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At least 1,099 records · Page 61Linked to original sources
PubMed2000

Postnatal corticosteroids in preterm infants: systematic review of effects on mortality and motor function.

BACKGROUND: Postnatal corticosteroid therapy has been proved in randomized controlled trials to reduce ventilator dependence and the rate of chronic lung disease in preterm infants with few serious short-term side effects. However, there are other consequences that might follow postnatal corticosteroid therapy that are more important, including mortality or cerebral palsy. OBJECTIVES: To review the evidence from reported randomized controlled trials on the effects of postnatal corticosteroid on long-term mortality and motor dysfunction, including cerebral palsy. METHODS: The methods involved a meta-analysis of reported randomized controlled trials, following guidelines of the Cochrane Collaboration, including calculation of event rate differences (ERD) and 95% confidence intervals (CI). RESULTS: The mortality rate difference was non-significant both statistically and clinically (ERD - 0.1% favouring corticosteroids, 95% CI -2.9% to 2.8%). There were no subgroups in which a beneficial effect of postnatal corticosteroids on survival could be demonstrated. The rate of motor dysfunction in survivors was significantly higher in survivors from the postnatal corticosteroid group (ERD 11.9% favouring controls, 95% CI 4.6% to 19.2%). The rate of survival, free of motor dysfunction, was significantly lower in the postnatal corticosteroid group (ERD 7.8% favouring controls, 95% CI 0.5% to 15.1%). CONCLUSIONS: Although postnatal corticosteroids have short-term benefits, they do not increase the survival rate, and they may cause motor dysfunction in survivors. A large-scale, placebo-controlled randomized trial, with survival free of sensorineural impairments and disabilities as the major endpoint, is urgently needed.

Adrenal Cortex Hormones↗
PubMed2004

Restoration of motor function of the deep fibular (peroneal) nerve by direct nerve transfer of branches from the tibial nerve: an anatomical study.

Traction injuries of the common fibular (peroneal) nerve frequently result in significant morbidity due to tibialis anterior muscle paralysis and the associated loss of ankle dorsiflexion. Because current treatment options are often unsuccessful or unsatisfactory, other treatment approaches need to be explored. In this investigation, the anatomical feasibility of an alternative option, consisting of nerve transfer of motor branches from the tibial nerve to the deep fibular nerve, was studied. In ten cadaveric limbs, the branching pattern, length, and diameter of motor branches of the tibial nerve in the proximal leg were characterized; nerve transfer of each of these motor branches was then simulated to the proximal deep fibular nerve. A consistent, reproducible pattern of tibial nerve innervation was seen with minor variability. Branches to the flexor hallucis longus and flexor digitorum longus muscles were determined to be adequate, based on their branch point, branch pattern, and length, for direct nerve transfer in all specimens. Other branches, including those to the tibialis posterior, popliteus, gastrocnemius, and soleus muscles were not consistently adequate for direct nerve transfer for injuries extending to the bifurcation of the common fibular nerve or distal to it. For neuromas of the common fibular nerve that do not extend as far distally, branches to the soleus and lateral head of the gastrocnemius may be adequate for direct transfer if the intramuscular portions of these nerves are dissected. This study confirms the anatomical feasibility of direct nerve transfer using nerves to toe-flexor muscles as a treatment option to restore ankle dorsiflexion in cases of common fibular nerve injury.

Adult↗
PubMed1997

Disruption of the dopamine beta-hydroxylase gene in mice suggests roles for norepinephrine in motor function, learning, and memory.

Mice unable to synthesize norepinephrine (NE) were created by targeted disruption of the dopamine beta-hydroxylase (DBH) gene. DBH-deficient (DBH -/-) mice display normal home cage activity; however, they swim more slowly than their littermates, and some drown. The mutant mice also perform less well on a rapidly rotating rod, and approximately 20% do not learn to walk when the rod begins to turn. Restoration of NE with dihydroxyphenylserine eliminated these motor deficits. DBH -/- mice exhibit normal learning and retention of a passive avoidance paradigm; however, they do not master an active-avoidance paradigm as readily as controls and exhibit more rapid extinction of the active-avoidance task. DBH -/- mice learn to find the hidden platform in the Morris water maze in spite of their slower swim speed and show normal preference for the correct quadrant in the transfer test immediately after training. However, this preference declines relative to controls during the next 2 days.

