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Sample records for rhythmic movement disorder

  1. Rhythmic movement disorder in children.

    PubMed

    Hoban, Timothy F

    2003-02-01

    How should sleep-related rhythmic movements in children be assessed and treated? Rhythmic movement disorder (RMD) represents an unusual variety of childhood parasomnia characterized by repetitive motion of the head, trunk, or extremities, which usually occurs during the transition from wakefulness to sleep or arises during sustained sleep. Although the condition most often affects infants and toddlers in a transient and self-limited fashion, the condition occasionally persists in a problematic fashion, which may nevertheless be amenable to treatment. Since RMD may occasionally cause injury or resemble nocturnal seizure, prompt recognition, and appropriate management on the part of the clinician is essential. This article will examine the spectrum of RMD in children, including their common clinical manifestations; data regarding their epidemiology and natural history; the role of polysomnography, electroencephalography; and other diagnostic testing. Potential causes of the condition and available methods of treatment are also examined.

  2. An unusual case of rhythmic movement disorder.

    PubMed

    Kaneda, R; Furuta, H; Kazuto, K; Arayama, K; Sano, J; Koshino, Y

    2000-06-01

    Rhythmic movement disorder is one of the sleep-wake transition disorders listed in the International Classification of Sleep Disorders. According to this classification, the condition commonly occurs in infants and toddlers, and persistence beyond 4 years of age is unusual. Recently, we encountered a case in which rhythmic movement disorder persisted up until the age of 12 years with spikes registering on the sleep electroencephalogram. Epileptic seizure was ruled out because of the characteristic rolling movement, absence of any other epileptic symptoms (e.g. vocalization and tonic-clonic seizure) and cessation as a result of removal of the blanket.

  3. Rhythmic movement disorder in sleep persisting into childhood and adulthood.

    PubMed

    Stepanova, Iva; Nevsimalova, Sona; Hanusova, Jaroslava

    2005-07-01

    To evaluate the type, duration, and distribution of rhythmic movements in sleep stages in school-aged children and young adults; to find out if cases of rhythmic movement disorder persisting beyond infancy are associated with any daytime symptoms or psychopathology. All participants underwent neurologic examination, biochemical screening, electroencephalography, neuroimaging, overnight videopolysomnography, and psychologic examination. Department of Neurology and Sleep Laboratory, 1st Medical Faculty, Charles University, Prague. Ten subjects referred to the sleep disorders center because of rhythmic movement disorder. Five males, 5 females; age range, 7-24 years; mean age 14.7 +/- 5.69 years. None. Biochemical screening, electroencephalogram, and neuroimaging were unremarkable in all cases. According to duration, 2 types of rhythmic movements were observed on polysomnography: longer episodes appeared in wakefulness and in non-rapid eye movement stage 1 sleep, while shorter episodes (2-80 seconds) occurred during non-rapid eye movement stage 2, non-rapid eye movement stage 3-4, and rapid eye movement sleep. According to sleep-stage distribution, we defined (a) rhythmic movements prevailing in the first half of the night and in the morning hours, usually associated with wakefulness or superficial sleep; (b) rhythmic movements occurring throughout the night in all sleep stages; (c) rhythmic movements prevailing in the second half of the night and mainly associated with rapid eye movement sleep. Psychologic examination showed symptoms of the attention-deficit/hyperactivity disorder in 6 cases. According to our study, rhythmic movement disorder persisting beyond infancy may be connected with various daytime symptoms; a strong association between rhythmic movement disorder and attention-deficit/hyperactivity disorder was found in school-aged children. We speculate that pathogenetic mechanisms similar to those in attention-deficit/hyperactivity disorder are involved in

  4. Multiple forms of rhythmic movements in an adolescent boy with rhythmic movement disorder.

    PubMed

    Su, Changjun; Miao, Jianting; Liu, Yu; Liu, Rui; Lei, Gesheng; Zhang, Wei; Yang, Ting; Li, Zhuyi

    2009-12-01

    Rhythmic movement disorder (RMD) refers to a group of stereotyped, repetitive movements involving large muscles, usually occurring prior to the onset of sleep and persisting into sleep. RMD more commonly exhibits only one or two forms of rhythmic movements (RM) in most reported cases. However, multiple RM forms of RMD occurring in a patient in the same night have rarely been reported. In this report, we present the unique case of a 15-year-old boy with RMD affected by multiple forms of RM in the same night, including four known forms (i.e., body rocking, head banging, leg rolling, and rhythmic feet movements) and two new kinds of RM (bilateral rhythmic arm rocking and rhythmic hands movements). Two video-polysomnographic recordings were performed in this patient before starting pharmacologic treatment and after long-term oral clonazepam treatment (1.0mg nightly for 3 months). The characteristics of RMD with multiple RM forms and the effectiveness of clonazepam on the RM episodes and polysomnographic findings observed in our patient are discussed. This report raises the fact that a patient with RMD may present with multiple complex rhythmic movements disrupting sleep, which emphasizes that better understanding of the clinical features of complex rhythmic movements during sleep in primary care settings is essential for early clinical diagnosis and optimal management.

  5. Rhythmic movement disorder in childhood: An integrative review.

    PubMed

    Gwyther, Amy R M; Walters, Arthur S; Hill, Catherine M

    2017-10-01

    Rhythmic movement disorder consists of repetitive stereotypic movements, such as head banging or body rocking, that recur every second or so and may last from a few minutes to hours, usually prior to sleep onset. This review of childhood rhythmic movement disorder highlights the lack of systematic research into core aspects of the condition, relying heavily on small case series or case reports. Interpretation is further limited by almost universal failure to confirm the core diagnostic criteria (C) of the International classification of sleep disorders (III), namely that the rhythmic movements should have clinical consequences. Nonetheless, a number of themes emerge. Rhythmic movement disorder is likely to start in infancy and have a developmental course with spontaneous resolution in early childhood in many cases. Factors associated with persistence are, however, unclear. Associations with ADHD and neurodevelopmental disorders are intriguing, require further study and may shed light on the underlying cause of the condition. There is a pressing need for a systematic approach to classify rhythmic movement disorder, to allow standardization of the much needed research into the underlying aetiology and treatment of this relatively neglected sleep disorder. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Rhythmic movement disorder (head banging) in an adult during rapid eye movement sleep.

    PubMed

    Anderson, Kirstie N; Smith, Ian E; Shneerson, John M

    2006-06-01

    Sleep-related rhythmic movements (head banging or body rocking) are extremely common in normal infants and young children, but less than 5% of children over the age of 5 years old exhibit these stereotyped motor behaviors. They characteristically occur during drowsiness or sleep onset rather than in deep sleep or rapid eye movement (REM) sleep. We present a 27-year-old man with typical rhythmic movement disorder that had persisted into adult life and was restricted to REM sleep. This man is the oldest subject with this presentation reported to date and highlights the importance of recognizing this nocturnal movement disorder when it does occur in adults.

  7. A boy infant with sleep related rhythmic movement disorder showing arm banging.

    PubMed

    Kohyama, Jun; Takano, Tomoyuki

    2014-09-01

    To present a male patient who performed arm banging on his face during sleep every night since 7 months of age. Clinical course of this patient with electroencephalographic recording with video recording at 23 months of age was shown. His arm banging began at the age of 7 months and showed no complete remission at the age of 57 months of age, although clonazepam revealed mild effects on its intensity and frequency. We diagnosed him as having arm banging type of sleep related rhythmic movement disorder. To our knowledge, no precise description on this type of sleep related rhythmic movement disorder has been found. In addition, this patient seemed to be the youngest case of sleep related rhythmic movement disorder showing arm banging.

  8. Association of idiopathic rapid eye movement sleep behavior disorder in an adult with persistent, childhood onset rhythmic movement disorder.

    PubMed

    Xu, Zheyu; Anderson, Kirstie N; Shneerson, John M

    2009-08-15

    We present a case of a 41-year-old man with the association of REM sleep behavior disorder (RBD) and rhythmic movement disorder (RMD). The RMD had a childhood onset and persisted into adulthood. The RMD worsened with the development of RBD and has persisted despite successful treatment of RBD. However, the pathogenesis of RMD remains unclear and the movements have been suggested to play a maturational role as part of psychomotor development by stimulating the vestibular apparatus. Current models underlying the control of REM sleep may need to be refined to explain the observed association of RBD and RMD.

  9. A multigenerational family with persistent sleep related rhythmic movement disorder (RMD) and insomnia.

    PubMed

    Attarian, Hrayr; Ward, Norman; Schuman, Catherine

    2009-12-15

    In the International Classification of Sleep Disorders 2nd Edition (ICSD-2), sleep related rhythmic movement disorder (RMD) is classified as a disorder characterized by rhythmic movements of large muscle groups in different parts of the body. These are repetitive, stereotyped, rhythmic motor behaviors that occur predominantly during drowsiness or sleep,and are typically seen in infants and children. Episodes often occur at sleep onset, at any time during the night, and during quiet wakeful activities at a frequency of 0.5-2 sec), lasting <15 min. The prevalence is high in infants (59%), dropping to 5% at the age of 5 years. When persisting to older childhood or beyond, association with mental retardation, autism, or other significant pathology is reported. Few cases in adults of normal intelligence have been reported in the literature. There is a strong association with attention deficit hyperactivity disorder, suggesting a similar pathogenetic mechanism. There is also one adult case report occurring during strictly REM sleep. Mayer et al reported 24 subjects with RMD that persisted into adolescence and adulthood. Twenty of the subjects were adults, and 16 of them had the condition since childhood. Of these 20, 16 had no other sleep disorders (but 2 had a family history of RMD), and 4 had obstructive sleep apnea. This was the first ever report of familial RMD.

  10. Atypical Headbanging Presentation of Idiopathic Sleep Related Rhythmic Movement Disorder: Three Cases with Video-Polysomnographic Documentation

    PubMed Central

    Yeh, Shih-Bin; Schenck, Carlos H.

    2012-01-01

    Study Objectives: To describe three cases of sleep related, idiopathic rhythmic movement disorder (RMD) with atypical headbanging, consisting of head punching and head slapping. Methods: Three consecutive patients (2 males [11 and 13 years old) and one female [22 years old]) presented with atypical headbanging of 6 years, 7 years, and 17 years duration. In 2 cases, typical rhythmic headbanging (with use of the head) shifted after 3-4 years to atypical headbanging, with frontal head punching that was quasi-rhythmic. In one case, atypical headbanging (head-slapping) was the initial and only RMD. There was no injury from the headbanging. Prenatal, perinatal, developmental, behavioral-psychological, medical-neurological, and family histories were negative. Clinical evaluations and nocturnal video-polysomnography with seizure montage were performed on all patients. Results: Atypical headbanging was documented in all 3 cases; episodes always emerged late in the sleep cycle: from N2 sleep in 11 episodes, from REM sleep in 4 episodes, and from N1 sleep in 1 episode. Epileptiform activity was not detected. Clonazepam therapy was substantially effective in 1 case but not effective in 2 cases. Conclusions: These 3 cases of idiopathic atypical headbanging expand the literature on this RMD variant, as to our knowledge only one previously documented case has been reported. Citation: Yeh SB; Schenck CH. Atypical headbanging presentation of idiopathic sleep related rhythmic movement disorder: three cases with video-polysomnographic documentation. J Clin Sleep Med 2012;8(4):403-411. PMID:22893771

  11. Atypical headbanging presentation of idiopathic sleep related rhythmic movement disorder: three cases with video-polysomnographic documentation.

    PubMed

    Yeh, Shih-Bin; Schenck, Carlos H

    2012-08-15

    To describe three cases of sleep related, idiopathic rhythmic movement disorder (RMD) with atypical headbanging, consisting of head punching and head slapping. Three consecutive patients (2 males [11 and 13 years old) and one female [22 years old]) presented with atypical headbanging of 6 years, 7 years, and 17 years duration. In 2 cases, typical rhythmic headbanging (with use of the head) shifted after 3-4 years to atypical headbanging, with frontal head punching that was quasi-rhythmic. In one case, atypical headbanging (head-slapping) was the initial and only RMD. There was no injury from the headbanging. Prenatal, perinatal, developmental, behavioral-psychological, medical-neurological, and family histories were negative. Clinical evaluations and nocturnal video-polysomnography with seizure montage were performed on all patients. Atypical headbanging was documented in all 3 cases; episodes always emerged late in the sleep cycle: from N2 sleep in 11 episodes, from REM sleep in 4 episodes, and from N1 sleep in 1 episode. Epileptiform activity was not detected. Clonazepam therapy was substantially effective in 1 case but not effective in 2 cases. These 3 cases of idiopathic atypical headbanging expand the literature on this RMD variant, as to our knowledge only one previously documented case has been reported.

  12. Parasomnia with rhythmic movements manifesting as nocturnal tongue biting.

    PubMed

    Tuxhorn, I; Hoppe, M

    1993-06-01

    The case of a healthy 2-year-old girl with repeated nocturnal tongue biting as a result of rhythmic movements of the jaw associated with body rocking in non-REM sleep is described. Parasomnias manifesting with rhythmic, stereotyped movements of the head, trunk and extremities are well described in healthy children. The term rhythmic movement disorders (RMD) was introduced for these repetive movements in sleep which may appear as head banging (jactatio capitis), body rocking or leg rolling. Severe injuries including fractures, subdural effusions and eye injures are reported. Repeated tongue injuries have not been described as a consequence of RMD. The differential diagnosis from nocturnal seizures is crucial to avoid overtreatment of this benign albeit dramatically presenting condition.

  13. Auditory rhythmic cueing in movement rehabilitation: findings and possible mechanisms.

    PubMed

    Schaefer, Rebecca S

    2014-12-19

    Moving to music is intuitive and spontaneous, and music is widely used to support movement, most commonly during exercise. Auditory cues are increasingly also used in the rehabilitation of disordered movement, by aligning actions to sounds such as a metronome or music. Here, the effect of rhythmic auditory cueing on movement is discussed and representative findings of cued movement rehabilitation are considered for several movement disorders, specifically post-stroke motor impairment, Parkinson's disease and Huntington's disease. There are multiple explanations for the efficacy of cued movement practice. Potentially relevant, non-mutually exclusive mechanisms include the acceleration of learning; qualitatively different motor learning owing to an auditory context; effects of increased temporal skills through rhythmic practices and motivational aspects of musical rhythm. Further considerations of rehabilitation paradigm efficacy focus on specific movement disorders, intervention methods and complexity of the auditory cues. Although clinical interventions using rhythmic auditory cueing do not show consistently positive results, it is argued that internal mechanisms of temporal prediction and tracking are crucial, and further research may inform rehabilitation practice to increase intervention efficacy. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

  14. Auditory rhythmic cueing in movement rehabilitation: findings and possible mechanisms

    PubMed Central

    Schaefer, Rebecca S.

    2014-01-01

    Moving to music is intuitive and spontaneous, and music is widely used to support movement, most commonly during exercise. Auditory cues are increasingly also used in the rehabilitation of disordered movement, by aligning actions to sounds such as a metronome or music. Here, the effect of rhythmic auditory cueing on movement is discussed and representative findings of cued movement rehabilitation are considered for several movement disorders, specifically post-stroke motor impairment, Parkinson's disease and Huntington's disease. There are multiple explanations for the efficacy of cued movement practice. Potentially relevant, non-mutually exclusive mechanisms include the acceleration of learning; qualitatively different motor learning owing to an auditory context; effects of increased temporal skills through rhythmic practices and motivational aspects of musical rhythm. Further considerations of rehabilitation paradigm efficacy focus on specific movement disorders, intervention methods and complexity of the auditory cues. Although clinical interventions using rhythmic auditory cueing do not show consistently positive results, it is argued that internal mechanisms of temporal prediction and tracking are crucial, and further research may inform rehabilitation practice to increase intervention efficacy. PMID:25385780

  15. Movement Coordination or Movement Interference: Visual Tracking and Spontaneous Coordination Modulate Rhythmic Movement Interference

    PubMed Central

    Romero, Veronica; Coey, Charles; Schmidt, R. C.; Richardson, Michael J.

    2012-01-01

    When an actor performs a rhythmic limb movement while observing a spatially incongruent movement he or she exhibits increased movement orthogonal to the instructed motion. Known as rhythmic movement interference, this phenomenon has been interpreted as a motor contagion effect, whereby observing the incongruent movement interferes with the intended movement and results in a motor production error. Here we test the hypothesis that rhythmic movement interference is an emergent property of rhythmic coordination. Participants performed rhythmic limb movements at a self-selected tempo while observing a computer stimulus moving in a congruent or incongruent manner. The degree to which participants visually tracked the stimulus was manipulated to influence whether participants became spontaneously entrained to the stimulus or not. Consistent with the rhythmic coordination hypothesis, participants only exhibited the rhythmic movement interference effect when they became spontaneously entrained to the incongruent stimulus. PMID:23028607

  16. Movement Disorders

    MedlinePlus

    ... want them to. If you have a movement disorder, you experience these kinds of impaired movement. Dyskinesia ... and is a common symptom of many movement disorders. Tremors are a type of dyskinesia. Nerve diseases ...

  17. Biological clockwork underlying adaptive rhythmic movements

    PubMed Central

    Iwasaki, Tetsuya; Chen, Jun; Friesen, W. Otto

    2014-01-01

    Owing to the complexity of neuronal circuits, precise mathematical descriptions of brain functions remain an elusive ambition. A more modest focus of many neuroscientists, central pattern generators, are more tractable neuronal circuits specialized to generate rhythmic movements, including locomotion. The relative simplicity and well-defined motor functions of these circuits provide an opportunity for uncovering fundamental principles of neuronal information processing. Here we present the culmination of mathematical analysis that captures the adaptive behaviors emerging from interactions between a central pattern generator, the body, and the physical environment during locomotion. The biologically realistic model describes the undulatory motions of swimming leeches with quantitative accuracy and, without further parameter tuning, predicts the sweeping changes in oscillation patterns of leeches undulating in air or swimming in high-viscosity fluid. The study demonstrates that central pattern generators are capable of adapting oscillations to the environment through sensory feedback, but without guidance from the brain. PMID:24395788

  18. Teaching Rhythmic Movement to Children: "Chock-Let Pie"

    ERIC Educational Resources Information Center

    Hastie, Peter A.; Martin, Ellen H.; Gibson, Gary S.

    2005-01-01

    It is doubtful that any teacher would question the value of rhythmic movement in a physical education program. The benefits of being able to move rhythmically and to keep a beat are numerous. First, children with rhythm have an increased kinesthetic awareness of their body in motion and stillness. As most physical activities have an inherent…

  19. Teaching Rhythmic Movement to Children: "Chock-Let Pie"

    ERIC Educational Resources Information Center

    Hastie, Peter A.; Martin, Ellen H.; Gibson, Gary S.

    2005-01-01

    It is doubtful that any teacher would question the value of rhythmic movement in a physical education program. The benefits of being able to move rhythmically and to keep a beat are numerous. First, children with rhythm have an increased kinesthetic awareness of their body in motion and stillness. As most physical activities have an inherent…

  20. Rhythmic movements during sleep: a physiological and pathological profile.

    PubMed

    Manni, R; Terzaghi, M

    2005-12-01

    Rhythmic movement disorder (RMD) consists of rhythmic movements (RMs) that occur on falling asleep or during sleep, can involve any part of the body and have a reported frequency ranging from 0.5 to 2 Hz. RMs have been reported to occur in a high proportion of normal children as a self-limiting phenomenon starting and remitting within early infancy. However, there have also been descriptions of forms of RMD occurring against a background of mental retardation or persisting beyond childhood, or having onset in adulthood. So, the occurrence of RMs can be regarded as both a physiological and a pathological phenomenon. The few polysomnographic studies conducted in this field have shown that, in some forms of RMD, RMs are highly linked to arousal fluctuations. However, the mechanisms that underlie the genesis of RMs and are capable of leading to both physiological and pathological patterns of RMs are not fully understood. Here we emphasise the possibility that the central motor pattern generator, recently hypothesised to play a role in the genesis of motor phenomena during sleep in the cases of parasomnia and epileptic seizures, might account for the occurrence of RMs in both physiological and pathological conditions.

  1. Stereotypic movement disorders.

    PubMed

    Singer, Harvey S

    2011-01-01

    Stereotypic movements are repetitive, rhythmic, fixed, patterned in form, amplitude, and localization, but purposeless (e.g., hand shaking, waving, body rocking, head nodding). They are commonly seen in children; both in normal children (primary stereotypy) and in individuals with additional behavioral or neurological signs and symptoms (secondary stereotypy). They should be differentiated from compulsions (OCD), tics (tic disorders), trichotillomania, skin picking disorder, or the direct physiological effect of a substance. There is increasing evidence to support a neurobiological mechanism. Response to behavioral and pharmacological therapies is variable. Copyright © 2011 Elsevier B.V. All rights reserved.

  2. Association of body rolling, leg rolling, and rhythmic feet movements in a young adult: A video-polysomnographic study performed before and after one night of clonazepam.

    PubMed

    Merlino, Giovanni; Serafini, Anna; Dolso, Pierluigi; Canesin, Roberto; Valente, Mariarosaria; Gigli, Gian Luigi

    2008-03-15

    We report clinical and polysomnographic data of a young adult affected by several forms of rhythmic movement disorder (RMD), present in the same night, including a new kind of it, known as rhythmic feet movements. The patient was monitored by means of three consecutive video-polysomnographic recordings, the first two performed to confirm the presence of the sleep disorder and the last one to observe the acute effectiveness of clonazepam on rhythmic movements. We discuss the characteristics of the RMD and the response to the first administration of pharmacological treatment, observed in our patient. (c) 2007 Movement Disorder Society.

  3. Parameterization of Movement Execution in Children with Developmental Coordination Disorder

    ERIC Educational Resources Information Center

    Van Waelvelde, Hilde; De Weerdt, Willy; De Cock, Paul; Janssens, Luc; Feys, Hilde; Engelsman, Bouwien C. M. Smits

    2006-01-01

    The Rhythmic Movement Test (RMT) evaluates temporal and amplitude parameterization and fluency of movement execution in a series of rhythmic arm movements under different sensory conditions. The RMT was used in combination with a jumping and a drawing task, to evaluate 36 children with Developmental Coordination Disorder (DCD) and a matched…

  4. Sleep-related movement disorders.

    PubMed

    Silber, Michael H

    2013-02-01

    This article reviews the sleep-related movement disorders, including restless legs syndrome (RLS; Willis-Ekbom disease), periodic limb movement disorder, rhythmic movement disorders, sleep-related bruxism, and sleep-related leg cramps. The prevalence of clinically significant RLS is 1.5% to 3.0%. The pathophysiology of RLS may involve abnormal iron transport across the blood-brain barrier and down-regulation of putaminal D2 receptors. The availability of the rotigotine patch provides an additional form of dopaminergic therapy for RLS. Calcium channel alpha-2-delta ligands (gabapentin, gabapentin enacarbil, and pregabalin) provide alternative therapies for RLS especially in patients with augmentation, impulse control disorders, or hypersomnia induced by dopamine agonists. Long-term use of opioid medication is safe and effective for refractory cases of RLS. RLS is a common disorder causing considerable morbidity. Accurate diagnosis and appropriate investigations are essential. Many effective therapies are available, but the side effects of each class of medication should be considered in determining optimal treatment. Periodic limb movements of sleep, bruxism, and rhythmic movement disorders are sleep-related phenomena often accompanying other sleep disorders and only sometimes requiring primary therapy. Sleep-related leg cramps are generally idiopathic. Management is challenging with few effective therapies.

