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[Clinical comparison between radial and lateral forearm flap].

BACKGROUND: Free fasciocutaneous flap transplantation is a versatile method for soft tissue reconstruction. This clinical study points out differences between the radial forearm flap and the lateral arm flap. METHODS: We used the radial forearm flap in 36 patients following tumor ablation and in 11 patients we used the lateral arm flap for soft tissue reconstruction. We studied the arterial and venous vessel calibers of the flaps, the vessel pedicle length, and the size of the skin paddle. Motor and sensory function tests of the upper/ lower arm and hand were performed after surgery. Recipient and donor site morbidity was noted. RESULTS: Compared to the forearm flap the lateral arm flap is bulky (1-5 cm vs. 0.5-1.5 cm), its vessel calibers are smaller (Art.: 1.4 vs. 1.8 mm, Ven.: 1.8 vs. 2.0 mm), flap size and maximum vessel pedicle length (10 vs. 12 cm) are equal. Raising the lateral arm flap is more demanding and needs more time due to the deep location of the vessel pedicle and the accompanying radial nerve within the intermuscular septum. On the other hand the lateral arm flap is advantageous because of primary wound closure of the donor site. The donor site of the forearm flap had to be covered with skin graft in all cases. We found sensory deficits of the proximal lower arm in 50% after dissection of the lateral arm flap and in 14% on the distal lower arm and thumb joint after dissection of the radial forearm flap. CONCLUSIONS: Both transplants are fasciocutaneous and optional innervated, they offer a constant anatomy and can be harvested simultaneously without interference to the head and neck team. Because of the specific characteristics of these flaps we prefer the radial forearm flap for soft tissue reconstruction. We use the lateral upper arm flap, if a forearm flap cannot be harvested, for head or neck augmentation and for reconstruction of large and deep defects.

Forearm↗

Pain perception under chronic high-altitude hypoxia.

Following studies of respiratory sensory functions during high-altitude adaptation, pain perception investigations were carried out on European lowlanders during an expedition on the Bhrikuti peak, Himalaya (first ascent). Perception thresholds and discrimination performances of electrical stimuli applied to the skin were determined with a constant stimulus method. Additionally, Clark's Situational Pain Questionnaire was used to measure discriminability and response bias of the subjects' reports of pain. The tests were performed in the field under normoxic conditions, before and after ascent, and under hypoxic conditions at altitudes of 3500 and 5600 m. The tests were also performed in a control group under normoxic conditions and similar ambient temperatures. Under normoxic conditions, the expedition group differed from the control group and demonstrated a more stoic attitude and a lower pain threshold. At high altitudes, pain thresholds decreased through improved sensory discrimination performances. Hypoxia is supposed to be the main cause of this sensory adaptive reaction to altitude as psychological attitude remained unchanged and a decrease in ambient temperature was without effect on pain perception in the control group. Increased discrimination in pain perception may be a component of a general improvement in sensory processing during the early stages of altitude acclimatization.

Adult↗

The anatomical basis of a new method for re-innervation of the gluteal region in paraplegics.

The surgical treatment of pressure sores in paraplegic patients currently consists of myocutaneous flaps, direct suture and cover with split thickness skin grafts. These surgical methods of closing defects in pressure bearing areas do not normally provide any sensory function unless the skin flaps have intact sensibility or have been re-innervated in a first stage operation. The aim of the present project is to study the feasibility of re-innervating the gluteal region directly by mobilizing intercostal nerves, extending their reach by nerve grafts and neurotization of the required area without involving other skin areas so achieving: 1) re-innervation of skin to gain protective sensibility in the pressure bearing area, 2) re-innervation of the gluteus maximus muscle to gain voluntary muscle contraction to improve blood flow and diminish ischaemia. So far, 10 cadaver dissections have been performed to define anatomical relationships. Different intercostal nerves were dissected to allow for the various levels of spinal cord lesion among the patients. Through an incision in the midgluteal region, the sensory nerve to the skin covering the ischial tuberosity and the motor nerve to the gluteus maximus were located. The technical possibilities of connecting these nerves to intercostal nerves via sural nerve grafts were demonstrated.

Buttocks↗

Comparison of Hoffmann reflex with quantitative assessment of cutaneous sensation in diabetic neuropathy.

