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PubMed1986

Construct validity of the Kendrick Battery with institutionalized aged.

In this study, we attempted to explore the construct validity of the Kendrick Battery by using an American sample and psychometric tests as indexes of diffuse organicity, depression, and normality. Institutionalized residents (N = 53) were tested twice (6-week interval). When organicity was defined by disorientation and memory deficits, then both the Object Learning test and the Digit Copying test were accurate in differentiating preestablished criterion groups. When organicity was defined more broadly, including sensorimotor function, the Digit Copying test alone was more accurate when depression was defined in terms of irritability, restlessness, and despair. These data suggest that although the Kendrick scales appeared to be sensitive to organicity and depression in this sample, their validity varied with the criteria for each when such were defined psychometrically.

Aged↗

PubMed1991

Postural stability and associated physiological factors in a population of aged persons.

A battery of 13 visual, vestibular, sensorimotor, and balance tests was administered to 95 elderly persons (mean age 82.7 years) to examine the relationships between specific sensorimotor functions and measures of postural stability. When subjects stood on a firm surface, increased body sway was associated with poor tactile sensitivity and poor joint position sense. When subjects stood on a compliant surface (which reduced peripheral sensation) with their eyes open, increased body sway was associated with poor visual acuity and contrast sensitivity, reduced vibration sense, and decreased ankle dorsiflexion strength as well as reduced joint position sense. Increased body sway with eyes closed on the compliant surface was associated with poor tactile sensation, reduced quadriceps and ankle dorsiflexion strength, and increased reaction time. Poor performance in two clinical measures of postural stability was associated with reduced sensation in the lower limbs as measured by joint position sense, tactile sensitivity and vibration sense, reduced quadriceps and ankle dorsiflexion strength, and slow reaction times. The prevalence of vestibular impairments was high in this group, but vestibular function was not significantly associated with sway under any of the test conditions. The results suggest that reduced sensation, muscle weakness in the legs, and increased reaction time are all important factors associated with postural instability. An analysis of the percentage increases in sway under conditions where visual and peripheral sensation systems are removed or diminished, compared with sway under optimal conditions, indicated that peripheral sensation is the most important sensory system in the maintenance of static postural stability.

Aged↗

PubMed1976

Phantom limb phenomenon in patients with leprosy.

The phantom limb phenomenon (PLP) was studied in 42 patients with leprosy who had limb amputation and/or digital shortening; some of the patients also had another type of limb deformity, such as claw-hand or foot-drop, which did not involve significant loss of tissue. Thirty-eight (90 per cent) of the patients reported having at least one phantom limb (PL) for a missing or deformed part. Associated with each of the three types of limb defects, two descriptively and experientially distinct types of PLs were found: the paresthetic or typical (TPL) and the painless or natural (NPL). Descriptions of the TPL and the NPL are given. The findings were compared to various reports, particularly those of Stetter and Frederiks. The leprosy TPL was similar both to the PL of amputees as frequently described in the literature, and to what Stetter and Frederiks termed the PL sensations. A close correspondence, if not identity, was noted between the NPL of leprosy patients and the equivalent categories of Stetter's PL experience and Frederiks' PL as such. Included in these three designations are aspects of the PLP that are associated with the normal, intact limb; these aspects are thought to be usual concomitants of the PLP and to constitute manifestations of the persistence of the normal body image. From our findings, we conclude that for the appearance of a PLP, the actual loss of a part of a limb, whether slow or sudden, is not required, but the loss of its sensorimotor functions is sufficient.

Adult↗

PubMed1991

Prognostic significance of cerebral status: dimensions of clinical outcome.

This report examines the relationship between a set of neurobehavioral predictor variables (premorbid cognitive-perceptual abilities, sensorimotor functions, and complex integrative skills) and three dimensions of clinical outcome (social outcome, work functioning, and rehospitalization) 2 years after discharge from inpatient treatment for a group of psychiatric disorders. Results indicated the strongest relationship was between premorbid ability levels and work performance, particularly maintaining stability of employment or work role function. This finding is discussed from the standpoint of neurological processes underlying early acquisition of basic cognitive-perceptual skills in the prediction of outcome.

Adult↗

PubMed1991

Herniated L4-L5 disc after placement of Harrington instrumentation for a fracture of the thoracolumbar spine.

