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PubMed2004

Relationship between motor function of the proximal stomach and transient lower oesophageal sphincter relaxation after morphine.

BACKGROUND: Morphine reduces the rate of transient lower oesophageal sphincter (LOS) relaxations but its site of action is presently unknown. There are no data available concerning its motor effects on the proximal stomach, an important site for triggering transient LOS relaxations. AIM: To evaluate the effect of morphine on the rate of transient LOS relaxations and motor function of the proximal stomach. SUBJECTS AND METHODS: In 19 healthy subjects, concurrent transient LOS relaxations with a sleeve sensor and motor function of the proximal stomach with a bag connected to an electronic barostat were recorded during pressure controlled (n = 9) and volume controlled (n = 10) gastric distensions after intravenous administration of placebo and morphine 100 microg/kg. RESULTS: During pressure controlled distensions, intrabag volume was markedly decreased by morphine (median 189 ml (interquartile range 101-448) v 404 (265-868) after placebo; p<0.01) as was the rate of transient LOS relaxations (0.5/30 minutes (0.4-2) v 2.5 (2-4); p<0.01). When intrabag volume was kept constant (525 ml (490-600)) (that is, in volume controlled distensions), the rate of transient LOS relaxations was not affected by morphine (2/30 minutes (2-3) v 2.5 (2-3)). Gastric contractions decreased after morphine similarly during pressure controlled and volume controlled distensions (8.5/30 minutes (4-10) v 15.5 (9.5-20.5), p<0.02; and 6.5 (0-24) v 19.5 (12-22), p<0.05). CONCLUSIONS: The effect of morphine on transient LOS relaxations is dependent on the decrease in volume of the proximal stomach. Our data suggest that pharmacological interventions which decrease fundal volume should result in control of transient LOS relaxation mediated gastro-oesophageal reflux.

Adult↗
PubMed1987

Gallbladder motor function in chagasic patients with megacolon and/or megaesophagus.

Gallbladder motor function was evaluated in 21 Chagasic patients with megacolon and/or megaesophagus and the results were compared with those obtained in 19 control subjects. Gallbladder contraction was evaluated by the radiologic method after the application of two different stimuli: an exogenous one consisting of intravenous injection of cholecystokinin octapeptide at the dose of 30 ng/kg over a period of 1 min, radiologic evaluation was performed before and 5, 10, 15 and 20 min after the stimulus; an endogenous one produced by standardised intraduodenal instillation of a lipid emulsion, radiologic evaluation was performed before and 3, 5, 10, 15, 20, 25 and 30 min after the beginning of intraduodenal infusion. The gallbladder of the Chagasic patients was found to be hypersensitive to both stimuli, since it contracted in a statistically more intense manner, with contraction starting earlier and lasting longer than among the controls. This difference in contracting behavior suggests impairment of the inhibitory intrinsic innervation of the gallbladder.

Adolescent↗
PubMed2000

Gastrointestinal motor function in patients with portal hypertension.

BACKGROUND: Existing data on gastric emptying and small-intestinal transit rates in portal-hypertensive patients are scarce and contradictory, and so far, the motor function of the colon has not been assessed in these patients. In this study we evaluated the propulsive effect of all main segments of the gastrointestinal tract in patients with well-characterized portal hypertension. METHODS: Eight patients with a postsinusoidal hepatic pressure gradient of at least 13 mmHg and eight age- and sex-matched healthy controls participated in the study. Gastric emptying, small-intestinal transit, and colonic transit rates were evaluated in all subjects by means of a gamma camera technique. The technique was also used to measure the frequency of antral contractions. RESULTS: No difference was observed in gastric mean emptying time or small-intestinal mean transit time of liquid and solid markers between patients and controls. After 24 h, however, the geometric center of the liquid marker had a more caudal localization in the colon of the patient group than in the controls (P = 0.04); that is, the patients had a faster colonic transit. No difference was found in the frequency of antral contractions 45 min after the test meal between patients and controls. CONCLUSIONS: These data suggest that the colonic transit is often accelerated in patients with portal hypertension, whereas the motor function of the stomach and the small intestine is unaffected.

Adult↗
PubMed1998

Modulation of motor functions involving the dopaminergic system by AT1 receptor antagonist, losartan.