  5. Automatic recognition and scoring of olympic rhythmic gymnastic movements.

    PubMed

    Díaz-Pereira, M Pino; Gómez-Conde, Iván; Escalona, Merly; Olivieri, David N

    2014-04-01

    We describe a conceptually simple algorithm for assigning judgement scores to rhythmic gymnastic movements, which could improve scoring objectivity and reduce judgemental bias during competitions. Our method, implemented as a real-time computer vision software, takes a video shot or a live performance video stream as input and extracts detailed velocity field information from body movements, transforming them into specialized spatio-temporal image templates. The collection of such images over time, when projected into a velocity covariance eigenspace, trace out unique but similar trajectories for a particular gymnastic movement type. By comparing separate executions of the same atomic gymnastic routine, our method assigns a quality judgement score that is related to the distance between the respective spatio-temporal trajectories. For several standard gymnastic movements, the method accurately assigns scores that are comparable to those assigned by expert judges. We also describe our rhythmic gymnastic video shot database, which we have made freely available to the human movement research community. The database can be obtained at http://www.milegroup.net/apps/gymdb/.

  6. Linear and nonlinear stiffness and friction in biological rhythmic movements.

    PubMed

    Beek, P J; Schmidt, R C; Morris, A W; Sim, M Y; Turvey, M T

    1995-11-01

    Biological rhythmic movements can be viewed as instances of self-sustained oscillators. Auto-oscillatory phenomena must involve a nonlinear friction function, and usually involve a nonlinear elastic function. With respect to rhythmic movements, the question is: What kinds of nonlinear friction and elastic functions are involved? The nonlinear friction functions of the kind identified by Rayleigh (involving terms such as theta3) and van der Pol (involving terms such as theta2theta), and the nonlinear elastic functions identified by Duffing (involving terms such as theta3), constitute elementary nonlinear components for the assembling of self-sustained oscillators, Recently, additional elementary nonlinear friction and stiffness functions expressed, respectively, through terms such as theta2theta3 and thetatheta2, and a methodology for evaluating the contribution of the elementary components to any given cyclic activity have been identified. The methodology uses a quantification of the continuous deviation of oscillatory motion from ideal (harmonic) motion. Multiple regression of this quantity on the elementary linear and nonlinear terms reveals the individual contribution of each term to the oscillator's non-harmonic behavior. In the present article the methodology was applied to the data from three experiments in which human subjects produced pendular rhythmic movements under manipulations of rotational inertia (experiment 1), rotational inertia and frequency (experiment 2), and rotational inertia and amplitude (experiment 3). The analysis revealed that the pendular oscillators assembled in the three experiments were compositionally rich, braiding linear and nonlinear friction and elastic functions in a manner that depended on the nature of the task.

  7. Bilateral Reflex Fluctuations during Rhythmic Movement of Remote Limb Pairs

    PubMed Central

    Mezzarane, Rinaldo A.; Nakajima, Tsuyoshi; Zehr, E. Paul

    2017-01-01

    The modulation of spinal cord excitability during rhythmic limb movement reflects the neuronal coordination underlying actions of the arms and legs. Integration of network activity in the spinal cord can be assessed by reflex variability between the limbs, an approach so far very little studied. The present work addresses this question by eliciting Hoffmann (H-) reflexes in both limbs to assess if common drive onto bilateral pools of motoneurons influence spinal cord excitability simultaneously or with a delay between sides. A cross-covariance (CCV) sequence between reflexes in both arms or legs was evaluated under conditions providing common drive bilaterally through voluntary muscle contraction and/or rhythmic movement of the remote limbs. For H-reflexes in the flexor carpi radialis (FCR) muscle, either contraction of the FCR or leg cycling induced significant reduction in the amplitude of the peak at the zero lag in the CCV sequence, indicating independent variations in spinal excitability between both sides. In contrast, for H-reflexes in the soleus (SO) muscle, arm cycling revealed no reduction in the amplitude of the peak in the CCV sequence at the zero lag. This suggests a more independent control of the arms compared with the legs. These results provide new insights into the organization of human limb control in rhythmic activity and the behavior of bilateral reflex fluctuations under different motor tasks. From a functional standpoint, changes in the co-variability might reflect dynamic adjustments in reflex excitability that are subsumed under more global control features during locomotion. PMID:28725191

  8. Movement disorders and sleep.

    PubMed

    Driver-Dunckley, Erika D; Adler, Charles H

    2012-11-01

    This article summarizes what is currently known about sleep disturbances in several movement disorders including Parkinson disease, essential tremor, parkinsonism, dystonia, Huntington disease, myoclonus, and ataxias. There is an association between movement disorders and sleep. In some cases the prevalence of sleep disorders is much higher in patients with movement disorder, such as rapid eye movement sleep behavior disorder in Parkinson disease. In other cases, sleep difficulties worsen the involuntary movements. In many cases the medications used to treat patients with movement disorder disturb sleep or cause daytime sleepiness. The importance of discussing sleep issues in patients with movement disorders cannot be underestimated.

  9. Different corticospinal control between discrete and rhythmic movement of the ankle

    PubMed Central

    Goto, Yumeno; Jono, Yasutomo; Hatanaka, Ryota; Nomura, Yoshifumi; Tani, Keisuke; Chujo, Yuta; Hiraoka, Koichi

    2014-01-01

    We investigated differences in corticospinal and spinal control between discrete and rhythmic ankle movements. Motor evoked potentials (MEPs) in the tibialis anterior and soleus muscles and soleus H-reflex were elicited in the middle of the plantar flexion phase during discrete ankle movement or in the initial or later cycles of rhythmic ankle movement. The H-reflex was evoked at an intensity eliciting a small M-wave and MEPs were elicited at an intensity of 1.2 times the motor threshold of the soleus MEPs. Only trials in which background EMG level, ankle angle, and ankle velocity were similar among the movement conditions were included for data analysis. In addition, only trials with a similar M-wave were included for data analysis in the experiment evoking H-reflexes. Results showed that H reflex and MEP amplitudes in the soleus muscle during discrete movement were not significantly different from those during rhythmic movement. MEP amplitude in the tibialis anterior muscle during the later cycles of rhythmic movement was significantly larger than that during the initial cycle of the rhythmic movement or during discrete movement. Higher corticospinal excitability in the tibialis anterior muscle during the later cycles of rhythmic movement may reflect changes in corticospinal control from the initial cycle to the later cycles of rhythmic movement. PMID:25126066

  10. Eye Movement Disorders

    MedlinePlus

    ... t work properly. There are many kinds of eye movement disorders. Two common ones are Strabismus - a disorder ... of the eyes, sometimes called "dancing eyes" Some eye movement disorders are present at birth. Others develop over ...

  11. Physiology of Psychogenic Movement Disorders

    PubMed Central

    Hallett, Mark

    2010-01-01

    Psychogenic movement disorders (PMDs) are common, but their physiology is largely unknown. In most situations, the movement is involuntary, but in a minority, when the disorder is malingering or factitious, the patient is lying and the movement is voluntary. Physiologically, we cannot tell the difference between voluntary and involuntary. The Bereitschaftspotential (BP) is indicative of certain brain mechanisms for generating movement, and is seen with ordinarily voluntary movements, but by itself does not indicate that a movement is voluntary. There are good clinical neurophysiological methods available to determine whether myoclonus or tremor is a PMD. For example, psychogenic myoclonus generally has a BP, and psychogenic stimulus-sensitive myoclonus has a variable latency with times similar to normal reaction times. Psychogenic tremor will have variable frequency over time, be synchronous in the two arms, and might well be entrained with voluntary rhythmic movements. These facts suggest that PMDs share voluntary mechanisms for movement production. There are no definitive tests to differentiate psychogenic dystonia from organic dystonia, although one has been recently reported. Similar physiological abnormalities are seen in both groups. The question arises as to how a movement can be produced with voluntary mechanisms, but not be considered voluntary. PMID:20493708

  12. Physiology of psychogenic movement disorders.

    PubMed

    Hallett, Mark

    2010-08-01

    Psychogenic movement disorders (PMDs) are common, but their physiology is largely unknown. In most situations, the movement is involuntary, but in a minority, when the disorder is malingering or factitious, the patient is lying and the movement is voluntary. Physiologically, we cannot tell the difference between voluntary and involuntary. The Bereitschaftspotential (BP) is indicative of certain brain mechanisms for generating movement, and is seen with ordinarily voluntary movements, but by itself does not indicate that a movement is voluntary. There are good clinical neurophysiological methods available to determine whether myoclonus or tremor is a PMD. For example, psychogenic myoclonus generally has a BP, and psychogenic stimulus-sensitive myoclonus has a variable latency with times similar to normal reaction times. Psychogenic tremor will have variable frequency over time, be synchronous in the two arms, and might well be entrained with voluntary rhythmic movements. These facts suggest that PMDs share voluntary mechanisms for movement production. There are no definitive tests to differentiate psychogenic dystonia from organic dystonia, although one has been recently reported. Similar physiological abnormalities are seen in both groups. The question arises as to how a movement can be produced with voluntary mechanisms, but not be considered voluntary.

  13. Distinct Functional Modules for Discrete and Rhythmic Forelimb Movements in the Mouse Motor Cortex.

    PubMed

    Hira, Riichiro; Terada, Shin-Ichiro; Kondo, Masashi; Matsuzaki, Masanori

    2015-09-30

    Movements of animals are composed of two fundamental dynamics: discrete and rhythmic movements. Although the movements with distinct dynamics are thought to be differently processed in the CNS, it is unclear how they are represented in the cerebral cortex. Here, we investigated the cortical representation of movement dynamics by developing prolonged transcranial optogenetic stimulation (pTOS) using awake, channelrhodopsin-2 transgenic mice. We found two domains that induced discrete forelimb movements in the forward and backward directions, and these sandwiched a domain that generated rhythmic forelimb movements. The forward discrete movement had an intrinsic velocity profile and the rhythmic movement had an intrinsic oscillation frequency. Each of the forward discrete and rhythmic domains possessed intracortical synaptic connections within its own domain, independently projected to the spinal cord, and weakened the neuronal activity and movement induction of the other domain. pTOS-induced movements were also classified as ethologically relevant movements. Forepaw-to-mouth movement was mapped in a part of the forward discrete domain, while locomotion-like movement was in a part of the rhythmic domain. Interestingly, photostimulation of the rhythmic domain resulted in a nonrhythmic, continuous lever-pull movement when a lever was present. The motor cortex possesses functional modules for distinct movement dynamics, and these can adapt to environmental constraints for purposeful movements. Significance statement: Animal behavior has discrete and rhythmic components, such as reaching and locomotion. It is unclear how these movements with distinct dynamics are represented in the cerebral cortex. We investigated the dynamics of movements induced by long-duration transcranial photostimulation on the dorsal cortex of awake channelrhodopsin-2 transgenic mice. We found two domains causing forward and backward discrete forelimb movements and a domain for rhythmic forelimb

  14. A Computational Model for Rhythmic and Discrete Movements in Uni- and Bimanual Coordination

    PubMed Central

    Ronsse, Renaud; Sternad, Dagmar; Lefèvre, Philippe

    2012-01-01

    Current research on discrete and rhythmic movements differs in both experimental procedures and theory, despite the ubiquitous overlap between discrete and rhythmic components in everyday behaviors. Models of rhythmic movements usually use oscillatory systems mimicking central pattern generators (CPGs). In contrast, models of discrete movements often employ optimization principles, thereby reflecting the higher-level cortical resources involved in the generation of such movements. This letter proposes a unified model for the generation of both rhythmic and discrete movements. We show that a physiologically motivated model of a CPG can not only generate simple rhythmic movements with only a small set of parameters, but can also produce discrete movements if the CPG is fed with an exponentially decaying phasic input. We further show that a particular coupling between two of these units can reproduce main findings on in-phase and antiphase stability. Finally, we propose an integrated model of combined rhythmic and discrete movements for the two hands. These movement classes are sequentially addressed in this letter with increasing model complexity. The model variations are discussed in relation to the degree of recruitment of the higher-level cortical resources, necessary for such movements. PMID:19018700

  15. Context-Dependent Neural Activation: Internally and Externally Guided Rhythmic Lower Limb Movement in Individuals With and Without Neurodegenerative Disease.

    PubMed

    Hackney, Madeleine E; Lee, Ho Lim; Battisto, Jessica; Crosson, Bruce; McGregor, Keith M

    2015-01-01

    Parkinson's disease is a neurodegenerative disorder that has received considerable attention in allopathic medicine over the past decades. However, it is clear that, to date, pharmacological and surgical interventions do not fully address symptoms of PD and patients' quality of life. As both an alternative therapy and as an adjuvant to conventional approaches, several types of rhythmic movement (e.g., movement strategies, dance, tandem biking, and Tai Chi) have shown improvements to motor symptoms, lower limb control, and postural stability in people with PD (1-6). However, while these programs are increasing in number, still little is known about the neural mechanisms underlying motor improvements attained with such interventions. Studying limb motor control under task-specific contexts can help determine the mechanisms of rehabilitation effectiveness. Both internally guided (IG) and externally guided (EG) movement strategies have evidence to support their use in rehabilitative programs. However, there appears to be a degree of differentiation in the neural substrates involved in IG vs. EG designs. Because of the potential task-specific benefits of rhythmic training within a rehabilitative context, this report will consider the use of IG and EG movement strategies, and observations produced by functional magnetic resonance imaging and other imaging techniques. This review will present findings from lower limb imaging studies, under IG and EG conditions for populations with and without movement disorders. We will discuss how these studies might inform movement disorders rehabilitation (in the form of rhythmic, music-based movement training) and highlight research gaps. We believe better understanding of lower limb neural activity with respect to PD impairment during rhythmic IG and EG movement will facilitate the development of novel and effective therapeutic approaches to mobility limitations and postural instability.

  16. Context-Dependent Neural Activation: Internally and Externally Guided Rhythmic Lower Limb Movement in Individuals With and Without Neurodegenerative Disease

    PubMed Central

    Hackney, Madeleine E.; Lee, Ho Lim; Battisto, Jessica; Crosson, Bruce; McGregor, Keith M.

    2015-01-01

    Parkinson’s disease is a neurodegenerative disorder that has received considerable attention in allopathic medicine over the past decades. However, it is clear that, to date, pharmacological and surgical interventions do not fully address symptoms of PD and patients’ quality of life. As both an alternative therapy and as an adjuvant to conventional approaches, several types of rhythmic movement (e.g., movement strategies, dance, tandem biking, and Tai Chi) have shown improvements to motor symptoms, lower limb control, and postural stability in people with PD (1–6). However, while these programs are increasing in number, still little is known about the neural mechanisms underlying motor improvements attained with such interventions. Studying limb motor control under task-specific contexts can help determine the mechanisms of rehabilitation effectiveness. Both internally guided (IG) and externally guided (EG) movement strategies have evidence to support their use in rehabilitative programs. However, there appears to be a degree of differentiation in the neural substrates involved in IG vs. EG designs. Because of the potential task-specific benefits of rhythmic training within a rehabilitative context, this report will consider the use of IG and EG movement strategies, and observations produced by functional magnetic resonance imaging and other imaging techniques. This review will present findings from lower limb imaging studies, under IG and EG conditions for populations with and without movement disorders. We will discuss how these studies might inform movement disorders rehabilitation (in the form of rhythmic, music-based movement training) and highlight research gaps. We believe better understanding of lower limb neural activity with respect to PD impairment during rhythmic IG and EG movement will facilitate the development of novel and effective therapeutic approaches to mobility limitations and postural instability. PMID:26696952

  17. Complex movement disorders induced by fluoxetine.

    PubMed

    Bharucha, K J; Sethi, K D

    1996-05-01

    We report two cases of complex movement disorders induced by fluoxetine. A 72-year-old woman developed rhythmic palatal movements, myoclonus, chorea, and possibly dystonia after 2 years of therapy with fluoxetine. On withdrawal of fluoxetine, the movements abated after 5 days and did not recur. The second patient, a 58-year-old man, developed myoclonic jerking and rapid, stereotypic movements of his toes after a year of fluoxetine therapy. These complex movements have not been reported previously as an adverse effect of fluoxetine.

  18. Movement Sonification: Effects on Motor Learning beyond Rhythmic Adjustments.

    PubMed

    Effenberg, Alfred O; Fehse, Ursula; Schmitz, Gerd; Krueger, Bjoern; Mechling, Heinz

    2016-01-01

    motor skill (technique acquisition of indoor rowing). One group was treated with visual information and two groups with audiovisual information (sonification vs. natural sounds). For all three groups learning became evident and remained stable. Participants treated with additional movement sonification showed better performance compared to both other groups. Results indicate that movement sonification enhances motor learning of a complex gross motor skill-even exceeding usually expected acoustic rhythmic effects on motor learning.

  19. Movement Sonification: Effects on Motor Learning beyond Rhythmic Adjustments

    PubMed Central

    Effenberg, Alfred O.; Fehse, Ursula; Schmitz, Gerd; Krueger, Bjoern; Mechling, Heinz

    2016-01-01

    motor skill (technique acquisition of indoor rowing). One group was treated with visual information and two groups with audiovisual information (sonification vs. natural sounds). For all three groups learning became evident and remained stable. Participants treated with additional movement sonification showed better performance compared to both other groups. Results indicate that movement sonification enhances motor learning of a complex gross motor skill—even exceeding usually expected acoustic rhythmic effects on motor learning. PMID:27303255

  20. Effects of Electroacupuncture on the Daily Rhythmicity of Intestinal Movement and Circadian Rhythmicity of Colonic Per2 Expression in Rats with Spinal Cord Injury

    PubMed Central

    Wang, Xueqiang; Zhang, Wenyi; Xie, Bin; Zhu, Zhaojin; Lu, Yuemei

    2016-01-01

    Background. Spinal cord injury (SCI) leads to bowel dysfunction. Electroacupuncture (EA) may improve bowel function. Objective. To assess EA on daily rhythmicity of intestinal movement and circadian rhythmicity of colonic Per2 expression in rats with SCI. Methods. Rats were randomized to the sham, SCI, and SCI+EA groups. EA was performed at bilateral Zusanli point (ST36) during daytime (11:00–11:30) for 14 days following SCI. Intestinal transit and daily rhythmicity of intestinal movement were assessed. Circadian rhythmicity of colonic Per2 expression was assessed by real-time RT-PCR. Results. EA shortened the stool efflux time and increased the dry fecal weight within 24 h in SCI rats. Daily rhythmicity of intestinal movements was unaffected by SCI. The expression of colonic Per2 peaked at 20:00 and the nadir was observed at 8:00 in the SCI and sham groups. In the SCI+EA group, colonic Per2 expression peaked at 12:00 and 20:00, and the nadir was observed at 8:00. Conclusion. SCI did not change the circadian rhythmicity of colonic Per2 expression in rats, and daily intestinal movement rhythmicity was retained. EA changed the daily rhythmicity of intestinal movement and the circadian rhythmicity of colonic Per2 expression in rats with SCI, increasing Per2 expression shortly after EA treatment. PMID:27999821

  1. Separate representations of dynamics in rhythmic and discrete movements: evidence from motor learning.

    PubMed

    Howard, Ian S; Ingram, James N; Wolpert, Daniel M

    2011-04-01

    Rhythmic and discrete arm movements occur ubiquitously in everyday life, and there is a debate as to whether these two classes of movements arise from the same or different underlying neural mechanisms. Here we examine interference in a motor-learning paradigm to test whether rhythmic and discrete movements employ at least partially separate neural representations. Subjects were required to make circular movements of their right hand while they were exposed to a velocity-dependent force field that perturbed the circularity of the movement path. The direction of the force-field perturbation reversed at the end of each block of 20 revolutions. When subjects made only rhythmic or only discrete circular movements, interference was observed when switching between the two opposing force fields. However, when subjects alternated between blocks of rhythmic and discrete movements, such that each was uniquely associated with one of the perturbation directions, interference was significantly reduced. Only in this case did subjects learn to corepresent the two opposing perturbations, suggesting that different neural resources were employed for the two movement types. Our results provide further evidence that rhythmic and discrete movements employ at least partially separate control mechanisms in the motor system.

  2. Electrophysiological analysis of rhythmic jaw movements in the freely moving mouse.

    PubMed

    Kobayashi, Masayuki; Masuda, Yuji; Fujimoto, Yoshiyuki; Matsuya, Tokuzo; Yamamura, Kensuke; Yamada, Yoshiaki; Maeda, Norihiko; Morimoto, Toshifumi

    2002-03-01

    Although rhythmic jaw movement in feeding has been studied in mammals, such as rats, rabbits and monkeys, the cellular and molecular mechanisms underlying it are not well understood. Transgenic and gene-targeting technologies enable direct control of the genetic makeup of the mouse, and have led to the development of a new category of reagents that have the potential to elucidate the cellular and molecular mechanisms of neural networks. The present study attempts to characterize rhythmic jaw movements in the mouse and to demonstrate its relevance to rhythmic jaw movements found in higher mammals using newly developed jaw-tracking systems and electromyograms of the masticatory muscles. The masticatory sequence of the mouse during feeding was classified into two stages, incision and chewing. Small and rapid (8 Hz) open-close jaw movements were observed during incision, while large and slow (5 Hz) open-close jaw movements were observed during chewing. Integrated electromyograms of the masseteric and digastric muscles were larger during chewing than those observed during incision. Licking behavior was associated with regular (8 Hz), small open-close jaw movements with smaller masseteric activity than those observed during mastication. Grooming showed variable patterns of jaw movement and electromyograms depending on the grooming site. These results suggest that there are neuronal mechanisms producing different frequencies of rhythmic jaw movements in the mouse, and we conclude that the mouse is useful for understanding rhythmic jaw movements in higher mammals.

  3. Separate representations of dynamics in rhythmic and discrete movements: evidence from motor learning

    PubMed Central

    Ingram, James N.; Wolpert, Daniel M.