Animals↗
PubMedDate not supplied

[Specific features of the motor function of the digestive organs in persons with different degree of resistance to motion sickness].

The effect of three exposures to Coriolis acceleration on the frequency and amplitude of fasting stomach contractions was investigated in 6 resistant and 16 susceptible to motion sickness test subjects. After tests all of them underwent gastroduodenoscopy and 4 subjects from each group were subjected to echography to measure gall bladder contractility in response to glucose-milk loads. After tests the motor activity of the stomach increased slightly in resistant subjects due to an increase of the amplitude and a slight decrease of biopotential frequency. During gastroscopy antral and pyloric sphincters were closed. In the stomach there was an insignificant amount of contents without gall. In the susceptible group, the motor activity was, on the contrary, inhibited due to a significant decline of the wave amplitude and frequency (by 40% and 11%, respectively). In the stomach, one or both sphincters were widely open; it also contained a large amount of gastric juice and gall. In 36% of susceptible and 17% resistant subjects, diaphragmatic hernia (at the esophageal opening) was found. Ultrasonic examination of the gall bladder showed that susceptible subjects developed its faster and stronger contraction when compared to resistant subject in response to glucose-milk loading. This pointed to a more prolonged duration of the gall excretion phase. Reactive changes of the gastroduodenal zone in response to motion tests facilitated duodenal-gastric reflux and major gastrointestinal symptoms of motion sickness.

Adult↗
PubMed1977

Motor function of the esophagus after repair of esophageal atresia and tracheoesophageal fistula.

Eleven patients with previous esophageal atresia repair (TEF) underwent esophageal motility studies and were compared to 10 normal patients. The upper sphincters (UES) in the two groups did not differ in resting pressure, contraction pressure, or coordination. UES relaxation, was 100% in normal patients and 83+/-8% in the TEF patients (p less than 0.05). In the proximal esophagus, 100% of the TEF group showed a normal peristaltic wave, coupled with an abnormal nonperistaltic wave. The normal group did not show this type of contraction. In the middle esophagus, the mean peak pressure of 30.5+/-2.0 mm Hg was greater in controls than the 14.6+/-1.0 in the TEF group (p less than 0.001). Coordination was observed in 97+/-1% of the controls, while present in only 27+/-4% of the TEF patients (p less than 0.001). In the distal 10 cm of esophagus, peak contraction pressures were 43.3+/-1.6 in controls and 21.3+/-1.1 in the TEF group (p less than 0.001). Coordination was 94+/-1% in normal subjects and 66+/-4% in the TEF patients (p less than 0.001). The resting pressure in TEF patients was significantly higher at all three esophageal levels (proximal, mid, distal) than in normal patients. In both groups lower esophageal sphincter function did not show any significant difference, except for closing pressure, which was significantly higher in controls (39.9+/-6.8 mm Hg) than in the TEF groups (21.3+/-3.0 mm Hg) (p less than 0.02). These studies suggest that marked motility abnormalities occur in the repaired esophagus after atresia. These abnormalities are distinctly different from other motor disorders of the esophagus.

Adolescent↗
PubMed1998

Assessment of motor function after stereotactic pallidotomy.

Despite a paucity of controlled data, stereotactic pallidotomy is increasingly used for the treatment of advanced Parkinson's disease (PD). To study the efficacy of the procedure on the cardinal PD features of rigidity, tremor, bradykinesia, and postural instability, we blindly rated randomized videos of 34 patients recorded in the "off' state immediately before and 3 months after unilateral stereotactic lesioning of the globus pallidus internus. Total "off' time Unified Parkinson's Disease Rating Scale motor scores improved 13.6% from 28.9 +/- 7.5 to 25.0 +/- 7.0 (p < 0.001). Particularly robust improvement was seen in contralateral tremor, gait, and arising from a chair (p < 0.001). Significant improvement was also seen in ipsilateral tremor, contralateral and some ipsilateral dexterity measures, and body bradykinesia. Most other features tended toward improvement but did not reach statistical significance. We conclude that pallidotomy is a safe and effective treatment of parkinsonian symptoms, many of which improve bilaterally.