Growing evidence has indicated the existence of a brain renin angiotensin system and its possible interaction with other putative neurotransmitters and their receptors. In the present study, the effect of losartan, an AT1 receptor antagonist, was studied on the motor functions involving the dopaminergic system. Losartan (5-30 mg/kg) per se decreased locomotor activity without producing motor toxicity. It partially reversed the apomorphine-induced hyperlocomotion and stereotypy in mice, and potentiated neuroleptic-induced catalepsy in rats. On chronic administration (once daily for 21 days) losartan failed to block apomorphine-induced hyperlocomotion, but the inhibition of stereotypic response and potentiation of neuroleptic-induced catalepsy remained unaltered. These observations suggest that losartan inhibited the release of dopamine through AT1 receptor and also suggest the existence of a compensatory mechanism in certain brain region concerned with dopamine motor function.

Angiotensin Receptor Antagonists↗
PubMed2006

p21Cip1/WAF1 regulates radial axon growth and enhances motor functional recovery in the injured peripheral nervous system.

Recent studies have provided evidence that p21Cip1/WAF1 has not only cell cycle-associated activities but also other biological activities like neurite elongation. To investigate the role of p21Cip1/WAF1 in the in vivo axonal regeneration in the peripheral nervous system, we developed a p21Cip1/WAF1 knockout (KO) mice sciatic nerve injury model. We performed quantitative assessments of the functional, histological, and electrophysiological recoveries after sciatic nerve injury in p21Cip1/WAF1 KO mice and compared the results with those of the wild-type mice. p21Cip1/WAF1 KO mice showed a significant delay of the motor functional recovery between 21 and 42 days after sciatic nerve injury. The values of motor conduction velocity in p21Cip1/WAF1 KO mice were significantly lower than those in the wild-type mice on postoperative day 28. The mean percent neural tissue and the mean nerve axon width of p21Cip1/WAF1 KO mice were significantly less than those of the wild-type mice, which was caused by hyperphosphorylation of neurofilaments. Therefore, p21Cip1/WAF1 was considered to be involved in radial axon growth and to be essential for the motor functional recovery following peripheral nervous system injury.

Animals↗
PubMed2002

[Motor function during patient-controlled analgesia via a lumbar epidural catheter after major abdominal surgery. Ropivacaine-sufentanil vs. bupivacaine-sufentanil].

INTRODUCTION: The aim of the present study was to investigate postoperative motoric impairment during patient-controlled analgesia after major abdominal surgery with ropivacaine-sufentanil and bupivacaine-sufentanil via a lumbar epidural catheter. METHODS: After approval of the local ethics committee, 40 patients scheduled for major lower abdominal surgery were randomly allocated to receive bupivacaine 0.25 % or ropivacaine 0.2 %, both with sufentanil 2 microgram/ml in a double blind manner. General anaesthesia (midazolam, etomidate, fentanyl, vecuronium, and desflurane in N2O/O2) and postoperative management of the patients were standardised. Postoperatively, the motoric function and ability for active early mobilisation was examined clinically (application of the Bromage scale, ability to leave the bed and ability to walk). Reduction of muscular force of the legs was measured postoperatively using a scale and compared with preoperative baseline values. To ensure a similar level of analgesia, a 10-cm visual analogue scale was applied at rest and while coughing. RESULTS: The two groups did not differ with respect to the demographic data and postoperative levels of analgesia. Less reduction of motoric function at rest was observed in the ropivacaine group (p = 0,044). However, this did not lead to an increased ability to get up from bed (p = 0,57) or to walk around (p = 0,17). A high number of patients did not meet the requirements for early ambulation. Almost half of the patients of both groups were unable to leave their beds in the morning of the first postoperative day. On the second postoperative day about 25 - 30 % of the patients could not walk even when support was applied. Furthermore, median reduction (10th/90th percentile) of muscular strength was reduced to 50 % (37 %/76 %) in the ropivacaine group and to 48 % (31 %/61 %) in the bupivacaine group compared with preoperative values. DISCUSSION: While quality of analgesia was similar, mobility of the legs at rest is better preserved with ropivacaine 0.2 % than with bupivacaine 0.25 %. However, despite the fact that high dose sufentanil was added to both local anaesthetics, there was marked motoric impairment in both groups probably due to the lumbar site of the epidural catheter. This was associated with an unacceptable high incidence of patients unsuitable for early postoperative mobilisation.