    2011-01-01

    Rhythmic and discrete arm movements occur ubiquitously in everyday life, and there is a debate as to whether these two classes of movements arise from the same or different underlying neural mechanisms. Here we examine interference in a motor-learning paradigm to test whether rhythmic and discrete movements employ at least partially separate neural representations. Subjects were required to make circular movements of their right hand while they were exposed to a velocity-dependent force field that perturbed the circularity of the movement path. The direction of the force-field perturbation reversed at the end of each block of 20 revolutions. When subjects made only rhythmic or only discrete circular movements, interference was observed when switching between the two opposing force fields. However, when subjects alternated between blocks of rhythmic and discrete movements, such that each was uniquely associated with one of the perturbation directions, interference was significantly reduced. Only in this case did subjects learn to corepresent the two opposing perturbations, suggesting that different neural resources were employed for the two movement types. Our results provide further evidence that rhythmic and discrete movements employ at least partially separate control mechanisms in the motor system. PMID:21273324

  4. Functional eye movement disorders.

    PubMed

    Kaski, D; Bronstein, A M

    2017-01-01

    Functional (psychogenic) eye movement disorders are perhaps less established in the medical literature than other types of functional movement disorders. Patients may present with ocular symptoms (e.g., blurred vision or oscillopsia) or functional eye movements may be identified during the formal examination of the eyes in patients with other functional disorders. Convergence spasm is the most common functional eye movement disorder, but functional gaze limitation, functional eye oscillations (also termed "voluntary nystagmus"), and functional convergence paralysis may be underreported. This chapter reviews the different types of functional eye movement abnormalities and provides a practical framework for their diagnosis and management.

  5. A little elastic for a better performance: kinesiotaping of the motor effector modulates neural mechanisms for rhythmic movements

    PubMed Central

    Bravi, Riccardo; Quarta, Eros; Cohen, Erez J.; Gottard, Anna; Minciacchi, Diego

    2014-01-01

    A rhythmic motor performance is brought about by an integration of timing information with movements. Investigations on the millisecond time scale distinguish two forms of time control, event-based timing and emergent timing. While event-based timing asserts the existence of a central internal timekeeper for the control of repetitive movements, the emergent timing perspective claims that timing emerges from dynamic control of nontemporal movements parameters. We have recently demonstrated that the precision of an isochronous performance, defined as performance of repeated movements having a uniform duration, was insensible to auditory stimuli of various characteristics (Bravi et al., 2014). Such finding has led us to investigate whether the application of an elastic therapeutic tape (Kinesio® Tex taping; KTT) used for treating athletic injuries and a variety of physical disorders, is able to reduce the timing variability of repetitive rhythmic movement. Young healthy subjects, tested with and without KTT, have participated in sessions in which sets of repeated isochronous wrist's flexion-extensions (IWFEs) were performed under various auditory conditions and during their recall. Kinematics was recorded and temporal parameters were extracted and analyzed. Our results show that the application of KTT decreases the variability of rhythmic movements by a 2-fold effect: on the one hand KTT provides extra proprioceptive information activating cutaneous mechanoreceptors, on the other KTT biases toward the emergent timing thus modulating the processes for rhythmic movements. Therefore, KTT appears able to render movements less audio dependent by relieving, at least partially, the central structures from time control and making available more resources for an augmented performance. PMID:25309355

  6. Central pattern generators and the control of rhythmic movements.

    PubMed

    Marder, E; Bucher, D

    2001-11-27

    Central pattern generators are neuronal circuits that when activated can produce rhythmic motor patterns such as walking, breathing, flying, and swimming in the absence of sensory or descending inputs that carry specific timing information. General principles of the organization of these circuits and their control by higher brain centers have come from the study of smaller circuits found in invertebrates. Recent work on vertebrates highlights the importance of neuro-modulatory control pathways in enabling spinal cord and brain stem circuits to generate meaningful motor patterns. Because rhythmic motor patterns are easily quantified and studied, central pattern generators will provide important testing grounds for understanding the effects of numerous genetic mutations on behavior. Moreover, further understanding of the modulation of spinal cord circuitry used in rhythmic behaviors should facilitate the development of new treatments to enhance recovery after spinal cord damage.

  7. Locomotor-Like Leg Movements Evoked by Rhythmic Arm Movements in Humans

    PubMed Central

    Sylos-Labini, Francesca; Ivanenko, Yuri P.; MacLellan, Michael J.; Cappellini, Germana; Poppele, Richard E.; Lacquaniti, Francesco

    2014-01-01

    Motion of the upper limbs is often coupled to that of the lower limbs in human bipedal locomotion. It is unclear, however, whether the functional coupling between upper and lower limbs is bi-directional, i.e. whether arm movements can affect the lumbosacral locomotor circuitry. Here we tested the effects of voluntary rhythmic arm movements on the lower limbs. Participants lay horizontally on their side with each leg suspended in an unloading exoskeleton. They moved their arms on an overhead treadmill as if they walked on their hands. Hand-walking in the antero-posterior direction resulted in significant locomotor-like movements of the legs in 58% of the participants. We further investigated quantitatively the responses in a subset of the responsive subjects. We found that the electromyographic (EMG) activity of proximal leg muscles was modulated over each cycle with a timing similar to that of normal locomotion. The frequency of kinematic and EMG oscillations in the legs typically differed from that of arm oscillations. The effect of hand-walking was direction specific since medio-lateral arm movements did not evoke appreciably leg air-stepping. Using externally imposed trunk movements and biomechanical modelling, we ruled out that the leg movements associated with hand-walking were mainly due to the mechanical transmission of trunk oscillations. EMG activity in hamstring muscles associated with hand-walking often continued when the leg movements were transiently blocked by the experimenter or following the termination of arm movements. The present results reinforce the idea that there exists a functional neural coupling between arm and legs. PMID:24608249

  8. Effects of sympathetic stimulation on the rhythmical jaw movements produced by electrical stimulation of the cortical masticatory areas of rabbits.

    PubMed

    Roatta, S; Windhorst, U; Djupsjöbacka, M; Lytvynenko, S; Passatore, M

    2005-03-01

    The somatomotor and sympathetic nervous systems are intimately linked. One example is the influence of peripheral sympathetic fibers on the discharge characteristics of muscle spindles. Since muscle spindles play important roles in various motor behaviors, including rhythmic movements, the working hypothesis of this research was that changes in sympathetic outflow to muscle spindles can change rhythmic movement patterns. We tested this hypothesis in the masticatory system of rabbits. Rhythmic jaw movements and EMG activity induced by long-lasting electrical cortical stimulation were powerfully modulated by electrical stimulation of the peripheral stump of the cervical sympathetic nerve (CSN). This modulation manifested itself as a consistent and marked reduction in the excursion of the mandibular movements (often preceded by a transient modest enhancement), which could be attributed mainly to corresponding changes in masseter muscle activity. These changes outlasted the duration of CSN stimulation. In some of the cortically evoked rhythmic jaw movements (CRJMs) changes in masticatory frequency were also observed. When the jaw-closing muscles were subjected to repetitive ramp-and-hold force pulses, the CRMJs changed characteristics. Masseter EMG activity was strongly enhanced and digastric EMG slightly decreased. This change was considerably depressed during CSN stimulation. These effects of CSN stimulation are similar in sign and time course to the depression exerted by sympathetic activity on the jaw-closing muscle spindle discharge. It is suggested that the change in proprioceptive information induced by an increase in sympathetic outflow (a) has important implications even under normal conditions for the control of motor function in states of high sympathetic activity, and (b) is one of the mechanisms responsible for motor impairment under certain pathological conditions such as chronic musculoskeletal head-neck disorders, associated with stress conditions.

  9. Human cervical spinal cord circuitry activated by tonic input can generate rhythmic arm movements.

    PubMed

    Solopova, I A; Selionov, V A; Zhvansky, D S; Gurfinkel, V S; Ivanenko, Y

    2016-02-01

    The coordination between arms and legs during human locomotion shares many features with that in quadrupeds, yet there is limited evidence for the central pattern generator for the upper limbs in humans. Here we investigated whether different types of tonic stimulation, previously used for eliciting stepping-like leg movements, may evoke nonvoluntary rhythmic arm movements. Twenty healthy subjects participated in this study. The subject was lying on the side, the trunk was fixed, and all four limbs were suspended in a gravity neutral position, allowing unrestricted low-friction limb movements in the horizontal plane. The results showed that peripheral sensory stimulation (continuous muscle vibration) and central tonic activation (postcontraction state of neuronal networks following a long-lasting isometric voluntary effort, Kohnstamm phenomenon) could evoke nonvoluntary rhythmic arm movements in most subjects. In ∼40% of subjects, tonic stimulation elicited nonvoluntary rhythmic arm movements together with rhythmic movements of suspended legs. The fact that not all participants exhibited nonvoluntary limb oscillations may reflect interindividual differences in responsiveness of spinal pattern generation circuitry to its activation. The occurrence and the characteristics of induced movements highlight the rhythmogenesis capacity of cervical neuronal circuitries, complementing the growing body of work on the quadrupedal nature of human gait.

  10. Simulating discrete and rhythmic multi-joint human arm movements by optimization of nonlinear performance indices.

    PubMed

    Biess, Armin; Nagurka, Mark; Flash, Tamar

    2006-07-01

    An optimization approach applied to mechanical linkage models is used to simulate human arm movements. Predicted arm trajectories are the result of minimizing a nonlinear performance index that depends on kinematic or dynamic variables of the movement. A robust optimization algorithm is presented that computes trajectories which satisfy the necessary conditions with high accuracy. It is especially adapted to the analysis of discrete and rhythmic movements. The optimization problem is solved by parameterizing each generalized coordinate (e.g., joint angular displacement) in terms of Jacobi polynomials and Fourier series, depending on whether discrete or rhythmic movements are considered, combined with a multiple shooting algorithm. The parameterization of coordinates has two advantages. First, it provides an initial guess for the multiple shooting algorithm which solves the optimization problem with high accuracy. Second, it leads to a low dimensional representation of discrete and rhythmic movements in terms of expansion coefficients. The selection of a suitable feature space is an important prerequisite for comparison, recognition and classification of movements. In addition, the separate computational analysis of discrete and rhythmic movements is motivated by their distinct neurophysiological realizations in the cortex. By investigating different performance indices subject to different boundary conditions, the approach can be used to examine possible strategies that humans adopt in selecting specific arm motions for the performance of different tasks in a plane and in three-dimensional space.

  11. Intermittent visual feedback can boost motor learning of rhythmic movements: evidence for error feedback beyond cycles.

    PubMed

    Ikegami, Tsuyoshi; Hirashima, Masaya; Osu, Rieko; Nozaki, Daichi

    2012-01-11

    Movement error is a driving force behind motor learning. For motor learning with discrete movements, such as point-to-point reaching, it is believed that the brain uses error information of the immediately preceding movement only. However, in the case of continuous and repetitive movements (i.e., rhythmic movements), there is a ceaseless inflow of performance information. Thus, an accurate temporal association of the motor commands with the resultant movement errors is not necessarily guaranteed. We investigated how the brain overcomes this challenging situation. Human participants adapted rhythmic movements between two targets to visuomotor rotations, the amplitudes of which changed randomly from cycle to cycle (the duration of one cycle was ∼400 ms). A system identification technique revealed that the motor adaptation was affected not just by the preceding movement error, but also by a history of errors from the previous cycles. Error information obtained from more than one previous cycle tended to increase, rather than decrease, movement error. This result led to a counterintuitive prediction: providing visual error feedback for only a fraction of cycles should enhance visuomotor adaptation. As predicted, we observed that motor adaptation to a constant visual rotation (30°) was significantly enhanced by providing visual feedback once every fourth or fifth cycle rather than for every cycle. These results suggest that the brain requires a specific processing time to modify the motor command, based on the error information, and so is unable to deal appropriately with the overwhelming flow of error information generated during rhythmic movements.

  12. Rhythmic tongue movements during sleep: a peculiar parasomnia in Costello syndrome.

    PubMed

    Della Marca, Giacomo; Rubino, Marco; Vollono, Catello; Vasta, Isabella; Scarano, Emanuele; Mariotti, Paolo; Cianfoni, Alessandro; Mennuni, Gioacchino Francesco; Tonali, Pietro; Zampino, Giuseppe

    2006-04-01

    We describe a peculiar parasomnia observed in four Costello infants, characterized by periodic rhythmic movements of the tongue. Ten Costello patients (4 male; age range 9 months to 29 years) underwent 1 full-night laboratory-based video polysomnography. The four youngest patients (2 male and 2 female; age range 9-31 months) presented during sleep repeated stereotyped movements of the tongue, producing a sucking-like or licking-like movement, mostly during non-rapid eye movement (NREM) sleep. Rhythmic tongue movements in Costello syndrome show the features of an NREM sleep parasomnia. Tongue movements during sleep probably originate from brainstem structures and could be facilitated by an impaired control of the oropharyngeal and tongue muscles.

  13. [Sleep related movement disorders].

    PubMed

    Suzuki, Keisuke; Miyamoto, Masayuki; Miyamoto, Tomoyuki; Hirata, Koichi

    2015-06-01

    Sleep related movement disorders (SRMD) are characterized by simple, stereotyped movements occur during sleep, with the exception of restless legs syndrome (RLS). RLS has the following essential features; an urge to move the legs usually accompanied by uncomfortable sensation in the legs, improvement of symptoms after movement (non-stereotypical movements, such as walking and stretching, to reduce symptoms), and symptoms occur or worsen during periods of rest and in the evening and night. However, RLS is closely associated with periodic limb movement, which shows typical stererotyped limb movements. In the International Classification of Sleep Disorders, 3rd edition, sleep disturbances or daytime symptoms are prerequiste for a diagnosis of SRMD. We here review diagnosis and treatment of SRMD.

  14. Using an Artificial Neural Bypass to Restore Cortical Control of Rhythmic Movements in a Human with Quadriplegia

    PubMed Central

    Sharma, Gaurav; Friedenberg, David A.; Annetta, Nicholas; Glenn, Bradley; Bockbrader, Marcie; Majstorovic, Connor; Domas, Stephanie; Mysiw, W. Jerry; Rezai, Ali; Bouton, Chad

    2016-01-01

    Neuroprosthetic technology has been used to restore cortical control of discrete (non-rhythmic) hand movements in a paralyzed person. However, cortical control of rhythmic movements which originate in the brain but are coordinated by Central Pattern Generator (CPG) neural networks in the spinal cord has not been demonstrated previously. Here we show a demonstration of an artificial neural bypass technology that decodes cortical activity and emulates spinal cord CPG function allowing volitional rhythmic hand movement. The technology uses a combination of signals recorded from the brain, machine-learning algorithms to decode the signals, a numerical model of CPG network, and a neuromuscular electrical stimulation system to evoke rhythmic movements. Using the neural bypass, a quadriplegic participant was able to initiate, sustain, and switch between rhythmic and discrete finger movements, using his thoughts alone. These results have implications in advancing neuroprosthetic technology to restore complex movements in people living with paralysis. PMID:27658585

  15. Using an Artificial Neural Bypass to Restore Cortical Control of Rhythmic Movements in a Human with Quadriplegia

    NASA Astrophysics Data System (ADS)

    Sharma, Gaurav; Friedenberg, David A.; Annetta, Nicholas; Glenn, Bradley; Bockbrader, Marcie; Majstorovic, Connor; Domas, Stephanie; Mysiw, W. Jerry; Rezai, Ali; Bouton, Chad

    2016-09-01

    Neuroprosthetic technology has been used to restore cortical control of discrete (non-rhythmic) hand movements in a paralyzed person. However, cortical control of rhythmic movements which originate in the brain but are coordinated by Central Pattern Generator (CPG) neural networks in the spinal cord has not been demonstrated previously. Here we show a demonstration of an artificial neural bypass technology that decodes cortical activity and emulates spinal cord CPG function allowing volitional rhythmic hand movement. The technology uses a combination of signals recorded from the brain, machine-learning algorithms to decode the signals, a numerical model of CPG network, and a neuromuscular electrical stimulation system to evoke rhythmic movements. Using the neural bypass, a quadriplegic participant was able to initiate, sustain, and switch between rhythmic and discrete finger movements, using his thoughts alone. These results have implications in advancing neuroprosthetic technology to restore complex movements in people living with paralysis.

  16. Posttraumatic functional movement disorders.

    PubMed

    Ganos, C; Edwards, M J; Bhatia, K P

    2017-01-01

    Traumatic injury to the nervous system may account for a range of neurologic symptoms. Trauma location and severity are important determinants of the resulting symptoms. In severe head injury with structural brain abnormalities, the occurrence of trauma-induced movement disorders, most commonly hyperkinesias such as tremor and dystonia, is well recognized and its diagnosis straightforward. However, the association of minor traumatic events, which do not lead to significant persistent structural brain damage, with the onset of movement disorders is more contentious. The lack of clear clinical-neuroanatomic (or symptom lesion) correlations in these cases, the variable timing between traumatic event and symptom onset, but also the presence of unusual clinical features in a number of such patients, which overlap with signs encountered in patients with functional neurologic disorders, contribute to this controversy. The purpose of this chapter is to provide an overview of the movement disorders, most notably dystonia, that have been associated with peripheral trauma and focus on their unusual characteristics, as well as their overlap with functional neurologic disorders. We will then provide details on pathophysiologic views that relate minor peripheral injuries to the development of movement disorders and compare them to knowledge from primary organic and functional movement disorders. Finally, we will comment on the appropriate management of these disorders.

  17. [Sleep and movement disorders].

    PubMed

    Poryazova, R; Bassetti, C L

    2007-01-01

    The three different states of being (wakefulness, NREM and REM sleep) are associated with profound neurophysiological and neurochemical changes in the brain. These changes explain the existence of movement disorders appearing only or preferentially during sleep, and the effects of sleep on movement disorders. Sleep-related movement disorders are of clinical relevance for multiple reasons: 1) high frequency (e.g. restless legs syndrome (RLS)); 2) diagnostic relevance (e.g. REM sleep behavior disorder (RBD) as first manifestation of Parkinson disorder); 3) diagnostic uncertainty (e.g. parasomnias vs nocturnal epilepsy); 4) association with injuries (e.g. RBD, sleepwalking), sleep disruption/daytime sleepiness (e.g. RLS), and psycho-social burden (e.g. enuresis); 5) requirement of specific treatments (e.g. nocturnal epilepsy, stridor, RBD). This article gives an overview on clinical manifestations, pathophysiology, work-up and treatment of sleep-related movement disorders (e.g. RLS, bruxism), parasomnias (e.g. sleepwalking, RBD), sleep-related epilepsies, and on sleep-associated manifestations of movement disorders (e.g. Parkinson disease, multiple system atrophy).

  18. Movement Disorders in 2012

    PubMed Central

    McFarland, Nikolaus R.; Okun, Michael S.

    2013-01-01

    Standfirst Research in movement disorders in 2012 had led to advances in understanding the pathogenic mechanisms of disease and to development of potential novel therapeutic approaches. Key advances include elucidating mechanisms of spreading neurodegenerative pathology, immunotherapy, stem cells, genetics and deep brain stimulation in Parkinsonisms and related disorders. PMID:23296342

  19. Psychogenic movement disorders.

    PubMed

    Thenganatt, Mary Ann; Jankovic, Joseph

    2015-02-01

    Psychogenic movement disorders (PMDs) can present with varied phenomenology that may resemble organic movement disorders. The diagnosis is based on clinical evaluation with a supporting history and classic features on neurologic examination. Ancillary testing, such as imaging and neurophysiologic studies, can provide supplementary information but is not necessary for diagnosis. There is no standard protocol for the treatment of PMDs, but a multidisciplinary approach has been recommended. This review discusses the clinical characteristics of various PMDs as well as ancillary testing, treatment, and research in the pathophysiology of this complex group of disorders.

  20. Hearing What the Body Feels: Auditory Encoding of Rhythmic Movement

    ERIC Educational Resources Information Center

    Phillips-Silver, Jessica; Trainor, Laurel J.

    2007-01-01

    Phillips-Silver and Trainor (Phillips-Silver, J., Trainor, L.J., (2005). Feeling the beat: movement influences infants' rhythm perception. "Science", 308, 1430) demonstrated an early cross-modal interaction between body movement and auditory encoding of musical rhythm in infants. Here we show that the way adults move their bodies to music…

  1. Hearing What the Body Feels: Auditory Encoding of Rhythmic Movement

    ERIC Educational Resources Information Center

    Phillips-Silver, Jessica; Trainor, Laurel J.

    2007-01-01

    Phillips-Silver and Trainor (Phillips-Silver, J., Trainor, L.J., (2005). Feeling the beat: movement influences infants' rhythm perception. "Science", 308, 1430) demonstrated an early cross-modal interaction between body movement and auditory encoding of musical rhythm in infants. Here we show that the way adults move their bodies to music…

  2. Autoimmune movement disorders.

    PubMed

    Mckeon, Andrew; Vincent, Angela

    2016-01-01

    Autoimmune movement disorders encapsulate a large and diverse group of neurologic disorders occurring either in isolation or accompanying more diffuse autoimmune encephalitic illnesses. The full range of movement phenomena has been described and, as they often occur in adults, many of the presentations can mimic neurodegenerative disorders, such as Huntington disease. Disorders may be ataxic, hypokinetic (parkinsonism), or hyperkinetic (myoclonus, chorea, tics, and other dyskinetic disorders). The autoantibody targets are diverse and include neuronal surface proteins such as leucine-rich, glioma-inactivated 1 (LGI1) and glycine receptors, as well as antibodies (such as intracellular antigens) that are markers of a central nervous system process mediated by CD8+ cytotoxic T cells. However, there are two conditions, stiff-person syndrome (also known as stiff-man syndrome) and progressive encephalomyelitis with rigidity and myoclonus (PERM), that are always autoimmune movement disorders. In some instances (such as Purkinje cell cytoplasmic antibody-1 (PCA-1) autoimmunity), antibodies detected in serum and cerebrospinal fluid can be indicative of a paraneoplastic cause, and may direct the cancer search. In other instances (such as 65kDa isoform of glutamic acid decarboxylase (GAD65) autoimmunity), a paraneoplastic cause is very unlikely, and early treatment with immunotherapy may promote improvement or recovery. Here we describe the different types of movement disorder and the clinical features and antibodies associated with them, and discuss treatment.