Adult↗
PubMed1980

[Motor functions and their analysis in the developmental neurology. Part II: Spontaneous motility and straightening functions (author's transl)].

In a prospective longitudinal study, we investigated all low-risk infants on five occasions up to the end of their first year of life. In the second part of the report, we present the developmental changes of spontaneous motility and straightening functions. The consideration of behavioural state is important for the outcome of neurological testing. The changes of spontaneous motility (intensity, speed and quantity of motions, startles, tremor, prehension ...) are sufficient parameters for developmental diagnosis. Some functions (goal directed arm-motion, prehension...) are correlated to environmental influences. The usual practice of developmental diagnosis is insufficiently directed to developmental processes in the CNS.

Child Development↗
PubMed1990

Analgesic synergy and improved motor function produced by combinations of mu-delta- and mu-kappa-opioids.

This study evaluated the effects of intrathecal administration of a low-analgesic dose of the selective mu-agonist DAMGO co-administered with sequentially increasing doses of either the selective delta-agonist DPDPE or the selective kappa-agonist, U50,488H on mechanical nociceptive thresholds in the rat. Potent analgesic synergy was observed with both combinations. Since an elevation in nociceptive threshold can result from motor deficits, as well as true analgesia, we also evaluated the effects of the combination regimens on motor coordination using a rotarod apparatus. The combination regimens produced significantly less motor deficits than those observed when DPDPE and U50,488H were administered as single agents. These findings of enhanced analgesia with decreased motor side-effects associated with administration of fixed mu/delta or mu/kappa combinations suggest that co-administration of opiates that act at different receptors may constitute a superior approach to the treatment of pain.

3,4-Dichloro-N-methyl-N-(2-(1-pyrrolidinyl)-cycloh↗
PubMedDate not supplied

Delta-9-tetrahydrocannabinol differentially suppresses cisplatin-induced emesis and indices of motor function via cannabinoid CB(1) receptors in the least shrew.

We have recently shown that the cannabinoid CB(1) receptor antagonist, SR 141716A, produces emesis in the least shrew (Cryptotis parva) in a dose- and route-dependent manner. This effect was blocked by delta-9-tetrahydrocannabinol (Delta(9)-THC). The present study investigates the cannabinoid receptor mechanisms by which Delta(9)-THC produces its antiemetic effects against cisplatin (20 mg/kg, i.p.)-induced emesis as well as its cannabimimetic activity profile (motor reduction) in the least shrew. Intraperitoneal administration of Delta(9)-THC (1, 2.5, 5 and 10 mg/kg) dose-dependently reduced both the percentage of animals vomiting (ID(50)=1.8+/-1.6 mg/kg) and the frequency of vomits (ID(50)=0.36+/-1.18 mg/kg) in a potent manner. The lowest significantly effective antiemetic dose of Delta(9)-THC for the latter emesis parameters was 2.5 mg/kg. Although Delta(9)-THC reduced the frequency of vomits up to 98%, it failed to completely protect all tested shrews from vomiting (80% protection). The cannabinoid CB(1) antagonist (SR 141716A) and not the CB(2) antagonist (SR 144528), reversed the antiemetic effects of Delta(9)-THC in a dose-dependent fashion. Delta(9)-THC (1, 5, 10 and 20 mg/kg, ip) suppressed locomotor parameters (spontaneous locomotor activity, duration of movement and rearing frequency) in a biphasic manner and only the 20-mg/kg dose simultaneously suppressed the triad of locomotor parameters to a significant degree. Subcutaneous (1-10 mg/kg) and intraperitoneal (0.05-40 mg/kg) injection of some doses of SR 141716A caused significant reductions in one or more components of the triad of locomotor parameters but these reductions were not dose dependent. Subcutaneous injection of SR 141716A (0.2, 1, 5 and 10 mg/kg) reversed the motor suppressant effects of a 20-mg/kg dose of Delta(9)-THC (ip) in a dose-dependent manner. Relative to its motor suppressant effects, Delta(9)-THC is a more potent antiemetic agent. Both effects are probably mediated via CB(1) receptors in distinct loci.

