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PubMed1999

Bradykinesia akinesia inco-ordination test (BRAIN TEST): an objective computerised assessment of upper limb motor function.

OBJECTIVES: A simple and rapid computerised keyboard test, based on the alternating finger tapping test, has been developed to quantify upper limb motor function. The test generates several variables: (1) kinesia score: the number of keystrokes in 60 seconds; (2) akinesia time: cumulative time that keys are depressed; (3) dysmetria score: a weighted index calculated using the number of incorrectly hit keys corrected for speed; (4) incoordination score: a measure of rhythmicity which corresponds to the variance of the time interval between keystrokes. METHODS: The BRAIN TEST(Copyright ) was assessed on 35 patients with idiopathic Parkinson's disease, 12 patients with cerebellar dysfunction, and 27 normal control subjects. RESULTS: The mean kinesia scores of patients with Parkinson's disease or cerebellar dysfunction were significantly slower than normal controls (Parkinson's disease=107 (SD 28) keys/min v cerebellar dysfunction=86+/- (SD 28) v normal controls=182 (SD 26), p<0.001) and correlated with the UPDRS (r =-0.69, p<0.001). The akinesia time is very insensitive and was only abnormal in patients with severe parkinsonism. The median dysmetria (cerebellar dysfunction=13.8 v Parkinson's disease=6.1 v normal controls=4.2, p=0.002) and inco-ordination scores (cerebellar dysfunction=5.12 v Parkinson's disease=0.84 v normal controls=0.15, p=0.002) were significantly higher in patients with cerebellar dysfunction, in whom the dysmetria score correlated with a cerebellar disease rating scale (r=0.64, p=0.02). CONCLUSION: The BRAIN TEST(Copyright ) provides a simple, rapid, and objective assessment of upper limb motor function. It assesses speed, accuracy, and rhythmicity of upper limb movements regardless of their physiological basis. The results of the test correlate well with clinical rating scales in Parkinson's disease and cerebellar dysfunction. The BRAIN test will be useful in clinical studies. It can be downloaded from the Internet ().

Adult↗
PubMed2001

Esophageal and upper esophageal sphincter motor function in babies.

The incidence of concomitant feeding and airway-related disorders is high among premature infants and babies with congenital anomalies. The cause of these disorders is commonly attributed to foregut dysfunction, and the approach to diagnosis and management is largely empiric. Management strategies usually are based on the failure to improve feeding tolerance with advancing maturation and the presence of supraesophageal complications of reflux disease. Very little information exists about the functional development of deglutitive and airway-protective mechanisms in neonates. The purpose of this article is to review the available information on esophageal and upper esophageal sphincter (UES) motor function in human infants. Understanding the maturation of the motor functions of the pharynx-UES and esophagus and related airway-protection responses is essential for determining the pathophysiologic basis of feeding-related airway disorders.

Child Development↗
PubMed1983

Vagal mechanisms controlling serotonin release from the gastrointestinal tract and pyloric motor function.

This chapter focuses on investigations of two mechanisms controlled by the vagal nerve; serotonin (5-HT) release from the small intestine and pyloric motor function. Morphological, physiological, pharmacological and biochemical methods were combined in these studies. 5-HT is mainly stored in enterochromaffin cells (EC), but is present also in mast cells and nerve terminals of the gut, as observed by immunocytochemistry. Vagal nerve stimulation causes a release of 5-HT from EC to the portal circulation and to the gut lumen. Morphological evidence for the endoluminal release of 5-HT was obtained by autoradiography and immunofluorescence. The 5-HT release from EC is mediated by a beta-adrenoceptor mechanism via sympathetic adrenergic fibers in the vagal nerve, originating from sympathetic ganglia, e.g. the superior cervical ganglion. This vagal adrenergic pathway was studied by fluorescence microscopy and retrograde tracing of horseradish peroxidase. The vagal peptidergic (nonadrenergic, noncholinergic) control of pyloric motor function was studied in chloralosed cats by means of an in vivo model, where changes of an applied flow of body-warm saline through the pylorus were recorded. Also, gastric volume changes were monitored. By means of immunofluorescence the presence of VIP-, enkephalin (ENK)- and substance P (SP)-like immunoreactivity was demonstrated in pyloric neurons and in the vagal nerve. Physiological evidence for a vagal VIPergic relaxatory mechanism was obtained, while ENK-neurons seem to mediate the vagally induced pyloric contraction, prevented by naloxone pretreatment. SP may mediate part of the vagally induced pyloric and gastric contraction, the latter probably via axon collaterals on final cholinergic neurons. ENKergic and SPergic vagal contractile mechanisms seem to be additive for the pylorus.

