Biofeedback for robotic gait rehabilitation.

PubMed

Lünenburger, Lars; Colombo, Gery; Riener, Robert

2007-01-23

Development and increasing acceptance of rehabilitation robots as well as advances in technology allow new forms of therapy for patients with neurological disorders. Robot-assisted gait therapy can increase the training duration and the intensity for the patients while reducing the physical strain for the therapist. Optimal training effects during gait therapy generally depend on appropriate feedback about performance. Compared to manual treadmill therapy, there is a loss of physical interaction between therapist and patient with robotic gait retraining. Thus, it is difficult for the therapist to assess the necessary feedback and instructions. The aim of this study was to define a biofeedback system for a gait training robot and test its usability in subjects without neurological disorders. To provide an overview of biofeedback and motivation methods applied in gait rehabilitation, previous publications and results from our own research are reviewed. A biofeedback method is presented showing how a rehabilitation robot can assess the patients' performance and deliver augmented feedback. For validation, three subjects without neurological disorders walked in a rehabilitation robot for treadmill training. Several training parameters, such as body weight support and treadmill speed, were varied to assess the robustness of the biofeedback calculation to confounding factors. The biofeedback values correlated well with the different activity levels of the subjects. Changes in body weight support and treadmill velocity had a minor effect on the biofeedback values. The synchronization of the robot and the treadmill affected the biofeedback values describing the stance phase. Robot-aided assessment and feedback can extend and improve robot-aided training devices. The presented method estimates the patients' gait performance with the use of the robot's existing sensors, and displays the resulting biofeedback values to the patients and therapists. The therapists can adapt the

Biofeedback for robotic gait rehabilitation

PubMed Central

Lünenburger, Lars; Colombo, Gery; Riener, Robert

2007-01-01

Background Development and increasing acceptance of rehabilitation robots as well as advances in technology allow new forms of therapy for patients with neurological disorders. Robot-assisted gait therapy can increase the training duration and the intensity for the patients while reducing the physical strain for the therapist. Optimal training effects during gait therapy generally depend on appropriate feedback about performance. Compared to manual treadmill therapy, there is a loss of physical interaction between therapist and patient with robotic gait retraining. Thus, it is difficult for the therapist to assess the necessary feedback and instructions. The aim of this study was to define a biofeedback system for a gait training robot and test its usability in subjects without neurological disorders. Methods To provide an overview of biofeedback and motivation methods applied in gait rehabilitation, previous publications and results from our own research are reviewed. A biofeedback method is presented showing how a rehabilitation robot can assess the patients' performance and deliver augmented feedback. For validation, three subjects without neurological disorders walked in a rehabilitation robot for treadmill training. Several training parameters, such as body weight support and treadmill speed, were varied to assess the robustness of the biofeedback calculation to confounding factors. Results The biofeedback values correlated well with the different activity levels of the subjects. Changes in body weight support and treadmill velocity had a minor effect on the biofeedback values. The synchronization of the robot and the treadmill affected the biofeedback values describing the stance phase. Conclusion Robot-aided assessment and feedback can extend and improve robot-aided training devices. The presented method estimates the patients' gait performance with the use of the robot's existing sensors, and displays the resulting biofeedback values to the patients and

The gait disorder in downbeat nystagmus syndrome.

PubMed

Schniepp, Roman; Wuehr, Max; Huth, Sabrina; Pradhan, Cauchy; Schlick, Cornelia; Brandt, Thomas; Jahn, Klaus

2014-01-01

Downbeat nystagmus (DBN) is a common form of acquired fixation nystagmus with key symptoms of oscillopsia and gait disturbance. Gait disturbance could be a result of impaired visual feedback due to the involuntary ocular oscillations. Alternatively, a malfunction of cerebellar locomotor control might be involved, since DBN is considered a vestibulocerebellar disorder. Investigation of walking in 50 DBN patients (age 72 ± 11 years, 23 females) and 50 healthy controls (HS) (age 70 ± 11 years, 23 females) using a pressure sensitive carpet (GAITRite). The patient cohort comprised subjects with only ocular motor signs (DBN) and subjects with an additional limb ataxia (DBNCA). Gait investigation comprised different walking speeds and walking with eyes closed. In DBN, gait velocity was reduced (p<0.001) with a reduced stride length (p<0.001), increased base of support (p<0.050), and increased double support (p<0.001). Walking with eyes closed led to significant gait changes in both HS and DBN. These changes were more pronounced in DBN patients (p<0.001). Speed-dependency of gait variability revealed significant differences between the subgroups of DBN and DBNCA (p<0.050). (I) Impaired visual control caused by involuntary ocular oscillations cannot sufficiently explain the gait disorder. (II) The gait of patients with DBN is impaired in a speed dependent manner. (III) Analysis of gait variability allows distinguishing DBN from DBNCA: Patients with pure DBN show a speed dependency of gait variability similar to that of patients with afferent vestibular deficits. In DBNCA, gait variability resembles the pattern found in cerebellar ataxia.

The Gait Disorder in Downbeat Nystagmus Syndrome

PubMed Central

Schniepp, Roman; Wuehr, Max; Huth, Sabrina; Pradhan, Cauchy; Schlick, Cornelia; Brandt, Thomas; Jahn, Klaus

2014-01-01

Background Downbeat nystagmus (DBN) is a common form of acquired fixation nystagmus with key symptoms of oscillopsia and gait disturbance. Gait disturbance could be a result of impaired visual feedback due to the involuntary ocular oscillations. Alternatively, a malfunction of cerebellar locomotor control might be involved, since DBN is considered a vestibulocerebellar disorder. Methods Investigation of walking in 50 DBN patients (age 72±11 years, 23 females) and 50 healthy controls (HS) (age 70±11 years, 23 females) using a pressure sensitive carpet (GAITRite). The patient cohort comprised subjects with only ocular motor signs (DBN) and subjects with an additional limb ataxia (DBNCA). Gait investigation comprised different walking speeds and walking with eyes closed. Results In DBN, gait velocity was reduced (p<0.001) with a reduced stride length (p<0.001), increased base of support (p<0.050), and increased double support (p<0.001). Walking with eyes closed led to significant gait changes in both HS and DBN. These changes were more pronounced in DBN patients (p<0.001). Speed-dependency of gait variability revealed significant differences between the subgroups of DBN and DBNCA (p<0.050). Conclusions (I) Impaired visual control caused by involuntary ocular oscillations cannot sufficiently explain the gait disorder. (II) The gait of patients with DBN is impaired in a speed dependent manner. (III) Analysis of gait variability allows distinguishing DBN from DBNCA: Patients with pure DBN show a speed dependency of gait variability similar to that of patients with afferent vestibular deficits. In DBNCA, gait variability resembles the pattern found in cerebellar ataxia. PMID:25140517

The value of 'positive' clinical signs for weakness, sensory and gait disorders in conversion disorder: a systematic and narrative review.

PubMed

Daum, Corinna; Hubschmid, Monica; Aybek, Selma

2014-02-01

Experts in the field of conversion disorder have suggested for the upcoming DSM-V edition to put less weight on the associated psychological factors and to emphasise the role of clinical findings. Indeed, a critical step in reaching a diagnosis of conversion disorder is careful bedside neurological examination, aimed at excluding organic signs and identifying 'positive' signs suggestive of a functional disorder. These positive signs are well known to all trained neurologists but their validity is still not established. The aim of this study is to provide current evidence regarding their sensitivity and specificity. We conducted a systematic search on motor, sensory and gait functional signs in Embase, Medline, PsycINfo from 1965 to June 2012. Studies in English, German or French reporting objective data on more than 10 participants in a controlled design were included in a systematic review. Other relevant signs are discussed in a narrative review. Eleven controlled studies (out of 147 eligible articles) describing 14 signs (7 motor, 5 sensory, 2 gait) reported low sensitivity of 8-100% but high specificity of 92-100%. Studies were evidence class III, only two had a blinded design and none reported on inter-rater reliability of the signs. Clinical signs for functional neurological symptoms are numerous but only 14 have been validated; overall they have low sensitivity but high specificity and their use should thus be recommended, especially with the introduction of the new DSM-V criteria.

Gait disorders in the elderly and dual task gait analysis: a new approach for identifying motor phenotypes.

PubMed

Auvinet, Bernard; Touzard, Claude; Montestruc, François; Delafond, Arnaud; Goeb, Vincent

2017-01-31

Gait disorders and gait analysis under single and dual-task conditions are topics of great interest, but very few studies have looked for the relevance of gait analysis under dual-task conditions in elderly people on the basis of a clinical approach. An observational study including 103 patients (mean age 76.3 ± 7.2, women 56%) suffering from gait disorders or memory impairment was conducted. Gait analysis under dual-task conditions was carried out for all patients. Brain MRI was performed in the absence of contra-indications. Three main gait variables were measured: walking speed, stride frequency, and stride regularity. For each gait variable, the dual task cost was computed and a quartile analysis was obtained. Nonparametric tests were used for all the comparisons (Wilcoxon, Kruskal-Wallis, Fisher or Chi 2 tests). Four clinical subgroups were identified: gait instability (45%), recurrent falls (29%), memory impairment (18%), and cautious gait (8%). The biomechanical severity of these subgroups was ordered according to walking speed and stride regularity under both conditions, from least to most serious as follows: memory impairment, gait instability, recurrent falls, cautious gait (p < 0.01 for walking speed, p = 0.05 for stride regularity). According to the established diagnoses of gait disorders, 5 main pathological subgroups were identified (musculoskeletal diseases (n = 11), vestibular diseases (n = 6), mild cognitive impairment (n = 24), central nervous system pathologies, (n = 51), and without diagnosis (n = 8)). The dual task cost for walking speed, stride frequency and stride regularity were different among these subgroups (p < 0.01). The subgroups mild cognitive impairment and central nervous system pathologies both showed together a higher dual task cost for each variable compared to the other subgroups combined (p = 0.01). The quartile analysis of dual task cost for stride frequency and stride regularity

Occupational Neurological Disorders in Korea

PubMed Central

Kang, Seong-Kyu

2010-01-01

The purpose of this article was to provide a literature review of occupational neurological disorders and related research in Korea, focusing on chemical hazards. We reviewed occupational neurological disorders investigated by the Occupational Safety and Health Research Institute of Korean Occupational Safety and Health Agency between 1992 and 2009, categorizing them as neurological disorders of the central nervous system (CNS), of the peripheral nervous system (PNS) or as neurodegenerative disorders. We also examined peer-reviewed journal articles related to neurotoxicology, published from 1984 to 2009. Outbreaks of occupational neurological disorder of the CNS due to inorganic mercury and carbon disulfide poisoning had helped prompt the development of the occupational safety and health system of Korea. Other major neurological disorders of the CNS included methyl bromide intoxication and chronic toxic encephalopathy. Most of the PNS disorders were n-hexane-induced peripheral neuritis, reported from the electronics industry. Reports of manganese-induced Parkinsonism resulted in the introduction of neuroimaging techniques to occupational medicine. Since the late 1990s, the direction of research has been moving toward degenerative disorder and early effect of neurotoxicity. To understand the early effects of neurotoxic chemicals in the preclinical stage, more follow-up studies of a longer duration are necessary. PMID:21258587

Effects of functional electrical stimulation on gait recovery post-neurological injury during inpatient rehabilitation.

PubMed

Lairamore, Chad I; Garrison, Mark K; Bourgeon, Laetitia; Mennemeier, Mark

2014-10-01

This stage 2 trial investigated the therapeutic effect of single channel, peroneal functional electrical stimulation (FES) for improving gait and muscle activity in people with neurological injuries who were enrolled in an inpatient rehabilitation program. Twenty-six patients (16 male; M age = 51.3 yr., SD = 16.2; 2-33 days post-injury) completed the study. Participants were randomly assigned to an experimental group (n = 13) or control group (n = 13). The experimental group received FES and the control group received sensory stimulation during 45-min. gait training sessions three times a week for the duration of their stay in a rehabilitation facility (average of four sessions for both groups). Changes in gait speed, tibialis anterior muscle electromyography (EMG), and FIM™ locomotion scores were compared between groups. No significant differences were found, as both groups demonstrated similar improvements. The current results with this small sample suggest a low dose of gait training with single channel FES did not augment gait nor EMG activity beyond gait training with sensory stimulation; therefore, clinicians will likely be better served using a larger dose of FES or multichannel FES in this clinical population.

Sleep Disorders in Childhood Neurological Diseases

PubMed Central

Liu, Zhao

2017-01-01

Sleep problems are frequently addressed as a primary or secondary concern during the visit to the pediatric neurology clinic. Sleep disorders can mimic other neurologic diseases (e.g., epilepsy and movement disorders), and this adds challenges to the diagnostic process. Sleep disorders can significantly affect the quality of life and functionality of children in general and those with comorbid neurological diseases in particular. Understanding the pathophysiology of sleep disorders, recognizing the implications of sleep disorder in children with neurologic diseases and behavioral difficulties, and early intervention continue to evolve resulting in better neurocognitive outcomes. PMID:28937639

Wikipedia and neurological disorders.

PubMed

Brigo, Francesco; Igwe, Stanley C; Nardone, Raffaele; Lochner, Piergiorgio; Tezzon, Frediano; Otte, Willem M

2015-07-01

Our aim was to evaluate Wikipedia page visits in relation to the most common neurological disorders by determining which factors are related to peaks in Wikipedia searches for these conditions. Millions of people worldwide use the internet daily as a source of health information. Wikipedia is a popular free online encyclopedia used by patients and physicians to search for health-related information. The following Wikipedia articles were considered: Alzheimer's disease; Amyotrophic lateral sclerosis; Dementia; Epilepsy; Epileptic seizure; Migraine; Multiple sclerosis; Parkinson's disease; Stroke; Traumatic brain injury. We analyzed information regarding the total article views for 90 days and the rank of these articles among all those available in Wikipedia. We determined the highest search volume peaks to identify possible relation with online news headlines. No relation between incidence or prevalence of neurological disorders and the search volume for the related articles was found. Seven out of 10 neurological conditions showed relations in search volume peaks and news headlines. Six out of these seven peaks were related to news about famous people suffering from neurological disorders, especially those from showbusiness. Identification of discrepancies between disease burden and health seeking behavior on Wikipedia is useful in the planning of public health campaigns. Celebrities who publicly announce their neurological diagnosis might effectively promote awareness programs, increase public knowledge and reduce stigma related to diagnoses of neurological disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

Neurologic disorder and criminal responsibility.

PubMed

Yaffe, Gideon

2013-01-01

Sufferers from neurologic and psychiatric disorders are not uncommonly defendants in criminal trials. This chapter surveys a variety of different ways in which neurologic disorder bears on criminal responsibility. It discusses the way in which a neurologic disorder might bear on the questions of whether or not the defendant acted voluntarily; whether or not he or she was in the mental state that is required for guilt for the crime; and whether or not he or she is deserving of an insanity defense. The discussion demonstrates that a just determination of whether a sufferer from a neurologic disorder is diminished in his or her criminal responsibility for harmful conduct requires equal appreciation of the nature of the relevant disorder and its impact on behavior, on the one hand, and of the legal import of facts about the psychologic mechanisms through which behavior is generated, on the other. © 2013 Elsevier B.V. All rights reserved.

Psychological state estimation from physiological recordings during robot-assisted gait rehabilitation.

PubMed

Koenig, Alexander; Omlin, Ximena; Zimmerli, Lukas; Sapa, Mark; Krewer, Carmen; Bolliger, Marc; Müller, Friedemann; Riener, Robert

2011-01-01

Robot-assisted treadmill training is an established intervention used to improve walking ability in patients with neurological disorders. Although it has been shown that attention to the task is a key factor for successful rehabilitation, the psychological state of patients during robot-assisted gait therapy is often neglected. We presented 17 nondisabled subjects and 10 patients with neurological disorders a virtual-reality task with varying difficulty levels to induce feelings of being bored, excited, and overstressed. We developed an approach to automatically estimate and classify a patient's psychological state, i.e., his or her mental engagement, in real time during gait training. We used psychophysiological measurements to obtain an objective measure of the current psychological state. Automatic classification was performed by a neural network. We found that heart rate, skin conductance responses, and skin temperature can be used as markers for psychological states in the presence of physical effort induced by walking. The classifier achieved a classification error of 1.4% for nondisabled subjects and 2.1% for patients with neurological disorders. Using our new method, we processed the psychological state data in real time. Our method is a first step toward real-time auto-adaptive gait training with potential to improve rehabilitation results by optimally challenging patients at all times during exercise.

Clinical Spectrum, Etiology, and Outcome of Neurological Disorders in the Rural Hospital of Mosango, the Democratic Republic of Congo.

PubMed

Mukendi, Deby; Lilo Kalo, Jean-Roger; Mpanya, Alain; Minikulu, Luigi; Kayembe, Tharcisse; Lutumba, Pascal; Barbé, Barbara; Gillet, Philippe; Jacobs, Jan; Van Loen, Harry; Yansouni, Cédric P; Chappuis, François; Ravinetto, Raffaella; Verdonck, Kristien; Boelaert, Marleen; Winkler, Andrea S; Bottieau, Emmanuel

2017-11-01

There is little published information on the epidemiology of neurological disorders in rural Central Africa, although the burden is considered to be substantial. This study aimed to investigate the pattern, etiology, and outcome of neurological disorders in children > 5 years and adults admitted to the rural hospital of Mosango, province of Kwilu, Democratic Republic of Congo, with a focus on severe and treatable infections of the central nervous system (CNS). From September 2012 to January 2015, 351 consecutive patients hospitalized for recent and/or ongoing neurological disorder were prospectively evaluated by a neurologist, subjected to a set of reference diagnostic tests in blood or cerebrospinal fluid, and followed-up for 3-6 months after discharge. No neuroimaging was available. Severe headache (199, 56.7%), gait/walking disorders (97, 27.6%), epileptic seizure (87, 24.8%), and focal neurological deficit (86, 24.5%) were the predominant presentations, often in combination. Infections of the CNS were documented in 63 (17.9%) patients and mainly included bacterial meningitis and unspecified meningoencephalitis (33, 9.4%), second-stage human African trypanosomiasis (10, 2.8%), and human immunodeficiency virus (HIV)-related neurological disorders (10, 2.8%). Other focal/systemic infections with neurological manifestations were diagnosed in an additional 60 (17.1%) cases. The leading noncommunicable conditions were epilepsy (61, 17.3%), psychiatric disorders (56, 16.0%), and cerebrovascular accident (23, 6.6%). Overall fatality rate was 8.2% (29/351), but up to 23.8% for CNS infections. Sequelae were observed in 76 (21.6%) patients. Clinical presentations and etiologies of neurological disorders were very diverse in this rural Central African setting and caused considerable mortality and morbidity.

A human quadrupedal gait following poliomyelitis: From the Dercum-Muybridge collaboration (1885).

PubMed

Lanska, Douglas J

2016-03-01

Beginning in the late 1870s, before the invention of movie cameras or projectors, pioneering English American photographer Eadweard Muybridge photographed iconic image sequences of people and animals in motion using arrays of sequentially triggered single-image cameras. In 1885, Philadelphia neurologist Francis Dercum initiated a collaborative relationship with Muybridge at the University of Pennsylvania to photograph sequential images of patients with various neurologic disorders of movement, including an acquired pathologic quadrupedal gait in a young boy that developed as a consequence of poliomyelitis. This pathologic human quadrupedal gait was compared with other quadrupedal gaits filmed by Muybridge, including a toddler girl and an adult woman crawling on hands and knees, an adult woman bear crawling on hands and feet, and a baboon walking. All of the human quadrupedal gaits were lateral sequence gaits, whereas the baboon's walking gait was a diagonal sequence gait. Modern studies have confirmed the nonpathologic quadrupedal gait sequences of humans and nonhuman primates. Despite Dercum's assertion to the contrary, the limb placement pattern of the boy with a pathologic quadrupedal gait after poliomyelitis was not the typical gait of a primate quadruped, but rather was the typical gait sequence for normal human developmental and volitional quadrupedal gaits. © 2016 American Academy of Neurology.

The modified gait abnormality rating scale in patients with a conversion disorder: a reliability and responsiveness study.

PubMed

Vandenberg, Justin M; George, Deanna R; O'Leary, Andrea J; Olson, Lindsay C; Strassburg, Kaitlyn R; Hollman, John H

2015-01-01

Individuals with conversion disorder have neurologic symptoms that are not identified by an underlying organic cause. Often the symptoms manifest as gait disturbances. The modified gait abnormality rating scale (GARS-M) may be useful for quantifying gait abnormalities in these individuals. The purpose of this study was to examine the reliability, responsiveness and concurrent validity of GARS-M scores in individuals with conversion disorder. Data from 27 individuals who completed a rehabilitation program were included in this study. Pre- and post-intervention videos were obtained and walking speed was measured. Five examiners independently evaluated gait performance according to the GARS-M criteria. Inter- and intrarater reliability of GARS-M scores were estimated with intraclass correlation coefficients (ICCs). Responsiveness was estimated with the minimum detectable change (MDC). Pre- to post-treatment changes in GARS-M scores were analyzed with a dependent t-test. The correlation between GARS-M scores and walking speed was analyzed to assess concurrent validity. GARS-M scores were quantified with good-to-excellent inter- (ICC = 0.878) and intrarater reliability (ICC = 0.989). The MDC was 2 points. Mean GARS-M scores decreased from 7 ± 5 at baseline to 1 ± 2 at discharge (t26 = 7.411, p < 0.001) and 85% of patients improved beyond the MDC. Furthermore, GARS-M scores and walking speed measurements were moderately correlated (r = -0.582, p = 0.004), indicating that the GARS-M has acceptable concurrent validity. Our findings provide evidence that the GARS-M scores are reliable, valid and responsive for quantifying gait abnormalities in patients with conversion disorder. GARS-M scores provide objective measures upon which treatment effects can be assessed. Copyright © 2014 Elsevier B.V. All rights reserved.

Neurological soft signs discriminate schizophrenia from bipolar disorder.

PubMed

Rigucci, Silvia; Dimitri-Valente, Giorgia; Mandarelli, Gabriele; Manfredi, Giovanni; Comparelli, Anna; De Filippis, Sergio; Gherardelli, Simona; Bersani, Giuseppe; Girardi, Paolo; Ferracuti, Stefano

2014-03-01

Although neurological soft signs have been consistently described in patients with schizophrenia, their diagnostic specificity is not well clarified. To test the hypothesis that neurological soft signs are specifically related to schizophrenia, we examined 305 subjects (patients with schizophrenia-spectrum disorder, n=167; patients with bipolar I disorder, n=88; controls, n=50). Neurological soft signs were assessed using the Neurological Evaluation Scale (NES). Multiple logistic regression analysis was used to compute the diagnostic predictive power of neurological soft signs. Patients in the schizophrenia-spectrum disorder group were found to have significantly greater neurological impairment (NES total score=23.9, standard deviation [SD] 11.2) than those in the bipolar disorder group (NES total score=18.2, SD 7.6; p<0.001). Neurological functioning was closely associated with psychopathology (all p<0.001). The NES total score reliably distinguished patients with schizophrenia spectrum disorders from those with bipolar disorder in 68.7% of the cases (p<0.001). Moreover, a particular set of neurological soft signs showed specificity for the schizophrenia-spectrum disorder diagnostic group. Our findings suggest that schizophrenia and bipolar disorder can be distinguished in terms of neurological impairment. Furthermore, we recommend the utility of neurological soft signs as a useful, quantifiable, sensitive, and inexpensive tool for the diagnostic work-up of schizophrenia.

Meige's Syndrome: Rare Neurological Disorder Presenting as Conversion Disorder.

PubMed

Debadatta, Mohapatra; Mishra, Ajay K

2013-07-01

Meige's syndrome is a rare neurological syndrome characterized by oromandibular dystonia and blepharospasm. Its pathophysiology is not clearly determined. A 35-year-old female presented to psychiatric department with blepharospasm and oromandibular dystonia with clinical provisional diagnosis of psychiatric disorder (Conversion Disorder). After thorough physical examination including detailed neurological exam and psychiatric evaluation no formal medical or psychiatric diagnosis could be made. The other differential diagnoses of extra pyramidal symptom, tardive dyskinesia, conversion disorder, anxiety disorder were ruled out by formal diagnostic criteria. Consequently with suspicion of Meige's syndrome she was referred to the department of Neurology and the diagnosis was confirmed. Hence, Meige's syndrome could be misdiagnosed as a psychiatric disorder such as conversion disorder or anxiety disorder because clinical features of Meige's syndrome are highly variable and affected by psychological factors and also can be inhibited voluntarily to some extent.

The spectrum of neurological disorders presenting at a neurology clinic in Yaoundé, Cameroon.

PubMed

Tegueu, Callixte Kuate; Nguefack, Séraphin; Doumbe, Jacques; Fogang, Yannick Fogoum; Mbonda, Paul Chimi; Mbonda, Elie

2013-01-01

The burden of these neurological diseases is higher in developing countries. However, there is a paucity and scarcity of literature on neurological diseases in sub-Saharan Africa. This study was therefore undertaken to determine the pattern of neurological diseases in this setting and then, compare to those elsewhere in the African continent and also serve as a baseline for planning and care for neurological disorders in Cameroon. The study was conducted at the Clinique Bastos, in Yaoundé, city capital of Cameroon, centre region. Over a period of six years, all medical records were reviewed by a neurologist and neurological diagnoses classified according to ICD-10. Out of 4526 admissions 912 patients (20.15%) were given a neurological diagnosis. The most frequent neurological disorders were headache (31.9%), epilepsy (9.86%), intervertebral disc disorder (7.67%), followed by lumbar and cervical arthrosis, polyneuropathy, stroke, Parkinson disease and dementia. According to ICD-10 classification, Episodic and paroxysmal disorders (headaches, epilepsy, cerebrovascular, sleep disorders) were observed on 424 (46.48%) patients; followed by nerve, nerve root and plexus disorders in 115 (12.6%) patients. The above data emphasizes that neurological disease contributes substantially to morbidity in an urban African hospital. Headaches, epilepsy and intervertebral disc disorders are major causes of morbidity.

Bridging Neuroanatomy, Neuroradiology and Neurology: Three-Dimensional Interactive Atlas of Neurological Disorders

PubMed Central

Nowinski, W.L.; Chua, B.C.

2013-01-01

Understanding brain pathology along with the underlying neuroanatomy and the resulting neurological deficits is of vital importance in medical education and clinical practice. To facilitate and expedite this understanding, we created a three-dimensional (3D) interactive atlas of neurological disorders providing the correspondence between a brain lesion and the resulting disorder(s). The atlas contains a 3D highly parcellated atlas of normal neuroanatomy along with a brain pathology database. Normal neuroanatomy is divided into about 2,300 components, including the cerebrum, cerebellum, brainstem, spinal cord, arteries, veins, dural sinuses, tracts, cranial nerves (CN), white matter, deep gray nuclei, ventricles, visual system, muscles, glands and cervical vertebrae (C1-C5). The brain pathology database contains 144 focal and distributed synthesized lesions (70 vascular, 36 CN-related, and 38 regional anatomy-related), each lesion labeled with the resulting disorder and associated signs, symptoms, and/or syndromes compiled from materials reported in the literature. The initial view of each lesion was preset in terms of its location and size, surrounding surface and sectional (magnetic resonance) neuroanatomy, and labeling of lesion and neuroanatomy. In addition, a glossary of neurological disorders was compiled and for each disorder materials from textbooks were included to provide neurological description. This atlas of neurological disorders is potentially useful to a wide variety of users ranging from medical students, residents and nurses to general practitioners, neuroanatomists, neuroradiologists and neurologists, as it contains both normal (surface and sectional) brain anatomy and pathology correlated with neurological disorders presented in a visual and interactive way. PMID:23859280

Bridging neuroanatomy, neuroradiology and neurology: three-dimensional interactive atlas of neurological disorders.

PubMed

Nowinski, W L; Chua, B C

2013-06-01

Understanding brain pathology along with the underlying neuroanatomy and the resulting neurological deficits is of vital importance in medical education and clinical practice. To facilitate and expedite this understanding, we created a three-dimensional (3D) interactive atlas of neurological disorders providing the correspondence between a brain lesion and the resulting disorder(s). The atlas contains a 3D highly parcellated atlas of normal neuroanatomy along with a brain pathology database. Normal neuroanatomy is divided into about 2,300 components, including the cerebrum, cerebellum, brainstem, spinal cord, arteries, veins, dural sinuses, tracts, cranial nerves (CN), white matter, deep gray nuclei, ventricles, visual system, muscles, glands and cervical vertebrae (C1-C5). The brain pathology database contains 144 focal and distributed synthesized lesions (70 vascular, 36 CN-related, and 38 regional anatomy-related), each lesion labeled with the resulting disorder and associated signs, symptoms, and/or syndromes compiled from materials reported in the literature. The initial view of each lesion was preset in terms of its location and size, surrounding surface and sectional (magnetic resonance) neuroanatomy, and labeling of lesion and neuroanatomy. In addition, a glossary of neurological disorders was compiled and for each disorder materials from textbooks were included to provide neurological description. This atlas of neurological disorders is potentially useful to a wide variety of users ranging from medical students, residents and nurses to general practitioners, neuroanatomists, neuroradiologists and neurologists, as it contains both normal (surface and sectional) brain anatomy and pathology correlated with neurological disorders presented in a visual and interactive way.

Analysis of Parallel and Transverse Visual Cues on the Gait of Individuals with Idiopathic Parkinson's Disease

ERIC Educational Resources Information Center

de Melo Roiz, Roberta; Azevedo Cacho, Enio Walker; Cliquet, Alberto, Jr.; Barasnevicius Quagliato, Elizabeth Maria Aparecida

2011-01-01

Idiopathic Parkinson's disease (IPD) has been defined as a chronic progressive neurological disorder with characteristics that generate changes in gait pattern. Several studies have reported that appropriate external influences, such as visual or auditory cues may improve the gait pattern of patients with IPD. Therefore, the objective of this…

The developmental dynamics of gait maturation with a focus on spatiotemporal measures.

PubMed

Kraan, C M; Tan, A H J; Cornish, K M

2017-01-01

Gait analysis is recognised as a powerful clinical tool for studying relationships between motor control and brain function. By drawing on the literature investigating gait in individuals with neurological disorders, this review provides insight into the neural processes that contribute to and regulate specific spatiotemporal sub-components of gait and how they may mature across early to late childhood. This review also discusses the roles of changing anthropomorphic characteristics, and maturing sensory and higher-order cognitive processes in differentiating the developmental trajectories of the sub-components of gait. Importantly, although studies have shown that cognitive-gait interference is larger in children compared to adults, the contributing neurocognitive mechanisms may vary across age groups who have different types of attentional or cognitive vulnerabilities. These findings have implications for current models of gait maturation by highlighting the need for a dynamic model that focuses on the integration of various factors that contribute to gait though experience and practice. This is essential to elucidating why gait and other motor deficits are often contiguous with cognitive neurodevelopmental disorders. Copyright © 2016. Published by Elsevier B.V.

Key sleep neurologic disorders

PubMed Central

St. Louis, Erik K.

2014-01-01

Summary Sleep disorders are frequent comorbidities in neurologic patients. This review focuses on clinical aspects and prognosis of 3 neurologic sleep disorders: narcolepsy, restless legs syndrome/Willis-Ekbom disease (RLS/WED), and REM sleep behavior disorder (RBD). Narcolepsy causes pervasive, enduring excessive daytime sleepiness, adversely affecting patients' daily functioning. RLS/WED is characterized by an uncomfortable urge to move the legs before sleep, often evolving toward augmentation and resulting in daylong bothersome symptoms. RBD causes potentially injurious dream enactment behaviors that often signify future evolution of overt synucleinopathy neurodegeneration in as many as 81% of patients. Timely recognition, referral for polysomnography, and longitudinal follow-up of narcolepsy, RLS/WED, and RBD patients are imperatives for neurologists in providing quality comprehensive patient care. PMID:24605270

Gait disorder rehabilitation using vision and non-vision based sensors: A systematic review

PubMed Central

Ali, Asraf; Sundaraj, Kenneth; Ahmad, Badlishah; Ahamed, Nizam; Islam, Anamul

2012-01-01

Even though the amount of rehabilitation guidelines has never been greater, uncertainty continues to arise regarding the efficiency and effectiveness of the rehabilitation of gait disorders. This question has been hindered by the lack of information on accurate measurements of gait disorders. Thus, this article reviews the rehabilitation systems for gait disorder using vision and non-vision sensor technologies, as well as the combination of these. All papers published in the English language between 1990 and June, 2012 that had the phrases “gait disorder” “rehabilitation”, “vision sensor”, or “non vision sensor” in the title, abstract, or keywords were identified from the SpringerLink, ELSEVIER, PubMed, and IEEE databases. Some synonyms of these phrases and the logical words “and” “or” and “not” were also used in the article searching procedure. Out of the 91 published articles found, this review identified 84 articles that described the rehabilitation of gait disorders using different types of sensor technologies. This literature set presented strong evidence for the development of rehabilitation systems using a markerless vision-based sensor technology. We therefore believe that the information contained in this review paper will assist the progress of the development of rehabilitation systems for human gait disorders. PMID:22938548

Kinematics gait disorder in men with fibromyalgia.

PubMed

Heredia-Jimenez, Jose M; Soto-Hermoso, Victor M

2014-01-01

The aim of this study was to assess the kinematics disorder of gait in men with fibromyalgia. We studied 12 male with fibromyalgia and 14 healthy men. Each participant of the study walked five trials along a 18.6-m walkway. Fibromyalgia patients completed a Spanish version of Fibromyalgia Impact Questionnaire. Significant differences between fibromyalgia and control groups were found in velocity, stride length, and cadence. Gait parameters of men affected by fibromyalgia were impaired when compared to those of healthy group due to bradykinesia. According to previous studies to assess gait variables in female patients, the male with fibromyalgia also showed lower values of velocity, cadence, and stride length than healthy group but not reported significant differences in swing, stance, single, or double support phase.

Community-Acquired Pneumonia Hospitalization among Children with Neurologic Disorders.

PubMed

Millman, Alexander J; Finelli, Lyn; Bramley, Anna M; Peacock, Georgina; Williams, Derek J; Arnold, Sandra R; Grijalva, Carlos G; Anderson, Evan J; McCullers, Jonathan A; Ampofo, Krow; Pavia, Andrew T; Edwards, Kathryn M; Jain, Seema

2016-06-01

To describe and compare the clinical characteristics, outcomes, and etiology of pneumonia among children hospitalized with community-acquired pneumonia (CAP) with neurologic disorders, non-neurologic underlying conditions, and no underlying conditions. Children <18 years old hospitalized with clinical and radiographic CAP were enrolled at 3 US children's hospitals. Neurologic disorders included cerebral palsy, developmental delay, Down syndrome, epilepsy, non-Down syndrome chromosomal abnormalities, and spinal cord abnormalities. We compared the epidemiology, etiology, and clinical outcomes of CAP in children with neurologic disorders with those with non-neurologic underlying conditions, and those with no underlying conditions using bivariate, age-stratified, and multivariate logistic regression analyses. From January 2010-June 2012, 2358 children with radiographically confirmed CAP were enrolled; 280 (11.9%) had a neurologic disorder (52.1% of these individuals also had non-neurologic underlying conditions), 934 (39.6%) had non-neurologic underlying conditions only, and 1144 (48.5%) had no underlying conditions. Children with neurologic disorders were older and more likely to require intensive care unit (ICU) admission than children with non-neurologic underlying conditions and children with no underlying conditions; similar proportions were mechanically ventilated. In age-stratified analysis, children with neurologic disorders were less likely to have a pathogen detected than children with non-neurologic underlying conditions. In multivariate analysis, having a neurologic disorder was associated with ICU admission for children ≥2 years of age. Children with neurologic disorders hospitalized with CAP were less likely to have a pathogen detected and more likely to be admitted to the ICU than children without neurologic disorders. Published by Elsevier Inc.

[Clinical study of comparing comorbidity between depression and neurological disorder with depressive disorder].

PubMed

Zhang, Jing; He, Mao-Lin; Li, Shun-Wei

2010-01-26

To compare the clinical traits in comorbidity between depression and neurological disorder with depressive disorder and explore the characteristic of the outpatients with neurological disorder comorbidity in depression. According to Diagnosis and Statistic Manual for Mental Disorder-IV (DSM-IV) criteria, outpatients were diagnosed as depressive disorder at Departments of Neurology and Psychology. We used HAMD-17 scale to evaluate the patient's severity. There was no statistical difference in severity of depression in two groups. But the clinical traits showed significant differences between two outpatient groups: the outpatients with neurological disorder comorbidity in depression were elder, had more somatic disorders and a higher retard symptom factor score while the other are relative younger, have less physical disorders and higher the core symptom factor score on the other hand. The patients of comorbidity between depression and neurological disorders have unique clinical traits. Thus it will be helpful to improve the identification of diagnosis and choose an appropriate treatment if we know the differences well.

Gait performance and foot pressure distribution during wearable robot-assisted gait in elderly adults.

PubMed

Lee, Su-Hyun; Lee, Hwang-Jae; Chang, Won Hyuk; Choi, Byung-Ok; Lee, Jusuk; Kim, Jeonghun; Ryu, Gyu-Ha; Kim, Yun-Hee

2017-11-28

A robotic exoskeleton device is an intelligent system designed to improve gait performance and quality of life for the wearer. Robotic technology has developed rapidly in recent years, and several robot-assisted gait devices were developed to enhance gait function and activities of daily living in elderly adults and patients with gait disorders. In this study, we investigated the effects of the Gait-enhancing Mechatronic System (GEMS), a new wearable robotic hip-assist device developed by Samsung Electronics Co, Ltd., Korea, on gait performance and foot pressure distribution in elderly adults. Thirty elderly adults who had no neurological or musculoskeletal abnormalities affecting gait participated in this study. A three-dimensional (3D) motion capture system, surface electromyography and the F-Scan system were used to collect data on spatiotemporal gait parameters, muscle activity and foot pressure distribution under three conditions: free gait without robot assistance (FG), robot-assisted gait with zero torque (RAG-Z) and robot-assisted gait (RAG). We found increased gait speed, cadence, stride length and single support time in the RAG condition. Reduced rectus femoris and medial gastrocnemius muscle activity throughout the terminal stance phase and reduced effort of the medial gastrocnemius muscle throughout the pre-swing phase were also observed in the RAG condition. In addition, walking with the assistance of GEMS resulted in a significant increase in foot pressure distribution, specifically in maximum force and peak pressure of the total foot, medial masks, anterior masks and posterior masks. The results of the present study reveal that GEMS may present an alternative way of restoring age-related changes in gait such as gait instability with muscle weakness, reduced step force and lower foot pressure in elderly adults. In addition, GEMS improved gait performance by improving push-off power and walking speed and reducing muscle activity in the lower

Neurological symptoms in patients with biopsy proven celiac disease.

PubMed

Bürk, Katrin; Farecki, Marie-Louise; Lamprecht, Georg; Roth, Guenter; Decker, Patrice; Weller, Michael; Rammensee, Hans-Georg; Oertel, Wolfang

2009-12-15

In celiac disease (CD), the gut is the typical manifestation site but atypical neurological presentations are thought to occur in 6 to 10% with cerebellar ataxia being the most frequent symptom. Most studies in this field are focused on patients under primary neurological care. To exclude such an observation bias, patients with biopsy proven celiac disease were screened for neurological disease. A total of 72 patients with biopsy proven celiac disease (CD) (mean age 51 +/- 15 years, mean disease duration 8 +/- 11 years) were recruited through advertisements. All participants adhered to a gluten-free diet. Patients were interviewed following a standard questionnaire and examined clinically for neurological symptoms. Medical history revealed neurological disorders such as migraine (28%), carpal tunnel syndrome (20%), vestibular dysfunction (8%), seizures (6%), and myelitis (3%). Interestingly, 35% of patients with CD reported of a history of psychiatric disease including depression, personality changes, or even psychosis. Physical examination yielded stance and gait problems in about one third of patients that could be attributed to afferent ataxia in 26%, vestibular dysfunction in 6%, and cerebellar ataxia in 6%. Other motor features such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus were infrequent. 35% of patients with CD showed deep sensory loss and reduced ankle reflexes in 14%. Gait disturbances in CD do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment. Neurological problems may even develop despite strict adherence to a gluten-free diet. (c) 2009 Movement Disorder Society.

[Prevalence of neurological disorders among children with Down syndrome].

PubMed

Gaete, Beatriz; Mellado, Cecilia; Hernández, Marta

2012-02-01

Neurological disturbances are common problems in children with Down Syndrome (DS). To determine the prevalence of neurological disorders affecting children with Down Syndrome. Review of medical records of 253 children aged from 1 day to 23 years affected with DS, attended at a public hospital and a University clinic. The overall prevalence of neurological disorders was 38.7%. The most common problems were ocular motor disorders in 26% of cases and epilepsy in 12%. Neurological disorders are more common in children with DS than in the general population. Motor ocular disorders and epilepsy are the predominant disturbances detected.

Feeding problems in children with neurological disorders.

PubMed

Jamroz, Ewa; Głuszkiewicz, Ewa; Grzybowska-Chlebowczyk, Urszula; Woś, Halina

2012-01-01

The aim of this study was to evaluate the prevalence of selected risk factors of weight deficiency in children with chronic metabolic diseases. The study group involved 160 children, from 2 months to 15 years (mean age 3.14 years), with diseases of the nervous system and body weight deficiency. According to the type of neurological disease the following groups of patients were separated: static encephalopathies, progressive encephalopathies, disorders of mental development of undetermined etiology, genetically determined diseases. As the exponent of malnutrition, z-score of weight-for-age standards was used. An inclusion criterion for the study group was z-score of weight-for-age < - 2SD. The analysed risk factors of body weight deficiency were: mode of feeding children, neurological disorders, oral motor dysfunction, diseases of other organs, gastrointestinal motility disorders (oral cavity, esophagus, intestines) and type of nutritional therapy. The most advanced malnutrition was in children with progressive encephalopathies and genetically determined diseases. Seizures and muscular hypotonia were most common neurological disorders. Oral motor dysfunctions were observed in 40% of patients. Malnutrition in children with neurological disorders is associated mainly with neurological deficits. In this group of children monitoring of somatic development and early nutritional intervention are necessary.

Children's sleep disturbance scale in differentiating neurological disorders.

PubMed

Cohen, Rony; Halevy, Ayelet; Shuper, Avinoam

2013-12-01

We use the Sleep Disturbance Scale for Children (SDSC) routinely as a tool for evaluating children's sleep quality in our pediatric neurology clinic. We analyzed at its ability to detect sleep disturbances distinctive to selected neurological disorders. One-hundred and eighty-six children (age range 2-18 years) who were evaluated by the SDSC questionnaire were divided into three groups according to their principal diagnosis: epilepsy, attention deficit hyperactivity disorder, or others. Their responses were analyzed. The average frequency of abnormal total sleep score was 26.9%. The most frequent sleep disorders were excessive somnolence (25.3%), initiating and maintaining sleep (24.7%), and arousal/nightmares (23.1%). There were no significant group differences for total scores or sleep disorder-specific scores; although a sleep-wake transition disorder was more frequent among children with epilepsy (31%). A literature search revealed that the frequency of abnormal total scores in several neurological disorders (e.g., epilepsy, cerebral palsy) ranges between 20% and 30%. The mechanism underlying sleep disturbances in many neurological disorders may be unrelated to that of the primary disease but rather originate from nonspecific or environmental factors (e.g., familial/social customs and habits, temperament, psychological parameters). Although the SDSC is noninformative for studying the effect of a specific neurological disorder on sleep, we still recommend its implementation for screening for sleep disturbances in children with neurological abnormalities. Copyright © 2013 Elsevier Inc. All rights reserved.

Autism spectrum symptoms in children with neurological disorders.

PubMed

Ryland, Hilde K; Hysing, Mari; Posserud, Maj-Britt; Gillberg, Christopher; Lundervold, Astri J

2012-11-12

The aims of the present study were to assess symptoms associated with an autism spectrum disorder (ASD) in children with neurological disorders as reported by parents and teachers on the Autism Spectrum Screening Questionnaire (ASSQ), as well as the level of agreement between informants for each child. The ASSQ was completed by parents and teachers of the 5781 children (11-13 years) who participated in the second wave of the Bergen Child Study (BCS), an on-going longitudinal population-based study. Out of these children, 496 were reported to have a chronic illness, including 99 whom had a neurological disorder. The neurological disorder group included children both with and without intellectual disabilities. Children with neurological disorders obtained significantly higher parent and teacher reported ASSQ scores than did non-chronically ill children and those with other chronic illnesses (p<.01; ES = .50-1.01), and 14.1% were screened above the positive cutoff score for ASD according to their combined parent and teacher ASSQ scores. Parent/teacher agreement over ASSQ scores for children with neurological disorders was moderate to high for the total score and for three sub scores generated from a factor analysis, and low to moderate for single items. The ASSQ identifies a high rate of ASD symptoms in children with neurological disorders, and a large number of children screened in the positive range for ASD. Although a firm conclusion awaits further clinical studies, the present results suggest that health care professionals should be aware of potential ASD related problems in children with neurological disorders, and should consider inclusion of the ASSQ or similar screening instruments as part of their routine assessment of this group of children.

From photography to cinematography: recording movement and gait in a neurological context.

PubMed

Aubert, Geneviève

2002-09-01

The major challenge of photography has been freezing movement, to transform it into a fixed image or series of images. Very soon, photographers became interested in movement itself and tried to use photography as a tool to analyze movement. At the early stages, physicians interested in movement, perhaps surprisingly, made important technical contributions. Mécanisme de la physionomie humaine, by Duchenne, the first book with physiological experiments illustrated by photographs, is a landmark in this historical development. At the Salpêtrière, thanks to Charcot, photography officially entered clinical neurology. Medical journals with photographs were actively developed by Bourneville. Londe established a clinical photographic laboratory and published the first book on medical photography. The study of animal and human movement by Muybridge and Marey in the 1880s led to chronophotography and later cinematography. Clinicians such as Dercum and Richer took advantage of these new techniques to study pathological movement and gait in neurological diseases.

[Neurological Disorders and Pregnancy].

PubMed

Berlit, P

2016-02-01

Neurological disorders caused by pregnancy and puerperium include the posterior reversible encephalopathy syndrome, the amniotic fluid embolism syndrome (AFES), the postpartum angiopathy due to reversible vasoconstriction syndrome, and the Sheehan syndrome. Hypertension and proteinuria are the hallmarks of preeclampsia, seizures define eclampsia. Hemolysis, elevated liver enzymes and low platelets constitute the HELLP syndrome. Vision disturbances including cortical blindness occur in the posterior reversible encephalopathy syndrome (PRES). The Sheehan syndrome presents with panhypopituitarism post partum due to apoplexia of the pituitary gland in severe peripartal blood loss leading to longstanding hypotension. Some neurological disorders occur during pregnancy and puerperium with an increased frequency. These include stroke, sinus thrombosis, the restless legs syndrome and peripheral nerve syndromes, especially the carpal tunnel syndrome. Chronic neurologic diseases need an interdisciplinary approach during pregnancy. Some anticonvulsants double the risk of birth defects. The highest risk exists for valproic acid, the lowest for lamotrigine and levetiracetam. For MS interval treatment, glatiramer acetate and interferones seem to be safe during pregnancy. All other drugs should be avoided. © Georg Thieme Verlag KG Stuttgart · New York.

Etiology of Attention Disorders: A Neurological/Genetic Perspective.

ERIC Educational Resources Information Center

Grantham, Madeline Kay

This paper explores the historical origins of attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD) as a neurological disorder, current neurological and genetic research concerning the etiology of ADD/ADHD, and implications for diagnosis and treatment. First, ADD/ADHD is defined and then the origins of ADD/ADHD as a…

[Current emergency medicine for neurological disorders in children].

PubMed

Osamura, Toshio

2010-01-01

In 2006, the number of pediatric outpatients consulting our hospital during non-practice hours increased by 218.1% of that in 1996. The number of pediatric inpatients during non-practice hours in 2006 increased by 71.3% of that in 1996. In 2006, the number of patients who were admitted with neurological disorders in children during non-practice hours increased to 213.3% of that in 1996. The proportion of these pediatric patients among those who were admitted during non-practice hours was 16.6% in our hospital, suggesting the importance of neurological disorders in pediatric emergency medicine. More than 60% of inpatients with neurological disorders in children were 3 years old or younger. The most common neurological symptoms observed at admission included convulsion (81.6%) and disturbance of consciousness (8.5%). The disorders were mainly febrile seizure (41.4%) and epilepsy (29.0%). Most patients with severe disorders requiring emergency medicine, such as head bruise, acute encephalitis/encephalopathy, purulent meningitis, and head trauma, were admitted during non-practice hours. The prognoses of most neurological disorders in children were favorable. However, patients with sequelae (especially, hypoxic encephalopathy, acute encephalitis/encephalopathy) showed an unfavorable neurological prognosis. Early rehabilitation during admission was useful as a support method for their families. In the future, a comprehensive rehabilitation program for children with acquired brain injury should be established and laws to promote home care must be passed.