The authors report a case in which L5 radiculopathy developed acutely after surgery for placement of Harrington rod instrumentation for an L1 body fracture. Computed tomographic myelography demonstrated a large L4-L5 herniated disc that had not been present in preoperative studies. An emergency laminectomy was performed, and a large, free, subligamentous disc fragment was removed. The patient subsequently regained L5 sensorimotor function. The postoperative development of lumbar radiculopathy is an uncommon complication of Harrington rod instrumentation that may result from several biomechanical features of the instrumentation. These injuries may not be detected by intraoperative monitoring of somatosensory evoked potentials, and therefore, the postoperative neurological examination assumes a crucial role in the early diagnosis of these lesions. As our case demonstrates, these radicular deficits may be reversible if their cause is promptly recognized and treated.

Aged↗

PubMed1989

Pathogenesis of spinal cord injury and newer treatments. A review.

Many victims of traumatic spinal cord injury (SCI) suffer immediate paralysis as well as a subsequent progressive worsening of the cord pathology. Certain sensorimotor functions that might otherwise have returned are irreversibly lost because of this delayed response. An understanding of the pathophysiology behind this progressive, self-destructive sequence is yet to be acquired; however, numerous proposals have been set forth involving processes such as edema formation, vascular changes, an inflammatory reaction, and destruction of the neuronal plasma membranes. In this review, the authors outline many of the chemical, anatomic, and functional changes associated with SCI as well as a number of treatment regimens that have been found to improve recovery from SCI (including parenteral glucocorticoid therapy, localized cord cooling, calcium channel blockers, and opiate antagonism). From this, a number of mechanisms accounting for the mediation and/or prevention of the secondary destructive response are synthesized.

Animals↗

PubMed1995

The effect of a 12-month exercise trial on balance, strength, and falls in older women: a randomized controlled trial.

OBJECTIVE: To determine whether a 12-month program of regular exercise can improve balance, reaction time, neuromuscular control, and muscle strength and reduce the rate of falling in older women. DESIGN: A randomized, controlled trial of 12 months duration. SETTING: Conducted as part of the Randwick Falls and Fractures Study in Sydney, Australia. PARTICIPANTS: One hundred ninety-seven women aged 60 to 85 years (mean age 71.6, SD = 5.4) who were randomly recruited from the community. OUTCOME MEASURES: Accidental falls, postural sway, reaction time, neuromuscular control, and lower limb muscle strength. MAIN RESULTS: Exercise and control subjects were tested before, midway through, and at the end of the trial. At initial testing, exercisers and controls performed similarly in all tests and were well matched in relevant health and lifestyle factors. The mean number of classes attended for the 75 exercise subjects who completed the program was 60.0 (range 26-82). At the end of the trial, the exercise subjects showed improved performance in all five strength measures, in reaction time, neuromuscular control, body sway on a firm surface with the eyes open, and body sway on a compliant surface with the eyes open and closed. In contrast, there were no significant improvements in any of the test measures in the controls. In one test measure, hip flexion strength, the exercisers showed continued improvement throughout the study year. There was no significant difference in the proportion of fallers between the exercise and control subjects. Interesting trends were evident, however, between falls frequency and adherence to the exercise program. CONCLUSIONS: These findings show that exercise can produce long-term benefits with regard to improving sensorimotor function in older persons. The findings also suggest that high compliance to an exercise program may reduce falls frequency, although further studies are required to conclusively demonstrate that exercise offers an effective means of preventing falls.

Accidental Falls↗

PubMed1980

Postural dependence of reaction time after a VL thalamotomy.

Postural dependence of the EMG-RT of the triceps brachii muscles was measured in 68 parkinsonian patients of which 38 underwent a ventrolateral thalamotomy. A thalamotomy did not affect patients' EMG-RT per se, but it changed the postural dependence of the EMG-RT. After left thalamotomy the position changes of both shoulders did not influence the EMG-RT of the right triceps, and after right thalamotomy the position change of the left shoulder had no influence on the EMG-RT of both triceps. As for the sensorimotor function, it is assumed that the right thalamus has bilateral control on the input system and the left thalamus has bilateral control on the output system.