Animals↗
PubMed1991

Cesarean section before the onset of labor and subsequent motor function in infants with meningomyelocele diagnosed antenatally.

Background. Meningomyelocele can now be detected before birth. Few data are available on its natural history, however, and optimal management at the time of delivery is controversial, although it has been suggested that labor and vaginal delivery may cause pressure on exposed nerve roots, resulting in additional loss of neural function. Methods. To assess the effect of labor and the type of delivery on the level of motor function in fetuses with uncomplicated meningomyelocele, we identified 200 cases of this disorder, accounting for 95 percent of the cases that occurred in the state of Washington during our 10-year study period. We compared the outcomes of 47 infants delivered by cesarean section before labor began, 35 delivered by cesarean section after a period of labor, and 78 who were delivered vaginally (another 40 were ineligible for the study). In cases of meningomyelocele detected prenatally, cesarean section was performed before the onset of labor if isolated meningomyelocele without severe hydrocephalus was present. The infants delivered in this manner were compared with those who were delivered either vaginally or by cesarean section after labor began. Results. At two years of age, the infants who had been exposed to labor were 2.2 times more likely to have severe paralysis than those delivered by cesarean section without labor (95 percent confidence interval, 1.7 to 2.8). Infants delivered by cesarean section before the beginning of labor had a mean (+/- SD) level of paralysis 3.3 +/- 3.0 segments below the anatomical level of the spinal lesion at two years of age, as compared with 1.1 +/- 2.3 for infants delivered vaginally and 0.9 +/- 4.1 for infants delivered by cesarean section after the beginning of labor (P less than 0.001 for both comparisons). Exposure to labor did not affect the frequency of neonatal complications or later intellectual performance. Conclusions. For the fetus with uncomplicated meningomyelocele, delivery by cesarean section before the onset of labor may result in better subsequent motor function than vaginal delivery or delivery by cesarean section after a period of labor.

Cesarean Section↗
PubMed2004

Loss of an individual proteasome subunit alters motor function but not cognitive function or ambulation in mice.

The proteasome is a large intracellular protease, composed of multiple subunits, that is present in all cells. In the present study we examined motor function, cognitive function, and ambulation in transgenic mice that lack the low molecular protein 2 (LMP2) proteasome subunit. Comparison of LMP2 knock out (LMP2 KO) mice and non-transgenic mice of the same background demonstrate that LMP2 KO mice exhibit a higher degree of motor function, but possess a similar level of cognitive function and ambulation, as compared to non-transgenic control mice. Interestingly, LMP2 KO mice also exhibited increased body weight as compared to non-transgenic mice. These data demonstrate for the first time that specific proteasome subunits may play a role in regulating both brain function and body weight.

Animals↗
PubMed2005

Cortical reorganization and associated functional motor recovery after virtual reality in patients with chronic stroke: an experimenter-blind preliminary study.