Cerebral Palsy Gait, Clinical Importance

PubMed Central

TUGUI, Raluca Dana; ANTONESCU, Dinu

2013-01-01

ABSTRACT Cerebral palsy refers to a lesion on an immature brain, that determines permanent neurological disorders. Knowing the exact cause of the disease does not alter the treatment management. The etiology is 2-2.5/1000 births and the rate is constant in the last 40-50 years because advances in medical technologies have permitted the survival of smaller and premature new born children. Gait analysis has four directions: kinematics (represents body movements analysis without calculating the forces), kinetics (represents body moments and forces), energy consumption (measured by oximetry), and neuromuscular activity (measured by EMG). Gait analysis can observe specific deviations in a patient, allowing us to be more accurate in motor diagnoses and treatment solutions: surgery intervention, botulinum toxin injection, use of orthosis, physical kinetic therapy, oral medications, baclofen pump. PMID:24790675

Gait disorders in patients with fibromyalgia.

PubMed

Auvinet, Bernard; Bileckot, Richard; Alix, Anne-Sophie; Chaleil, Denis; Barrey, Eric

2006-10-01

The objective of this study was to compare gait in patients with fibromyalgia and in matched controls. Measurements must be obtained in patients with fibromyalgia, as the evaluation scales for this disorder are semi-quantitative. We used a patented gait analysis system (Locometrix Centaure Metrix, France) developed by the French National Institute for Agricultural Research. Relaxed walking was evaluated in 14 women (mean age 50+/-5 years; mean height 162+/-5 cm; and mean body weight 68+/-13 kg) meeting American College of Rheumatology criteria for fibromyalgia and in 14 controls matched on sex, age, height, and body weight. Gait during stable walking was severely altered in the patients. Walking speed was significantly diminished (P<0.001) as a result of reductions in stride length (P<0.001) and cycle frequency (P<0.001). The resulting bradykinesia (P<0.001) was the best factor for separating the two groups. Regularity was affected in the patients (P<0.01); this variable is interesting because it is independent of age and sex in healthy, active adults. Measuring the variables that characterize relaxed walking provides useful quantitative data in patients with fibromyalgia.

Diagnostic Exercise: Neurologic Disorder in a Cat

DTIC Science & Technology

1989-12-21

IWORK UNIT ELEMENT NO. NO. NO. ACCESSION NO. 11. TITLE (Include Security Classification) Diagnostic Exercise - Neurologic Disorder in a Cat 12...and identify by block number) This report documents the fifth reported occurrance of cerebral phaeophyphomycosis in cats . Because mycotic...Exercise: Neurologic Disorder in a Cat Ronald C. Bell United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick

Neurological disorders and inflammatory bowel diseases

PubMed Central

Casella, Giovanni; Tontini, Gian Eugenio; Bassotti, Gabrio; Pastorelli, Luca; Villanacci, Vincenzo; Spina, Luisa; Baldini, Vittorio; Vecchi, Maurizio

2014-01-01

Extraintestinal manifestations occur in about one-third of patients living with inflammatory bowel disease (IBD) and may precede the onset of gastrointestinal symptoms by many years. Neurologic disorders associated with IBD are not frequent, being reported in 3% of patients, but they often represent an important cause of morbidity and a relevant diagnostic issue. In addition, the increasing use of immunosuppressant and biological therapies for IBD may also play a pivotal role in the development of neurological disorders of different type and pathogenesis. Hence, we provide a complete and profound review of the main features of neurological complications associated with IBD, with particular reference to those related to drugs and with a specific focus on their clinical presentation and possible pathophysiological mechanisms. PMID:25083051

Modern network science of neurological disorders.

PubMed

Stam, Cornelis J

2014-10-01

Modern network science has revealed fundamental aspects of normal brain-network organization, such as small-world and scale-free patterns, hierarchical modularity, hubs and rich clubs. The next challenge is to use this knowledge to gain a better understanding of brain disease. Recent developments in the application of network science to conditions such as Alzheimer's disease, multiple sclerosis, traumatic brain injury and epilepsy have challenged the classical concept of neurological disorders being either 'local' or 'global', and have pointed to the overload and failure of hubs as a possible final common pathway in neurological disorders.

Paraneoplastic Neurological Disorder in Nasopharyngeal Carcinoma.

PubMed

Ng, Sze Yin; Kongg, Min Han; Yunus, Mohd Razif Mohamad

2017-03-01

Paraneoplastic neurological disorder (PND) is a condition due to immune cross-reactivity between the tumour cells and the normal tissue, whereby the "onconeural" antibodies attack the normal host nervous system. It can present within weeks to months before or after the diagnosis of malignancies. Nasopharyngeal carcinoma is associated with paraneoplastic syndrome, for example, dermatomyositis, and rarely with a neurological disorder. We report on a case of nasopharyngeal carcinoma with probable PND. Otolaryngologists, oncologists and neurologists need to be aware of this condition in order to make an accurate diagnosis and to provide prompt treatment.

Urea cycle disorders: brain MRI and neurological outcome.

PubMed

Bireley, William R; Van Hove, Johan L K; Gallagher, Renata C; Fenton, Laura Z

2012-04-01

Urea cycle disorders encompass several enzyme deficiencies that can result in cerebral damage, with a wide clinical spectrum from asymptomatic to severe. The goal of this study was to correlate brain MRI abnormalities in urea cycle disorders with clinical neurological sequelae to evaluate whether MRI abnormalities can assist in guiding difficult treatment decisions. We performed a retrospective chart review of patients with urea cycle disorders and symptomatic hyperammonemia. Brain MRI images were reviewed for abnormalities that correlated with severity of clinical neurological sequelae. Our case series comprises six urea cycle disorder patients, five with ornithine transcarbamylase deficiency and one with citrullinemia type 1. The observed trend in distribution of brain MRI abnormalities as the severity of neurological sequelae increased was the peri-insular region first, extending into the frontal, parietal, temporal and, finally, the occipital lobes. There was thalamic restricted diffusion in three children with prolonged hyperammonemia. Prior to death, this site is typically reported to be spared in urea cycle disorders. The pattern and extent of brain MRI abnormalities correlate with clinical neurological outcome in our case series. This suggests that brain MRI abnormalities may assist in determining prognosis and helping clinicians with subsequent treatment decisions.

Thyroid-related neurological disorders and complications in children.

PubMed

Nandi-Munshi, Debika; Taplin, Craig E

2015-04-01

Thyroid hormones exert critical roles throughout the body and play an important and permissive role in neuroendocrine, neurological, and neuromuscular function. We performed a PubMed search through June 2014 with search terms including "hypothyroidism," "hyperthyroidism," "neurological complications," "neuropathy," "myopathy," "congenital hypothyroidism," and "encephalopathy." Relevant publications reviewed included case series, individual case reports, systematic reviews, retrospective analyses, and randomized controlled trials. The neurological outcomes of congenital hypothyroidism were reviewed, along with the clinical features of associated neuromuscular syndromes of both hypothyroidism and hyperthyroidism, including other autoimmune conditions. Evidence for, and pathophysiological controversies surrounding, Hashimoto encephalopathy was also reviewed. The establishment of widespread newborn screening programs has been highly successful in attenuating or preventing early and irreversible neurological harm resulting from congenital thyroid hormone deficiency, but some children continue to display neuromuscular, sensory, and cognitive defects in later life. Acquired disorders of thyroid function such as Hashimoto thyroiditis and Graves' disease are associated with a spectrum of central nervous system and/or neuromuscular dysfunction. However, considerable variation in clinical phenotype is described, and much of our knowledge of the role of thyroid disease in childhood neurological disorders is derived from adult case series. Early and aggressive normalization of thyroxine levels in newborn infants with congenital hypothyroidism is important in minimizing neurological sequelae, but maternal thyroid hormone sources are also critically important to the early developing brain. A spectrum of neurological disorders has been reported in older children with acquired thyroid disease, but the frequency with which these occur remains poorly defined in the literature, and

Technological Advances in Interventions to Enhance Post-Stroke Gait

PubMed Central

Sheffler, Lynne R.; Chae, John

2012-01-01

Synopsis This article provides a comprehensive review of specific rehabilitation interventions used to enhance hemiparetic gait following stroke. Neurologic rehabilitation interventions may be either therapeutic resulting in enhanced motor recovery or compensatory whereby assistance or substitution for neurological deficits results in improved functional performance. Included in this review are lower extremity functional electrical stimulation (FES), body-weight supported treadmill training (BWSTT), and lower extremity robotic-assisted gait training. These post-stroke gait training therapies are predicated on activity-dependent neuroplasticity which is the concept that cortical reorganization following central nervous system injury may be induced by repetitive, skilled, and cognitively engaging active movement. All three interventions have been trialed extensively in both research and clinical settings to demonstrate a positive effect on various gait parameters and measures of walking performance. However, more evidence is necessary to determine if specific technology-enhanced gait training methods are superior to conventional gait training methods. This review provides an overview of evidence-based research which supports the efficacy of these three interventions to improve gait, as well as provide perspective on future developments to enhance post-stroke gait in neurologic rehabilitation. PMID:23598265

Astrogliopathology in neurological, neurodevelopmental and psychiatric disorders

PubMed Central

Verkhratsky, Alexei; Parpura, Vladimir

2015-01-01

Astroglial cells represent a main element in the maintenance of homeostasis and providing defense to the brain. Consequently, their dysfunction underlies many, if not all, neurological, neuropsychiatric and neurodegenerative disorders. General astrogliopathy is evident in diametrically opposing morpho-functional changes in astrocytes, i.e. their hypertrophy along with reactivity or atrophy with asthenia. Neurological disorders with astroglial participation can be genetic, of which Alexander disease is a primary sporadic astrogliopathy, environmentally caused, such as heavy metal encephalopathies, or neurodevelopmental in origin. Astroglia also play a role in major neuropsychiatric disorders, ranging from schizophrenia to depression, as well as in additive disorders. Furthermore, astroglia contribute to neurodegenerative processes seen in amyotrophic lateral sclerosis, Alzheimer’s and Huntington’s diseases. PMID:25843667

Genetic testing for paediatric neurological disorders.

PubMed

Valente, Enza Maria; Ferraris, Alessandro; Dallapiccola, Bruno

2008-12-01

Paediatric neurological disorders encompass a large group of clinically heterogeneous diseases, of which some are known to have a genetic cause. Over the past few years, advances in nosological classifications and in strategies for molecular testing have substantially improved the diagnosis, genetic counselling, and clinical management of many patients, and have facilitated the possibility of prenatal diagnoses for future pregnancies. However, the increasing availability of genetic tests for paediatric neurological disorders is raising important questions with regard to the appropriateness, choice of protocols, interpretation of results, and ethical and social concerns of these services. In this Review, we discuss these topics and how these concerns affect genetic counselling.

Conversion disorder and mass psychogenic illness in child neurology.

PubMed

Mink, Jonathan W

2013-11-01

A common problem faced by neurologists is the existence of disorders that present with neurological symptoms but do not have identifiable neurological bases. Conversion disorder is the most common of these disorders. In some situations, members of a cohesive social group will develop the same or similar symptoms. This review discusses conversion disorder in children, with an emphasis on function movement disorders. It also reviews a recent occurrence of mass psychogenic illness in New York State with discussion of the key features of mass psychogenic illness. © 2013 New York Academy of Sciences.

Mitochondria in neuroplasticity and neurological disorders.

PubMed

Mattson, Mark P; Gleichmann, Marc; Cheng, Aiwu

2008-12-10

Mitochondrial electron transport generates the ATP that is essential for the excitability and survival of neurons, and the protein phosphorylation reactions that mediate synaptic signaling and related long-term changes in neuronal structure and function. Mitochondria are highly dynamic organelles that divide, fuse, and move purposefully within axons and dendrites. Major functions of mitochondria in neurons include the regulation of Ca(2+) and redox signaling, developmental and synaptic plasticity, and the arbitration of cell survival and death. The importance of mitochondria in neurons is evident in the neurological phenotypes in rare diseases caused by mutations in mitochondrial genes. Mitochondria-mediated oxidative stress, perturbed Ca(2+) homeostasis, and apoptosis may also contribute to the pathogenesis of prominent neurological diseases including Alzheimer's, Parkinson's, and Huntington's diseases; stroke; amyotrophic lateral sclerosis; and psychiatric disorders. Advances in understanding the molecular and cell biology of mitochondria are leading to novel approaches for the prevention and treatment of neurological disorders.

[Can music therapy for patients with neurological disorders?].

PubMed

Myskja, Audun

2004-12-16

Recent developments in brain research and in the field of music therapy have led to the development of music-based methods specifically aimed at relieving symptoms of Parkinson's disease and other neurologic disorders. Rhythmic auditory stimulation uses external rhythmic auditory cues from song, music or metronome to aid patients improving their walking functioning and has been shown to be effective both within sessions and as a result of training over time. Melodic intonation therapy and related vocal techniques can improve expressive dysphasia and aid rehabilitation of neurologic disorders, particularly Parkinson's disease, stroke and developmental disorders.

78 FR 13359 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-27

... Neurological Disorders and Stroke; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory... Neurological Disorders and Stroke Initial Review Group Neurological Sciences and Disorders K. Date: March 7... review and funding cycle. Name of Committee: National Institute of Neurological Disorders and Stroke...

Survey of Neurological Disorders in Children Aged 9-15 Years in Northern India.

PubMed

Kumar, Rashmi; Bhave, Anupama; Bhargava, Roli; Agarwal, G G

2016-04-01

The prevalence of neurological disorders in resource-poor settings, although likely to be high, is largely unexplored. The prevalence and risk factors for neurological disorders, including epilepsy and intellectual, motor, vision, and hearing deficits, in children aged 9 to 15 years in the community were investigated. A new instrument was developed, validated, and used in a 2-stage community survey for neurological disorders in Lucknow, India. Screen-positives and random proportion of screen-negatives were validated using predefined criteria. Prevalence of different neurological disorders was calculated by weighted proportions. Of 6431 children screened, 221 were positive. A total of 214 screen-positives and 251 screen-negatives were validated. Prevalence of neurological disorders was 31.3 per 1000 children of this age group (weighted 95% confidence interval = 16.5, 46.4). The final model for risk factors included age, mud house, delayed cry at birth, and previous head injury. The prevalence of neurological disorders is high in this region. Predictors of neurological disorders are largely modifiable. © The Author(s) 2015.

Neurological disorders in Gulf War veterans

PubMed Central

Rose, Michael R; Brix, Kelley Ann

2006-01-01

We present a review of neurological function in Gulf War veterans (GWV). Twenty-two studies were reviewed, including large hospitalization and registry studies, large population-based epidemiological studies, investigations of a single military unit, small uncontrolled studies of ill veterans and small controlled studies of veterans. In nearly all studies, neurological function was normal in most GWVs, except for a small proportion who were diagnosed with compression neuropathies (carpal tunnel syndrome or ulnar neuropathy). In the great majority of controlled studies, there were no differences in the rates of neurological abnormalities in GWVs and controls. In a national US study, the incidence of amyotrophic lateral sclerosis (ALS) seems to be significantly increased in GWVs, compared to the rate in controls. However, it is possible that military service, in general, might be associated with an increased risk of ALS, rather than Gulf War service in particular. Taken together, the conclusion is that if a neurological examination in a GWV is within normal limits, then extensive neurological testing is unlikely to diagnose occult neurological disorders. PMID:16687265

[Neurologic disorders in Whipple's disease].

PubMed

Jović, N S; Jović, J Z

1996-01-01

The disease is named after George H. Whipple who, in 1907, was the first to describe an intestinal "lipodystrophy". Although Whipple's disease is generally recognized as a multisystem chronic granulomatous disease, primarily involving the digestive system, it can also appear as a primary neurological disorder in rare cases. Most often it is manifested with loss of weight, diarrhea, malabsorption, abdominal pain, lymphadenopathy, cardiopathy, hyperpigmentation and hypotension. The presence of periodic acid-Schiff (PAS)-positive macrophages in biopsy specimens (not only jejunal) and demonstration of "Whipple's bacilli" visible by electron microscopy, are diagnostic signs of active Whipple's disease. Whipple's disease confined to the CNS is rare. It is rarely found in the differential diagnosis of patients with progressive neurological deterioration. The most common neurological picture includes progressive dementia, external ophalmoplegia, myoclonus, seizures, ataxia, hypothalamic dysfunction (sleep disorders, hyperphagia, polydipsia) and meningitis. Oculofacial-skeletal myorhythmia as a movement disorder, associated with Whipple's disease, is reported. Fulminant course of cerebral Whipple's disease is unusual and unfavourable. The confusing and nonspecific clinical appearance is typical for primary CNS involvement. It has recently been suggested that CNS involvement occurs in all cases, although only 10-20% of patients may show it. The CNS is the most common site of disease relapse. The CT scans and MRI of the brain are often normal, but may show cortical/subcortical atrophy, hydrocephalus, focal or intracerebral mass lesions. The cerebrospinal fluid can sometimes contain PAS-positive macrophages. Brain biopsy is suggested as a diagnostic method in cases of high suspicion of CNS Whipple's disease. However, the lesions are frequently inaccessible and false negative. Without extended antibiotic therapy, the course of Whipple's disease is lethal. Now, the prognosis is

Transition to adult care for children with chronic neurological disorders.

PubMed

Camfield, Peter; Camfield, Carol

2011-03-01

Chronic neurological disorders in children have significant effects on adult medical and social function. Transition and then formal transfer of care from pediatric to adult services is a complex process, although there are virtually no objective data to inform physicians about the most effective approach. Some neurological disorders that start in children are a danger to society if poorly treated in adulthood, some disorders that were previously lethal in childhood now permit survival well into adulthood, and others are static in childhood but progressive in adulthood. Some disorders remit or are cured in childhood but continue to have serious comorbidity in adulthood, whereas others are similar and persistent in children and adults. Maturity, provision of information, and cognitive problems are confounders. We discuss several models of transition/transfer but prefer a joint pediatric/adult transition clinic. We make a series of suggestions about how to improve the transition/transfer process with the hope of better medical and social adult outcome for children with neurological disorders. Copyright © 2011 American Neurological Association.

[The influence of locomotor treatment using robotic body-weight-supported treadmill training on rehabilitation outcome of patients suffering from neurological disorders].

PubMed

Schwartz, Isabella; Meiner, Zeev

2013-03-01

Regaining one's ability to walk is of great importance for neurological patients and is a major goal of all rehabilitation programs. Treating neurological patients in the acute phase after the event is technically difficult because of their motor weakness and balance disturbances. Based on studies in spinalized animals, a novel locomotor training that incorporates high repetitions of task-oriented practice by the use of body weight-supported treadmill training (BWSTT) was developed to overcome these obstacles. The use of BWSTT enables early initiation of gait training, integration of weightbearing activities, stepping and balance by the use of a task-specific approach, and a symmetrical gait pattern. However, despite the theoretical potential of BWSTT to become an invaluable therapeutic tool, its effect on walking outcomes was disappointing when compared with conventional training of the same duration. To facilitate the deLivery of BWSTT, a motorized robotic driven gait orthosis (RBWSTT) was recently developed. It has many advantages over the conventional method, including less effort for the physiotherapists, longer session duration, more physiological and reproducible gait patterns, and the possibility of measuring a patient's performances. Several studies have been conducted using RBWSTT in patients after stroke, spinal cord injury, multiple sclerosis and other neurological diseases. Although some of the results were encouraging, there is still uncertainty regarding proper patient selection, timing and protocol for RBWTT treatment following neurological diseases. More large randomized controlled studies are needed in order to answer these questions.

Aquatic rehabilitation for the treatment of neurological disorders.

PubMed

Morris, D M

1994-01-01

Patients with neurological disorders present therapists with complex challenges for treatment, including weakness, hypertonicity, voluntary movement deficit, limited range of motion, sensory loss, incoordination, and postural instability. The presence of one or more of these impairments negatively influences these patients by contributing to problems in walking, transferring, and reaching. Aquatic rehabilitation offers a unique, versatile approach to the treatment of these disabilities. This article examines the problems encountered by patients with neurological disorders, general principles guiding neurotreatment, and aquatic neurorehabilitation approaches.

75 FR 53319 - National Institute of Neurological Disorders and Stroke; Notice of Meetings

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2010-08-31

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76 FR 28054 - National Institute of Neurological Disorders and Stroke; Notice of Meetings

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2011-05-13

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75 FR 52010 - National Institute of Neurological Disorders and Stroke; Notice of Meetings

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2010-08-24

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75 FR 3475 - National Institute Of Neurological Disorders and Stroke; Notice of Meetings

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2010-01-21

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75 FR 22607 - National Institute of Neurological Disorders and Stroke; Notice of Meetings

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2010-04-29

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76 FR 2129 - National Institute of Neurological Disorders And Stroke; Notice of Meeting

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2011-01-12

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Evidence based effects of yoga in neurological disorders.

PubMed

Mooventhan, A; Nivethitha, L

2017-09-01

Though yoga is one of the widely used mind-body medicine for health promotion, disease prevention and as a possible treatment modality for neurological disorders, there is a lack of evidence-based review. Hence, we performed a comprehensive search in the PubMed/Medline electronic database to review relevant articles in English, using keywords "yoga and neurological disorder, yoga and multiple sclerosis, yoga and stroke, yoga and epilepsy, yoga and Parkinson's disease, yoga and dementia, yoga and cerebrovascular disease, yoga and Alzheimer disease, yoga and neuropathy, yoga and myelopathy, and yoga and Guillain-Barre syndrome". A total of 700 articles published from 1963 to 14th December 2016 were available. Of 700 articles, 94 articles were included in this review. Based on the available literature, it could be concluded that yoga might be considered as an effective adjuvant for the patients with various neurological disorders. Copyright © 2017 Elsevier Ltd. All rights reserved.

Advantages of Structure-Based Drug Design Approaches in Neurological Disorders

PubMed Central

Aarthy, Murali; Panwar, Umesh; Selvaraj, Chandrabose; Singh, Sanjeev Kumar

2017-01-01

Objective: The purpose of the review is to portray the theoretical concept on neurological disorders from research data. Background: The freak changes in chemical response of nerve impulse causes neurological disorders. The research evidence of the effort done in the older history suggests that the biological drug targets and their effective feature with responsive drugs could be valuable in promoting the future development of health statistics structure for improved treatment for curing the nervous disorders. Methods: In this review, we summarized the most iterative theoretical concept of structure based drug design approaches in various neurological disorders to unfathomable understanding of reported information for future drug design and development. Results: On the premise of reported information we analyzed the model of theoretical drug designing process for understanding the mechanism and pathology of the neurological diseases which covers the development of potentially effective inhibitors against the biological drug targets. Finally, it also suggests the management and implementation of the current treatment in improving the human health system behaviors. Conclusion: With the survey of reported information we concluded the development strategies of diagnosis and treatment against neurological diseases which leads to supportive progress in the drug discovery. PMID:28042767

[Conversion disorder: from DSM IV to DSM 5 or from a psychiatric to a neurological diagnosis].

PubMed

Vermeulen, M; Willems, M H A

2015-01-01

According to one of the diagnostic criteria of the dsm iv for conversion disorder there has to be a temporal relationship between psychological factors and the onset, or the worsening, of the symptoms. This criterion has been omitted in the dsm-5. Another criterion, namely that the symptoms are not produced intentionally, has also been abandoned. A new recommendation is that therapists should look for neurological symptoms that support the diagnosis. To investigate whether studies support the changes in the criteria. We searched literature using PubMed. When the symptoms first appear, trauma or stress in 37% of patients is of a physical rather than a psychological nature. Different forms of stress were found in equal proportions (20%) in patients with or without conversion disorder. There are no specific stressors, except possibly in patients with dysphonia. The percentages of childhood abuse vary widely, namely from 0 to 85%. The characteristic phenomenon of 'la belle indifference' occurs in only 3% of patients with conversion disorder versus only 2% of controls. Most of the 'positive' clinical tests for partial paralysis and sensory and gait disorders are highly specific. There are no reliable tests for distinguishing conversion disorder from simulation. The changes of the criteria are supported by recent studies.

78 FR 24221 - National Institute of Neurological Disorders and Stroke

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2013-04-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended... Neurological Disorders and Stroke, NIH, 31 Center Drive, Room 8A03, Bethesda, MD 20892, Phone: (301) 496-9271...

Genetics of hereditary neurological disorders in children.

PubMed

Huang, Yue; Yu, Sui; Wu, Zhanhe; Tang, Beisha

2014-04-01

Hereditary neurological disorders (HNDs) are relatively common in children compared to those occurring in adulthood. Recognising clinical manifestations of HNDs is important for the selection of genetic testing, genetic testing results interpretation, and genetic consultation. Meanwhile, advances in next generation sequencing (NGS) technologies have significantly enabled the discovery of genetic causes of HNDs and also challenge paediatricians on applying genetic investigation. Combination of both clinical information and advanced technologies will enhance the genetic test yields in clinical setting. This review summarises the clinical presentations as well as genetic causes of paediatric neurological disorders in four major areas including movement disorders, neuropsychiatric disorders, neuron peripheral disorders and epilepsy. The aim of this review is to help paediatric neurologists not only to see the clinical features but also the complex genetic aspect of HNDs in order to utilise genetic investigation confidently in their clinical practice. A smooth transition from research based to clinical use of comprehensive genetic testing in HNDs in children could be foreseen in the near future while genetic testing, genetic counselling and genetic data interpretation are in place appropriately.

76 FR 2129 - National Institute of Neurological Disorders and Stroke; Notice of Meeting

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2011-01-12

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77 FR 33470 - National Institute of Neurological Disorders and Stroke Notice of Closed Meetings

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2012-06-06

... Neurological Disorders and Stroke Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Initial Review Group; Neurological Sciences and Disorders K. Date: June 25-26, 2012..., [email protected] . Name of Committee: National Institute of Neurological Disorders and Stroke Special...

Do (epi)genetics impact the brain in functional neurologic disorders?

PubMed

Frodl, T

2016-01-01

Advances in neuropsychiatric research are supposed to lead to significant improvements in understanding functional neurologic disorders and their diagnosis. However, epigenetic and genetic research on conversion disorders and somatoform disorders is only at its start. This review demonstrates the current state within this field and tries to bridge a gap from what is known on gene-stress interactions in other psychiatric disorders like depression. The etiology of conversion disorders is hypothesized to be multifactorial. These considerations also suggest that potential etiologic factors lead to alterations in brain function, either episodically or chronically, eventually leading to structural brain changes. In particular, the knowledge of how the environment influences brain structure and function, e.g., via epigenetic regulation, may be interesting for future research in functional neurologic disorders. Reviewing the literature results in evidence that childhood adversities play a role in the development of functional neurologic disorders, whereby at present no reports exist about the interactive effect between childhood adversity and genetic factors or about the impact of epigenetics. © 2016 Elsevier B.V. All rights reserved.

77 FR 27783 - National Institute of Neurological Disorders and Stroke Notice of Closed Meetings

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2012-05-11

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Blood lead levels in children with neurological disorders: a single centre preliminary study.

PubMed

Mahmoudian, Touran; Modaresi, Mohamadreza; Zarei, Ali; Poursafa, Parinaz; Kelishadi, Roya

2009-11-01

Lead poisoning is a potentially devastating problem among young children. Chronic low level lead exposure can lead to learning disabilities and behavior changes such as colic, insomnia, hyperactivity, impaired growth, hearing loss and upper extremity weakness. The purpose of this cross sectional study was to determine the blood lead level in children with neurological disorders in comparison with healthy controls. Blood lead concentrations were measured by flame atomic absorption spectrometry in 100 children aged 1-10 years and suffering from various neurological disorders. One hundred age and sex-matched healthy children served as controls. The mean blood lead concentration was higher in children with neurological disorders than in controls (113.2 + or - 47.5 microg/L vs 84.7 + or - 38.0 microg/L; p<0.01). Overall, 44% of children with neurological disorders and 19% of controls were found to have increased blood lead levels, i.e.>100 microg/L. An increase in blood lead level in children might be related to neurological disorders. The measurement of blood lead level might be included in diagnostic eveluation of children with neurological disorders.

Neural substrates of levodopa-responsive gait disorders and freezing in advanced Parkinson's disease: a kinesthetic imagery approach.

PubMed

Maillet, Audrey; Thobois, Stéphane; Fraix, Valérie; Redouté, Jérôme; Le Bars, Didier; Lavenne, Franck; Derost, Philippe; Durif, Franck; Bloem, Bastiaan R; Krack, Paul; Pollak, Pierre; Debû, Bettina

2015-03-01

Gait disturbances, including freezing of gait, are frequent and disabling symptoms of Parkinson's disease. They often respond poorly to dopaminergic treatments. Although recent studies have shed some light on their neural correlates, their modulation by dopaminergic treatment remains quite unknown. Specifically, the influence of levodopa on the networks involved in motor imagery (MI) of parkinsonian gait has not been directly studied, comparing the off and on medication states in the same patients. We therefore conducted an [H2 (15) 0] Positron emission tomography study in eight advanced parkinsonian patients (mean disease duration: 12.3 ± 3.8 years) presenting with levodopa-responsive gait disorders and FoG, and eight age-matched healthy subjects. All participants performed three tasks (MI of gait, visual imagery and a control task). Patients were tested off, after an overnight withdrawal of all antiparkinsonian treatment, and on medication, during consecutive mornings. The order of conditions was counterbalanced between subjects and sessions. Results showed that imagined gait elicited activations within motor and frontal associative areas, thalamus, basal ganglia and cerebellum in controls. Off medication, patients mainly activated premotor-parietal and pontomesencephalic regions. Levodopa increased activation in motor regions, putamen, thalamus, and cerebellum, and reduced premotor-parietal and brainstem involvement. Areas activated when patients are off medication may represent compensatory mechanisms. The recruitment of these accessory circuits has also been reported for upper-limb movements in Parkinson's disease, suggesting a partly overlapping pathophysiology between imagined levodopa-responsive gait disorders and appendicular signs. Our results also highlight a possible cerebellar contribution in the pathophysiology of parkinsonian gait disorders through kinesthetic imagery. © 2014 Wiley Periodicals, Inc.

78 FR 59041 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

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2013-09-25

... Disorders and Stroke Initial Review, Group Neurological Sciences and Disorders C. Date: October 17-18, 2013... Officer, Scientific Review Branch, Division of Extramural Research, NINDS, NIH, NSC, 6001 Executive Blvd...: National Institute of Neurological Disorders and Stroke Initial Review, Group Neurological Sciences and...

Expanding medicines for neurologic disorders on the WHO Model List.

PubMed

Rimmer, Kathryn; Shah, Hiral; Thakur, Kiran

2017-03-07

The WHO Model List of Essential Medicines is a recommended formulary for high-priority diseases based on public health trends and epidemiology patterns. The biennial publication serves as a guide for countries, particularly low- and lower-middle-income countries, to develop their own national essential medicines list (EML), and many nongovernmental organizations base their medication supplies on the WHO EML. Over the last 40 years, WHO has expanded the EML in response to treatment gaps for infectious diseases, pediatrics, palliative care, and cancer. In contrast, neurotherapeutics are poorly represented on the Model List despite the global burden of neurologic disorders, which have continued to increase in the last decade. It is imperative that the neurology community advocate for more evidence-based neurologic medicines on the WHO EML. Equitable access to essential neurologic medicines is a crucial step toward reducing the treatment gap for high-burden neurologic disorders worldwide. © 2017 American Academy of Neurology.

[Pharmacological hypotheses and therapeutic strategies for gait disorders in Parkinson's disease].

PubMed

Devos, D; Bordet, R; Defebvre, L

2010-02-01

Gait disorders form part of the axial symptoms observed in Parkinson's disease (PD) and also represent a major source of therapeutic failure in the later stages of PD, with the appearance of freezing of gait (FOG) and falls. Double-blind clinical trials and, above all, clinical experience have demonstrated that l-DOPA is effective in reducing FOG. Dopaminergic agonists appear to be less effective than l-DOPA and lack formal proof of their efficacy. The enzyme inhibitors provide modest benefits, which need to be confirmed. Hence, these symptoms appear to be partially doparesistant and justify investigation of other major neurotransmission systems. Of the various drugs with partial noradrenergic activity, methylphenidate may improve FOG and attention disorders. Memantine has shown some value in improving motor symptoms and gait in fluctuating parkinsonian patients - possibly by reducing the effect of glutamatergic hyperactivation of the subthalamic nucleus on the pedunculopontine nucleus (PPN). The PPN's dense cholinergic innervation also suggests that cholinesterase inhibitors may be of use, although any benefits must be set against a potential aggravation of rest tremor. The many interactions between the serotoninergic and dopaminergic systems require the implementation of clinical studies on the complex motor impact of serotoninergic treatments, which may aggravate the parkinsonian syndrome while improving gait (as is the case with paroxetine and ritanserin). This review seeks to develop the various pathophysiological hypotheses prompted by the results of fundamental studies and pilot clinical trials, with a view to justifying the implementation of confirmatory, double-blind, placebo-controlled therapeutic trials. Copyright 2009 Elsevier Masson SAS. All rights reserved.

Zolpidem for the Treatment of Neurologic Disorders: A Systematic Review.

PubMed

Bomalaski, Martin N; Claflin, Edward S; Townsend, Whitney; Peterson, Mark D

2017-09-01

Given its selective action on the ω1 subtype of the γ-aminobutyric acid A receptor, zolpidem tartrate presents a potential treatment mechanism for other neurologic disorders. To synthesize studies that used zolpidem to treat neurologic disorders. Eligibility criteria included any published English-language article that examined the use of zolpidem for noninsomnia neurologic disorders in humans for all dates up to March 20, 2015. Searched databases included PubMed, Scopus, Web of Science Core Collection, the Cochrane Library, EMBASE, CENTRAL, and clinicaltrials.gov. Publication bias was mitigated by searching clinicaltrials.gov for unpublished studies. Two rounds of screening were performed based on title and then abstract, and coding was performed by 2 coders. All methods followed the PRISMA Reporting Guidelines for systematic reviews of the literature. The initial search produced 2314 articles after removing duplicates. After exclusion based on a review of abstracts, 67 articles remained for full manuscript review. Thirty-one studies treated movement disorders, 22 treated disorders of consciousness, and 14 treated other neurologic conditions, including stroke, traumatic brain injury, encephalopathy, and dementia. Study designs included case reports (n = 28), case series (n = 8), single-patient interventional (n = 13), pretest and posttest (n = 9), randomized clinical trials (n = 9), and crossover studies (n = 5). Only 11 studies had more than 10 participants. Effects of zolpidem were wide ranging (eg, improvement on the JFK Coma Recovery Scale-Revised, the Unified Parkinson Disease Rating Scale, and the Burke-Fahn-Marsden Dystonia Rating Scale) and generally lasted 1 to 4 hours before the participant returned to baseline. Sedation was the most common adverse effect. Zolpidem has been observed to transiently treat a large variety of neurologic disorders, most often related to movement disorders and disorders of consciousness. Much of what

[Do children with attention deficit and hyperactivity disorder (ADHD) have a diferent gait pattern? Relationship between idiopathic toe-walking and ADHD].

PubMed

Soto Insuga, Víctor; Moreno Vinués, Beatriz; Losada Del Pozo, Rebeca; Rodrigo Moreno, María; Martínez González, Marta; Cutillas Ruiz, Raquel; Mateos Carmen, Carmen

2018-04-01

Idiopathic toe-walking (ITW) is described as a gait pattern with no contact between the heels and the ground in children older than 3years. The diagnosis is clinical, making it necessary to rule out other neurological and orthopaedic conditions. A relationship between ITW and vestibular dysfunction and/or proprioceptive sensibility has been proposed. Children with neurodevelopmental disorders (autism, language and cognitive disorders) often have ITW. To determine the frequency of ITW in children with attention deficit disorder and hyperactivity (ADHD). A study was conducted on children diagnosed with ADHD, with normal neurological examination, with no alterations in MRI scan, cognitive disorder or autism. A complete clinical anamnesis was performed and Achilles shortening was measured with a goniometer. The study included 312 children with a mean age of 11 years (73.7% boys). The ADHD combined subtype was the most frequent (53.8%), followed by the inattentive (44.9%), and hyperactive (1.3%). ITW was observed in 20.8% of patients, particularly in the combined subtype (P=.054). Only 32 of them (49.2%) had Achilles shortening. ITW was associated with sociability disorders (P=.01), absence of pain in legs (P=.022), and family history of ITW (P=.004). Only 11% had previously visited a doctor for this reason. As in other neurodevelopmental disorders, children with ADHD have frequently more ITW and Achilles shortening than controls, especially if they presented with a social communication disorder or a family history of ITW. An early diagnosis is essential to establish effective treatments. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

77 FR 52337 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

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2012-08-29

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76 FR 20691 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

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2011-04-13

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78 FR 36201 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

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2013-06-17

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78 FR 22273 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

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2013-04-15

... Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Counselors, National Advisory Neurological Disorders and Stroke. The meeting will be closed to the public as... conducted by the National Institute of Neurological Disorders and Stroke, including consideration of...

Fibrinolytic activity in cerebrospinal fluid of dogs with different neurological disorders.

PubMed

de la Fuente, C; Monreal, L; Cerón, J; Pastor, J; Viu, J; Añor, S

2012-01-01

Fibrinolytic activity in cerebrospinal fluid (CSF) is activated in humans by different pathologic processes. To investigate fibrinolytic activity in the CSF of dogs with neurological disorders by measuring CSF D-dimer concentrations. One hundred and sixty-nine dogs with neurological disorders, 7 dogs with systemic inflammatory diseases without central nervous system involvement (SID), and 7 healthy Beagles were included in the study. Dogs with neurological disorders included 11 with steroid-responsive meningitis-arteritis (SRMA), 37 with other inflammatory neurological diseases (INF), 38 with neoplasia affecting the central nervous system (NEO), 28 with spinal compressive disorders (SCC), 15 with idiopathic epilepsy (IE), and 40 with noninflammatory neurological disorders (NON-INF). Prospective observational study. D-dimers and C-reactive protein (CRP) were simultaneously measured in paired CSF and blood samples. D-dimers and CRP were detected in 79/183 (43%) and in 182/183 (99.5%) CSF samples, respectively. All dogs with IE, SID, and controls had undetectable concentrations of D-dimers in the CSF. CSF D-dimer concentrations were significantly (P < .001) higher in dogs with SRMA than in dogs with other diseases and controls. CSF CRP concentration in dogs with SRMA was significantly (P < .001) higher than in dogs of other groups and controls, except for the SID group. No correlation was found between blood and CSF D-dimer concentrations. Intrathecal fibrinolytic activity seems to be activated in some canine neurological disorders, and it is high in severe meningeal inflammatory diseases. CSF D-dimer concentrations may be considered a diagnostic marker for SRMA. Copyright © 2012 by the American College of Veterinary Internal Medicine.

[Neurology of hysteria (conversion disorder)].

PubMed

Sonoo, Masahiro

2014-07-01

Hysteria has served as an important driving force in the development of both neurology and psychiatry. Jean Martin Charcot's devotion to mesmerism for treating hysterical patients evoked the invention of psychoanalysis by Sigmund Freud. Meanwhile, Joseph Babinski took over the challenge to discriminate between organic and hysterical patients from Charcot and found Babinski's sign, the greatest milestone in modern neurological symptomatology. Nowadays, the usage of the term hysteria is avoided. However, new terms and new classifications are complicated and inconsistent between the two representative taxonomies, the DSM-IV and ICD-10. In the ICD-10, even the alternative term conversion disorder, which was becoming familiar to neurologists, has also disappeared as a group name. The diagnosis of hysteria remains important in clinical neurology. Extensive exclusive diagnoses and over investigation, including various imaging studies, should be avoided because they may prolong the disease course and fix their symptoms. Psychological reasons that seem to explain the conversion are not considered reliable. Positive neurological signs suggesting nonorganic etiologies are the most reliable measures for diagnosing hysteria, as Babinski first argued. Hysterical paresis has several characteristics, such as giving-way weakness or peculiar distributions of weakness. Signs to uncover nonorganic paresis utilizing synergy include Hoover's test and the Sonoo abductor test.

Computerized visual feedback: an adjunct to robotic-assisted gait training.

PubMed

Banz, Raphael; Bolliger, Marc; Colombo, Gery; Dietz, Volker; Lünenburger, Lars

2008-10-01

Robotic devices for walking rehabilitation allow new possibilities for providing performance-related information to patients during gait training. Based on motor learning principles, augmented feedback during robotic-assisted gait training might improve the rehabilitation process used to regain walking function. This report presents a method to provide visual feedback implemented in a driven gait orthosis (DGO). The purpose of the study was to compare the immediate effect on motor output in subjects during robotic-assisted gait training when they used computerized visual feedback and when they followed verbal instructions of a physical therapist. Twelve people with neurological gait disorders due to incomplete spinal cord injury participated. Subjects were instructed to walk within the DGO in 2 different conditions. They were asked to increase their motor output by following the instructions of a therapist and by observing visual feedback. In addition, the subjects' opinions about using visual feedback were investigated by a questionnaire. Computerized visual feedback and verbal instructions by the therapist were observed to result in a similar change in motor output in subjects when walking within the DGO. Subjects reported that they were more motivated and concentrated on their movements when using computerized visual feedback compared with when no form of feedback was provided. Computerized visual feedback is a valuable adjunct to robotic-assisted gait training. It represents a relevant tool to increase patients' motor output, involvement, and motivation during gait training, similar to verbal instructions by a therapist.

Towards automated human gait disease classification using phase space representation of intrinsic mode functions

NASA Astrophysics Data System (ADS)

Pratiher, Sawon; Patra, Sayantani; Pratiher, Souvik

2017-06-01

A novel analytical methodology for segregating healthy and neurological disorders from gait patterns is proposed by employing a set of oscillating components called intrinsic mode functions (IMF's). These IMF's are generated by the Empirical Mode Decomposition of the gait time series and the Hilbert transformed analytic signal representation forms the complex plane trace of the elliptical shaped analytic IMFs. The area measure and the relative change in the centroid position of the polygon formed by the Convex Hull of these analytic IMF's are taken as the discriminative features. Classification accuracy of 79.31% with Ensemble learning based Adaboost classifier validates the adequacy of the proposed methodology for a computer aided diagnostic (CAD) system for gait pattern identification. Also, the efficacy of several potential biomarkers like Bandwidth of Amplitude Modulation and Frequency Modulation IMF's and it's Mean Frequency from the Fourier-Bessel expansion from each of these analytic IMF's has been discussed for its potency in diagnosis of gait pattern identification and classification.

Laryngotracheal Stenosis in Children and Infants With Neurological Disorders: Management and Outcome.

PubMed

Nicollas, Richard; Moreddu, Eric; Le Treut-Gay, Claire; Roman, Stéphane; Mancini, Julien; Triglia, Jean-Michel

2016-12-01

The goal of this retrospective study is to compare the management and outcome of surgical treatment of laryngotracheal stenosis in children and infants with and without an associated neurological disorder. In a series of children operated on for subglottic stenosis (SGS), patients with an associated neurological disorder were identified. The following criteria were compared in children with and without neurological disease: grade of stenosis, age, technique (Crico-Tracheal Resection (CTR), Laryngo-Tracheo-Plasty (LTP) in single and 2 stage, laser), analyzing duration, preoperative tracheostomy, decannulation rate, preoperative gastrostomy, and number of days in intensive care unit and in hospital. Two hundred twenty-three children were operated on for subglottic stenosis, of whom 68 (30.5%) had an associated neurological disorder. Some criteria were found to be statistically different between the 2 populations: mean age of 43 months in neurological population versus 13 months (P < .001). The distribution of the grades of SGS appeared similar in the 2 groups (P = .088), and the mean duration of stay in hospital and in ICU were not statistically different (respectively, P = .186 and P = .056) between the 2 groups; a 2-stage procedure was performed more frequently than 1-stage in the cases with associated neurological disorder-66.6% versus 36.5% (P = .013); the median duration of stenting was 20 days in those with neurological disease versus 12 (P = .021). Preoperative tracheotomy was noted in 75% of neurological patients versus 47.7% of the others (P < .001). The outcome was considered to be good (decannulation and no further treatment) following a single procedure in 82.4% of patients with neurological disorder, as against 86.5% of neurologically unimpaired subjects. The difference in outcome of surgery was not statistically different (P = .392) between the 2 groups. It appears that subglottic stenosis in children with associated neurological disorder is not more

Hyperactivity in the Gunn rat model of neonatal jaundice: age-related attenuation and emergence of gait deficits

PubMed Central

Stanford, John A.; Shuler, Jeffrey M.; Fowler, Stephen C.; Stanford, Kimberly G.; Ma, Delin; Bittel, Douglas C.; Le Pichon, Jean-Baptiste; Shapiro, Steven M.

2014-01-01

Background Neonatal jaundice resulting from elevated unconjugated bilirubin (UCB) occurs in 60–80% of newborn infants. Although mild jaundice is generally considered harmless, little is known about its long-term consequences. Recent studies have linked mild bilirubin-induced neurological dysfunction (BIND) with a range of neurological syndromes, including attention deficit-hyperactivity disorder. The goal of this study was to measure BIND across the lifespan in the Gunn rat model of BIND. Methods Using a sensitive force plate actometer, we measured locomotor activity and gait in jaundiced (jj) Gunn rats versus their non-jaundiced (Nj) littermates. Data were analyzed for young adult (3–4 months), early middle-aged (9–10 months), and late middle-aged (17–20 months) male rats. Results jj rats exhibited lower body weights at all ages and a hyperactivity that resolved at 17–20 months of age. Increased propulsive force and gait velocity accompanied hyperactivity during locomotor bouts at 9–10 months in jj rats. Stride length did not differ between the two groups at this age. Hyperactivity normalized and gait deficits, including decreased stride length, propulsive force, and gait velocity, emerged in the 17–20-month-old jj rats. Conclusions These results demonstrate that, in aging, hyperactivity decreases with the onset of gait deficits in the Gunn rat model of BIND. PMID:25518009

Virtual gait training for children with cerebral palsy using the Lokomat gait orthosis.

PubMed

Koenig, Alexander; Wellner, Mathias; Köneke, Susan; Meyer-Heim, Andreas; Lünenburger, Lars; Riener, Robert

2008-01-01

The Lokomat gait orthosis was developed in the Spinal Cord Injury Center at the University Hospital Balgrist Zurich and provides automatic gait training for patients with neurological gait impairments, such as Cerebral Palsy (CP). Each patient undergoes a task-oriented Lokomat rehabilitation training program via a virtual reality setup. In four virtual scenarios, the patient is able to exercise tasks such as wading through water, playing soccer, overstepping obstacles or training in a street scenario, each task offering varying levels of difficulty. Patients provided positive feedback in reference to the utilized haptic method, specifically addressing the sufficient degree of realism. In a single case study, we verified the task difficulty.

Cognitive-analytical therapy for a patient with functional neurological symptom disorder-conversion disorder (psychogenic myopia): A case study.

PubMed

Nasiri, Hamid; Ebrahimi, Amrollah; Zahed, Arash; Arab, Mostafa; Samouei, Rahele

2015-05-01

Functional neurological symptom disorder commonly presents with symptoms and defects of sensory and motor functions. Therefore, it is often mistaken for a medical condition. It is well known that functional neurological symptom disorder more often caused by psychological factors. There are three main approaches namely analytical, cognitive and biological to manage conversion disorder. Any of such approaches can be applied through short-term treatment programs. In this case, study a 12-year-old boy with the diagnosed functional neurological symptom disorder (psychogenic myopia) was put under a cognitive-analytical treatment. The outcome of this treatment modality was proved successful.

Neurologic Manifestations of Vitamin B Deficiency after Bariatric Surgery.

PubMed

Punchai, Suriya; Hanipah, Zubaidah Nor; Meister, Katherine M; Schauer, Philip R; Brethauer, Stacy A; Aminian, Ali

2017-08-01

The aim of this study was to assess the incidence, clinical presentation, and outcomes of neurologic disorders secondary to vitamin B deficiencies following bariatric surgery. Patients at a single academic institution who underwent bariatric surgery and developed neurologic complications secondary to low levels of vitamins B1, B2, B6, and B12 between the years 2004 and 2015 were studied. In total, 47 (0.7%) bariatric surgical patients (Roux-en-Y gastric bypass n = 36, sleeve gastrectomy n = 9, and duodenal switch n = 2) developed neurologic manifestations secondary to vitamin B deficiencies. Eleven (23%) patients developed postoperative anatomical complications contributed to poor oral intake. Median duration to onset of neurologic manifestation following surgery was 12 months (IQR, 5-32). Vitamin deficiencies reported in the cohort included B1 (n = 30), B2 (n = 1), B6 (n = 12), and B12 (n = 12) deficiency. The most common manifestations were paresthesia (n = 31), muscle weakness (n = 15), abnormal gait (n = 11), and polyneuropathy (n = 7). Four patients were diagnosed with Wernicke-Korsakoff syndrome (WKS) which was developed after gastric bypass (n = 3) and sleeve gastrectomy (n = 1). Seven patients required readmission for management of severe vitamin B deficiencies. Overall, resolution of neurologic symptoms with nutritional interventions and pharmacotherapy was noted in 40 patients (85%). The WKS was not reversible, and all four patients had residual mild ataxia and nystagmus at the last follow-up time. Nutritional neurologic disorders secondary to vitamin B deficiency are relatively uncommon after bariatric surgery. While neurologic disorders are reversible in most patients (85%) with vitamin replacements, persistent residual neurologic symptoms are common in patients with WKS.

Identification of mouse gaits using a novel force-sensing exercise wheel.