  3. Processing Rhythmic Pattern during Chinese Sentence Reading: An Eye Movement Study.

    PubMed

    Luo, Yingyi; Duan, Yunyan; Zhou, Xiaolin

    2015-01-01

    Prosodic constraints play a fundamental role during both spoken sentence comprehension and silent reading. In Chinese, the rhythmic pattern of the verb-object (V-O) combination has been found to rapidly affect the semantic access/integration process during sentence reading (Luo and Zhou, 2010). Rhythmic pattern refers to the combination of words with different syllabic lengths, with certain combinations disallowed (e.g., [2 + 1]; numbers standing for the number of syllables of the verb and the noun respectively) and certain combinations preferred (e.g., [1 + 1] or [2 + 2]). This constraint extends to the situation in which the combination is used to modify other words. A V-O phrase could modify a noun by simply preceding it, forming a V-O-N compound; when the verb is disyllabic, however, the word order has to be O-V-N and the object is preferred to be disyllabic. In this study, we investigated how the reader processes the rhythmic pattern and word order information by recording the reader's eye-movements. We created four types of sentences by crossing rhythmic pattern and word order in compounding. The compound, embedding a disyllabic verb, could be in the correct O-V-N or the incorrect V-O-N order; the object could be disyllabic or monosyllabic. We found that the reader spent more time and made more regressions on and after the compounds when either type of anomaly was detected during the first pass reading. However, during re-reading (after all the words in the sentence have been viewed), less regressive eye movements were found for the anomalous rhythmic pattern, relative to the correct pattern; moreover, only the abnormal rhythmic pattern, not the violated word order, influenced the regressive eye movements. These results suggest that while the processing of rhythmic pattern and word order information occurs rapidly during the initial reading of the sentence, the process of recovering from the rhythmic pattern anomaly may ease the reanalysis processing at the

  4. Processing Rhythmic Pattern during Chinese Sentence Reading: An Eye Movement Study

    PubMed Central

    Luo, Yingyi; Duan, Yunyan; Zhou, Xiaolin

    2015-01-01

    Prosodic constraints play a fundamental role during both spoken sentence comprehension and silent reading. In Chinese, the rhythmic pattern of the verb-object (V-O) combination has been found to rapidly affect the semantic access/integration process during sentence reading (Luo and Zhou, 2010). Rhythmic pattern refers to the combination of words with different syllabic lengths, with certain combinations disallowed (e.g., [2 + 1]; numbers standing for the number of syllables of the verb and the noun respectively) and certain combinations preferred (e.g., [1 + 1] or [2 + 2]). This constraint extends to the situation in which the combination is used to modify other words. A V-O phrase could modify a noun by simply preceding it, forming a V-O-N compound; when the verb is disyllabic, however, the word order has to be O-V-N and the object is preferred to be disyllabic. In this study, we investigated how the reader processes the rhythmic pattern and word order information by recording the reader's eye-movements. We created four types of sentences by crossing rhythmic pattern and word order in compounding. The compound, embedding a disyllabic verb, could be in the correct O-V-N or the incorrect V-O-N order; the object could be disyllabic or monosyllabic. We found that the reader spent more time and made more regressions on and after the compounds when either type of anomaly was detected during the first pass reading. However, during re-reading (after all the words in the sentence have been viewed), less regressive eye movements were found for the anomalous rhythmic pattern, relative to the correct pattern; moreover, only the abnormal rhythmic pattern, not the violated word order, influenced the regressive eye movements. These results suggest that while the processing of rhythmic pattern and word order information occurs rapidly during the initial reading of the sentence, the process of recovering from the rhythmic pattern anomaly may ease the reanalysis processing at the

  5. Perceptual coupling in rhythmic movement coordination: stable perception leads to stable action.

    PubMed

    Wilson, Andrew D; Collins, David R; Bingham, Geoffrey P

    2005-08-01

    Rhythmic movement coordination exhibits characteristic patterns of stability, specifically that movements at 0 degrees mean relative phase are maximally stable, 180 degrees is stable but less so than 0 degrees, and other coordinations are unstable without training. Recent research has demonstrated a role for perception in creating this pattern; perceptual variability judgments covary with movement variability results. This suggests that the movement results could be due in part to differential perceptual resolution of the target movement coordinations. The current study used a paradigm that enabled simultaneous access to both perception (between-trial) and movement (within-trial) stability measures. A visually specified 0 degrees target mean relative phase enabled participants to produce stable movements when the movements were at a non-0 degrees relationship to the target being tracked. Strong relationships were found between within-trial stability (the traditional movement measure) and between-trial stability (the traditional perceptual judgment measure), suggestive of a role for perception in producing coordination stability phenomena. The stabilization was incomplete, however, indicating that visual perception was not the sole determinant of movement stability. Rhythmic movement coordination is intrinsically a perception/action system.

  6. Psychostimulants and movement disorders.

    PubMed

    Asser, Andres; Taba, Pille

    2015-01-01

    Psychostimulants are a diverse group of substances with their main psychomotor effects resembling those of amphetamine, methamphetamine, cocaine, or cathinone. Due to their potential as drugs of abuse, recreational use of most of these substances is illegal since 1971 Convention on Psychotropic Substances. In recent years, new psychoactive substances have emerged mainly as synthetic cathinones with new molecules frequently complementing the list. Psychostimulant related movement disorders are a known entity often seen in emergency rooms around the world. These admissions are becoming more frequent as are fatalities associated with drug abuse. Still the legal constraints of the novel synthetic molecules are bypassed. At the same time, chronic and permanent movement disorders are much less frequently encountered. These disorders frequently manifest as a combination of movement disorders. The more common symptoms include agitation, tremor, hyperkinetic and stereotypical movements, cognitive impairment, and also hyperthermia and cardiovascular dysfunction. The pathophysiological mechanisms behind the clinical manifestations have been researched for decades. The common denominator is the monoaminergic signaling. Dopamine has received the most attention but further research has demonstrated involvement of other pathways. Common mechanisms linking psychostimulant use and several movement disorders exist.

  7. Psychostimulants and Movement Disorders

    PubMed Central

    Asser, Andres; Taba, Pille

    2015-01-01

    Psychostimulants are a diverse group of substances with their main psychomotor effects resembling those of amphetamine, methamphetamine, cocaine, or cathinone. Due to their potential as drugs of abuse, recreational use of most of these substances is illegal since 1971 Convention on Psychotropic Substances. In recent years, new psychoactive substances have emerged mainly as synthetic cathinones with new molecules frequently complementing the list. Psychostimulant related movement disorders are a known entity often seen in emergency rooms around the world. These admissions are becoming more frequent as are fatalities associated with drug abuse. Still the legal constraints of the novel synthetic molecules are bypassed. At the same time, chronic and permanent movement disorders are much less frequently encountered. These disorders frequently manifest as a combination of movement disorders. The more common symptoms include agitation, tremor, hyperkinetic and stereotypical movements, cognitive impairment, and also hyperthermia and cardiovascular dysfunction. The pathophysiological mechanisms behind the clinical manifestations have been researched for decades. The common denominator is the monoaminergic signaling. Dopamine has received the most attention but further research has demonstrated involvement of other pathways. Common mechanisms linking psychostimulant use and several movement disorders exist. PMID:25941511

  8. The impact of the perception of rhythmic music on self-paced oscillatory movements.

    PubMed

    Peckel, Mathieu; Pozzo, Thierry; Bigand, Emmanuel

    2014-01-01

    Inspired by theories of perception-action coupling and embodied music cognition, we investigated how rhythmic music perception impacts self-paced oscillatory movements. In a pilot study, we examined the kinematic parameters of self-paced oscillatory movements, walking and finger tapping using optical motion capture. In accordance with biomechanical constraints accounts of motion, we found that movements followed a hierarchical organization depending on the proximal/distal characteristic of the limb used. Based on these findings, we were interested in knowing how and when the perception of rhythmic music could resonate with the motor system in the context of these constrained oscillatory movements. In order to test this, we conducted an experiment where participants performed four different effector-specific movements (lower leg, whole arm and forearm oscillation and finger tapping) while rhythmic music was playing in the background. Musical stimuli consisted of computer-generated MIDI musical pieces with a 4/4 metrical structure. The musical tempo of each song increased from 60 BPM to 120 BPM by 6 BPM increments. A specific tempo was maintained for 20 s before a 2 s transition to the higher tempo. The task of the participant was to maintain a comfortable pace for the four movements (self-paced) while not paying attention to the music. No instruction on whether to synchronize with the music was given. Results showed that participants were distinctively influenced by the background music depending on the movement used with the tapping task being consistently the most influenced. Furthermore, eight strategies put in place by participants to cope with the task were unveiled. Despite not instructed to do so, participants also occasionally synchronized with music. Results are discussed in terms of the link between perception and action (i.e., motor/perceptual resonance). In general, our results give support to the notion that rhythmic music is processed in a motoric

  9. The impact of the perception of rhythmic music on self-paced oscillatory movements

    PubMed Central

    Peckel, Mathieu; Pozzo, Thierry; Bigand, Emmanuel

    2014-01-01

    Inspired by theories of perception-action coupling and embodied music cognition, we investigated how rhythmic music perception impacts self-paced oscillatory movements. In a pilot study, we examined the kinematic parameters of self-paced oscillatory movements, walking and finger tapping using optical motion capture. In accordance with biomechanical constraints accounts of motion, we found that movements followed a hierarchical organization depending on the proximal/distal characteristic of the limb used. Based on these findings, we were interested in knowing how and when the perception of rhythmic music could resonate with the motor system in the context of these constrained oscillatory movements. In order to test this, we conducted an experiment where participants performed four different effector-specific movements (lower leg, whole arm and forearm oscillation and finger tapping) while rhythmic music was playing in the background. Musical stimuli consisted of computer-generated MIDI musical pieces with a 4/4 metrical structure. The musical tempo of each song increased from 60 BPM to 120 BPM by 6 BPM increments. A specific tempo was maintained for 20 s before a 2 s transition to the higher tempo. The task of the participant was to maintain a comfortable pace for the four movements (self-paced) while not paying attention to the music. No instruction on whether to synchronize with the music was given. Results showed that participants were distinctively influenced by the background music depending on the movement used with the tapping task being consistently the most influenced. Furthermore, eight strategies put in place by participants to cope with the task were unveiled. Despite not instructed to do so, participants also occasionally synchronized with music. Results are discussed in terms of the link between perception and action (i.e., motor/perceptual resonance). In general, our results give support to the notion that rhythmic music is processed in a motoric

  10. [Movement disorders is psychiatric diseases].

    PubMed

    Hidasi, Zoltan; Salacz, Pal; Csibri, Eva

    2014-12-01

    Movement disorders are common in psychiatry. The movement disorder can either be the symptom of a psychiatric disorder, can share a common aetiological factor with it, or can be the consequence of psychopharmacological therapy. Most common features include tic, stereotypy, compulsion, akathisia, dyskinesias, tremor, hypokinesia and disturbances of posture and gait. We discuss characteristics and clinical importance of these features. Movement disorders are frequently present in mood disorders, anxiety disorders, schizophrenia, catatonia, Tourette-disorder and psychogenic movement disorder, leading to differential-diagnostic and therapeutical difficulties in everyday practice. Movement disorders due to psychopharmacotherapy can be classified as early-onset, late-onset and tardive. Frequent psychiatric comorbidity is found in primary movement disorders, such as Parkinson's disease, Wilson's disease, Huntington's disease, diffuse Lewy-body disorder. Complex neuropsychiatric approach is effective concerning overlapping clinical features and spectrums of disorders in terms of movement disorders and psychiatric diseases.

  11. Using a noninvasive decoding method to classify rhythmic movement imaginations of the arm in two planes.

    PubMed

    Ofner, Patrick; Müller-Putz, Gernot R

    2015-03-01

    A brain-computer interface (BCI) can help to overcome movement deficits in persons with spinal-cord injury. Ideally, such a BCI detects detailed movement imaginations, i.e., trajectories, and transforms them into a control signal for a neuroprosthesis or a robotic arm restoring movement. Robotic arms have already been controlled successfully by means of invasive recording techniques, and executed movements have been reconstructed using noninvasive decoding techniques. However, it is unclear if detailed imagined movements can be decoded noninvasively using electroencephalography (EEG). We made progress toward imagined movement decoding and successfully classified horizontal and vertical imagined rhythmic movements of the right arm in healthy subjects using EEG. Notably, we used an experimental design which avoided muscle and eye movements to prevent classification results being affected. To classify imagined movements of the same limb, we decoded the movement trajectories and correlated them with assumed movement trajectories (horizontal and vertical). We then assigned the decoded movements to the assumed movements with the higher correlation. To train the decoder, we applied partial least squares, which allowed us to interpret the classifier weights although channels were highly correlated. To conclude, we showed the classification of imagined movements of one limb in two different movement planes in seven out of nine subjects. Furthermore, we found a strong involvement of the supplementary motor area. Finally, as our classifier was based on the decoding approach, we indirectly showed the decoding of imagined movements.

  12. Hearing what the body feels: auditory encoding of rhythmic movement.

    PubMed

    Phillips-Silver, Jessica; Trainor, Laurel J

    2007-12-01

    Phillips-Silver and Trainor (Phillips-Silver, J., Trainor, L.J., (2005). Feeling the beat: movement influences infants' rhythm perception. Science, 308, 1430) demonstrated an early cross-modal interaction between body movement and auditory encoding of musical rhythm in infants. Here we show that the way adults move their bodies to music influences their auditory perception of the rhythm structure. We trained adults, while listening to an ambiguous rhythm with no accented beats, to bounce by bending their knees to interpret the rhythm either as a march or as a waltz. At test, adults identified as similar an auditory version of the rhythm pattern with accented strong beats that matched their previous bouncing experience in comparison with a version whose accents did not match. In subsequent experiments we showed that this effect does not depend on visual information, but that movement of the body is critical. Parallel results from adults and infants suggest that the movement-sound interaction develops early and is fundamental to music processing throughout life.

  13. Modification of cortically evoked rhythmic jaw movements by reflex deglutition in rabbits.

    PubMed

    Sumi, T

    1977-01-01

    In rabbits, lightly anesthetized with ether, tetanic stimulation of the superior laryngeal nerve (SLN) displaced the jaw toward opening and reduced the amplitude of cortically evoked rhythmic jaw movements. With increased intensity of stimulus, the effects became remarkable and the opened jaw movement ultimately ceased. Reflex swallowing in reaction to weak electrical stimuli of SLN or to a small amount of water squirted into the oropharynx yielded a brief and instantaneous cessation of rhythmic jaw movements with the jaw open. Strong electrical stimuli to the nerve or a squirt of relatively large amount of water into the oropharynx prolonged the duration of both swallowing and the cessation of rhythmic jaw movements for about 1.0 sec. Reflex swallowing yielded a burst of activity for about 300 msec in the mylohyoideus and silence for a longer period in the masseter. Spontaneous activity of the masseter was moderately decreased during the nerve stimulation and, when swallowing occurred, this decrease became prominent for a short period.

  14. Motor Performance and Rhythmic Perception of Children with Intellectual and Developmental Disability and Developmental Coordination Disorder

    ERIC Educational Resources Information Center

    Kartasidou, Lefkothea; Varsamis, Panagiotis; Sampsonidou, Anna

    2012-01-01

    Professionals who work with children presenting intellectual and developmental disability (IDD) and developmental coordination disorder (DCD) are concerned with their motor development and their rhythmic perception. The aim of this study is to investigate the correlation between a motor performance test and a music rhythmic test that measures…

  15. Joint Rhythmic Movement Increases 4-Year-Old Children's Prosocial Sharing and Fairness Toward Peers.

    PubMed

    Rabinowitch, Tal-Chen; Meltzoff, Andrew N

    2017-01-01

    The allocation of resources to a peer partner is a prosocial act that is of fundamental importance. Joint rhythmic movement, such as occurs during musical interaction, can induce positive social experiences, which may play a role in developing and enhancing young children's prosocial skills. Here, we investigated whether joint rhythmic movement, free of musical context, increases 4-year-olds' sharing and sense of fairness in a resource allocation task involving peers. We developed a precise procedure for administering joint synchronous experience, joint asynchronous experience, and a baseline control involving no treatment. Then we tested how participants allocated resources between self and peer. We found an increase in the generous allocation of resources to peers following both synchronous and asynchronous movement compared to no treatment. At a more theoretical level, this result is considered in relation to previous work testing other aspects of child prosociality, for example, peer cooperation, which can be distinguished from judgments of fairness in resource allocation tasks. We draw a conceptual distinction between two types of prosocial behavior: resource allocation (an other-directed individual behavior) and cooperation (a goal-directed collaborative endeavor). Our results highlight how rhythmic interactions, which are prominent in joint musical engagements and synchronized activity, influence prosocial behavior between preschool peers.

  16. Energy efficient and robust rhythmic limb movement by central pattern generators.

    PubMed

    Verdaasdonk, B W; Koopman, H F J M; Helm, F C T Van Der

    2006-05-01

    Humans show great energy efficiency and robustness in rhythmic tasks, such as walking and arm swinging. In this study a mathematical model of rhythmic limb movement is presented, which shows that tight local coupling of Central Pattern Generators (CPGs) to limbs could explain part of this behavior. Afferent feedback to flexor and extensor centers of the CPG is crucial in providing energy efficiency by means of resonance tuning. Feedback of positional information provides resonance tuning above the endogenous frequency of the CPG. Integral feedback provides resonance tuning at and below the endogenous frequency. Feedback of velocity information is necessary to compensate for the time delay in the loop, coupling limb to CPG; without velocity feedback bi-stability occurs and resonance tuning is not possible at high movement frequencies. The concepts of energy efficient and robust control of rhythmic limb movements are also applicable to robotics. It is the first CPG model, which provides resonance tuning at natural limb frequencies above and below its endogenous frequency.

  17. Anatomical Pathways Involved in Generating and Sensing Rhythmic Whisker Movements

    PubMed Central

    Bosman, Laurens W. J.; Houweling, Arthur R.; Owens, Cullen B.; Tanke, Nouk; Shevchouk, Olesya T.; Rahmati, Negah; Teunissen, Wouter H. T.; Ju, Chiheng; Gong, Wei; Koekkoek, Sebastiaan K. E.; De Zeeuw, Chris I.

    2011-01-01

    The rodent whisker system is widely used as a model system for investigating sensorimotor integration, neural mechanisms of complex cognitive tasks, neural development, and robotics. The whisker pathways to the barrel cortex have received considerable attention. However, many subcortical structures are paramount to the whisker system. They contribute to important processes, like filtering out salient features, integration with other senses, and adaptation of the whisker system to the general behavioral state of the animal. We present here an overview of the brain regions and their connections involved in the whisker system. We do not only describe the anatomy and functional roles of the cerebral cortex, but also those of subcortical structures like the striatum, superior colliculus, cerebellum, pontomedullary reticular formation, zona incerta, and anterior pretectal nucleus as well as those of level setting systems like the cholinergic, histaminergic, serotonergic, and noradrenergic pathways. We conclude by discussing how these brain regions may affect each other and how they together may control the precise timing of whisker movements and coordinate whisker perception. PMID:22065951

  18. Activity of the rat pontomedullary reticular neurons related to rhythmical jaw movements.

    PubMed

    Ohta, M; Sasamoto, K; Kishikawa, N; Kuraoka, N

    1999-11-01

    Electrical stimulation of the cerebral peduncle or oral mechanical or chemical stimulation induced rhythmical jaw movements (RJM) in the anesthetized rat. Extracellular recording was made from the pontomedullary reticular neurons in relation to RJM. The RJM-related activity was classified to a tonic, a transient and a phase-dependent rhythmical activities (116, 92 and 45 neurons, respectively). We found that the neurons showing the phase-dependent activities discharged exclusively or almost exclusively during RJM without responding to at least one of three kinds of RJM-inducing stimulation. Fourteen neurons were activated by all kinds of RJM-inducing stimulation and majority of them showed weak or no change in activity during RJM, although some showed the transient or the rhythmical activity during RJM. We propose that the phase-dependent rhythmical activity is necessary to generate RJM since any stimulation-induced RJM was reversibly blocked by microinjection of lidocaine or glutamate receptor blocking agents into the brainstem site concentrated by this type of neurons. No other type of activity was observed exclusively during RJM.

  19. Apraxia in movement disorders.

    PubMed

    Zadikoff, Cindy; Lang, Anthony E

    2005-07-01

    The definition of apraxia specifies that the disturbance of performed skilled movements cannot be explained by the more elemental motor disorders typical of patients with movement disorders. Generally this does not present a significant diagnostic problem when dealing with 'higher-level' praxic disturbances (e.g. ideational apraxia), but it can be a major confound in establishing the presence of limb-kinetic apraxia. Most motor disturbances characteristic of extrapyramidal disorders, particularly bradykinesia and dystonia, will compromise the ability to establish the presence of loss of dexterity and deftness that constitutes this subtype. The term 'apraxia' has also been applied to other motor disturbances, such as 'gait apraxia' and 'apraxia of eyelid opening', that perhaps are misnomers, demonstrating the lack of a coherent nomenclature in this field. Apraxia is a hallmark of corticobasal degeneration (CBD) and historically this has received the most attention among the movement disorders. Corticobasal degeneration is characterized by various forms of apraxia affecting limb function, particularly ideomotor apraxia and limb-kinetic apraxia, although buccofacial and oculomotor apraxia can be present as well. The syndrome of parkinsonism and prominent apraxia, designated the 'corticobasal syndrome' (CBS), may be caused by a variety of other central nervous system pathologies including progressive supranuclear palsy (PSP), Alzheimer's disease, dementia with Lewy bodies and frontotemporal dementias. Distinct from the CBS, PSP and Parkinson's disease can demonstrate varying degrees of apraxia on selected tests, especially in those patients with more severe cognitive dysfunction. Diseases that cause the combination of apraxia and a primary movement disorder most often involve a variety of cerebral cortical sites as well as basal ganglia structures. Clinical-pathological correlates and functional imaging studies are compromised by both this diffuse involvement and the

  20. Physiological modules for generating discrete and rhythmic movements: action identification by a dynamic recurrent neural network.

    PubMed

    Bengoetxea, Ana; Leurs, Françoise; Hoellinger, Thomas; Cebolla, Ana M; Dan, Bernard; McIntyre, Joseph; Cheron, Guy

    2014-01-01

    In this study we employed a dynamic recurrent neural network (DRNN) in a novel fashion to reveal characteristics of control modules underlying the generation of muscle activations when drawing figures with the outstretched arm. We asked healthy human subjects to perform four different figure-eight movements in each of two workspaces (frontal plane and sagittal plane). We then trained a DRNN to predict the movement of the wrist from information in the EMG signals from seven different muscles. We trained different instances of the same network on a single movement direction, on all four movement directions in a single movement plane, or on all eight possible movement patterns and looked at the ability of the DRNN to generalize and predict movements for trials that were not included in the training set. Within a single movement plane, a DRNN trained on one movement direction was not able to predict movements of the hand for trials in the other three directions, but a DRNN trained simultaneously on all four movement directions could generalize across movement directions within the same plane. Similarly, the DRNN was able to reproduce the kinematics of the hand for both movement planes, but only if it was trained on examples performed in each one. As we will discuss, these results indicate that there are important dynamical constraints on the mapping of EMG to hand movement that depend on both the time sequence of the movement and on the anatomical constraints of the musculoskeletal system. In a second step, we injected EMG signals constructed from different synergies derived by the PCA in order to identify the mechanical significance of each of these components. From these results, one can surmise that discrete-rhythmic movements may be constructed from three different fundamental modules, one regulating the co-activation of all muscles over the time span of the movement and two others elliciting patterns of reciprocal activation operating in orthogonal directions.