Neurophysiological studies of diabetic patients may show abnormalities even when clinical examination has revealed no sign of neuropathy. Quantitation of sensory function provides additional information when examining a patient with neuropathy. The value of the Hoffmann (H) reflex was investigated in diabetics who had undergone this examination. H-M intervals of the H-reflex, vibration perception thresholds (VPT's) and thermal discrimination thresholds (TDT's) were determined in 34 diabetics with clinical evidence of neuropathy and 16 diabetics without symptoms or signs of neuropathy. Normal values for VPT and TDT were obtained from the examination of 40 healthy subjects. The values of the H-M interval were significantly correlated with VPT's and not with TDT's. Three patients with clinical evidence of neuropathy and abnormal VPT's and TDT's had normal H-M intervals. For research purposes it is recommended that H-reflex studies are combined with the determination of sensory thresholds, but from a practical point of view determination of the H-M interval proved to be an effective tool for the investigation of neuropathy in diabetic patients.

Adult↗

Ipsilateral hand input to area 3b revealed by converging hemodynamic and electrophysiological analyses in macaque monkeys.

Functional magnetic resonance imaging (fMRI) of the hand representation in primary somatosensory cortex (area 3b) of macaque monkeys revealed an ipsilateral hand input undetected by most previous studies. Ipsilateral responses had a hemodynamic signature indistinguishable from that of contralateral hand responses. We explored the neural mechanisms of the fMRI effects using a second derivative analysis of field potentials [current source density (CSD) analysis] combined with action potential profiles, sampled from area 3b using linear array multielectrodes. In contrast to the predominantly excitatory contralateral response, the colocated ipsilateral response appeared dominated by inhibition, suggesting that ipsilateral inputs may have modulatory effects on contralateral input processing. Our findings confirm bimanual convergence at the earliest stage of cortical somatosensory processing in primates. They also illustrate the value of combined CSD and fMRI analyses in monkeys for defining hidden aspects of sensory function and for investigating the neuronal processes generating fMRI signals.

Animals↗

ATP is a mediator of chemosensory transduction in the central nervous system.

Extracellular signalling by the purine nucleotide ATP has long been associated with sensory function. In the periphery, ATP mediates nociception, mechanosensitivity, thermal sensitivity and O2 chemosensitivity. These processes share a common mechanism that involves the release of ATP to excite afferent fibres via activation of ionotropic P2X and/or metabotropic P2Y receptors. Chemosensors located in the brainstem are crucial for the maintenance of physiological levels of blood gases through the regulation of breathing. Here we show that an increase in pCO2 in the arterial blood triggers the immediate release of ATP from three chemosensitive regions located on the ventral surface of the medulla oblongata. Blockade of ATP receptors at these sites diminishes the chemosensory control of breathing, suggesting that ATP release constitutes a key step in central chemosensory transduction. These new data suggest that ATP, a phylogenetically ancient, unique and simple molecule, has been widely used in the evolution of afferent systems to mediate distinct forms of sensory transduction not only in the periphery but also within the central nervous system.

Adenosine Triphosphate↗

Assessment of cutaneous sensory and autonomic axon reflexes in rheumatoid arthritis.

OBJECTIVE: To assess sensory function in skin overlying the joints of patients with rheumatoid arthritis, in relation to the pain and tenderness which commonly arises in structures not directly involved in the inflammatory process. METHODS: An intradermal injection of capsaicin 0.05 microgram in 10 microliters was made over the wrists and forearms of 40 patients with rheumatoid arthritis and 46 control subjects. Axon reflex vasodilatation was measured using laser Doppler flowmetry. Cholinergic sympathetic function was assessed by measuring axon reflex sweating induced by a single intradermal injection of nicotine 0.5 microgram in 0.1 ml. RESULTS: Capsaicin induced axon reflex vasodilation over the wrists was found to decrease with age in normal subjects (r = -0.62, p < 0.001). In patients with rheumatoid arthritis, capsaicin induced axon reflex vasodilatation was significantly greater over the wrists, but not the forearms, when compared with age matched normal controls (p < 0.01). A minimal correlation between axon reflex vasodilatation and visual analogue pain score was apparent in the rheumatoid group (r = -0.37, p < 0.05). Nicotine induced sweating responses were similar in the rheumatoid and normal groups, and both showed a linear age related decline. CONCLUSIONS: The results show a selective increase of capsaicin induced vasodilatation in skin overlying joints in patients with rheumatoid arthritis. This suggests that the activity of a sub-population of periarticular small sensory fibres is altered, which may explain, at least in part, some of the clinical findings in this disorder.