PubMed

Smith, Benjamin J H; Cullingford, Lottie; Usherwood, James R

2015-09-15

The gaits that animals use can provide information on neurological and musculoskeletal disorders, as well as the biomechanics of locomotion. Mice are a common research model in many fields; however, there is no consensus in the literature on how (and if) mouse gaits vary with speed. One of the challenges in studying mouse gaits is that mice tend to run intermittently on treadmills or overground; this paper attempts to overcome this issue with a novel exercise wheel that measures vertical ground reaction forces. Unlike previous instrumented wheels, this wheel is able to measure forces continuously and can therefore record data from consecutive strides. By concatenating the maximum limb force at each time point, a force trace can be constructed to quantify and identify gaits. The wheel was three dimensionally printed, allowing the design to be shared with other researchers. The kinematic parameters measured by the wheel were evaluated using high-speed video. Gaits were classified using a metric called "3S" (stride signal symmetry), which quantifies the half wave symmetry of the force trace peaks. Although mice are capable of using both symmetric and asymmetric gaits throughout their speed range, the continuum of gaits can be divided into regions based on the frequency of symmetric and asymmetric gaits; these divisions are further supported by the fact that mice run less frequently at speeds near the boundaries between regions. The boundary speeds correspond to gait transition speeds predicted by the hypothesis that mice move in a dynamically similar fashion to other legged animals. Copyright © 2015 the American Physiological Society.

Identification of mouse gaits using a novel force-sensing exercise wheel

PubMed Central

Cullingford, Lottie; Usherwood, James R.

2015-01-01

The gaits that animals use can provide information on neurological and musculoskeletal disorders, as well as the biomechanics of locomotion. Mice are a common research model in many fields; however, there is no consensus in the literature on how (and if) mouse gaits vary with speed. One of the challenges in studying mouse gaits is that mice tend to run intermittently on treadmills or overground; this paper attempts to overcome this issue with a novel exercise wheel that measures vertical ground reaction forces. Unlike previous instrumented wheels, this wheel is able to measure forces continuously and can therefore record data from consecutive strides. By concatenating the maximum limb force at each time point, a force trace can be constructed to quantify and identify gaits. The wheel was three dimensionally printed, allowing the design to be shared with other researchers. The kinematic parameters measured by the wheel were evaluated using high-speed video. Gaits were classified using a metric called “3S” (stride signal symmetry), which quantifies the half wave symmetry of the force trace peaks. Although mice are capable of using both symmetric and asymmetric gaits throughout their speed range, the continuum of gaits can be divided into regions based on the frequency of symmetric and asymmetric gaits; these divisions are further supported by the fact that mice run less frequently at speeds near the boundaries between regions. The boundary speeds correspond to gait transition speeds predicted by the hypothesis that mice move in a dynamically similar fashion to other legged animals. PMID:26139220

The development and validity of the Salford Gait Tool: an observation-based clinical gait assessment tool.

PubMed

Toro, Brigitte; Nester, Christopher J; Farren, Pauline C

2007-03-01

To develop the construct, content, and criterion validity of the Salford Gait Tool (SF-GT) and to evaluate agreement between gait observations using the SF-GT and kinematic gait data. Tool development and comparative evaluation. University in the United Kingdom. For designing construct and content validity, convenience samples of 10 children with hemiplegic, diplegic, and quadriplegic cerebral palsy (CP) and 152 physical therapy students and 4 physical therapists were recruited. For developing criterion validity, kinematic gait data of 13 gait clusters containing 56 children with hemiplegic, diplegic, and quadriplegic CP and 11 neurologically intact children was used. For clinical evaluation, a convenience sample of 23 pediatric physical therapists participated. We developed a sagittal plane observational gait assessment tool through a series of design, test, and redesign iterations. The tool's grading system was calibrated using kinematic gait data of 13 gait clusters and was evaluated by comparing the agreement of gait observations using the SF-GT with kinematic gait data. Criterion standard kinematic gait data. There was 58% mean agreement based on grading categories and 80% mean agreement based on degree estimations evaluated with the least significant difference method. The new SF-GT has good concurrent criterion validity.

Inter- and intraobserver repeatability of the Salford Gait Tool: an observation-based clinical gait assessment tool.

PubMed

Toro, Brigitte; Nester, Christopher J; Farren, Pauline C

2007-03-01

To evaluate the inter- and intraobserver repeatability of the Salford Gait Tool (SF-GT), a new observation-based gait assessment tool for evaluating sagittal plane cerebral palsy (CP) gait. Masked comparative evaluation. University in the United Kingdom. A convenience sample of 23 pediatric physical therapists with varying degrees of clinical experience recruited from the Greater Manchester area. Participants viewed videotapes of the sagittal plane gait of 13 children and used the SF-GT to analyze their 13 different gait styles on 2 occasions. Eleven children had hemiplegic, diplegic, or quadriplegic CP and 2 were neurologically intact. Inter- and intraobserver repeatability of hip, knee, and ankle joint positions at 6 different phases of the gait cycle. The SF-GT demonstrated good interobserver (77%) and intraobserver (75%) repeatability. We have established that the SF-GT is a repeatable clinical assessment tool with which to guide the diagnosis, treatment planning, and evaluation of interventions by pediatric physical therapists of sagittal plane gait deviations in CP.

75 FR 2149 - National Institute of Neurological Disorders and Stroke; Notice of Meeting

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2010-01-14

... Neurological Disorders and Stroke; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory... Neurological Disorders and Stroke Council. The meeting will be open to the public as indicated below, with... Disorders and Stroke Council, Clinical Trials Subcommittee. Date: February 3-4, 2010. [[Page 2150

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2012-08-15

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2013-12-18

... Neurological Disorders and Stroke; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Council. The meeting will be open to the public as indicated below, with attendance... Committee: National Advisory Neurological Disorders and Stroke Council. Date: January 30-31, 2014. Open...

Neurological disorders in HIV-infected children in India.

PubMed

Gupta, S; Shah, D M; Shah, I

2009-09-01

There are few studies of HIV-related neurological disorders from centres in low-income countries where facilities are available for detailed investigation. Records of all patients attending the paediatric HIV outpatient department at B. J. Wadia Hospital for Children, Mumbai between April 2000 and March 2008 were reviewed. Of 668 HIV-infected patients, 48 (7.2%) had neurological manifestations and are included in this study. Twenty-six (54.2%) children had HIV encephalopathy. Other causes of neurological manifestations include febrile convulsion in five (10.4%), bacterial meningitis in three (6.3%), epilepsy in two (4.2%), tuberculous meningitis and progressive multi-focal encephalopathy in two (4.2%) each and toxoplasmosis, vasculitis, acute demyelinating encephalomyelitis, anti-phospholipid antibody syndrome, Down's syndrome, birth asphyxia, herpes simplex encephalopathy and mitochondrial encephalopathy in one (2.1%) each. Mean (SD) age at presentation was 4.36 (3.38) years with a range of 2 months to 15 years. The common subtle neurological manifestations were abnormal deep tendon reflexes and extensor plantar reflexes. The common symptomatic manifestations were delayed milestones in 21 children (43.8%) and seizures in 19 (39.6%). Seizures were more common in males (54%) than in females (25%) (p=0.038). In children <5 years, delayed milestones was the most common manifestation while focal neurological deficits were more common in older children. Of the 13 children who received HAART, nine (60.23%) improved. Early diagnosis of neurological disorders in HIV-infected children is important for appropriate investigation and management, especially the introduction of HAART.

The Relationship between Psychopathology and Speech and Language Disorders in Neurologic Patients.

ERIC Educational Resources Information Center

Sapir, Shimon; Aronson, Arnold E.

1990-01-01

This paper reviews findings that suggest a causal relationship between depression, anxiety, or conversion reaction and voice, speech, and language disorders in neurologic patients. The paper emphasizes the need to consider the psychosocial and psychopathological aspects of neurologic communicative disorders, the link between emotional and…

[Effects of cognitive state on balance disturbances and gait disorders in institutionalised elderly].

PubMed

Díaz-Pelegrina, Ana; Cabrera-Martos, Irene; López-Torres, Isabel; Rodríguez-Torres, Janet; Valenza, Marie Carmen

2016-01-01

Ageing has been linked to a high prevalence of cognitive impairment, which, in turn, has been related to balance disturbances and gait disorders. The aim of this study was to identify whether there are differences between subjects with and without cognitive impairment regarding the quality of gait and balance. An observational study was conducted on institutionalised people older than 65 years (n=82). Gait and balance was evaluated after the assessment of cognitive impairment using the Mini-Mental State Examination (MMSE). Single and dual tests were used including, the 6-minute walking, stride length, and gait speed. Timed Up and Go tests were also used to evaluate balance. The participants were divided into three groups: 28 subjects in the group without cognitive impairment (MMSE≥27), 29 subjects with mild (27Gait assessment showed significant between-groups differences in all the variables (P<.05). The variables assessing balance also showed significantly worse values in those groups with cognitive impairment. The severity of cognitive impairment is related to impaired balance and gait, thus the clinical monitoring of these variables in population at risk is needed. Copyright © 2015 SEGG. Published by Elsevier Espana. All rights reserved.

Neuropharmacological Potential and Delivery Prospects of Thymoquinone for Neurological Disorders

PubMed Central

Cho, Duk-Yeon; Ezazul Haque, Md.; Kim, In-Su; Ganesan, Palanivel

2018-01-01

Thymoquinone (TQ) is an active ingredient isolated from Nigella sativa and has various pharmacological activities, such as protection against oxidative stress, inflammation, and infections. In addition, it might be a potential neuropharmacological agent because it exhibits versatile potential for attenuating neurological impairments. It features greater beneficial effects in toxin-induced neuroinflammation and neurotoxicity. In various models of neurological disorders, it demonstrates emergent functions, including safeguarding various neurodegenerative diseases and other neurological diseases, such as stroke, schizophrenia, and epilepsy. TQ also has potential effects in trauma mediating and chemical-, radiation-, and drug-induced central nervous system injuries. Considering the pharmacokinetic limitations, research has concentrated on different TQ novel formulations and delivery systems. Here, we visualize the neuropharmacological potential, challenges, and delivery prospects of TQ, specifically focusing on neurological disorders along with its chemistry, pharmacokinetics, and toxicity. PMID:29743967

77 FR 2075 - National Institute of Neurological Disorders and Stroke Notice of Closed Meeting

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2012-01-13

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78 FR 19498 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

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2013-04-01

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2012-04-25

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2013-04-15

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2012-01-11

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2012-05-16

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2013-12-23

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Functional neurological disorders in Parkinson disease.

PubMed

Wissel, Benjamin D; Dwivedi, Alok K; Merola, Aristide; Chin, Danielle; Jacob, Cara; Duker, Andrew P; Vaughan, Jennifer E; Lovera, Lilia; LaFaver, Kathrin; Levy, Ariel; Lang, Anthony E; Morgante, Francesca; Nirenberg, Melissa Jill; Stephen, Christopher; Sharma, Nutan; Romagnolo, Alberto; Lopiano, Leonardo; Balint, Bettina; Yu, Xin X; Bhatia, Kailash P; Espay, Alberto J

2018-06-01

To ascertain demographic and clinical features of Parkinson disease (PD) associated with functional neurological features. A standardised form was used to extract data from electronic records of 53 PD patients with associated functional neurological disorders (PD-FND) across eight movement disorders centres in the USA, Canada and Europe. These subjects were matched for age, gender and disease duration to PD patients without functional features (PD-only). Logistic regression analysis was used to compare both groups after adjusting for clustering effect. Functional symptoms preceded or co-occurred with PD onset in 34% of cases, nearly always in the most affected body side. Compared with PD-only subjects, PD-FND were predominantly female (68%), had longer delay to PD diagnosis, greater prevalence of dyskinesia (42% vs 18%; P=0.023), worse depression and anxiety (P=0.033 and 0.025, respectively), higher levodopa-equivalent daily dose (972±701 vs 741±559 mg; P=0.029) and lower motor severity (P=0.019). These patients also exhibited greater healthcare resource utilisation, higher use of [(123)I]FP-CIT SPECT and were more likely to have had a pre-existing psychiatric disorder (P=0.008) and family history of PD (P=0.036). A subtype of PD with functional neurological features is familial in one-fourth of cases and associated with more psychiatric than motor disability and greater use of diagnostic and healthcare resources than those without functional features. Functional manifestations may be prodromal to PD in one-third of patients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Review on Graph Clustering and Subgraph Similarity Based Analysis of Neurological Disorders

PubMed Central

Thomas, Jaya; Seo, Dongmin; Sael, Lee

2016-01-01

How can complex relationships among molecular or clinico-pathological entities of neurological disorders be represented and analyzed? Graphs seem to be the current answer to the question no matter the type of information: molecular data, brain images or neural signals. We review a wide spectrum of graph representation and graph analysis methods and their application in the study of both the genomic level and the phenotypic level of the neurological disorder. We find numerous research works that create, process and analyze graphs formed from one or a few data types to gain an understanding of specific aspects of the neurological disorders. Furthermore, with the increasing number of data of various types becoming available for neurological disorders, we find that integrative analysis approaches that combine several types of data are being recognized as a way to gain a global understanding of the diseases. Although there are still not many integrative analyses of graphs due to the complexity in analysis, multi-layer graph analysis is a promising framework that can incorporate various data types. We describe and discuss the benefits of the multi-layer graph framework for studies of neurological disease. PMID:27258269

Review on Graph Clustering and Subgraph Similarity Based Analysis of Neurological Disorders.

PubMed

Thomas, Jaya; Seo, Dongmin; Sael, Lee

2016-06-01

How can complex relationships among molecular or clinico-pathological entities of neurological disorders be represented and analyzed? Graphs seem to be the current answer to the question no matter the type of information: molecular data, brain images or neural signals. We review a wide spectrum of graph representation and graph analysis methods and their application in the study of both the genomic level and the phenotypic level of the neurological disorder. We find numerous research works that create, process and analyze graphs formed from one or a few data types to gain an understanding of specific aspects of the neurological disorders. Furthermore, with the increasing number of data of various types becoming available for neurological disorders, we find that integrative analysis approaches that combine several types of data are being recognized as a way to gain a global understanding of the diseases. Although there are still not many integrative analyses of graphs due to the complexity in analysis, multi-layer graph analysis is a promising framework that can incorporate various data types. We describe and discuss the benefits of the multi-layer graph framework for studies of neurological disease.

77 FR 2740 - National Institute of Neurological Disorders and Stroke Notice of Closed Meeting

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2012-01-19

... Neurological Disorders and Stroke Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Initial Review Group; Neurological Sciences and Disorders B. Date: February 23, 2012... Disorders and Stroke, NIH, NSC, 6001 Executive Blvd., Room 3202, MSC 9529, Bethesda, MD 20892-9529, (301...

An assistive lower limb exoskeleton for people with neurological gait disorders.

PubMed

Ortlieb, A; Bouri, M; Baud, R; Bleuler, H

2017-07-01

Lower limb exoskeletons have already proven the capability to give back mobility to people suffering from spinal cord injury (SCI). Other important populations such as people with multiple sclerosis or muscular dystrophy, frail elderly and stroke victims, suffer from severe gait impairments and could benefit from similar technology. The work presented in the current paper describes a novel design of a 6-actuated degrees of freedom (DOFs) assistive lower limb exoskeleton for people with moderate mobility impairments. The electrical actuators are all remotely located on the back of the user for a more compact design with high dynamics. Cable driven solutions are used to transmit the flexion/extension of the hip and knee joints, while a powerful ballscrew carries out the hip adduction/abduction. The design of this exoskeleton, named AUTONOMYO, follows the key specifications of being highly back-drivable and able to perform dynamic motions at low energy consumption. AUTONOMYO is capable to assist the user's balance by providing complementary torques at the hip and the knee. Results show that the projected level of assistance for sit-to-stand transition varies from 50% to 100% in function of the user's bodyweight and height while higher level of assistance are reached for walking and stairs climbing activities.

The classification of conversion disorder (functional neurologic symptom disorder) in ICD and DSM.

PubMed

Levenson, J L; Sharpe, M

2016-01-01

The name given to functional neurologic symptoms has evolved over time in the different editions of the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM), reflecting a gradual move away from an etiologic conception rooted in hysterical conversion to an empiric phenomenologic one, emphasizing the central role of the neurologic examination and testing in demonstrating that the symptoms are incompatible with recognized neurologic disease pathophysiology, or are internally inconsistent. © 2016 Elsevier B.V. All rights reserved.

[Comorbidity in autism spectrum disorders - II. Genetic syndromes and neurological problems].

PubMed

Noterdaeme, Michele A; Hutzelmeyer-Nickels, Anna

2010-07-01

Children with a pervasive developmental disorder show in addition to core symptoms a variety of genetic syndromes as well as neurological problems, which are relevant for the treatment and the course of the disorder. The objective of our study is to analyse the nature and the frequency of these co-morbid somatic disorders in relation to the level of intellectual functioning of the patients. The sample consists of 601 patients with a pervasive developmental disorder diagnosed at the Department of Developmental Disorders at the Heckscher-Klinikum between 1997 and 2007. In addition to genetic syndromes, we also recorded a variety of neurological disorders. 373 of the patients (62%) had at least one additional diagnosis and 121 (20%) had at least two additional diagnoses on Axis IV of the multi-axial classification scheme. Genetic syndromes were found in 6% of the patients (N = 37). Movement disorders (N = 214; 35.6%) and epilepsy (N = 98; 16.3%) were the most frequent neurological disorders. Children with mental retardation showed significantly more somatic diagnoses than children without mental retardation. Children with pervasive developmental disorders show a wide variety of co-morbid somatic problems, which are relevant for the treatment and the course of the disorder. Children with autism and mental retardation show more co-morbid conditions and are more impaired in their psychosocial adaptation than children with autism without mental retardation.

Mild neurological impairment may indicate a psychomotor endophenotype in patients with borderline personality disorder.

PubMed

Arbabi, Mohammad; Paast, Negin; Karim, Hamid Reza; Faghfori, Sara; Memari, Amir Hossein

2016-11-30

The aim of the present study was to determine whether patients with borderline personality disorder (BPD) show any neurological soft signs compared to healthy controls. Furthermore we sought to examine the role of common symptoms related to BPD, such as depression, anxiety or impulsivity, in association with neurological soft signs. Thirty patients with borderline personality disorder and thirty hospital-based controls were examined for neurological soft signs. The total score of neurological soft signs in BPD was significantly higher than controls. In terms of subscales, patients had higher scores in Sensory Integration and Motor Coordination and other neurological soft signs compared to control group. Multiple regression analysis showed that the impulsivity score was the best significant predictor of neurological soft signs in BPD. The increase of neurological soft signs in patients with BPD may address a non-focal neurological dysfunction in borderline personality disorder. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

77 FR 6570 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-08

... Neurological Disorders and Stroke; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Initial Review Group; Neurological Sciences and Disorders C. Date: March 1-2, 2012... Disorders and Stroke, NIH, NSC, 6001 Executive Blvd., Room 3202, MSC 9529, Bethesda, MD 20892-9529, (301...

76 FR 20695 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-13

... Neurological Disorders and Stroke; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute of Neurological... Neurological Disorders and Stroke Initial Review Group; NST-2 Subcommittee. Date: June 20-21, 2011. Time: 8 a.m...

Current Concepts in Diagnosis and Treatment of Functional Neurological Disorders.

PubMed

Espay, Alberto J; Aybek, Selma; Carson, Alan; Edwards, Mark J; Goldstein, Laura H; Hallett, Mark; LaFaver, Kathrin; LaFrance, W Curt; Lang, Anthony E; Nicholson, Tim; Nielsen, Glenn; Reuber, Markus; Voon, Valerie; Stone, Jon; Morgante, Francesca

2018-06-04

Functional neurological disorders (FND) are common sources of disability in medicine. Patients have often been misdiagnosed, correctly diagnosed after lengthy delays, and/or subjected to poorly delivered diagnoses that prevent diagnostic understanding and lead to inappropriate treatments, iatrogenic harm, unnecessary and costly evaluations, and poor outcomes. Functional Neurological Symptom Disorder/Conversion Disorder was adopted by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, replacing the term psychogenic with functional and removing the criterion of psychological stress as a prerequisite for FND. A diagnosis can now be made in an inclusionary manner by identifying neurological signs that are specific to FNDs without reliance on presence or absence of psychological stressors or suggestive historical clues. The new model highlights a wider range of past sensitizing events, such as physical trauma, medical illness, or physiological/psychophysiological events. In this model, strong ideas and expectations about these events correlate with abnormal predictions of sensory data and body-focused attention. Neurobiological abnormalities include hypoactivation of the supplementary motor area and relative disconnection with areas that select or inhibit movements and are associated with a sense of agency. Promising evidence has accumulated for the benefit of specific physical rehabilitation and psychological interventions alone or in combination, but clinical trial evidence remains limited. Functional neurological disorders are a neglected but potentially reversible source of disability. Further research is needed to determine the dose and duration of various interventions, the value of combination treatments and multidisciplinary therapy, and the therapeutic modality best suited for each patient.

Molecular Targets of Cannabidiol in Neurological Disorders.

PubMed

Ibeas Bih, Clementino; Chen, Tong; Nunn, Alistair V W; Bazelot, Michaël; Dallas, Mark; Whalley, Benjamin J

2015-10-01

Cannabis has a long history of anecdotal medicinal use and limited licensed medicinal use. Until recently, alleged clinical effects from anecdotal reports and the use of licensed cannabinoid medicines are most likely mediated by tetrahydrocannabinol by virtue of: 1) this cannabinoid being present in the most significant quantities in these preparations; and b) the proportion:potency relationship between tetrahydrocannabinol and other plant cannabinoids derived from cannabis. However, there has recently been considerable interest in the therapeutic potential for the plant cannabinoid, cannabidiol (CBD), in neurological disorders but the current evidence suggests that CBD does not directly interact with the endocannabinoid system except in vitro at supraphysiological concentrations. Thus, as further evidence for CBD's beneficial effects in neurological disease emerges, there remains an urgent need to establish the molecular targets through which it exerts its therapeutic effects. Here, we conducted a systematic search of the extant literature for original articles describing the molecular pharmacology of CBD. We critically appraised the results for the validity of the molecular targets proposed. Thereafter, we considered whether the molecular targets of CBD identified hold therapeutic potential in relevant neurological diseases. The molecular targets identified include numerous classical ion channels, receptors, transporters, and enzymes. Some CBD effects at these targets in in vitro assays only manifest at high concentrations, which may be difficult to achieve in vivo, particularly given CBD's relatively poor bioavailability. Moreover, several targets were asserted through experimental designs that demonstrate only correlation with a given target rather than a causal proof. When the molecular targets of CBD that were physiologically plausible were considered for their potential for exploitation in neurological therapeutics, the results were variable. In some cases

Homovanillic acid in cerebrospinal fluid of 1388 children with neurological disorders.

PubMed

Molero-Luis, Marta; Serrano, Mercedes; Ormazábal, Aida; Pérez-Dueñas, Belén; García-Cazorla, Angels; Pons, Roser; Artuch, Rafael

2013-06-01

To determine the prevalence of dopaminergic abnormalities in 1388 children with neurological disorders, and to analyse their clinical, neuroradiological, and electrophysiological characteristics. We studied biogenic amines in 1388 cerebrospinal fluid (CSF) samples from children with neurological disorders (mean age 3y 10mo, SD 4y 5mo; 712 males, 676 females. Correlations among CSF homovanillic acid (HVA) values and other biochemical, clinical, neuroradiological, and electrophysiological parameters were analysed. Twenty-one patients with primary dopaminergic deficiencies were identified. Of the whole sample, 20% showed altered HVA. We report neurological diseases with abnormal CSF HVA values such as pontocerebellar hypoplasia, perinatal asphyxia, central nervous system infections, mitochondrial disorders, and other genetic diseases. Overlapping HVA levels between primary and secondary dopamine deficiencies were observed. Prevalence of low CSF HVA levels was significantly higher in neonatal patients (χ(2) =84.8, p<0.001). Abnormalities in white matter were associated with low CSF HVA (odds ratio 2.3, 95% confidence interval 1.5-3.5). HVA abnormalities are observed in various neurological diseases, but some are probably an unspecific finding. No clear limits for CSF HVA values pointing towards primary diseases can be stated. We report several neurological diseases showing HVA alterations. No neuroimaging traits were associated with low HVA values, except for white matter abnormalities. © The Authors. Developmental Medicine & Child Neurology © 2013 Mac Keith Press.

77 FR 15112 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-14

... Neurological Disorders and Stroke; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel, Neurosurgeon Scientific Training. Date: March 30, 2012. Time: 8... . Name of Committee: National Institute of Neurological Disorders and Stroke Special Emphasis Panel...

75 FR 4577 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke, Initial Review Group Neurological Sciences and Disorders C. Dates: February 18-19...

Functional Neuroanatomy and Neurophysiology of Functional Neurological Disorders (Conversion Disorder).

PubMed

Voon, Valerie; Cavanna, Andrea E; Coburn, Kerry; Sampson, Shirlene; Reeve, Alya; LaFrance, W Curt

2016-01-01

Much is known regarding the physical characteristics, comorbid symptoms, psychological makeup, and neuropsychological performance of patients with functional neurological disorders (FNDs)/conversion disorders. Gross neurostructural deficits do not account for the patients' deficits or symptoms. This review describes the literature focusing on potential neurobiological (i.e. functional neuroanatomic/neurophysiological) findings among individuals with FND, examining neuroimaging and neurophysiological studies of patients with the various forms of motor and sensory FND. In summary, neural networks and neurophysiologic mechanisms may mediate "functional" symptoms, reflecting neurobiological and intrapsychic processes.

75 FR 30409 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Initial Review Group, Neurological Sciences and Disorders K. Date: June 21, 2010. Time...

76 FR 34716 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Initial Review Group, Neurological Sciences and Disorders K. Date: June 23-24, 2011...

76 FR 25702 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Initial Review Group, Neurological Sciences and Disorders A. Date: June 22-23, 2011...

Functional (Psychogenic) Cognitive Disorders: A Perspective from the Neurology Clinic.

PubMed

Stone, Jon; Pal, Suvankar; Blackburn, Daniel; Reuber, Markus; Thekkumpurath, Parvez; Carson, Alan

2015-09-24

Cognitive symptoms such as poor memory and concentration represent a common cause of morbidity among patients presenting to general practitioners and may result in referral for a neurological opinion. In many cases, these symptoms do not relate to an underlying neurological disease or dementia. In this article we present a personal perspective on the differential diagnosis of cognitive symptoms in the neurology clinic, especially as this applies to patients who seek advice about memory problems but have no neurological disease process. These overlapping categories include the following 'functional' categories: 1) cognitive symptoms as part of anxiety or depression; 2) "normal" cognitive symptoms that become the focus of attention; 3) isolated functional cognitive disorder in which symptoms are outwith 'normal' but not explained by anxiety; 4) health anxiety about dementia; 5) cognitive symptoms as part of another functional disorder; and 6) retrograde dissociative (psychogenic) amnesia. Other 'non-dementia' diagnoses to consider in addition are 1) cognitive symptoms secondary to prescribed medication or substance misuse; 2) diseases other than dementia causing cognitive disorders; 3) patients who appear to have functional cognitive symptoms but then go on to develop dementia/another neurological disease; and finally 4) exaggeration/malingering. We discuss previous attempts to classify the problem of functional cognitive symptoms, the importance of making a positive diagnosis for the patient, and the need for large cohort studies to better define and manage this large group of patients.

Neurological Disorders in Medical Use of Cannabis: An Update.

PubMed

Solimini, Renata; Rotolo, Maria Concetta; Pichini, Simona; Pacifici, Roberta

2017-01-01

Medical cannabis is increasingly used as a treatment or adjunct treatment with different levels of efficacy in several neurological disorders or related symptoms (such as multiple sclerosis, autism, Parkinson and Alzheimer disease, Tourette's syndrome, Huntington's disease, neuropathic pain, epilepsy, headache), as well as in other medical conditions (e.g. nausea and vomiting, glaucoma, appetite stimulation, cancer, inflammatory conditions, asthma). Nevertheless, a number of neurological adverse effects from use of medical cannabis on the short- and on the longterm have been reported, in addition to other adverse health events. It has been noticed that the use of medical cannabis can lead to a paradoxical effects depending on the amount of delta-9-tetrahydrocannabinol (THC) -like cannabinoids the preparation contain. Accordingly, some neurological disorders or symptoms (e.g. multiple sclerosis, seizures, epilepsy, headache) may be caused or exacerbated by the same treatment supposed to cure them. The current review presents an update of the neurological adverse effects resulting from the use of cannabis for medical purposes, highlighting the need to weigh the benefits and risks, when using cannabinoidbased treatments. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

78 FR 42969 - National Institute of Neurological Disorders and Stroke; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory... Institute of Neurological Disorders and Stroke, NIH, 6001 Executive Boulevard, NSC 2172, Bethesda, MD 20892...

77 FR 59203 - National Institute of Neurological Disorders and Stroke; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory... Director, National Institute of Neurological Disorders and Stroke, NIH, 31 Center Drive, Room 8A03...

Stimulation of the mesencephalic locomotor region for gait recovery after stroke.

PubMed

Fluri, Felix; Malzahn, Uwe; Homola, György A; Schuhmann, Michael K; Kleinschnitz, Christoph; Volkmann, Jens

2017-11-01

One-third of all stroke survivors are unable to walk, even after intensive physiotherapy. Thus, other concepts to restore walking are needed. Because electrical stimulation of the mesencephalic locomotor region (MLR) is known to elicit gait movements, this area might be a promising target for restorative neurostimulation in stroke patients with gait disability. The present study aims to delineate the effect of high-frequency stimulation of the MLR (MLR-HFS) on gait impairment in a rodent stroke model. Male Wistar rats underwent photothrombotic stroke of the right sensorimotor cortex and chronic implantation of a stimulating electrode into the right MLR. Gait was assessed using clinical scoring of the beam-walking test and video-kinematic analysis (CatWalk) at baseline and on days 3 and 4 after experimental stroke with and without MLR-HFS. Kinematic analysis revealed significant changes in several dynamic and static gait parameters resulting in overall reduced gait velocity. All rats exhibited major coordination deficits during the beam-walking challenge and were unable to cross the beam. Simultaneous to the onset of MLR-HFS, a significantly higher walking speed and improvements in several dynamic gait parameters were detected by the CatWalk system. Rats regained the ability to cross the beam unassisted, showing a reduced number of paw slips and misses. MLR-HFS can improve disordered locomotor function in a rodent stroke model. It may act by shielding brainstem and spinal locomotor centers from abnormal cortical input after stroke, thus allowing for compensatory and independent action of these circuits. Ann Neurol 2017;82:828-840. © 2017 American Neurological Association.

77 FR 70791 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-27

... Neurological Disorders and Stroke; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel; Translational SEP. Date: November 30, 2012. Time: 2:00 p.m. to... Institute of Neurological Disorders and Stroke Special Emphasis Panel; NINDS T-32. Date: December 12, 2012...

Minor neurological dysfunction in children with autism spectrum disorder.

PubMed

De Jong, Marianne; Punt, Marja; De Groot, Erik; Minderaa, Ruud B; Hadders-Algra, Mijna

2011-07-01

The aim of this study was to improve the understanding of brain function in children with autism spectrum disorder (ASD) in relation to minor neurological dysfunctions (MNDs). We studied MNDs in 122 children (93 males, 29 females; mean age 8 y 1 mo, SD 2 y 6 mo) who, among a total cohort of 705 children (513 males, 192 females; mean age 9 y, SD 2 y 0.5 mo) referred to a regional outpatient non-academic psychiatric centre in the Netherlands, were diagnosed with ASD after an extensive multidisciplinary psychiatric assessment. Children with clear neurological abnormalities (e.g. cerebral palsy or spina bifida) were excluded from the study. MNDs were assessed in all 705 children using the Touwen examination method. Special attention was paid to the severity and type of MND. Data of the children with ASD were compared with neurological morbidity data of children with other psychiatric disorders and with children in the general population, who were born at Groningen University Hospital between 1975 and 1978. Seventy-four percent of the children with ASD showed complex MNDs compared with 52% of the children with other psychiatric disorders and 6% of the reference group (χ(2) =18.0, p<0.001; χ(2) =937.5, p<0.001 respectively). Specific dysfunctions frequently encountered in ASD were dysfunctional posture and muscle tone, fine manipulative disability, dyscoordination, and excessive associated movements. These findings suggest a contribution of dysfunctional supraspinal networks involving multiple parts of the brain in the pathogenesis of ASD. This is consistent with findings from neuroimaging studies, and highlights the importance of neurological examinations in paediatric psychiatric assessments. © The Authors. Developmental Medicine & Child Neurology © 2011 Mac Keith Press.

Guidelines for Assessment of Gait and Reference Values for Spatiotemporal Gait Parameters in Older Adults: The Biomathics and Canadian Gait Consortiums Initiative

PubMed Central

Beauchet, Olivier; Allali, Gilles; Sekhon, Harmehr; Verghese, Joe; Guilain, Sylvie; Steinmetz, Jean-Paul; Kressig, Reto W.; Barden, John M.; Szturm, Tony; Launay, Cyrille P.; Grenier, Sébastien; Bherer, Louis; Liu-Ambrose, Teresa; Chester, Vicky L.; Callisaya, Michele L.; Srikanth, Velandai; Léonard, Guillaume; De Cock, Anne-Marie; Sawa, Ryuichi; Duque, Gustavo; Camicioli, Richard; Helbostad, Jorunn L.

2017-01-01

Background: Gait disorders, a highly prevalent condition in older adults, are associated with several adverse health consequences. Gait analysis allows qualitative and quantitative assessments of gait that improves the understanding of mechanisms of gait disorders and the choice of interventions. This manuscript aims (1) to give consensus guidance for clinical and spatiotemporal gait analysis based on the recorded footfalls in older adults aged 65 years and over, and (2) to provide reference values for spatiotemporal gait parameters based on the recorded footfalls in healthy older adults free of cognitive impairment and multi-morbidities. Methods: International experts working in a network of two different consortiums (i.e., Biomathics and Canadian Gait Consortium) participated in this initiative. First, they identified items of standardized information following the usual procedure of formulation of consensus findings. Second, they merged databases including spatiotemporal gait assessments with GAITRite® system and clinical information from the “Gait, cOgnitiOn & Decline” (GOOD) initiative and the Generation 100 (Gen 100) study. Only healthy—free of cognitive impairment and multi-morbidities (i.e., ≤ 3 therapeutics taken daily)—participants aged 65 and older were selected. Age, sex, body mass index, mean values, and coefficients of variation (CoV) of gait parameters were used for the analyses. Results: Standardized systematic assessment of three categories of items, which were demographics and clinical information, and gait characteristics (clinical and spatiotemporal gait analysis based on the recorded footfalls), were selected for the proposed guidelines. Two complementary sets of items were distinguished: a minimal data set and a full data set. In addition, a total of 954 participants (mean age 72.8 ± 4.8 years, 45.8% women) were recruited to establish the reference values. Performance of spatiotemporal gait parameters based on the recorded

The Ketogenic Diet as a Treatment Paradigm for Diverse Neurological Disorders

PubMed Central

Stafstrom, Carl E.; Rho, Jong M.

2012-01-01

Dietary and metabolic therapies have been attempted in a wide variety of neurological diseases, including epilepsy, headache, neurotrauma, Alzheimer disease, Parkinson disease, sleep disorders, brain cancer, autism, pain, and multiple sclerosis. The impetus for using various diets to treat – or at least ameliorate symptoms of – these disorders stems from both a lack of effectiveness of pharmacological therapies, and also the intrinsic appeal of implementing a more “natural” treatment. The enormous spectrum of pathophysiological mechanisms underlying the aforementioned diseases would suggest a degree of complexity that cannot be impacted universally by any single dietary treatment. Yet, it is conceivable that alterations in certain dietary constituents could affect the course and impact the outcome of these brain disorders. Further, it is possible that a final common neurometabolic pathway might be influenced by a variety of dietary interventions. The most notable example of a dietary treatment with proven efficacy against a neurological condition is the high-fat, low-carbohydrate ketogenic diet (KD) used in patients with medically intractable epilepsy. While the mechanisms through which the KD works remain unclear, there is now compelling evidence that its efficacy is likely related to the normalization of aberrant energy metabolism. The concept that many neurological conditions are linked pathophysiologically to energy dysregulation could well provide a common research and experimental therapeutics platform, from which the course of several neurological diseases could be favorably influenced by dietary means. Here we provide an overview of studies using the KD in a wide panoply of neurologic disorders in which neuroprotection is an essential component. PMID:22509165

Long-Term Training with a Brain-Machine Interface-Based Gait Protocol Induces Partial Neurological Recovery in Paraplegic Patients.

PubMed

Donati, Ana R C; Shokur, Solaiman; Morya, Edgard; Campos, Debora S F; Moioli, Renan C; Gitti, Claudia M; Augusto, Patricia B; Tripodi, Sandra; Pires, Cristhiane G; Pereira, Gislaine A; Brasil, Fabricio L; Gallo, Simone; Lin, Anthony A; Takigami, Angelo K; Aratanha, Maria A; Joshi, Sanjay; Bleuler, Hannes; Cheng, Gordon; Rudolph, Alan; Nicolelis, Miguel A L

2016-08-11

Brain-machine interfaces (BMIs) provide a new assistive strategy aimed at restoring mobility in severely paralyzed patients. Yet, no study in animals or in human subjects has indicated that long-term BMI training could induce any type of clinical recovery. Eight chronic (3-13 years) spinal cord injury (SCI) paraplegics were subjected to long-term training (12 months) with a multi-stage BMI-based gait neurorehabilitation paradigm aimed at restoring locomotion. This paradigm combined intense immersive virtual reality training, enriched visual-tactile feedback, and walking with two EEG-controlled robotic actuators, including a custom-designed lower limb exoskeleton capable of delivering tactile feedback to subjects. Following 12 months of training with this paradigm, all eight patients experienced neurological improvements in somatic sensation (pain localization, fine/crude touch, and proprioceptive sensing) in multiple dermatomes. Patients also regained voluntary motor control in key muscles below the SCI level, as measured by EMGs, resulting in marked improvement in their walking index. As a result, 50% of these patients were upgraded to an incomplete paraplegia classification. Neurological recovery was paralleled by the reemergence of lower limb motor imagery at cortical level. We hypothesize that this unprecedented neurological recovery results from both cortical and spinal cord plasticity triggered by long-term BMI usage.

Long-Term Training with a Brain-Machine Interface-Based Gait Protocol Induces Partial Neurological Recovery in Paraplegic Patients

PubMed Central

Donati, Ana R. C.; Shokur, Solaiman; Morya, Edgard; Campos, Debora S. F.; Moioli, Renan C.; Gitti, Claudia M.; Augusto, Patricia B.; Tripodi, Sandra; Pires, Cristhiane G.; Pereira, Gislaine A.; Brasil, Fabricio L.; Gallo, Simone; Lin, Anthony A.; Takigami, Angelo K.; Aratanha, Maria A.; Joshi, Sanjay; Bleuler, Hannes; Cheng, Gordon; Rudolph, Alan; Nicolelis, Miguel A. L.

2016-01-01

Brain-machine interfaces (BMIs) provide a new assistive strategy aimed at restoring mobility in severely paralyzed patients. Yet, no study in animals or in human subjects has indicated that long-term BMI training could induce any type of clinical recovery. Eight chronic (3–13 years) spinal cord injury (SCI) paraplegics were subjected to long-term training (12 months) with a multi-stage BMI-based gait neurorehabilitation paradigm aimed at restoring locomotion. This paradigm combined intense immersive virtual reality training, enriched visual-tactile feedback, and walking with two EEG-controlled robotic actuators, including a custom-designed lower limb exoskeleton capable of delivering tactile feedback to subjects. Following 12 months of training with this paradigm, all eight patients experienced neurological improvements in somatic sensation (pain localization, fine/crude touch, and proprioceptive sensing) in multiple dermatomes. Patients also regained voluntary motor control in key muscles below the SCI level, as measured by EMGs, resulting in marked improvement in their walking index. As a result, 50% of these patients were upgraded to an incomplete paraplegia classification. Neurological recovery was paralleled by the reemergence of lower limb motor imagery at cortical level. We hypothesize that this unprecedented neurological recovery results from both cortical and spinal cord plasticity triggered by long-term BMI usage. PMID:27513629

75 FR 21643 - National Institute of Neurological Disorders and Stroke; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-26

... Neurological Disorders and Stroke; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory... Stroke Council. Date: May 27, 2010. Closed: 10 a.m. to 1 p.m. Agenda: To review and evaluate grant... Director for Extramural Research, National Institute of Neurological Disorders and Stroke, NIH, 6001...

Neurologic disorders associated with weight lifting and bodybuilding.

PubMed

Busche, Kevin

2008-02-01

Weight lifting and other forms of strength training are becoming more common because of an increased awareness of the need to maintain individual physical fitness. Emergency room data indicate that injuries caused by weight training have become more universal over time, likely because of increased participation rates. Neurologic injuries can result from weight lifting and related practices. Although predominantly peripheral nervous system injuries have been described, central nervous system disease may also occur. This article illustrates the types of neurologic disorders associated with weight lifting.

Neurologic disorders associated with weight lifting and bodybuilding.

PubMed

Busche, Kevin

2009-02-01

Weight lifting and other forms of strength training are becoming more common because of an increased awareness of the need to maintain individual physical fitness. Emergency room data indicate that injuries caused by weight training have become more universal over time, likely because of increased participation rates. Neurologic injuries can result from weight lifting and related practices. Although predominantly peripheral nervous system injuries have been described, central nervous system disease may also occur. This article illustrates the types of neurologic disorders associated with weight lifting.

Neurologic disorders associated with anti-glutamic acid decarboxylase antibodies: A comparison of anti-GAD antibody titers and time-dependent changes between neurologic disease and type I diabetes mellitus.

PubMed

Nakajima, Hideto; Nakamura, Yoshitsugu; Inaba, Yuiko; Tsutsumi, Chiharu; Unoda, Kiichi; Hosokawa, Takafumi; Kimura, Fumiharu; Hanafusa, Toshiaki; Date, Masamichi; Kitaoka, Haruko

2018-04-15

To determine clinical features of neurologic disorders associated with anti-glutamic acid decarboxylase antibodies (anti-GAD-Ab), we examined titers and time-dependent changes of anti-GAD-Ab. Six patients, stiff person syndrome (2), cerebellar ataxia (1), limbic encephalitis (1), epilepsy (1), brainstem encephalitis (1), were compared with 87 type I diabetes mellitus (T1DM) patients without neurologic disorders. Anti-GAD-Ab titers and index were higher in neurologic disorders than in T1DM, suggesting intrathecal antibody synthesis. Anti-GAD-Ab titers in T1DM decreased over time, whereas they remained high in neurologic disorders. Immunotherapy improved neurological disorders and anti-GAD-Ab titers and index provide clinically meaningful information about their diagnostic accuracy. Copyright © 2018 Elsevier B.V. All rights reserved.

Household food insecurity and symptoms of neurologic disorder in Ethiopia: an observational analysis.

PubMed

El-Sayed, Abdulrahman M; Hadley, Craig; Tessema, Fasil; Tegegn, Ayelew; Cowan, John A; Galea, Sandro

2010-12-31

Food insecurity (FI) has been shown to be associated with poor health both in developing and developed countries. Little is known about the relation between FI and neurological disorder. We assessed the relation between FI and risk for neurologic symptoms in southwest Ethiopia. Data about food security, gender, age, household assets, and self-reported neurologic symptoms were collected from a representative, community-based sample of adults (N = 900) in Jimma Zone, Ethiopia. We calculated univariate statistics and used bivariate chi-square tests and multivariate logistic regression models to assess the relation between FI and risk of neurologic symptoms including seizures, extremity weakness, extremity numbness, tremors/ataxia, aphasia, carpal tunnel syndrome, vision dysfunction, and spinal pain. In separate multivariate models by outcome and gender, adjusting for age and household socioeconomic status, severe FI was associated with higher odds of seizures, movement abnormalities, carpal tunnel, vision dysfunction, spinal pain, and comorbid disorders among women. Severe FI was associated with higher odds of seizures, extremity numbness, movement abnormalities, difficulty speaking, carpal tunnel, vision dysfunction, and comorbid disorders among men. We found that FI was associated with symptoms of neurologic disorder. Given the cross-sectional nature of our study, the directionality of these associations is unclear. Future research should assess causal mechanisms relating FI to neurologic symptoms in sub-Saharan Africa.

75 FR 51278 - National Institute of Neurological Disorders and Stroke; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-19

... Neurological Disorders and Stroke; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory... Stroke Council. Date: September 23, 2010. Open: 9:45 a.m. to 2:30 p.m. Agenda: Report by the Director... Neurological Disorders and Stroke, NIH, 6001 Executive Blvd., Suite 3309, MSC 9531, Bethesda, MD 20892, (301...

Increased pediatric functional neurological symptom disorders after the Boston marathon bombings: a case series.

PubMed

Guerriero, Réjean M; Pier, Danielle B; de Gusmão, Claudio M; Bernson-Leung, Miya E; Maski, Kiran P; Urion, David K; Waugh, Jeff L

2014-11-01

Functional neurological symptom disorders are frequently the basis for acute neurological consultation. In children, they are often precipitated by high-frequency everyday stressors. The extent to which a severe traumatic experience may also precipitate functional neurological abnormalities is unknown. For the 2-week period after the Boston Marathon bombings, we prospectively collected data on patients whose presentation suggested a functional neurological symptom disorder. We assessed clinical and demographic variables, duration of symptoms, extent of educational impact, and degree of connection to the Marathon bombing. We contacted all patients at 6 months after presentation to determine the outcome and accuracy of the diagnosis. In a parallel study, we reported a baseline of 2.6 functional neurological presentations per week in our emergency room. In the week after the Marathon bombings, this frequency tripled. Ninety-one percent of presentations were delayed by 1 week, with onset around the first school day after a city-wide lockdown. Seventy-three percent had a history of a prior psychiatric diagnosis. At the 6 months follow-up, no functional neurological symptom disorder diagnoses were overturned and no new organic diagnosis was made. Pediatric functional neurological symptom disorder may be precipitated by both casual and high-intensity stressors. The 3.4-fold increase in incidence after the Boston Marathon bombings and city-wide lockdown demonstrates the marked effect that a community-wide tragedy can have on the mental health of children. Care providers must be aware of functional neurological symptom disorders after stressful community events in vulnerable patient populations, particularly those with prior psychiatric diagnoses. Copyright © 2014 Elsevier Inc. All rights reserved.

Shedding light on walking in the dark: the effects of reduced lighting on the gait of older adults with a higher-level gait disorder and controls.

PubMed

Kesler, Anat; Leibovich, Gregory; Herman, Talia; Gruendlinger, Leor; Giladi, Nir; Hausdorff, Jeffrey M

2005-08-28

To study the effects of reduced lighting on the gait of older adults with a high level gait disorder (HLGD) and to compare their response to that of healthy elderly controls. 22 patients with a HLGD and 20 age-matched healthy controls were studied under usual lighting conditions (1000 lumens) and in near darkness (5 lumens). Gait speed and gait dynamics were measured under both conditions. Cognitive function, co-morbidities, depressive symptoms, and vision were also evaluated. Under usual lighting conditions, patients walked more slowly, with reduced swing times, and increased stride-to-stride variability, compared to controls. When walking under near darkness conditions, both groups slowed their gait. All other measures of gait were not affected by lighting in the controls. In contrast, patients further reduced their swing times and increased their stride-to-stride variability, both stride time variability and swing time variability. The unique response of the patients was not explained by vision, mental status, co-morbidities, or the values of walking under usual lighting conditions. Walking with reduced lighting does not affect the gait of healthy elderly subjects, except for a reduction in speed. On the other hand, the gait of older adults with a HLGD becomes more variable and unsteady when they walk in near darkness, despite adapting a slow and cautious gait. Further work is needed to identify the causes of the maladaptive response among patients with a HLGD and the potential connection between this behavior and the increased fall risk observed in these patients.

Mental, neurologic, and substance use (MNS) disorders among street homeless people in Ethiopia.

PubMed

Ayano, Getinet; Assefa, Dawit; Haile, Kibrom; Chaka, Asrat; Solomon, Haddish; Hagos, Petros; Yohannis, Zegeye; Haile, Kelemua; Bekana, Lulu; Agidew, Melkamu; Demise, Seife; Tsegaye, Belachew; Solomon, Melat

2017-01-01

About 25-60% of the homeless population is reported to have some form of mental disorder. To our knowledge, there are no studies aimed at the screening, diagnosis, treatment, care, rehabilitation, and support of homeless people with mental, neurologic, and substance use (MNS) disorders in general in Ethiopia. This is the first study of its kind in Africa which was aimed at screening, diagnosis, care, treatment, rehabilitation, and support of homeless individuals with possible MNS disorder. Community-based survey was conducted from January to March 2015. Homeless people who had overt and observable psychopathology and positive for screening instruments (SRQ20, ASSIST, and PSQ) were involved in the survey and further assessed for possible diagnosis by structured clinical interview for DSM-IV diagnoses and international diagnostic criteria for seizure disorders for possible involvement in care, treatment, rehabilitation services, support, and training. The Statistical Program for Social Science (SPSS version 20) was used for data entry, clearance, and analyses. A total of 456 homeless people were involved in the survey. Majority of the participants were male ( n   =  402; 88.16%). Most of the homeless participants had migrated into Addis Ababa from elsewhere in Ethiopia and Eritrea (62.50%). Mental, neurologic, and substance use disorders resulted to be common problems in the study participants (92.11%; n   =  420). Most of the participants with mental, neurologic, and substance use disorders (85.29%; n   =  354) had psychotic disorders. Most of those with psychosis had schizophrenia (77.40%; n   =  274). Almost all of the participants had a history of substance use (93.20%; n   =  425) and about one in ten individuals had substance use disorders (10.54%; n   =  48). Most of the participants with substance use disorder had comorbid other mental and neurologic disorders (83.33%; n   =  40). Mental, neurologic, and substance use disorders are common (92

78 FR 4423 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-22

... clearly unwarranted invasion of personal privacy. Name of Committee: Neurological Sciences Training... 20037. Contact Person: Raul A. Saavedra, Ph.D., Scientific Review Officer, Scientific Review Branch... Disorders and Stroke Initial Review Group; Neurological Sciences and Disorders B. Date: February 21-22, 2013...