Animals↗
PubMed1997

[Motor functional MRI by spiral scan--compared with GRE].

Recently, functional MRI (fMRI) has been performed in two methods using 1.5 tesla machine. One was performed using gradient recalled echo (GRE), the other was performed using echo planner imaging (EPI). There is a third method for fMRI called spiral scan. This method is applicable without strong gradient magnetic field such as required by EPI. In this study, motor fMRI was performed in ten normal volunteers by both spiral scan and GRE. Less than 1% risk (t-test), spiral scan showed the reactive area more clearly than GRE. And GRE showed higher signal intensity changing ratio than spiral scan, but there was no significant difference between spiral scan and GRE. The acquisition time of spiral scan was 2 seconds per image, and that of GRE was 10.5 seconds. Spiral scan has good temporal resolution and contrast-noise ratio. These are very advantageous for fMRI.

Adult↗
PubMed2003

Motor functional MRI for pre-operative and intraoperative neurosurgical guidance.

Functional MRI (fMRI) may provide a means of locating areas of eloquent cortex that can be used to guide neurosurgeons in their quest to maximize intracerebral tumour resection whilst minimizing post-procedural neurological deficits. This work aimed to develop and provide an initial assessment of such a technique. 19 patients with mass lesions close to the primary motor cortex underwent fMRI at 1.5T. A single shot echo planar technique was used to acquire data corresponding to right and left hand movement. Resultant activation maps were used to aid pre-surgical planning. Data was used in conjunction with an intraoperative navigation system in 13 cases. Activation was attributed to primary motor, primary somatosensory or supplementary motor cortex in 17 of 19 subjects. No permanent changes in motor deficit were detected post surgery. The additional information provided by fMRI, particularly when incorporated into a neuronavigation guided craniotomy, was deemed highly valuable to the neurosurgeon as it enabled safe resection of tumour in anatomical locations previously deemed to be too high risk for safe resection using conventional (non-fMRI-guided) technique. This observation is reinforced by the fact that no patients suffered permanent neurological deficit after radical tumour debulking (surgical estimates >90% tumour resection).

Adolescent↗
PubMed2001

Cognitive and motor function and the size of the cerebellum in adolescents born very pre-term.

Individuals born before 33 weeks' gestation are at risk of brain lesions, which have the potential to disrupt subsequent neurodevelopment. As a result they manifest an increased incidence of neuromotor signs and cognitive deficits, which can still be detected in adolescence. The cerebellum is known to be involved in both the co-ordination of movement and in cognitive processes. We therefore set out to establish whether cognitive and motor impairments in adolescents born very pre-term are associated with abnormalities of the cerebellum as revealed by volumetric analysis of brain MRI scans. The volume of the whole cerebellum was determined manually using a PC-based Cavalieri procedure in 67 adolescents born very pre-term and 50 age-matched, full-term born controls. Cognitive and neurological assessments were performed at 1, 4, 8 and 14-15 years of age as part of the long-term follow-up of the pre-term subjects. The pre-term-born subjects had significantly reduced cerebellar volume compared with term-born controls (P<0.001). This difference was still present after controlling for potential confounders. There was no association between cerebellar volume and motor neurological signs. However, there were significant associations between cerebellar volume and several cognitive test scores, in particular the Wechsler Intelligence Scale for Children-Revised, the Kaufman Assessment Battery for Children and the Schonnel reading age. This provides further evidence implicating the cerebellum in cognition and suggests that cerebellar abnormalities may underlie some of the cognitive deficits found in individuals born very pre-term.

Adolescent↗
PubMed1985

Developmental regulation of motor function: an uncharted sea.

