within the normal range in a wide variety of areas. Limited impairments, probably due to peripheral neuropathy, were in evidence on the Grooved Pegboard, Finger Tapping (females), and Grip Strength (females) measures. Impairments suggestive of cerebral dysfunction were also noted on the Benton Visual Retention Test and on the Trail Making Test, Parts A and B, with particularly severe impairment noted on Part B. Despite significant daily changes in serum levels of toxic substances retained in uremia, there was little or no evidence to suggest that well-dialyzed patients undergo daily fluctuations in their cognitive and sensory-motor functioning.

Adult

Motor functions of the basal ganglia.

A study of movement disorders such as Parkinson's disease and Huntington's disease can provide an indication of the motor functions of the basal ganglia. Basal-ganglia diseases affect voluntary movement and can cause involuntary movement. Deficits are often manifested during the coordination of fine multi-joint movements (e.g., handwriting). The disturbances of motor control (e.g. akinesia, bradykinesia) caused by basal-ganglia disorders are illustrated. Data suggest that the basal ganglia play an important role in the automatic execution of serially ordered complex movements.

Basal Ganglia

[The effect of exogenous bradykinin on gastric motor function in an experimental model of ulcerative lesions of the antrum].

Experiments on 29 cats demonstrated a direct dependence of changes in stomach motor activity on the amount of injected bradykinin. The motor response to the agent was stronger in cats with ulcer of the stomach than in intact animals. A stimulating effect of exogenous bradykinin on motor function and increased sensitivity of kininergic structures of the stomach in experimental ulcer were revealed.

Acetates

Foregut motor function in chronic renal failure.

In children with chronic renal failure (CRF) anorexia, nausea, and vomiting are common yet poorly understood symptoms. We studied oesophageal and gastric motor function in 12 children (age 7 months-6.8 years) with severe CRF not undergoing dialysis who had persistent anorexia and vomiting. Eight of 12 patients had significant gastro-oesophageal reflux (reflux index 5.2% to 21.9%, mean 11.3%; controls < 5%), 7/10 had altered gastric half emptying times (T1/2) for 5% glucose or milk (glucose meal--controls: 8-14 min, two CRF patients: 18-25 min; milk meal--controls: 48-72 min, five CRF patients 27, 28, 82, 83, and 110 min). Gastric antral electrical control activity was abnormal in 6/11 patients, with different types of gastric dysrhythmias whereas the remainder and controls showed a regular dominant frequency of 0.05 Hz. In 7/9 patients fasting serum gastrin concentration was raised (53 to > 400, mean 168 pmol/l, controls < 40 pmol/l). All CRF patients with anorexia and vomiting had one or more disorder of foregut motility. The nature and variety of the motor disorders and the raised concentrations of circulating gastrin suggest that the normal environment generated by CRF affects the function of the smooth muscle of the foregut.

Child

The response of manual motor functioning in Parkinsonians to frontal EMG biofeedback and progressive relaxation.

The purpose of the current investigation was to determine the effects of frontal EMG biofeedback and progressive relaxation training on manual motor functioning in Parkinsonians. Twenty patients were matched and randomly assigned to two groups. All subjects were administered a brief manual motor assessment. The experimental group then underwent weekly sessions of frontal EMG and relaxation training for a period of 15 weeks. At the conclusion of the training period, both experimental and control groups were again administered the manual motor tasks. The results indicated that Parkinsonian patients are capable of significantly lowering frontal EMG activity levels. The motor task results, however, yielded no statistically significant differences between the two groups as a result of the biofeedback training.

Aged

A new device for the rapid measurement of impaired motor function in mice.

Measurement of the ability of mice to balance on a rotating rod or cone is often used as a measure of impaired motor function. In most of these procedures the mice must be trained prior to the test. In the new screen test described in this paper, untrained mice are used in a 60 sec test which measures the ability of mice to either climb to the top of or cling to the bottom of a horizontal screen. The ED50 values obtained for failure to reach the top of the horizontal screen are similar to those obtained with the rotarod; the values for falling from the screen are somewhat higher. With both of the horizontal screen measures there were fewer control failures than in the rotarod procedure.

Animals

[A model of mild spinal cord injury in rats--dynamics of changes in motor function].

Authors proceeded by performing compressive spinal traumas of variable intensity in 21 rats at lower thoracic level over an intact dura. The deficit of hind limbs motor functions was evaluated simultaneously with the two tests as follows: a) in observing the gait of an animal along with graduation in accord with modified Tarlov's classification, b) with the method of inclined plane. The reproducibility of injuries of various intensity appeared to be imperfect. Five animals with severe injury died up to 4 weeks (Fig. 4, 5). The remainder of them showed substantial approval (mild injury--Fig. 6-13). The dynamics of motor disorder showed changes up to 6 weeks, after then the state persisted unchanged up to 2 months. Within this survival interval, rats were killed either in the state of mild paresis or even under regained normal condition. It outflowed from our study that a long term monitoring of postinjury spinal cord function is important in order not to ascribe possible approval of the functions to the therapy applied. Further on course of disorder can be predicted in accordance with duration of initial paraplegia. The post-surgery paraplegia had lasted for only several hours in the animals whose injuries resulted in a normal condition.

Animals

Regulation of tyrosine protein kinase receptor Trk-B and motor function in rats following cardiac arrest.

Following 10 min cardiac arrest and resuscitation, male Sprague-Dawley rats developed posthypoxic myoclonus. Sixty days later, the motor function of the animals was restored. In the present study, we investigated brain levels of tyrosine protein kinase receptor Trk-B with quantitative immunoblot analysis at various time points following cardiac arrest. In the frontal cortex, a significant reduction of Trk-B was found in rats 3 days (53%) after cardiac arrest, whereas significant increases were detected in rats 14 (124%) and an average 60 days (98%) after cardiac arrest. In the striatum, significant increases were found in rats 3 (389%), 14 (483%), and 60 days (521%) after resuscitation. In contrast, significant reductions of Trk-B were detected in the cerebellum of rats 3 (46%), 14 (22%), and 60 days (18%) after cardiac arrest. The results indicate that regulation of Trk-B may vary in different brain regions and have important roles in recovery processes following hypoxic-ischemic insults to the brain.

Animals