Quality of life of unaffected siblings of children with chronic neurological disorders.

PubMed

Rana, Pratyaksha; Mishra, Devendra

2015-06-01

To study quality of life (QoL) of the siblings of children with chronic neurological disorders. Between 1st August and 30th September, 2013, 50 children aged 12-18 y, whose child sibling was suffering from a chronic neurological disorder, were enrolled (Study group). Fifty age- and sex- matched siblings of apparently non-neurologically affected children were enrolled as controls (Control group). Those with more than one affected child or any affected adult in the family were excluded. QoL was assessed by a validated version of the WHOQOL-BREF in Hindi, and QoL was compared between cases and controls. The disorders in the index cases included cerebral palsy, 18 (15 with epilepsy); autism, 15; mental retardation, 12 and epilepsy, 5. The QoL in all domains was significantly poorer in the study group as compared to the controls. 64% study group children had insufficient knowledge about their sibling's condition. More than 1/4th study subjects faced difficulties in studies, play or work. There was no difference among the groups with regard to number of siblings who had 'dropped from the school'. The QoL of unaffected siblings of children with chronic neurological disorders was significantly impaired. Health-workers may consider including older siblings of neurologically affected children during family-counseling sessions, to provide information and suggest coping strategies. This intervention is likely to improve the functioning of the family unit as a whole.

Balzac and human gait analysis.

PubMed

Collado-Vázquez, S; Carrillo, J M

2015-05-01

People have been interested in movement analysis in general, and gait analysis in particular, since ancient times. Aristotle, Hippocrates, Galen, Leonardo da Vinci and Honoré de Balzac all used observation to analyse the gait of human beings. The purpose of this study is to compare Honoré de Balzac's writings with a scientific analysis of human gait. Honoré de Balzac's Theory of walking and other works by that author referring to gait. Honoré de Balzac had an interest in gait analysis, as demonstrated by his descriptions of characters which often include references to their way of walking. He also wrote a treatise entitled Theory of walking (Théorie de la demarche) in which he employed his keen observation skills to define gait using a literary style. He stated that the walking process is divided into phases and listed the factors that influence gait, such as personality, mood, height, weight, profession and social class, and also provided a description of the correct way of walking. Balzac considered gait analysis to be very important and this is reflected in both his character descriptions and Theory of walking, his analytical observation of gait. In our own technology-dominated times, this serves as a reminder of the importance of observation. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

77 FR 65896 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-31

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory... Institute of Neurological Disorders and Stroke Special Emphasis Panel; Blueprint SEP. Date: December 5, 2012...

[Drooling therapy in children with neurological disorders].

PubMed

Táboas-Pereira, M Andrea; Paredes-Mercado, Cecilia; Alonso-Curcó, Xènia; Badosa-Pagès, Joaquim; Muchart, Jordi; Póo, Pilar

2015-07-16

Drooling is the inability to retain saliva in the mouth and its progression to the digestive tract, being a common problem in pediatric patients with neurological disorders. Three different treatment options are available. To assess the effectiveness and safety of trihexyphenidyl, scopolamine and botulinum toxin infiltration in the treatment of drooling in children with neurological disorders. This is an open and prospective type study. We include patients treated in the Neurology Service that present excessive drooling, affecting their quality of life, between 2009 and 2013. We enrolled 46 patients in the study. The treatment with oral trihexyphenidyl was indicated in 46, obtaining good result in 15 (32.6%), three with temporary effect and the rest with lasting effect. Three patients presented side effects (6.5%). Four out of 11 (36.36%) patients treated with scopolamine patch had beneficial effects. One was withdrawn due to lack of efficacy and six due to side effects. Twenty-five patients were infiltrated with botulinum toxin, with a significant decrease of drooling in 16 patients (64%) after the first injection. We observed no significant changes in nine patients. Only one out of 25 showed side effects (mild dysphagia). Currently there is not a fully effective therapeutic option for drooling. We recommend starting treatment with trihexyphenidyl. A second option could be the scopolamine patch and botulinum toxin as a third option. Botulinum toxin infiltration in salivary glands is shown as an effective and safe alternative in our study.

Real-Time Classification of Patients with Balance Disorders vs. Normal Subjects Using a Low-Cost Small Wireless Wearable Gait Sensor.

PubMed

Nukala, Bhargava Teja; Nakano, Taro; Rodriguez, Amanda; Tsay, Jerry; Lopez, Jerry; Nguyen, Tam Q; Zupancic, Steven; Lie, Donald Y C

2016-11-29

Gait analysis using wearable wireless sensors can be an economical, convenient and effective way to provide diagnostic and clinical information for various health-related issues. In this work, our custom designed low-cost wireless gait analysis sensor that contains a basic inertial measurement unit (IMU) was used to collect the gait data for four patients diagnosed with balance disorders and additionally three normal subjects, each performing the Dynamic Gait Index (DGI) tests while wearing the custom wireless gait analysis sensor (WGAS). The small WGAS includes a tri-axial accelerometer integrated circuit (IC), two gyroscopes ICs and a Texas Instruments (TI) MSP430 microcontroller and is worn by each subject at the T4 position during the DGI tests. The raw gait data are wirelessly transmitted from the WGAS to a near-by PC for real-time gait data collection and analysis. In order to perform successful classification of patients vs. normal subjects, we used several different classification algorithms, such as the back propagation artificial neural network (BP-ANN), support vector machine (SVM), k -nearest neighbors (KNN) and binary decision trees (BDT), based on features extracted from the raw gait data of the gyroscopes and accelerometers. When the range was used as the input feature, the overall classification accuracy obtained is 100% with BP-ANN, 98% with SVM, 96% with KNN and 94% using BDT. Similar high classification accuracy results were also achieved when the standard deviation or other values were used as input features to these classifiers. These results show that gait data collected from our very low-cost wearable wireless gait sensor can effectively differentiate patients with balance disorders from normal subjects in real time using various classifiers, the success of which may eventually lead to accurate and objective diagnosis of abnormal human gaits and their underlying etiologies in the future, as more patient data are being collected.

76 FR 47218 - National Institute of Neurological Disorders and Stroke Amended; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-04

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke Amended; Notice of Meeting Notice is hereby given of a change in the meeting of the National Institute of Neurological Disorders and Stroke Special Emphasis Panel, August 2, 2011...

76 FR 23613 - National Institute of Neurological Disorders and Stroke; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Institute of Neurological Disorders and Stroke Special Emphasis Panel, April 19, 2011...

78 FR 42529 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-16

... Stroke Special Emphasis Panel Stroke Trials Network NCCC SEP. Date: August 15, 2013. Time: 8:00 a.m. to...: National Institute of Neurological Disorders and Stroke Special Emphasis Panel Stroke Trial Network Sites... Related to Neurological Disorders; 93.854, Biological Basis Research in the Neurosciences, National...

Increased Anterior Pelvic Angle Characterizes the Gait of Children with Attention Deficit/Hyperactivity Disorder (ADHD).

PubMed

Naruse, Hiroaki; Fujisawa, Takashi X; Yatsuga, Chiho; Kubota, Masafumi; Matsuo, Hideaki; Takiguchi, Shinichiro; Shimada, Seiichiro; Imai, Yuto; Hiratani, Michio; Kosaka, Hirotaka; Tomoda, Akemi

2017-01-01

Children with attention deficit/hyperactivity disorder (ADHD) frequently have motor problems. Previous studies have reported that the characteristic gait in children with ADHD is immature and that subjects demonstrate higher levels of variability in gait characteristics for the lower extremities than healthy controls. However, little is known about body movement during gait in children with ADHD. The purpose of this study was to identify the characteristic body movements associated with ADHD symptoms in children with ADHD. Using a three-dimensional motion analysis system, we compared gait variables in boys with ADHD (n = 19; mean age, 9.58 years) and boys with typical development (TD) (n = 21; mean age, 10.71 years) to determine the specific gait characteristics related to ADHD symptoms. We assessed spatiotemporal gait variables (i.e. speed, stride length, and cadence), and kinematic gait variables (i.e. angle of pelvis, hip, knee, and ankle) to measure body movement when walking at a self-selected pace. In comparison with the TD group, the ADHD group demonstrated significantly higher values in cadence (t = 3.33, p = 0.002) and anterior pelvic angle (t = 3.08, p = 0.004). In multiple regression analysis, anterior pelvic angle was associated with the ADHD rating scale hyperactive/impulsive scores (β = 0.62, t = 2.58, p = 0.025), but not other psychiatric symptoms in the ADHD group. Our results suggest that anterior pelvic angle represents a specific gait variable related to ADHD symptoms. Our kinematic findings could have potential implications for evaluating the body movement in boys with ADHD.

Neurological deterioration during intubation in cervical spine disorders

PubMed Central

Durga, Padmaja; Sahu, Barada Prasad

2014-01-01

Anaesthesiologists are often involved in the management of patients with cervical spine disorders. Airway management is often implicated in the deterioration of spinal cord function. Most evidence on neurological deterioration resulting from intubation is from case reports which suggest only association, but not causation. Most anaesthesiologists and surgeons probably believe that the risk of spinal cord injury (SCI) during intubation is largely due to mechanical compression produced by movement of the cervical spine. But it is questionable that the small and brief deformations produced during intubation can produce SCI. Difficult intubation, more frequently encountered in patients with cervical spine disorders, is likely to produce greater movement of spine. Several alternative intubation techniques are shown to improve ease and success, and reduce cervical spine movement but their role in limiting SCI is not studied. The current opinion is that most neurological injuries during anaesthesia are the result of prolonged deformation, impaired perfusion of the cord, or both. To prevent further neurological injury to the spinal cord and preserve spinal cord function, minimizing movement during intubation and positioning for surgery are essential. The features that diagnose laryngoscopy induced SCI are myelopathy present on recovery, short period of unconsciousness, autonomic disturbances following laryngoscopy, cranio-cervical junction disease or gross instability below C3. It is difficult to accept or refute the claim that neurological deterioration was induced by intubation. Hence, a record of adequate care at laryngoscopy and also perioperative period are important in the event of later medico-legal proceedings. PMID:25624530

Poor Gait Performance and Prediction of Dementia: Results From a Meta-Analysis.

PubMed

Beauchet, Olivier; Annweiler, Cédric; Callisaya, Michele L; De Cock, Anne-Marie; Helbostad, Jorunn L; Kressig, Reto W; Srikanth, Velandai; Steinmetz, Jean-Paul; Blumen, Helena M; Verghese, Joe; Allali, Gilles

2016-06-01

Poor gait performance predicts risk of developing dementia. No structured critical evaluation has been conducted to study this association yet. The aim of this meta-analysis was to systematically examine the association of poor gait performance with incidence of dementia. An English and French Medline search was conducted in June 2015, with no limit of date, using the medical subject headings terms "Gait" OR "Gait Disorders, Neurologic" OR "Gait Apraxia" OR "Gait Ataxia" AND "Dementia" OR "Frontotemporal Dementia" OR "Dementia, Multi-Infarct" OR "Dementia, Vascular" OR "Alzheimer Disease" OR "Lewy Body Disease" OR "Frontotemporal Dementia With Motor Neuron Disease" (Supplementary Concept). Poor gait performance was defined by standardized tests of walking, and dementia was diagnosed according to international consensus criteria. Four etiologies of dementia were identified: any dementia, Alzheimer disease (AD), vascular dementia (VaD), and non-AD (ie, pooling VaD, mixed dementias, and other dementias). Fixed effects meta-analyses were performed on the estimates in order to generate summary values. Of the 796 identified abstracts, 12 (1.5%) were included in this systematic review and meta-analysis. Poor gait performance predicted dementia [pooled hazard ratio (HR) combined with relative risk and odds ratio = 1.53 with P < .001 for any dementia, pooled HR = 1.79 with P < .001 for VaD, HR = 1.89 with P value < .001 for non-AD]. Findings were weaker for predicting AD (HR = 1.03 with P value = .004). This meta-analysis provides evidence that poor gait performance predicts dementia. This association depends on the type of dementia; poor gait performance is a stronger predictor of non-AD dementias than AD. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

The emerging link between O-GlcNAcylation and neurological disorders.

PubMed

Ma, Xiaofeng; Li, He; He, Yating; Hao, Junwei

2017-10-01

O-linked β-N-acetylglucosaminylation (O-GlcNAcylation) is involved in the regulation of many cellular cascades and neurological diseases such as Alzheimer's disease (AD), Parkinson's disease (PD), and stroke. In the brain, the expression of O-GlcNAcylation is notably heightened, as is that of O-linked N-acetylglucosaminyltransferase (OGT) and β-N-acetylglucosaminidase (OGA), the presence of which is prominent in many regions of neurological importance. Most importantly, O-GlcNAcylation is believed to contribute to the normal functioning of neurons; conversely, its dysregulation participates in the pathogenesis of neurological disorders. In neurodegenerative diseases, O-GlcNAcylation of the brain's key proteins, such as tau and amyloid-β, interacts with their phosphorylation, thereby triggering the formation of neurofibrillary tangles and amyloid plaques. An increase of O-GlcNAcylation by pharmacological intervention prevents neuronal loss. Additionally, O-GlcNAcylation is stress sensitive, and its elevation is cytoprotective. Increased O-GlcNAcylation ameliorated brain damage in victims of both trauma-hemorrhage and stroke. In this review, we summarize the current understanding of O-GlcNAcylation's physiological and pathological roles in the nervous system and provide a foundation for development of a therapeutic strategy for neurological disorders.

Measuring outcomes for neurological disorders: a review of disease-specific health status instruments for three degenerative neurological conditions.

PubMed

Heffernan, Catherine; Jenkinson, Crispin

2005-06-01

Health-related quality-of-life measures have been increasingly used in research into neurological disorders in recent years. The aim of this paper is to provide an objective appraisal of the evidence in regard to disease-specific quality-of-life measures used in research on health interventions for three degenerative neurological disorders: multiple sclerosis, motor neurone disease/amyotrophic lateral sclerosis and Parkinson's disease. A comprehensive search strategy was developed to include nine relevant electronic databases. Only studies pertaining to patient-based outcome measurements in multiple sclerosis, motor neurone disease and Parkinson's disease were included. We identified 76 eligible studies. As studies consisted of descriptive and cross-sectional survey study designs, results were reported qualitatively rather than in the form of a meta-analysis. Four disease-specific measures were found for Parkinson's disease, 11 for multiple sclerosis and one for motor neurone disease. We conclude that health-related quality-of-life measures are useful in assessing the impact of treatments and interventions for neurological disorders. However, further research is needed on the development of instruments using psychometric methods and on the validation, utilization and responsiveness of instruments to change.

77 FR 24971 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-26

... Disorders and Stroke Initial Review Group; Neurological Sciences and Disorders C. Date: June 18-19, 2012..., Scientific Review Branch, Division of Extramural Research, NINDS, NIH, NSC, 6001 Executive Blvd., Suite 3204...: Neurological Sciences Training Initial Review Group; NST-2 Subcommittee. Date: June 25-26, 2012. Time: 8 a.m...

77 FR 59939 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-01

... Disorders and Stroke Initial Review Group; Neurological Sciences and Disorders B. Date: October 25-26, 2012... Officer, Scientific Review Branch, Division of Extramural Research, NINDS/NIH/DHHS, NSC, 6001 Executive...: Neurological Sciences Training Initial Review Group; NST-2 Subcommittee. Date: November 5-6, 2012. Time: 8:00 a...

A Microsoft Kinect-Based Point-of-Care Gait Assessment Framework for Multiple Sclerosis Patients.

PubMed

Gholami, Farnood; Trojan, Daria A; Kovecses, Jozsef; Haddad, Wassim M; Gholami, Behnood

2017-09-01

Gait impairment is a prevalent and important difficulty for patients with multiple sclerosis (MS), a common neurological disorder. An easy to use tool to objectively evaluate gait in MS patients in a clinical setting can assist clinicians to perform an objective assessment. The overall objective of this study is to develop a framework to quantify gait abnormalities in MS patients using the Microsoft Kinect for the Windows sensor; an inexpensive, easy to use, portable camera. Specifically, we aim to evaluate its feasibility for utilization in a clinical setting, assess its reliability, evaluate the validity of gait indices obtained, and evaluate a novel set of gait indices based on the concept of dynamic time warping. In this study, ten ambulatory MS patients, and ten age and sex-matched normal controls were studied at one session in a clinical setting with gait assessment using a Kinect camera. The expanded disability status scale (EDSS) clinical ambulation score was calculated for the MS subjects, and patients completed the Multiple Sclerosis walking scale (MSWS). Based on this study, we established the potential feasibility of using a Microsoft Kinect camera in a clinical setting. Seven out of the eight gait indices obtained using the proposed method were reliable with intraclass correlation coefficients ranging from 0.61 to 0.99. All eight MS gait indices were significantly different from those of the controls (p-values less than 0.05). Finally, seven out of the eight MS gait indices were correlated with the objective and subjective gait measures (Pearson's correlation coefficients greater than 0.40). This study shows that the Kinect camera is an easy to use tool to assess gait in MS patients in a clinical setting.

Clinical perspectives on medical marijuana (cannabis) for neurologic disorders.

PubMed

Fife, Terry D; Moawad, Heidi; Moschonas, Constantine; Shepard, Katie; Hammond, Nancy

2015-08-01

The American Academy of Neurology published an evidence-based systematic review of randomized controlled trials using marijuana ( Cannabis sativa ) or cannabinoids in neurologic disorders. Several cannabinoids showed effectiveness or probable effectiveness for spasticity, central pain, and painful spasms in multiple sclerosis. The review justifies insurance coverage for dronabinol and nabilone for these indications. Many insurance companies already cover these medications for other indications. It is unlikely that the review will alter coverage for herbal marijuana. Currently, no payers cover the costs of herbal medical marijuana because it is illegal under federal law and in most states. Cannabinoid preparations currently available by prescription may have a role in other neurologic conditions, but quality scientific evidence is lacking at this time.

RIT2: responsible and susceptible gene for neurological and psychiatric disorders.

PubMed

Daneshmandpour, Yousef; Darvish, Hossein; Emamalizadeh, Babak

2018-06-02

RIT2 gene was recently introduced as a susceptibility gene in neurological disorders, a group of major problems in human society affecting millions of people worldwide. Several variants, including single nucleotide polymorphisms and CNVs, have been identified and studied in different populations. In this review, we have summarized the studies relevant to the RIT2 gene and its related disorders, including Parkinson's disease, schizophrenia, and autism. The protein product of RIT2 is a member of the Ras superfamily that plays important roles in many vital cellular functions, such as differentiation and survival. We have also investigated the protein network of the RIT2 protein and the diseases related to members of this network so as to obtain some clues for future studies by identifying the molecular pathophysiology of neurological disorders and revealing new possible disorders related to RIT2.

78 FR 64223 - National Institute of Neurological Disorders and Stroke Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke Amended Notice of Meeting Notice is hereby given of a change in the meeting of the Neurological Sciences and Disorders C, October 17, 2013, 08:00 a.m. to October 18, 2013, 05:00...

75 FR 57043 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Neurological Disorders and Stroke Special Emphasis Panel; EUREKA. Date: November 8, 2010. Time: 8 a.m. to 6 p.m...

78 FR 64227 - National Institute of Neurological Disorders and Stroke; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the Neurological Sciences and Disorders A, October 24, 2013, 08:30 a.m. to October 25, 2013, 06:00...

Olfactory Disorder Pattern In Patients With Neurological Diseases Excluding Psychiatric And Traumatic Aetiologies.

PubMed

de Haro-Licer, Josep; González-Fernández, Adela; Planas-Comes, Albert; González-Ares, Josep Antón

2018-03-23

The most common cause of olfactory ENT disorders are colds and flu, chronic sinusitis, allergies and traumatic brain injury. Rarer aetiologies include certain neurological, psychiatric and metabolic injuries. The aim of this paper was to check the sort of olfactory disorders found in people who have suffered a brain injury, excluding: cranial traumas, psychiatric diseases, epilepsy, Parkinson's and Alzheimer's disease, and synaesthesia. A descriptive study based on 61 patients with diagnoses of various neurological injuries, which were tested by BAST-24 olfactometer. The results were compared with those of a control group (n= 120). The results show major impairment in these patients' olfactory sense. The neurological injury patients were able to detect from 60-77% of the odours, while the control group were able to detect between 98-100%. The neurological patients were able, at best, to identify, 11-32% of the odours correctly, while the control group were able to correctly detect between 59 -75%. The differences between odour detection and correct identification were statistically significant (p<.05). We concluded: a) Neurological injury, not caused by traumatic brain injury, psychiatric disorders or ENT diseases, ranged from 68-89% of the olfactory failures. b) We must bear in mind that these sorts of injuries can cause olfactory disorders. c) ENT and Neurologists should collaborate in the treatment of these disorders. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.

Fear of falling and gait variability in older adults: a systematic review and meta-analysis.

PubMed

Ayoubi, Farah; Launay, Cyrille P; Annweiler, Cédric; Beauchet, Olivier

2015-01-01

Fear of falling (FOF) and increased gait variability are both independent markers of gait instability. There is a complex interplay between both entities. The purposes of this study were (1) to perform a qualitative analysis of all published studies on FOF-related changes in gait variability through a systematic review, and (2) to quantitatively synthesize FOF-related changes in gait variability. A systematic Medline literature search was conducted in May 2014 using the Medical Subject Heading (MeSH) terms "Fear" OR "fear of falling" combined with "Accidental Falls" AND "Gait" OR "Gait Apraxia" OR "Gait Ataxia" OR "Gait disorders, Neurologic" OR "Gait assessment" OR "Functional gait assessment" AND "Self efficacy" OR "Self confidence" AND "Aged" OR "Aged, 80 and over." Systematic review and fixed-effects meta-analysis using an inverse-variance method were performed. Of the 2184 selected studies, 10 observational studies (including 5 cross-sectional studies, 4 prospective cohort studies, and 1 case-control study) met the selection criteria. All were of good quality. The number of participants ranged from 52 to 1307 older community-dwellers (26.2%-85.0% women). The meta-analysis was performed on 10 studies with a total of 999 cases and 4502 controls. In one study, the higher limits of the effect size's confidence interval (CI) were lower than zero. In the remaining studies, the higher limits of the CI were positive. The summary random effect size of 0.29 (95% CI 0.13-0.45) was significant albeit of small magnitude, and indicated that gait variability was overall 0.29 SD higher in FOF cases compared with controls. Our findings show that FOF is associated with a statistically significant, albeit of small magnitude, increase in gait variability. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

[Neurological soft signs in pervasive developmental disorders].

PubMed

Halayem, S; Bouden, A; Halayem, M B; Tabbane, K; Amado, I; Krebs, M O

2010-09-01

Many studies have focused on specific motor signs in autism and Asperger's syndrome, but few has been published on the complete range of neurological soft signs (NSS) in children with pervasive developmental disorder (PDD). Scarce are the studies evaluating NSS in children suffering from PDD not otherwise specified (PDDNOS). This study compared performance of 11 autistic children (AD) and 10 children with PDDNOS, with controls matched on age, sex and cognitive performance on Krebs et al.'s NSS scale. Because of the duration of the assessments and specific difficulties encountered in managing some items, an adaptation of the scale had to be made during a pilot study with the agreement of the author. To be eligible, patients had to meet the following inclusion criteria: an age range of 6-16 years, a diagnosis of autistic disorder or PDDNOS based on the DSM IV criteria (American Psychiatric Association 1994). The autism diagnostic interview-revised (ADI-R) was used in order to confirm the diagnosis and to evaluate the association of the symptoms to the severity of the NSS. The childhood autism rating scale (CARS) was completed for the patients in order to evaluate symptoms at the time of the NSS examination. Cognitive ability was assessed with Raven's progressive matrices. Were excluded patients with: history of cerebral palsy, congenital anomaly of the central nervous system, epilepsy, known genetic syndrome, tuberous sclerosis, neurofibromatosis, antecedent of severe head trauma, Asperger's syndrome, obvious physical deformities or sensory deficits that would interfere with neurological assessment, deep mental retardation and recent or chronic substance use or abuse. Healthy controls shared the same exclusion criteria, with no personal history of neurological, psychiatric disorder or substance abuse, no family history of psychiatric disorder and normal or retardation in schooling. All study procedures were approved by the local Ethics Committee (Comité d

A perceptual map for gait symmetry quantification and pathology detection.

PubMed

Moevus, Antoine; Mignotte, Max; de Guise, Jacques A; Meunier, Jean

2015-10-29

The gait movement is an essential process of the human activity and the result of collaborative interactions between the neurological, articular and musculoskeletal systems, working efficiently together. This explains why gait analysis is important and increasingly used nowadays for the diagnosis of many different types (neurological, muscular, orthopedic, etc.) of diseases. This paper introduces a novel method to quickly visualize the different parts of the body related to an asymmetric movement in the human gait of a patient for daily clinical usage. The proposed gait analysis algorithm relies on the fact that the healthy walk has (temporally shift-invariant) symmetry properties in the coronal plane. The goal is to provide an inexpensive and easy-to-use method, exploiting an affordable consumer depth sensor, the Kinect, to measure the gait asymmetry and display results in a perceptual way. We propose a multi-dimensional scaling mapping using a temporally shift invariant distance, allowing us to efficiently visualize (in terms of perceptual color difference) the asymmetric body parts of the gait cycle of a subject. We also propose an index computed from this map and which quantifies locally and globally the degree of asymmetry. The proposed index is proved to be statistically significant and this new, inexpensive, marker-less, non-invasive, easy to set up, gait analysis system offers a readable and flexible tool for clinicians to analyze gait characteristics and to provide a fast diagnostic. This system, which estimates a perceptual color map providing a quick overview of asymmetry existing in the gait cycle of a subject, can be easily exploited for disease progression, recovery cues from post-operative surgery (e.g., to check the healing process or the effect of a treatment or a prosthesis) or might be used for other pathologies where gait asymmetry might be a symptom.

Endocannabinoid System in Neurological Disorders.

PubMed

Ranieri, Roberta; Laezza, Chiara; Bifulco, Maurizio; Marasco, Daniela; Malfitano, Anna M

2016-01-01

Several studies support the evidence that the endocannabinoid system and cannabimimetic drugs might have therapeutic potential in numerous pathologies. These pathologies range from neurological disorders, atherosclerosis, stroke, cancer to obesity/metabolic syndrome and others. In this paper we review the endocannabinoid system signaling and its alteration in neurodegenerative disorders like multiple sclerosis, Alzheimer's disease, Parkinson's disease and Huntington's disease and discuss the main findings about the use of cannabinoids in the therapy of these pathologies. Despite different etiologies, neurodegenerative disorders exhibit similar mechanisms like neuro-inflammation, excitotoxicity, deregulation of intercellular communication, mitochondrial dysfunction and disruption of brain tissue homeostasis. Current treatments ameliorate the symptoms but are not curative. Interfering with the endocannabinoid signaling might be a valid therapeutic option in neuro-degeneration. To this aim, pharmacological intervention to modulate the endocannabinoid system and the use of natural and synthetic cannabimimetic drugs have been assessed. CB1 and CB2 receptor signaling contributes to the control of Ca2+ homeostasis, trophic support, mitochondrial activity, and inflammatory conditions. Several studies and patents suggest that the endocannabinoid system has neuro-protective properties and might be a target in neurodegenerative diseases.

Vestibular evoked myogenic potentials (VEMPs) in central neurological disorders.

PubMed

Venhovens, J; Meulstee, J; Verhagen, W I M

2016-01-01

Several types of acoustic stimulation (i.e. tone bursts or clicks), bone-conducted vibration, forehead taps, and galvanic stimulation elicit myogenic potentials. These can be recorded in cervical and ocular muscles, the so called vestibular evoked myogenic potentials (VEMPs). The cervical VEMP (cVEMP) resembles the vestibulo-collic reflex and the responses can be recorded from the ipsilateral sternocleidomastoid muscle. The ocular VEMP resembles the vestibulo-ocular reflex and can be recorded from extra-ocular muscles by a surface electrode beneath the contralateral infraorbital margin. Initially, the literature concerning VEMPs was limited to peripheral vestibular disorders, however, the field of VEMP testing is rapidly expanding, with an increasing focus on central neurological disorders. The current literature concerning VEMP abnormalities in central neurological disorders is critically reviewed, especially regarding the methodological aspects in relation to quality as well as the clinical interpretation of the VEMP results. Suggestions for further research are proposed as well as some clinically useful indications. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Blood Lead Level in Children with Neurological Disorders.

PubMed

Parhoudeh, Marzieh; Inaloo, Soroor; Zahmatkeshan, Mozhgan; Seratishirazi, Zahra; Haghbin, Saeedeh

2018-01-01

We aimed to investigate the blood lead level (BLL) in children with neurologic disorders of unknown causes and compare with normal children. In this prospective case-control study, 68 patients aged 1 to 18 yr with neurologic disorders of unknown causes, were referred to pediatric neurology clinics and wards, Shiraz, Iran selected during a 12 months period from Sep 2013. They were compared with 1:1 ratio, age, and sex-matched healthy children. BLL was checked from all participants using 3 cc heparinized venous blood sample. Level of ≥5 mcg/dl was considered toxic dose. Totally, 136 children (68 cases and 68 controls) with mean ages of 5.20±4.12 and 4.18±3.86 yr, respectively, were enrolled. Mean BLL was higher in case group than in controls but the difference was not significant ( P =0.84), though they were less than toxic levels in both. In addition, the difference in mean BLLs was not significant in terms of living place, sex, and age. Totally, 17.7% of the study sample had BLL ≥5 mcg/dl. The frequency of BLL ≥5 mcg/dl was significantly higher in case group ( P =0.024) with an odds ratio 2.9 times higher (95% CI: 1.066-7.60). Strategies in public health must focus on practicing primary and secondary preventions of lead exposure in children.

Hippotherapy effects on trunk, pelvic, and hip motion during ambulation in children with neurological impairments.

PubMed

Encheff, Jenna L; Armstrong, Charles; Masterson, Michelle; Fox, Christine; Gribble, Phillip

2012-01-01

This study investigated the effects of a 10-week hippotherapy program on trunk, pelvis, and hip joint positioning during the stance phase of gait. Eleven children (6 boys and 5 girls; 7.9 ± 2.7 years) with neurological disorders and impaired ambulation participated. Joint range of motion data were collected via 3-dimensional computerized gait analysis before and after the program. Paired t tests were performed on kinematic data for each joint. Significant improvements (P ≤ .008) and large effect sizes (ESs) for sagittal plane hip positions at initial contact and toe-off were found. No differences in pelvic or trunk positioning were determined, although sagittal plane pelvic positioning displayed a trend toward improvement with large ESs. Several trunk variables displayed moderate ESs with a trend toward more upright positioning. Improvements in pelvic and hip joint positioning and more normalized vertical trunk position may indicate increased postural control during gait after 10 sessions of hippotherapy.

Clinical perspectives on medical marijuana (cannabis) for neurologic disorders

PubMed Central

Fife, Terry D.; Moawad, Heidi; Moschonas, Constantine; Hammond, Nancy

2015-01-01

Summary The American Academy of Neurology published an evidence-based systematic review of randomized controlled trials using marijuana (Cannabis sativa) or cannabinoids in neurologic disorders. Several cannabinoids showed effectiveness or probable effectiveness for spasticity, central pain, and painful spasms in multiple sclerosis. The review justifies insurance coverage for dronabinol and nabilone for these indications. Many insurance companies already cover these medications for other indications. It is unlikely that the review will alter coverage for herbal marijuana. Currently, no payers cover the costs of herbal medical marijuana because it is illegal under federal law and in most states. Cannabinoid preparations currently available by prescription may have a role in other neurologic conditions, but quality scientific evidence is lacking at this time. PMID:26336632

Parkinsonian gait ameliorated with a moving handrail, not with a banister.

PubMed

Rabin, Ely; Demin, Aleksandr; Pirrotta, Stefania; Chen, Jason; Patel, Hemal; Bhambri, Ankur; Noyola, Estella; Lackner, James R; DiZio, Paul; DiFrancisco-Donoghue, Joanne; Werner, William

2015-04-01

To determine whether haptic (touch and proprioception) cues from touching a moving handrail while walking can ameliorate the gait symptoms of Parkinson disease (PD), such as slowness and small stride length. Nonrandomized, controlled before-after trial. Physical therapy clinic. People with PD (n=16) and healthy age-matched control subjects (n=16) with no neurologic disorders volunteered. No participants withdrew. We compared gait using a moving handrail as a novel assistive aid (speed self-selected) versus a banister and unassisted walking. Participants with PD were tested on and off dopaminergic medication. Mean gait speed, stride length, stride duration, double-support duration, and medial-lateral excursion. With the moving handrail, participants with PD increased gait speed relative to unassisted gait by 16% (.166m/s, P=.009, d=.76; 95% confidence interval [CI], .054-.278m/s) and increased stride length by 10% (.053m, P=.022, d=.37; 95% CI, .009-.097m) without significantly changing stride or double-support duration. The banister reduced speed versus unassisted gait by 11% (-.097m/s, P=.040, d=.40; 95% CI, .002-.193m/s) and reduced stride length by 8% (.32m, P=.004, d=.26; 95% CI, .010-.054m), whereas it increased stride duration by 3% (.023s, P=.022, d=.21; 95% CI, .004-.041s) and double-support duration by 35% (.044s, P=.031, d=.58; 95% CI, .005-.083s). All medication × condition interactions were P>.05. Using haptic speed cues from the moving handrail, people with PD walked faster by spontaneously (ie, without specific instruction) increasing stride length without altering cadence; banisters slowed gait. Haptic cues from the moving handrail can be used by people with PD to engage biomechanical and neural mechanisms for interpreting tactile and proprioception changes related to gait speed to control gait better than static cues afforded by banisters. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Oscillatory Activities in Neurological Disorders of Elderly: Biomarkers to Target for Neuromodulation.

PubMed

Giovanni, Assenza; Capone, Fioravante; di Biase, Lazzaro; Ferreri, Florinda; Florio, Lucia; Guerra, Andrea; Marano, Massimo; Paolucci, Matteo; Ranieri, Federico; Salomone, Gaetano; Tombini, Mario; Thut, Gregor; Di Lazzaro, Vincenzo

2017-01-01

Non-invasive brain stimulation (NIBS) has been under investigation as adjunct treatment of various neurological disorders with variable success. One challenge is the limited knowledge on what would be effective neuronal targets for an intervention, combined with limited knowledge on the neuronal mechanisms of NIBS. Motivated on the one hand by recent evidence that oscillatory activities in neural systems play a role in orchestrating brain functions and dysfunctions, in particular those of neurological disorders specific of elderly patients, and on the other hand that NIBS techniques may be used to interact with these brain oscillations in a controlled way, we here explore the potential of modulating brain oscillations as an effective strategy for clinical NIBS interventions. We first review the evidence for abnormal oscillatory profiles to be associated with a range of neurological disorders of elderly (e.g., Parkinson's disease (PD), Alzheimer's disease (AD), stroke, epilepsy), and for these signals of abnormal network activity to normalize with treatment, and/or to be predictive of disease progression or recovery. We then ask the question to what extent existing NIBS protocols have been tailored to interact with these oscillations and possibly associated dysfunctions. Our review shows that, despite evidence for both reliable neurophysiological markers of specific oscillatory dis-functionalities in neurological disorders and NIBS protocols potentially able to interact with them, there are few applications of NIBS aiming to explore clinical outcomes of this interaction. Our review article aims to point out oscillatory markers of neurological, which are also suitable targets for modification by NIBS, in order to facilitate in future studies the matching of technical application to clinical targets.

Oscillatory Activities in Neurological Disorders of Elderly: Biomarkers to Target for Neuromodulation

PubMed Central

Assenza, Giovanni; Capone, Fioravante; di Biase, Lazzaro; Ferreri, Florinda; Florio, Lucia; Guerra, Andrea; Marano, Massimo; Paolucci, Matteo; Ranieri, Federico; Salomone, Gaetano; Tombini, Mario; Thut, Gregor; Di Lazzaro, Vincenzo

2017-01-01

Non-invasive brain stimulation (NIBS) has been under investigation as adjunct treatment of various neurological disorders with variable success. One challenge is the limited knowledge on what would be effective neuronal targets for an intervention, combined with limited knowledge on the neuronal mechanisms of NIBS. Motivated on the one hand by recent evidence that oscillatory activities in neural systems play a role in orchestrating brain functions and dysfunctions, in particular those of neurological disorders specific of elderly patients, and on the other hand that NIBS techniques may be used to interact with these brain oscillations in a controlled way, we here explore the potential of modulating brain oscillations as an effective strategy for clinical NIBS interventions. We first review the evidence for abnormal oscillatory profiles to be associated with a range of neurological disorders of elderly (e.g., Parkinson’s disease (PD), Alzheimer’s disease (AD), stroke, epilepsy), and for these signals of abnormal network activity to normalize with treatment, and/or to be predictive of disease progression or recovery. We then ask the question to what extent existing NIBS protocols have been tailored to interact with these oscillations and possibly associated dysfunctions. Our review shows that, despite evidence for both reliable neurophysiological markers of specific oscillatory dis-functionalities in neurological disorders and NIBS protocols potentially able to interact with them, there are few applications of NIBS aiming to explore clinical outcomes of this interaction. Our review article aims to point out oscillatory markers of neurological, which are also suitable targets for modification by NIBS, in order to facilitate in future studies the matching of technical application to clinical targets. PMID:28659788

[Psychogenetic neurological disorders in draft age personnel].

PubMed

Akhmetianov, L A; Ovchinnikov, A V

2012-07-01

The tendency of psychogenetic neurological disorders increases with predominance in young persons being students of high schools, students of military, technical and other lyceum was shown. The origin of diseases are psychotraumas (family, work), stress. Also genetic and hereditary factors take place that are indicative for individual rehabilitation organization. The basics of psychosomatic diseases pathogenesis are the disintegration mechanisms in brain structure activity,the disorders of integrative apparatus which provides the relationship between somatic, emotional and vegetative functions. The confirmation of brain work disintegration is achieved by modern computer diagnostic systems. As psychogenic diseases increase the need in methods of computer electroencephalography, evoked potentials, and rheoencephalography application is more actual.

Cannabis: old medicine with new promise for neurological disorders.

PubMed

Carter, Gregory T; Weydt, Patrick

2002-03-01

Marijuana is a complex substance containing over 60 different forms of cannabinoids, the active ingredients. Cannabinoids are now known to have the capacity for neuromodulation, via direct, receptor-based mechanisms at numerous levels within the nervous system. These have therapeutic properties that may be applicable to the treatment of neurological disorders; including anti-oxidative, neuroprotective, analgesic and anti-inflammatory actions; immunomodulation, modulation of glial cells and tumor growth regulation. This article reviews the emerging research on the physiological mechanisms of endogenous and exogenous cannabinoids in the context of neurological disease.

Manipulations of MeCP2 in glutamatergic neurons highlight their contributions to Rett and other neurological disorders

USDA-ARS?s Scientific Manuscript database

Many postnatal onset neurological disorders such as autism spectrum disorders (ASDs) and intellectual disability are thought to arise largely from disruption of excitatory/inhibitory homeostasis. Although mouse models of Rett syndrome (RTT), a postnatal neurological disorder caused by loss-of-functi...

Excitotoxicity in the pathogenesis of neurological and psychiatric disorders: Therapeutic implications.

PubMed

Olloquequi, Jordi; Cornejo-Córdova, Elizabeth; Verdaguer, Ester; Soriano, Francesc X; Binvignat, Octavio; Auladell, Carme; Camins, Antoni

2018-03-01

Neurological and psychiatric disorders are leading contributors to the global disease burden, having a serious impact on the quality of life of both patients and their relatives. Although the molecular events underlying these heterogeneous diseases remain poorly understood, some studies have raised the idea of common mechanisms involved. In excitotoxicity, there is an excessive activation of glutamate receptors by excitatory amino acids, leading to neuronal damage. Thus, the excessive release of glutamate can lead to a dysregulation of Ca 2+ homeostasis, triggering the production of free radicals and oxidative stress, mitochondrial dysfunction and eventually cell death. Although there is a consensus in considering excitotoxicity as a hallmark in most neurodegenerative diseases, increasing evidence points to the relevant role of this pathological mechanism in other illnesses affecting the central nervous system. Consequently, antagonists of glutamate receptors are used in current treatments or in clinical trials in both neurological and psychiatric disorders. However, drugs modulating other aspects of the excitotoxic mechanism could be more beneficial. This review discusses how excitotoxicity is involved in the pathogenesis of different neurological and psychiatric disorders and the promising strategies targeting the excitotoxic insult.

Role of non-coding RNAs in non-aging-related neurological disorders.

PubMed

Vieira, A S; Dogini, D B; Lopes-Cendes, I

2018-06-11

Protein coding sequences represent only 2% of the human genome. Recent advances have demonstrated that a significant portion of the genome is actively transcribed as non-coding RNA molecules. These non-coding RNAs are emerging as key players in the regulation of biological processes, and act as "fine-tuners" of gene expression. Neurological disorders are caused by a wide range of genetic mutations, epigenetic and environmental factors, and the exact pathophysiology of many of these conditions is still unknown. It is currently recognized that dysregulations in the expression of non-coding RNAs are present in many neurological disorders and may be relevant in the mechanisms leading to disease. In addition, circulating non-coding RNAs are emerging as potential biomarkers with great potential impact in clinical practice. In this review, we discuss mainly the role of microRNAs and long non-coding RNAs in several neurological disorders, such as epilepsy, Huntington disease, fragile X-associated ataxia, spinocerebellar ataxias, amyotrophic lateral sclerosis (ALS), and pain. In addition, we give information about the conditions where microRNAs have demonstrated to be potential biomarkers such as in epilepsy, pain, and ALS.

Secondary Abnormalities of Neurotransmitters in Infants with Neurological Disorders

ERIC Educational Resources Information Center

Garcia-Cazorla, A.; Serrano, M.; Perez-Duenas, B.; Gonzalez, V.; Ormazabal, A.; Pineda, M.; Fernandez-Alvarez, E.; Campistol, J. M. D.; Artuch, R. M. D.

2007-01-01

Neurotransmitters are essential in young children for differentiation and neuronal growth of the developing nervous system. We aimed to identify possible factors related to secondary neurotransmitter abnormalities in pediatric patients with neurological disorders. We analyzed cerebrospinal fluid (CSF) and biogenic amine metabolites in 56 infants…

Social correlates of mental, neurological, and substance use disorders in China and India: a review.

PubMed

Cheng, Hui G; Shidhaye, Rahul; Charlson, Fiona; Deng, Fei; Lyngdoh, Tanica; Chen, Shengnan; Nanda, Sharmishtha; Lacroix, Kimberly; Baxter, Amanda; Whiteford, Harvey

2016-09-01

Understanding the epidemiological profiles of mental, neurological, and substance use disorders provides opportunities for the identification of high-risk population subgroups and for the development of effective country-specific prevention and intervention strategies. Guided by the Conceptual Framework for Action on the Social Determinants of Health by WHO we reviewed the literature to examine the association between a range of social correlates (eg, sex, age, education, income, urbanicity, marital status, and regional differences) and mental, neurological, and substance use disorders in China and India, the most populous countries in the world. We looked for papers on mental, neurological, and substance use disorders with location identifiers and socioeconomic correlates published between 1990 and 2015 and our search found 65 relevant studies from China and 29 from India. Several association patterns between social correlates and mental, neurological, and substance use disorders were not consistent with those reported in high-income countries, including a high concentration of middle-aged men with alcohol use disorders in China and to a lesser extent in India, and a positive association between being married and depression among women in India. Consistent with previous global reports, low education and poverty were associated with higher occurrence of dementia in both China and India, although there is evidence of an interaction between education and income in the risk for dementia in China. Large variations across regions and ethnic groups were consistently documented in China. These unique correlation patterns for mental, neurological, and substance use disorders identified in China and India emphasise the importance of understanding the local social context when planning targeted strategies to reduce the burden of these disorders. High-quality, up-to-date information about the constantly changing pattern of societal factors correlated with mental, neurological

Functional neurological symptom disorder (conversion disorder): A role for microglial-based plasticity mechanisms?

PubMed

Stephenson, Chris P; Baguley, Ian J

2018-02-01

Functional Neurological Symptom Disorder (FND) is a relatively common neurological condition, accounting for approximately 3-6% of neurologist referrals. FND is considered a transient disorder of neuronal function, sometimes linked to physical trauma and psychological stress. Despite this, chronic disability is common, for example, around 40% of adults with motor FND have permanent disability. Building on current theoretical models, this paper proposes that microglial dysfunction could perpetuate functional changes within acute motor FND, thus providing a pathophysiological mechanism underlying the chronic stage of the motor FND phenotypes seen clinically. Core to our argument is microglia's dual role in modulating neuroimmunity and their control of synaptic plasticity, which places them at a pathophysiological nexus wherein coincident physical trauma and psychological stress could cause long-term change in neuronal networks without producing macroscopic structural abnormality. This model proposes a range of hypotheses that are testable with current technologies. Copyright © 2017. Published by Elsevier Ltd.

Managing patients with neurologic disorders who participate in sports activities.

PubMed

Crutchfield, Kevin E

2014-12-01

Patients with neurologic conditions have been discouraged from participating in organized sports because of theoretical detrimental effects of these activities to their underlying conditions. The purpose of this article is to review known risks associated with three specific clinical conditions most commonly encountered in a sports neurology clinic (epilepsy, migraines, and multiple sclerosis and to add to the neurologist's toolkit suggested interventions regarding management of athletes with these disorders. Increased participation in sports and athletics has positive benefits for patients with neurologic conditions and can be safely integrated into the lives of these patients with proper supervision from their treating neurologists. Patients with neurologic conditions can and should be encouraged to participate in organized sports as a method of maintaining their overall fitness, improving their overall level of function, and reaping the physical and psychological benefits that athletic competition has to offer.

Optics in gait analysis and anthropometry

NASA Astrophysics Data System (ADS)

Silva Moreno, Alejandra Alicia

2013-11-01

Since antiquity, human gait has been studied to understand human movement, the kind of gait, in some cases, can cause musculoskeletal disorders or other health problems; in addition, also from antiquity, anthropometry has been important for the design of human items such as workspaces, tools, garments, among others. Nowadays, thanks to the development of optics and electronics, more accurate studies of gait and anthropometry can be developed. This work will describe the most important parameters for gait analysis, anthropometry and the optical systems used.

N-acetylcysteine (NAC) in neurological disorders: mechanisms of action and therapeutic opportunities

PubMed Central

Bavarsad Shahripour, Reza; Harrigan, Mark R; Alexandrov, Andrei V

2014-01-01

Background There is an expanding field of research investigating the benefits of medicines with multiple mechanisms of action across neurological disorders. N-acetylcysteine (NAC), widely known as an antidote to acetaminophen overdose, is now emerging as treatment of vascular and nonvascular neurological disorders. NAC as a precursor to the antioxidant glutathione modulates glutamatergic, neurotrophic, and inflammatory pathways. Aim and discussion Most NAC studies up to date have been carried out in animal models of various neurological disorders with only a few studies completed in humans. In psychiatry, NAC has been tested in over 20 clinical trials as an adjunctive treatment; however, this topic is beyond the scope of this review. Herein, we discuss NAC molecular, intracellular, and systemic effects, focusing on its potential applications in neurodegenerative diseases including spinocerebellar ataxia, Parkinson's disease, tardive dyskinesia, myoclonus epilepsy of the Unverricht–Lundbor type as well as multiple sclerosis, amyotrophic lateral sclerosis, and Alzheimer's disease. Conclusion Finally, we review the potential applications of NAC to facilitate recovery after traumatic brain injury, cerebral ischemia, and in treatment of cerebrovascular vasospasm after subarachnoid hemorrhage. PMID:24683506

Zinc in gut-brain interaction in autism and neurological disorders.

PubMed

Vela, Guillermo; Stark, Peter; Socha, Michael; Sauer, Ann Katrin; Hagmeyer, Simone; Grabrucker, Andreas M

2015-01-01

A growing amount of research indicates that abnormalities in the gastrointestinal (GI) system during development might be a common factor in multiple neurological disorders and might be responsible for some of the shared comorbidities seen among these diseases. For example, many patients with Autism Spectrum Disorder (ASD) have symptoms associated with GI disorders. Maternal zinc status may be an important factor given the multifaceted effect of zinc on gut development and morphology in the offspring. Zinc status influences and is influenced by multiple factors and an interdependence of prenatal and early life stress, immune system abnormalities, impaired GI functions, and zinc deficiency can be hypothesized. In line with this, systemic inflammatory events and prenatal stress have been reported to increase the risk for ASD. Thus, here, we will review the current literature on the role of zinc in gut formation, a possible link between gut and brain development in ASD and other neurological disorders with shared comorbidities, and tie in possible effects on the immune system. Based on these data, we present a novel model outlining how alterations in the maternal zinc status might pathologically impact the offspring leading to impairments in brain functions later in life.

Zinc in Gut-Brain Interaction in Autism and Neurological Disorders

PubMed Central

Vela, Guillermo; Stark, Peter; Socha, Michael; Sauer, Ann Katrin; Hagmeyer, Simone; Grabrucker, Andreas M.