The field of developmental neurobiology is entering a very exciting phase, in which the application of new techniques promises to lead to major advances in our understanding of basic developmental processes. There is a need to apply much of this new knowledge to problems of spinal cord and muscle development, about which little is known at present. An understanding of the development of muscle fiber types and the spinal circuitry controlling locomotion would have a major impact on fundamental problems in motor control and exercise physiology. Significant progress is likely to be made in these areas in the next few years, but only if researchers interested in motor control and related areas take an interest in development. Among the most immediate problems that need to be addressed are: the lineage analysis of spinal neurons; identification of the factors controlling neuron differentiation; identification of the molecular basis for directed axon growth; and analysis of the factors controlling network assembly in the spinal cord. In muscle development, an understanding of how fiber type proportions are generated would have great significance for disciplines related to motor performance. The interaction and exchange of ideas between developmental biologists and exercise scientists promises to accelerate understanding and progress in both fields of endeavor.

Animals↗
PubMed2006

Subthalamic glutamic acid decarboxylase gene therapy: changes in motor function and cortical metabolism.

Parkinson's disease (PD) is associated with increased excitatory activity within the subthalamic nucleus (STN). We sought to inhibit STN output in hemiparkinsonian macaques by transfection with adeno-associated virus (AAV) containing the gene for glutamic acid decarboxylase (GAD). In total, 13 macaques were rendered hemiparkinsonian by right intracarotid 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine injection. Seven animals were injected with AAV-GAD into the right STN, and six received an AAV gene for green fluorescent protein (GFP). Videotaped motor ratings were performed in a masked fashion on a weekly basis over a 55-week period. At 56 weeks, the animals were scanned with (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET). Histological examination was performed at the end of the study. No adverse events were observed after STN gene therapy. We found that the clinical rating scores for the two treatment groups had different patterns of change over time (group x time interaction, P<0.001). On FDG PET, the GAD animals exhibited an increase in glucose utilization in the right motor cortex relative to GFP controls (P<0.001). Metabolism in this region correlated with clinical ratings at end point (P<0.01). Histology confirmed GAD expression in treated animals. These findings suggest that STN AAV-GAD is well tolerated and potentially effective in a primate model of PD. The changes in motor cortical glucose utilization observed after gene therapy are consistent with the modulation of metabolic brain networks associated with this disorder.

Animals↗
PubMed1980

The vagal control of the pyloric motor function: a physiological and immunohistochemical study in cat and man.

In acute experiments in anesthetized cats (n = 75), with ligated adrenals the influence on the pyloric sphincter of afferent and efferent electrical stimulation of the cervical vagi was studied with a flow recording technique. Gastric motility was recorded simultaneously with a volume recording technique. Efferent stimulation using high threshold parameters (8 V; 5 ms; 8 Hz) resulted in a prompt gastric contraction and a delayed pyloric contraction (23 +/- 17 s). In one third of the cats biphasic pyloric motor response, consisting of a short period of increased flow preceding a longlasting cessation of the flow, was observed. When the transpyloric flow was reduced by splanchnic nerve stimulation or noradrenalin infusion, efferent vagal nerve stimulation induced an increased flow supporting the assumption of relaxatory fibres to the pylorus within the vagus as well. Unilateral afferent stimulation resulted in a decreased flow within 5 +/- 3 s and a prompt gastric relaxation, which were both abolished at transection of the intact contralateral vagus indicating vago-vagal reflexes. After atropine (0.2 mg/kg i.v. b.w.) efferent stimulation resulted in a gastric relaxation, while the biphasic pyloric motor response was even more pronounced with a long (60 s) latency of the contractile phase. Addition of guanethidine (2 mg/kg i.v. b.w.) did not affect these responses. After hexamethonium (25 mg i.v. + 50 mg +/- 10 mg i.a./h) the stimulation procedure resulted in a gastric relaxation, while the pyloric contraction was blocked. The relaxatory phase required the addition of atropine for blockade, indicating separate transmission mechanisms for the two components of the pyloric motor response at such stimulation. Hexamethonium effectively antagonized the pyloric contraction at afferent stimulation. Immunohistochemical studies revealed a rich enkephalinergic innervation of the pylorus and the presence of enkephalin-like material within vagal axons. VIP-like material was demonstrated within the same tissues with a similar distribution. The hypothesis of a transmission via non-classical receptors was corroborated in experiments, where the pyloric contraction at vagal efferent stimulation was blocked dose-dependently by the opiate receptor antagonist, naloxone i.a. Furthermore, micromolar doses i.a. of enkephalins mimicked the vagal motor effects, i.e. pyloric contraction and gastric relaxation, which were reversed by equimolar doses of naloxone in favour of a pyloric enkephalinergic contraction. Intraarterial injection of nanomolar doses of this VIP resulted in both a gastric and pyloric relaxation. Specimens of the human vagus from the thoracic and abdominal levels were investigated with immunohistochemistry. Substance P and enkephalin containing fibres and a low number of VIP fibres were seen at all levels indicating the presence of an axonal transport of these peptides in the human vagus.