  1. Physiological modules for generating discrete and rhythmic movements: action identification by a dynamic recurrent neural network

    PubMed Central

    Bengoetxea, Ana; Leurs, Françoise; Hoellinger, Thomas; Cebolla, Ana M.; Dan, Bernard; McIntyre, Joseph; Cheron, Guy

    2014-01-01

    In this study we employed a dynamic recurrent neural network (DRNN) in a novel fashion to reveal characteristics of control modules underlying the generation of muscle activations when drawing figures with the outstretched arm. We asked healthy human subjects to perform four different figure-eight movements in each of two workspaces (frontal plane and sagittal plane). We then trained a DRNN to predict the movement of the wrist from information in the EMG signals from seven different muscles. We trained different instances of the same network on a single movement direction, on all four movement directions in a single movement plane, or on all eight possible movement patterns and looked at the ability of the DRNN to generalize and predict movements for trials that were not included in the training set. Within a single movement plane, a DRNN trained on one movement direction was not able to predict movements of the hand for trials in the other three directions, but a DRNN trained simultaneously on all four movement directions could generalize across movement directions within the same plane. Similarly, the DRNN was able to reproduce the kinematics of the hand for both movement planes, but only if it was trained on examples performed in each one. As we will discuss, these results indicate that there are important dynamical constraints on the mapping of EMG to hand movement that depend on both the time sequence of the movement and on the anatomical constraints of the musculoskeletal system. In a second step, we injected EMG signals constructed from different synergies derived by the PCA in order to identify the mechanical significance of each of these components. From these results, one can surmise that discrete-rhythmic movements may be constructed from three different fundamental modules, one regulating the co-activation of all muscles over the time span of the movement and two others elliciting patterns of reciprocal activation operating in orthogonal directions

  2. Movement disorders in cerebrovascular disease.

    PubMed

    Mehanna, Raja; Jankovic, Joseph

    2013-06-01

    Movement disorders can occur as primary (idiopathic) or genetic disease, as a manifestation of an underlying neurodegenerative disorder, or secondary to a wide range of neurological or systemic diseases. Cerebrovascular diseases represent up to 22% of secondary movement disorders, and involuntary movements develop after 1-4% of strokes. Post-stroke movement disorders can manifest in parkinsonism or a wide range of hyperkinetic movement disorders including chorea, ballism, athetosis, dystonia, tremor, myoclonus, stereotypies, and akathisia. Some of these disorders occur immediately after acute stroke, whereas others can develop later, and yet others represent delayed-onset progressive movement disorders. These movement disorders have been encountered in patients with ischaemic and haemorrhagic strokes, subarachnoid haemorrhage, cerebrovascular malformations, and dural arteriovenous fistula affecting the basal ganglia, their connections, or both.

  3. Rhythmic movement in Parkinson’s disease: effects of visual feedback and medication state

    PubMed Central

    Levy-Tzedek, S.; Arle, J. E.; Shils, J. L.; Poizner, H.

    2011-01-01

    Previous studies examining discrete movements of Parkinson’s disease (PD) patients have found that in addition to performing movements that were slower than those of control participants, they exhibit specific deficits in movement coordination and in sensorimotor integration required to accurately guide movements. With medication, movement speed was normalized, but the coordinative aspects of movement were not. This led to the hypothesis that dopaminergic medication more readily compensates for intensive aspects of movement (such as speed), than for coordinative aspects (such as coordination of different limb segments) (Schettino et al., Exp Brain Res 168:186–202, 2006). We tested this hypothesis on rhythmic, continuous movements of the forearm. In our task, target peak speed and amplitude, availability of visual feedback, and medication state (on/off) were varied. We found, consistent with the discrete-movement results, that peak speed (intensive aspect) was normalized by medication, while accuracy, which required coordination of speed and amplitude modulation (coordinative aspect), was not normalized by dopaminergic treatment. However, our findings that amplitude, an intensive aspect of movement, was also not normalized by medication, suggests that a simple pathway gain increase does not act to remediate all intensive aspects of movement to the same extent. While it normalized movement peak speed, it did not normalize movement amplitude. Furthermore, we found that when visual feedback was not available, all participants (PD and controls) made faster movements. The effects of dopaminergic medication and availability of visual feedback on movement speed were additive. The finding that movement speed uniformly increased both in the PD and the control groups suggests that visual feedback may be necessary for calibration of peak speed, otherwise underestimated by the motor control system. PMID:21526337

  4. How Moving Together Brings Us Together: When Coordinated Rhythmic Movement Affects Cooperation.

    PubMed

    Cross, Liam; Wilson, Andrew D; Golonka, Sabrina

    2016-01-01

    Although it is well established that rhythmically coordinating with a social partner can increase cooperation, it is as yet unclear when and why intentional coordination has such effects. We distinguish three dimensions along which explanations might vary. First, pro-social effects might require in-phase synchrony or simply coordination. Second, the effects of rhythmic movements on cooperation might be direct or mediated by an intervening variable. Third, the pro-social effects might occur in proportion to the quality of the coordination, or occur once some threshold amount of coordination has occurred. We report an experiment and two follow-ups which sought to identify which classes of models are required to account for the positive effects of coordinated rhythmic movement on cooperation. Across the studies, we found evidence (1) that coordination, and not just synchrony, can have pro-social consequences (so long as the social nature of the task is perceived), (2) that the effects of intentional coordination are direct, not mediated, and (3) that the degree of the coordination did not predict the degree of cooperation. The fact of inter-personal coordination (moving together in time and in a social context) is all that's required for pro-social effects. We suggest that future research should use the kind of carefully controllable experimental task used here to continue to develop explanations for when and why coordination affects pro-social behaviors.

  5. Advantages of rhythmic movements at resonance: minimal active degrees of freedom, minimal noise, and maximal predictability.

    PubMed

    Goodman, L; Riley, M A; Mitra, S; Turvey, M T

    2000-03-01

    Using time delay embedding, the authors applied phase space reconstruction to the time series of rhythmic movements of a hand-held pendulum. Subjects (N = 6) produced the manual oscillations about the wrist at the pendulum's resonant frequency and at a higher and a lower frequency. The number of active degrees of freedom required to capture the dynamics of the rhythmic behavior was 3 for the resonant frequency and 4 for each of the nonresonant frequencies. The residual high-dimensional noise was similarly lowest for the resonant frequency. Whereas 33% and 20%, respectively, of the vectors in the phase spaces of the dynamics higher and lower than resonance were unpredictable, only 12% were unpredictable at resonance. Finally, the predictability of the evolving dynamics extended farther into the future for oscillations at the resonant frequency. At resonance, the prediction horizon was 5 times farther than the prediction horizon for the higher than resonance behavior and 2.5 times farther than that for the lower than resonance behavior. The results suggest that, in pendular oscillations of a limb or limb segment, attunement of the central nervous system to the resonant frequency minimizes the variables to be controlled and maximizes the predictability of the rhythmic movement's chaotic dynamics.

  6. How Moving Together Brings Us Together: When Coordinated Rhythmic Movement Affects Cooperation

    PubMed Central

    Cross, Liam; Wilson, Andrew D.; Golonka, Sabrina

    2016-01-01

    Although it is well established that rhythmically coordinating with a social partner can increase cooperation, it is as yet unclear when and why intentional coordination has such effects. We distinguish three dimensions along which explanations might vary. First, pro-social effects might require in-phase synchrony or simply coordination. Second, the effects of rhythmic movements on cooperation might be direct or mediated by an intervening variable. Third, the pro-social effects might occur in proportion to the quality of the coordination, or occur once some threshold amount of coordination has occurred. We report an experiment and two follow-ups which sought to identify which classes of models are required to account for the positive effects of coordinated rhythmic movement on cooperation. Across the studies, we found evidence (1) that coordination, and not just synchrony, can have pro-social consequences (so long as the social nature of the task is perceived), (2) that the effects of intentional coordination are direct, not mediated, and (3) that the degree of the coordination did not predict the degree of cooperation. The fact of inter-personal coordination (moving together in time and in a social context) is all that's required for pro-social effects. We suggest that future research should use the kind of carefully controllable experimental task used here to continue to develop explanations for when and why coordination affects pro-social behaviors. PMID:28066301

  7. EEG Oscillations Are Modulated in Different Behavior-Related Networks during Rhythmic Finger Movements.

    PubMed

    Seeber, Martin; Scherer, Reinhold; Müller-Putz, Gernot R

    2016-11-16

    Sequencing and timing of body movements are essential to perform motoric tasks. In this study, we investigate the temporal relation between cortical oscillations and human motor behavior (i.e., rhythmic finger movements). High-density EEG recordings were used for source imaging based on individual anatomy. We separated sustained and movement phase-related EEG source amplitudes based on the actual finger movements recorded by a data glove. Sustained amplitude modulations in the contralateral hand area show decrease for α (10-12 Hz) and β (18-24 Hz), but increase for high γ (60-80 Hz) frequencies during the entire movement period. Additionally, we found movement phase-related amplitudes, which resembled the flexion and extension sequence of the fingers. Especially for faster movement cadences, movement phase-related amplitudes included high β (24-30 Hz) frequencies in prefrontal areas. Interestingly, the spectral profiles and source patterns of movement phase-related amplitudes differed from sustained activities, suggesting that they represent different frequency-specific large-scale networks. First, networks were signified by the sustained element, which statically modulate their synchrony levels during continuous movements. These networks may upregulate neuronal excitability in brain regions specific to the limb, in this study the right hand area. Second, movement phase-related networks, which modulate their synchrony in relation to the movement sequence. We suggest that these frequency-specific networks are associated with distinct functions, including top-down control, sensorimotor prediction, and integration. The separation of different large-scale networks, we applied in this work, improves the interpretation of EEG sources in relation to human motor behavior. EEG recordings provide high temporal resolution suitable to relate cortical oscillations to actual movements. Investigating EEG sources during rhythmic finger movements, we distinguish sustained from

  8. Overview of Movement Disorders

    MedlinePlus

    ... and Throat Disorders Eye Disorders Fundamentals Heart and Blood Vessel Disorders Hormonal and Metabolic Disorders Immune Disorders Infections Injuries and Poisoning Kidney and Urinary Tract Disorders Liver ...

  9. Physiological modules for generating discrete and rhythmic movements: component analysis of EMG signals.

    PubMed

    Bengoetxea, Ana; Leurs, Françoise; Hoellinger, Thomas; Cebolla, Ana Maria; Dan, Bernard; Cheron, Guy; McIntyre, Joseph

    2014-01-01

    A central question in Neuroscience is that of how the nervous system generates the spatiotemporal commands needed to realize complex gestures, such as handwriting. A key postulate is that the central nervous system (CNS) builds up complex movements from a set of simpler motor primitives or control modules. In this study we examined the control modules underlying the generation of muscle activations when performing different types of movement: discrete, point-to-point movements in eight different directions and continuous figure-eight movements in both the normal, upright orientation and rotated 90°. To test for the effects of biomechanical constraints, movements were performed in the frontal-parallel or sagittal planes, corresponding to two different nominal flexion/abduction postures of the shoulder. In all cases we measured limb kinematics and surface electromyographic activity (EMG) signals for seven different muscles acting around the shoulder. We first performed principal component analysis (PCA) of the EMG signals on a movement-by-movement basis. We found a surprisingly consistent pattern of muscle groupings across movement types and movement planes, although we could detect systematic differences between the PCs derived from movements performed in each shoulder posture and between the principal components associated with the different orientations of the figure. Unexpectedly we found no systematic differences between the figure eights and the point-to-point movements. The first three principal components could be associated with a general co-contraction of all seven muscles plus two patterns of reciprocal activation. From these results, we surmise that both "discrete-rhythmic movements" such as the figure eight, and discrete point-to-point movement may be constructed from three different fundamental modules, one regulating the impedance of the limb over the time span of the movement and two others operating to generate movement, one aligned with the

  10. Physiological modules for generating discrete and rhythmic movements: component analysis of EMG signals

    PubMed Central

    Bengoetxea, Ana; Leurs, Françoise; Hoellinger, Thomas; Cebolla, Ana Maria; Dan, Bernard; Cheron, Guy; McIntyre, Joseph

    2015-01-01

    A central question in Neuroscience is that of how the nervous system generates the spatiotemporal commands needed to realize complex gestures, such as handwriting. A key postulate is that the central nervous system (CNS) builds up complex movements from a set of simpler motor primitives or control modules. In this study we examined the control modules underlying the generation of muscle activations when performing different types of movement: discrete, point-to-point movements in eight different directions and continuous figure-eight movements in both the normal, upright orientation and rotated 90°. To test for the effects of biomechanical constraints, movements were performed in the frontal-parallel or sagittal planes, corresponding to two different nominal flexion/abduction postures of the shoulder. In all cases we measured limb kinematics and surface electromyographic activity (EMG) signals for seven different muscles acting around the shoulder. We first performed principal component analysis (PCA) of the EMG signals on a movement-by-movement basis. We found a surprisingly consistent pattern of muscle groupings across movement types and movement planes, although we could detect systematic differences between the PCs derived from movements performed in each shoulder posture and between the principal components associated with the different orientations of the figure. Unexpectedly we found no systematic differences between the figure eights and the point-to-point movements. The first three principal components could be associated with a general co-contraction of all seven muscles plus two patterns of reciprocal activation. From these results, we surmise that both “discrete-rhythmic movements” such as the figure eight, and discrete point-to-point movement may be constructed from three different fundamental modules, one regulating the impedance of the limb over the time span of the movement and two others operating to generate movement, one aligned with the

  11. Movement disorders in childhood.

    PubMed

    Cardoso, Francisco

    2014-01-01

    The aim of this article is to review movement disorders in children. They are common but have etiology and phenomenology different than in adults. Tics are the most common phenomena although in most instances they are mild and have a favorable long-term prognosis. Dystonia is the second most common phenomena but when present it is usually genetic or idiopathic and causes meaningful disability. Sydenham's chorea is the most common cause of chorea in children worldwide. Systemic lupus erythematosus is a much rarer cause of chorea but it is always to be ruled out given the lack of a specific diagnostic marker for Sydenham's chorea. Tremor, usually caused by drugs or essential tremor, is regarded as rather uncommon in children. Arguably, most pediatric patients with tremor do not seek medical attention because of the lack of disability. Stereotypies are relatively uncommon but their recognition is clinically relevant since they are usually associated with severe conditions such as autism and Rett syndrome. Parkinsonism is quite rare in children and either results from encephalitis or is a side effect of medications. Wilson's disease must be ruled out in all children with movement disorders.

  12. Occurrence of a rhythmic slower wave in EMG prior to a rapid voluntary movement.

    PubMed

    Tanii, K

    1984-05-01

    The aim of the present study was to investigate whether an EMG slower wave prior to a rapid straightening-up movement is associated with motor preparation to perform the movement. The straightening movement was performed at 6 load intensities and under 3 conditions: without any external load; with an additional load; lifting a load. The subject could freely begin the rapid movement from a moderate forward-bending position whenever he was fully ready for the beginning of the movement after he held the bent posture. Bipolar surface EMGs of the erector spinal muscles at the L1 and L4 level, the gluteus maximus muscle and the semitendinosus muscle were led by a pair of skin electrodes with a time constant of 0.03 sec. The signal from the hip goniometer was measured simultaneously to identify the period of the movement. A distinct relationship between the occurrence of the slower wave and both load intensities and conditions was not found. However, the rhythmic slower wave often occurred in the muscles 200-450 msec before the movement. The occurrence of the wave in the muscles was often simultaneous. The signal from the hip goniometer did not change with the occurrence of the slower wave. The amplitude of the slower wave increased frequently. The present results suggest that the slower wave may reflect a significant change of motoneuronal activity in connection with motor preparation to perform the movement.

  13. Sleep-to-wake transition movement disorders.

    PubMed

    Vetrugno, Roberto; Montagna, Pasquale

    2011-12-01

    Consciousness and vigilance level are important factors for the manifestation and variability of many disorders, including movement disorders. Usually lumped together into unspecified "Wakefulness," the transition between wakefulness and sleep--the pre-dormitum, and between sleep and wakefulness--the post-dormitum, possess intrinsic cerebral metabolic patterns and mental, behavioural, and neurophysiological characteristics which make these peculiar states of vigilance independent. Moreover, the pre- and post-dormitum, with the relative state-dependent changes in firing patterns of many neuronal supra-pinal populations, act to release pacemakers responsible for different sleep-related motor phenomena. The relevance of pre-dormitum and post-dormitum as states different from full wakefulness and full sleep is, indeed, indicated by disorders which appear exclusively during either state, including motor disorders such as propriospinal myoclonus and awakening epilepsy. We will focus on three paradigmatic physiological/pathological motor phenomena (rhythmic movement disorder, hypnic jerks, and propriospinal myoclonus) strictly linked to the sleep-wake transition periods. Thereafter we will briefly discuss how the process of pre-dormitum and post-dormitum can lead to such disruption of motor control. Copyright © 2011 Elsevier B.V. All rights reserved.

  14. Increased breathing resistance compromises the time course of rhythmical forearm movements-a pilot study.

    PubMed

    Tabary, Ariane; Rassler, Beate

    2015-01-01

    Skeletal muscle dysfunction is a major problem among the co-morbidities associated with chronic obstructive pulmonary disease (COPD). However, muscle weakness and increased fatigability are not the only limitations of skeletal muscle function. Motor-respiratory coordination (MRC) may occur even during movements at lowest workloads. MRC modifies the temporal pattern of motor actions, thus probably impairing motor performance and movement precision. Little attention has been paid to the question of whether motor functions may be compromised in COPD patients independent of workload and required muscle strength and endurance. The present pilot study was designed to investigate the effects of a simulated obstruction (SO) in healthy subjects on their breathing pattern and the timing of a rhythmical forearm movement. Twenty-one subjects performed flexion- extension movements with their right forearm at a self-chosen rate within a range between 0.2 and 0.4 Hz. After a control experiment with normal breathing, a plug with a narrow hole was inserted between face mask and pneumotachograph to simulate obstruction. Subjects were required to repeat the rhythmical forearm movement at the same rate as in the control experiment. The condition of SO significantly prolonged breath duration but reduced tidal volume and ventilation. In addition, period duration of the forearm movement increased significantly under this condition while the movement-to-breathing frequency ratio remained almost constant. Increased breathing resistance was considered to cause prolonged breath duration accompanied by an increase in movement period duration. The constant near-integer ratio between movement and breathing rates indicates that the change in movement period duration resulted from MRC. The findings of this pilot study demonstrate that increased breathing resistance may compromise motor performance even at lower workloads. This means that in COPD patients, not only muscle strength and endurance

  15. Psychiatric comorbidities in movement disorders.

    PubMed

    Miguel-Puga, Adán; Villafuerte, Gabriel; Arias-Carrión, Oscar

    2017-07-06

    Psychiatric comorbidities are common in movement disorders. This review provides a practical approach to help clinicians to recognize psychiatric disorders in the most frequent movement disorders. However, the extent of neurodegeneration, as well as the impact of medications with considerable CNS effects, influences the diverse psychiatric presentations that, in turn, are influenced by the stress of living with a movement disorder. Depression, anxiety, and psychosis are the most common psychiatric comorbidities in movement disorders and of the medications used to treat the motor disturbances. These psychiatric problems impair patients' functioning throughout the course of the chronic neurodegenerative diseases. Due to the direct connection between brain dysfunction and psychiatric symptoms, there is hope that understanding the psychiatric comorbidities in movement disorders will lead to a better quality-of-life.

  16. Neuromechanical considerations for incorporating rhythmic arm movement in the rehabilitation of walking

    NASA Astrophysics Data System (ADS)

    Klimstra, Marc D.; Thomas, Evan; Stoloff, Rebecca H.; Ferris, Daniel P.; Zehr, E. Paul

    2009-06-01

    We have extensively used arm cycling to study the neural control of rhythmic movements such as arm swing during walking. Recently rhythmic movement of the arms has also been shown to enhance and shape muscle activity in the legs. However, restricted information is available concerning the conditions necessary to maximally alter lumbar spinal cord excitability. Knowledge on the neuromechanics of a task can assist in the determination of the type, level, and timing of neural signals, yet arm swing during walking and arm cycling have not received a detailed neuromechanical comparison. The purpose of this research was to provide a combined neural and mechanical measurement approach that could be used to assist in the determination of the necessary and sufficient conditions for arm movement to assist in lower limb rehabilitation after stroke and spinal cord injury. Subjects performed three rhythmic arm movement tasks: (1) cycling (cycle); (2) swinging while standing (swing); and (3) swinging while treadmill walking (walk). We hypothesized that any difference in neural control between tasks (i.e., pattern of muscle activity) would reflect changes in the mechanical constraints unique to each task. Three-dimensional kinematics were collected simultaneously with force measurement at the hand and electromyography from the arms and trunk. All data were appropriately segmented to allow a comparison between and across conditions and were normalized and averaged to 100% movement cycle based on shoulder excursion. Separate mathematical principal components analysis of kinematic and neural variables was performed to determine common task features and muscle synergies. The results highlight important neural and mechanical features that distinguish differences between tasks. For example, there are considerable differences in the anatomical positions of the arms during each task, which relate to the moments experienced about the elbow and shoulder. Also, there are differences between

  17. Movement disorders in systemic diseases.

    PubMed

    Poewe, Werner; Djamshidian-Tehrani, Atbin

    2015-02-01

    Movement disorders, classically involving dysfunction of the basal ganglia commonly occur in neurodegenerative and structural brain disorders. At times, however, movement disorders can be the initial manifestation of a systemic disease. In this article we discuss the most common movement disorders which may present in infectious, autoimmune, paraneoplastic, metabolic and endocrine diseases. Management often has to be multidisciplinary involving primary care physicians, neurologists, allied health professionals including nurses, occupational therapists and less frequently neurosurgeons. Recognizing and treating the underlying systemic disease is important in order to improve the neurological symptoms.

  18. Analysis of rhythmical jaw movements produced by taste stimulation in rats.

    PubMed

    Sasamoto, K; Nishimuta, K; Yasumatsu, K; Ninomiya, Y

    2001-04-01

    Taste stimulation of the mouth induces various oral movements. Sucrose or salt solution induces rhythmical jaw movements (RJM) or tongue protrusion as an ingestive behavior. Bitter taste induces a gaping or tongue retraction as an aversive behavior. There is no report that describes the precise pattern of jaw movements induced by taste stimulation. The purpose of the present study is to clarify the pattern of the taste-induced RJM with electromyographic activities of the masticatory muscles in the anesthetized rat. When water was injected into the mouth of the rat, an RJM was induced. In this type of RJM, the lower jaw swung right and left side in each open-close cycle alternately. The anterior digastric muscle was active in every opening phase, while activities of the jaw closing muscles were generally weak. The RJM induced by water was opening-dominant movements. Sucrose or salt solution induced a similar pattern of RJM to water-induced RJM. When acetic acid was injected, amplitude of the alternate lateral jaw movement was significantly larger than that in the water-induced RJM. The activity of the superficial temporalis muscle was large in those closing phases with ipsilateral side movement, while it was small in the closing phases with contralateral movement. The pattern of quinine-induced RJM was characterized by small lateral, large open-close and large antero-posterior movements. Tastes which are reported to induce ingestive behavior such as sweet or salty don't alter the pattern of RJM; however, the tastes which induce aversive behavior make the pattern of RJM different from the water-induced RJM.