2015-01-01

A growing amount of research indicates that abnormalities in the gastrointestinal (GI) system during development might be a common factor in multiple neurological disorders and might be responsible for some of the shared comorbidities seen among these diseases. For example, many patients with Autism Spectrum Disorder (ASD) have symptoms associated with GI disorders. Maternal zinc status may be an important factor given the multifaceted effect of zinc on gut development and morphology in the offspring. Zinc status influences and is influenced by multiple factors and an interdependence of prenatal and early life stress, immune system abnormalities, impaired GI functions, and zinc deficiency can be hypothesized. In line with this, systemic inflammatory events and prenatal stress have been reported to increase the risk for ASD. Thus, here, we will review the current literature on the role of zinc in gut formation, a possible link between gut and brain development in ASD and other neurological disorders with shared comorbidities, and tie in possible effects on the immune system. Based on these data, we present a novel model outlining how alterations in the maternal zinc status might pathologically impact the offspring leading to impairments in brain functions later in life. PMID:25878905

The Spanish Burden of Disease 2010: Neurological, mental and substance use disorders.

PubMed

Lara, Elvira; Garin, Noé; Ferrari, Alize J; Tyrovolas, Stefanos; Olaya, Beatriz; Sànchez-Riera, Lidia; Whiteford, Harvey A; Haro, Josep Maria

2015-01-01

We used data from the Global Burden of Disease, Injuries, and Risk Factors Study 2010 to report on the burden of neuropsychiatric disorders in Spain. The summary measure of burden used in the study was the disability-adjusted life-year (DALY), which sums of the years of life lost due to premature mortality (YLLs) and the years lived with disability (YLDs). DALYs were adjusted for comorbidity and estimated with 95% uncertainty intervals. The burden of neuropsychiatric disorders accounted for 18.4% of total all-cause DALYs generated in Spain for 2010. Within this group, the top five leading causes of DALYs were: depressive disorders, Alzheimer's disease, migraine, substance-use disorders, and anxiety disorder, which accounted for 70.9% of all DALYs due to neuropsychiatric disorders. Neurological disorders represented 5.03% of total all cause YLLs, whereas mental and substance-use disorders accounted for 0.8%. Mental and substance-use disorders accounted for 22.4% of total YLDs, with depression being the most disabling disorder. Neurological disorders represented 8.3% of total YLDs. Neuropsychiatric disorders were one of the leading causes of disability in 2010. This finding contributes to our understanding of the burden of neuropsychiatric disorders in the Spanish population and highlights the importance of prioritising neuropsychiatric disorders in the Spanish public health system. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.

Clinical Uses of Melatonin in Neurological Diseases and Mental and Behavioural Disorders.

PubMed

Sanchez-Barcelo, Emilio J; Rueda, Noemi; Mediavilla, María D; Martinez-Cue, Carmen; Reiter, Russel J

2017-11-20

Melatonin is a molecule with numerous properties applicable to the treatment of neurological diseases. Among these properties are the following: potent scavenger of oxygen and nitrogen reactive species, anti-inflammatory features, immuno-enhancing nature, and modulation of circadian rhythmicity. Furthermore, low concentrations of melatonin are usually found in patients with neurological diseases and mental disorders. The positive results obtained in experimental models of diverse pathologies, including diseases of the nervous system (e.g., Alzheimer's disease, Parkinson's disease, multiple sclerosis, amyotrophic lateral sclerosis, Huntington's disease, epilepsy, headaches, etc.) as well as mental and behavioural disordes (e.g., autism spectrum disorders, attention-deficit hyperactivity disorders, etc.), have served as a basis for the design of clinical trials to study melatonin's possible usefulness in human pathology, although the satisfactory results obtained from the laboratory "bench" are not always applicable to the patient's "bedside". In this article, we review those papers describing the results of the administration of melatonin to humans for various therapeutic purposes in the field of neuropathology. Clinical trials with strong methodologies and appropriate doses of melatonin are necessary to support or reject the usefulness of melatonin in neurological diseases. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Effect of Chinese Herbal Medicine on Molecular Imaging of Neurological Disorders.

PubMed

Yao, Yao; Chen, Ting; Huang, Jing; Zhang, Hong; Tian, Mei

2017-01-01

Chinese herbal medicine has been used to treat a wide variety of neurological disorders including stroke, Alzheimer's disease, and Parkinson's disease. However, its mechanism behind the effectiveness remains unclear. Recently, molecular imaging technology has been applied for this purpose, since it can assess the cellular or molecular function in a living subject by using specific imaging probes and/or radioactive tracers, which enable efficient analysis and monitoring the therapeutic response repetitively. This chapter reviews the in vivo functional and metabolic changes after administration of Chinese herbal medicine in various neurological disorders and provides perspectives on the future evaluations of therapeutic response of Chinese herbal medicine. © 2017 Elsevier Inc. All rights reserved.

Rhythmic auditory cueing to improve walking in patients with neurological conditions other than Parkinson's disease--what is the evidence?

PubMed

Wittwer, Joanne E; Webster, Kate E; Hill, Keith

2013-01-01

To investigate whether synchronising over-ground walking to rhythmic auditory cues improves temporal and spatial gait measures in adults with neurological clinical conditions other than Parkinson's disease. A search was performed in June 2011 using the computerised databases AGELINE, AMED, AMI, CINAHL, Current Contents, EMBASE, MEDLINE, PsycINFO and PUBMED, and extended using hand-searching of relevant journals and article reference lists. Methodological quality was independently assessed by two reviewers. A best evidence synthesis was applied to rate levels of evidence. Fourteen studies, four of which were randomized controlled trials (RCTs), met the inclusion criteria. Patient groups included those with stroke (six studies); Huntington's disease and spinal cord injury (two studies each); traumatic brain injury, dementia, multiple sclerosis and normal pressure hydrocephalus (one study each). The best evidence synthesis found moderate evidence of improved velocity and stride length of people with stroke following gait training with rhythmic music. Insufficient evidence was found for other included neurological disorders due to low study numbers and poor methodological quality of some studies. Synchronising walking to rhythmic auditory cues can result in short-term improvement in gait measures of people with stroke. Further high quality studies are needed before recommendations for clinical practice can be made.

[Gait speed and the appearance of neurocognitive disorders in older adults: Results of a Peruvian cohort].

PubMed

Parodi, José F; Nieto-Gutierrez, Wendy; Tellez, Walter A; Ventocilla-Gonzales, Iris; Runzer-Colmenares, Fernando M; Taype-Rondan, Alvaro

The prevention and management of neurocognitive disorders (NCD) among older adults can be improved by early identification of risk factors such as walking speed. The objective of the study is to assess the association between gait speed and NCD onset in a population of Peruvian older adults. Cohort conducted in older adults who attended the geriatrics service of Naval Medical Center (Callao, Peru). During the baseline assessment, participants' gait speed was recorded. Subsequently, participants were followed-up annually for 5 years, with a mean of 21 months. NCD onset was defined as the occurrence of a score ≤24 points on the Mini Mental State Examination (screening test) during follow-up. The hazard ratios (HR) and their 95% confidence intervals (95% CI) were calculated using Cox regression. The study included 657 participants, with a mean age of 73.4±9.2 (SD) years, of whom 47.0% were male, 47.8% had a gait speed <0.8 m/s, and 20.1% developed NCD during the follow up. It was found that older adults who had gait speed <0.8 m/s at baseline were more likely to develop NCD than those who had a gait speed ≥0.8 m/s (adjusted HR=1.41, 95% CI=1.34-1.47). A longitudinal association was found between decreased gait speed and NCD onset, suggesting that gait speed could be useful to identify patients at risk of NCD onset. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

Compensation for occupational neurological and mental disorders.

PubMed

Kang, Dong-Mug; Kim, Inah

2014-06-01

Standards for the recognition of occupational diseases (ODs) in Korea were established in 1954 and have been amended several times. In 2013, there was a significant change in these standards. On the basis of scientific evidence and causality, the International Labour Organization list, European Commission schedule, and compensated cases in Korea were reviewed to revise the previous standards for the recognition of ODs in Korea. A disease-based approach using the International Classification of Diseases (10th version) was added on the previous standards, which were agent-specific approaches. The amended compensable occupational neurological disorders and occupational mental disorders (OMDs) in Korea are acute and chronic central nervous system (CNS) disorders, toxic neuropathy, peripheral neuropathy, manganese-related disorders, and post-traumatic stress disorder. Several agents including trichloroethylene (TCE), benzene, vinyl chloride, organotin, methyl bromide, and carbon monoxide (CO) were newly included as acute CNS disorders. TCE, lead, and mercury were newly included as chronic CNS disorders. Mercury, TCE, methyl n-butyl ketone, acrylamide, and arsenic were newly included in peripheral neuropathy. Post-traumatic stress disorders were newly included as the first OMD. This amendment makes the standard more comprehensive and practical. However, this amendment does not perfectly reflect the recent scientific progress and social concerns. Ongoing effort, research, and expert consensus are needed to improve the standard.

Prevalence and risk factors for neurological disorders in children aged 6 months to 2 years in northern India.

PubMed

Kumar, Rashmi; Bhave, Anupama; Bhargava, Roli; Agarwal, Girdhar G

2013-04-01

To study prevalence and risk factors for neurological disorders--epilepsy, global developmental delay, and motor, vision, and hearing defects--in children aged 6 months to 2 years in northern India. A two-stage community survey for neurological disorders was conducted in rural and urban areas of Lucknow. After initial screening with a new instrument, the Lucknow Neurodevelopment Screen, screen positives and a random proportion of screen negatives were validated using predefined criteria. Prevalence was calculated by weighted estimates. Demographic, socio-economic, and medical risk factors were compared between validated children who were positive and negative for neurological disorders by univariate and logistic regression analysis. Of 4801 children screened (mean age [SD] 15.32mo [5.96]; 2542 males, 2259 females), 196 were positive; 190 screen positives and 269 screen negatives were validated. Prevalence of neurological disorders was 27.92 per 1000 (weighted 95% confidence interval 12.24-43.60). Significant risk factors (p≤0.01) for neurological disorders were higher age in months (p=0.010), lower mean number of appliances in the household (p=0.001), consanguineous marriage of parents (p=0.010), family history of neurological disorder (p=0.001), and infants born exceptionally small (parental description; p=0.009). On logistic regression, the final model included age (p=0.0193), number of appliances (p=0.0161), delayed cry at birth (p=0.0270), postneonatal meningoencephalitis (p=0.0549), and consanguinity (p=0.0801). Perinatal factors, lower socio-economic status, and consanguinity emerged as predictors of neurological disorders. These factors are largely modifiable. © The Authors. Developmental Medicine & Child Neurology © 2013 Mac Keith Press.

Effects of unilateral real-time biofeedback on propulsive forces during gait.

PubMed

Schenck, Christopher; Kesar, Trisha M

2017-06-06

In individuals with post-stroke hemiparesis, reduced push-off force generation in the paretic leg negatively impacts walking function. Gait training interventions that increase paretic push-off can improve walking function in individuals with neurologic impairment. During normal locomotion, push-off forces are modulated with variations in gait speed and slope. However, it is unknown whether able-bodied individuals can selectively modulate push-off forces from one leg in response to biofeedback. Here, in a group of young, neurologically-unimpaired individuals, we determined the effects of a real-time visual and auditory biofeedback gait training paradigm aimed at unilaterally increasing anteriorly-directed ground reaction force (AGRF) in the targeted leg. Ground reaction force data during were collected from 7 able-bodied individuals as they walked at a self-selected pace on a dual-belt treadmill instrumented with force platforms. During 11-min of gait training, study participants were provided real-time AGRF biofeedback encouraging a 20-30% increase in peak AGRF generated by their right (targeted) leg compared to their baseline (pre-training) AGRF. AGRF data were collected before, during, and after the biofeedback training period, as well as during two retention tests performed without biofeedback and after standing breaks. Compared to AGRFs generated during the pre-training gait trials, participants demonstrated a significantly greater AGRF in the targeted leg during and immediately after training, indicating that biofeedback training was successful at inducing increased AGRF production in the targeted leg. Additionally, participants continued to demonstrate greater AGRF production in the targeted leg after two standing breaks, showing short-term recall of the gait pattern learned during the biofeedback training. No significant effects of training were observed on the AGRF in the non-targeted limb, showing the specificity of the effects of biofeedback toward the

Neurological Diseases, Disorders and Injuries in Canada: Highlights of a National Study.

PubMed

Bray, Garth M; Huggett, Deanna L

2016-01-01

The National Population Health Study of Neurological Conditions, a partnership between Neurological Health Charities Canada and the Government of Canada, was the largest study of neurological diseases, disorders, and injuries ever conducted in Canada. Undertaken between 2009 and 2013, the expansive program of research addressed the epidemiology, impacts, health services, and risk factors of 18 neurological conditions and estimated the health outcomes and costs of these conditions in Canada through 2031. This review summarizes highlights from the component projects of the study as presented in the synthesis report, Mapping Connections: An Understanding of Neurological Conditions in Canada. The key findings included new prevalence and incidence estimates, documentation of the diverse and often debilitating effects of neurological conditions, and identification of the utilization, economic costs, and current limitations of related health services. The study findings will support health charities, governments, and other stakeholders to reduce the impact of neurological conditions in Canada.

Gait variability and basal ganglia disorders: stride-to-stride variations of gait cycle timing in Parkinson's disease and Huntington's disease

NASA Technical Reports Server (NTRS)

Hausdorff, J. M.; Cudkowicz, M. E.; Firtion, R.; Wei, J. Y.; Goldberger, A. L.

1998-01-01

The basal ganglia are thought to play an important role in regulating motor programs involved in gait and in the fluidity and sequencing of movement. We postulated that the ability to maintain a steady gait, with low stride-to-stride variability of gait cycle timing and its subphases, would be diminished with both Parkinson's disease (PD) and Huntington's disease (HD). To test this hypothesis, we obtained quantitative measures of stride-to-stride variability of gait cycle timing in subjects with PD (n = 15), HD (n = 20), and disease-free controls (n = 16). All measures of gait variability were significantly increased in PD and HD. In subjects with PD and HD, gait variability measures were two and three times that observed in control subjects, respectively. The degree of gait variability correlated with disease severity. In contrast, gait speed was significantly lower in PD, but not in HD, and average gait cycle duration and the time spent in many subphases of the gait cycle were similar in control subjects, HD subjects, and PD subjects. These findings are consistent with a differential control of gait variability, speed, and average gait cycle timing that may have implications for understanding the role of the basal ganglia in locomotor control and for quantitatively assessing gait in clinical settings.

Medical marijuana: emerging applications for the management of neurologic disorders.

PubMed

Carter, Gregory T; Ugalde, Vivian

2004-11-01

Marijuana contains over 60 different types of cannabinoids, which are its medicinally active ingredients. Cannabinoids have the capacity for neuromodulation--through direct, receptor-based mechanisms--at many levels within the nervous system, providing therapeutic properties that may be applicable to the treatment of neurologic disorders. These include antioxidation, neuroprotection, analgesia, anti-inflammation, immunomodulation, modulation of glial cells, and tumor growth regulation. This article reviews the current and emerging research on the physiologic mechanisms of endogenous and exogenous cannabinoids and their applications in the management of neurologic disease.

Factors Related to Social Support in Neurological and Mental Disorders

PubMed Central

Kamenov, Kaloyan; Cabello, Maria; Caballero, Francisco Félix; Cieza, Alarcos; Sabariego, Carla; Raggi, Alberto; Anczewska, Marta; Pitkänen, Tuuli; Ayuso-Mateos, Jose Luis

2016-01-01

Despite the huge body of research on social support, literature has been primarily focused on its beneficial role for both physical and mental health. It is still unclear why people with mental and neurological disorders experience low levels of social support. The main objective of this study was to explore what are the strongest factors related to social support and how do they interact with each other in neuropsychiatric disorders. The study used cross-sectional data from 722 persons suffering from dementia, depression, epilepsy, migraine, multiple sclerosis, Parkinson's disease, schizophrenia, stroke, and substance use disorders. Multiple linear regressions showed that disability was the strongest factor for social support. Extraversion and agreeableness were significant personality variables, but when the interaction terms between personality traits and disability were included, disability remained the only significant variable. Moreover, level of disability mediated the relationship between personality (extraversion and agreeableness) and level of social support. Moderation analysis revealed that people that had mental disorders experienced lower levels of support when being highly disabled compared to people with neurological disorders. Unlike previous literature, focused on increasing social support as the origin of improving disability, this study suggested that interventions improving day-to-day functioning or maladaptive personality styles might also have an effect on the way people perceive social support. Future longitudinal research, however, is warranted to explore causality. PMID:26900847

Psychologic theories in functional neurologic disorders.

PubMed

Carson, A; Ludwig, L; Welch, K

2016-01-01

In this chapter we review key psychologic theories that have been mooted as possible explanations for the etiology of functional neurologic symptoms, conversion disorder, and hysteria. We cover Freudian psychoanalysis and later object relations and attachment theories, social theories, illness behavior, classic and operant conditioning, social learning theory, self-regulation theory, cognitive-behavioral theories, and mindfulness. Dissociation and modern cognitive neuroscience theories are covered in other chapters in this series and, although of central importance, are omitted from this chapter. Our aim is an overview with the emphasis on breadth of coverage rather than depth. © 2016 Elsevier B.V. All rights reserved.

Atropa belladonna neurotoxicity: Implications to neurological disorders.

PubMed

Kwakye, Gunnar F; Jiménez, Jennifer; Jiménez, Jessica A; Aschner, Michael

2018-06-01

Atropa belladonna, commonly known as belladonna or deadly nightshade, ranks among one of the most poisonous plants in Europe and other parts of the world. The plant contains tropane alkaloids including atropine, scopolamine, and hyoscyamine, which are used as anticholinergics in Food and Drug Administration (FDA) approved drugs and homeopathic remedies. These alkaloids can be very toxic at high dose. The FDA has recently reported that Hyland's baby teething tablets contain inconsistent amounts of Atropa belladonna that may have adverse effects on the nervous system and cause death in children, thus recalled the product in 2017. A greater understanding of the neurotoxicity of Atropa belladonna and its modification of genetic polymorphisms in the nervous system is critical in order to develop better treatment strategies, therapies, regulations, education of at-risk populations, and a more cohesive paradigm for future research. This review offers an integrated view of the homeopathy and neurotoxicity of Atropa belladonna in children, adults, and animal models as well as its implications to neurological disorders. Particular attention is dedicated to the pharmaco/toxicodynamics, pharmaco/toxicokinetics, pathophysiology, epidemiological cases, and animal studies associated with the effects of Atropa belladonna on the nervous system. Additionally, we discuss the influence of active tropane alkaloids in Atropa belladonna and other similar plants on FDA-approved therapeutic drugs for treatment of neurological disorders. Copyright © 2018. Published by Elsevier Ltd.

Neurological Soft Signs in Indian Children with Specific Developmental Disorders of Scholastic Skills

ERIC Educational Resources Information Center

Sadhu, Raja; Mehta, Manju; Kalra, Veena; Sagar, Rajesh; Mongia, Monica

2008-01-01

Aim: To compare the occurrence of neurological soft signs (NSS) in children with specific developmental disorders of scholastic skills (SDDSS) and normal children. Methods: 36 cases of SDDSS were compared with 30 control children regarding sociodemographic and clinical variables and neurological soft signs. Results: Children with SDDSS had…

Gait, posture and cognition in Parkinson's disease

PubMed Central

Barbosa, Alessandra Ferreira; Chen, Janini; Freitag, Fernanda; Valente, Debora; Souza, Carolina de Oliveira; Voos, Mariana Callil; Chien, Hsin Fen

2016-01-01

Gait disorders and postural instability are the leading causes of falls and disability in Parkinson's disease (PD). Cognition plays an important role in postural control and may interfere with gait and posture assessment and treatment. It is important to recognize gait, posture and balance dysfunctions by choosing proper assessment tools for PD. Patients at higher risk of falling must be referred for rehabilitation as early as possible, because antiparkinsonian drugs and surgery do not improve gait and posture in PD. PMID:29213470

Prevalence of mental, neurological, and substance use disorders in China and India: a systematic analysis.

PubMed

Baxter, Amanda J; Charlson, Fiona J; Cheng, Hui G; Shidhaye, Rahul; Ferrari, Alize J; Whiteford, Harvey A

2016-09-01

Population-representative prevalence data for mental, neurological, and substance use disorders are essential for evidence-based decision making. As a background to the China-India Mental Health Alliance Series, we aim to examine the availability of data and report prevalence for the most common mental, neurological, and substance use disorders in China and India from the Global Burden of Disease study 2013 (GBD 2013). In this systematic analysis, data sources were identified from GBD 2013 for the prevalence of mental, neurological, and substance use disorders in China and India published up to Dec 31, 2013. We calculated the proportion of the population represented by the data with the adjusted population coverage (APC) method adjusting for age, sex, and population size. We developed prevalence models with DisMod-MR 2.0, a Bayesian meta-regression instrument used to pool population-representative epidemiological data as part of GBD 2013. We report estimates and 95% uncertainly intervals (95% UI) for 15 mental, neurological, and substance use disorders for China and India in 1990 and 2013, and benchmark these against those for other BRICS countries (Brazil, Russia, and South Africa) in 2013. Few population-representative data were found for the disorders, with an average coverage of 15% of the population of the Chinese mainland and 1% of the population of India. For men in both China and India, major depressive disorder, anxiety disorders, and alcohol dependence were the most common mental, neurological, and substance use disorders. Prevalence of major depressive disorder was 2·2% (95% UI 1·5-2·8) in Chinese men and 3·5% (2·4-4·6) in Indian men; prevalence of anxiety disorders was 2·0% (1·1-3·2) and 1·9% (1·2-2·3), respectively. For women, anxiety disorders, major depressive disorder, and dysthymia were the most common. Prevalence of major depressive disorder was 3·3% (2·3-4·1) in Chinese women and 4·7% (95% UI 3·3-6·2) in Indian women; prevalence

Disruptive technology disorder: A past, present, and future neurologic syndrome.

PubMed

Weaver, Donald F

2017-07-25

Based upon an analysis of 6 major historical technological advances over the last 150 years, a new syndrome, disruptive technology disorder (DTD), is introduced. DTD describes the human health ailments that accompany the implementation of disruptive technologies. Elevator sickness, railway spine, and bicycle face are representative examples. Though the underlying causative disruptive technologies may differ, many neurologic symptoms (headache, dizziness, weakness) are common to multiple DTDs. Born of technology-driven societal change, DTDs manifest as a complex interplay between biological and psychological symptoms. © 2017 American Academy of Neurology.

The effects of aquatic therapy on mobility of individuals with neurological diseases: a systematic review.

PubMed

Marinho-Buzelli, Andresa R; Bonnyman, Alison M; Verrier, Mary C

2015-08-01

To summarize evidence on the effects of aquatic therapy on mobility in individuals with neurological diseases. MEDLINE, EMBASE, PsycInfo, CENTRAL, CINAHL, SPORTDiscus, PEDro, PsycBITE and OT Seeker were searched from inception to 15 September 2014. Hand-searching of reference lists was performed in the selected studies. The search included randomized controlled trials and quasi-experimental studies that investigated the use of aquatic therapy and its effect on mobility of adults with neurological diseases. One reviewer screened titles and abstracts of retrieved studies from the search strategy. Two reviewers independently examined the full texts and conducted the study selection, data extraction and quality assessment. A narrative synthesis of data was applied to summarize information from included studies. The Downs and Black Scale was used to assess methodological quality. A total of 116 articles were obtained for full text eligibility. Twenty studies met the specified inclusion criteria: four Randomized Controlled Trials (RCTs), four non-randomized studies and 12 before-and-after tests. Two RCTs (30 patients with stroke in the aquatic therapy groups), three non-randomized studies and three before-and-after studies showed "fair" evidence that aquatic therapy increases dynamic balance in participants with some neurological disorders. One RCT (seven patients with stroke in the aquatic therapy group) and two before-and-after tests (20 patients with multiple sclerosis) demonstrated "fair" evidence on improvement of gait speed after aquatic therapy. Our synthesis showed "fair" evidence supporting the use of aquatic therapy to improve dynamic balance and gait speed in adults with certain neurological conditions. © The Author(s) 2014.

The social brain in psychiatric and neurological disorders

PubMed Central

Kennedy, Daniel P.; Adolphs, Ralph

2013-01-01

Psychiatric and neurological disorders have historically provided key insights into the structure-function relationships that subserve human social cognition and behavior, informing the concept of the ‘social brain’. In this review, we take stock of the current status of this concept, retaining a focus on disorders that impact social behavior. We discuss how the social brain, social cognition, and social behavior are interdependent, and emphasize the important role of development and compensation. We suggest that the social brain, and its dysfunction and recovery, must be understood not in terms of specific structures, but rather in terms of their interaction in large-scale networks. PMID:23047070

Stiff person case misdiagnosed as conversion disorder: A case report.

PubMed

Razmeh, Saeed; Habibi, Amir Hasan; Sina, Farzad; Alizadeh, Elham; Eslami, Monireh

2017-01-01

Stiff person syndrome (SPS) is a rare neurological disease resulting in stiffness and spasm of muscles. It initially affects the axial muscles and then spread to limb muscles. Emotional stress exacerbated the symptoms and signs of the disease. The pathophysiology of the disease is caused by the decreased level of the glutamic acid decarboxylase (GAD) activity due to an autoantibody against GAD that decreases the level of gamma-aminobutyric acid (GABA). In this paper, we present a case of atypical presentation of SPS with lower limb stiffness misdiagnosed as conversion disorder. We report a patient with atypical presentation of SPS with lower limb stiffness and gait disorder misdiagnosed as conversion disorder for a year. Her antithyroid peroxidase antibody (anti-TPO Ab) level was 75 IU (normal value: 0-34 IU). Intravenous immunoglobulin (IVIG) was administered (2gr/kg, 5 days) for the patient that showed significant improvement in the follow-up visit. It is essential that in any patient with bizarre gait disorder and suspicious to conversion disorder due to the reversibility of symptoms, SPS and other movement disorder should be considered.

Balance control during gait initiation: State-of-the-art and research perspectives.

PubMed

Yiou, Eric; Caderby, Teddy; Delafontaine, Arnaud; Fourcade, Paul; Honeine, Jean-Louis

2017-11-18

It is well known that balance control is affected by aging, neurological and orthopedic conditions. Poor balance control during gait and postural maintenance are associated with disability, falls and increased mortality. Gait initiation - the transient period between the quiet standing posture and steady state walking - is a functional task that is classically used in the literature to investigate how the central nervous system (CNS) controls balance during a whole-body movement involving change in the base of support dimensions and center of mass progression. Understanding how the CNS in able-bodied subjects exerts this control during such a challenging task is a pre-requisite to identifying motor disorders in populations with specific impairments of the postural system. It may also provide clinicians with objective measures to assess the efficiency of rehabilitation programs and better target interventions according to individual impairments. The present review thus proposes a state-of-the-art analysis on: (1) the balance control mechanisms in play during gait initiation in able bodied subjects and in the case of some frail populations; and (2) the biomechanical parameters used in the literature to quantify dynamic stability during gait initiation. Balance control mechanisms reviewed in this article included anticipatory postural adjustments, stance leg stiffness, foot placement, lateral ankle strategy, swing foot strike pattern and vertical center of mass braking. Based on this review, the following viewpoints were put forward: (1) dynamic stability during gait initiation may share a principle of homeostatic regulation similar to most physiological variables, where separate mechanisms need to be coordinated to ensure stabilization of vital variables, and consequently; and (2) rehabilitation interventions which focus on separate or isolated components of posture, balance, or gait may limit the effectiveness of current clinical practices.

Balance control during gait initiation: State-of-the-art and research perspectives

PubMed Central

Yiou, Eric; Caderby, Teddy; Delafontaine, Arnaud; Fourcade, Paul; Honeine, Jean-Louis

2017-01-01

It is well known that balance control is affected by aging, neurological and orthopedic conditions. Poor balance control during gait and postural maintenance are associated with disability, falls and increased mortality. Gait initiation - the transient period between the quiet standing posture and steady state walking - is a functional task that is classically used in the literature to investigate how the central nervous system (CNS) controls balance during a whole-body movement involving change in the base of support dimensions and center of mass progression. Understanding how the CNS in able-bodied subjects exerts this control during such a challenging task is a pre-requisite to identifying motor disorders in populations with specific impairments of the postural system. It may also provide clinicians with objective measures to assess the efficiency of rehabilitation programs and better target interventions according to individual impairments. The present review thus proposes a state-of-the-art analysis on: (1) the balance control mechanisms in play during gait initiation in able bodied subjects and in the case of some frail populations; and (2) the biomechanical parameters used in the literature to quantify dynamic stability during gait initiation. Balance control mechanisms reviewed in this article included anticipatory postural adjustments, stance leg stiffness, foot placement, lateral ankle strategy, swing foot strike pattern and vertical center of mass braking. Based on this review, the following viewpoints were put forward: (1) dynamic stability during gait initiation may share a principle of homeostatic regulation similar to most physiological variables, where separate mechanisms need to be coordinated to ensure stabilization of vital variables, and consequently; and (2) rehabilitation interventions which focus on separate or isolated components of posture, balance, or gait may limit the effectiveness of current clinical practices. PMID:29184756

Hyperhomocysteinemia and neurologic disorders: a review.

PubMed

Ansari, Ramin; Mahta, Ali; Mallack, Eric; Luo, Jin Jun

2014-10-01

Homocysteine (Hcy) is a sulfur-containing amino acid that is generated during methionine metabolism. It has a physiologic role in DNA metabolism via methylation, a process governed by the presentation of folate, and vitamins B6 and B12. Physiologic Hcy levels are determined primarily by dietary intake and vitamin status. Elevated plasma levels of Hcy (eHcy) can be caused by deficiency of either vitamin B12 or folate, or a combination thereof. Certain genetic factors also cause eHcy, such as C667T substitution of the gene encoding methylenetetrahydrofolate reductase. eHcy has been observed in several medical conditions, such as cardiovascular disorders, atherosclerosis, myocardial infarction, stroke, minimal cognitive impairment, dementia, Parkinson's disease, multiple sclerosis, epilepsy, and eclampsia. There is evidence from laboratory and clinical studies that Hcy, and especially eHcy, exerts direct toxic effects on both the vascular and nervous systems. This article provides a review of the current literature on the possible roles of eHcy relevant to various neurologic disorders.

Gait Analysis Methods for Rodent Models of Arthritic Disorders: Reviews and Recommendations

PubMed Central

Lakes, Emily H.; Allen, Kyle D.

2016-01-01

Gait analysis is a useful tool to understand behavioral changes in preclinical arthritis models. While observational scoring and spatiotemporal gait parameters are the most widely performed gait analyses in rodents, commercially available systems can now provide quantitative assessments of spatiotemporal patterns. However, inconsistencies remain between testing platforms, and laboratories often select different gait pattern descriptors to report in the literature. Rodent gait can also be described through kinetic and kinematic analyses, but systems to analyze rodent kinetics and kinematics are typically custom made and often require sensitive, custom equipment. While the use of rodent gait analysis rapidly expands, it is important to remember that, while rodent gait analysis is a relatively modern behavioral assay, the study of quadrupedal gait is not new. Nearly all gait parameters are correlated, and a collection of gait parameters is needed to understand a compensatory gait pattern used by the animal. As such, a change in a single gait parameter is unlikely to tell the full biomechanical story; and to effectively use gait analysis, one must consider how multiple different parameters contribute to an altered gait pattern. The goal of this article is to review rodent gait analysis techniques and provide recommendations on how to use these technologies in rodent arthritis models, including discussions on the strengths and limitations of observational scoring, spatiotemporal, kinetic, and kinematic measures. Recognizing rodent gait analysis is an evolving tool, we also provide technical recommendations we hope will improve the utility of these analyses in the future. PMID:26995111

Cochlear implantation in children with congenital cytomegalovirus infection accompanied by psycho-neurological disorders.

PubMed

Yamazaki, Hiroshi; Yamamoto, Rinko; Moroto, Saburo; Yamazaki, Tomoko; Fujiwara, Keizo; Nakai, Masako; Ito, Juichi; Naito, Yasushi

2012-04-01

Cochlear implantation was effective for deaf children with congenital cytomegalovirus (CMV) infection, but their cochlear implant (CI) outcomes were often impaired, depending on the types of CMV-associated psycho-neurological disorders. Evaluation of cognitive development and autistic tendency of implantees might be useful to predict their CI outcomes. To reveal the influence of CMV-associated psycho-neurological disorders on CI outcomes. This was a retrospective evaluation of 11 implantees with congenital CMV infection (CMV-CIs) and 14 implantees with autosomal recessive hearing loss (genetic-CIs). Nine of 11 CMV-CIs suffered from psycho-neurological disorders; one from attention deficit hyperactivity disorder, two from pervasive developmental disorder, and six from mental retardation. Aided hearing thresholds with CIs in the two groups did not differ, but two autistic and two mentally retarded CMV-CIs showed significantly low scores in speech discrimination tests. Language-Social (L-S) developmental quotients (DQs) evaluated by the Kyoto Scale of Psychological development were improved after the implantation in both groups, but the postoperative increase of L-S DQs was significantly smaller in the CMV-CIs than that of genetic-CIs. Interestingly, the postoperative L-S and Cognitive-Adaptive (C-A) DQs showed statistically significant correlation in all cases except for two autistic CMV-CIs whose L-S DQs were much lower than those expected from their C-A DQs.

78 FR 72683 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-03

... Disorders and Stroke, Special Emphasis Panel, Stroke Trials Network-NDMC. Date: December 18, 2013. Time: 9... Program Nos. 93.853, Clinical Research Related to Neurological Disorders; 93.854, Biological Basis...

Effect of natural products on diabetes associated neurological disorders.

PubMed

Patel, Sita Sharan; Udayabanu, Malairaman

2017-04-01

Diabetes mellitus, a metabolic disorder, is associated with neurological complications such as depression, anxiety, hypolocomotion, cognitive dysfunction, phobias, anorexia, stroke, pain, etc. Traditional system of medicine is long known for its efficient management of diabetes. The current review discusses the scope of some common medicinal herbs as well as secondary metabolites with a special focus on diabetes-mediated central nervous system complications. Literatures suggest that natural products reduce diabetes-mediated neurological complications partly by reducing oxidative stress and/or inflammation or apoptosis in certain brain regions. Natural products are known to modulate diabetes-mediated alterations in the level of acetylcholinesterase, choline acetyltransferase, monoamine oxidase, serotonin receptors, muscarinic receptors, insulin receptor, nerve growth factor, brain-derived neurotrophic factor, and neuropeptide in brain. Further, there are several natural products reported to manage diabetic complications with unknown mechanism. In conclusion, medicinal plants or their secondary metabolites have a wide scope and possess therapeutic potential to effectively manage neurological complications associated with chronic diabetes.

[Trans fatty acids in the nutrition of children with neurological disorders].

PubMed

Cortés, E; Aguilar, M J; Rizo, M M; Hidalgo, M J

2013-01-01

Trans-fatty acids are present in various foods, being the only source of the same in humans. Its presence in high concentrations is a risk factor for health, being involved in a series of events, cardiovascular, inflammatory, etc. Therefore, steps have been taken for its decrease in the diet. The aim is to determine serum and phospholipids of membranes in healthy children and neurological alterations. It has analyzed the fatty acids trans in 34 healthy children and 374 with various neurological pathologies. Serum and blood cells, making the lipid extraction, samples have been separation of the phospholipids of cells membranes, methylation of fatty acids, separation by gas chromatography and quantification using mass detector. The data have been processed statistically. The distribution of trans fatty acids and their sum is not normally distributed, so its nonparemetric tests were used. The values are higher than in serum phospholipids and membrane with a weak but significant correlation. The tC18: 1 is in a double proportion in children with neurological disorders in healthy children, both in serum and membrane phospholipids, with significant differences. The highest proportion of trans-fatty acids in the group of children with neurological disorders is caused no doubt by an increase in intake, due to less adequate food. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

Lack of maintenance of gait pattern as measured by instrumental methods suggests psychogenic gait.

PubMed

Merello, Marcelo; Ballesteros, Diego; Rossi, Malco; Arena, Julieta; Crespo, Marcos; Cervio, Andres; Cuello Oderiz, Carolina; Rivero, Alberto; Cerquetti, Daniel; Risk, Marcelo; Balej, Jorge

2012-01-01

Fluctuation is a common feature of all psychogenic gait disorder (PGD) patterns. Whether this fluctuation involves only the degree of impairment or whether it affects the gait pattern itself remains an interesting question. We hypothesize that, on repeated measurements, both normal and abnormal gait may present quantitative differences while maintaining their basic underlying pattern; conversely, in psychogenic gait, the basic pattern appears not to be preserved. Using an optoelectronic system, data acquired from 19 normal subjects and 66 patients were applied to train a neural network (NN) and subsequently classify gait patterns into four different groups (normal, ataxic, spastic-paraparetic and parkinsonian). Five patients who fulfilled clinical criteria for psychogenic gait and six controls were then prospectively evaluated on two separate occasions, three months apart. Normal controls and ataxic, parkinsonian or spastic patients were correctly identified by the NN, and categorized within the corresponding groups at baseline as well as at a three-month follow-up evaluation. NN analysis showed that after three months, no PGD patient preserved the gait pattern detected at baseline, even though this finding was not clinically apparent. Modification of gait pattern detected by repeated kinematic measurement and NN analysis could suggest the presence of PGD, particularly in difficult-to-diagnose cases.

Individual Differences in Beat Perception Affect Gait Responses to Low- and High-Groove Music

PubMed Central

Leow, Li-Ann; Parrott, Taylor; Grahn, Jessica A.

2014-01-01

Slowed gait in patients with Parkinson’s disease (PD) can be improved when patients synchronize footsteps to isochronous metronome cues, but limited retention of such improvements suggest that permanent cueing regimes are needed for long-term improvements. If so, music might make permanent cueing regimes more pleasant, improving adherence; however, music cueing requires patients to synchronize movements to the “beat,” which might be difficult for patients with PD who tend to show weak beat perception. One solution may be to use high-groove music, which has high beat salience that may facilitate synchronization, and affective properties, which may improve motivation to move. As a first step to understanding how beat perception affects gait in complex neurological disorders, we examined how beat perception ability affected gait in neurotypical adults. Synchronization performance and gait parameters were assessed as healthy young adults with strong or weak beat perception synchronized to low-groove music, high-groove music, and metronome cues. High-groove music was predicted to elicit better synchronization than low-groove music, due to its higher beat salience. Two musical tempi, or rates, were used: (1) preferred tempo: beat rate matched to preferred step rate and (2) faster tempo: beat rate adjusted to 22.5% faster than preferred step rate. For both strong and weak beat-perceivers, synchronization performance was best with metronome cues, followed by high-groove music, and worst with low-groove music. In addition, high-groove music elicited longer and faster steps than low-groove music, both at preferred tempo and at faster tempo. Low-groove music was particularly detrimental to gait in weak beat-perceivers, who showed slower and shorter steps compared to uncued walking. The findings show that individual differences in beat perception affect gait when synchronizing footsteps to music, and have implications for using music in gait rehabilitation. PMID:25374521

Dextromethorphan: An update on its utility for neurological and neuropsychiatric disorders.

PubMed

Nguyen, Linda; Thomas, Kelan L; Lucke-Wold, Brandon P; Cavendish, John Z; Crowe, Molly S; Matsumoto, Rae R

2016-03-01

Dextromethorphan (DM) is a commonly used antitussive and is currently the only FDA-approved pharmaceutical treatment for pseudobulbar affect. Its safety profile and diverse pharmacologic actions in the central nervous system have stimulated new interest for repurposing it. Numerous preclinical investigations and many open-label or blinded clinical studies have demonstrated its beneficial effects across a variety of neurological and psychiatric disorders. However, the optimal dose and safety of chronic dosing are not fully known. This review summarizes the preclinical and clinical effects of DM and its putative mechanisms of action, focusing on depression, stroke, traumatic brain injury, seizure, pain, methotrexate neurotoxicity, Parkinson's disease and autism. Moreover, we offer suggestions for future research with DM to advance the treatment for these and other neurological and psychiatric disorders. Copyright © 2016 Elsevier Inc. All rights reserved.

History of cannabis use is associated with altered gait.

PubMed

Pearson-Dennett, Verity; Todd, Gabrielle; Wilcox, Robert A; Vogel, Adam P; White, Jason M; Thewlis, Dominic

2017-09-01

Despite evidence that cannabinoid receptors are located in movement-related brain regions (e.g., basal ganglia, cerebral cortex, and cerebellum), and that chronic cannabis use is associated with structural and functional brain changes, little is known about the long-term effect of cannabis use on human movement. The aim of the current study was to investigate balance and walking gait in adults with a history of cannabis use. We hypothesised that cannabis use is associated with subtle changes in gait and balance that are insufficient in magnitude for detection in a clinical setting. Cannabis users (n=22, 24±6years) and non-drug using controls (n=22, 25±8years) completed screening tests, a gait and balance test (with a motion capture system and in-built force platforms), and a clinical neurological examination of movement. Compared to controls, cannabis users exhibited significantly greater peak angular velocity of the knee (396±30 versus 426±50°/second, P=0.039), greater peak elbow flexion (53±12 versus 57±7°, P=0.038) and elbow range of motion (33±13 versus 36±10°, P=0.044), and reduced shoulder flexion (41±19 versus 26±16°, P=0.007) during walking gait. However, balance and neurological parameters did not significantly differ between the groups. The results suggest that history of cannabis use is associated with long-lasting changes in open-chain elements of walking gait, but the magnitude of change is not clinically detectable. Further research is required to investigate if the subtle gait changes observed in this population become more apparent with aging and increased cannabis use. Copyright © 2017 Elsevier B.V. All rights reserved.

Objective assessment of gait in xylazine-induced ataxic horses.

PubMed

Nout-Lomas, Y S; Page, K M; Kang, H G; Aanstoos, M E; Greene, H M

2017-05-01

There is poor agreement between observers of equine neurological gait abnormalities using the modified Mayhew grading scale. To stimulate a dose-dependent ataxia in horses through xylazine administration and identify quantifiable relevant gait parameters. Balanced, randomised, 2-way crossover design. Eight horses were assessed before and after administration of xylazine (low dose and high dose). Gait analyses performed before and after xylazine administration included: 1) kinematic data collected on an equine high-speed treadmill (flat and 10% decline) and from accelerometers placed on head and sacrum; and 2) kinetic data collected on a force plate. All horses developed dose-dependent ataxia. Horses developed a dose-dependent increased stride time, stride length, and time of contact (P<0.0001), and a decreased stride frequency (P<0.0002) after administration of xylazine. Although pelvic acceleration increased in the mediolateral direction (P<0.05) in horses walked on the treadmill, this movement decreased when walking over ground after administration of xylazine (P<0.05). Furthermore, centre of pressure and path length indices changed significantly in horses following administration of xylazine (P<0.05). This study examined one breed of horse (Arabian), all of similar height and weight. Accelerometers were attached to skin, not bone; no correction was made for artefacts from skin displacement. The sedative drug effect is of certain duration, limiting the data collection period. Administration of xylazine induced a dose-dependent ataxia in horses and resulted in significant changes of gait parameters, pelvic accelerations, and stabilographic variables, some of which changed in a dose-dependent fashion. Some of the altered gait parameters in this model were probably a result of overall slowing down of the stride cycle secondary to the sedative effect. Continued efforts to discover and evaluate quantifiable gait parameters that are susceptible to change following

Body integrity identity disorder: from a psychological to a neurological syndrome.

PubMed

Sedda, Anna

2011-12-01

Body Integrity Identity Disorder (BIID) is a condition in which individuals experience an intense desire for amputation of an healthy limb. Recently, McGeoch and colleagues provided the first direct evidence that this syndrome may be neurological rather than psychological in its origin. However, before including BIID in body ownership disorders, several concerns should be clarified, exploring other components of body representation and not only somatosensory perception.

78 FR 29144 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-17

... clearly unwarranted invasion of personal privacy. Name of Committee: Neurological Sciences Training Initial Review Group Neurological Sciences and Disorders B. Date: June 20-21, 2013. Time: 8:00 a.m. to 6..., Scientific Review Branch, Division of Extramural Research, NINDS, NIH, NSC, 6001 Executive Blvd., Suite 3208...

The Global Burden of Mental, Neurological and Substance Use Disorders: An Analysis from the Global Burden of Disease Study 2010

PubMed Central

Whiteford, Harvey A.; Ferrari, Alize J.; Degenhardt, Louisa; Feigin, Valery; Vos, Theo

2015-01-01

Background The Global Burden of Disease Study 2010 (GBD 2010), estimated that a substantial proportion of the world’s disease burden came from mental, neurological and substance use disorders. In this paper, we used GBD 2010 data to investigate time, year, region and age specific trends in burden due to mental, neurological and substance use disorders. Method For each disorder, prevalence data were assembled from systematic literature reviews. DisMod-MR, a Bayesian meta-regression tool, was used to model prevalence by country, region, age, sex and year. Prevalence data were combined with disability weights derived from survey data to estimate years lived with disability (YLDs). Years lost to premature mortality (YLLs) were estimated by multiplying deaths occurring as a result of a given disorder by the reference standard life expectancy at the age death occurred. Disability-adjusted life years (DALYs) were computed as the sum of YLDs and YLLs. Results In 2010, mental, neurological and substance use disorders accounted for 10.4% of global DALYs, 2.3% of global YLLs and, 28.5% of global YLDs, making them the leading cause of YLDs. Mental disorders accounted for the largest proportion of DALYs (56.7%), followed by neurological disorders (28.6%) and substance use disorders (14.7%). DALYs peaked in early adulthood for mental and substance use disorders but were more consistent across age for neurological disorders. Females accounted for more DALYs in all mental and neurological disorders, except for mental disorders occurring in childhood, schizophrenia, substance use disorders, Parkinson’s disease and epilepsy where males accounted for more DALYs. Overall DALYs were highest in Eastern Europe/Central Asia and lowest in East Asia/the Pacific. Conclusion Mental, neurological and substance use disorders contribute to a significant proportion of disease burden. Health systems can respond by implementing established, cost effective interventions, or by supporting the

Novel homozygous variants in ATCAY, MCOLN1, and SACS in complex neurological disorders.

PubMed

Manzoor, Humera; Brüggemann, Norbert; Hussain, Hafiz Muhammad Jafar; Bäumer, Tobias; Hinrichs, Frauke; Wajid, Muhammad; Münchau, Alexander; Naz, Sadaf; Lohmann, Katja

2018-06-01

Neurological disorders comprise a large group of clinically and genetically heterogeneous disorders, many of which have a genetic cause. In addition to a detailed neurological examination, exome sequencing is being increasingly used as a complementary diagnostic tool to identify the underlying genetic cause in patients with unclear, supposedly genetically determined disorders. To identify the genetic cause of a complex movement disorder in five consanguineous Pakistani families. We included five consanguineous Pakistani families with complex recessively inherited movement disorders. Clinical investigation including videotaping was carried out in a total of 59 family members (4-21 per family) and MRI in six patients. Exome sequencing was performed in 4-5 family members per pedigree to explore the underlying genetic cause. Patients presented a wide spectrum of neurological symptoms including ataxia and/or dystonia. We identified three novel homozygous, segregating variants in ATCAY (p.Pro200Profs*20), MCOLN1 (p.Ile184Thr), and SACS (p.Asn3040Lysfs*4) in three of the families. Thus, we were able to identify the likely cause of the disease in a considerable number of families (60%) with the relatively simple and nowadays widely available method of exome sequencing. Of note, close collaboration of neurologists and geneticists was instrumental for proper data interpretation. We expand the phenotypic, genotypic, and ethnical spectrum of mutations in these genes. Our findings alert neurologists that rare genetic causes should be considered in complex phenotypes regardless of ethnicity. Copyright © 2018 Elsevier Ltd. All rights reserved.

Oxidative stress and neurological disorders in relation to blood lead levels in children.

PubMed

Ahamed, M; Fareed, Mohd; Kumar, A; Siddiqui, W A; Siddiqui, M K J

2008-01-01

Oxidative stress plays a pivotal role in the pathogenesis of neurological disorders. Free radical generation appears to be the mode of lead toxicity. We evaluated the effects of blood lead levels on oxidative stress parameters in children suffering from neurological disorders. Thirty children (aged 3-12 years) with neurological disorders (cerebral palsy [n = 12], seizures [n = 11], and encephalopathy [n = 7]) were recruited in the study group. Sixty healthy children (aged 3-12 years) from similar socio-economic environments and not suffering from any chronic disease were taken as the controls. Blood lead levels and oxidant/antioxidant status were determined. Mean blood lead level was significantly higher while delta-aminolevulinic acid dehydratase (delta-ALAD) activity, a biomarker for lead exposure, was significantly lower in the study group as compared to the control group (P < 0.05 for each). Malondialdehyde (MDA) levels, an end-product of lipid peroxidation, were significantly higher while the antioxidant glutathione (GSH) levels were significantly lower in the study group as compared to the control group (P < 0.05 for each). Activities of the antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT) were significantly higher in the study group than those of the control group (P < 0.05 for each). There were significant negative correlations of blood lead levels with delta-ALAD (r = -0.35; P < 0.05) and GSH (r = -0.31; P < 0.05), and positive correlations with MDA (r = 0.37; P < 0.05), SOD (r = 0.53; P < 0.05), and CAT (r = 0.31; P < 0.05). In turn, delta-ALAD had significant negative correlations with MDA (r = -0.29; P < 0.05), SOD (r = -0.28; P < 0.05) and CAT (r = -0.34; P < 0.05), but positive correlation with GSH (r = 0.32; P < 0.05). Although a causal pathway can not be determined from the present study, our findings indicate lead-induced oxidative stress in blood of children with neurological disorders. Lead-induced oxidative stress as an

Targeting cellular energy production in neurological disorders.