Amides↗
PubMed1994

Cognitive and sensori-motor functioning in the absence of the corpus callosum: neuropsychological studies in callosal agenesis and callosotomized patients.

The aim of the present study was to investigate the role of the corpus callosum in cognitive and sensori-motor functioning as measured by a neuropsychological test battery. After a brief review and analysis of the literature, we report our own studies in acallosal subjects (n = 9) and callosotomized patients (n = 25). The main instrument of evaluation was the Michigan Neuropsychological Test Battery. This battery was supplemented by age-appropriate intelligence tests. The performance of the acallosal group was compared to that of two matched control groups: one group consisting of children and adolescents that attended the same school as the acallosals and a second group of subjects recruited from regular schools. The callosotomized patients, tested pre- and post-operatively, served as their own controls. Taken together, the results of the reviewed and personal studies suggest that absence of the corpus callosum does not necessarily impede cognitive functioning. However, samples drawn from clinical populations tend to show a larger variability as to their mental abilities. In keeping with previous findings, our results indicate that the corpus callosum does play a role in bimanual motor coordination although other pathways (probably ipsilateral and/or subcortical) may provide adequate compensation in many cases. The data further suggest that the corpus callosum may be important for interhemispheric transfer of tactuo-motor learning when a spatial component is involved. Finally, our results are consistent with a facilitatory role of the corpus callosum in cognitive and sensori-motor functioning which allows for interhemispheric compensation as part of cerebral reorganization in the case of unilateral brain damage.

Adolescent↗
PubMed1996

A criterion for stability of the motor function of the lower extremity in stroke patients using the Fugl-Meyer Assessment Scale.

A test-retest reproducibility study was performed to define a criterion for stability as opposed to change of motor function of the lower extremity in stroke patients. Forty-nine patients with stroke were examined twice by the same physiotherapist, using the Fugl-Meyer Assessment Scale. The interval between both measurements was three weeks. The mean differences between the first and the second measurement were small, with 0.04 points for the lower extremity scale and 0.92 points for the balance scale, respectively. Intraclass correlation coefficient for the lower extremity scale was 0.86, and 0.34 for the balance scale. The standard error of measurement for each scale was 1.76 and 1.17 points, respectively. The standard error of measurement can be transformed in an 'error threshold', which is a criterion to differentiate real changes from changes due to chance variation or measurement error. As the absence of real change is a parameter for stability, a change of less than 5 points for the lower extremity scale and of less than 4 points for balance confirms stability of motor function.

Adolescent↗
PubMed1979

[Restoration of motor functions in disruption of the spinal cord or cauda equina].

Eight patients with a rupture of the spinal cord at the level of middle thoracic vertebrae or cauda equina at the lumbar level showed partial recovery of motor functions. The development of the activity was revealed by electromyography in body muscles and M. gluteus media in all the patients who attempted voluntary movements. Appearance and development of the activity was also observed in the muscles of the femur and crus. The level of rehabilitation shown by the patients was high enough. They could walk in fixation apparatuses, returned to their occupational activities and could practice self-service. The motor functions recovered more rapidly at the low levels of injury; however, the same and possibly complete rehabilitation was attained in 2 patients with a higher level of injury. The mechanism of the function recovery is underlain by the compensatory development of activity in the muscles of the body and capacity of the distal strip of the spinal cord for elaboration of new motor reactions in which the muscles of the extremities participate.

Cauda Equina↗
PubMed1992

Trait analyses of the Luria-Nebraska Intellectual Processes, Motor Functions, and Memory Scales.

Trait analyses of the Luria-Nebraska's Intellectual Processes, Motor Functions, and Memory Scales were performed using multitrait-multimethod procedures and confirmatory factor analysis. Three measures each of intellectual, motor, and memory functions were administered to 161 neuropsychiatric patients. Intellectual scales (viz., Luria-Nebraska and WAIS-R) were found to have convincing discriminant properties, but motor and memory measures demonstrated visibly less such robustness. Confirmatory factor analyses supported a three-factor model of the 9 x 9 matrix, in which each of the three Luria-Nebraska scales serves as a marker for the factors. Issues related to the neuropsychological constructs, test construction, and construct validity of measurement procedures employed in clinical neuropsychology are discussed.

Journal Article↗
PubMed2001

Relationship of substantia nigra echogenicity and motor function in elderly subjects.