OBJECTIVE: To investigate the effects of virtual reality (VR) on cortical reorganization and motor recovery. DESIGN: Nonparametric pre- and posttest design with experimenter blinded. SETTING: University medical center. PARTICIPANTS: Five patients with hemiparesis (age, 59.8+/-3.4y) were recruited. INTERVENTION: Five patients received VR for 60 minutes a day, 5 times a week for 4 weeks. VR was designed to provide a virtual rehabilitation scene where the intensity of practice and sensory feedback could be systematically manipulated to provide the most appropriate, individualized motor retraining program. MAIN OUTCOME MEASURES: Cortical activation and associated motor recovery were measured before and after VR using functional magnetic resonance imaging and standardized motor tests, respectively. Nonparametric tests were used at P less than .05. RESULTS: Prior to VR, the bilateral primary sensorimotor cortices (SM1s), contralesional premotor cortex, and contralesional or ipsilesional supplementary motor area were activated. After VR, the altered activations disappeared and predominantly the ipsilesional SM1 was activated (P<.05). Motor function was improved (P<.05). CONCLUSIONS: This is a novel demonstration of VR-induced neuroplastic changes and associated motor recovery in chronic stroke.

Adult↗
PubMed2004

Amyloid beta protein impairs motor function via thromboxane A2 in the rat striatum.

Amyloid beta protein (Abeta) deposits are found in the striatum of patients with Alzheimer disease (AD) showing extrapyramidal motor dysfunction, but neuronal cell loss has not yet been detected. To clarify how Abeta impairs motor function, we analyzed intrastriatally Abeta-injected rats. Unilateral injection of Abeta(25-35) enhanced apomorphine-induced circling in an ipsilateral direction, indicating ipsilateral dysfunction of dopaminergic nigrostriatal pathways. Volumes of lesion in the Abeta(25-35)-injected striata were significantly higher than those in the saline-injected ones. The correlation between lesion volume and circling behavior was close to significance, but slightly too low, suggesting the possible involvement of other factors in the striatal dysfunction. Abeta(25-35) significantly elevated the level of thromboxane A2 (TXA2). A stable TXA2 agonist, U46619, enhanced circling behavior, and TXA2 receptor antagonists attenuated U46619- and Abeta(25-35)-enhanced circling behavior. This study demonstrated that Abeta(25-35) impairs the motor function of dopaminergic neurons via neuronal cell loss and TXA2. It also sheds light on the therapeutic potential of TXA2 receptor blockers for the neurotoxicity of Abeta.

Amyloid beta-Peptides↗
PubMed2000

Correlation between ICIDH handicap code and Gross Motor Function Classification System in children with cerebral palsy.

The aim of this study was to apply the International Classification of Impairments, Disabilities and Handicap (ICIDH; WHO 1980) parallel to the Gross Motor Function Classification System (GMFCS; Palisano et al. 1997) in a population-based series of children with cerebral palsy (CP). Of the 116 children studied, birth characteristics, data on gross motor function, and level of handicap at 5 to 6 years of age, were retrospectively collected from medical records and documentation made by rehabilitation team members. Low handicap scores and mild levels of gross motor disability were present in children with hemiplegic CP, moderate scores in children with diplegic CP, simple ataxia, and athetotic CP, and high scores in children with dystonic CP and tetraplegic CP. A significant correlation was found between high handicap scores as well as high levels on the GMFCS and the presence of learning disability, epilepsy, and obvious aetiology of CP. A strong correlation was found between the handicap code and the GMFCS, the strongest concerning the dimension of mobility (r = 0.95,p<0.0001). A striking similarity in the grading of disability was present between the ICIDH handicap code and the GMFCS. The GMFCS is considerably less time-consuming and can be evaluated retrospectively. The handicap code requires more detailed information and is more useful for a comprehensive profile of the child.

Cerebral Palsy↗
PubMed2007

The relationship between gross motor function and participation restriction in children with cerebral palsy: an exploratory analysis.

BACKGROUND: Children with cerebral palsy (CP) experience a variety of functional limitations depending on the severity of their condition that impact on their participation in day-to-day activities. METHODS: The gross motor function and participation restrictions experienced by 60 ambulant children with CP (mean age 11.04 years) were assessed using the Gross Motor Function Measure (GMFM-88) and the Lifestyle Assessment Questionnaire - Cerebral Palsy (LAQ-CP). RESULTS: A significant negative correlation existed between the GMFM-88 and the LAQ-CP (r = -0.52, P < 0.001). Significant relationships were also identified between the GMFM-88 and the physical independence, mobility, economic burden and social integration domains of the LAQ-CP. CONCLUSION: In ambulatory children with CP, better physical function is associated with a lesser impact of disability; however, the relationship between function and participation is complex. Measures of participation restriction may assist with goal setting appropriate to the specific needs of the child and family.