PubMed

Baker, Steven K; Tarnopolsky, Mark A

2003-10-01

The concepts of energy dysregulation and oxidative stress and their complicated interdependence have rapidly evolved to assume primary importance in understanding the pathophysiology of numerous neurological disorders. Therefore, neuroprotective strategies addressing specific bioenergetic defects hold particular promise in the treatment of these conditions (i.e., amyotrophic lateral sclerosis, Huntington's disease, Parkinson's disease, Friedreich's ataxia, mitochondrial cytopathies and other neuromuscular diseases), all of which, to some extent, share 'the final common pathway' leading to cell death through either necrosis or apoptosis. Compounds such as creatine monohydrate and coenzyme Q(10) offer substantial neuroprotection against ischaemia, trauma, oxidative damage and neurotoxins. Miscellaneous agents, including alpha-lipoic acid, beta-OH-beta-methylbutyrate, riboflavin and nicotinamide, have also been shown to improve various metabolic parameters in brain and/or muscle. This review will highlight the biological function of each of the above mentioned compounds followed by a discussion of their utility in animal models and human neurological disease. The balance of this work will be comprised of discussions on the therapeutic applications of creatine and coenzyme Q(10).

[Neurological disorders in patients with hypoparathyroidism].

PubMed

Roztoczyńska, Dorota; Kroczka, Sławomir; Kumorowicz-Czoch, Małgorzata; Dolezal-Ołtarzewska, Katarzyna; Kacińsk, Marek; Starzyk, Jerzy

2010-01-01

The term hypoparathyroidism refers to a group of disorders in which a relative or absolute deficiency of PTH leads to hypocalcemia and hyperphosphatemia. Was to evaluate clinical symptoms in patients with hypoparathyroidism during normocalcemic period and to try to establish its etiology (electrolyte imbalance, organic central nervous system lesions, coincidence of tetany and epilepsy). The analysis included a group of 14 patients with hypoparathyroidism: 3 boys and 11 girls, aged from 12 months to 31 years (median 16.11 years), with duration of the disease 12 months to 26 years (median 10.9 years). In all the patients, the diagnosis was confirmed based on history, physical examination, results of biochemical and hormonal laboratory tests, radiological and neurological examinations. All the patients were followed by endocrinology specialists. Low phosphorus diet, calcium, magnesium, active vitamin D supplementation and management of other endocrine disorders were employed. In 9 patients, pseudo-hypoparathyrodism was diagnosed; of this number, in 8 children, type Ia Albright syndrome was confirmed. Five patients were diagnosed as true hypoparathyroidism, two girls in this group were found to have autoimmune hypoparathyroidism as a component of the autoimmune polyglandular syndrome type 1, 2 others were diagnosed in infancy as congenital hypoparathyroidism and 1 girl had true hypoparathyroidism as a component of Kearns-Sayre syndrome. Five patients were referred to neurological department with epilepsy suspicion. In the medical history, 9 patients had generalized epileptic seizures, moreover, 1 girl manifested absence attack and balance disturbances. In 3 patients, EEG demonstrated changes typical of generalized seizure activity. In 5 patients on anti-epileptic management, additional calcium and active vitamin D treatment was initiated, allowing for achieving seizure remission. CT of the head and pituitary gland showed calcification foci in the central nervous system

Early presentation of gait impairment in Wolfram Syndrome

PubMed Central

2012-01-01

Background Classically characterized by early onset insulin-dependent diabetes mellitus, optic atrophy, deafness, diabetes insipidus, and neurological abnormalities, Wolfram syndrome (WFS) is also associated with atypical brainstem and cerebellar findings in the first decade of life. As such, we hypothesized that gait differences between individuals with WFS and typically developing (TD) individuals may be detectable across the course of the disease. Methods Gait was assessed for 13 individuals with WFS (min 6.4 yrs, max 25.8 yrs) and 29 age-matched, typically developing individuals (min 5.6 yrs, max 28.5 yrs) using a GAITRite ® walkway system. Velocity, cadence, step length, base of support and double support time were compared between groups. Results Across all tasks, individuals with WFS walked slower (p = 0.03), took shorter (p ≤ 0.001) and wider (p ≤ 0.001) steps and spent a greater proportion of the gait cycle in double support (p = 0.03) compared to TD individuals. Cadence did not differ between groups (p = 0.62). Across all tasks, age was significantly correlated with cadence and double support time in the TD group but only double support time was correlated with age in the WFS group and only during preferred pace forward (rs= 0.564, p = 0.045) and dual task forward walking (rs= 0.720, p = 0.006) tasks. Individuals with WFS also had a greater number of missteps during tandem walking (p ≤ 0.001). Within the WFS group, spatiotemporal measures of gait did not correlate with measures of visual acuity. Balance measures negatively correlated with normalized gait velocity during fast forward walking (rs = −0.59, p = 0.03) and percent of gait cycle in double support during backward walking (rs = −0.64, p = 0.03). Conclusions Quantifiable gait impairments can be detected in individuals with WFS earlier than previous clinical observations suggested. These impairments are not fully accounted for by the visual or balance deficits associated with WFS

78 FR 11898 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-20

... Neurological Disorders and Stroke; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel; Specialized Neuroscience Research Program (SNRP). Date: April 2... Disorders and Stroke Special Emphasis Panel; Wellstone Review. Date: April 10-11, 2013. Time: 8:00 a.m. to 6...

A data mining methodology for predicting early stage Parkinson’s disease using non-invasive, high-dimensional gait sensor data

PubMed Central

Tucker, Conrad; Han, Yixiang; Nembhard, Harriet Black; Lewis, Mechelle; Lee, Wang-Chien; Sterling, Nicholas W; Huang, Xuemei

2017-01-01

Parkinson’s disease (PD) is the second most common neurological disorder after Alzheimer’s disease. Key clinical features of PD are motor-related and are typically assessed by healthcare providers based on qualitative visual inspection of a patient’s movement/gait/posture. More advanced diagnostic techniques such as computed tomography scans that measure brain function, can be cost prohibitive and may expose patients to radiation and other harmful effects. To mitigate these challenges, and open a pathway to remote patient-physician assessment, the authors of this work propose a data mining driven methodology that uses low cost, non-invasive sensors to model and predict the presence (or lack therefore) of PD movement abnormalities and model clinical subtypes. The study presented here evaluates the discriminative ability of non-invasive hardware and data mining algorithms to classify PD cases and controls. A 10-fold cross validation approach is used to compare several data mining algorithms in order to determine that which provides the most consistent results when varying the subject gait data. Next, the predictive accuracy of the data mining model is quantified by testing it against unseen data captured from a test pool of subjects. The proposed methodology demonstrates the feasibility of using non-invasive, low cost, hardware and data mining models to monitor the progression of gait features outside of the traditional healthcare facility, which may ultimately lead to earlier diagnosis of emerging neurological diseases. PMID:29541376

Hyperhomocysteinemia and Neurologic Disorders: a Review

PubMed Central

Ansari, Ramin; Mallack, Eric; Luo, Jin Jun

2014-01-01

Homocysteine (Hcy) is a sulfur-containing amino acid that is generated during methionine metabolism. It has a physiologic role in DNA metabolism via methylation, a process governed by the presentation of folate, and vitamins B6 and B12. Physiologic Hcy levels are determined primarily by dietary intake and vitamin status. Elevated plasma levels of Hcy (eHcy) can be caused by deficiency of either vitamin B12 or folate, or a combination thereof. Certain genetic factors also cause eHcy, such as C667T substitution of the gene encoding methylenetetrahydrofolate reductase. eHcy has been observed in several medical conditions, such as cardiovascular disorders, atherosclerosis, myocardial infarction, stroke, minimal cognitive impairment, dementia, Parkinson's disease, multiple sclerosis, epilepsy, and eclampsia. There is evidence from laboratory and clinical studies that Hcy, and especially eHcy, exerts direct toxic effects on both the vascular and nervous systems. This article provides a review of the current literature on the possible roles of eHcy relevant to various neurologic disorders. PMID:25324876

Reliability of videotaped observational gait analysis in patients with orthopedic impairments

PubMed Central

Brunnekreef, Jaap J; van Uden, Caro JT; van Moorsel, Steven; Kooloos, Jan GM

2005-01-01

Background In clinical practice, visual gait observation is often used to determine gait disorders and to evaluate treatment. Several reliability studies on observational gait analysis have been described in the literature and generally showed moderate reliability. However, patients with orthopedic disorders have received little attention. The objective of this study is to determine the reliability levels of visual observation of gait in patients with orthopedic disorders. Methods The gait of thirty patients referred to a physical therapist for gait treatment was videotaped. Ten raters, 4 experienced, 4 inexperienced and 2 experts, individually evaluated these videotaped gait patterns of the patients twice, by using a structured gait analysis form. Reliability levels were established by calculating the Intraclass Correlation Coefficient (ICC), using a two-way random design and based on absolute agreement. Results The inter-rater reliability among experienced raters (ICC = 0.42; 95%CI: 0.38–0.46) was comparable to that of the inexperienced raters (ICC = 0.40; 95%CI: 0.36–0.44). The expert raters reached a higher inter-rater reliability level (ICC = 0.54; 95%CI: 0.48–0.60). The average intra-rater reliability of the experienced raters was 0.63 (ICCs ranging from 0.57 to 0.70). The inexperienced raters reached an average intra-rater reliability of 0.57 (ICCs ranging from 0.52 to 0.62). The two expert raters attained ICC values of 0.70 and 0.74 respectively. Conclusion Structured visual gait observation by use of a gait analysis form as described in this study was found to be moderately reliable. Clinical experience appears to increase the reliability of visual gait analysis. PMID:15774012

When human walking becomes random walking: fractal analysis and modeling of gait rhythm fluctuations

NASA Astrophysics Data System (ADS)

Hausdorff, Jeffrey M.; Ashkenazy, Yosef; Peng, Chang-K.; Ivanov, Plamen Ch.; Stanley, H. Eugene; Goldberger, Ary L.

2001-12-01

We present a random walk, fractal analysis of the stride-to-stride fluctuations in the human gait rhythm. The gait of healthy young adults is scale-free with long-range correlations extending over hundreds of strides. This fractal scaling changes characteristically with maturation in children and older adults and becomes almost completely uncorrelated with certain neurologic diseases. Stochastic modeling of the gait rhythm dynamics, based on transitions between different “neural centers”, reproduces distinctive statistical properties of the gait pattern. By tuning one model parameter, the hopping (transition) range, the model can describe alterations in gait dynamics from childhood to adulthood - including a decrease in the correlation and volatility exponents with maturation.

Telerehabilitation, virtual therapists, and acquired neurologic speech and language disorders.

PubMed

Cherney, Leora R; van Vuuren, Sarel

2012-08-01

Telerehabilitation (telerehab) offers cost-effective services that potentially can improve access to care for those with acquired neurologic communication disorders. However, regulatory issues including licensure, reimbursement, and threats to privacy and confidentiality hinder the routine implementation of telerehab services into the clinical setting. Despite these barriers, rapid technological advances and a growing body of research regarding the use of telerehab applications support its use. This article reviews the evidence related to acquired neurologic speech and language disorders in adults, focusing on studies that have been published since 2000. Research studies have used telerehab systems to assess and treat disorders including dysarthria, apraxia of speech, aphasia, and mild Alzheimer disease. They show that telerehab is a valid and reliable vehicle for delivering speech and language services. The studies represent a progression of technological advances in computing, Internet, and mobile technologies. They range on a continuum from working synchronously (in real-time) with a speech-language pathologist to working asynchronously (offline) with a stand-in virtual therapist. One such system that uses a virtual therapist for the treatment of aphasia, the Web-ORLA™ (Rehabilitation Institute of Chicago, Chicago, IL) system, is described in detail. Future directions for the advancement of telerehab for clinical practice are discussed. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Evaluation and management of crouch gait.

PubMed

Kedem, Paz; Scher, David M

2016-02-01

Crouch gait is defined as excessive ankle dorsiflexion, knee and hip flexion during the stance phase. This gait disorder is common among patients with cerebral palsy. The present article brings an up-to-date literature review on the pathoanatomy, natural history, and treatment of this frequent gait abnormality. Hamstrings are often not shortened in patients with crouch. Patella alta must be addressed if surgery is performed. Surgical correction of joint contractures and lever arm dysfunction can be effectively achieved through a single-event multilevel surgery. Crouch gait is a common gait deviation, often seen among ambulatory diplegic and quadriplegic patients, once they reach the pubertal spurt, when weak muscles can no longer support a toe walking pattern because of rapidly increased weight. This form of gait is highly ineffective and might compromise walking ability over time. The anterior knee is overloaded; pain, extensor mechanism failure, and arthritis might develop. Its progressive nature often requires surgical intervention. The cause of crouch gait is multifactorial, and surgery should be tailored to meet the individual's specific anatomic and physiologic abnormalities.

Gait analysis in children with cerebral palsy.

PubMed

Armand, Stéphane; Decoulon, Geraldo; Bonnefoy-Mazure, Alice

2016-12-01

Cerebral palsy (CP) children present complex and heterogeneous motor disorders that cause gait deviations.Clinical gait analysis (CGA) is needed to identify, understand and support the management of gait deviations in CP. CGA assesses a large amount of quantitative data concerning patients' gait characteristics, such as video, kinematics, kinetics, electromyography and plantar pressure data.Common gait deviations in CP can be grouped into the gait patterns of spastic hemiplegia (drop foot, equinus with different knee positions) and spastic diplegia (true equinus, jump, apparent equinus and crouch) to facilitate communication. However, gait deviations in CP tend to be a continuum of deviations rather than well delineated groups. To interpret CGA, it is necessary to link gait deviations to clinical impairments and to distinguish primary gait deviations from compensatory strategies.CGA does not tell us how to treat a CP patient, but can provide objective identification of gait deviations and further the understanding of gait deviations. Numerous treatment options are available to manage gait deviations in CP. Generally, treatments strive to limit secondary deformations, re-establish the lever arm function and preserve muscle strength.Additional roles of CGA are to better understand the effects of treatments on gait deviations. Cite this article: Armand S, Decoulon G, Bonnefoy-Mazure A. Gait analysis in children with cerebral palsy. EFORT Open Rev 2016;1:448-460. DOI: 10.1302/2058-5241.1.000052.

Minor Neurological Dysfunction in Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

de Jong, Marianne; Punt, Marja; de Groot, Erik; Minderaa, Ruud B; Hadders-Algra, Mijna

2011-01-01

Aim: The aim of this study was to improve the understanding of brain function in children with autism spectrum disorder (ASD) in relation to minor neurological dysfunctions (MNDs). Method: We studied MNDs in 122 children (93 males, 29 females; mean age 8y 1mo, SD 2y 6mo) who, among a total cohort of 705 children (513 males, 192 females; mean age…

Abnormalities on the Neurological Examination and EEG in Young Children with Pervasive Developmental Disorders

ERIC Educational Resources Information Center

Akshoomoff, Natacha; Farid, Nikdokht; Courchesne, Eric; Haas, Richard

2007-01-01

This study examined the nature and frequency of neurological and EEG abnormalities in 60 young children (ages 2-6 years) with pervasive developmental disorders. A number of standard neurological functions could not be adequately assessed due to the young age of the children and/or limited comprehension and cooperation. The most common neurological…

Gait analysis in demented subjects: Interests and perspectives

PubMed Central

Beauchet, Olivier; Allali, Gilles; Berrut, Gilles; Hommet, Caroline; Dubost, Véronique; Assal, Frédéric

2008-01-01

Gait disorders are more prevalent in dementia than in normal aging and are related to the severity of cognitive decline. Dementia-related gait changes (DRGC) mainly include decrease in walking speed provoked by a decrease in stride length and an increase in support phase. More recently, dual-task related changes in gait were found in Alzheimer’s disease (AD) and non-Alzheimer dementia, even at an early stage. An increase in stride-to-stride variability while usual walking and dual-tasking has been shown to be more specific and sensitive than any change in mean value in subjects with dementia. Those data show that DRGC are not only associated to motor disorders but also to problem with central processing of information and highlight that dysfunction of temporal and frontal lobe may in part explain gait impairment among demented subjects. Gait assessment, and more particularly dual-task analysis, is therefore crucial in early diagnosis of dementia and/or related syndromes in the elderly. Moreover, dual-task disturbances could be a specific marker of falling at a pre-dementia stage. PMID:18728766

Intestinal helminthiasis in children with chronic neurological disorders in Benin City, Nigeria: intensity and behavioral risk factors.

PubMed

Nwaneri, Damia Uchechukwu; Ibadin, Michael Okoeguale; Ofovwe, Gabriel Egberue; Sadoh, Ayebo Evawere

2013-05-01

Behavioral aberrations such as nail biting, finger sucking, and pica have been postulated as risk factors that enhance helminths ova transmission. These aberrations may present commonly in children with chronic neurological disorders and predispose them to heavy intensity of intestinal helminthiasis. This comparative cross-sectional study was to determine the prevalence, intensity, and behavioral risk factors for intestinal helminthiasis in children with chronic neurological disorders and apparently healthy controls. Fresh stool samples from 155 children (2-17 years) with chronic neurological disorders seen at the child neurology clinic and 155 age and sex matched controls from nursery and primary schools in Benin City were analyzed using the Kato-Katz technique for detection of ova of helminths from November 2008 to April 2009. The prevalence of intestinal helminthiasis (31.0%) was significantly higher in children with chronic neurological disorders compared with the controls (19.4%) (P=0.03). The intensity of infections in both groups was light ranging 24-144 eggs per gram. Ascaris lumbricoides, Trichuris trichiura and hookworm were the intestinal helminths isolated in both groups. Behavioral aberrations were significantly more represented in the subjects than in the controls (P<0.0001, OR=2.8). Nail biting and encopresis were the most significant independent predictors of intestinal helminthiasis (P=0.025 and 0.001, respectively) in the subjects only. Hand washing with water and soap after defecation and frequent de-worming exercise were practices significantly associated with decreased prevalence of intestinal helminthiasis in the subjects and controls. Behavioral modification in children with chronic neurological disorders should be an integral part of the control program for intestinal helminthiasis.

Association of Dual-Task Gait With Incident Dementia in Mild Cognitive Impairment: Results From the Gait and Brain Study.

PubMed

Montero-Odasso, Manuel M; Sarquis-Adamson, Yanina; Speechley, Mark; Borrie, Michael J; Hachinski, Vladimir C; Wells, Jennie; Riccio, Patricia M; Schapira, Marcelo; Sejdic, Ervin; Camicioli, Richard M; Bartha, Robert; McIlroy, William E; Muir-Hunter, Susan

2017-07-01

Gait performance is affected by neurodegeneration in aging and has the potential to be used as a clinical marker for progression from mild cognitive impairment (MCI) to dementia. A dual-task gait test evaluating the cognitive-motor interface may predict dementia progression in older adults with MCI. To determine whether a dual-task gait test is associated with incident dementia in MCI. The Gait and Brain Study is an ongoing prospective cohort study of community-dwelling older adults that enrolled 112 older adults with MCI. Participants were followed up for 6 years, with biannual visits including neurologic, cognitive, and gait assessments. Data were collected from July 2007 to March 2016. Incident all-cause dementia was the main outcome measure, and single- and dual-task gait velocity and dual-task gait costs were the independent variables. A neuropsychological test battery was used to assess cognition. Gait velocity was recorded under single-task and 3 separate dual-task conditions using an electronic walkway. Dual-task gait cost was defined as the percentage change between single- and dual-task gait velocities: ([single-task gait velocity - dual-task gait velocity]/ single-task gait velocity) × 100. Cox proportional hazard models were used to estimate the association between risk of progression to dementia and the independent variables, adjusted for age, sex, education, comorbidities, and cognition. Among 112 study participants with MCI, mean (SD) age was 76.6 (6.9) years, 55 were women (49.1%), and 27 progressed to dementia (24.1%), with an incidence rate of 121 per 1000 person-years. Slow single-task gait velocity (<0.8 m/second) was not associated with progression to dementia (hazard ratio [HR], 3.41; 95% CI, 0.99-11.71; P = .05)while high dual-task gait cost while counting backward (HR, 3.79; 95% CI, 1.57-9.15; P = .003) and naming animals (HR, 2.41; 95% CI, 1.04-5.59; P = .04) were associated with dementia progression (incidence rate, 155 per

Global Health: Pediatric Neurology.

PubMed

Bearden, David R; Ciccone, Ornella; Patel, Archana A

2018-04-01

Neurologic disorders contribute significantly to both morbidity and mortality among children in resource-limited settings, but there are a few succinct studies summarizing the epidemiology of neurologic disorders in these settings. A review of available literature was performed to identify data on the prevalence, etiology, outcomes, and treatment of neurologic disorders in children in resource-limited settings. The burden of neurologic disorders in children is high in resource-limited settings. Barriers to optimal care include lack of trained personnel, limited access to diagnostic technology, and limited availability of drugs used to treat common conditions. Several solutions have been suggested to deal with these challenges including increased collaborations to train neurologists willing to practice in resource-limited settings and increased training of physician extenders or community health workers. Further studies are necessary to improve our understanding of the epidemiology of neurologic disorders in resource-limited settings. Future epidemiologic studies should incorporate multiple countries in resource-limited settings and utilize standardized definitions and methodologies to enable comparison across regions. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Stiff person case misdiagnosed as conversion disorder: A case report

PubMed Central

Razmeh, Saeed; Habibi, Amir Hasan; Sina, Farzad; Alizadeh, Elham; Eslami, Monireh

2017-01-01

Background: Stiff person syndrome (SPS) is a rare neurological disease resulting in stiffness and spasm of muscles. It initially affects the axial muscles and then spread to limb muscles. Emotional stress exacerbated the symptoms and signs of the disease. The pathophysiology of the disease is caused by the decreased level of the glutamic acid decarboxylase (GAD) activity due to an autoantibody against GAD that decreases the level of gamma-aminobutyric acid (GABA). In this paper, we present a case of atypical presentation of SPS with lower limb stiffness misdiagnosed as conversion disorder. Case presentation: We report a patient with atypical presentation of SPS with lower limb stiffness and gait disorder misdiagnosed as conversion disorder for a year. Her antithyroid peroxidase antibody (anti-TPO Ab) level was 75 IU (normal value: 0–34 IU). Intravenous immunoglobulin (IVIG) was administered (2gr/kg, 5 days) for the patient that showed significant improvement in the follow-up visit. Conclusion: It is essential that in any patient with bizarre gait disorder and suspicious to conversion disorder due to the reversibility of symptoms, SPS and other movement disorder should be considered. PMID:29201327

Technology-Based Feedback and Its Efficacy in Improving Gait Parameters in Patients with Abnormal Gait: A Systematic Review.

PubMed

Chamorro-Moriana, Gema; Moreno, Antonio José; Sevillano, José Luis

2018-01-06

This systematic review synthesized and analyzed clinical findings related to the effectiveness of innovative technological feedback for tackling functional gait recovery. An electronic search of PUBMED, PEDro, WOS, CINAHL, and DIALNET was conducted from January 2011 to December 2016. The main inclusion criteria were: patients with modified or abnormal gait; application of technology-based feedback to deal with functional recovery of gait; any comparison between different kinds of feedback applied by means of technology, or any comparison between technological and non-technological feedback; and randomized controlled trials. Twenty papers were included. The populations were neurological patients (75%), orthopedic and healthy subjects. All participants were adults, bar one. Four studies used exoskeletons, 6 load platforms and 5 pressure sensors. The breakdown of the type of feedback used was as follows: 60% visual, 40% acoustic and 15% haptic. 55% used terminal feedback versus 65% simultaneous feedback. Prescriptive feedback was used in 60% of cases, while 50% used descriptive feedback. 62.5% and 58.33% of the trials showed a significant effect in improving step length and speed, respectively. Efficacy in improving other gait parameters such as balance or range of movement is observed in more than 75% of the studies with significant outcomes. Treatments based on feedback using innovative technology in patients with abnormal gait are mostly effective in improving gait parameters and therefore useful for the functional recovery of patients. The most frequently highlighted types of feedback were immediate visual feedback followed by terminal and immediate acoustic feedback.

Does robot-assisted gait training ameliorate gait abnormalities in multiple sclerosis? A pilot randomized-control trial.

PubMed

Straudi, S; Benedetti, M G; Venturini, E; Manca, M; Foti, C; Basaglia, N

2013-01-01

Gait disorders are common in multiple sclerosis (MS) and lead to a progressive reduction of function and quality of life. Test the effects of robot-assisted gait rehabilitation in MS subjects through a pilot randomized-controlled study. We enrolled MS subjects with Expanded Disability Status Scale scores within 4.5-6.5. The experimental group received 12 robot-assisted gait training sessions over 6 weeks. The control group received the same amount of conventional physiotherapy. Outcomes measures were both biomechanical assessment of gait, including kinematics and spatio-temporal parameters, and clinical test of walking endurance (six-minute walk test) and mobility (Up and Go Test). 16 subjects (n = 8 experimental group, n = 8 control group) were included in the final analysis. At baseline the two groups were similar in all variables, except for step length. Data showed walking endurance, as well as spatio-temporal gait parameters improvements after robot-assisted gait training. Pelvic antiversion and reduced hip extension during terminal stance ameliorated after aforementioned intervention. Robot-assisted gait training seems to be effective in increasing walking competency in MS subjects. Moreover, it could be helpful in restoring the kinematic of the hip and pelvis.

Neurological and endocrine phenotypes of fragile X carrier women.

PubMed

Hall, D; Todorova-Koteva, K; Pandya, S; Bernard, B; Ouyang, B; Walsh, M; Pounardjian, T; Deburghraeve, C; Zhou, L; Losh, M; Leehey, M; Berry-Kravis, E

2016-01-01

Women who carry fragile X mental retardation 1 (FMR1)gene premutation expansions frequently report neurological or endocrine symptoms and prior studies have predominantly focused on questionnaire report of medical issues. Premutation carrier (PMC) women (n = 33) and non-carrier controls (n = 13) were recruited and evaluated by a neurologist, neuropsychologist, and endocrinologist. Blood and skin biopsies were collected for molecular measures. Scales for movement disorders, neuropathy, cognitive function, psychiatric symptoms, sleep, and quality of life were completed. The average age of the women was 51 years (n = 46) and average CGG repeat size was 91 ± 24.9 in the FMR1 PMC women. Seventy percent of the PMC women had an abnormal neurological examination. PMC women had significantly higher scores on the Fragile X-Associated Tremor Ataxia Syndrome (FXTAS) rating scale, more neuropathy, and difficulty with tandem gait compared to controls. Central sensitivity syndromes, a neuroticism profile on the NEO Personality Profile, and sleep disorders were also prevalent. Discrepancies between subject report and examination findings were also seen. This pilot study suggests that women with the FMR1 premutation may have a phenotype that overlaps with that seen in FXTAS. Additional research with larger sample sizes is warranted to better delineate the clinical features. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Functional neurological symptom disorders in a pediatric emergency room: diagnostic accuracy, features, and outcome.

PubMed

de Gusmão, Claudio M; Guerriero, Réjean M; Bernson-Leung, Miya Elizabeth; Pier, Danielle; Ibeziako, Patricia I; Bujoreanu, Simona; Maski, Kiran P; Urion, David K; Waugh, Jeff L

2014-08-01

In children, functional neurological symptom disorders are frequently the basis for presentation for emergency care. Pediatric epidemiological and outcome data remain scarce. Assess diagnostic accuracy of trainee's first impression in our pediatric emergency room; describe manner of presentation, demographic data, socioeconomic impact, and clinical outcomes, including parental satisfaction. (1) More than 1 year, psychiatry consultations for neurology patients with a functional neurological symptom disorder were retrospectively reviewed. (2) For 3 months, all children whose emergency room presentation suggested the diagnosis were prospectively collected. (3) Three to six months after prospective collection, families completed a structured telephone interview on outcome measures. Twenty-seven patients were retrospectively assessed; 31 patients were prospectively collected. Trainees' accurately predicted the diagnosis in 93% (retrospective) and 94% (prospective) cohorts. Mixed presentations were most common (usually sensory-motor changes, e.g. weakness and/or paresthesias). Associated stressors were mundane and ubiquitous, rarely severe. Families were substantially affected, reporting mean symptom duration 7.4 (standard error of the mean ± 1.33) weeks, missing 22.4 (standard error of the mean ± 5.47) days of school, and 8.3 (standard error of the mean ± 2.88) of parental workdays (prospective cohort). At follow-up, 78% were symptom free. Parental dissatisfaction was rare, attributed to poor rapport and/or insufficient information conveyed. Trainees' clinical impression was accurate in predicting a later diagnosis of functional neurological symptom disorder. Extraordinary life stressors are not required to trigger the disorder in children. Although prognosis is favorable, families incur substantial economic burden and negative educational impact. Improving recognition and appropriately communicating the diagnosis may speed access to treatment and potentially reduce

[Today and tomorrow in child neurology at a neurological clinic for children--the importance of child neurology as the life-long neurology].

PubMed

Nomura, Yoshiko

2005-05-01

Segawa Neurological Clinic for Children was founded in 1973, and specializes in neurological disorders that start in childhood. In thirty-one years since the foundation, about 16,000 patients visited this clinic. The ages of the first visit to this clinic of the patients are mostly below 15 years. The main diseases are epilepsy, autism, mental retardation with various etiologies, Tourette syndrome, and other neurological disorders. Most of the diseases follow a chronic course and require long term follow-up. In this clinic those patients who need the continuous follow-up are seen even after reaching to adulthood. The average age of patients who were seen in the clinic during 2003 was about 21 years of age (20.77 +/- 14.28), suggesting that many of the patients are followed in this clinic for 20-30 years. The etiologies and pathophysiologies of most of these diseases are not fully understood. Therefore, the treatments based on the causes are difficult. The pathophysiologies of these diseases are modified by the ages. For example, some patients with epilepsy develop psychiatric symptoms in adulthood, and require the consultation by psychiatrists. The long-term follow up of certain disorders and evaluations of the disorders at different ages up to the adulthood have lead to new scientific discoveries. Examples include age-dependent symptoms observed in Segawa disease, psychiatric symptoms developing in frontal lobe epilepsy cases, alterations of behaviors in autism and Tourette syndrome. This knowledge suggests insights for the early prevention of later adverse outcomes. Social awareness and understanding of these neurological problems occurring in childhood are essential. The medical economic base for child neurology is another challenging and urgent issue to be solved. The importance of child neurology in the life-long neurology is stressed.

Imaging: what can it tell us about parkinsonian gait?

PubMed Central

Bohnen, Nicolaas I.; Jahn, Klaus

2013-01-01

Functional neuroimaging has provided new tools to study cerebral gait control in Parkinson disease (PD). First, imaging of blood flow functions has identified a supraspinal locomotor network that includes the (frontal) cortex, basal ganglia, brainstem tegmentum and the cerebellum. These studies emphasize also the cognitive and attentional dependency of gait in PD. Furthermore, gait in PD and related syndromes like progressive supranuclear palsy may be associated with dysfunction of the indirect, modulatory prefrontal–subthalamic–pedunculopontine loop of locomotor control. The direct, stereotyped locomotor loop from the primary motor cortex to the spinal cord with rhythmic cerebellar input appears preserved and may contribute to the unflexible gait pattern in parkinsonian gait. Second, neurotransmitter and proteinopathy imaging studies are beginning to unravel novel mechanisms of parkinsonian gait and postural disturbances. Dopamine displacement imaging studies have shown evidence for a mesofrontal dopaminergic shift from a depleted striatum in parkinsonian gait. This may place additional burden on other brain systems mediating attention functions to perform previously automatic motor tasks. For example, our preliminary cholinergic imaging studies suggest significant slowing of gait speed when additional forebrain cholinergic denervation occurs in PD. Cholinergic denervation of the pedunculopontine nucleus and its thalamic projections have been associated with falls and impaired postural control. Deposition of β-amyloid may represent another non-dopaminergic correlate of gait disturbance in PD. These findings illustrate the emergence of dopamine non-responsive gait problems to reflect the transition from a predominantly hypodopaminergic disorder to a multisystem neurodegenerative disorder involving non-dopaminergic locomotor network structures and pathologies. PMID:24132837

Granins as disease-biomarkers: translational potential for psychiatric and neurological disorders.

PubMed

Bartolomucci, A; Pasinetti, G M; Salton, S R J

2010-09-29

The identification of biomarkers represents a fundamental medical advance that can lead to an improved understanding of disease pathogenesis, and holds the potential to define surrogate diagnostic and prognostic endpoints. Because of the inherent difficulties in assessing brain function in patients and objectively identifying neurological and cognitive/emotional symptoms, future application of biomarkers to neurological and psychiatric disorders is extremely desirable. This article discusses the biomarker potential of the granin family, a group of acidic proteins present in the secretory granules of a wide variety of endocrine, neuronal and neuroendocrine cells: chromogranin A (CgA), CgB, Secretogranin II (SgII), SgIII, HISL-19 antigen, 7B2, NESP55, VGF and ProSAAS. Their relative abundance, functional significance, and secretion into the cerebrospinal fluid (CSF), saliva, and the general circulation have made granins tractable targets as biomarkers for many diseases of neuronal and endocrine origin, recently impacting diagnosis of a number of neurological and psychiatric disorders including amyotrophic lateral sclerosis (ALS), Alzheimer's disease, frontotemporal dementia, and schizophrenia. Although research has not yet validated the clinical utility of granins as surrogate endpoints for the progression or treatment of neurological or psychiatric disease, a growing body of experimental evidence indicates that the use of granins as biomarkers might be of great potential clinical interest. Advances that further elucidate the mechanism(s) of action of granins, coupled with improvements in biomarker technology and direct clinical application, should increase the translational effectiveness of this family of proteins in disease diagnosis and drug discovery. Copyright 2010 IBRO. Published by Elsevier Ltd. All rights reserved.

Three-dimensional gait analysis of obese adults.

PubMed

Lai, Peggy P K; Leung, Aaron K L; Li, Agnes N M; Zhang, M

2008-01-01

Obesity has been clinically associated with musculoskeletal disorders. However, the findings were mainly focused on the analysis in the sagittal plane. The objectives of this study were to investigate the three-dimensional gait characteristics of Chinese obese adults and to compare the results with normal subjects. Fourteen obese subjects, mean age 35.4 (8.8)years, eight females and six males, with body mass index 33.06 (4.2)kg/m(2) and 14 non-obese subjects, mean age 27.6 (8.6)years, eight females and six males, with body mass index 21.33 (1.5)kg/m(2) participated in this study. All subjects did not have current or past neurological or cardiovascular illness, orthopaedic abnormality, or pain which might affect gait. The kinematics and kinetics data of all subjects were recorded during their self-selected walking speed with a three-dimensional motion analysis system. The obese group walked slower and had a shorter stride length. They also spent more time on stance phase and double support in walking. Greater hip adduction was shown in the obese group during terminal stance and pre-swing. The maximum knee adduction angles of the obese group in both stance and swing phases were significantly higher. The ankle eversion angle of the obese group was significantly higher from mid stance to pre-swing. There were reduction of peak ankle plantar flexor moment, and increase of ankle inversion moment. There were some significant differences in temporal-spatial, joint motion and joint moment data between the obese and the non-obese participants. The obese individuals might adjust their gait characteristics in response to their heavy bodies to reduce the moment about the knee and the energy expenditure per unit time.

Global, regional, and national burden of neurological disorders during 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.

PubMed

2017-11-01

Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to neurological disorders in 2015 and its relationship with country development level. We estimated global and country-specific prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for various neurological disorders that in the GBD classification have been previously spread across multiple disease groupings. The more inclusive grouping of neurological disorders included stroke, meningitis, encephalitis, tetanus, Alzheimer's disease and other dementias, Parkinson's disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, medication overuse headache, brain and nervous system cancers, and a residual category of other neurological disorders. We also analysed results based on the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility, to identify patterns associated with development and how countries fare against expected outcomes relative to their level of development. Neurological disorders ranked as the leading cause group of DALYs in 2015 (250·7 [95% uncertainty interval (UI) 229·1 to 274·7] million, comprising 10·2% of global DALYs) and the second-leading cause group of deaths (9·4 [9·1 to 9·7] million], comprising 16·8% of global deaths). The most prevalent neurological disorders were tension-type headache (1505·9 [UI 1337·3 to 1681·6 million cases]), migraine (958·8 [872·1 to 1055·6] million), medication overuse headache (58·5 [50·8 to 67·4 million

The value of the NDT-Bobath method in post-stroke gait training.

PubMed

Mikołajewska, Emilia

2013-01-01

Stroke is perceived a major cause of disability, including gait disorders. Looking for more effective methods of gait reeducation in post-stroke survivors is one of the most important issues in contemporary neurorehabilitation. Following a stroke, patients suffer from gait disorders. The aim of this paper is to present the outcomes of a study of post-stroke gait reeducation using the NeuroDevelopmental Treatment-Bobath (NDT-Bobath) method. The research was conducted among 60 adult patients who had undergone ischemic stroke. These patients were treated using the NDT-Bobath method. These patients' gait reeducation was assessed using spatio-temporal gait parameters (gait velocity, cadence and stride length). Measurements of these parameters were conducted by the same therapist twice: on admission, and after the tenth session of gait reeducation. Among the 60 patients involved in the study, the results were as follows: in terms of gait velocity, recovery was observed in 39 cases (65%), in terms of cadence, recovery was observed in 39 cases (65%), in terms of stride length, recovery was observed in 50 cases (83.33%). Benefits were observed after short-term therapy, reflected by measurable statistically significant changes in the patients' gait parameters.

Current Issues in the Neurology and Genetics of Learning-Related Traits and Disorders: Introduction to the Special Issue.

ERIC Educational Resources Information Center

Gilger, Jeffrey W.

2001-01-01

This introductory article briefly describes each of the following eight articles in this special issue on the neurology and genetics of learning related disorders. It notes the greater appreciation of learning disability as a set of complex disorders with broad and intricate neurological bases and of the large individual differences in how these…

Neurologic disorders of mineral metabolism and parathyroid disease.

PubMed

Agrawal, Lily; Habib, Zeina; Emanuele, Nicholas V

2014-01-01

Disorders of mineral metabolism may cause neurologic manifestations of the central and peripheral nervous systems. This is because plasma calcium stabilizes excitable membranes in the nerve and muscle tissue, magnesium is predominantly intracellular and is required for activation of many intracellular enzymes, and extracellular magnesium affects synaptic transmission. This chapter reviews abnormalities in electrolytes and minerals which can be associated with several neuromuscular symptoms including neuromuscular irritability, mental status changes, cardiac and smooth muscle changes, etc. © 2014 Elsevier B.V. All rights reserved.

A review of the emerging potential therapy for neurological disorders: human embryonic stem cell therapy

PubMed Central

Shroff, Geeta; Dhanda Titus, Jyoti; Shroff, Rhea

2017-01-01

The first human embryonic stem cell (hESC) line was developed in the late nineties. hESCs are capable of proliferating indefinitely and differentiate into all the three embryonic germ layers. Further, the differentiation of hESC lines into neural precursor cells and neurons, astrocytes and oligodendrocytes showed their potential in treating several incurable neurological disorders such as spinal cord injury (SCI), cerebral palsy (CP), Parkinson’s disease (PD). In this review, we will discuss the global scenario of research and therapeutic use of hESCs in the treatment of neurological disorders. Following this, we will discuss the development of a unique hESC line, how it differs from the other available hESC lines and its use in the treatment of neurological disorders. hESCs were isolated from mixture of neuronal and non-neuronal progenitor cells in their pre progenitor state in a Good Laboratory Practices, Good Tissue Practices and Good Manufacturing Practices compliant laboratory. Blastomere cells have served as a source to derive the hESCs and the xeno-free culture was demonstrated to be more safe and effective in clinical therapeutic application of hESCs. All the patients showed a remarkable improvement in their conditions and no serious adverse events were reported. This study concluded that hESC lines could be scalable and used in the treatment of various neurological disorders such as SCI, CP, and PD. PMID:28533935

Educational Programming for Pupils with Neurologically Based Language Disorders. Final Report.

ERIC Educational Resources Information Center

Zedler, Empress Y.

To investigate procedures whereby schools may achieve maximal results with otherwise normal underachieving pupils with neurologically based language-learning disorders, 100 such subjects were studied over a 2-year period. Fifty experimental subjects remained in regular classes in school and received individualized teaching outside of school hours…

78 FR 45933 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel Huntington's Disease Ancillary Studies SEP. Date: August 7, 2013...

76 FR 73653 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

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2011-11-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel, Epilepsy EUREKA Application Review. Date: December 6-7, 2011...

77 FR 43097 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

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2012-07-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel, NEURO-QOL Interim Sustainability and Training. Date: July 26...

78 FR 66372 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

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2013-11-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel; Ancillary Studies in Huntington's Disease. Date: November 5...

76 FR 56772 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

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2011-09-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel, Blueprint Neurotherapeutics. Date: September 27, 2011. Time: 9...

78 FR 17420 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

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2013-03-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel; Blueprint Neurotherapeutics Review. Date: April 25, 2013. Time...

75 FR 65497 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel, Blueprint Neurotherapeutics. Date: December 2, 2010. Time: 8 a...

Grey matter abnormalities in children and adolescents with functional neurological symptom disorder.

PubMed

Kozlowska, Kasia; Griffiths, Kristi R; Foster, Sheryl L; Linton, James; Williams, Leanne M; Korgaonkar, Mayuresh S

2017-01-01

Functional neurological symptom disorder refers to the presence of neurological symptoms not explained by neurological disease. Although this disorder is presumed to reflect abnormal function of the brain, recent studies in adults show neuroanatomical abnormalities in brain structure . These structural brain abnormalities have been presumed to reflect long-term adaptations to the disorder, and it is unknown whether child and adolescent patients, with illness that is typically of shorter duration, show similar deficits or have normal brain structure. High-resolution, three-dimensional T1-weighted magnetic resonance images (MRIs) were acquired in 25 patients (aged 10-18 years) and 24 healthy controls. Structure was quantified in terms of grey matter volume using voxel-based morphometry. Post hoc, we examined whether regions of structural difference related to a measure of motor readiness to emotional signals and to clinical measures of illness duration, illness severity, and anxiety/depression. Patients showed greater volumes in the left supplementary motor area (SMA) and right superior temporal gyrus (STG) and dorsomedial prefrontal cortex (DMPFC) (corrected p < 0.05). Previous studies of adult patients have also reported alterations of the SMA. Greater SMA volumes correlated with faster reaction times in identifying emotions but not with clinical measures. The SMA, STG, and DMPFC are known to be involved in the perception of emotion and the modulation of motor responses. These larger volumes may reflect the early expression of an experience-dependent plasticity process associated with increased vigilance to others' emotional states and enhanced motor readiness to organize self-protectively in the context of the long-standing relational stress that is characteristic of this disorder.

Factitious disorders and malingering in relation to functional neurologic disorders.

PubMed

Bass, C; Halligan, P

2016-01-01

Interest in malingering has grown in recent years, and is reflected in the exponential increase in academic publications since 1990. Although malingering is more commonly detected in medicolegal practice, it is not an all-or-nothing presentation and moreover can vary in the extent of presentation. As a nonmedical disorder, the challenge for clinical practice remains that malingering by definition is intentional and deliberate. As such, clinical skills alone are often insufficient to detect it and we describe psychometric tests such as symptom validity tests and relevant nonmedical investigations. Finally, we describe those areas of neurologic practice where symptom exaggeration and deception are more likely to occur, e.g., postconcussional syndrome, psychogenic nonepileptic seizures, motor weakness and movement disorders, and chronic pain. Factitious disorders are rare in clinical practice and their detection depends largely on the level of clinical suspicion supported by the systematic collection of relevant information from a variety of sources. In this chapter we challenge the accepted DSM-5 definition of factitious disorder and suggest that the traditional glossaries have neglected the extent to which a person's reported symptoms can be considered a product of intentional choice or selective psychopathology largely beyond the subject's voluntary control, or more likely, both. We present evidence to suggest that neurologists preferentially diagnose factitious presentations in healthcare workers as "hysterical," possibly to avoid the stigma of simulated illness. © 2016 Elsevier B.V. All rights reserved.

The Inpatient Assessment and Management of Motor Functional Neurological Disorders: An Interdisciplinary Perspective.

PubMed

McKee, Kathleen; Glass, Sean; Adams, Caitlin; Stephen, Christopher D; King, Franklin; Parlman, Kristin; Perez, David L; Kontos, Nicholas

2018-01-08

Motor functional neurologic disorders (FND)-previously termed "hysteria" and later "conversion disorder"-are exceedingly common and frequently encountered in the acute hospital setting. Despite their high prevalence, patients with motor FND can be challenging to diagnose accurately and manage effectively. To date, there is limited guidance on the inpatient approach to the neuropsychiatric evaluation of patients with functional (psychogenic) neurologic symptoms. The authors outline an inpatient multidisciplinary approach, involving neurology, psychiatry, and physical therapy, for the assessment and acute inpatient management of motor FND. A vignette of a patient with motor FND is presented followed by a discussion of general assessment principles. Thereafter, a detailed description of the neurologic and psychiatric assessments is outlined. Delivery of a "rule-in" diagnosis is emphasized and specific guidance for what can be accomplished postdiagnosis in the hospital is suggested. We encourage an interdisciplinary approach beginning at the early stages of the diagnostic assessment once an individual is suspected of having motor FND. Practical suggestions for the inpatient assessment of motor FND are presented. It is also important to individualize the diagnostic assessment. Future research should be conducted to test best practices for motor FND management in the acute inpatient hospital setting. Copyright © 2018 Academy of Consultation-Liaison Psychiatry. Published by Elsevier Inc. All rights reserved.

The effect of hydrotherapy treatment on gait characteristics of hereditary spastic paraparesis patients.

PubMed

Zhang, Yanxin; Roxburgh, Richard; Huang, Liang; Parsons, John; Davies, T Claire

2014-04-01

Hereditary spastic paraparesis (HSP) is a group of neurological disorders characterised by slowly progressive increasing muscle tone, predominantly in the lower limbs, with relatively preserved power. This leads to progressive difficulties in motor control and walking. The purpose of this study was to evaluate the effectiveness of hydrotherapy treatment when used as a means to increase locomotor function in individuals with late onset HSP. This paper discusses the analysis of the effect on gait characteristics. Nine people with HSP were asked to participate in pre- and post-hydrotherapy gait analyses. Ground reaction force and motion trajectories were recorded and used to calculate spatiotemporal gait parameters, joint angles and moments. The normalised joint kinematics and kinetics profile revealed that the biomechanics of people with HSP were similar to that of controls for most of the joints, but with lower range of motion. Walking speed increased significantly (11%) after the course of hydrotherapy. Though part of this was achieved through increased ROM there was also a further increase in hip internal rotation and in peak hip extension moment. Although participants had increased walking speed and step length, it appears that hydrotherapy increases the ability to perform compensatory strategies rather than resulting in a more typical kinematic and kinetic approach. Copyright © 2014 Elsevier B.V. All rights reserved.

Quantitative Evaluation System of Soft Neurological Signs for Children with Attention Deficit Hyperactivity Disorder.

PubMed

Kaneko, Miki; Yamashita, Yushiro; Iramina, Keiji

2016-01-18

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity. Soft neurological signs (SNS) are minor neurological abnormalities in motor performance, and are used as one evaluation method for neurodevelopmental delays in children with ADHD. Our aim is to establish a quantitative evaluation system for children with ADHD. We focused on the arm movement called pronation and supination, which is one such soft neurological sign. Thirty three children with ADHD aged 7-11 years (27 males, six females) and twenty five adults participants aged 21-29 years old (19 males, six females) participated in our experiments. Our results suggested that the pronation and supination function in children with ADHD has a tendency to lag behind that of typically developing children by several years. From these results, our system has a possibility to objectively evaluate the neurodevelopmental delay of children with ADHD.

A machine learning approach for gait speed estimation using skin-mounted wearable sensors: From healthy controls to individuals with multiple sclerosis.

PubMed

McGinnis, Ryan S; Mahadevan, Nikhil; Moon, Yaejin; Seagers, Kirsten; Sheth, Nirav; Wright, John A; DiCristofaro, Steven; Silva, Ikaro; Jortberg, Elise; Ceruolo, Melissa; Pindado, Jesus A; Sosnoff, Jacob; Ghaffari, Roozbeh; Patel, Shyamal

2017-01-01

Gait speed is a powerful clinical marker for mobility impairment in patients suffering from neurological disorders. However, assessment of gait speed in coordination with delivery of comprehensive care is usually constrained to clinical environments and is often limited due to mounting demands on the availability of trained clinical staff. These limitations in assessment design could give rise to poor ecological validity and limited ability to tailor interventions to individual patients. Recent advances in wearable sensor technologies have fostered the development of new methods for monitoring parameters that characterize mobility impairment, such as gait speed, outside the clinic, and therefore address many of the limitations associated with clinical assessments. However, these methods are often validated using normal gait patterns; and extending their utility to subjects with gait impairments continues to be a challenge. In this paper, we present a machine learning method for estimating gait speed using a configurable array of skin-mounted, conformal accelerometers. We establish the accuracy of this technique on treadmill walking data from subjects with normal gait patterns and subjects with multiple sclerosis-induced gait impairments. For subjects with normal gait, the best performing model systematically overestimates speed by only 0.01 m/s, detects changes in speed to within less than 1%, and achieves a root-mean-square-error of 0.12 m/s. Extending these models trained on normal gait to subjects with gait impairments yields only minor changes in model performance. For example, for subjects with gait impairments, the best performing model systematically overestimates speed by 0.01 m/s, quantifies changes in speed to within 1%, and achieves a root-mean-square-error of 0.14 m/s. Additional analyses demonstrate that there is no correlation between gait speed estimation error and impairment severity, and that the estimated speeds maintain the clinical significance

Repetitive transcranial magnetic stimulation for clinical applications in neurological and psychiatric disorders: an overview.