Adult↗

[Dislocated multiple fragment fractures of the head of the humerus. Does dislocation of the humeral head fragment signify a worse prognosis?].

PROBLEM: The vascularity of the articular fragment is of key importance for the final outcome in three- and four-part fractures of the humeral head. Displacement of the articular segment may compromise the arterial blood supply to the humeral head and result in avascular necrosis. There is still controversy as to whether three-and four-part fracture dislocations (articular fragment outside the glenoid) have an even worse prognosis than displaced three- and four-part fractures. PATIENTS AND METHODS: Between January 1985 and May 1993, 102 patients with three- and four-part fractures of the humeral head were treated by ORIF (mostly tension band wiring) at our institution. In a retrospective study we analysed the functional (Constant 100 point score) and radiological outcome of 67 (66%) of these patients. There were 21 patients with fracture dislocations (FD), n = 5 type B2X, n = 5 type B3X, n = 3 type C2X, n = 8 type C3X, according to the classification of Habermeyer [7]. The "X" represents the dislocation of the articular fragment, whereas the classification to each type is done after reduction of the head. The remaining 46 patients presented with displaced, but not dislocated, three- and four-part fractures (DF), n = 24 type B2, n = 7 type B3, n = 3 type C2, n = 12 type C3. Average follow-up was 25 months (7-72 months). Patients with FD were significantly younger (average age 50 years) than patients with DF (average age 63 years, P < 0.05) and showed a significantly higher incidence of traumatic nerve or plexus lesions (FD 19%, DF 2%, P < 0.05). RESULTS: Concerning the functional results, there was no statistically significant difference between the two groups. The FD patients even showed a slight tendency to better results than patients with DF. This was true for the three-part fractures (average Constant score 78 versus 67 points), as well as for the four-part fractures (average Constant score 62 versus 55 points). The significantly younger age of the FD patients may explain their better results. The entire group of patients with three-part fractures showed a significantly better functional outcome (average Constant score 68 points) than patients with four-part fractures (average Constant score 55 points, P < 0.05). The rate of partial and total avascular necrosis of the humeral head was strongly correlated to the fracture type (number of fragments, fracture of the anatomical or surgical neck, according to the classification of Habermeyer),but again there was no difference between the FD and DF group (B2X: 20%, B3X: 20%, C2X: 33%, C3X: 63%; B2: 25%, B3: 29%, C2: 33%, C3: 67%). Astonishingly, the FD were not associated with an increased rate of avascular necrosis of the humeral head. Three (axillary nerve) out of the five observed primary nerve and plexus lesions had a full neurological recovery after 6-12 months; the two patients with alterations of the brachial plexus showed a slow tendency of improvement at follow-up (12 and 18 months), but still had gross muscular atrophy and impaired sensory function. CONCLUSION: In displaced three-and four-part fractures of the humeral head the dislocation of the articular segment does not seem to increase the risk of avascular necrosis, if treated by timely and careful ORIF with respect to the vascularity. Even with the increased risk of primary nerve and plexus lesions in fracture dislocations, good functional results can be achieved by early operative nerve decompression and fracture stabilization in this middle-aged patient group. However, older patients with displaced or dislocated four-fragment fractures through the anatomical neck (type C3) have a poor chance of a favourable outcome, and therefore primary prosthetic replacement should be considered.

Adult↗

Extended genioplasty: long-term cephalometric, morphometric and sensory results.

The incision, dissection, osteotomy design and fixation are important technical considerations when performing a genioplasty. The purpose of this study was to describe an extended genioplasty technique and to evaluate stability of position, form, surface area of the chin and incidence of postoperative sensory deficit. Records of 15 consecutive adult patients who underwent the extended genioplasty procedure were reviewed. The technique included incision in the labial vestibule from 2nd premolar to 2nd premolar, dissection, mobilization and retraction of the mental nerves, osteotomy parallel to the occlusal plane extending proximally to the antegonial notch and rigid fixation. Lateral cephalograms pre- and postoperatively and at the latest follow-up (> 6 months) were analyzed by linear and computer morphometric measurements to evaluate changes in position, shape and surface area of the chin. Neurosensory data from examination or questionnaire were recorded. Immediately postoperatively (T1), mean advancement in the sagittal plane was +8.7 mm and increase in surface area was +1.1 cm2. At the end of follow-up (T2), there were no significant changes (T2-T1) in chin position or surface area. Inferior border form was rated as smooth in all cases. Neurosensory evaluation revealed that 12/12 patients evaluated had functional sensory return at T2.

