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Results for “Functional Laterality”

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PubMed2000

Hereditary progressive dystonia with marked diurnal fluctuation.

Hereditary progressive dystonia with marked diurnal fluctuation or the strictly defined dopa-responsive dystonia (HPD/DRD) is an autosomally dominantly inherited dystonia caused by abnormalities of the gene of the GTP cyclohydrolase I (GCH 1) located on the 14q22. 1-q22.2. The heterozygotic gene abnormality induces partial decrement of tetrahydrobiopterin (BH4) and affects synthesis of tyrosine hydroxylase (TH) rather selectively. The reduction of TH exists at the terminals of the nigrostriatal (NS) dopamine (DA) neuron, predominantly in the ventral area of the striatum and disfacilitates the D1 receptor-striatal direct pathway. This consequently disinhibit the inhibitory efferent pathways and develops postural dystonia via the particular descending pathways to the reticulospinal tract and postural tremor via the ascending pathways to the ventralis lateralis (VL) nucleus of the thalamus. This also inhibits the efferents to the superior colliculus, and affects voluntary saccade but spares that to the pedunculo-pontine nucleus (PPN) preserving locomotive movement clinically. The DA-D2 receptors, the striatal indirect pathways or the efferent connecting to these pathways are not involved in the pathophysiology of HPD/DRD. So parkinsonian plastic rigidity, parkinsonian resting tremor, cogwheel rigidity or levodopa induced dyskinesia are not observed. In some patients, particularly in compound hetereozygotes, there are symptoms suggesting the involvement of serotonergic neurons or those thought to be caused by exaggeration of DA-D2 receptors. Neuropathologically there is no degenerative changes. Clinical laboratory examinations suggest that levels of TH and DA activities are around 20% of the normal values throughout the course of illness. Therefore, the age-dependent clinical course, marked progression in the first one and one half decades, its subsiding in the third decade and almost stationary course from the fourth decade are just the reflection of age-related decremental variation of the TH activities at the terminal of the normal NS-DA neuron. The diurnal fluctuation is also the reflection of circadian oscillation of the TH activities at the terminal. Functional maturation of the striatal indirect pathways in the first one and one half decades and developmental decremental variation of the DA-D2 receptor in the first three decades also reflect in the age-dependent variation of symptoms by modulating the background tone of muscle. The later functional development of the ascending efferents of the basal ganglia to the thalamus, may cause the postural tremor which appears in the second decade and becomes predominant in the fourth decade. Early decrease of TH due to deficiency of BH4 in HPD/DRD also affects the DA-D4 receptor of the tuberoinfundibular DA neuron and cause stagnation of increase of body length in childhood. With normal preservation of the fundamental function of the NS-DA neuron, levodopa, by replacing the DA content at the terminal, alleviates the motor symptoms completely and the effects sustain without any side effects. Levodopa also improves the short body length, if it is administrated before puberty. Up to now 60 mutations have been detected in the GCH 1 gene. The locus of mutation differs among families except for two pare of families with different ethnic background which showed identical mutations. Experimentally, one abnormal heterozygotic gene decreased the production of the enzyme to less than 50%, e.g. some below 20% and others around 30-40%, which clinically as symptomatic patients and asymptomatic carriers, respectively. Other experiments show dominant negative effects which differ among families or the loci of mutation. These might be the background for developing the intra-familial variation, that is, in some there is anticipation, and in the other the symptoms and clinical course are identical or vary in a family without any relation to the generation. (ABSTRACT TRUNCATED)

Animals↗

PubMed1986

The cognitive laterality battery: tests of specialized cognitive function.

The Cognitive Laterality Battery of neuropsychological tests is described and normative data and statistics are presented. Selection of tests was based on converging evidence from studies on patients with unilateral cerebral lesions, complete forebrain commissurotomy, and on normal subjects suggesting that visuospatial skills are primarily related to the right hemisphere while verbal and sequential skills are primarily related to the left. Factor analyses confirmed the dichotomy of the test choices. It is suggested that test results on individuals be interpreted as a cognitive profile defining the relative performance of specialized functions rather than the relative right or hemisphere locations. Previous studies with the CLB are described.