  19. Cranial functional (psychogenic) movement disorders.

    PubMed

    Kaski, Diego; Bronstein, Adolfo M; Edwards, Mark J; Stone, Jon

    2015-12-01

    Functional (psychogenic) neurological symptoms are frequently encountered in neurological practice. Cranial movement disorders--affecting the eyes, face, jaw, tongue, or palate--are an under-recognised feature of patients with functional symptoms. They can present in isolation or in the context of other functional symptoms; in particular, for functional eye movements, positive clinical signs such as convergence spasms can be triggered by the clinical examination. Although the specialty of functional neurological disorders has expanded, appreciation of cranial functional movement disorders is still insufficient. Identification of the positive features of cranial functional movement disorders such as convergence and unilateral platysmal spasm might lend diagnostic weight to a suspected functional neurological disorder. Understanding of the differential diagnosis, which is broad and includes many organic causes (eg, stroke), is essential to make an early and accurate diagnosis to prevent complications and initiate appropriate management. Increased understanding of these disorders is also crucial to drive clinical trials and studies of individually tailored therapies.

  20. Neural control of rhythmic, cyclical human arm movement: task dependency, nerve specificity and phase modulation of cutaneous reflexes.

    PubMed

    Zehr, E P; Kido, A

    2001-12-15

    1. The organization and pattern of cutaneous reflex modulation during rhythmic cyclical movements of the human upper limbs has received much less attention than that afforded the lower limb. Our working hypothesis is that control mechanisms underlying the modulation of cutaneous reflex amplitude during rhythmic arm movement are similar to those that control reflex modulation in the leg. Thus, we hypothesized that cutaneous reflexes would show task dependency and nerve specificity in the upper limb during rhythmic cyclical arm movement as has been demonstrated in the human lower limb. 2. EMG was recorded from 10 muscles crossing the human shoulder, elbow and wrist joints while bilateral whole arm rhythmic cyclical movements were performed on a custom-made, hydraulic apparatus. 3. Cutaneous reflexes were evoked with trains (5 x 1.0 ms pulses at 300 Hz) of electrical stimulation delivered at non-noxious intensities (approximately 2 x threshold for radiating parasthesia) to the superficial radial, median and ulnar nerves innervating the hand. 4. Cutaneous reflexes were typically modulated with the movement cycle (i.e. phase dependency was observed). There was evidence for nerve specificity of cutaneous reflexes during rhythmic movement of the upper limbs. Task-dependent modulation was also seen as cutaneous reflexes were of larger amplitude or inhibitory (reflex reversal) during arm cycling as compared to static contraction. 5. While there are some differences in the patterns of cutaneous reflex modulation seen between the arms and legs, it is concluded that cutaneous reflexes are modulated similarly in the upper and lower limbs implicating similar motor control mechanisms.

  1. Neural control of rhythmic, cyclical human arm movement: task dependency, nerve specificity and phase modulation of cutaneous reflexes

    PubMed Central

    Zehr, E Paul; Kido, Aiko

    2001-01-01

    The organization and pattern of cutaneous reflex modulation during rhythmic cyclical movements of the human upper limbs has received much less attention than that afforded the lower limb. Our working hypothesis is that control mechanisms underlying the modulation of cutaneous reflex amplitude during rhythmic arm movement are similar to those that control reflex modulation in the leg. Thus, we hypothesized that cutaneous reflexes would show task dependency and nerve specificity in the upper limb during rhythmic cyclical arm movement as has been demonstrated in the human lower limb. EMG was recorded from 10 muscles crossing the human shoulder, elbow and wrist joints while bilateral whole arm rhythmic cyclical movements were performed on a custom-made, hydraulic apparatus. Cutaneous reflexes were evoked with trains (5× 1.0 ms pulses at 300 Hz) of electrical stimulation delivered at non-noxious intensities (∼2× threshold for radiating parasthesia) to the superficial radial, median and ulnar nerves innervating the hand. Cutaneous reflexes were typically modulated with the movement cycle (i.e. phase dependency was observed). There was evidence for nerve specificity of cutaneous reflexes during rhythmic movement of the upper limbs. Task-dependent modulation was also seen as cutaneous reflexes were of larger amplitude or inhibitory (reflex reversal) during arm cycling as compared to static contraction. While there are some differences in the patterns of cutaneous reflex modulation seen between the arms and legs, it is concluded that cutaneous reflexes are modulated similarly in the upper and lower limbs implicating similar motor control mechanisms. PMID:11744775

  2. Impaired movement timing in neurological disorders: rehabilitation and treatment strategies

    PubMed Central

    Hove, Michael J.; Keller, Peter E.

    2014-01-01

    Timing abnormalities have been reported in many neurological disorders, including Parkinson’s disease (PD). In PD, motor-timing impairments are especially debilitating in gait. Despite impaired audiomotor synchronization, PD patients’ gait improves when they walk with an auditory metronome or with music. Building on that research, we make recommendations for optimizing sensory cues to improve the efficacy of rhythmic cuing in gait rehabilitation. Adaptive rhythmic metronomes (that synchronize with the patient’s walking) might be especially effective. In a recent study we showed that adaptive metronomes synchronized consistently with Parkinson patients’ footsteps without requiring attention; this improved stability and reinstated healthy gait dynamics. Other strategies could help optimize sensory cues for gait rehabilitation. Groove music strongly engages the motor system and induces movement; bass-frequency tones are associated with movement and provide strong timing cues. Thus, groove and bass-frequency pulses could deliver potent rhythmic cues. These strategies capitalize on the close neural connections between auditory and motor networks; and auditory cues are typically preferred. However, moving visual cues greatly improve visuomotor synchronization and could warrant examination in gait rehabilitation. Together, a treatment approach that employs groove, auditory, bass-frequency, and adaptive (GABA) cues could help optimize rhythmic sensory cues for treating motor and timing deficits. PMID:25773624

  3. A coupled-oscillator model with a conservation law for the rhythmic amoeboid movements of plasmodial slime molds

    NASA Astrophysics Data System (ADS)

    Tero, A.; Kobayashi, R.; Nakagaki, T.

    2005-06-01

    Experiments on the fusion and partial separation of plasmodia of the true slime mold Physarum polycephalum are described, concentrating on the spatio-temporal phase patterns of rhythmic amoeboid movement. On the basis of these experimental results we introduce a new model of coupled oscillators with one conserved quantity. Simulations using the model equations reproduce the experimental results well.

  4. Trichotillomania, stereotypic movement disorder, and related disorders.

    PubMed

    Stein, Dan J; Garner, Joseph P; Keuthen, Nancy J; Franklin, Martin E; Walkup, John T; Woods, Douglas W

    2007-08-01

    Trichotillomania is currently classified as an impulse control disorder not otherwise classified, whereas body-focused behaviors other than hair-pulling may be diagnosed as stereotypic movement disorder. A number of disorders characterized by repetitive, body-focused behaviors (eg, skin-picking) are prevalent and disabling and may have phenomenological and psychobiological overlap. Such disorders deserve greater recognition in the official nosology, and there would seem to be clinical utility in classifying them in the same diagnostic category.

  5. Neural control of rhythmic human arm movement: phase dependence and task modulation of hoffmann reflexes in forearm muscles.

    PubMed

    Zehr, E Paul; Collins, David F; Frigon, Alain; Hoogenboom, Nienke

    2003-01-01

    Although we move our arms rhythmically during walking, running, and swimming, we know little about the neural control of such movements. Our working hypothesis is that neural mechanisms controlling rhythmic movements are similar in the human lumbar and cervical spinal cord. Thus reflex modulation during rhythmic arm movement should be similar to that seen during leg movement. Our main experimental hypotheses were that the amplitude of H-reflexes in the forearm muscles would be modulated during arm movement (i.e., phase-dependent) and would be inhibited during cycling compared with static contraction (i.e., task-dependent). Furthermore, to determine the locus of any modulation, we tested the effect that active and passive movement of the ipsilateral (relative to stimulated arm) and contralateral arm had on H-reflex amplitude. Subjects performed rhythmic arm cycling on a custom-made hydraulic ergometer in which the two arms could be constrained to move together (180 degrees out of phase) or could rotate independently. Position of the stimulated limb in the movement cycle is described with respect to the clock face. H-reflexes were evoked at 12, 3, 6, and 9 o'clock positions during static contraction as well as during rhythmic arm movements. Reflex amplitudes were compared between tasks at equal M wave amplitudes and similar levels of electromyographic (EMG) activity in the target muscle. Surface EMG recordings were obtained bilaterally from flexor carpi radialis as well as from other muscles controlling the wrist, elbow, and shoulder. Compared with reflexes evoked during static contractions, movement of the stimulated limb attenuated H-reflexes by 50.8% (P < 0.005), 65.3% (P < 0.001), and 52.6% (P < 0.001) for bilateral, active ipsilateral, and passive ipsilateral movements, respectively. In contrast, movement of the contralateral limb did not significantly alter H-reflex amplitude. H-reflexes were also modulated by limb position (P < 0.005). Thus task- and phase

  6. Rhythmic Bimanual Coordination Is Impaired in Young Children with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Isenhower, Robert W.; Marsh, Kerry L.; Richardson, Michael J.; Helt, Molly; Schmidt, R. C.; Fein, Deborah

    2012-01-01

    Impairments in motor coordination are a common behavioral manifestation of autism spectrum disorder (ASD). We, therefore, used a drumming methodology to examine rhythmic bimanual coordination in children diagnosed with ASD (M = 47.3 months) and age-matched typically developing (TD) children (M = 42.6 months). Both groups were instructed to drum on…

  7. Rhythmic Bimanual Coordination Is Impaired in Young Children with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Isenhower, Robert W.; Marsh, Kerry L.; Richardson, Michael J.; Helt, Molly; Schmidt, R. C.; Fein, Deborah

    2012-01-01

    Impairments in motor coordination are a common behavioral manifestation of autism spectrum disorder (ASD). We, therefore, used a drumming methodology to examine rhythmic bimanual coordination in children diagnosed with ASD (M = 47.3 months) and age-matched typically developing (TD) children (M = 42.6 months). Both groups were instructed to drum on…

  8. Investigation of the effects of transcranial alternating current stimulation (tACS) on self-paced rhythmic movements.

    PubMed

    Varlet, Manuel; Wade, Alanna; Novembre, Giacomo; Keller, Peter E

    2017-03-18

    Human rhythmic movements spontaneously entrain to external rhythmic stimuli. Such sensory-motor entrainment can attract movements to different tempi and enhance their efficiency, with potential clinical applications for motor rehabilitation. Here we investigate whether entrainment of self-paced rhythmic movements can be induced via transcranial alternating current stimulation (tACS), which uses alternating currents to entrain spontaneous brain oscillations at specific frequencies. Participants swung a handheld pendulum at their preferred tempo with the right hand while tACS was applied over their left or right primary motor cortex at frequencies equal to their preferred tempo (Experiment 1) or in the alpha (10Hz) and beta (20Hz) ranges (Experiment 2). Given that entrainment generally occurs only if the frequency difference between two rhythms is small, stimulations were delivered at frequencies equal to participants' preferred movement tempo (≈1Hz) and ±12.5% in Experiment 1, and at 10Hz and 20Hz, and ±12.5% in Experiment 2. The comparison of participants' movement frequency, amplitude, variability, and phase synchrony with and without tACS failed to reveal entrainment or movement modifications across the two experiments. However, significant differences in stimulation-related side effects reported by participants were found between the two experiments, with phosphenes and burning sensations principally occurring in Experiment 2, and metallic tastes reported marginally more often in Experiment 1. Although other stimulation protocols may be effective, our results suggest that rhythmic movements such as pendulum swinging or locomotion that are low in goal-directedness and/or strongly driven by peripheral and mechanical constraints may not be susceptible to modulation by tACS.

  9. Mathematical model for rhythmic protoplasmic movement in the true slime mold.

    PubMed

    Kobayashi, Ryo; Tero, Atsushi; Nakagaki, Toshiyuki

    2006-08-01

    The plasmodium of the true slime mold Physarum polycephalum is a large amoeboid organism that displays "smart" behavior such as chemotaxis and the ability to solve mazes and geometrical puzzles. These amoeboid behaviors are based on the dynamics of the viscoelastic protoplasm and its biochemical rhythms. By incorporating both these aspects, we constructed a mathematical model for the dynamics of the organism as a first step towards understanding the relation between protoplasmic movement and its unusual abilities. We tested the validity of the model by comparing it with physiological observation. Our model reproduces fundamental characteristics of the spatio-temporal pattern of the rhythmic movement: (1) the antiphase oscillation between frontal tip and rear when the front is freely extending; (2) the asynchronous oscillation pattern when the front is not freely extending; and (3) the formation of protoplasmic mounds over a longer time scale. Both our model and physiological observation suggest that cell stiffness plays a primary role in plasmodial behaviors, in contrast to the conventional theory of coupled oscillator systems.

  10. Treatable inherited rare movement disorders.

    PubMed

    Jinnah, H A; Albanese, Alberto; Bhatia, Kailash P; Cardoso, Francisco; Da Prat, Gustavo; de Koning, Tom J; Espay, Alberto J; Fung, Victor; Garcia-Ruiz, Pedro J; Gershanik, Oscar; Jankovic, Joseph; Kaji, Ryuji; Kotschet, Katya; Marras, Connie; Miyasaki, Janis M; Morgante, Francesca; Munchau, Alexander; Pal, Pramod Kumar; Rodriguez Oroz, Maria C; Rodríguez-Violante, Mayela; Schöls, Ludger; Stamelou, Maria; Tijssen, Marina; Uribe Roca, Claudia; de la Cerda, Andres; Gatto, Emilia M

    2017-09-01

    There are many rare movement disorders, and new ones are described every year. Because they are not well recognized, they often go undiagnosed for long periods of time. However, early diagnosis is becoming increasingly important. Rapid advances in our understanding of the biological mechanisms responsible for many rare disorders have enabled the development of specific treatments for some of them. Well-known historical examples include Wilson disease and dopa-responsive dystonia, for which specific and highly effective treatments have life-altering effects. In recent years, similarly specific and effective treatments have been developed for more than 30 rare inherited movement disorders. These treatments include specific medications, dietary changes, avoidance or management of certain triggers, enzyme replacement therapy, and others. This list of treatable rare movement disorders is likely to grow during the next few years because a number of additional promising treatments are actively being developed or evaluated in clinical trials. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

  11. Stereotypic movement disorder

    MedlinePlus

    Motor stereotypies ... Ryan CA, Trieu ML, DeMaso DR, Walter HJ. Motor disorders and habits. In: Kliegman RM, Stanton BF, ... Singer HS, Mink JW, Gilbert DL, Jankovic J. Motor stereotypies. In: Singer HS, Mink JW, Gilbert DL, ...

  12. Autoantibody-associated movement disorders.

    PubMed

    Mohammad, Shekeeb S; Ramanathan, Sudarshini; Brilot, Fabienne; Dale, Russell C

    2013-12-01

    Autoantibodies to the extracellular domain of neuronal proteins cause different neurological conditions with movement disorders as a prominent feature. We reviewed the literature of autoantibody-mediated and autoantibody-associated diseases focusing on anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, autoimmune basal ganglia encephalitis, Sydenham chorea, and the rare syndrome of progressive encephalomyelitis with rigidity and myoclonus. NMDAR encephalitis is a diffuse encephalitis with psychiatric and cognitive features associated with autoantibodies against the NR1 subunit of the NMDAR. The movement disorder phenotype is diverse and often generalized in young children. Although orofacial dyskinesia was the initial movement phenotype, chorea, dystonia, catatonia, and stereotypical movements are now described. The stereotypical movements can be bizarre and include cycling movements and compulsive self-injurious behavior. Autoimmune basal ganglia encephalitis is an inflammatory encephalitis localizing to the basal ganglia that is sometimes associated with serum antibodies against dopamine-2 receptor. Although psychiatric features are common, the dominant problem is a movement disorder, with dystonia-parkinsonism being characteristic. Sydenham chorea is the prototypic poststreptococcal autoimmune neuropsychiatric disorder and several autoantibodies may be involved in disease generation. The syndrome is characterized by a pure chorea, although hypotonia, dysarthria, and emotional lability are common. Progressive encephalomyelitis with rigidity and myoclonus is a rare autoimmune disorder causing rigidity, stimulus sensitive spasms, and myoclonus of nonepileptic origin and is associated with autoantibodies of multiple types including those against the glycine receptor. These disorders are important to recognize and diagnose, as immune therapy can shorten disease duration and improve outcome. Georg Thieme Verlag KG Stuttgart · New York.

  13. Psychopathology and Psychogenic Movement Disorders

    PubMed Central

    Kranick, Sarah; Ekanayake, Vindhya; Martinez, Valeria; Ameli, Rezvan; Hallett, Mark; Voon, Valerie

    2014-01-01

    Psychogenic movement disorder is defined as abnormal movements unrelated to a medical cause and presumed related to underlying psychological factors. Although psychological factors are of both clinical and pathophysiological relevance, very few studies to date have systematically assessed their role in psychogenic movement disorder. We sought to assess the role of previous life stress using validated quantitative measures in patients with psychogenic movement disorder compared with age- and sex-matched healthy volunteers as well as a convenience sample of patients with focal hand dystonia. Sixty-four patients with psychogenic movement disorder (72% female; mean age, 45.2 years [standard deviation, 15.2 years]), 38 healthy volunteers (74% female; mean age, 49 years [standard deviation, 13.7 years]), and 39 patients with focal hand dystonia (37% female; mean age, 48.7 years [standard deviation, 11.7 years]) were evaluated using a standardized psychological interview as well as validated quantitative scales to assess trauma and previous stressors, depression, anxiety, and personality traits. Patients with psychogenic movement disorder reported higher rates of childhood trauma, specifically greater emotional abuse and physical neglect, greater fear associated with traumatic events, and a greater number of traumatic episodes compared with healthy volunteers and patients with focal hand dystonia controlled for depressive symptoms and sex (Bonferroni corrected P < .005). There were no differences in categorical psychiatric diagnoses or scores on childhood physical or sexual abuse subscales, personality traits, or the dissociative experience scale. Our findings highlight a biopsychosocial approach toward the pathophysiology of psychogenic movement disorder, although the association with psychological issues is much less prominent than expected compared with the nonepileptic seizure population. A careful psychological assessment is indicated to optimize therapeutic

  14. Movement disorders and MDMA abuse.

    PubMed

    Wilcox, James Allen; Wilcox, Aidee Herrera

    2009-06-01

    This article present the cases of two young men with chronic MDMA abuse who later developed movement disorders typical of the Parkinson's syndrome. It is worth noting that both men bought the presumed MDMA from the same illicit source. Potential risks of MDMA use and movement disorders are discussed. The risks inherent from contaminants and similar factors associated with illegal drug manufacture are discussed. The authors conclude that as long as nonpharmaceutical-grade MDMA is illicitly produced, health risks will be associated with its use.

  15. Music, clicks, and their imaginations favor differently the event-based timing component for rhythmic movements.

    PubMed

    Bravi, Riccardo; Quarta, Eros; Del Tongo, Claudia; Carbonaro, Nicola; Tognetti, Alessandro; Minciacchi, Diego

    2015-06-01

    The involvement or noninvolvement of a clock-like neural process, an effector-independent representation of the time intervals to produce, is described as the essential difference between event-based and emergent timing. In a previous work (Bravi et al. in Exp Brain Res 232:1663-1675, 2014a. doi: 10.1007/s00221-014-3845-9 ), we studied repetitive isochronous wrist's flexion-extensions (IWFEs), performed while minimizing visual and tactile information, to clarify whether non-temporal and temporal characteristics of paced auditory stimuli affect the precision and accuracy of the rhythmic motor performance. Here, with the inclusion of new recordings, we expand the examination of the dataset described in our previous study to investigate whether simple and complex paced auditory stimuli (clicks and music) and their imaginations influence in a different way the timing mechanisms for repetitive IWFEs. Sets of IWFEs were analyzed by the windowed (lag one) autocorrelation-wγ(1), a statistical method recently introduced for the distinction between event-based and emergent timing. Our findings provide evidence that paced auditory information and its imagination favor the engagement of a clock-like neural process, and specifically that music, unlike clicks, lacks the power to elicit event-based timing, not counteracting the natural shift of wγ(1) toward positive values as frequency of movements increase.

  16. Rhythmic alternating patterns of brain activity distinguish rapid eye movement sleep from other states of consciousness

    PubMed Central

    Chow, Ho Ming; Horovitz, Silvina G.; Carr, Walter S.; Picchioni, Dante; Coddington, Nate; Fukunaga, Masaki; Xu, Yisheng; Balkin, Thomas J.; Duyn, Jeff H.; Braun, Allen R.

    2013-01-01

    Rapid eye movement (REM) sleep constitutes a distinct “third state” of consciousness, during which levels of brain activity are commensurate with wakefulness, but conscious awareness is radically transformed. To characterize the temporal and spatial features of this paradoxical state, we examined functional interactions between brain regions using fMRI resting-state connectivity methods. Supporting the view that the functional integrity of the default mode network (DMN) reflects “level of consciousness,” we observed functional uncoupling of the DMN during deep sleep and recoupling during REM sleep (similar to wakefulness). However, unlike either deep sleep or wakefulness, REM was characterized by a more widespread, temporally dynamic interaction between two major brain systems: unimodal sensorimotor areas and the higher-order association cortices (including the DMN), which normally regulate their activity. During REM, these two systems become anticorrelated and fluctuate rhythmically, in reciprocally alternating multisecond epochs with a frequency ranging from 0.1 to 0.01 Hz. This unique spatiotemporal pattern suggests a model for REM sleep that may be consistent with its role in dream formation and memory consolidation. PMID:23733938

  17. Rhythmic alternating patterns of brain activity distinguish rapid eye movement sleep from other states of consciousness.