Adult↗

PubMed1992

Physiological factors associated with injurious falls in older people living in the community.

Performance in six tests of sensorimotor function was measured in 50 subjects who were admitted to an acute hospital because of a fall (ICD codes E880-888), but who did not suffer a fracture of the lower limbs as a result. Performances in these tests were compared with 50 subjects of the same age and sex who had not fallen in the previous 12 months. It was found that those admitted to hospital because of a fall had decreased tactile sensation, reduced quadriceps strength and increased body sway on firm and compliant surfaces. The fallers also performed poorly in clinical tests of static and dynamic balance. Psychoactive-drug use was associated with falling and a number of test measures, including body sway, static balance, dynamic balance and quadriceps strength. Twenty-seven percent of fallers had poor outcomes, in that 1 year after testing, they had either suffered three or more additional falls, been readmitted to hospital, been transferred to nursing homes or died.

Accidental Falls↗

PubMed1989

Photochemical stroke model: flunarizine prevents sensorimotor deficits after neocortical infarcts in rats.

We produced unilateral photochemical infarcts in the hindlimb sensorimotor neocortex of 186 rats by intravenous injection of the fluorescein derivative rose bengal and focal illumination of the intact skull surface. Infarcted rats showed specific, long-lasting deficits in tactile and proprioceptive placing reactions of the contralateral limbs, mostly the hindlimb. Placing deficits were most prominent during transition to immobility and/or when independent limb movements were required. Administration of flunarizine, a Class IV calcium antagonist, 30 minutes after infarction resulted in marked sparing of sensorimotor function in 30 rats. In contrast to 20 vehicle-treated rats, which remained deficient for at least 21 days, 15 (75%) of the rats treated with 1.25 mg/kg i.v. flunarizine showed normal placing on Day 1 after infarction, whereas the remaining five (25%) recovered within 5 days. Oral treatment of 10 rats with 40 mg/kg flunarizine was also effective. Neocortical infarct volume and thalamic gliosis, assessed 21 days after infarction, did not differ between 30 flunarizine- and 30 vehicle-treated rats. However, when 4-hour-old infarcts were measured in 16 rats, posttreatment with intravenous flunarizine reduced infarct size by 31%. In combination with appropriate behavioral analyses, photochemical thrombosis may constitute a relevant stroke model, in which flunarizine preserved behavioral function during a critical period, corresponding to the spread of ischemic damage.

Animals↗

PubMed1986

Neglect induced by thalamotomy in humans: a quantitative appraisal of the sensory and motor deficits.

Stereotactic lesions for the treatment of tremor and rigidity in patients with Parkinson's disease are occasionally followed by neglect of the use of contralateral extremities for spontaneous movement when there are no specific sensory or motor deficits. A group of patients with neglected extremities was compared with a group of patients in which thalamotomy did not produce neglect. Neglect was shown by changes in motor performance, somatosensory evoked potentials (SEP) and electroencephalographic frequency induced by the lesion, as well as radiological evidence of brain atrophy and place and extension of lesions. Reaction time to both auditory and somatosensory stimuli was significantly increased only in the extremities contralateral to the lesion of patients with neglect; tremor decreased equally in both groups, and other motor abilities remained unchanged. P-200 component of SEP decreased in amplitude and increased in latency only in cases with neglect, particularly ipsilateral to the lesion; early components and mean electroencephalographic frequency remained unchanged. Brain atrophy was significant in patients with neglect, particularly for the posterior portion of the 3rd ventricle. No differences in size and location of the lesions were found between the groups. Results indicate that this type of neglect is not secondary to lesions in specific sensory of motor pathways, but to lesions of structures coupling sensorimotor functions and the process of attention and that midline thalamic nuclei atrophy precipitates the neglect, perhaps by critically decreasing the amount of reticulothalamocortical projections engaged in selective attention.

Adult↗

PubMed1984

Drug-induced ego states. I. Cocaine: phenomenology and implications.