Adolescent↗

PubMed1995

Modelling and gait evaluation of asymmetrical-keel foot prosthesis.

The paper documents a new concept in prosthetic foot design. It is based on the capacity of a flexible keel to allow a greater medio-lateral function than previously available. The heel has a complex curvature consisting of a medially concave shape that joins the mid-foot. There a hump acting as a leaf-spring ends at the metatarsal break, with an inwardly curved toe extremity. These curvatures contribute to increased medio-lateral control at heel-strike and propulsion for weight transfer and push-off. Results from finite-element modelling indicate that the asymmetrically shaped keel is at least twice as active in storing energy compared with a completely symmetrical one. A preliminary gait study is carried out for a 24-year-old below-knee amputee fitted with the new design, the SPACE foot and a dynamic elastic response foot with a symmetrical keel. With the SPACE foot, there is a 14% increase in walking speed combined with a reduction in the phasic asymmetries. The absolute difference between the initial and terminal double support is 1.4% for the asymmetrical keel design compared with 4.4% for the symmetrical keel foot prosthesis. The peak ankle power generation burst indicates that the SPACE foot behaves as a dynamic elastic response foot.

Biomechanical Phenomena↗

PubMed2000

Parameters of suicidal crises vary as a function of previous suicide attempts in youth inpatients.

OBJECTIVES: Although suicidal crises demand an enormous amount of clinical attention, surprisingly little empirical research has been conducted on the parameters of suicidal crises in general, and in children and adolescents in particular. On the basis of past conceptual work on the unique characteristics of multiple suicide attempters, as well as work on the effect of previous suicidal and depressive experience on later functioning, the authors developed predictions regarding the intensity and duration of suicidal crises in youths presenting to inpatient psychiatry units. Specifically, it was hypothesized that multiple attempt status would relate significantly to intensity of suicidal crises and would relate more strongly to intensity than to duration of crises. METHOD: Data on past suicide history and self-rated symptoms were collected for 50 suicidal patients, all of whom were available at follow-up. RESULTS: Findings conformed to prediction: Multiple attempters experienced more intense but not more long-lasting crises; the relation between multiple attempt status and crisis intensity exceeded that between multiple attempt status and crisis duration. CONCLUSIONS: Previous suicidal experience may alter the parameters of current suicidal crises. Implications of these findings for suicide risk and clinical assessment and management are discussed.

Acute Disease↗

PubMed2002

Long term reshaping of language, sensory, and motor maps after glioma resection: a new parameter to integrate in the surgical strategy.

OBJECTIVES: To describe cortical reorganisation and the effects of glioma infiltration on local brain function in three patients who underwent two operations 12-24 months apart. METHODS: Three patients who had no neurological deficit underwent two operations for low grade glioma, located in functionally important brain regions. During each operation, local brain function was characterised by electrical mapping and awake craniotomy. RESULTS: Language or sensorimotor areas had been invaded by the tumour at the time of the first operation, leading to incomplete glioma removal in all cases. Because of a tumour recurrence, the patients were reoperated on between 12 and 24 months later. Functional reorganisation of the language, sensory, and motor maps was detected by electrical stimulation of the brain, and this allowed total glioma removal without neurological sequelae. CONCLUSIONS: These findings show that surgical resection of a glioma can lead to functional reorganisation in the peritumorous and infiltrated brain. It may be that this reorganisation is directly or indirectly caused by the surgical procedure. If this hypothesis is confirmed by other studies, the use of such brain plasticity potential could be used when planning surgical options in some patients with low grade glioma. Such a strategy could extend the limits of tumour resection in gliomas involving eloquent brain areas without causing permanent morbidity.

Adult↗

PubMed2005

Forward genetic analysis of visual behavior in zebrafish.