Adult↗

Isolation and characterization of the regulatory subunit of cAMP-dependent protein kinase from the filarial parasite Onchocerca volvulus.

Protein kinases exert major regulatory effects in eukaryotic signaling events. As these proteins play central regulatory and sensory functions they are interesting targets for antiparasitic drug development and serve as vaccine candidates. A cDNA with an open reading frame of 1122 bp coding for the regulatory subunit of the cAMP-dependent protein kinase (Ov-pka-r) of the pathogenic human nematode Onchocerca volvulus has been isolated. The predicted protein displays 84% homology to the corresponding protein of Caenorhabditis elegans and 71% to the human homologue. The O. volvulus protein has unique features, it includes six cysteine residues, as compared to four residues in mammals. Ov-PKA-r was recombinantly expressed as His-tagged protein and under reducing conditions showed a molecular mass of 52 kDa. In sera from O. volvulus patients IgG antibodies were found that strongly reacted with the recombinant Ov-PKA-r. Using rabbit antisera raised against the recombinant protein for immunohistology allowed the localization of the native Ov-PKA-r within the nervous system and sensory organs of adult O. volvulus worms and of microfilariae. The predominant expression in the nervous system and sensory organs as well as the unique structural features identify this signaling molecule of O. volvulus as a new and interesting target for drug or vaccine development.

Amino Acid Sequence↗

Associations between the neuroendocrine and immune systems.

Organisms respond to infection with complex adaptations involving bidirectional communication between the immune and neuroendocrine systems. The idea of intercellular communication between the neuroendocrine and immune systems via common signal molecules has provided a conceptual framework for such crosstalk. The studies to date show that cells of the immune system contain receptors for neuroendocrine hormones and can also be considered a source of pituitary and hypothalamic peptides. The structure and pattern of synthesis of these peptides by leukocytes appear similar to neuroendocrine hormones, although some differences exist. Once secreted, these peptide hormones may function as endogenous regulators of the immune system as well as conveyors of information from the immune to the neuroendocrine system. The plasma hormone concentrations contributed by lymphocytes usually do not reach the levels required when the pituitary gland is the source, but because immune cells are mobile, they have the potential to locally deposit the hormone at the target site. Likewise, other studies show that cells of the neuroendocrine system contain receptors for cytokines and can also be considered a source of cytokines, particularly interleukin-1 (IL-1) and IL-6. In the pituitary IL-1 beta coexists with thyroid stimulating hormone in a subpopulation of thyrotropes, suggesting it may have a role as a pituitary paracrine factor. The cytokines, including IL-1, IL-2, IL-6, interferon-gamma, and tumor necrosis factor, exert profound effects on hypothalamic pituitary axes. It is our hypothesis that the relay of information to the neuroendocrine system represents a sensory function for the immune system wherein leukocytes recognize stimuli that are not recognizable by the central and peripheral nervous systems (i.e., bacteria, tumors, viruses, and antigens). The recognition of such noncognitive stimuli by immunocytes is then converted into information and a physiological change occurs. Future studies into the physiological role that cytokines and neuroendocrine hormones have in these systems will be of considerable interest for both immunologists and endocrinologists.

Animals↗

Loss of pain perception in diabetes is dependent on a receptor of the immunoglobulin superfamily.

Molecular events that result in loss of pain perception are poorly understood in diabetic neuropathy. Our results show that the receptor for advanced glycation end products (RAGE), a receptor associated with sustained NF-kappaB activation in the diabetic microenvironment, has a central role in sensory neuronal dysfunction. In sural nerve biopsies, ligands of RAGE, the receptor itself, activated NF-kappaBp65, and IL-6 colocalized in the microvasculature of patients with diabetic neuropathy. Activation of NF-kappaB and NF-kappaB-dependent gene expression was upregulated in peripheral nerves of diabetic mice, induced by advanced glycation end products, and prevented by RAGE blockade. NF-kappaB activation was blunted in RAGE-null (RAGE(-/-)) mice compared with robust enhancement in strain-matched controls, even 6 months after diabetes induction. Loss of pain perception, indicative of long-standing diabetic neuropathy, was reversed in WT mice treated with soluble RAGE. Most importantly, loss of pain perception was largely prevented in RAGE(-/-) mice, although they were not protected from diabetes-induced loss of PGP9.5-positive plantar nerve fibers. These data demonstrate, for the first time to our knowledge, that the RAGE-NF-kappaB axis operates in diabetic neuropathy, by mediating functional sensory deficits, and that its inhibition may provide new therapeutic approaches.