PubMed

Machado, Sergio; Arias-Carrión, Oscar; Paes, Flávia; Vieira, Renata Teles; Caixeta, Leonardo; Novaes, Felipe; Marinho, Tamires; Almada, Leonardo Ferreira; Silva, Adriana Cardoso; Nardi, Antonio Egidio

2013-10-01

Neurological and psychiatric disorders are characterized by several disabling symptoms for which effective, mechanism-based treatments remain elusive. Consequently, more advanced non-invasive therapeutic methods are required. A method that may modulate brain activity and be viable for use in clinical practice is repetitive transcranial magnetic stimulation (rTMS). It is a non-invasive procedure whereby a pulsed magnetic field stimulates electrical activity in the brain. Here, we focus on the basic foundation of rTMS, the main stimulation parametters, the factors that influence individual responses to rTMS and the experimental advances of rTMS that may become a viable clinical application to treat neurological and psychiatric disorders. The findings showed that rTMS can improve some symptoms associated with these conditions and might be useful for promoting cortical plasticity in patients with neurological and psychiatric disorders. However, these changes are transient and it is premature to propose these applications as realistic therapeutic options, even though the rTMS technique has been evidenced as a potential modulator of sensorimotor integration and neuroplasticity. Functional imaging of the region of interest could highlight the capacity of rTMS to bring about plastic changes of the cortical circuitry and hint at future novel clinical interventions. Thus, we recommend that further studies clearly determine the role of rTMS in the treatment of these conditions. Finally, we must remember that however exciting the neurobiological mechanisms might be, the clinical usefulness of rTMS will be determined by its ability to provide patients with neurological and psychiatric disorders with safe, long-lasting and substantial improvements in quality of life.

Repetitive Transcranial Magnetic Stimulation for Clinical Applications in Neurological and Psychiatric Disorders: An Overview

PubMed Central

Machado, Sergio; Arias-Carrión, Oscar; Paes, Flávia; Vieira, Renata Teles; Caixeta, Leonardo; Novaes, Felipe; Marinho, Tamires; Almada, Leonardo Ferreira; Silva, Adriana Cardoso; Nardi, Antonio Egidio

2013-01-01

Neurological and psychiatric disorders are characterized by several disabling symptoms for which effective, mechanism-based treatments remain elusive. Consequently, more advanced non-invasive therapeutic methods are required. A method that may modulate brain activity and be viable for use in clinical practice is repetitive transcranial magnetic stimulation (rTMS). It is a non-invasive procedure whereby a pulsed magnetic field stimulates electrical activity in the brain. Here, we focus on the basic foundation of rTMS, the main stimulation parametters, the factors that influence individual responses to rTMS and the experimental advances of rTMS that may become a viable clinical application to treat neurological and psychiatric disorders. The findings showed that rTMS can improve some symptoms associated with these conditions and might be useful for promoting cortical plasticity in patients with neurological and psychiatric disorders. However, these changes are transient and it is premature to propose these applications as realistic therapeutic options, even though the rTMS technique has been evidenced as a potential modulator of sensorimotor integration and neuroplasticity. Functional imaging of the region of interest could highlight the capacity of rTMS to bring about plastic changes of the cortical circuitry and hint at future novel clinical interventions. Thus, we recommend that further studies clearly determine the role of rTMS in the treatment of these conditions. Finally, we must remember that however exciting the neurobiological mechanisms might be, the clinical usefulness of rTMS will be determined by its ability to provide patients with neurological and psychiatric disorders with safe, long-lasting and substantial improvements in quality of life. PMID:25610279

Advantages of virtual reality in the rehabilitation of balance and gait: Systematic review.

PubMed

Cano Porras, Desiderio; Siemonsma, Petra; Inzelberg, Rivka; Zeilig, Gabriel; Plotnik, Meir

2018-05-29

Virtual reality (VR) has emerged as a therapeutic tool facilitating motor learning for balance and gait rehabilitation. The evidence, however, has not yet resulted in standardized guidelines. The aim of this study was to systematically review the application of VR-based rehabilitation of balance and gait in 6 neurologic cohorts, describing methodologic quality, intervention programs, and reported efficacy. This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. VR-based treatments of Parkinson disease, multiple sclerosis, acute and chronic poststroke, traumatic brain injury, and cerebral palsy were researched in PubMed and Scopus, including earliest available records. Therapeutic validity (CONTENT scale) and risk of bias in randomized controlled trials (RCT) (Cochrane Collaboration tool) and non-RCT (Newcastle-Ottawa scale) were assessed. Ninety-seven articles were included, 68 published in 2013 or later. VR improved balance and gait in all cohorts, especially when combined with conventional rehabilitation. Most studies presented poor methodologic quality, lacked a clear rationale for intervention programs, and did not utilize motor learning principles meticulously. RCTs with more robust methodologic designs were widely recommended. Our results suggest that VR-based rehabilitation is developing rapidly, has the potential to improve balance and gait in neurologic patients, and brings additional benefits when combined with conventional rehabilitation. This systematic review provides detailed information for developing theory-driven protocols that may assist overcoming the observed lack of argued choices for intervention programs and motor learning implementation and serves as a reference for the design and planning of personalized VR-based treatments. PROSPERO CRD42016042051. © 2018 American Academy of Neurology.

75 FR 20370 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-19

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel; NINDS Conference Grant Review Panel. Date: April 19, 2010. Time...

Transplantation of Human Chorion-Derived Cholinergic Progenitor Cells: a Novel Treatment for Neurological Disorders.

PubMed

Mohammadi, Alireza; Maleki-Jamshid, Ali; Sanooghi, Davood; Milan, Peiman Brouki; Rahmani, Arash; Sefat, Farshid; Shahpasand, Koorosh; Soleimani, Mansoureh; Bakhtiari, Mehrdad; Belali, Rafie; Faghihi, Faezeh; Joghataei, Mohammad Taghi; Perry, George; Mozafari, Masoud

2018-03-16

A neurological disorder is any disorder or abnormality in the nervous system. Among different neurological disorders, Alzheimer's disease (AD) is recognized as the sixth leading cause of death globally. Considerable research has been conducted to find pioneer treatments for this devastating disorder among which cell therapy has attracted remarkable attentions over the last decade. Up to now, targeted differentiation into specific desirable cell types has remained a major obstacle to clinical application of cell therapy. Also, potential risks including uncontrolled growth of stem cells could be disastrous. In our novel protocol, we used basal forebrain cholinergic progenitor cells (BFCN) derived from human chorion-derived mesenchymal stem cells (hC-MSCs) which made it possible to obtain high-quality population of cholinergic neurons and in vivo in much shorter time period than previous established methods. Remarkably, the transplanted progenitors fully differentiated to cholinergic neurons which in turn integrated in higher cortical networks of host brains, resulting in significant improvement in cognitive assessments. This method may have profound implications in cell therapies for any other neurodegenerative disorders. Graphical Abstract ᅟ.

The Early Use of Blinding in Therapeutic Clinical Research of Neurological Disorders

PubMed Central

Jensen, Matthew B.; Janik, Erika L.; Waclawik, Andrew J.

2016-01-01

We sought to identify early uses of blinding in therapeutic clinical trials of neurological disorders by multiple search methods. A 1784 report by Benjamin Franklin and others described the evaluation of the use of Mesmerism to treat neurological and other syndromes including headache and epilepsy, using blindfolds and screens. This report demonstrated the usefulness of blinding to reduce bias in clinical research, yet despite this early discovery, blinding was not widely accepted or routinely used until the 20th century. Blinded clinical trials began to be used for various neurological syndromes in the 1950s, sporadically at first and then increasing in frequency in subsequent years. The reason for this delay is unclear, but we propose several hypotheses. PMID:27617324

Stem cells for the treatment of neurological disorders

NASA Astrophysics Data System (ADS)

Lindvall, Olle; Kokaia, Zaal

2006-06-01

Many common neurological disorders, such as Parkinson's disease, stroke and multiple sclerosis, are caused by a loss of neurons and glial cells. In recent years, neurons and glia have been generated successfully from stem cells in culture, fuelling efforts to develop stem-cell-based transplantation therapies for human patients. More recently, efforts have been extended to stimulating the formation and preventing the death of neurons and glial cells produced by endogenous stem cells within the adult central nervous system. The next step is to translate these exciting advances from the laboratory into clinically useful therapies.

Freezing of gait in PD: prospective assessment in the DATATOP cohort.

PubMed

Giladi, N; McDermott, M P; Fahn, S; Przedborski, S; Jankovic, J; Stern, M; Tanner, C

2001-06-26

To study the development of freezing of gait in PD. Freezing of gait is a common, disabling, and poorly understood symptom in PD. The authors analyzed data from 800 patients with early PD from the Deprenyl and Tocopherol Antioxidative Therapy of Parkinsonism (DATATOP) clinical trial who were assigned either placebo, deprenyl, tocopherol, or the combination of deprenyl and tocopherol. The primary outcome measure was the time from randomization until the freezing of gait score on the Unified Parkinson's Disease Rating Scale (UPDRS) became positive. Fifty-seven patients (7.1%) had freezing of gait at study entry and 193 (26%) of the remaining patients experienced the symptom by the end of the follow-up period. Those with freezing of gait at baseline had significantly more advanced disease than those without the symptom, as measured by total UPDRS and Hoehn and Yahr stage. High baseline risk factors for developing freezing of gait during the follow-up period were the onset of PD with a gait disorder; higher scores of rigidity, postural instability, bradykinesia and speech; and longer disease duration. In contrast, tremor was strongly associated with a decreased risk for freezing of gait. At the end of follow-up, the signs most strongly associated with the freezing phenomenon were gait, balance, and speech disorders, not rigidity or bradykinesia. Deprenyl treatment was strongly associated with a decreased risk for developing freezing of gait; tocopherol had no effect. Freezing of gait is directly related to duration of PD. Risk factors at onset of disease are the absence of tremor and PD beginning as a gait disorder. The development of freezing of gait in the course of the illness is strongly associated with the development of balance and speech problems, less so with the worsening of bradykinesia, and is not associated with the progression of rigidity. These results support the concept that the freezing phenomenon is distinct from bradykinesia. Deprenyl, in the absence

"Symptomatic" infection-associated acute encephalopathy in children with underlying neurological disorders.

PubMed

Hirayama, Yoshimichi; Saito, Yoshiaki; Maegaki, Yoshihiro

2017-03-01

Development of infection-associated acute encephalopathy (AE) is precipitated by several factors, including viral agents, age, and genetic polymorphisms. In addition, children with prior underlying neurological disorders can also present with AE. We reviewed 55 children with AE who were referred to hospitals participating in the Status Epilepticus Study Group from 1988 to 2013. AE was classified into eight subtypes: acute encephalopathy with biphasic seizures and late reduced diffusion (AESD); hemiconvulsion-hemiplegia syndrome (HH); acute necrotizing encephalopathy; hemorrhagic shock and encephalopathy syndrome (HSES); clinically mild encephalitis/encephalopathy with a reversible splenial lesion; acute encephalitis with refractory, repetitive partial seizures; Reye-like syndrome; and unclassified. Of the 55 AE cases, 14 (25.4%) had underlying neurological disorders, including perinatal insults (n=6) and genetic syndrome and/or brain malformations (n=8). These preceding morbidities were relatively common in AESD (6/18, 33.3%), HH (3/9, 33.3%), and HSES (3/6, 50.0%). History of epilepsy or febrile seizures were frequent in HH cases (4/9, 44.4%), whereas they were rare in other AE subtypes. Among the AE subgroups, HH, HSES, and AESD frequently emerged in preceding etiologies with augmented neuronal excitability. These subgroups may have distinct pathomechanism from the "cytokine storm" mediated AEs during childhood. Copyright © 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

78 FR 24764 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel; NeuroNEXT Special Emphasis Panel. Date: May 3, 2013. Time: 1:00...

78 FR 2414 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel, Translational SEP. Date: January 24, 2013. Time: 9:00 a.m. to 5...

76 FR 66730 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel, Pilot Clinical Trial. Date: November 4, 2011. Time: 5 p.m. to 6...

78 FR 18996 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel; Huntington's Disease SEP. Date: April 15, 2013. Time: 9:00 a.m...

IgLON5 antibody: Neurological accompaniments and outcomes in 20 patients.

PubMed

Honorat, Josephe A; Komorowski, Lars; Josephs, Keith A; Fechner, Kai; St Louis, Erik K; Hinson, Shannon R; Lederer, Sabine; Kumar, Neeraj; Gadoth, Avi; Lennon, Vanda A; Pittock, Sean J; McKeon, Andrew

2017-09-01

To describe the phenotypes, treatment response, and outcome of IgLON5 autoimmunity. Archived serum and CSF specimens from 367 patients known to harbor unclassified antibodies which stained neural synapses diffusely (mimicking amphiphysin-IgG) were reevaluated by indirect immunofluorescence assay (IFA) using a composite of mouse tissues and recombinant IgLON5-transfected cell-based assay (CBA, Euroimmun). Available specimens (serum, 25; CSF, 9) from 26/367 patients (7%) had identical IFA appearance and robust IgLON5 CBA positivity. Clinical information was available for 20/26 patients; 13 were women. Median disease-onset age was 62 years (range, 46-75 years). Most patients had insidious onset and progression of neurological symptoms affecting movement and sleep predominantly. Sleep disorders were sleep-disordered breathing (11) and parasomnias (3). Brainstem disorders were gait instability (14), dysphagia (10), abnormal eye movements (7), respiratory dysfunction (6), ataxia (5), craniocervical dystonia (3), and dysarthria (3). Findings compatible with hyperexcitability included myoclonus (3), cramps (3), fasciculations (2), and exaggerated startle (2). Neuropsychiatric disorders included cognitive dysfunction (6), psychiatric symptoms (5), and seizures (1). Dysautonomia, in 9, affected bladder function (7), gastrointestinal motility (3), thermoregulation (3), and orthostatic tolerance (1). Just 2 patients had coexisting autoimmune disease. Brain MRI findings were nonspecific and CSF was noninflammatory in all tested. Seven of 9 immunotherapy-treated patients improved: 6 of those 7 were stable at last follow-up. Three untreated patients died. Each IgLON5-IgG subclass (1-4) was readily detectable in ≥80% of specimens using CBA. IgLON5-IgG is diagnostic of a potentially treatable neurological disorder, where autoimmune clues are otherwise lacking.

Technology-Based Feedback and Its Efficacy in Improving Gait Parameters in Patients with Abnormal Gait: A Systematic Review

PubMed Central

Chamorro-Moriana, Gema; Moreno, Antonio José

2018-01-01

This systematic review synthesized and analyzed clinical findings related to the effectiveness of innovative technological feedback for tackling functional gait recovery. An electronic search of PUBMED, PEDro, WOS, CINAHL, and DIALNET was conducted from January 2011 to December 2016. The main inclusion criteria were: patients with modified or abnormal gait; application of technology-based feedback to deal with functional recovery of gait; any comparison between different kinds of feedback applied by means of technology, or any comparison between technological and non-technological feedback; and randomized controlled trials. Twenty papers were included. The populations were neurological patients (75%), orthopedic and healthy subjects. All participants were adults, bar one. Four studies used exoskeletons, 6 load platforms and 5 pressure sensors. The breakdown of the type of feedback used was as follows: 60% visual, 40% acoustic and 15% haptic. 55% used terminal feedback versus 65% simultaneous feedback. Prescriptive feedback was used in 60% of cases, while 50% used descriptive feedback. 62.5% and 58.33% of the trials showed a significant effect in improving step length and speed, respectively. Efficacy in improving other gait parameters such as balance or range of movement is observed in more than 75% of the studies with significant outcomes. Conclusion: Treatments based on feedback using innovative technology in patients with abnormal gait are mostly effective in improving gait parameters and therefore useful for the functional recovery of patients. The most frequently highlighted types of feedback were immediate visual feedback followed by terminal and immediate acoustic feedback. PMID:29316645

Modeling human neurological disorders with induced pluripotent stem cells.

PubMed

Imaizumi, Yoichi; Okano, Hideyuki

2014-05-01

Human induced pluripotent stem (iPS) cells obtained by reprogramming technology are a source of great hope, not only in terms of applications in regenerative medicine, such as cell transplantation therapy, but also for modeling human diseases and new drug development. In particular, the production of iPS cells from the somatic cells of patients with intractable diseases and their subsequent differentiation into cells at affected sites (e.g., neurons, cardiomyocytes, hepatocytes, and myocytes) has permitted the in vitro construction of disease models that contain patient-specific genetic information. For example, disease-specific iPS cells have been established from patients with neuropsychiatric disorders, including schizophrenia and autism, as well as from those with neurodegenerative diseases, including Parkinson's disease and Alzheimer's disease. A multi-omics analysis of neural cells originating from patient-derived iPS cells may thus enable investigators to elucidate the pathogenic mechanisms of neurological diseases that have heretofore been unknown. In addition, large-scale screening of chemical libraries with disease-specific iPS cells is currently underway and is expected to lead to new drug discovery. Accordingly, this review outlines the progress made via the use of patient-derived iPS cells toward the modeling of neurological disorders, the testing of existing drugs, and the discovery of new drugs. The production of human induced pluripotent stem (iPS) cells from the patients' somatic cells and their subsequent differentiation into specific cells have permitted the in vitro construction of disease models that contain patient-specific genetic information. Furthermore, innovations of gene-editing technologies on iPS cells are enabling new approaches for illuminating the pathogenic mechanisms of human diseases. In this review article, we outlined the current status of neurological diseases-specific iPS cell research and described recently obtained

Semantic Pattern Analysis for Verbal Fluency Based Assessment of Neurological Disorders

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sukumar, Sreenivas R; Ainsworth, Keela C; Brown, Tyler C

In this paper, we present preliminary results of semantic pattern analysis of verbal fluency tests used for assessing cognitive psychological and neuropsychological disorders. We posit that recent advances in semantic reasoning and artificial intelligence can be combined to create a standardized computer-aided diagnosis tool to automatically evaluate and interpret verbal fluency tests. Towards that goal, we derive novel semantic similarity (phonetic, phonemic and conceptual) metrics and present the predictive capability of these metrics on a de-identified dataset of participants with and without neurological disorders.

77 FR 35987 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel; Center Core Grants. Date: June 28, 2012. Time: 8:00 a.m. to 5...

78 FR 42528 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel; EUREKA. Date: August 14, 2013. Time: 8:00 a.m. to 6:00 p.m...

76 FR 6487 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-04

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel; EUREKA. Date: March 17, 2011. Time: 8 a.m. to 5 p.m. Agenda: To...

75 FR 54162 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-03

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel; T32 Training Grants. Date: October 19-20, 2010. Time: 8 a.m. to...

Auditory-Perceptual Assessment of Fluency in Typical and Neurologically Disordered Speech

ERIC Educational Resources Information Center

Penttilä, Nelly; Korpijaakko-Huuhka, Anna-Maija; Kent, Ray D.

2018-01-01

Purpose: The aim of this study is to investigate how speech fluency in typical and atypical speech is perceptually assessed by speech-language pathologists (SLPs). Our research questions were as follows: (a) How do SLPs rate fluency in speakers with and without neurological communication disorders? (b) Do they differentiate the speaker groups? and…

Neurologic manifestations of electrolyte disturbances.

PubMed

Riggs, Jack E

2002-02-01

Electrolyte disturbances occur commonly and are associated with a variety of characteristic neurologic manifestations involving both the central and peripheral nervous systems. Electrolyte disturbances are essentially always secondary processes. Effective management requires identification and treatment of the underlying primary disorder. Since neurological symptoms of electrolyte disorders are generally functional rather than structural, the neurologic manifestations of electrolyte disturbances are typically reversible. The neurologic manifestations of serum sodium, potassium, calcium, and magnesium disturbances are reviewed.

Quantification and recognition of parkinsonian gait from monocular video imaging using kernel-based principal component analysis

PubMed Central

2011-01-01

Background The computer-aided identification of specific gait patterns is an important issue in the assessment of Parkinson's disease (PD). In this study, a computer vision-based gait analysis approach is developed to assist the clinical assessments of PD with kernel-based principal component analysis (KPCA). Method Twelve PD patients and twelve healthy adults with no neurological history or motor disorders within the past six months were recruited and separated according to their "Non-PD", "Drug-On", and "Drug-Off" states. The participants were asked to wear light-colored clothing and perform three walking trials through a corridor decorated with a navy curtain at their natural pace. The participants' gait performance during the steady-state walking period was captured by a digital camera for gait analysis. The collected walking image frames were then transformed into binary silhouettes for noise reduction and compression. Using the developed KPCA-based method, the features within the binary silhouettes can be extracted to quantitatively determine the gait cycle time, stride length, walking velocity, and cadence. Results and Discussion The KPCA-based method uses a feature-extraction approach, which was verified to be more effective than traditional image area and principal component analysis (PCA) approaches in classifying "Non-PD" controls and "Drug-Off/On" PD patients. Encouragingly, this method has a high accuracy rate, 80.51%, for recognizing different gaits. Quantitative gait parameters are obtained, and the power spectrums of the patients' gaits are analyzed. We show that that the slow and irregular actions of PD patients during walking tend to transfer some of the power from the main lobe frequency to a lower frequency band. Our results indicate the feasibility of using gait performance to evaluate the motor function of patients with PD. Conclusion This KPCA-based method requires only a digital camera and a decorated corridor setup. The ease of use and

76 FR 6485 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-04

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Initial Review Group; NST-2 Subcommittee. Date: March 7-8, 2011. Time: 8 a.m. to 5 p.m...

77 FR 76054 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel; NeuroNEXT. Date: January 7, 2013. Time: 9:00 a.m. to 5:00 p.m...

On the personal facets of quality of life in chronic neurological disorders.

PubMed

Giovagnoli, Anna R; Martins da Silva, Antonio; Federico, Antonio; Cornelio, Ferdinando

2009-01-01

Quality of life (QOL) is an important clinical endpoint, but it remarkably varies in patients with similar neurological conditions. This study explored the role of spirituality (i.e., the complex of personal transcendence, connectedness, purpose, and values) in determining QOL in chronic neurological disorders.~Seventy-two patients with epilepsy, brain tumours or ischemic or immune-mediate brain damage compiled inventories for QOL (WHOQOL 100), spirituality (Spiritual, Religious and Personal Beliefs, WHOSRPB), depression (Beck Depression Inventory, BDI), anxiety (State-Trait Anxiety Inventory, STAI), and cognitive self-efficacy (Multiple Ability Self-Report Questionnaire, MASQ) and underwent neuropsychological testing. With respect to 45 healthy controls, the patients reported worse QOL, with no difference between the four patient subgroups. Factor analyses of the WHOSRPB, STAI, and BDI scores and of the MASQ and neuropsychological test scores yielded four (Personal Meaning, Inner Energy, Awe and Openness, Mood) and three factors (Control Functions, Cognition, Memory), respectively. Mood, Cognition, Inner Energy, schooling, and subjective health status correlated with the WHOQOL scores, but at regression analysis only Mood and Inner Energy predicted QOL. This suggests that spirituality, as a personal dimension distinct from mood, contributes to determine QOL. A multidimensional assessment of QOL, including personal facets, may explain differences between patients with chronic neurological disorders.

Growth associated protein (GAP-43): cloning and the development of a sensitive ELISA for neurological disorders.

PubMed

Gnanapavan, Sharmilee; Yousaf, Nasim; Heywood, Wendy; Grant, Donna; Mills, Kevin; Chernajovsky, Yuti; Keir, Geoff; Giovannoni, Gavin

2014-11-15

GAP-43 has been studied in the rodent and mammalian brain and shown to be present specifically in areas undergoing axonal elongation and synapse formation. GAP-43 was cloned using the baculovirus expression system and purified. A sandwich ELISA was developed using the recombinant GAP-43 as standard and validated. CSF GAP-43 levels were analysed in benign intracranial hypertension, movement disorders, multiple sclerosis, neuropathy, CNS infections, motor neuron disease, and headache (neurological controls). GAP-43 levels were low in all disorders analysed (in particular motor neuron disease; p=0.001, and movement disorders and multiple sclerosis; p<0.0001) compared to controls, aside from CNS infections. GAP-43 is preferentially reduced in the CSF of neurological disorders associated with neurodegeneration. Copyright © 2014. Published by Elsevier B.V.

Guided self-help interventions for mental health disorders in children with neurological conditions: study protocol for a pilot randomised controlled trial.

PubMed

Bennett, Sophie; Heyman, Isobel; Coughtrey, Anna; Simmonds, Jess; Varadkar, Sophia; Stephenson, Terence; DeJong, Margaret; Shafran, Roz

2016-11-04

Rates of mental health disorders are significantly greater in children with physical illnesses than in physically well children. Children with neurological conditions, such as epilepsy, are known to have particularly high rates of mental health disorders. Despite this, mental health problems in children with neurological conditions have remained under-recognised and under-treated in clinical settings. Evidence-based guided self-help interventions are efficacious in reducing symptoms of mental health disorders in children, but their efficacy in reducing symptoms of common mental health disorders in children with neurological conditions has not been investigated. We aim to pilot a guided self-help intervention for the treatment of mental health disorders in children with neurological conditions. A pilot randomised controlled trial with 18 patients with neurological conditions and mental health disorders will be conducted. Participants attending specialist neurology clinics at a National UK Children's Hospital will be randomised to receive guided self-help for common mental health disorders or to a 12-week waiting list control. Participants in the treatment group will receive 10 sessions of guided self-help delivered over the telephone. The waiting list control group will receive the intervention after a waiting period of 12 weeks. The primary outcome measure is reduction in symptoms of mental health disorders. Exclusion criteria are limited to those at significant risk of harm to self or others, the presence of primary mental health disorder other than anxiety, depression or disruptive behaviour (e.g. psychosis, eating disorder, obsessive-compulsive disorder) or intellectual disability at a level meaning potential participants would be unable to access the intervention. The study has ethical approval from the Camden and Islington NHS Research Ethics Committee, registration number 14.LO.1353. Results will be disseminated to patients, the wider public, clinicians and

Neurologic Music Therapy Training for Mobility and Stability Rehabilitation with Parkinson's Disease - A Pilot Study.

PubMed

Bukowska, Anna A; Krężałek, Piotr; Mirek, Elżbieta; Bujas, Przemysław; Marchewka, Anna

2015-01-01

Idiopathic Parkinson's Disease (PD) is a progressive condition with gait disturbance and balance disorder as the main symptoms. Previous research studies focused on the application of Rhythmic Auditory Stimulation (RAS) in PD gait rehabilitation. The key hypothesis of this pilot study, however, assumes the major role of the combination of all three Neurologic Music Therapy (NMT) sensorimotor techniques in improving spatio-temporal gait parameters, and postural stability in the course of PD. The 55 PD-diagnosed subjects invited to the study were divided into two groups: 30 in the experimental and 25 in the control group. Inclusion criteria included Hoehn and Yahr stages 2 or 3, the ability to walk independently without any aid and stable pharmacological treatment for the duration of the experiment. In order to evaluate the efficacy of the chosen therapy procedure the following measures were applied: Optoelectrical 3D Movement Analysis, System BTS Smart for gait, and Computerized Dynamic Posturography CQ Stab for stability and balance. All measures were conducted both before and after the therapy cycle. The subjects from the experimental group attended music therapy sessions four times a week for 4 weeks. Therapeutic Instrumental Music Performance (TIMP), Pattern Sensory Enhancement (PSE) and RAS were used in every 45-min session for practicing daily life activities, balance, pre-gait, and gait pattern. Percussion instruments, the metronome and rhythmic music were the basis for each session. The subjects from the control group were asked to stay active and perform daily life activities between the measures. The research showed that the combination of the three NMT sensorimotor techniques can be used to improve gait and other rhythmical activities in PD rehabilitation. The results demonstrated significant improvement in the majority of the spatiotemporal gait parameters in the experimental group in comparison to the control group. In the stability tests with eyes

The use of ketogenic diet in special situations: expanding use in intractable epilepsy and other neurologic disorders

PubMed Central

2012-01-01

The ketogenic diet has been widely used and proved to be effective for intractable epilepsy. Although the mechanisms underlying its anti-epileptic effects remain to be proven, there are increasing experimental evidences for its neuroprotective effects along with many researches about expanding use of the diet in other neurologic disorders. The first success was reported in glucose transporter type 1 deficiency syndrome, in which the diet served as an alternative metabolic source. Many neurologic disorders share some of the common pathologic mechanisms such as mitochondrial dysfunction, altered neurotransmitter function and synaptic transmission, or abnormal regulation of reactive oxygen species, and the role of the ketogenic diet has been postulated in these mechanisms. In this article, we introduce an overview about the expanding use and emerging trials of the ketogenic diet in various neurologic disorders excluding intractable epilepsy and provide explanations of the mechanisms in that usage. PMID:23049588

Alzheimer's disease and other neurological disorders.

PubMed

Henderson, V W

2007-10-01

Menopausal status and estrogen-containing hormone therapy may influence several neurological disorders, including Alzheimer's disease, epilepsy, migraine headache, multiple sclerosis, Parkinson's disease, sleep disorders, and stroke. For most of these illnesses, evidence on hormone therapy is insufficient to guide practice decisions. For stroke, clinical trial evidence indicates that hormone therapy increases risk of cerebral infarction. For women with Alzheimer's disease, estrogen treatment trials have tended to be small and of short duration. Most suggest that estrogen started after the onset of dementia symptoms does not meaningfully improve cognition or slow disease progression. Hormone therapy initiated after age 64 increased all-cause dementia in the Women's Health Initiative Memory Study. Many observational studies, however, report protective associations between hormone use and Alzheimer risk. Apparent risk reduction may represent a bias toward hormone therapy, since hormones are more often prescribed to healthier women. However, when compared to the Women's Health Initiative Memory Study, estrogen exposures in many observational studies reflect hormone initiation at a younger age, closer to the time of menopause. One intriguing hypothesis is that hormone therapy initiated or used during an early critical window may reduce later Alzheimer incidence. Public health implications of this hypothesis are important, but current data are inadequate to decide the issue.

78 FR 24763 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel, Re-Review of K99-R00. Date: May 7, 2013. Time: 1:30 p.m. to 2...

77 FR 37421 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-21

... Neurological Disorders and Stroke; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory... Disorders and Stroke Special Emphasis Panel, NINDS Center for Clinical Trial Resources. Date: July 10, 2012... Stroke Special Emphasis Panel, PD Biomarker Review. Date: July 18, 2012. Time: 8:00 a.m. to 6:00 p.m...

Neurologic manifestations of hypothyroidism in dogs.

PubMed

Bertalan, Abigail; Kent, Marc; Glass, Eric

2013-03-01

Hypothyroidism is a common endocrine disease in dogs. A variety of clinicopathologic abnormalities may be present; however, neurologic deficits are rare. In some instances, neurologic deficits may be the sole manifestation of hypothyroidism. Consequent ly, the diagnosis and management of the neurologic disorders associated with hypothyroidism can be challenging. This article describes several neurologic manifestations of primary hypothyroidism in dogs; discusses the pathophysiology of hypothyroidism-induced neurologic disorders affecting the peripheral and central nervous systems; and reviews the evidence for the neurologic effects of hypothyroidism.

The feasibility of establishing a free clinic for uninsured patients with neurologic disorders.

PubMed

Taylor, Joseph J; Larrew, Thomas; Omole, Armina; Roberts, Mallory; Kornegay, Adam; Kornegay, Kelly; Yamada, Lidia; Revuelta, Gonzalo J; Sohn, Mimi; Hughes, Thomas; Edwards, Jonathan C

2015-08-01

The Dream Center Neurology Clinic (DCNC) is a free specialty clinic associated with the Medical University of South Carolina that provides health care for uninsured patients with neurologic disorders. Routine neurologic care is often neglected by free primary care clinics, leaving indigent and uninsured patients to suffer from treatable neurologic ailments. The DCNC was established by supplementing existing resources from a free primary care facility called the Dream Center. Our strategy of building a high-need specialty service into a preexisting primary care infrastructure may provide a blueprint for neurologists who are eager to address the neurologic needs of the underserved in their local communities. According to local charge estimates, the DCNC has provided roughly $120,000 worth of outpatient neurologic care over the past year. The clinic runs through the collaborative effort of medical students as well as academic and private health care providers. Donated services such as EEG, diagnostic lab work, botulinum toxin, supplies, and imaging are also critical to clinic operations. In addition to providing the uninsured with services that are normally inaccessible to them, the DCNC provides a unique educational opportunity for medical students, residents, and all volunteers who are eager to help and learn.

The Required Coefficient of Friction for evaluating gait alterations in people with Multiple Sclerosis during gait.

PubMed

Pacifici, Ilaria; Galli, Manuela; Kleiner, Ana Francisca Rozin; Corona, Federica; Coghe, Giancarlo; Marongiu, Elisabetta; Loi, Andrea; Crisafulli, Antonio; Cocco, Eleonora; Marrosu, Maria Giovanna; Pau, Massimiliano

2016-11-01

Required Coefficient of Friction (RCOF) is one of the most critical gait parameters associated to the occurrence of slipping in individuals affected by neurological disorders characterized by balance impairments. This study aims to calculate RCOF in people with Multiple Sclerosis (MS) on the basis of three-dimensional Gait Analysis (GA) data. This study enrolls 22 people with MS (pwMS) who were characterized by an Expanded Disability Status Score in the range 1.5-6 and 10 healthy controls (HC). All participants underwent to three-dimensional GA from which we extracted kinematic and kinetic data (i.e. the Ground Reaction Forces, GRF, and joint moments and powers in the sagittal plane). RCOF was calculated as the ratio of the shear to normal GRF components during the stance phase of gait cycle, and normalized by the walking velocity. Thus, the following variables were extracted: first peak (named P1COF), valley (named V1COF), and second peak (named P2COF) in RCOF curve; also computating the maximum ankle dorsi-plantarflexion moment (MOMmax) and the maximum ankle joint power (PWRmax). Our data revealed that P2COF results are significantly lower in pwMS when compared to HC (p=0.043; Z=-2.025). In pwMS, the study found a moderate, positive correlation between V1COF and MOMmax (r=0.558; p<0.001) and a moderate, positive correlation between EDSS score and MOMmax (rho=0.622; p=0.001). While, in HC group, the study detected a moderate positive correlation between P1COF and MOM max (r=0.636; p=0.008). Friction during mid stance and push off phases is critically important to determine whether the frictional capabilities of foot/floor interface are sufficient to prevent slips in pwMS. The impaired ankle moment in MS group causes increased P2COF in comparison to HC, increasing the risk of slipping in the critical phase of transmission of the developed forces to kinematic chain. Also, the correlation analysis among RCOF values and kinetic variables describe the interplay between

Effect of rivastigmine on mobility of patients with higher-level gait disorder: a pilot exploratory study.

PubMed

Gurevich, Tanya; Balash, Yacov; Merims, Doron; Peretz, Chava; Herman, Talia; Hausdorff, Jeffrey M; Giladi, Nir

2014-06-01

Higher-level gait disorder (HLGD) in older adults is characterized by postural instability, stepping dysrhythmicity, recurrent falls and progressive immobility. Cognitive impairments are frequently associated with HLGD. The aim of this study was to compare gait and cognitive performance before and after the use of rivastigmine in patients with HLGD, free from cognitive impairment or Parkinsonism. Fifteen non-demented patients with HLGD (age 79.2 ± 5.9 years; 11 women; Mini-Mental State Examination [MMSE] 28.3 ± 1.4) received escalating doses of rivastigmine for 12 weeks in an open-label, pilot study. They were assessed before and after treatment (week 0 and week 12), and after a 4-week washout period (week 16). Assessments included the Mindstreams computerized neuropsychological battery, Activities-specific Balance Confidence Scale, State-Trait Anxiety Inventory, Geriatric Depression Scale, Timed Up and Go (TUG) test, gait speed and stride time variability. One-way multiple analysis of variance tests for repeated measures were used, and Pillai's trace test was considered as robust to investigate significant differences. The mean dose of rivastigmine during the 8-12 week period was 5.1 ± 2.3 mg/day. A positive effect was observed on the Mindstreams memory subscale and anxiety scores [Pillai's trace: F(6,724) = 0.508, p = 0.010; and F(7,792) = 0.545, p = 0.006, respectively, over the course of the study] as well as on mobility (TUG test) [Pillai's trace: F(4,863) = 0.448; p = 0.028], whereas gait speed and stride time variability did not change. The use of relatively low-dose rivastigmine did not affect gait speed and stride time variability; however, the general mobility and anxiety were improved. These preliminary results warrant a larger, randomized, placebo-controlled study.

Detection of chaotic dynamics in human gait signals from mobile devices

NASA Astrophysics Data System (ADS)

DelMarco, Stephen; Deng, Yunbin

2017-05-01

The ubiquity of mobile devices offers the opportunity to exploit device-generated signal data for biometric identification, health monitoring, and activity recognition. In particular, mobile devices contain an Inertial Measurement Unit (IMU) that produces acceleration and rotational rate information from the IMU accelerometers and gyros. These signals reflect motion properties of the human carrier. It is well-known that the complexity of bio-dynamical systems gives rise to chaotic dynamics. Knowledge of chaotic properties of these systems has shown utility, for example, in detecting abnormal medical conditions and neurological disorders. Chaotic dynamics has been found, in the lab, in bio-dynamical systems data such as electrocardiogram (heart), electroencephalogram (brain), and gait data. In this paper, we investigate the following question: can we detect chaotic dynamics in human gait as measured by IMU acceleration and gyro data from mobile phones? To detect chaotic dynamics, we perform recurrence analysis on real gyro and accelerometer signal data obtained from mobile devices. We apply the delay coordinate embedding approach from Takens' theorem to reconstruct the phase space trajectory of the multi-dimensional gait dynamical system. We use mutual information properties of the signal to estimate the appropriate delay value, and the false nearest neighbor approach to determine the phase space embedding dimension. We use a correlation dimension-based approach together with estimation of the largest Lyapunov exponent to make the chaotic dynamics detection decision. We investigate the ability to detect chaotic dynamics for the different one-dimensional IMU signals, across human subject and walking modes, and as a function of different phone locations on the human carrier.

Backward compared to forward over ground gait retraining have additional benefits for gait in individuals with mild to moderate Parkinson's disease: A randomized controlled trial.

PubMed

Grobbelaar, Roné; Venter, Ranel; Welman, Karen Estelle

2017-10-01

Over ground gait retraining in the reverse direction has shown to be beneficial for neurological rehabilitation, but has not yet been investigated in Parkinson's disease (PD). Backwards walking (BW) might be a useful training alternative to improve PD gait and possibly reduce fall risk during complex multi-directional daily activities. The primary aim was to compare the effect of an eight-week forward (FWG) and backwards (BWG) gait retraining program on gait parameters in PD individuals. Twenty-nine participants (aged 71.0±8.8years; UPDRS-III 38.1±12.3; H&Y 2.7±0.5) were randomly assigned to either the control (FWG; n=14) or experimental group (BWG; n=15). Baseline measures included disease severity (UPDRS III), global cognition (MoCA) and depression (PHQ-9). Outcome measures were selected gait variables on the 10m-instrumented-walk-test (i10mWT) assessed before and after the interventions. Both groups improved usual gait speed (FWG: p=0.03, d=0.35; BWG: p<0.01, d=0.35) and height-normalized gait speed (FWG: p=0.04, d=0.35; BWG: p<0.01, d=0.57). Additionally, the BWG demonstrated improved cadence (p<0.01, d=0.67) and stride length (SL; p=0.02, d=0.39). Both interventions were effective to improved gait speed sufficiently to independently navigate in the community. Copyright © 2017 Elsevier B.V. All rights reserved.

75 FR 57971 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-23

..., MD 20892-9529, 301-496-9223. (Catalogue of Federal Domestic Assistance Program Nos. 93.853, Clinical Research Related to Neurological Disorders; 93.854, Biological Basis Research in the Neurosciences...

The Neural Basis of Postural Instability Gait Disorder Subtype of Parkinson's Disease: A PET and fMRI Study.

PubMed

Zhang, Li; Li, Tian-Nv; Yuan, Yong-Sheng; Jiang, Si-Ming; Tong, Qing; Wang, Min; Wang, Jian-Wei; Chen, Hua-Jun; Ding, Jian; Xu, Qin-Rong; Zhang, Ke-Zhong

2016-05-01

The aim of this study is to further uncover the neural basis of postural instability gait disorder (PIGD) subtype of Parkinson's disease. With F-18 fluorodeoxyglucose PET (FDG-PET), brain glucose metabolism of patients with PIGD (n = 15) was compared with healthy controls (n = 17) and tremor-dominant (TD) patients (n = 15), and the correlation between metabolism and PIGD symptoms was also assessed. Within PIGD symptom-correlated hypometabolic areas, the relationship of functional connectivity (FC) with motor and cognitive symptoms was examined by using functional MRI. Compared with controls, patients with PIGD displayed a distributed pattern of brain hypometabolism including striatal, frontal, and parietal areas. Relative to the pattern of TD patients, the pattern of patients with PIGD had additional metabolic decreases in caudate and inferior parietal lobule (IPL, Brodmann area [BA] 40). In PIGD group, the metabolic reductions in IPL (BA 40), middle frontal gyrus (MFG, BA 9) and fusiform gyrus (FG, BA 20) were associated with severe PIGD symptoms. Regions showing such correlation were chosen for further seed-based FC analysis. Decreased FC within the prefrontal-parietal network (between the MFG and IPL) was associated with severe PIGD symptoms. The involvement of the caudate, FG, and prefrontal-parietal network may be associated with the prominent gait impairments of PIGD subtype. Our findings expand the pathophysiological knowledge of PIGD subtype and provide valuable information for potential neuromodulation therapies alleviating gait disorders. © 2016 John Wiley & Sons Ltd.

Neurologic complications of vaccinations.

PubMed

Miravalle, Augusto A; Schreiner, Teri

2014-01-01

This chapter reviews the most common neurologic disorders associated with common vaccines, evaluates the data linking the disorder with the vaccine, and discusses the potential mechanism of disease. A literature search was conducted in PubMed using a combination of the following terms: vaccines, vaccination, immunization, and neurologic complications. Data were also gathered from publications of the American Academy of Pediatrics Committee on Infectious Diseases, the World Health Organization, the US Centers for Disease Control and Prevention, and the Vaccine Adverse Event Reporting System. Neurologic complications of vaccination are rare. Many associations have been asserted without objective data to support a causal relationship. Rarely, patients with a neurologic complication will have a poor outcome. However, most patients recover fully from the neurologic complication. Vaccinations have altered the landscape of infectious disease. However, perception of risk associated with vaccinations has limited the success of disease eradication measures. Neurologic complications can be severe, and can provoke fear in potential vaccines. Evaluating whether there is causal link between neurologic disorders and vaccinations, not just temporal association, is critical to addressing public misperception of risk of vaccination. Among the vaccines available today, the cost-benefit analysis of vaccinations and complications strongly argues in favor of vaccination. © 2014 Elsevier B.V. All rights reserved.

Usual gait speed independently predicts mortality in very old people: a population-based study.

PubMed

Toots, Annika; Rosendahl, Erik; Lundin-Olsson, Lillemor; Nordström, Peter; Gustafson, Yngve; Littbrand, Håkan

2013-07-01

In older people, usual gait speed has been shown to independently predict mortality; however, less is known about whether usual gait speed is as informative in very old populations, in which prevalence of multimorbidity and disability is high. The aim of this study was to investigate if usual gait speed can independently predict all-cause mortality in very old people, and whether the prediction is influenced by dementia disorder, dependency in activities of daily living (ADL), or use of walking aids in the gait speed test. Prospective cohort study. Population-based study in northern Sweden and Finland (the Umeå 85+/GERDA Study). A total of 772 participants with a mean age of 89.6 years, 70% women, 33% with dementia disorders, 54% with ADL dependency, and 39% living in residential care facilities. Usual gait speed assessed over 2.4 meters and mortality followed-up for 5 years. The mean ± SD gait speed was 0.52 ± 0.21 m/s for the 620 (80%) participants able to complete the gait speed test. Cox proportional hazard regression analyses adjusted for potential confounders were performed. Compared with the fastest gait speed group (≥ 0.64 m/s), the hazard ratio for mortality was for the following groups: unable = 2.27 (P < .001), ≤ 0.36 m/s = 1.97 (P = .001), 0.37 to 0.49 m/s = 1.99 (P < .001), 0.50 to 0.63 m/s = 1.11 (P = .604). No interaction effects were found between gait speed and age, sex, dementia disorder, dependency in ADLs, or use of walking aids. Among people aged 85 or older, including people dependent in ADLs and with dementia disorders, usual gait speed was an independent predictor of 5-year all-cause mortality. Inability to complete the gait test or gait speeds slower than 0.5 m/s appears to be associated with higher mortality risk. Gait speed might be a useful clinical indicator of health status among very old people. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Deep brain stimulation of the pedunculopontine nucleus for treatment of gait and balance disorder in progressive supranuclear palsy: Effects of frequency modulations and clinical outcome.

PubMed

Galazky, Imke; Kaufmann, Jörn; Lorenzl, Stefan; Ebersbach, Georg; Gandor, Florin; Zaehle, Tino; Specht, Sylke; Stallforth, Sabine; Sobieray, Uwe; Wirkus, Edyta; Casjens, Franziska; Heinze, Hans-Jochen; Kupsch, Andreas; Voges, Jürgen

2018-05-01

The pedunculopontine nucleus has been suggested as a potential deep brain stimulation target for axial symptoms such as gait and balance impairment in idiopathic Parkinson's disease as well as atypical Parkinsonian disorders. Seven consecutive patients with progressive supranuclear palsy received bilateral pedunculopontine nucleus deep brain stimulation. Inclusion criteria comprised of the clinical diagnosis of progressive supranuclear palsy, a levodopa-resistant gait and balance disorder, age <75 years, and absence of dementia or major psychiatric co-morbidities. Effects of stimulation frequencies at 8, 20, 60 and 130 Hz on motor scores and gait were assessed. Motor scores were followed up for two years postoperatively. Activities of daily living, frequency of falls, health-related quality of life, cognition and mood at 12 months were compared to baseline parameters. Surgical and stimulation related adverse events were assessed. Bilateral pedunculopontine nucleus deep brain stimulation at 8 Hz significantly improved axial motor symptoms and cyclic gait parameters, while high frequency stimulation did not ameliorate gait and balance but improved hypokinesia. This improvement however did not translate into clinically relevant benefits. Frequency of falls was not reduced. Activities of daily living, quality of life and frontal cognitive functions declined, while mood remained unchanged. Bilateral pedunculopontine nucleus deep brain stimulation in progressive supranuclear palsy generates frequency-dependent effects with improvement of cyclic gait parameters at low frequency and amelioration of hypokinesia at high frequency stimulation. However, these effects do not translate into a clinically important improvement. Copyright © 2018. Published by Elsevier Ltd.

Measurement instruments to assess posture, gait, and balance in Parkinson's disease: Critique and recommendations.

PubMed

Bloem, Bastiaan R; Marinus, Johan; Almeida, Quincy; Dibble, Lee; Nieuwboer, Alice; Post, Bart; Ruzicka, Evzen; Goetz, Christopher; Stebbins, Glenn; Martinez-Martin, Pablo; Schrag, Anette

2016-09-01

Disorders of posture, gait, and balance in Parkinson's disease (PD) are common and debilitating. This MDS-commissioned task force assessed clinimetric properties of existing rating scales, questionnaires, and timed tests that assess these features in PD. A literature review was conducted. Identified instruments were evaluated systematically and classified as "recommended," "suggested," or "listed." Inclusion of rating scales was restricted to those that could be used readily in clinical research and practice. One rating scale was classified as "recommended" (UPDRS-derived Postural Instability and Gait Difficulty score) and 2 as "suggested" (Tinetti Balance Scale, Rating Scale for Gait Evaluation). Three scales requiring equipment (Berg Balance Scale, Mini-BESTest, Dynamic Gait Index) also fulfilled criteria for "recommended" and 2 for "suggested" (FOG score, Gait and Balance Scale). Four questionnaires were "recommended" (Freezing of Gait Questionnaire, Activities-specific Balance Confidence Scale, Falls Efficacy Scale, Survey of Activities, and Fear of Falling in the Elderly-Modified). Four tests were classified as "recommended" (6-minute and 10-m walk tests, Timed Up-and-Go, Functional Reach). We identified several questionnaires that adequately assess freezing of gait and balance confidence in PD and a number of useful clinical tests. However, most clinical rating scales for gait, balance, and posture perform suboptimally or have been evaluated insufficiently. No instrument comprehensively and separately evaluates all relevant PD-specific gait characteristics with good clinimetric properties, and none provides separate balance and gait scores with adequate content validity for PD. We therefore recommend the development of such a PD-specific, easily administered, comprehensive gait and balance scale that separately assesses all relevant constructs. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder

Effect of Interpersonal Interaction on Festinating Gait Rehabilitation in Patients with Parkinson's Disease.