Activities of Daily Living↗
PubMed2002

Transplanted neural stem cells survive, differentiate, and improve neurological motor function after experimental traumatic brain injury.

OBJECTIVE: Using the neural stem cell (NSC) clone C17.2, we evaluated the ability of transplanted murine NSCs to attenuate cognitive and neurological motor deficits after traumatic brain injury. METHODS: Nonimmunosuppressed C57BL/6 mice (n = 65) were anesthetized and subjected to lateral controlled cortical impact brain injury (n = 52) or surgery without injury (sham operation group, n = 13). At 3 days postinjury, all brain-injured animals were reanesthetized and randomized to receive stereotactic injection of NSCs or control cells (human embryonic kidney cells) into the cortex-hippocampus interface in either the ipsilateral or the contralateral hemisphere. One group of animals (n = 7) was killed at either 1 or 3 weeks postinjury to assess NSC survival in the acute posttraumatic period. Motor function was evaluated at weekly intervals for 12 weeks in the remaining animals, and cognitive (i.e., learning) deficits were assessed at 3 and 12 weeks after transplantation. RESULTS: Brain-injured animals that received either ipsilateral or contralateral NSC transplants showed significantly improved motor function in selected tests as compared with human embryonic kidney cell-transplanted animals during the 12-week observation period. Cognitive dysfunction was unaffected by transplantation at either 3 or 12 weeks postinjury. Histological analyses showed that NSCs survive for as long as 13 weeks after transplantation and were detected in the hippocampus and/or cortical areas adjacent to the injury cavity. At 13 weeks, the NSCs transplanted ipsilateral to the impact site expressed neuronal (NeuN) or astrocytic (glial fibrillary acidic protein) markers but not markers of oligodendrocytes (2'3'cyclic nucleotide 3'-phosphodiesterase), whereas the contralaterally transplanted NSCs expressed neuronal but not glial markers (double-labeled immunofluorescence and confocal microscopy). CONCLUSION: These data suggest that transplanted NSCs can survive in the traumatically injured brain, differentiate into neurons and/or glia, and attenuate motor dysfunction after traumatic brain injury.

Animals↗
PubMed2005

Modulation of motor function by stress: a novel concept of the effects of stress and corticosterone on behavior.

Stress and stress hormones affect a variety of behaviors and cognitive abilities. The influences of stress and glucocorticoids on motor function, however, have not been characterized although the presence of glucocorticoid receptors in the motor system has been documented. Here we demonstrate that stress and the stress hormone corticosterone influence motor system function in rats. Groups of adult female Long-Evans rats underwent either a daily stress-inducing procedure (immobilization or swimming in cold water) or oral corticosterone treatment. While these treatments continued, animals were tested in skilled reaching and skilled walking tasks for a period of 2 weeks. Both acute (day 1) and chronic (day 14) stress and corticosterone treatment reduced skilled movement accuracy in reaching and walking and increased performance speed. Furthermore, both chronic stress and chronic corticosterone treatment altered skilled movement patterns in the reaching task. These findings indicate that stress modulates motor system function and that these effects are partially mediated by glucocorticoids. To examine whether stress-induced changes might also derive from enhanced emotionality, rats were treated with the benzodiazepine diazepam. Based on an inverted U-shaped dose-response relationship, a moderate dose of diazepam significantly improved reaching success while at the same time reducing corticosterone levels. Thus, stress-associated emotional responses such as anxiety might account for diminished movement accuracy. These results suggest that stress affects the motor system both directly via hormonal changes and indirectly via changes in emotionality. These findings are discussed with respect to the role of stress in motor system function and movement disorders.

Analysis of Variance↗
PubMed2004

Influence of somatosensory input on motor function in patients with chronic stroke.