Animals↗

A prospective electromyographic and computer-aided thermal sensitivity assessment of nerve lesions after sagittal split osteotomy and Le Fort I osteotomy.

PURPOSE: The purpose of this study was to determine the incidence of temporary and permanent sensory disturbance of the inferior alveolar nerve (IAN) after bilateral sagittal split osteotomy (BSSO) of the mandible and of the infraorbital nerve (ION) after Le Fort I osteotomy, as well as the rate of recovery of sensory function using subjective and objective measures. PATIENTS AND METHODS: Preoperatively and after 1 week, and 1, 3, 6, and 12 months postoperatively, sensibility in the distribution of 36 IONs after Le Fort I osteotomy and 24 IANs after BSSO in 19 patients were investigated by using sharp-blunt testing, 2-point discrimination, electromyographic recording, and thermal sensitivity (Pain and Thermal Sensitivity Test Device [PATH]) tests of the Adelta and C nerve fibers. RESULTS: With conventional clinical sharp-blunt and 2-point discrimination tests, the incidence of temporary impairment was 81% for the ION (29 of 36) and 83% for the IAN (20 of 24). The rate of permanent sensibility disturbance with conventional clinical testing was 6% for the ION and 15% for the IAN. Obvious recovery was found after 1 to 3 months for the ION, but it took 6 to 12 months for the IAN. In contrast, electromyography (EMG) testing showed lower rates of temporary sensory disturbance, namely, 54% (13 of 24) for the ION and 68% (15 of 22) for the IAN. Permanent sensory losses were not found. The results of the EMG test was confirmed by the PATH test. CONCLUSIONS: Objective tests for sensory disturbances show lower rates than the conventional tests. For quality control, preoperative and postoperative measurement and documentation of postoperative recovery of sensation is recommended.

Adolescent↗

Effect of age, sex and parity on anorectal function.

Ninety-one healthy subjects (51 women; age range 16-85 years) were studied prospectively to determine the effect of age, sex and parity on anorectal function. Maximum resting pressure, voluntary contraction pressure, rectal sensation to distension, rectal and mid-anal electrosensitivity, perineal descent, pudendal nerve terminal motor latency and fibre density of the external and sphincter were measured. Sex influenced mean(s.d.) voluntary contraction pressure (148(56) versus 95(43) cmH2O for men versus women, P < 0.0001), perineal descent on straining (1.0(0.5) versus 1.3(0.4) cm, P = 0.02) and fibre density (1.43(0.14) versus 1.52(0.15), P = 0.02). Age influenced resting pressure (r = -0.43, P = 0.0001), perineal position at rest (r = -0.55, P < or = 0.0001), mid-anal electrosensitivity (r = 0.42, P = 0.0001) and rectal electrosensitivity (r = 0.54, P < 0.0001). Parity affected mean(s.d.) voluntary contraction pressure (105(53) versus 75(20) cmH2O for nulliparous versus parous women, P = 0.04) and mid-anal electrosensitivity (5.3(2.3) versus 4.5(2.3) mA, P = 0.02). Increasing age leads to perineal descent at rest, slowed pudendal nerve conduction, a fall in resting anal pressure and decreased anorectal sensory function. Women have a lower and squeeze pressure, greater perineal descent, longer pudendal nerve terminal motor latency and a greater muscle fibre density than men. Parity leads only to lower squeeze pressure.

Adolescent↗

Apoptosis in the human inner ear. Detection by in situ end-labeling of fragmented DNA and correlation with other markers.