BACKGROUND: Patients with Parkinson's disease (PD) exhibit an increased echogenicity of the substantia nigra (SN) on transcranial sonography. Some healthy adults with the same echo characteristics showed a reduced 18fluorodopa uptake on PET, indicating a subclinical alteration of the nigrostriatal system. OBJECTIVES: To determine whether the sonographic phenotype of hyperechogenic SN has any relevance for motor function in elderly subjects and whether an increased echogenicity of the SN is associated with an impaired motor function. METHOD: In a population-based, cross-sectional study, 93 subjects older then 60 years without history of extrapyramidal disorder underwent sonographic and neurologic examinations, with a quantitative motor assessment. RESULTS: Elderly healthy subjects without prediagnosed extrapyramidal disorder but with SN hyperechogenicity had more frequent and more severe parkinsonian symptoms and a slower finger tapping than those with a regular echogenicity of the SN (p < 0.05, U test). CONCLUSION: With increasing age, subjects with SN hyperechogenicity develop a more substantial slowing of movements than subjects without this echo pattern, stressing the functional relevance of this sonographic finding. The authors speculate that hyperechogenicity of the SN may be detected by transcranial sonography early in life and may serve as a risk marker for nigral injury, although only a minority of these subjects will develop the full clinical picture of PD.

Aged↗
PubMed2002

The effect of food textures on intake by mouth and the recovery of oral motor function in the child with a severe brain injury.

The objective of this study was to evaluate the effect of different food textures on the amount of food intake by mouth and the recovery of oral motor function in children after acquired brain injury. The subjects were three children aged 3, 12, and 14 years with severe brain injury. A single case study with a Latin square design was used to randomly allocate three different food textures (puréed, minced, and soft) for each of three daily meals for up to 11 days per child. The primary outcomes were the amount of food intake by mouth and oral motor function, as measured by the Behavioral Assessment of Oral Functions in Feeding. Results indicated that texture and the person feeding the child are important variables for intake. The most clinically important conclusion was that the variability in each child with acquired brain injury reinforces the need for an individualized approach to decisions and treatment for feeding.

Adolescent↗
PubMed2001

Can symptoms predict esophageal motor function or acid exposure in gastroesophageal reflux disease? A comparison of esophageal manometric and twenty-four-hour pH parameters in typical and extraesophageal gastroesophageal reflux disease.

It has been suggested that patterns of esophageal motor function and acid exposure may differ between those patients with gastroesophageal reflux disease (GERD) with classic symptoms and those with extraesophageal manifestations. Our objective was to compare various parameters of esophageal motility and acid exposure between groups of patients who had presented with extraesophageal manifestations of GERD alone, a combination of classic and extraesophageal manifestations, or classic GERD symptoms alone. A retrospective review of consecutive patients undergoing esophageal manometry and 24-hour dual-channel esophageal pH testing was performed. Information on patient demographics, symptoms, and results of various manometric and pH testing parameters was examined. We evaluated 84 patients: 32 with extraesophageal symptoms alone, 24 with both classic and extraesophageal symptoms, and 28 with classic symptoms alone. Apart from a trend toward less supine acid exposure in those with extraesophageal symptoms alone, no significant differences were evident among the three patient groups in any of the other parameters of proximal or distal esophageal acid reflux. With respect to motility parameters, lower esophageal sphincter pressure was lower in those with combined symptoms; otherwise, manometric findings were similar in the three patient groups. Our data do not support the hypothesis that the nature of the clinical presentation of GERD, whether in the form of classic or extraesophageal manifestations, is related to differing patterns of esophageal motor function or esophageal acid exposure.

Adult↗
PubMed2006

Gastric motor function and emptying in the right decubitus and seated body position as assessed by magnetic resonance imaging.

PURPOSE: To determine the effect of the right decubitus lying body position (RP) on relevant parameters of human gastric motor function in healthy volunteers. MATERIALS AND METHODS: Postprandial gastric function after ingestion of a solid/liquid meal (150 g/150 mL) was assessed over 90 minutes in volunteers in the RP and seated position (SP). Ten healthy volunteers were imaged using two MRI systems that differed in architecture and field strength. Stomach and intragastric air volume, intragastric meal distribution, gastric emptying, and gastric peristalsis were compared between the RP and SP. RESULTS: Body position did not affect gastric relaxation (RP, 372 mL vs. SP, 384 mL) and initial gastric volumes (stomach: RP, 458 mL vs. SP, 462 mL; meal: RP, 377 mL vs. SP, 399 mL; intragastric air: RP, 110 mL vs. SP, 98 mL). Postprandial stomach volume and gastric activity (RP and SP, 3.1 minute(-1)) were also similar. Meal emptying showed different characteristics, resulting in a significant but small difference in meal volume of -43 mL at t = 90 minutes (P < 0.05). CONCLUSION: Gastric MRI in RP is feasible for clinical research assessing gastric motor function. The subtle difference in meal emptying may be induced by posture-dependent vagal activity. This study confirms that MRI is a highly sensitive imaging technique for assessing gastrointestinal function in humans.