The ego state experienced by chronic users of cocaine is described in terms of sensorimotor functioning, cognitive functioning, emotionality, spatiality , temporality , causality, and materiality . At low use levels the state is pleasurable, but at high levels fear, anxiety, and paranoia increase, and ultimately reality contact breaks down. Q-sort, Semantic Differential, and other data suggest that low-level users take cocaine to overcome personal insecurities and relieve boredom. Heavy users take it to support overvaulting ambitions and intense strivings for self-sufficiency. Psychotherapy with such persons must deal with their counterdependency , anger, and despair, and with their underlying sense of betrayal . These persons have unacknowledged needs for spiritual experience that must be dealt with openly. A description of persons most vulnerable to heavy use of cocaine is provided, and recommendations for research and social policy are presented.

Adult↗

PubMed1980

Visually monitored postrotary nystagmus in seven autistic children.

Therapists who evaluate the sensorimotor functions of autistic children have become increasingly interested in monitoring their responses to vestibular stimulation. In this study, the duration of the nystagmus reflex is visually monitored and then measured by means of a stop-watch. Each of 7 autistic subjects received 18 sessions (36 trials) of horizontal semicircular canal stimulation during a period of 25 days. In each trial a graduated acceleration in a hand operated rotating chair preceded an abrupt stop, with a rapid deceleration from 180 degrees/second to 0 degree/second. Although subject option (intentional response) imposes limitations on the data interpretation, inspection of the nystagmus functions over time suggests the following: substantial trial-to-trial variability; substantial subject-to-subject variability; greater scores following trials to the subjects' left (the direction of the second trial in each session) than to the right (the direction of the first); and no evidence of consistent change for most subjects in nystagmus duration across the 36 trials. Implications for clinical evaluation of nystagmus are discussed.

Autistic Disorder↗

PubMed1992

Decrement in manual arm performance during whole body cooling.

Six subjects performed three manual arm tasks: 1) prior to immersion in 8 degrees C water; 2) soon after immersion to the neck, but prior to any decrease in core temperature; and 3) every 15 min until core temperatures decreased 2-4.5 degrees C. The tasks were speed of flexion and extension of the fingers, handgrip strength and manual dexterity. There was no immediate effect of cold immersion; however, all scores decreased significantly after core temperature decreased 0.5 degrees C. Further decrease in core temperature was associated with a progressive impairment of performance, although at a slower rate than during the first 0.5 degrees C decrease. Flexion and extension of the fingers was affected relatively more than handgrip strength or manual dexterity. Decrement in performance is a result of peripheral cooling on sensorimotor function with a probable additional effect of central cooling on cerebral function.

Adult↗

PubMed1991

[Effect of the depth of anesthesia on the postoperative course].

An assessment of the influence of several variables during the perioperative period revealed a cause-determining correlation between the explanatory variables age, body size, weight, duration of operation, loss of blood, and pain level and the physiologic variables adrenaline, total protein, blood glucose level, transferrin, cholinesterase and immunoglobulin G that could be statistically be proven. An evaluation of the influence of the depth of anesthesia on this cause-determining correlation demonstrated significant advantages for a deep level of anesthesia. The depth of anesthesia should be seen as an influential factor during the perioperative period. Anesthesia should therefore not be regarded simply as analgesia and loss of consciousness; rather, one should stress the psychophysiological attenuation and its negative influence on the sensorimotor functions that are accompanied by changes in physiology. The central organ of regulation controls the physiological levels of the organism, and changes in brain function result in changes in physiology. During the perioperative period, rapid and programmed functional mechanisms that are controlled by more primitive parts of the brain and thus are not influenced by individual inappropriate decisions of the "higher" brain centers are needed for the patient's convalescence. This would explain the advantage of a deep level of anesthesia. The usual grading of stages of anesthesia according to Güdel provides little help in this respect; therefore, an assessment of the depth of anesthesia using EEGs and evoked potentials should be combined with an evaluation of physiological variables at several other levels of the organism such that further information can be obtained on the conditions existing at the onset of the postoperative course.

Adolescent↗

PubMed1990

NMDA receptors mediate poly- and monosynaptic potentials in motoneurons of rat embryos.