The aim of this study was to obtain baseline data on the recently described special form of single cell death, apoptosis, in normal human inner ears. For this purpose, in situ end-labeling of the fragmented DNA was applied, in conjunction with apoptosis-related markers, to detect cellular elements showing programmed cell death in decalcified and paraffin-embedded tissues. Over 20 specimens were analyzed which were obtained from autopsy cases with no history of acoustic lesions confirmed by histopathology. Based on staining results, we saw no apoptotic signs in the majority of normal adult inner ears. An apoptotic cell captured in the Reissner's membrane of the cochlea from an old patient may, however, indicate an age-related subtle cell loss with the process of apoptosis. Nevertheless, the fact that more apoptosis was not found in our cases suggests that this phenomenon does not contribute significantly to the tissue homeostasis in the adult inner ear under normal conditions. These data are in accordance with our immunohistochemical findings on the p53 nucleoprotein, and proliferating cell nuclear antigen expression since there was no staining in any of the cellular elements, including the mesenchymal cells. This reflects a stationary and stable condition of cells of the vestibular and the cochlear structures, probably to maintain their integrity and the fine sensory functions. As opposed to the above findings, during inner ear development, the epithelial cells lining the cochlear lumen, the ossifying cartilage of the temporal bone, and the mesenchymal cells show different degrees of proliferation in combination with single cell death as signs of maturation of the vestibular and the cochlear apparatus. In addition, apoptosis has been demonstrated in cells of the cochlear stria vascularis from an adult patient treated with high doses of cisplatin, vinblastine and bleomycin prior to death. Furthermore, a wide range of apoptosis could be induced experimentally in a normal ear by an external perfusion of actinomycin D (ActD), which is known to produce programmed cell death in many cell types of different origins. The potential role of cytostatic agents in the apoptotic process of the inner ear needs, however, to be confirmed in large-scale specimens from patients treated with genotoxins. The fact, however, that apoptotic cells are also seen in association with ActD indicates that the fine sensory structure of the cochlea may also be a target for certain chemotherapeutic agents when administered in high doses.

Adult↗

Nonpharmacologic interventions for psychotic symptoms in dementia.

This article proposes an initial nomenclature and systematic approach for the nonpharmacologic understanding and treatment of psychotic symptoms in dementia. An analysis of delusions and hallucinations must examine alternative etiologies, including misdiagnosis and misunderstanding, the misinterpretation of reality because of cognitive losses, sensory deprivation and vision loss, ambiguous sensations, and delirium and medical causes. Nonpharmacologic treatments frequently follow directly from etiology, such as improving sensory function via hearing aids or eyeglasses, providing stimulation, changing antecedents prone to misinterpretation (eg, reflections in windows), or circumventing misinterpretations (eg, ensuring that an equivalent object is available so there is no sense of loss or theft). Given the differences between psychotic symptoms in Alzheimer's disease and those in other diseases, the term psychosis should be abandoned for most dementia patients, and assessments of etiology should be developed. Future research should clarify what proportion of symptoms currently identified as psychotic are attributable to related etiologies.

Aged↗

Effects of supine body position and low radial accelerations on the visually perceived apparent zenith.

The visually perceived eye level (VPEL) has been shown to shift toward the lower part of the body in upright subjects facing toward the axis of rotation on a centrifuge. This shift occurs in the same direction as the shift in the gravito-inertial forces (Gis) produced by very low radial acceleration (centrifugation) combined with gravity. The purpose of this study was to determine whether the same phenomenon affects the visually perceived apparent zenith (VPAZ) in subjects in a supine position. Twelve supine subjects were instructed to set a luminous target to the VPAZ, either while they were in total darkness and motionless or while undergoing very low centrifugation. Data showed that Gis induced a VPAZ shift similar to that observed for the VPEL. Thus, as is the case for the VPEL, the corresponding logarithmic psychophysical function of the VPAZ may be considered to be a type of oculogravic illusion phenomenon with differences in the subjects' that differs from subject to subject, depending on the subject's sensitivity to low radial accelerations. Data on VPEL and VPAZ support the notion that the subjective perception of eye level in total darkness takes into account changes--even if extremely slight-in the direction of the gravito-inertial forces produced by the combination of gravity and low radial accelerations, although subjects are unaware of the Gi shift. However, depending on the intensity of the radial acceleration and the angular deviation of Gi relative to G, the shift of the VPEL and the VPAZ can be either amplified or attenuated. Moreover, differences between VPEL and VPAZ responses suggest two explanatory assumptions--namely, that this is (1) a peripheral phenomenon dependent on the neurophysiological anisotropy of the otolithic system or (2) a central phenomenon dependent on the relevance assigned to the peripheral information by the integrative sensory functions and the associative processes.

Adult↗

Effects of sensory and motor functioning on adult intellectual performance.

This study examined longitudinal health and intelligence data to determine whether sensory or motor deficits account for some of the age-related intellectual changes that are commonly seen from midlife onward. Although sensory and motor functioning did not account for the age-related decrements in performance on speeded, visual perceptual tasks found for this sample in previous work, we did find that hearing deficits added error variance to performance estimates on two verbal subtests of the Wechsler scales.

Adult↗