Adult↗
PubMed2006

Cognitive and motor function in people with multiple sclerosis in Stockholm County.

The aim of this study was to analyse cognitive and motor function in a population-based sample of people with multiple sclerosis (PwMS), taking into account both disease-related data and sociodemographic factors. Data were collected from 166 PwMS during home visits. Cognitive function was assessed by the Mini-Mental State Examination (MMSE), the Free Recall and Recognition of 12 Random Words Test (FRR12RWT), and the Symbol Digit Modalities Test (SDMT); manual dexterity by the Nine-Hole Peg Test (NHPT); global motor capacity by the Lindmark Motor Capacity Assessment; and walking capacity by a timed 10-metre walk. On cognitive tests, 55% (MMSE), 84% (FRR12RWT), and 45% (SDMT) of PwMS scored within the normal range; 27% of PwMS displayed normal manual dexterity, 9% had a maximal motorcapacity score, and 8% walked at normal speed. Factors associated with normal cognitive function were lower disability and higher education; lower disability and current employment were predictive of capacity to perform the NHPT and to walk 10 metres. In conclusion, cognitive function was normal in approximately half of the PwMS investigated, while a minority displayed normal manual dexterity and normal walking capacity. Thus, both disease severity and sociodemographic factors appear to influence cognitive and motor function in MS.

Activities of Daily Living↗
PubMed2003

The effect of mosapride on oesophageal motor function and acid reflux in patients with gastro-oesophageal reflux disease.

OBJECTIVE: To evaluate the efficiency of the 5-HT4 agonist and 5-HT3 antagonist mosapride, as compared with cisapride, on oesophageal acid reflux variables and oesophageal motor function in patients with chronic gastro-oesophageal reflux disease (GORD). METHOD: Forty-one patients with proven GORD were included in a double-blind, randomised, double-dummy, three-way crossover study. All patients received mosapride 60 mg twice daily, mosapride 30 mg three times daily, and cisapride 20 mg twice daily for seven days in a randomised order, separated by a washout period of at least five days. Twenty-three patients underwent four combined ambulatory 24-h motility and pH recordings within two weeks before the start of treatment and on day seven of each treatment period. The remaining 18 patients underwent three ambulatory 24-h pH recordings only, i.e. on treatment day seven of each treatment period. RESULTS: Mosapride had no significant effect on the total number of contractions in the oesophagus, or on the effectiveness, or possible effectiveness, of the propagations. Significant but numerically small effects on peristaltic durations and amplitudes were noted during both mosapride and cisapride treatment as compared with baseline values. The effect on acid reflux for both mosapride and cisapride was most pronounced for the duration of the longest reflux episode. The fraction of time with pH less than 4 was reduced by mosapride 30 mg three times daily in the supine position and by cisapride both totally and in the supine position. The number of reflux episodes was reduced significantly only by cisapride. Oesophageal clearance was reduced significantly by cisapride only in the supine position. CONCLUSION: Mosapride had small but statistically significant effects, comparable to those of cisapride, on acid reflux variables and oesophageal motor function in patients with GORD.

Adult↗
PubMed1983

Brain laterality: differences in cognitive style or motor function?

Two studies were completed to evaluate the role of motor function in the observable brain laterality of normal, familial, dextral males. A right-brain advantage was demonstrated on a figure-matching task and on a sequential-spatial task when subjects responded with a manual key press. A left-brain advantage for the same two tasks was demonstrated when subjects responded by compressing a microswitch embedded in a mouthpiece. The data suggest that both hemispheres of the brain may be capable of processing visuospatial stimuli but do not share the same facility for effecting appropriate motor responses. The results were discussed in terms of lateralized cognitive styles in brain and lateralized control of effector systems.

Adult↗