The visual system converts the distribution and wavelengths of photons entering the eye into patterns of neuronal activity, which then drive motor and endocrine behavioral responses. The gene products important for visual processing by a living and behaving vertebrate animal have not been identified in an unbiased fashion. Likewise, the genes that affect development of the nervous system to shape visual function later in life are largely unknown. Here we have set out to close this gap in our understanding by using a forward genetic approach in zebrafish. Moving stimuli evoke two innate reflexes in zebrafish larvae, the optomotor and the optokinetic response, providing two rapid and quantitative tests to assess visual function in wild-type (WT) and mutant animals. These behavioral assays were used in a high-throughput screen, encompassing over half a million fish. In almost 2,000 F2 families mutagenized with ethylnitrosourea, we discovered 53 recessive mutations in 41 genes. These new mutations have generated a broad spectrum of phenotypes, which vary in specificity and severity, but can be placed into only a handful of classes. Developmental phenotypes include complete absence or abnormal morphogenesis of photoreceptors, and deficits in ganglion cell differentiation or axon targeting. Other mutations evidently leave neuronal circuits intact, but disrupt phototransduction, light adaptation, or behavior-specific responses. Almost all of the mutants are morphologically indistinguishable from WT, and many survive to adulthood. Genetic linkage mapping and initial molecular analyses show that our approach was effective in identifying genes with functions specific to the visual system. This collection of zebrafish behavioral mutants provides a novel resource for the study of normal vision and its genetic disorders.

Animals↗

PubMedDate not supplied

Methods for determining patient improvement following visits to family physicians.

Two instruments were used to assess patient improvement following visits to providers in a university based family practice center--the Modified Williamson Functional Assessment (MWFA) and the Mini-Duke-UNC Health Profile (Mini-DUHP). Of the 90 patients over the age of 18 seen for problem or health maintenance visits who were included in the study, 64 adequately completed the instruments at the time of the visit and one month later. Functional assessments by in-person, mail, and telephone methods of administration were similar. Patients' MWFA scores did not significantly improve by the time of the one-month follow-up. Mini-DUHP subscales for symptom and physical function also did not significantly improve. Mini-DUHP emotional, social, and composite scores indicated a decrease in function following the visits, particularly visits for health maintenance. MWFA and Mini-DUHP scores correlated only modestly, with the highest correlation occurring between Mini-DUHP Physical Score and the MWFA (0.414 or 0.509, P less than .001). Additional study is needed to identify or develop an instrument that can adequately assess broad changes in functioning for multiple diagnoses following specific physician interventions, and the reason for the decline in emotional and social function following visits needs further elucidation and evaluation.

Adolescent↗

PubMed1987

Patient reports of health status as predictors of physiologic health measures in chronic disease.

Accurate assessment of health status and forecasting of risk for poor outcomes in chronic disease require a broad representation of health measures. To support this conclusion, the health of patients with diabetes (N = 73) and hypertension (N = 105) was assessed using measures of physical and role functioning, perceived health, and disease severity (blood sugar or diastolic blood pressure, respectively, for diabetes and hypertension). Health questionnaires measuring functional limitations, overall health rating, level of health concern, perceived susceptibility to illness, and number of health problems were administered at study enrollment. Laboratory tests for blood sugar (hemoglobin A1) and diastolic blood pressures were performed at enrollment and were repeated at a subsequent clinic visit, from 3 to 6 months later. Functional limitations correlated significantly with elevated blood sugar (r = 0.57) and blood pressure (r = 0.49) at study enrollment. Perceived poor health was not substantially related to either physiologic measure at enrollment. Using ordinary least squares regression, the best predictor of both blood sugar and blood pressure at follow-up was baseline blood sugar and blood pressure, respectively. However, both functional limitations and perceived poor health made significant and independent contributions to the prediction of blood sugar and blood pressure at follow-up. The results underscore the value of both health survey measures and clinical measures in studies of chronic disease.

Blood Glucose↗

PubMed1977

Saralasin infusion in the recognition of renovascular hypertension.

Saralasin, an angiotensin II antagonist, was infused into 49 patients with renal artery stenosis, 10 patients with essential hypertension and normal renal arteriograms, and five patients with "low-renin essential hypertension." Renal venous renin and differential renal function studies were used to assess the functional significance of arterial stenoses. "Response" to saralasin, evidenced by a fall in blood pressure during infusion, occurred in no patients with "low renin" hypertension and in only 20% of patients with normal renal arteriograms. In contrast, saralasin "response" occurred in more than 80% of patients with renal artery stenosis and lateralizing functional studies and 100% of cases of "proven" renovascular hypertension (cure or improvement of hypertension after operative treatment). We suggest that saralasin infusion might be a valuable screening test for the recognition of renovascular hypertension.