PubMed

Uchitomi, Hirotaka; Ogawa, Ken-Ichiro; Orimo, Satoshi; Wada, Yoshiaki; Miyake, Yoshihiro

2016-01-01

Although human walking gait rhythms are generated by native individual gait dynamics, these gait dynamics change during interactions between humans. A typical phenomenon is synchronization of gait rhythms during cooperative walking. Our previous research revealed that fluctuation characteristics in stride interval of subjects with Parkinson's disease changed from random to 1/f fluctuation as fractal characteristics during cooperative walking with the gait assist system Walk-Mate, which emulates a human interaction using interactive rhythmic cues. Moreover, gait dynamics were relearned through Walk-Mate gait training. However, the system's clinical efficacy was unclear because the previous studies did not focus on specific gait rhythm disorder symptoms. Therefore, this study aimed to evaluate the effect of Walk-Mate on festinating gait among subjects with Parkinson's disease. Three within-subject experimental conditions were used: (1) preinteraction condition, (2) interaction condition, and (3) postinteraction condition. The only difference between conditions was the interactive rhythmic cues generated by Walk-Mate. Because subjects with festinating gait gradually and involuntarily decreased their stride interval, the regression slope of stride interval as an index of severity of preinteraction festinating gait was elevated. The regression slope in the interaction condition was more gradual than during the preinteraction condition, indicating that the interactive rhythmic cues contributed to relieving festinating gait and stabilizing gait dynamics. Moreover, the gradual regression slope was carried over to the postinteraction condition, indicating that subjects with festinating gait have the potential to relearn stable gait dynamics. These results suggest that disordered gait dynamics are clinically restored through interactive rhythmic cues and that Walk-Mate may have the potential to assist therapists in more effective rehabilitation. UMIN Clinical Trials Registry

Insights into gait disorders: walking variability using phase plot analysis, Huntington's disease.

PubMed

Collett, Johnny; Esser, Patrick; Khalil, Hanan; Busse, Monica; Quinn, Lori; DeBono, Katy; Rosser, Anne; Nemeth, Andrea H; Dawes, Helen

2014-09-01

Huntington's disease (HD) is a progressive inherited neurodegenerative disorder. Identifying sensitive methodologies to quantitatively measure early motor changes have been difficult to develop. This exploratory observational study investigated gait variability and symmetry in HD using phase plot analysis. We measured the walking of 22 controls and 35 HD gene carriers (7 premanifest (PreHD)), 16 early/mid (HD1) and 12 late stage (HD2) in Oxford and Cardiff, UK. The unified Huntington's disease rating scale-total motor scores (UHDRS-TMS) and disease burden scores (DBS) were used to quantify disease severity. Data was collected during a clinical walk test (8.8 or 10 m) using an inertial measurement unit attached to the trunk. The 6 middle strides were used to calculate gait variability determined by spatiotemporal parameters (co-efficient of variation (CoV)) and phase plot analysis. Phase plots considered the variability in consecutive wave forms from vertical movement and were quantified by SDA (spatiotemporal variability), SDB (temporal variability), ratio ∀ (ratio SDA:SDB) and Δangleβ (symmetry). Step time CoV was greater in manifest HD (p<0.01, both manifest groups) than controls, as was stride length CoV for HD2 (p<0.01). No differences were found in spatiotemporal variability between PreHD and controls (p>0.05). Phase plot analysis identified differences between manifest HD and controls for SDB, Ratio ∀ and Δangle (all p<0.01, both manifest groups). Furthermore Ratio ∀ was smaller in PreHD compared with controls (p<0.01). Ratio ∀ also produced the strongest correlation with UHDRS-TMS (r=-0.61, p<0.01) and was correlated with DBS (r=-0.42, p=0.02). Phase plot analysis may be a sensitive method of detecting gait changes in HD and can be performed quickly during clinical walking tests. Copyright © 2014 Elsevier B.V. All rights reserved.

Quantitative Evaluation of the Use of Actigraphy for Neurological and Psychiatric Disorders

PubMed Central

Song, Yu; Kwak, Shin; Yoshida, Sohei; Yamamoto, Yoshiharu

2014-01-01

Quantitative and objective evaluation of disease severity and/or drug effect is necessary in clinical practice. Wearable accelerometers such as an actigraph enable long-term recording of a patient's movement during activities and they can be used for quantitative assessment of symptoms due to various diseases. We reviewed some applications of actigraphy with analytical methods that are sufficiently sensitive and reliable to determine the severity of diseases and disorders such as motor and nonmotor disorders like Parkinson's disease, sleep disorders, depression, behavioral and psychological symptoms of dementia (BPSD) for vascular dementia (VD), seasonal affective disorder (SAD), and stroke, as well as the effects of drugs used to treat them. We believe it is possible to develop analytical methods to assess more neurological or psychopathic disorders using actigraphy records. PMID:25214709

Gait impairment precedes clinical symptoms in spinocerebellar ataxia type 6.

PubMed

Rochester, Lynn; Galna, Brook; Lord, Sue; Mhiripiri, Dadirayi; Eglon, Gail; Chinnery, Patrick F

2014-02-01

Spinocerebellar ataxia type 6 (SCA6) is an inherited ataxia with no established treatment. Gait ataxia is a prominent feature causing substantial disability. Understanding the evolution of the gait disturbance is a key step in developing treatment strategies. We studied 9 gait variables in 24 SCA6 (6 presymptomatic; 18 symptomatic) and 24 controls and correlated gait with clinical severity (presymptomatic and symptomatic). Discrete gait characteristics precede symptoms in SCA6 with significantly increased variability of step width and step time, whereas a more global gait deficit was evident in symptomatic individuals. Gait characteristics discriminated between presymptomatic and symptomatic individuals and were selectively associated with disease severity. This is the largest study to include a detailed characterization of gait in SCA6, including presymptomatic subjects, allowing changes across the disease spectrum to be compared. Selective gait disturbance is already present in SCA6 before clinical symptoms appear and gait characteristics are also sensitive to disease progression. Early gait disturbance likely reflects primary pathology distinct from secondary changes. These findings open the opportunity for early evaluation and sensitive measures of therapeutic efficacy using instrumented gait analysis which may have broader relevance for all degenerative ataxias. © 2013 Movement Disorder Society.

Cingulo-insular structural alterations associated with psychogenic symptoms, childhood abuse and PTSD in functional neurological disorders.

PubMed

Perez, David L; Matin, Nassim; Barsky, Arthur; Costumero-Ramos, Victor; Makaretz, Sara J; Young, Sigrid S; Sepulcre, Jorge; LaFrance, W Curt; Keshavan, Matcheri S; Dickerson, Bradford C

2017-06-01

Adverse early-life events are predisposing factors for functional neurological disorder (FND) and post-traumatic stress disorder (PTSD). Cingulo-insular regions are implicated in the biology of both conditions and are sites of stress-mediated neuroplasticity. We hypothesised that functional neurological symptoms and the magnitude of childhood abuse would be associated with overlapping anterior cingulate cortex (ACC) and insular volumetric reductions, and that FND and PTSD symptoms would map onto distinct cingulo-insular areas. This within-group voxel-based morphometry study probes volumetric associations with self-report measures of functional neurological symptoms, adverse life events and PTSD symptoms in 23 mixed-gender FND patients. Separate secondary analyses were also performed in the subset of 18 women with FND to account for gender-specific effects. Across the entire cohort, there were no statistically significant volumetric associations with self-report measures of functional neurological symptom severity or childhood abuse. In women with FND, however, parallel inverse associations were observed between left anterior insular volume and functional neurological symptoms as measured by the Patient Health Questionnaire-15 and the Screening for Somatoform Symptoms Conversion Disorder subscale. Similar inverse relationships were also appreciated between childhood abuse burden and left anterior insular volume. Across all subjects, PTSD symptom severity was inversely associated with dorsal ACC volume, and the magnitude of lifetime adverse events was inversely associated with left hippocampal volume. This study reveals distinct cingulo-insular alterations for FND and PTSD symptoms and may advance our understanding of FND. Potential biological convergence between stress-related neuroplasticity, functional neurological symptoms and reduced insular volume was identified. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017

What do eye movements tell us about patients with neurological disorders? — An introduction to saccade recording in the clinical setting —

PubMed Central

TERAO, Yasuo; FUKUDA, Hideki; HIKOSAKA, Okihide

2017-01-01

Non-invasive and readily implemented in the clinical setting, eye movement studies have been conducted extensively not only in healthy human subjects but also in patients with neurological disorders. The purpose of saccade studies is to “read out” the pathophysiology underlying neurological disorders from the saccade records, referring to known primate physiology. In the current review, we provide an overview of studies in which we attempted to elucidate the patterns of saccade abnormalities in over 250 patients with neurological disorders, including cerebellar ataxia and brainstem pathology due to neurodegenerative disorders, and what they tell about the pathophysiology of patients with neurological disorders. We also discuss how interventions, such as deep brain stimulation, affect saccade performance and provide further insights into the workings of the oculomotor system in humans. Finally, we argue that it is important to understand the functional significance and behavioral correlate of saccade abnormalities in daily life, which could require eye tracking methodologies to be performed in settings similar to daily life. PMID:29225306

Occupational neurology.

PubMed Central

Feldman, R. G.

1987-01-01

The nervous system is vulnerable to the effects of certain chemicals and physical conditions found in the work environment. The activities of an occupational neurologist focus on the evaluation of patients with neurological disorders caused by occupational or environmental conditions. When one is making a differential diagnosis in patients with neurological disorders, the possibility of toxic exposure or encounters with physical factors in the workplace must not be overlooked. Central to an accurate clinical diagnosis is the patient's history. A diagnosis of an occupational or environmental neurological problem requires a careful assessment of the clinical abnormalities and confirmation of these disabilities by objective tests such as nerve conduction velocity, evoked potentials, electroencephalogram, neuropsychological batteries, or nerve biopsy. On the basis of information about hazards in the workplace, safety standards and environmental and biological monitoring can be implemented in the workplace to reduce the risks of undue injury. Clinical manifestations of headache, memory disturbance, and peripheral neuropathy are commonly encountered presentations of the effects of occupational hazards. Physicians in everyday clinical practice must be aware of the signs and symptoms associated with exposure to possible neurotoxins and work methods. Occupational and environmental circumstances must be explored when evaluating patients with neurologic disorders. PMID:3577214

Lesions causing freezing of gait localize to a cerebellar functional network

PubMed Central

Fasano, Alfonso; Laganiere, Simon E.; Lam, Susy; Fox, Michael D.

2016-01-01

Objective Freezing of gait is a disabling symptom in Parkinson’s disease and related disorders, but the brain regions involved in symptom generation remain unclear. Here we analyze brain lesions causing acute onset freezing of gait to identify regions causally involved in symptom generation. Methods Fourteen cases of lesion-induced freezing of gait were identified from the literature and lesions were mapped to a common brain atlas. Because lesion-induced symptoms can come from sites connected to the lesion location, not just the lesion location itself, we also identified brain regions functionally connected to each lesion location. This technique, termed lesion network mapping, has been recently shown to identify regions involved in symptom generation across a variety of lesion-induced disorders. Results Lesion location was heterogeneous and no single region could be considered necessary for symptom generation. However, over 90% (13/14) of lesions were functionally connected to a focal area in the dorsal medial cerebellum. This cerebellar area overlapped previously recognized regions that are activated by locomotor tasks, termed the cerebellar locomotor region. Connectivity to this region was specific to lesions causing freezing of gait compared to lesions causing other movement disorders (hemichorea or asterixis). Interpretation Lesions causing freezing of gait are located within a common functional network characterized by connectivity to the cerebellar locomotor region. These results based on causal brain lesions complement prior neuroimaging studies in Parkinson’s disease patients, advancing our understanding of the brain regions involved in freezing of gait. PMID:28009063

A physical mechanism in the treatment of neurologic disorders with externally applied pico Tesla magnetic fields.

PubMed

Jacobson, J I; Yamanashi, W S

1995-06-01

The clinical studies describing the treatment of some neurological disorders with an externally applied pico Tesla (10R Tesla, or 10(-8) gauss) magnetic field are considered from a physical view point. An equation relating the intrinsic or "rest" energy of a charged particle of mass with its energy of interaction in an externally applied magnetic field B is presented. The equation is proposed to represent an initial basic physical interaction as a part of a more complex biological mechanism to explain the therapeutic effects of externally applied magnetic fields in these and other neurologic disorders.

Novel paths towards neural cellular products for neurological disorders.

PubMed

Daadi, Marcel M

2011-11-01

The prospect of using neural cells derived from stem cells or from reprogrammed adult somatic cells provides a unique opportunity in cell therapy and drug discovery for developing novel strategies for brain repair. Cell-based therapeutic approaches for treating CNS afflictions caused by disease or injury aim to promote structural repair of the injured or diseased neural tissue, an outcome currently not achieved by drug therapy. Preclinical research in animal models of various diseases or injuries report that grafts of neural cells enhance endogenous repair, provide neurotrophic support to neurons undergoing degeneration and replace lost neural cells. In recent years, the sources of neural cells for treating neurological disorders have been rapidly expanding and in addition to offering therapeutic potential, neural cell products hold promise for disease modeling and drug discovery use. Specific neural cell types have been derived from adult or fetal brain, from human embryonic stem cells, from induced pluripotent stem cells and directly transdifferentiated from adult somatic cells, such as skin cells. It is yet to be determined if the latter approach will evolve into a paradigm shift in the fields of stem cell research and regenerative medicine. These multiple sources of neural cells cover a wide spectrum of safety that needs to be balanced with efficacy to determine the viability of the cellular product. In this article, we will review novel sources of neural cells and discuss current obstacles to developing them into viable cellular products for treating neurological disorders.

Paraneoplastic neurologic disorders in small cell lung carcinoma

PubMed Central

Woodhall, Mark; Chapman, Caroline; Nibber, Anjan; Waters, Patrick; Vincent, Angela; Lang, Bethan; Maddison, Paul

2015-01-01

Objective: To determine the frequency and range of paraneoplastic neurologic disorders (PNDs) and neuronal antibodies in small cell lung carcinoma (SCLC). Methods: Two hundred sixty-four consecutive patients with biopsy-proven SCLC were recruited at the time of tumor diagnosis. All patients underwent full neurologic examination. Serum samples were taken prior to chemotherapy and analyzed for 15 neuronal antibodies. Thirty-eight healthy controls were analyzed in parallel. Results: PNDs were quite prevalent (n = 24, 9.4%), most frequently Lambert-Eaton myasthenic syndrome (3.8%), sensory neuronopathy (1.9%), and limbic encephalitis (1.5%). Eighty-seven percent of all patients with PNDs had antibodies to SOX2 (62.5%), HuD (41.7%), or P/Q VGCC (50%), irrespective of their syndrome. Other neuronal antibodies were found at lower frequencies (GABAb receptor [12.5%] and N-type VGCC [20.8%]) or very rarely (GAD65, amphiphysin, Ri, CRMP5, Ma2, Yo, VGKC complex, CASPR2, LGI1, and NMDA receptor [all <5%]). Conclusions: The spectrum of PNDs is broader and the frequency is higher than previously appreciated, and selected antibody tests (SOX2, HuD, VGCC) can help determine the presence of an SCLC. PMID:26109714

Effects of using the nintendo wii fit plus platform in the sensorimotor training of gait disorders in Parkinson's disease.

PubMed

Gonçalves, Giovanna Barros; Leite, Marco Antônio A; Orsini, Marco; Pereira, João Santos

2014-01-17

The use of the Nintendo Wii has been considered a good alternative in the motor rehabilitation of individuals with Parkinson's disease (PD), requiring simultaneous interaction to develop strategies for physical, visual, auditory, cognitive, psychological and social activities in the performing of virtual activities, resulting in improvement in functional performance and gait. The aim of this study was to analyze the effect of virtual sensorimotor activity on gait disorders in people with PD. Fifteen subjects with a clinical diagnosis of PD were submitted to the Unified Parkinson's Disease Rating Scale (UPDRS III), Schwab and England Activities of Daily Living Scale (SE), Functional Independence Measure (FIM), and biomechanical gait analysis using digital images taken with a video camera before and after the treatment program. The activities with the Nintendo Wii virtual platform were standardized into three categories: aerobics, balance and Wii plus exercises. Participants carried out separate virtual exercises for 40 min, twice a week, for a total of 14 sessions. The program improved sensorimotor performance in PD gait, with an increase in stride length and gait speed, in addition to a reduction in motor impairment, especially in items of rigidity and flexibility of the lower limbs evaluated by UPDRS III, and greater functional independence, as evidenced in the SE and FIM scales. Improvements in items related to locomotion and stair climbing were also observed. The training was effective in motor recovery in chronic neurodegenerative diseases, showing improvement in motor performance and functional independence in individuals with PD.

Laboratory review: the role of gait analysis in seniors' mobility and fall prevention.

PubMed

Bridenbaugh, Stephanie A; Kressig, Reto W

2011-01-01

Walking is a complex motor task generally performed automatically by healthy adults. Yet, by the elderly, walking is often no longer performed automatically. Older adults require more attention for motor control while walking than younger adults. Falls, often with serious consequences, can be the result. Gait impairments are one of the biggest risk factors for falls. Several studies have identified changes in certain gait parameters as independent predictors of fall risk. Such gait changes are often too discrete to be detected by clinical observation alone. At the Basel Mobility Center, we employ the GAITRite electronic walkway system for spatial-temporal gait analysis. Although we have a large range of indications for gait analyses and several areas of clinical research, our focus is on the association between gait and cognition. Gait analysis with walking as a single-task condition alone is often insufficient to reveal underlying gait disorders present during normal, everyday activities. We use a dual-task paradigm, walking while simultaneously performing a second cognitive task, to assess the effects of divided attention on motor performance and gait control. Objective quantification of such clinically relevant gait changes is necessary to determine fall risk. Early detection of gait disorders and fall risk permits early intervention and, in the best-case scenario, fall prevention. We and others have shown that rhythmic movement training such as Jaques-Dalcroze eurhythmics, tai chi and social dancing can improve gait regularity and automaticity, thus increasing gait safety and reducing fall risk. Copyright © 2010 S. Karger AG, Basel.

Prevalence and incidence of neurological disorders among adult Ugandans in rural and urban Mukono district; a cross-sectional study.

PubMed

Kaddumukasa, Mark; Mugenyi, Leviticus; Kaddumukasa, Martin N; Ddumba, Edward; Devereaux, Michael; Furlan, Anthony; Sajatovic, Martha; Katabira, Elly

2016-11-17

The burden of neurological diseases is increasing in developing countries. However, there is a prominent scarcity of literature on the incidence of neurological diseases in sub-Saharan Africa. This study was therefore undertaken to determine the prevalence and incidence of neurological diseases in this setting to serve as a baseline for planning and care for neurological disorders in Uganda. The study was conducted within rural and urban Mukono district, east of Kampala city of Uganda, central region. Over a period of six months, a cross sectional survey was conducted and screening was performed using a standardized questionnaire. All subjects with neurological symptoms and signs were reviewed by a team of neurologists and neurological diagnoses made. Of the 3000 study subjects, 50.3% (1510/3000) were from the rural setting. Out of the participants screened, 67.4% were female, with a median age of 33 years. Among the 98 subjects with confirmed neurological disorders, the frequency of diseases was as follows; peripheral neuropathy (46.2%), chronic headaches (26.4%), and epilepsy (8.5%), followed by pain syndromes (7.5%), stroke (6.6%) and tremors/Parkinson disease (3.8%). The crude prevalence rates of these disorders (95% CI) were 14.3% (8.5-24.1); 13.3% (7.7-22.8); 33.7% (23.9-47.4) for stroke, epilepsy and peripheral neuropathy respectively. Peripheral neuropathy followed by chronic headaches had the highest estimated incidence/1000 years. Stroke had an estimated incidence of 3.6 new cases with 95% CI of (2.1-6.1)/1000 years. Peripheral neuropathy, chronic headaches and epilepsy disorders are major causes of morbidity in Sub-Saharan settings. There is an urgent need of more robust and powered studies to determine the incidence of these diseases.

Computational intelligence in gait research: a perspective on current applications and future challenges.

PubMed

Lai, Daniel T H; Begg, Rezaul K; Palaniswami, Marimuthu

2009-09-01

Our mobility is an important daily requirement so much so that any disruption to it severely degrades our perceived quality of life. Studies in gait and human movement sciences, therefore, play a significant role in maintaining the well-being of our mobility. Current gait analysis involves numerous interdependent gait parameters that are difficult to adequately interpret due to the large volume of recorded data and lengthy assessment times in gait laboratories. A proposed solution to these problems is computational intelligence (CI), which is an emerging paradigm in biomedical engineering most notably in pathology detection and prosthesis design. The integration of CI technology in gait systems facilitates studies in disorders caused by lower limb defects, cerebral disorders, and aging effects by learning data relationships through a combination of signal processing and machine learning techniques. Learning paradigms, such as supervised learning, unsupervised learning, and fuzzy and evolutionary algorithms, provide advanced modeling capabilities for biomechanical systems that in the past have relied heavily on statistical analysis. CI offers the ability to investigate nonlinear data relationships, enhance data interpretation, design more efficient diagnostic methods, and extrapolate model functionality. These are envisioned to result in more cost-effective, efficient, and easy-to-use systems, which would address global shortages in medical personnel and rising medical costs. This paper surveys current signal processing and CI methodologies followed by gait applications ranging from normal gait studies and disorder detection to artificial gait simulation. We review recent systems focusing on the existing challenges and issues involved in making them successful. We also examine new research in sensor technologies for gait that could be combined with these intelligent systems to develop more effective healthcare solutions.

Robot-assisted gait training in multiple sclerosis patients: a randomized trial.

PubMed

Schwartz, Isabella; Sajin, Anna; Moreh, Elior; Fisher, Iris; Neeb, Martin; Forest, Adina; Vaknin-Dembinsky, Adi; Karusis, Dimitrios; Meiner, Zeev

2012-06-01

Preservation of locomotor activity in multiple sclerosis (MS) patients is of utmost importance. Robotic-assisted body weight-supported treadmill training is a promising method to improve gait functions in neurologically impaired patients, although its effectiveness in MS patients is still unknown. To compare the effectiveness of robot-assisted gait training (RAGT) with that of conventional walking treatment (CWT) on gait and generalized functions in a group of stable MS patients. A prospective randomized controlled trial of 12 sessions of RAGT or CWT in MS patients of EDSS score 5-7. Primary outcome measures were gait parameters and the secondary outcomes were functional and quality of life parameters. All tests were performed at baseline, 3 and 6 months post-treatment by a blinded rater. Fifteen and 17 patients were randomly allocated to RAGT and CWT, respectively. Both groups were comparable at baseline in all parameters. As compared with baseline, although some gait parameters improved significantly following the treatment at each time point there was no difference between the groups. Both FIM and EDSS scores improved significantly post-treatment with no difference between the groups. At 6 months, most gait and functional parameters had returned to baseline. Robot-assisted gait training is feasible and safe and may be an effective additional therapeutic option in MS patients with severe walking disabilities.

Quadrupedal rodent gait compensations in a low dose monoiodoacetate model of osteoarthritis.

PubMed

Lakes, Emily H; Allen, Kyle D

2018-06-01

Rodent gait analysis provides robust, quantitative results for preclinical musculoskeletal and neurological models. In prior work, surgical models of osteoarthritis have been found to result in a hind limb shuffle-stepping gait compensation, while a high dose monoiodoacetate (MIA, 3 mg) model resulted in a hind limb antalgic gait. However, it is unknown whether the antalgic gait caused by MIA is associated with severity of degeneration from the high dosage or the whole-joint degeneration associated with glycolysis inhibition. This study evaluates rodent gait changes resulting from a low dose, 1 mg unilateral intra-articular injection of MIA compared to saline injected and naïve rats. Spatiotemporal and dynamic gait parameters were collected from a total of 42 male Lewis rats spread across 3 time points: 1, 2, and 4 weeks post-injection. To provide a detailed analysis of this low dose MIA model, gait analysis was used to uniquely quantify both fore and hind limb gait parameters. Our data indicate that 1 mg of MIA caused relatively minor degeneration and a shuffle-step gait compensation, similar to the compensation observed in prior surgical models. These data from a 1 mg MIA model show a different gait compensation compared to a previously studied 3 mg model. This 1 mg MIA model resulted in gait compensations more similar to a previously studied surgical model of osteoarthritis. Additionally, this study provides detailed 4 limb analysis of rodent gait that includes spatiotemporal and dynamic data from the same gait trial. These data highlight the importance of measuring dynamic data in combination with spatiotemporal data, since compensatory gait patterns may not be captured by spatial, temporal, or dynamic characterizations alone. Copyright © 2018 Elsevier B.V. All rights reserved.

An initial physical mechanism in the treatment of neurologic disorders with externally applied pico Tesla magnetic fields.

PubMed

Jacobson, J I; Yamanashi, W S

1995-04-01

The recent clinical studies describing the treatment of some neurological disorders with an externally applied pico Tesla (10(-12) Tesla, or 10(-8) gauss) magnetic field are considered from a physical view point. An equation relating the intrinsic (or rest) energy of a charged particle of mass m with its energy of interaction in an externally applied magnetic field B is presented. The equation represents an initial basic physical interaction as a part of a more complex biological mechanism to explain the therapeutic effects of externally applied magnetic fields in these and other neurologic disorders.

75 FR 2146 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as [[Page 2147

78 FR 59945 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Neurological Disorders and Stroke; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as [[Page 59946

Upper limb movement analysis during gait in multiple sclerosis patients.

PubMed

Elsworth-Edelsten, Charlotte; Bonnefoy-Mazure, Alice; Laidet, Magali; Armand, Stephane; Assal, Frederic; Lalive, Patrice; Allali, Gilles

2017-08-01

Gait disorders in multiple sclerosis (MS) are well studied; however, no previous study has described upper limb movements during gait. However, upper limb movements have an important role during locomotion and can be altered in MS patients due to direct MS lesions or mechanisms of compensation. The aim of this study was to describe the arm movements during gait in a population of MS patients with low disability compared with a healthy control group. In this observational study we analyzed the arm movements during gait in 52 outpatients (mean age: 39.7±9.6years, female: 40%) with relapsing-remitting MS with low disability (mean EDSS: 2±1) and 25 healthy age-matched controls using a 3-dimension gait analysis. MS patients walked slower, with increased mean elbow flexion and decreased amplitude of elbow flexion (ROM) compared to the control group, whereas shoulder and hand movements were similar to controls. These differences were not explained by age or disability. Upper limb alterations in movement during gait in MS patients with low disability can be characterized by an increase in mean elbow flexion and a decrease in amplitude (ROM) for elbow flexion/extension. This upper limb movement pattern should be considered as a new component of gait disorders in MS and may reflect subtle motor deficits or the use of compensatory mechanisms. Copyright © 2017 Elsevier B.V. All rights reserved.

From Connectivity Models to Region Labels: Identifying Foci of a Neurological Disorder

PubMed Central

Venkataraman, Archana; Kubicki, Marek; Golland, Polina

2014-01-01

We propose a novel approach to identify the foci of a neurological disorder based on anatomical and functional connectivity information. Specifically, we formulate a generative model that characterizes the network of abnormal functional connectivity emanating from the affected foci. This allows us to aggregate pairwise connectivity changes into a region-based representation of the disease. We employ the variational expectation-maximization algorithm to fit the model and subsequently identify both the afflicted regions and the differences in connectivity induced by the disorder. We demonstrate our method on a population study of schizophrenia. PMID:23864168

Neurologic Music Therapy Training for Mobility and Stability Rehabilitation with Parkinson’s Disease – A Pilot Study

PubMed Central

Bukowska, Anna A.; Krężałek, Piotr; Mirek, Elżbieta; Bujas, Przemysław; Marchewka, Anna

2016-01-01

Idiopathic Parkinson’s Disease (PD) is a progressive condition with gait disturbance and balance disorder as the main symptoms. Previous research studies focused on the application of Rhythmic Auditory Stimulation (RAS) in PD gait rehabilitation. The key hypothesis of this pilot study, however, assumes the major role of the combination of all three Neurologic Music Therapy (NMT) sensorimotor techniques in improving spatio-temporal gait parameters, and postural stability in the course of PD. The 55 PD-diagnosed subjects invited to the study were divided into two groups: 30 in the experimental and 25 in the control group. Inclusion criteria included Hoehn and Yahr stages 2 or 3, the ability to walk independently without any aid and stable pharmacological treatment for the duration of the experiment. In order to evaluate the efficacy of the chosen therapy procedure the following measures were applied: Optoelectrical 3D Movement Analysis, System BTS Smart for gait, and Computerized Dynamic Posturography CQ Stab for stability and balance. All measures were conducted both before and after the therapy cycle. The subjects from the experimental group attended music therapy sessions four times a week for 4 weeks. Therapeutic Instrumental Music Performance (TIMP), Pattern Sensory Enhancement (PSE) and RAS were used in every 45-min session for practicing daily life activities, balance, pre-gait, and gait pattern. Percussion instruments, the metronome and rhythmic music were the basis for each session. The subjects from the control group were asked to stay active and perform daily life activities between the measures. The research showed that the combination of the three NMT sensorimotor techniques can be used to improve gait and other rhythmical activities in PD rehabilitation. The results demonstrated significant improvement in the majority of the spatiotemporal gait parameters in the experimental group in comparison to the control group. In the stability tests with eyes

Role of the gluten-free diet on neurological-EEG findings and sleep disordered breathing in children with celiac disease.

PubMed

Parisi, P; Pietropaoli, N; Ferretti, A; Nenna, R; Mastrogiorgio, G; Del Pozzo, M; Principessa, L; Bonamico, M; Villa, M P

2015-02-01

To determine whether celiac children are at risk for EEG-neurological features and sleep disordered breathing (SDB), and whether an appropriate gluten-free diet (GFD) influences these disorders. We consecutively enrolled 19 children with a new biopsy-proven celiac disease (CD) diagnosis. At CD diagnosis and after 6 months of GFD, each patient underwent a general and neurological examination, an electroencephalogram, a questionnaire about neurological features, and a validated questionnaire about SDB: OSA (obstructive sleep apnea) scores<0 predict normality; values>0 predict OSA. At CD diagnosis, 37% of patients complained headache that affected daily activities and 32% showed positive OSA score. The EEG examinations revealed abnormal finding in 48% of children. After 6 months of GFD headache disappeared in 72% of children and EEG abnormalities in 78%; all children showed negative OSA score. According to our preliminary data, in the presence of unexplained EEG abnormalities and/or other neurological disorders/SDB an atypical or silent CD should also be taken into account. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Children with central and peripheral neurologic disorders have distinguishable patterns of dysphagia on videofluoroscopic swallow study.

PubMed

van den Engel-Hoek, Lenie; Erasmus, Corrie E; van Hulst, Karen C M; Arvedson, Joan C; de Groot, Imelda J M; de Swart, Bert J M

2014-05-01

To determine whether findings on videofluoroscopic swallow studies reveal different patterns of dysphagia between children with central and peripheral neurologic disorders, a retrospective study of 118 videofluoroscopic swallow studies was completed. There were 3 groups: cerebral palsy with only spastic features (n = 53), cerebral palsy with dyskinetic features (n = 34), and neuromuscular disorders (myotonic dystrophy I, n = 5; spinal muscular atrophy I-II, n = 8; Duchenne muscular dystrophy, n = 8; other neuromuscular disorder, n = 10). Interpretation of the videofluoroscopic swallow studies was not blinded. The video fluoroscopic swallow study findings were compared dichotomously between the groups. Children with cerebral palsy demonstrated dysphagia in 1 or all phases of swallowing. In neuromuscular disorder, muscle weakness results in pharyngeal residue after swallow. The underlying swallowing problem in neuromuscular disorder is muscle weakness whereas that in cerebral palsy is more complex, having to do with abnormal control of swallowing. This study serves as a first exploration on specific characteristics of swallowing in different neurologic conditions and will help clinicians anticipate what they might expect.

Association between functional alterations of senescence and senility and disorders of gait and balance

PubMed Central

Teixeira-Leite, Homero; Manhães, Alex C.

2012-01-01

OBJECTIVES: Declines in cognition and mobility are frequently observed in the elderly, and it has been suggested that the appearance of gait disorders in older individuals may constitute a marker of cognitive decline that precedes significant findings in functional performance screening tests. This study sought to evaluate the relationship between functional capacities and gait and balance in an elderly community monitored by the Preventive and Integrated Care Unit of the Hospital Adventista Silvestre in Rio de Janeiro, RJ, Brazil. METHODS: Elderly individuals (193 females and 90 males) were submitted to a broad geriatric evaluation, which included the following tests: 1) a performance-oriented mobility assessment (POMA) to evaluate gait; 2) a mini-mental state examination (MMSE); 3) the use of Katz and Lawton scales to assess functional capacity; 4) the application of the geriatric depression scale (GDS); and 5) a mini-nutritional assessment (MNA) scale. RESULTS: Reductions in MMSE, Katz and Lawton scores were associated with reductions in POMA scores, and we also observed that significant reductions in POMA scores were present in persons for whom the MMSE and Katz scores did not clearly indicate cognitive dysfunction. We also demonstrated that a decline in the scores obtained with the GDS and MNA scales was associated with a decline in the POMA scores. CONCLUSIONS: Considering that significant alterations in the POMA scores were observed prior to the identification of significant alterations in cognitive capacity using either the MMSE or the Katz systems, a prospective study seems warranted to assess the predictive capacity of POMA scores regarding the associated decline in functional capacity. PMID:22892914

Association between functional alterations of senescence and senility and disorders of gait and balance.

PubMed

Teixeira-Leite, Homero; Manhães, Alex C

2012-07-01

Declines in cognition and mobility are frequently observed in the elderly, and it has been suggested that the appearance of gait disorders in older individuals may constitute a marker of cognitive decline that precedes significant findings in functional performance screening tests. This study sought to evaluate the relationship between functional capacities and gait and balance in an elderly community monitored by the Preventive and Integrated Care Unit of the Hospital Adventista Silvestre in Rio de Janeiro, RJ, Brazil. Elderly individuals (193 females and 90 males) were submitted to a broad geriatric evaluation, which included the following tests: 1) a performance-oriented mobility assessment (POMA) to evaluate gait; 2) a mini-mental state examination (MMSE); 3) the use of Katz and Lawton scales to assess functional capacity; 4) the application of the geriatric depression scale (GDS); and 5) a mini-nutritional assessment (MNA) scale. Reductions in MMSE, Katz and Lawton scores were associated with reductions in POMA scores, and we also observed that significant reductions in POMA scores were present in persons for whom the MMSE and Katz scores did not clearly indicate cognitive dysfunction. We also demonstrated that a decline in the scores obtained with the GDS and MNA scales was associated with a decline in the POMA scores. Considering that significant alterations in the POMA scores were observed prior to the identification of significant alterations in cognitive capacity using either the MMSE or the Katz systems, a prospective study seems warranted to assess the predictive capacity of POMA scores regarding the associated decline in functional capacity.

The promise of telemedicine for chronic neurological disorders: the example of Parkinson's disease.

PubMed

Schneider, Ruth B; Biglan, Kevin M

2017-07-01

Disparities in access to health care, particularly specialist care, exist worldwide. As the prevalence of chronic neurological disorders increases with ageing populations, access to neurologist care is likely to worsen in many regions if there are no changes to models of care. Telemedicine-defined here as the use of real-time, synchronous videoconferencing to deliver medical care-could be used to improve access to neurologist care for patients with a range of chronic neurological disorders. In Parkinson's disease, several studies have shown the feasibility and potential benefits of telemedicine-delivered care. Further research is needed to establish whether telemedicine can deliver on the promise of improved access to neurologist care and whether telemedicine-delivered care is comparable to in-person care in terms of clinical outcomes. Many barriers to widespread implementation of telemedicine services remain to be addressed, including reimbursement, legal considerations, and technological issues. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of exercise on depressive symptoms in adults with neurologic disorders: a systematic review and meta-analysis.

PubMed

Adamson, Brynn C; Ensari, Ipek; Motl, Robert W

2015-07-01

To review and quantify the effect of exercise on depression in adults with neurologic disorders. CINAHL, Cochrane Register of Controlled Clinical Trials, EMBASE, ERIC, MEDLINE, PsycINFO, PubMed, and SPORTDiscus were searched, with the last search performed in May 2014. Included were randomized controlled trials conducted in adults with a diagnosed neurologic disorder that compared an exercise intervention group with a control group and used depression as an outcome measure. Depression data were extracted independently by 2 authors. Methodological quality was assessed independently by 2 authors. Forty-three full-length articles were reviewed, and 26 trials met our inclusion criteria. These trials represented 1324 participants with 7 different neurologic disorders: Alzheimer disease (n=4 trials), migraine (n=1), multiple sclerosis (n=13), Parkinson disease (n=2), spinal cord injury (n=1), stroke (n=2), and traumatic brain injury (n=3). Data measuring depression were extracted and effect sizes were computed for 23 trials. Results from a meta-analysis yielded an overall effect size of .28 (SE=.07; 95% confidence interval, .15-.41; P=.00) favoring a reduction in depression outcomes after an exercise intervention compared with the control condition. Of note, interventions that met physical activity guidelines yielded an overall effect of .38 compared with .19 for studies that did not meet physical activity guidelines. This review provides evidence that exercise, particularly when meeting physical activity guidelines, can improve depressive symptoms in adults with neurologic disorders. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Dysregulated fibroblast growth factor (FGF) signaling in neurological and psychiatric disorders.

PubMed

Turner, Cortney A; Eren-Koçak, Emine; Inui, Edny G; Watson, Stanley J; Akil, Huda

2016-05-01

The role of the fibroblast growth factor (FGF) system in brain-related disorders has received considerable attention in recent years. To understand the role of this system in neurological and psychiatric disorders, it is important to identify the specific members of the FGF family that are implicated, their location and the various mechanisms they can be modulated. Each disorder appears to impact specific molecular players in unique anatomical locations, and all of these could conceivably become targets for treatment. In the last several years, the issue of how to target this system directly has become an area of increasing interest. To date, the most promising therapeutics are small molecule inhibitors and antibodies that modulate FGF receptor (FGFR) function. Beyond attempting to modify the primary players affected by a given brain disorder, it may prove useful to target molecules, such as membrane-bound or extracellular proteins that interact with FGF ligands or FGFRs to modulate signaling. Published by Elsevier Ltd.

Development of a Kinect-based exergaming system for motor rehabilitation in neurological disorders

NASA Astrophysics Data System (ADS)

Estepa, A.; Sponton Piriz, S.; Albornoz, E.; Martínez, C.

2016-04-01

The development of videogames for physical therapy, known as exergames, has gained much interest in the last years. In this work, a sytem for rehabilitation and clinical evaluation of neurological patients is presented. The Microsoft Kinect device is used to track the full body of patients, and three games were developed to exercise and assess different aspects of balance and gait rehabilitation. The system provides visual feedback by means of an avatar that follows the movements of the patients, and sound and visual stimuli for giving orders during the experience. Also, the system includes a database and management tools for further analysis and monitoring of therapies. The results obtained show, on the one side, a great reception and interest of patients to use the system. On the other side, the specialists considered very useful the data collected and the quantitative analysis provided by the system, which was then adopted for the clinical routine.

Lymphatics in Neurological Disorders: A neuro-lympho-vascular Component of Multiple Sclerosis and Alzheimer’s Disease

PubMed Central

Louveau, Antoine; Mesquita, Sandro Da; Kipnis, Jonathan

2016-01-01

Summary Lymphatic vasculature drains interstitial fluids, which contain the tissue’s waste products and ensures immune surveillance of the tissues, allowing immune-cell recirculation. Until recently the central nervous system (CNS) was considered to be devoid of a conventional lymphatic vasculature. The recent discovery in the meninges of a lymphatic network that drains the CNS calls into question classic models for the drainage of macromolecules and immune cells from the CNS. In the context of neurological disorders, the presence of a lymphatic system draining the CNS potentially offers a new player and a new avenue for therapy. In this review, we will attempt to integrate the known primary functions of the tissue lymphatic vasculature that exists in peripheral organs with the proposed function of meningeal lymphatic vessels in neurological disorders, specifically multiple sclerosis and Alzheimer’s disease. We propose that these (and potentially other) neurological afflictions can be viewed as diseases with neuro-lympho-vascular component and should be therapeutically targeted as such. PMID:27608759

The burden of mental, neurological, and substance use disorders in China and India: a systematic analysis of community representative epidemiological studies.

PubMed

Charlson, Fiona J; Baxter, Amanda J; Cheng, Hui G; Shidhaye, Rahul; Whiteford, Harvey A

2016-07-23

China and India jointly account for 38% of the world population, so understanding the burden attributed to mental, neurological, and substance use disorders within these two countries is essential. As part of the Lancet/Lancet Psychiatry China-India Mental Health Alliance Series, we aim to provide estimates of the burden of mental, neurological, and substance use disorders for China and India from the Global Burden of Disease Study 2013 (GBD 2013). In this systematic analysis for community representative epidemiological studies, we conducted systematic reviews in line with PRISMA guidelines for community representative epidemiological studies. We extracted estimates of prevalence, incidence, remission and duration, and mortality along with associated uncertainty intervals from GBD 2013. Using these data as primary inputs, DisMod-MR 2.0, a Bayesian meta-regression instrument, used a log rate and incidence-prevalence-mortality mathematical model to develop internally consistent epidemiological models. Disability-adjusted life-year (DALY) changes between 1990 and 2013 were decomposed to quantify change attributable to population growth and ageing. We projected DALYs from 2013 to 2025 for mental, neurological, and substance use disorders using United Nations population data. Around a third of global DALYs attributable to mental, neurological, and substance use disorders were found in China and India (66 million DALYs), a number greater than all developed countries combined (50 million DALYs). Disease burden profiles differed; India showed similarities with other developing countries (around 50% of DALYs attributable to non-communicable disease), whereas China more closely resembled developed countries (around 80% of DALYs attributable to non-communicable disease). The overall population growth in India explains a greater proportion of the increase in mental, neurological, and substance use disorder burden from 1990 to 2013 (44%) than in China (20%). The burden of

Effect of Interpersonal Interaction on Festinating Gait Rehabilitation in Patients with Parkinson’s Disease

PubMed Central

Uchitomi, Hirotaka; Ogawa, Ken-ichiro; Orimo, Satoshi; Wada, Yoshiaki; Miyake, Yoshihiro

2016-01-01

Although human walking gait rhythms are generated by native individual gait dynamics, these gait dynamics change during interactions between humans. A typical phenomenon is synchronization of gait rhythms during cooperative walking. Our previous research revealed that fluctuation characteristics in stride interval of subjects with Parkinson’s disease changed from random to 1/f fluctuation as fractal characteristics during cooperative walking with the gait assist system Walk-Mate, which emulates a human interaction using interactive rhythmic cues. Moreover, gait dynamics were relearned through Walk-Mate gait training. However, the system’s clinical efficacy was unclear because the previous studies did not focus on specific gait rhythm disorder symptoms. Therefore, this study aimed to evaluate the effect of Walk-Mate on festinating gait among subjects with Parkinson’s disease. Three within-subject experimental conditions were used: (1) preinteraction condition, (2) interaction condition, and (3) postinteraction condition. The only difference between conditions was the interactive rhythmic cues generated by Walk-Mate. Because subjects with festinating gait gradually and involuntarily decreased their stride interval, the regression slope of stride interval as an index of severity of preinteraction festinating gait was elevated. The regression slope in the interaction condition was more gradual than during the preinteraction condition, indicating that the interactive rhythmic cues contributed to relieving festinating gait and stabilizing gait dynamics. Moreover, the gradual regression slope was carried over to the postinteraction condition, indicating that subjects with festinating gait have the potential to relearn stable gait dynamics. These results suggest that disordered gait dynamics are clinically restored through interactive rhythmic cues and that Walk-Mate may have the potential to assist therapists in more effective rehabilitation. Trial Registration

Clinicopathologic correlations in 172 cases of rapid eye movement sleep behavior disorder with or without a coexisting neurologic disorder.

PubMed

Boeve, B F; Silber, M H; Ferman, T J; Lin, S C; Benarroch, E E; Schmeichel, A M; Ahlskog, J E; Caselli, R J; Jacobson, S; Sabbagh, M; Adler, C; Woodruff, B; Beach, T G; Iranzo, A; Gelpi, E; Santamaria, J; Tolosa, E; Singer, C; Mash, D C; Luca, C; Arnulf, I; Duyckaerts, C; Schenck, C H; Mahowald, M W; Dauvilliers, Y; Graff-Radford, N R; Wszolek, Z K; Parisi, J E; Dugger, B; Murray, M E; Dickson, D W

2013-08-01

To determine the pathologic substrates in patients with rapid eye movement (REM) sleep behavior disorder (RBD) with or without a coexisting neurologic disorder. The clinical and neuropathologic findings were analyzed on all autopsied cases from one of the collaborating sites in North America and Europe, were evaluated from January 1990 to March 2012, and were diagnosed with polysomnogram (PSG)-proven or probable RBD with or without a coexisting neurologic disorder. The clinical and neuropathologic diagnoses were based on published criteria. 172 cases were identified, of whom 143 (83%) were men. The mean±SD age of onset in years for the core features were as follows - RBD, 62±14 (range, 20-93), cognitive impairment (n=147); 69±10 (range, 22-90), parkinsonism (n=151); 68±9 (range, 20-92), and autonomic dysfunction (n=42); 62±12 (range, 23-81). Death age was 75±9 years (range, 24-96). Eighty-two (48%) had RBD confirmed by PSG, 64 (37%) had a classic history of recurrent dream enactment behavior, and 26 (15%) screened positive for RBD by questionnaire. RBD preceded the onset of cognitive impairment, parkinsonism, or autonomic dysfunction in 87 (51%) patients by 10±12 (range, 1-61) years. The primary clinical diagnoses among those with a coexisting neurologic disorder were dementia with Lewy bodies (n=97), Parkinson's disease with or without mild cognitive impairment or dementia (n=32), multiple system atrophy (MSA) (n=19), Alzheimer's disease (AD)(n=9) and other various disorders including secondary narcolepsy (n=2) and neurodegeneration with brain iron accumulation-type 1 (NBAI-1) (n=1). The neuropathologic diagnoses were Lewy body disease (LBD)(n=77, including 1 case with a duplication in the gene encoding α-synuclein), combined LBD and AD (n=59), MSA (n=19), AD (n=6), progressive supranulear palsy (PSP) (n=2), other mixed neurodegenerative pathologies (n=6), NBIA-1/LBD/tauopathy (n=1), and hypothalamic structural lesions (n=2). Among the neurodegenerative

A Mobile Kalman-Filter Based Solution for the Real-Time Estimation of Spatio-Temporal Gait Parameters.

PubMed

Ferrari, Alberto; Ginis, Pieter; Hardegger, Michael; Casamassima, Filippo; Rocchi, Laura; Chiari, Lorenzo

2016-07-01

Gait impairments are among the most disabling symptoms in several musculoskeletal and neurological conditions, severely limiting personal autonomy. Wearable gait sensors have been attracting attention as diagnostic tool for gait and are emerging as promising tool for tutoring and guiding gait execution. If their popularity is continuously growing, still there is room for improvement, especially towards more accurate solutions for spatio-temporal gait parameters estimation. We present an implementation of a zero-velocity-update gait analysis system based on a Kalman filter and off-the-shelf shoe-worn inertial sensors. The algorithms for gait events and step length estimation were specifically designed to comply with pathological gait patterns. More so, an Android app was deployed to support fully wearable and stand-alone real-time gait analysis. Twelve healthy subjects were enrolled to preliminarily tune the algorithms; afterwards sixteen persons with Parkinson's disease were enrolled for a validation study. Over the 1314 strides collected on patients at three different speeds, the total root mean square difference on step length estimation between this system and a gold standard was 2.9%. This shows that the proposed method allows for an accurate gait analysis and paves the way to a new generation of mobile devices usable anywhere for monitoring and intervention.

Neurological Signs and Symptoms in Fibromyalgia

PubMed Central

Watson, Nathaniel F.; Buchwald, Dedra; Goldberg, Jack; Noonan, Carolyn; Ellenbogen, Richard G.

2009-01-01

Objective To determine the type and frequency of neurological signs and symptoms in individuals with fibromyalgia (FM). Methods Persons with FM (n=166) and pain-free controls (n=66) underwent systematic neurological examination by a neurologist blinded to disease status. Neurological symptoms present over the preceding 3 months were assessed with a standard questionnaire. We used logistic regression to evaluate the association of neurological symptoms and examination findings with FM status. Within the FM group we examined the correlation between self-reported symptoms and physical examination findings. Results Compared to the control group, age and gender adjusted estimates revealed the FM group had significantly more neurological abnormalities in multiple categories including: cranial nerves IX and X (42% vs. 8%), sensory (65% vs. 25%), motor (33% vs. 3%), and gait (28% vs. 7%). Similarly, the FM group endorsed significantly more neurological symptoms than the control group in 27 of 29 categories with the biggest differences observed for photophobia (70% vs. 6%), poor balance (63% vs. 4%), and weakness (58% vs. 2%) and tingling (54% vs. 4%) in the arms and legs. Poor balance, coordination, tingling, weakness in the arms and legs, and numbness in any part of body correlated with appropriate neurological exam findings in the FM group. Conclusions This blinded, controlled study demonstrated neurological physical examination findings in persons with FM. The FM group had more neurological symptoms than controls, with moderate correlation between symptoms and signs. These findings have implications for the medical work-up of patients with FM. PMID:19714636

Neurologic signs and symptoms in fibromyalgia.