We determined the contribution of glutamate receptor subtypes to developing excitatory synaptic transmission in isolated spinal cord of rat embryos. Using electrophysiological and morphological techniques, we studied the pattern of development of synapses between dorsal root afferents and motoneurons in lumbar spinal cords of 15- to 21-d-old rat embryos. Motoneuron dendritic fields and afferent projections onto motoneurons were identified by labeling with HRP. Afferents first entered the gray matter at Day 15 of gestation, and by Day 16 they terminated close to motoneuron dendritic trees. Afferent axons projected onto motoneuron dendritic fields at Day 17, when boutons were detected on motoneuron dendrites that were crossed by afferent axons. To determine the time course of formation of functional sensorimotor synapses and their pharmacological properties, a dorsal root was stimulated while recording intracellularly from segmental motoneurons. At Day 16, excitatory postsynaptic potentials (EPSPs) with long latencies, slow rates of rise, and long durations were recorded. The amplitudes of these EPSPs increased with membrane depolarization and in the absence of extracellular Mg2+. These EPSPs were blocked by D-2-amino-5-phosphonovalerate (APV) and ketamine, which are selective antagonists of N-methyl-D-aspartate (NMDA) receptors. These findings suggest that initial synaptic transmission in embryonic motoneurons is mediated solely by NMDA receptors. Short-latency EPSPs with fast rates of rise were first recorded in most motoneurons by Day 17. These EPSPs were composed of fast- and slow-rising potentials. The slow component was blocked by APV, while the fast component was eliminated by 6-cyano-7-nitroquinoxaline-2,3-dione and kynurenate. This indicates that the short-latency EPSPs are mediated by both NMDA and non-NMDA receptors. Dose-response curves of motoneurons to L-glutamate, NMDA, and kainate demonstrated that motoneurons are sensitive to these agonists prior to the formation of synapses between afferents and motoneurons. Motoneuron responses to NMDA and kainate increased immediately after the onset of short-latency EPSPs. This increased sensitivity could be due to extracellular factors influenced by growing sensory axons or intrinsic properties of differentiating motoneurons.

Animals↗

PubMed1986

Relations between sensorimotor attainments and development of language comprehension in retarded children.

Although cognitive precursors of language production have received considerable attention, the relationship between cognitive development and language comprehension is still largely unknown. We report here on an investigation into the relationship between sensorimotor attainments and receptive language skills in normal and retarded infants aged 12-26 months. A major goal of this study was to translate some current notions about onset of representational language and its cognitive prerequisites into some clinically useful procedures both for early diagnosis and treatment of disabled infants. The Uzgiris-Hunt ordinal scales and receptive language tests were administered to 32 infants with motor delay and to 15 normal infants matched for chronological age. Comparison of the resulting scores indicated significant differences in favor of the normal infants on the six Uzgiris-Hunt scales and on the receptive language measures. The cognitive profile of the retarded infants was not homogeneous, some sensorimotor areas (object permanence, vocal and gestural imitation, schemes in relation to objects) showing later onset and slower development than others. Evidence for the parallel emergence of representational ability in language and thought was not as strong as stated by Piagetian theorists. No single stage of sensorimotor functioning prerequisite to language comprehension could be discerned, especially in the retarded infants, who showed considerable gaps between the two domains.

Age Factors↗

PubMed1989

Synaptic plasticity and learning: selective impairment of learning rats and blockade of long-term potentiation in vivo by the N-methyl-D-aspartate receptor antagonist AP5.

This paper reports a series of 5 experiments concerned with a possible role for N-methyl-D-aspartate (NMDA) receptors in certain types of learning. The results show that chronic intraventricular infusion of the NMDA receptor antagonist D,L-2-amino-5-phosphonopentanoic acid (D,L-AP5) caused an impairment of spatial but not of visual discrimination learning in rats. Such selectivity of the learning impairment occurred despite widespread distribution of the drug throughout the CNS. AP5 sometimes caused a disturbance of sensorimotor function during learning, but one experiment addressing whether this disturbance could be responsible for the spatial learning impairment established that it was statistically independent. Another experiment showed that AP5 did not affect the retention of previously acquired spatial information. These behavioral effects were all obtained with a concentration of AP5 that, in a final study, was found to be sufficient to block hippocampal long-term potentiation (LTP) in vivo without affecting normal synaptic transmission. Taken together, these observations (1) implicate NMDA receptors in certain types of learning, and (2) extend recent work showing that saturation of LTP causes an anterograde spatial amnesia (McNaughton et al., 1986). A preliminary report of parts of this work has been published (Morris et al., 1986a).

Animals↗