In healthy volunteers, reduction of somatosensory input from one hand leads to rapid performance improvements in the other hand. Thus, it is possible that reduction of somatosensory input from the healthy hand can influence motor function in the paretic hand of chronic stroke patients with unilateral hand weakness. To test this hypothesis, we had 13 chronic stroke patients perform motor tasks with the paretic hand and arm during cutaneous anesthesia of the healthy hand and healthy foot in separate sessions. Performance of a finger tapping task, but not a wrist flexion task, improved significantly with anesthesia of the hand, but not the foot. This effect progressed with the duration of anesthesia and correlated with baseline motor function. We conclude that cutaneous anesthesia of the healthy hand elicits transient site-specific improvements in motor performance of the moderately paretic hand in patients with chronic stroke, consistent with interhemispheric competition models of sensorimotor processing.

Adult↗
PubMed2004

Radioisotope technique to evaluate the motor functional status of donor nerve for upper extremity reconstruction.

A rapid and precise method of nerve fascicle identification based on measurement of choline acetyltransferase activity using radioisotope technique was used intraoperatively during upper extremity reconstruction. This technique can be used to evaluate the motor function of donor fascicles directly and quantitatively. This technique is useful to evaluate the motor functional status of donor fascicles during functioning free muscle transfer, to distinguish between preganglionic and postganglionic injuries in brachial plexus injury, and to differentiate between motor and sensory fascicles during nerve grafting procedures.

Journal Article↗
PubMed1989

Increased caudate dopamine turnover may contribute to the recovery of motor function in marmosets treated with the dopaminergic neurotoxin MPTP.

Administration of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) to common marmosets initially impaired motor function, but a partial recovery occurred over the following weeks. At both 10 days and 4-6 weeks following MPTP treatment, [3H]dopamine ([3H]DA) uptake into synaptosomal preparations of putamen was markedly decreased. At 10 days and 4-6 weeks following MPTP treatment DA, homovanillic acid (HVA) and 3,4-dihydroxyphenylacetic acid (DOPAC) levels in the caudate nucleus and nucleus accumbens were substantially reduced. However, the levels of HVA and DOPAC in caudate nucleus were higher at 4-6 weeks than at 10 days. The ratio of (DOPAC + HVA)/DA in caudate nucleus was elevated at 10 days following MPTP treatment and even more so at 4-6 weeks. No change in Bmax or Kd values for [3H]spiperone binding to caudate preparations were observed. The recovery of motor function in marmosets observed following MPTP treatment may result partially from a compensatory increase in caudate DA turnover by remaining neurones.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗
PubMed1996

Functional motor outcome in children with myelomeningocele: correlation with anatomic level on prenatal ultrasound.

Fifteen children with prenatally diagnosed myelomeningocele were followed for at least three years to determine the relations between prenatal anatomic level visualized on high-resolution ultrasound, radiographic level, neuromotor level and functional motor outcome. Prenatal anatomic level accurately predicted neuromotor level and functional motor outcome in 12 of the children and was a better predictor than motor level at birth. Clinicians involved in prenatal counseling may use the anatomic level determined on high-resolution ultrasound to discuss motor prognosis with families.

Child, Preschool↗
PubMed2004

[Functional myoelectrostimulation as a method for motor functions rehabilitation].

The main features, namely diagnostic, prognostic, therapeutic, of functional myoelectrostimulation (FMES) method are described. FMES is primarily indicated in muscle function deficit, which can be organic (neuromuscle disorders) and functional (muscle relaxation). Five most essential FMES operations include: (1) choice of correctable movements and stimulated muscles; determination of (2) amplitude and temporal stimulation programs; (3) stimulation regimes in pathological gait; (4) stimulation parameters; (5) localization of the skin electrodes on the body. A positive influence of FMES on the process of movement rehabilitation was demonstrated in 2 cases of severe central nervous system pathologies--the consequences of the spinal cord lesion in sacral-lumbar area and hemiparesis of cerebral genesis.

Adult↗