    PubMed

    Chow, Ho Ming; Horovitz, Silvina G; Carr, Walter S; Picchioni, Dante; Coddington, Nate; Fukunaga, Masaki; Xu, Yisheng; Balkin, Thomas J; Duyn, Jeff H; Braun, Allen R

    2013-06-18

    Rapid eye movement (REM) sleep constitutes a distinct "third state" of consciousness, during which levels of brain activity are commensurate with wakefulness, but conscious awareness is radically transformed. To characterize the temporal and spatial features of this paradoxical state, we examined functional interactions between brain regions using fMRI resting-state connectivity methods. Supporting the view that the functional integrity of the default mode network (DMN) reflects "level of consciousness," we observed functional uncoupling of the DMN during deep sleep and recoupling during REM sleep (similar to wakefulness). However, unlike either deep sleep or wakefulness, REM was characterized by a more widespread, temporally dynamic interaction between two major brain systems: unimodal sensorimotor areas and the higher-order association cortices (including the DMN), which normally regulate their activity. During REM, these two systems become anticorrelated and fluctuate rhythmically, in reciprocally alternating multisecond epochs with a frequency ranging from 0.1 to 0.01 Hz. This unique spatiotemporal pattern suggests a model for REM sleep that may be consistent with its role in dream formation and memory consolidation.

  18. Sensory aspects of movement disorders

    PubMed Central

    Patel, Neepa; Jankovic, Joseph; Hallett, Mark

    2016-01-01

    Movement disorders, which include disorders such as Parkinson’s disease, dystonia, Tourette’s syndrome, restless legs syndrome, and akathisia, have traditionally been considered to be disorders of impaired motor control resulting predominantly from dysfunction of the basal ganglia. This notion has been revised largely because of increasing recognition of associated behavioural, psychiatric, autonomic, and other non-motor symptoms. The sensory aspects of movement disorders include intrinsic sensory abnormalities and the effects of external sensory input on the underlying motor abnormality. The basal ganglia, cerebellum, thalamus, and their connections, coupled with altered sensory input, seem to play a key part in abnormal sensorimotor integration. However, more investigation into the phenomenology and physiological basis of sensory abnormalities, and about the role of the basal ganglia, cerebellum, and related structures in somatosensory processing, and its effect on motor control, is needed. PMID:24331796

  19. Sensory aspects of movement disorders.

    PubMed

    Patel, Neepa; Jankovic, Joseph; Hallett, Mark

    2014-01-01

    Movement disorders, which include disorders such as Parkinson's disease, dystonia, Tourette's syndrome, restless legs syndrome, and akathisia, have traditionally been considered to be disorders of impaired motor control resulting predominantly from dysfunction of the basal ganglia. This notion has been revised largely because of increasing recognition of associated behavioural, psychiatric, autonomic, and other non-motor symptoms. The sensory aspects of movement disorders include intrinsic sensory abnormalities and the effects of external sensory input on the underlying motor abnormality. The basal ganglia, cerebellum, thalamus, and their connections, coupled with altered sensory input, seem to play a key part in abnormal sensorimotor integration. However, more investigation into the phenomenology and physiological basis of sensory abnormalities, and about the role of the basal ganglia, cerebellum, and related structures in somatosensory processing, and its effect on motor control, is needed.

  20. Coordination of jaw and extrinsic tongue muscle activity during rhythmic jaw movements in anesthetized rabbits.

    PubMed

    Ariyasinghe, Sajjiv; Inoue, Makoto; Yamamura, Kensuke; Harasawa, Yohji; Kurose, Masayuki; Yamada, Yoshiaki

    2004-08-06

    To clarify the jaw-closer and tongue-retractor muscle activity patterns during mastication, electromyographic activity of the styloglossus (SG) as a tongue-retractor and masseter (Mass) as a jaw-closer muscles as well as jaw-movement trajectories were recorded during cortically evoked rhythmic jaw movements (CRJMs) in anesthetized rabbits. The SG and Mass muscles were mainly active during the jaw-closing (Cl) phase. The SG activity was composed of two bursts in one masticatory cycle; one had its peak during the jaw-opening (Op) phase (SG1 burst) and the other during the Cl phase (SG2 burst). The Mass activity during the Cl phase was dominant on the working side (opposite to the stimulating side) while the SG1 and SG2 bursts were not different between the sides. When the wooden stick was inserted between the molar teeth on the working side during CRJMs, the facilitatory effects on the SG1 and SG2 bursts on both sides were noted as well as those on the Mass bursts, but the effects on the SG1 burst seemed to be weak as compared with those on the Mass and SG2 bursts. The difference in the burst timing between the sides was noted only in the SG1 burst. When the trigeminal nerves were blocked, the peak and area of the SG and Mass burst decreased during CRJMs, and the facilitatory effects of the wooden stick application on the muscles were not noted. The results suggest that the jaw and tongue muscle activities may be adjusted to chew the food and make the food bolus.

  1. Excitability changes in human forearm corticospinal projections and spinal reflex pathways during rhythmic voluntary movement of the opposite limb

    PubMed Central

    Carson, R G; Riek, S; Mackey, D C; Meichenbaum, D P; Willms, K; Forner, M; Byblow, W D

    2004-01-01

    Rhythmic movements brought about by the contraction of muscles on one side of the body give rise to phase-locked changes in the excitability of the homologous motor pathways of the opposite limb. Such crossed facilitation should favour patterns of bimanual coordination in which homologous muscles are engaged simultaneously, and disrupt those in which the muscles are activated in an alternating fashion. In order to examine these issues, we obtained responses to transcranial magnetic stimulation (TMS), to stimulation of the cervicomedullary junction (cervicomedullary-evoked potentials, CMEPs), to peripheral nerve stimulation (H-reflexes and f-waves), and elicited stretch reflexes in the relaxed right flexor carpi radialis (FCR) muscle during rhythmic (2 Hz) flexion and extension movements of the opposite (left) wrist. The potentials evoked by TMS in right FCR were potentiated during the phases of movement in which the left FCR was most strongly engaged. In contrast, CMEPs were unaffected by the movements of the opposite limb. These results suggest that there was systematic variation of the excitability of the motor cortex ipsilateral to the moving limb. H-reflexes and stretch reflexes recorded in right FCR were modulated in phase with the activation of left FCR. As the f-waves did not vary in corresponding fashion, it appears that the phasic modulation of the H-reflex was mediated by presynaptic inhibition of Ia afferents. The observation that both H-reflexes and f-waves were depressed markedly during movements of the opposite indicates that there may also have been postsynaptic inhibition or disfacilitation of the largest motor units. Our findings indicate that the patterned modulation of excitability in motor pathways that occurs during rhythmic movements of the opposite limb is mediated primarily by interhemispheric interactions between cortical motor areas. PMID:15331684

  2. [Biomechanical and physiological substantiation for application of functional muscle electrostimulation in performing rhythmic movements on bicycle ergometer].

    PubMed

    Petrushanskaia, K A; Vitenzon, A S; Gritsenko, G P; Sutchenkov, I A

    2004-01-01

    Kinematic and electromyographic parameters in conduction of rhythmic movements on the bicycle ergometer were studied in a group of healthy subjects. It is shown that these movements are characterized by a stable biomechanical and innervation stereotype consisting of two interacting synergies: flexor and extensor. Force extensor synergy plays the key role which provides both triggering and maintenance of certain rhythm of rotation. Flexor synergy is primarily corrective. Basing on the data obtained, stimulated muscles are selected in basic phases of the cycle, algorithms of time and amplitude programs of muscle electrostimulation in conduction of bicycle ergometry are proposed.

  3. Sensorimotor integration in movement disorders.

    PubMed

    Abbruzzese, Giovanni; Berardelli, Alfredo

    2003-03-01

    Although current knowledge attributes movement disorders to a dysfunction of the basal ganglia-motor cortex circuits, abnormalities in the peripheral afferent inputs or in their central processing may interfere with motor program execution. We review the abnormalities of sensorimotor integration described in the various types of movement disorders. Several observations, including those of parkinsonian patients' excessive reliance on ongoing visual information during movement tasks, suggest that proprioception is defective in Parkinson's disease (PD). The disturbance of proprioceptive regulation, possibly related to the occurrence of abnormal muscle-stretch reflexes, might be important for generating hypometric or bradykinetic movements. Studies with somatosensory evoked potentials (SEPs), prepulse inhibition, and event-related potentials support the hypothesis of central abnormalities of sensorimotor integration in PD. In Huntington's disease (HD), changes in SEPs and long-latency stretch reflexes suggest that a defective gating of peripheral afferent input to the brain might impair sensorimotor integration in cortical motor areas, thus interfering with the processing of motor programs. Defective motor programming might contribute to some features of motor impairment in HD. Sensory symptoms are frequent in focal dystonia and sensory manipulation can modify the dystonic movements. In addition, specific sensory functions (kinaesthesia, spatial-temporal discrimination) can be impaired in patients with focal hand dystonia, thus leading to a "sensory overflow." Sensory input may be abnormal and trigger focal dystonia, or defective "gating" may cause an input-output mismatch in specific motor programs. Altogether, several observations strongly support the idea that sensorimotor integration is impaired in focal dystonia. Although elemental sensation is normal in patients with tics, tics can be associated with sensory phenomena. Some neurophysiological studies suggest that

  4. Disturbed motor control of rhythmic movement at 2 h and delayed after maximal eccentric actions.

    PubMed

    Bottas, Reijo; Miettunen, Kari; Komi, Paavo V; Linnamo, Vesa

    2010-08-01

    The aim of this study was to examine the influence of exercise-induced muscle damage on elbow rhythmic movement (RM) performance and neural activity pattern and to investigate whether this influence is joint angle specific. Ten males performed an exercise of 50 maximal eccentric elbow flexions in isokinetic machine with duty cycle of 1:15. Maximal dynamic and isometric force tests (90 degrees , 110 degrees and 130 degrees elbow angle) and both active and passive stretch reflex tests of elbow flexors were applied to the elbow joint. The intentional RM was performed in the horizontal plane at elbow angles; 60-120 degrees (SA-RM), 80-140 degrees (MA-RM) and 100-160 degrees (LA-RM). All measurements together with the determination of muscle soreness, swelling, passive stiffness, serum creatine kinase were conducted before, immediately and 2h as well as 2 days, 4 days, 6 days and 8 days post-exercise. Repeated maximal eccentric actions modified the RM trajectory symmetry acutely (SA-RM) and delayed (SA/MA/LA-RM) until the entire follow up of 8 days. Acutely lowered MA-RM peak velocity together with reduced activity of biceps brachii (BB) at every RM range, reflected a poorer acceleration and deceleration capacity of elbow flexors. A large acute drop of BB EMG burst amplitude together with parallel decrease in BB active stretch reflex amplitude, especially 2h post-exercise, suggested an inhibitory effect originating most likely from groups III/IV mechano-nociceptors. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

  5. Specific role of dopamine D1 receptors in spinal network activation and rhythmic movement induction in vertebrates

    PubMed Central

    Lapointe, Nicolas P; Rouleau, Pascal; Ung, Roth-Visal; Guertin, Pierre A

    2009-01-01

    Dopamine (DA) is well-recognized for its determinant role in the modulation of various brain functions. DA was also found in in vitro isolated invertebrate preparations to activate per se the central pattern generator for locomotion. However, it is less clear whether such a role as an activator of central neural circuitries exists in vertebrate species. Here, we studied in vivo the effects induced by selective DA receptor agonists and antagonists on hindlimb movement generation in mice completely spinal cord-transected (Tx) at the low-thoracic level (Th9/10). Administration of D1/D5 receptor agonists (0.5–2.5 mg kg−1, i.p.) was found to acutely elicit rhythmic locomotor-like movements (LMs) and non-locomotor movements (NLMs) in untrained and non-sensory stimulated animals. Comparable effects were found in mice lacking the D5 receptor (D5KO) whereas D1/D5 receptor antagonist-pretreated animals (wild-type or D5KO) failed to display D1/D5 agonist-induced LMs. In contrast, administration of broad spectrum or selective D2, D3 or D4 agonists consistently failed to elicit significant hindlimb movements. Overall, the results clearly show in mice the existence of a role for D1 receptors in spinal network activation and corresponding rhythmic movement generation. PMID:19204052

  6. Case vignettes of movement disorders.

    PubMed

    Yung, C Y

    1983-08-01

    This paper reports five movement disorders cases to serve as a basis for discussion of the problems encountered in the clinical management of these cases, and the pathophysiological mechanisms involved in these disorders as presented. Case 1 is a description of the subjective experience of a patient with acute orofacial dystonia from promethazine. Case 2 is the use of clonazepam is post-head injury tics. Case 3 is the complication from discontinuation of haloperidol and benztropine mesylate treatment. Case 4 is myoclonus in subacute sclerosing Panencephalitis, and Case 5 is rebound tremor from withdrawal of a beta-adrenergic blocker.

  7. Movement disorders in Latin America.

    PubMed

    Troiano, André R; Micheli, Federico E; Alarcón, Fernando; Teive, Hélio A G

    2006-04-01

    The authors review some particularities of movement disorders (MDs) in the ethnically diverse population of Latin America. Although idiopathic diseases are evenly prevalent, access to treatment encounters difficulties that are worth discussing. Infectious-parasitic diseases observed throughout the continent occasionally present as MDs, and will be individually reviewed. Inherited MDs with regional foci of increased prevalence, particularly spinocerebellar ataxias, will also be considered. Whereas there is no treatment for genetic disorders, most of the other conditions are preventable or amenable to adequate treatment. Hope for better health standards for the Latin American population lies in profound social and political changes that are still to come.

  8. Stereotypic movement disorder: easily missed.

    PubMed

    Freeman, Roger D; Soltanifar, Atefeh; Baer, Susan

    2010-08-01

    To expand the understanding of stereotypic movement disorder (SMD) and its differentiation from tics and autistic stereotypies. Forty-two children (31 males, mean age 6y 3mo, SD 2y 8mo; 11 females, mean age 6y 7mo, SD 1y 9mo) consecutively diagnosed with SMD, without-self-injurious behavior, intellectual disability, sensory impairment, or an autistic spectrum disorder (ASD), were assessed in a neuropsychiatry clinic. A list of probe questions on the nature of the stereotypy was administered to parents (and to children if developmentally ready). Questionnaires administered included the Stereotypy Severity Scale, Short Sensory Profile, Strengths and Difficulties Questionnaire, Repetitive Behavior Scale--Revised, and the Developmental Coordination Disorder Questionnaire. The stereotyped movement patterns were directly observed and in some cases further documented by video recordings made by parents. The probe questions were used again on follow-up at a mean age of 10 years 7 months (SD 4y 4mo). Mean age at onset was 17 months. Males exceeded females by 3:1. Family history of a pattern of SMD was reported in 13 and neuropsychiatric comorbidity in 30 (attention-deficit-hyperactivity disorder in 16, tics in 18, and developmental coordination disorder in 16). Obsessive-compulsive disorder occurred in only two. The Short Sensory Profile correlated with comorbidity (p<0.001), the Stereotypy Severity Scale (p=0.009), and the Repetitive Behavior Scale (p<0.001); the last correlated with the Stereotypy Severity Scale (p=0.001). Children (but not their parents) liked their movements, which were usually associated with excitement or imaginative play. Mean length of follow-up was 4 years 8 months (SD 2y 10mo). Of the 39 children followed for longer than 6 months, the behavior stopped or was gradually shaped so as to occur primarily privately in 25. Misdiagnosis was common: 26 were initially referred as tics, 10 as ASD, five as compulsions, and one as epilepsy. Co-occurring facial

  9. Developmental and benign movement disorders in childhood.

    PubMed

    Bonnet, Cecilia; Roubertie, Agathe; Doummar, Diane; Bahi-Buisson, Nadia; Cochen de Cock, Valérie; Roze, Emmanuel

    2010-07-30

    Developmental and benign movement disorders are a group of movement disorders with onset in the neonatal period, infancy, or childhood. They are characterized by the absence of associated neurological manifestations and by their favorable outcome, although developmental abnormalities can be occasionally observed. Knowledge of the clinical, neurophysiological, and pathogenetic aspects of these disorders is poor. Based on a comprehensive review of the literature and our practical experience, this article summarizes current knowledge in this area. We pay special attention to the recognition and management of these movement disorders in children. (c) 2010 Movement Disorder Society.

  10. Movement disorders in mitochondrial diseases.

    PubMed

    Tranchant, C; Anheim, M

    Mitochondrial diseases (MIDs) are a large group of heterogeneous disorders due to mutations in either mitochondrial DNA (mtDNA) or nuclear DNA (nDNA) genes, the latter encoding proteins involved in mitochondrial function. A multisystem clinical picture that involves several organs, including both the peripheral and central nervous systems, is a common presentation of MID. Movement disorders, even isolated ones, are not rare. Cerebellar ataxia is common in myoclonic epilepsy with ragged red fibers (MERFF) due to mutations in the mitochondrial transfer RNA (tRNA) lysine gene, in Kearns-Sayre syndrome due to mtDNA deletions, in sensory ataxic neuropathy with dysarthria and ophthalmoplegia (SANDO) due to nuclear POLG1 gene mutations, and also in ARCA2, Friedreich's ataxia, SPG7, SCA28 and autosomal-recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) due to mutations in nuclear genes involved in mitochondrial morphology or function. Myoclonus is a key feature of MERFF, but may also be encountered in mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS), ARCA2, POLG1 mutations and Leigh syndrome. Dystonia is common in Leigh syndrome (which may be caused by 75 different genes) and in Leber hereditary ocular neuropathy (LHON) plus disease, due to mutations in mtDNA genes that encode subunits of NADH dehydrogenase, as well as in ARCA2, pantothenate kinase-associated neurodegeneration (PKAN), mitochondrial membrane protein-associated neurodegeneration (MPAN) and POLG1 mutations. Other movement disorders are rarer (such as parkinsonism, tremor, chorea). Although parkinsonism is more frequent in POLG1 mutations, and myoclonus in MERFF, most movement disorders are found either isolated or combined in numerous MIDs. The presence of associated neurological signs, whether central or peripheral, or of evocative magnetic resonance imaging (MRI) abnormalities (striatal necrosis) should prompt a search for MID. In cases of a particular clinical

  11. Rhythmic auditory stimulation influences syntactic processing in children with developmental language disorders.

    PubMed

    Przybylski, Lauranne; Bedoin, Nathalie; Krifi-Papoz, Sonia; Herbillon, Vania; Roch, Didier; Léculier, Laure; Kotz, Sonja A; Tillmann, Barbara

    2013-01-01

    Children with developmental language disorders have been shown to be impaired not only in language processing (including syntax), but also in rhythm and meter perception. Our study tested the influence of external rhythmic auditory stimulation (i.e., musical rhythm) on syntax processing in children with specific language impairment (SLI; Experiment 1A) and dyslexia (Experiment 1B). Children listened to either regular or irregular musical prime sequences followed by blocks of grammatically correct and incorrect sentences. They were required to perform grammaticality judgments for each auditorily presented sentence. Performance of all children (SLI, dyslexia, and controls) in the grammaticality judgments was better after regular prime sequences than after irregular prime sequences, as shown by d' data. The benefit of the regular prime was stronger for SLI children (partial η2 = .34) than for dyslexic children (partial η2 = .14), who reached higher performance levels. Together with previous findings on deficits in temporal processing and sequencing, as well as with the recent proposition of a temporal sampling (oscillatory) framework for developmental language disorders (U. A. Goswami, 2011, Temporal sampling framework for developmental dyslexia, Trends in Cognitive Sciences, Vol. 15, pp. 3-10), our results point to potential avenues in using rhythmic structures (even in nonverbal materials) to boost linguistic structure processing.

  12. Influence of predominant patterns of coordination on the exploitation of interaction torques in a two-joint rhythmic arm movement.

    PubMed

    de Rugy, Aymar; Riek, Stephan; Carson, Richard G

    2006-11-01

    In this study we investigate the coordination between rhythmic flexion-extension (FE) and supination-pronation (SP) movements at the elbow joint-complex, while manipulating the intersegmental dynamics by means of a 2-degrees of freedom (df) robot arm. We hypothesized that constraints imposed by the structure of the neuromuscular-skeletal system would (1) result in predominant pattern(s) of coordination in the absence of interaction torques and (2) influence the capabilities of participants to exploit artificially induced interaction torques. Two experiments were conducted in which different conditions of interaction torques were applied on the SP-axis as a function of FE movements. These conditions promoted different patterns of coordination between the 2-df. Control trials conducted in the absence of interaction torques revealed that both the in-phase (supination synchronized with flexion) and the anti-phase (pronation synchronized with flexion) patterns were spontaneously established by participants. The predominance of these patterns of coordination is explained in terms of the mechanical action of bi-articular muscles acting at the elbow joint-complex, and in terms of the reflexes that link the activity of the muscles involved. Results obtained in the different conditions of interaction torques revealed that those neuromuscular-skeletal constraints either impede or favor the exploitation of intersegmental dynamics depending on the context. Interaction torques were indeed found to be exploited to a greater extent in conditions in which the profiles of interaction torques favored one of the two predominant patterns of coordination (i.e., in-phase or anti-phase) as opposed to other patterns of coordination (e.g., 90 degrees or 270 degrees). Those results are discussed in relation to recent studies reporting exploitation of interaction torques in the context of rhythmic movements.

  13. Development of information-movement couplings in a rhythmical ball-bouncing task: from space- to time-related information.

    PubMed

    Bazile, C; Benguigui, N; Siegler, I A

    2016-01-01

    We studied the development of information-movement couplings in a ball-bouncing task with a special interest in how space- and time-related information is used by people of different ages. Participants from four age groups (children aged 7-8, 9-10 and 11-12 years, and adults) performed a virtual ball-bouncing task in which space- and time-related information were independently manipulated. Task performance and information-movement couplings were analyzed. Our results confirm a clear use of time-related information in adults, while children demonstrated a predominant relationship between space-related information and the period of movement. In the course of development, however, the children become progressively more capable of using time-related information in order to control the rhythmic ball-bouncing task. A second and weaker coupling, between ball height information and racket velocity at impact, also appears in the course of development. The data seem to show that the development of children follows the freezing-freeing-exploiting sequence proposed by Savelsbergh and Van der Kamp (Int J Sport Psychol 31:467-484, 2000), with a significant change in how information is used to control movement related to age.

  14. Eye Movement Disorders in Dyslexia. Final Report.

    ERIC Educational Resources Information Center

    Festinger, Leon; And Others

    Eye movements of 18 male and seven female dyslexic children and 10 normal children were evaluated to determine if eye movement disorders may be the cause of some of the symptoms associated with dyslexia. Data on eye movements were collected while Ss moved their eyes from one fixation point to another in a nonreading situation. Errors in vertical…

  15. Time Processing and Motor Control in Movement Disorders.

    PubMed

    Avanzino, Laura; Pelosin, Elisa; Vicario, Carmelo M; Lagravinese, Giovanna; Abbruzzese, Giovanni; Martino, Davide

    2016-01-01

    cerebral networks including cortical areas, cerebellum, and other subcortical structures (Ivry and Spencer, 2004; Coull and Nobre, 2008). Timing is an essential component of motor control primarily within two types of motor tasks: (i) when producing sequential rhythmic movements or sustained movements of a definite duration (explicit timing); (ii) when the temporal information is used implicitly, such as when coordinating our movements to those of moving objects or individuals within the external environment (implicit timing). In this review, we will provide a brief description of the neural network supporting motor timing focusing only on instrumental information to explain the link between timing and motor control in movement disorders. Then we will review available data on motor timing in Parkinson's disease, dystonia, Huntington's disease, and Tourette syndrome, and discuss how this body of evidence integrates with the available information on the pathophysiology of these movement disorders. Finally, we will discuss the translational aspects of the explored neural mechanisms with respect to future rehabilitation strategies.