Angiotensin II↗

PubMed1987

An analysis of the embryonic defects in Punch mutants of Drosophila melanogaster.

Punch (Pu), a complex genetic locus, encodes GTP cyclohydrolase, the first enzyme in the pteridine biosynthetic pathway. In the larval and adult stages of the Drosophila life cycle, the function of the locus can be monitored by enzyme assays. Although enzyme activity cannot be detected prior to larval stages, the locus must also have earlier functions since most homozygous Pu mutants die during embryogenesis. In order to assess the role of the locus during this stage of development, morphological examinations of embryos from different classes of Pu mutants were performed. An exact correspondence has been found between genetic and morphological classes of Pu mutations. The locus is required during two periods of embryogenesis. These requirements are genetically separable as shown by mutants with defects specific to each period. An early function utilizes both maternal and zygotic components. Mutants defective for these components have abnormal segment patterns. Late in embryogenesis, a Pu product is necessary for the proper pigmentation of larval cuticle and proper orientation and differentiation of other larval structures, particularly in the head region. A cold-sensitive period corresponds to this later function as determined by temperature-shift experiments. Some of the phenotypes observed correspond to known physiological roles of pteridines; others are unexpected and unexplained.

Animals↗

PubMedDate not supplied

[The value of high dose steroid therapy in obstructive uropathy caused by a tumor].

The case of an 82-years old female patient with acute renal failure secondary to tumoral obstructive uropathy by neoplasic invasion of the trigone is described. The condition was treated with urinary deviation through percutaneous nephrostomy of the left kidney which achieved an improvement in the renal function. Later, the percutaneous nephrostomy was unintentionally moved not being possible to place a new one in none of the kidneys. The patient remained anuric for 24 hours, and therapy was then instaured with high doses of intravenous steroids (6 Metyl-Prednisolone 1.5 g I.V. in 24 hours), diuresis was recovered and renal function became normalized within a few days. The mechanism of action and therapeutic usefulness of high dosage steroids in tumoral obstructive pathology is discussed.

Aged↗

PubMed1985

Reversed hemispheric lateralization of cerebral function: a case study.

A case is presented of a right-handed man with a large left fronto-temporoparietal infarct which did not result in aphasia. He did, however, show a pattern of deficits in visuospatial/constructional, attentional, and affective functioning which is typically seen in patients with right hemisphere lesions. These findings are most parsimoniously explained by reversed hemispheric lateralization.

Affect↗

PubMed1983

The lateralization of hemispheric function in the recognition of Chinese characters.

Two experiments were conducted to investigate the lateralization of hemispheric functions. In experiment 1 single Chinese characters, English words and random dot forms were used as stimuli presented to the left or right visual field of adults. In experiment 2 adults and school children were asked to recognize single characters presented in one field and Arabic numerals in the opposite field. The results indicated that adults and children all showed left hemisphere superiority in the recognition of characters. Some possible causes were given to explain why Chinese characters, being an ideographic language, showed a similar superiority as phonetic languages.

Adult↗

PubMed1997

Sex-onset effects on neuropsychological function in schizophrenia.

Heterogeneity of results continues to hamper schizophrenia research. The examination of sex differences in the effort to reduce this heterogeneity has had mixed results in neuropsychology. We have begun to examine the validity of both sex and onset age to define early-onset male and late-onset female prototypes of the disorder. Extensive neuropsychological assessment of 191 schizophrenia/schizoaffective patients was conducted. Analysis of performance scores revealed a significant pattern reflecting poorer performance and less lateralized function in early-onset men and late-onset women compared with late-onset men and early-onset women. The discussion addresses the etiological implications of these findings.

Adult↗

PubMed2004

Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS.