Afferent Pathways↗
PubMed2005

Cannabinoid control of motor function at the basal ganglia.

Classic and novel data strengthen the idea of a prominent role for the endocannabinoid signaling system in the control of movement. This finding is supported by three-fold evidence: (1) the abundance of the cannabinoid CB1 receptor subtype, but also of CB2 and vanilloid VR1 receptors, as well as of endocannabinoids in the basal ganglia and the cerebellum, the areas that control movement; (2) the demonstration of a powerful action, mostly of an inhibitory nature, of plant-derived, synthetic, and endogenous cannabinoids on motor activity, exerted by modulating the activity of various classic neurotransmitters; and (3) the occurrence of marked changes in endocannabinoid transmission in the basal ganglia of humans affected by several motor disorders, an event corroborated in animal models of these neurological diseases. This three-fold evidence has provided support to the idea that cannabinoid-based compounds, which act at key steps of the endocannabinoid transmission [receptors, transporter, fatty acid amide hydrolase (FAAH)], might be of interest because of their potential ability to alleviate motor symptoms and/or provide neuroprotection in a variety of neurological pathologies directly affecting basal ganglia structures, such as Parkinson's disease and Huntington's chorea, or indirectly, such as multiple sclerosis and Alzheimer's disease. The present chapter will review the knowledge on this issue, trying to establish future lines for research into the therapeutic potential of the endocannabinoid system in motor disorders.

Animals↗
PubMed1992

Oesophageal motor function before and after healing of oesophagitis.

Forty three patients with reflux oesophagitis were studied to investigate the effect of healing on oesophageal function. All patients underwent oesophageal manometry and transit studies before and after complete healing of oesophagitis. Oesophagitis was treated with omeprazole 40 mg/day for a median duration of 12 weeks. Twenty three patients also had an acid clearance test before and after healing. Thirty eight of the 43 patients had 24 hour oesophageal pH monitoring before treatment and this was repeated after healing (while on omeprazole) in 31 of them. Thirty four volunteers served as controls. All volunteers underwent manometry, 33 had oesophageal transit studies, and 23 had acid clearance test. Patients had significantly reduced lower oesophageal sphincter pressures and distal and middle oesophageal amplitudes, longer durations of contraction, and slower velocity of propagation than the controls (16.5 v 22.5 mm Hg; 52 v 92 mm Hg; 46 v 79 mm Hg; 3.1 v 2.7 seconds; and 3.3 v 4.1 cm/second respectively with the corresponding p values = 0.017; 0.0001; 0.0001; 0.017; and 0.006). Patients had significantly longer transit times (9 v 7 and 17 v 11 seconds: p = 0.027 and 0.002 for erect and supine postures respectively). They also had longer acid clearance times (350 v 288 and 536 v 405 seconds: p = 0.044 and 0.016 for sitting and supine postures respectively). There was no significant change in any of the indices of oesophageal function after healing of oesophagitis (lower oesophageal sphincter pressure = 16.5 v 20; distal amplitude = 52 v 60; middle amplitude = 46 v 49; duration of contraction = 3.1 v 3.1; velocity = 3.3 v 3.3; erect transit time = 9 v 9; supine transit time = 17 v 24; acid clearance test (sitting) = 350 v 371; acid clearance test (supine) = 536 v 645). These results indicate that oesophageal motor dysfunction in reflux oesophagitis is a primary phenomenon.

Adult↗