It is generally accepted that cognitive deficits in schizophrenia are related to functional outcome. However, support for longitudinal relationships between cognition and functional outcome has not been as well documented. The current paper presents a review of 18 recently published longitudinal studies (minimum 6-month follow up) of the relationships between cognition and community outcome in schizophrenia. Results from these studies reveal considerable support for longitudinal associations between cognition and community outcome in schizophrenia. These studies demonstrate that cognitive assessment predict later functional outcome and provide a rationale for psychopharmacological interventions for cognitive deficits in schizophrenia. Although the relationships between cognition and community outcome are well-supported, it is clear that community functioning is also affected by a host of factors apart from cognition that are usually not considered in clinical trial studies (e.g., psychosocial rehabilitation and educational/vocational opportunities). In the second part of the paper, we consider intervening steps between cognitive performance measures and community outcome. These steps are apt to have important implications for clinical trials of cognition-enhancing agents in schizophrenia.

Antipsychotic Agents↗

PubMedDate not supplied

Neurologic sequelae and MRI in low-birth weight patients.

Periventricular hyperintensity was detected using long repetition and echo time on spin-echo magnetic resonance imaging in 24 of 32 children with birth weights less than 2,500 gm. Functionally, 11 children were normal, 6 mildly handicapped, 7 moderately handicapped, and 8 severely handicapped. The functional handicaps were correlated to the degree of periventricular hyperintensity observed on magnetic resonance imaging when periventricular hyperintensity was divided into 4 grades; therefore, the extent of periventricular hyperintensity observed on magnetic resonance imaging has been proved to be of value in the clinical assessment of low-birth weight infants and children and may contribute to the prediction of later functional deficits.

Brain Diseases↗

PubMed2000

Resting B lymphocytes as APC for naive T lymphocytes: dependence on CD40 ligand/CD40.

Although resting B cells as APC are tolerogenic for naive T cells in vivo, we show here that they can provide all the costimulatory signals necessary for naive T cell proliferation in vivo and in vitro. In the absence of an activating signal through the B cell Ag receptor, T cell proliferation after Ag recognition on resting B cells depends on CD40 expression on the B cells, implying that naive T cells use the membrane-bound cytokine, CD40 ligand (CD154), to induce the costimulatory signals that they need. Induction of B7-1 (CD80) and increased or sustained expression of CD44H, ICAM-1 (CD54), and B7-2 (CD86) are dependent on the interaction of CD40 ligand with CD40. Transient expression (12 h) of B7-2 is T cell- and peptide Ag-dependent, but CD40-independent. Only sustained (>/=24 h) expression of B7-2 and perhaps increased expression of ICAM-1 could be shown to be functionally important in this system. T cells cultured with CD40-deficient B cells and peptide remain about as responsive as fresh naive cells upon secondary culture with whole splenic APC. Therefore, B cells, and perhaps other APC, may be tolerogenic not because they fail to provide sufficient costimulation for T cell proliferation, but because they are deficient in some later functions necessary for a productive T cell response.

Animals↗

PubMed1995

Isokinetic cycle ergometer--application in sports medicine.

Paper deals with application of fully computerized isokinetic cycle ergometer with on-line registration of effective crank force in sports medicine, namely in functional diagnostic and rehabilitation. The system allows to carry out the time and position course analyses of effective pedal force and power produced at various revolution rates. Maximal or mean values of force and power produced by action of right and left leg may be used for the estimation of strength as well as for detection and quantitative assessment of lateral functional deficit for example due to injury. Short term bouts on isokinetic cycle ergometer may be applied as an effective means for the improvement of strength of lower extremities in patients as well as in competitive cyclists. The estimation of individual fluctuation of effective force (i.e. differences between maxima at horizontal and minima at vertical crank position) may be used for the evaluation of pedalling technique. Short term all-out efforts at various cadences allow to register not only peak and mean force and power at particular revolution rates, but also to estimate an optimal individual revolution rate, i.e. those allowing to produce highest power output. Such information can be employed for diagnostic assessment of anaerobic capabilities, namely in cyclists. Isokinetic cycling with self-controlled effort may be also used as a comfortable aerobic exercise. It may be concluded that isokinetic cycle ergometer represents a valuable diagnostic as well as therapeutic tool, which may be utilized in several areas of sports medicine.

Adult↗