  16. Time Processing and Motor Control in Movement Disorders

    PubMed Central

    Avanzino, Laura; Pelosin, Elisa; Vicario, Carmelo M.; Lagravinese, Giovanna; Abbruzzese, Giovanni; Martino, Davide

    2016-01-01

    diffuse cerebral networks including cortical areas, cerebellum, and other subcortical structures (Ivry and Spencer, 2004; Coull and Nobre, 2008). Timing is an essential component of motor control primarily within two types of motor tasks: (i) when producing sequential rhythmic movements or sustained movements of a definite duration (explicit timing); (ii) when the temporal information is used implicitly, such as when coordinating our movements to those of moving objects or individuals within the external environment (implicit timing). In this review, we will provide a brief description of the neural network supporting motor timing focusing only on instrumental information to explain the link between timing and motor control in movement disorders. Then we will review available data on motor timing in Parkinson's disease, dystonia, Huntington's disease, and Tourette syndrome, and discuss how this body of evidence integrates with the available information on the pathophysiology of these movement disorders. Finally, we will discuss the translational aspects of the explored neural mechanisms with respect to future rehabilitation strategies. PMID:28018198

  17. Movement disorders induced by deep brain stimulation.

    PubMed

    Baizabal-Carvallo, José Fidel; Jankovic, Joseph

    2016-04-01

    Deep brain stimulation represents a major advance in the treatment of several types of movement disorders. However, during stimulation new movement disorders may emerge, thus limiting the positive effects of this therapy. These movement disorders may be induced by: 1) stimulation of the targeted nucleus, 2) stimulation of surrounding tracts and nuclei, and 3) as a result of dose adjustment of accompanying medications, such as reduction of dopaminergic drugs in patients with Parkinson's disease. Various dyskinesias, blepharospasm, and apraxia of eyelid opening have been described mainly with subthalamic nucleus stimulation, whereas hypokinesia and freezing of gait have been observed with stimulation of the globus pallidus internus. Other deep brain stimulation-related movement disorders include dyskinesias associated with stimulation of the globus pallidus externus and ataxic gait as a side effect of chronic bilateral stimulation of the ventral intermediate nucleus of thalamus. These movement disorders are generally reversible and usually resolved once the stimulation is reduced or turned off. This, however, typically leads to loss of benefit of the underlying movement disorder which can be re-gained by using different contacts, changing targets or stimulation parameters, and adjusting pharmacological therapy. New and innovative emerging technologies and stimulation techniques may help to prevent or overcome the various deep brain stimulation-induced movement disorders. In this review we aim to describe the clinical features, frequency, pathophysiology, and strategies for treatment of these iatrogenic movement disorders.

  18. Transfer of learning between unimanual and bimanual rhythmic movement coordination: transfer is a function of the task dynamic.

    PubMed

    Snapp-Childs, Winona; Wilson, Andrew D; Bingham, Geoffrey P

    2015-07-01

    Under certain conditions, learning can transfer from a trained task to an untrained version of that same task. However, it is as yet unclear what those certain conditions are or why learning transfers when it does. Coordinated rhythmic movement is a valuable model system for investigating transfer because we have a model of the underlying task dynamic that includes perceptual coupling between the limbs being coordinated. The model predicts that (1) coordinated rhythmic movements, both bimanual and unimanual, are organised with respect to relative motion information for relative phase in the coupling function, (2) unimanual is less stable than bimanual coordination because the coupling is unidirectional rather than bidirectional, and (3) learning a new coordination is primarily about learning to perceive and use the relevant information which, with equal perceptual improvement due to training, yields equal transfer of learning from bimanual to unimanual coordination and vice versa [but, given prediction (2), the resulting performance is also conditioned by the intrinsic stability of each task]. In the present study, two groups were trained to produce 90° either unimanually or bimanually, respectively, and tested in respect to learning (namely improved performance in the trained 90° coordination task and improved visual discrimination of 90°) and transfer of learning (to the other, untrained 90° coordination task). Both groups improved in the task condition in which they were trained and in their ability to visually discriminate 90°, and this learning transferred to the untrained condition. When scaled by the relative intrinsic stability of each task, transfer levels were found to be equal. The results are discussed in the context of the perception-action approach to learning and performance.

  19. Review of the possible relationship and hypothetical links between attention deficit hyperactivity disorder (ADHD) and the simple sleep related movement disorders, parasomnias, hypersomnias, and circadian rhythm disorders.

    PubMed

    Walters, Arthur S; Silvestri, Rosalia; Zucconi, Marco; Chandrashekariah, Ranju; Konofal, Eric

    2008-12-15

    Recent evidence has been accumulating that the sleep of individuals with attention deficit hyperactivity disorder (ADHD) is not only disrupted in a nonspecific way but that ADHD has an increased association with simple sleep related movement disorders such as restless legs syndrome/periodic limb movements in sleep (RLS/PLMS), rhythmic movement disorder (body rocking and head banging), and parasomnias, such as disorders of partial arousal (sleep walking, sleep terrors, and confusional arousals). In addition increased associations have been reported between ADHD and hypersomnias such as narcolepsy and sleep apnea as well as circadian rhythm disorders, such as delayed sleep phase syndrome. These relationships are reviewed and the implications for such associations are explored. Patients with sleep disorders should be queried about the symptoms of ADHD and vice versa.

  20. Molecular imaging of movement disorders.

    PubMed

    Lizarraga, Karlo J; Gorgulho, Alessandra; Chen, Wei; De Salles, Antonio A

    2016-03-28

    -to-rostral direction. Uptake declines prior to symptom presentation and progresses from contralateral to the most symptomatic side to bilateral, correlating with symptom severity. In progressive supranuclear palsy (PSP) and multiple system atrophy (MSA), striatal activity is symmetrically and diffusely decreased. The caudal-to-rostral pattern is lost in PSP, but could be present in MSA. In corticobasal degeneration (CBD), there is asymmetric, diffuse reduction of striatal activity, contralateral to the most symptomatic side. Additionally, there is hypometabolism in contralateral parieto-occipital and frontal cortices in PD; bilateral putamen and cerebellum in MSA; caudate, thalamus, midbrain, mesial frontal and prefrontal cortices in PSP; and contralateral cortices in CBD. Finally, cardiac sympathetic SPECT signal is decreased in PD. The capacity of molecular imaging to provide in vivo time courses of gene expression, protein synthesis, receptor and transporter binding, could facilitate the development and evaluation of novel medical, surgical and genetic therapies in movement disorders.

  1. Molecular imaging of movement disorders

    PubMed Central

    Lizarraga, Karlo J; Gorgulho, Alessandra; Chen, Wei; De Salles, Antonio A

    2016-01-01

    caudal-to-rostral direction. Uptake declines prior to symptom presentation and progresses from contralateral to the most symptomatic side to bilateral, correlating with symptom severity. In progressive supranuclear palsy (PSP) and multiple system atrophy (MSA), striatal activity is symmetrically and diffusely decreased. The caudal-to-rostral pattern is lost in PSP, but could be present in MSA. In corticobasal degeneration (CBD), there is asymmetric, diffuse reduction of striatal activity, contralateral to the most symptomatic side. Additionally, there is hypometabolism in contralateral parieto-occipital and frontal cortices in PD; bilateral putamen and cerebellum in MSA; caudate, thalamus, midbrain, mesial frontal and prefrontal cortices in PSP; and contralateral cortices in CBD. Finally, cardiac sympathetic SPECT signal is decreased in PD. The capacity of molecular imaging to provide in vivo time courses of gene expression, protein synthesis, receptor and transporter binding, could facilitate the development and evaluation of novel medical, surgical and genetic therapies in movement disorders. PMID:27029029

  2. Modulation of the mandibular stretch reflex sensitivity during various phases of rhythmic open-close movements in humans.

    PubMed

    van der Bilt, A; Ottenhoff, F A; van der Glas, H W; Bosman, F; Abbink, J H

    1997-04-01

    The muscle spindles of the jaw elevator muscles provide positive feedback to the alpha motoneurons. It is generally assumed that the feedback is modulated during chewing so that counterproductive forces of the jaw elevator muscles can be avoided during jaw opening. Our aim was to investigate the modulation of the muscle spindle input to the alpha motoneurons during various phases of open-close movements in man. To that end, subjects made rhythmic open-close movements at their natural chewing frequency. A force impulse (5 N, 10 ms), eliciting a jaw-jerk reflex, was unexpectedly applied. The impulse was applied to the mandible at 8 different phases during an open-close cycle, but only 1 impulse per cycle. Jaw movement and surface EMG of the masseter and temporal muscles on both sides were recorded during 3 cycles without an impulse and 3 succeeding cycles with an impulse. To examine whether the modulation of the mandibular stretch reflex sensitivity depends on the food resistance, we applied an additional external force on the mandible, counteracting closing of the jaw each cycle. Two experimental sessions were performed in random order, i.e., without force and with an additional force of 20 N. We observed pronounced reflexes at the onset of jaw closing, during the closing phase, and at occlusion. No or only weak jaw-jerk reflexes were present during jaw opening. The reflex amplitudes at occlusion were larger when an external force was present. This increase in reflex amplitude may be the result of an adjusted gamma motoneuron activity, from pre-motor inhibition, or from both. The reflex amplitudes elicited during jaw closing were not correlated with the phase of the movement.

  3. Virtual Reality as a Tool for Evaluation of Repetitive Rhythmic Movements in the Elderly and Parkinson's Disease Patients

    PubMed Central

    Arias, Pablo; Robles-García, Verónica; Sanmartín, Gabriel; Flores, Julian; Cudeiro, Javier

    2012-01-01

    This work presents an immersive Virtual Reality (VR) system to evaluate, and potentially treat, the alterations in rhythmic hand movements seen in Parkinson's disease (PD) and the elderly (EC), by comparison with healthy young controls (YC). The system integrates the subjects into a VR environment by means of a Head Mounted Display, such that subjects perceive themselves in a virtual world consisting of a table within a room. In this experiment, subjects are presented in 1st person perspective, so that the avatar reproduces finger tapping movements performed by the subjects. The task, known as the finger tapping test (FT), was performed by all three subject groups, PD, EC and YC. FT was carried out by each subject on two different days (sessions), one week apart. In each FT session all subjects performed FT in the real world (FTREAL) and in the VR (FTVR); each mode was repeated three times in randomized order. During FT both the tapping frequency and the coefficient of variation of inter-tap interval were registered. FTVR was a valid test to detect differences in rhythm formation between the three groups. Intra-class correlation coefficients (ICC) and mean difference between days for FTVR (for each group) showed reliable results. Finally, the analysis of ICC and mean difference between FTVR vs FTREAL, for each variable and group, also showed high reliability. This shows that FT evaluation in VR environments is valid as real world alternative, as VR evaluation did not distort movement execution and detects alteration in rhythm formation. These results support the use of VR as a promising tool to study alterations and the control of movement in different subject groups in unusual environments, such as during fMRI or other imaging studies. PMID:22279559

  4. Cortical area inducing chewing-like rhythmical jaw movements and its connections with thalamic nuclei in guinea pigs.

    PubMed

    Isogai, Fumihiko; Kato, Takafumi; Fujimoto, Masaichiro; Toi, Shoko; Oka, Ayaka; Adachi, Tadafumi; Maeda, Yoshinobu; Morimoto, Toshifumi; Yoshida, Atsushi; Masuda, Yuji

    2012-12-01

    Repetitive electrical stimulation to the cortical masticatory areas (CMA) evokes rhythmical jaw movements (RJM), whose patterns vary depending on the stimulation site, in various species. In guinea pigs, although alternating bilateral jaw movements are usually seen during natural chewing, it is still unclear which cortical areas are responsible for chewing-like RJM. To address this issue, we first defined the cortical areas inducing chewing-like RJM by intracortical microstimulation. Stimulation of the most lateral area of the CMA, the granular cortex, induced chewing-like RJM, but from the region medial to this area, simple vertical RJM were induced. Subsequently, to reveal the properties of these two areas in the CMA, the connections between the CMA and the dorsal thalamus were examined by neuronal tract-tracing techniques. The area inducing chewing-like RJM possessed strong reciprocal connections, mainly with the medial part of the ventral posteromedial nucleus, which is the sensory-relay thalamus. On the other hand, the simple vertical RJM-inducing area had reciprocal connections with the motor thalamus. The present study suggests that the CMA inducing chewing-like RJM is different from the CMA inducing simple vertical RJM, and plays a role in cortically induced chewing-like RJM under the influence of the sensory thalamus in guinea pigs.

  5. Kinematic analysis of basic rhythmic movements of hip-hop dance: motion characteristics common to expert dancers.

    PubMed

    Sato, Nahoko; Nunome, Hiroyuki; Ikegami, Yasuo

    2015-02-01

    In hip-hop dance contests, a procedure for evaluating performances has not been clearly defined, and objective criteria for evaluation are necessary. It is assumed that most hip-hop dance techniques have common motion characteristics by which judges determine the dancer's skill level. This study aimed to extract motion characteristics that may be linked to higher evaluations by judges. Ten expert and 12 nonexpert dancers performed basic rhythmic movements at a rate of 100 beats per minute. Their movements were captured using a motion capture system, and eight judges evaluated the performances. Four kinematic parameters, including the amplitude of the body motions and the phase delay, which indicates the phase difference between two joint angles, were calculated. The two groups showed no significant differences in terms of the amplitudes of the body motions. In contrast, the phase delay between the head motion and the other body parts' motions of expert dancers who received higher scores from the judges, which was approximately a quarter cycle, produced a loop-shaped motion of the head. It is suggested that this slight phase delay was related to the judges' evaluations and that these findings may help in constructing an objective evaluation system.

  6. Deep Brain Stimulation for Movement Disorders.

    PubMed

    Revell, Maria A

    2015-12-01

    Disruption in the interaction between the central nervous system, nerves, and muscles cause movement disorders. These disorders can negatively affect quality of life. Deep brain stimulation (DBS) has been identified as a therapy for Parkinson disease and essential tremor that has significant advantages compared with medicinal therapies. Surgical intervention for these disorders before DBS included ablative therapies such as thalamotomy and pallidotomy. These procedures were not reversible and did not allow for treatment adjustments. The advent of DBS progressed therapies for significant movement disorders into the realm of being reversible and adjustable based on patient symptoms.

  7. Fundamental Movement Skills and Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Staples, Kerri L.; Reid, Greg

    2010-01-01

    Delays and deficits may both contribute to atypical development of movement skills by children with ASD. Fundamental movement skills of 25 children with autism spectrum disorders (ASD) (ages 9-12 years) were compared to three typically developing groups using the "Test of Gross Motor Development" ("TGMD-2"). The group matched on chronological age…

  8. Stereotyped movement disorder in ICD-11.

    PubMed

    Stein, Dan J; Woods, Douglas W

    2014-01-01

    According to current proposals for ICD-11, stereotyped movement disorder will be classified in the grouping of neurodevelopmental disorders, with a qualifier to indicate whether self-injury is present, similar to the classification of stereotypic movement disorder in DSM-5. At the same time, the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders has proposed a grouping of body-focused repetitive behavior disorders within the obsessive-compulsive and related disorders (OCRD) cluster to include trichotillomania and skin-picking disorder. DSM-5 has taken a slightly different approach: trichotillomania and excoriation (skin picking) disorder are included in the OCRD grouping, while body-focused repetitive behavior disorder is listed under other specified forms of OCRD. DSM-5 also includes a separate category of nonsuicidal self-injury in the section on "conditions for further study." There are a number of unresolved nosological questions regarding the relationships among stereotyped movement disorder, body-focused repetitive behavior disorders, and nonsuicidal self-injury. In this article, we attempt to provide preliminary answers to some of these questions as they relate to the ICD-11 classification of mental and behavioral disorders.

  9. Movement disorders secondary to craniocerebral trauma.

    PubMed

    Krauss, Joachim K

    2015-01-01

    Over the past few decades it has been recognized that traumatic brain injury may result in various movement disorders. In survivors of severe head injury, post-traumatic movement disorders were reported in about 20%, and they persisted in about 10% of patients. The most frequent persisting movement disorder in this population is kinetic cerebellar outflow tremor in about 9%, followed by dystonia in about 4%. While tremor is associated most frequently with cerebellar or mesencephalic lesions, patients with dystonia frequently have basal ganglia or thalamic lesions. Moderate or mild traumatic brain injury only rarely causes persistent post-traumatic movement disorders. It appears that the frequency of post-traumatic movement disorders overall has been declining which most likely is secondary to improved treatment of brain injury. In patients with disabling post-traumatic movement disorders which are refractory to medical treatment, stereotactic neurosurgery can provide long-lasting benefit. While in the past the primary option for severe kinetic tremor was thalamotomy and for dystonia thalamotomy or pallidotomy, today deep brain stimulation has become the preferred treatment. Parkinsonism is a rare consequence of single head injury, but repeated head injury such as seen in boxing can result in chronic encephalopathy with parkinsonian features. While there is still controversy whether or not head injury is a risk factor for the development of Parkinson's disease, recent studies indicate that genetic susceptibility might be relevant.

  10. Respiratory problems in neurologic movement disorders.

    PubMed

    Mehanna, Raja; Jankovic, Joseph

    2010-12-01

    Movement disorders are a group of neurological motor disturbances manifested by either paucity or slowness of movement, such as seen in Parkinson's disease, or by abnormal involuntary movements, called hyperkinesias, which include tremor, dystonia, chorea, tics, myoclonus, and stereotypy. The aim of this review is to draw attention to the respiratory problems that are sometimes associated with these various movement disorders. References for this review were identified by searches of PubMed through June 2010, a text word search strategy. There were no language restrictions. Books on movement disorders, personal experience and judgment were also used in preparation of this review. Data from 245 articles were critically reviewed, compared and integrated. Although movement disorders are primarily considered motor disorders, the purpose of this review is to draw attention to their involvement of the respiratory system. It is critical that clinicians recognize the phenomenology and take appropriate action to prevent and treat the various respiratory problems associated with the various neurological disorders. Timely institution of therapeutic interventions is needed to favorably impact on the quality of life and survival of these patients. Copyright © 2010 Elsevier Ltd. All rights reserved.

  11. Advances in surgery for movement disorders.

    PubMed

    Rowland, Nathan C; Sammartino, Francesco; Lozano, Andres M

    2017-01-01

    Movement disorder surgery has evolved throughout history as our knowledge of motor circuits and ways in which to manipulate them have expanded. Today, the positive impact on patient quality of life for a growing number of movement disorders such as Parkinson's disease is now well accepted and confirmed through several decades of randomized, controlled trials. Nevertheless, residual motor symptoms after movement disorder surgery such as deep brain stimulation and lack of a definitive cure for these conditions demand that advances continue to push the boundaries of the field and maximize its therapeutic potential. Similarly, advances in related fields - wireless technology, artificial intelligence, stem cell and gene therapy, neuroimaging, nanoscience, and minimally invasive surgery - mean that movement disorder surgery stands at a crossroads to benefit from unique combinations of all these developments. In this minireview, we outline some of these developments as well as evidence supporting topics of recent discussion and controversy in our field. Moving forward, expectations remain high that these improvements will come to encompass an even broader range of patients who might benefit from this therapy and decrease the burden of disease associated with these conditions. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

  12. Video recording in movement disorders: practical issues.

    PubMed

    Duker, Andrew P

    2013-10-01

    Video recording can provide a valuable and unique record of the physical examinations of patients with a movement disorder, capturing nuances of movement and supplementing the written medical record. In addition, video is an indispensable tool for education and research in movement disorders. Digital file recording and storage has largely replaced analog tape recording, increasing the ease of editing and storing video records. Practical issues to consider include hardware and software configurations, video format, the security and longevity of file storage, patient consent, and video protocols.

  13. Transcultural comparison of psychogenic movement disorders.

    PubMed

    Cubo, Esther; Hinson, Vanessa K; Goetz, Christopher G; Garcia Ruiz, Pedro; Garcia de Yebenes, Justo; Marti, María José; Rodriguez Oroz, Maria Cruz; Linazasoro, Gurutz; Chacón, José; Vázquez, Antonio; López del Val, Javier; Leurgans, Sue; Wuu, Joanne

    2005-10-01

    Prompted by the lack of cross-cultural comparative data, and because a better understanding in the different clinical presentations of psychogenic movement disorders (PMDs) is relevant to neurological assessment and interventions, we compared the phenomenology, anatomical distribution, and functional impairment of PMDs in the United States and Spain. Consecutive patients diagnosed with PMD by a movement disorder specialist from one US site and from eight Spanish university centers were included in the study. The two groups were similar in their movement types, anatomical distribution, and functional impairment. PMDs were more prevalent in women than in men and were most common in upper and lower extremities. Gait and speech dysfunctions were distributed similarly in both countries. We found action tremor to be the most frequent PMD in both countries. Copyright (c) 2005 Movement Disorder Society.

  14. Gravity influence on rhythmic plant movements - circumnutations. A study using the EMCS hardware on the ISS.

    NASA Astrophysics Data System (ADS)

    Johnsson, Anders; Gees Bokn Solheim, Bjarte; Iversen, Tor-Henning

    The European Modular Cultivation System, installed in the Destiny unit of the International Space Station, ISS, is now functioning and allows automatic long term biological experiments. We have endeavoured to study growth movements of Arabidopsis thaliana in a 75 days long experiment using the hardware. The experiment has a seed-to-seed study as the overall goal, but unforeseen technical problems allowed only concentrating on the other main goal, viz. a study of possible oscillatory movements of the plant parts in weightlessness. Seeds were planted in Plant Cultivation Chambers (PCCs) with Experimental Containers (ECs) that allowed them to germinate when imbibed. Roots developed in a zeolite medium. White plus red light was provided by LED arrays and a 16:8 LD regime was chosen. Automatic humidity control in the air as well as in the medium was provided to guarantee optimal growth. The ECs were mounted on two identical rotors, allowing centrifugation in the interval 0g to 2g. Images of the ECs were taken by programmed cameras that viewed the ECs via mirrors. Sampling procedures were nominally activated every sixth min. Due to technical difficulties and power off periods for the EMCS planned experimental sequences had to be abandoned at several occasions. However, the experiment allowed acceleration pulses between 0g and approximately 1g to be given to plants throughout their development, a novel feature which is possible to use in system analysis in long term experiments. The circumnutations in Arabidopsis thaliana (wild type) have been studied on Earth and are intriguingly complicated. Under 1 g (on the Earth) the hypocotyls show a multitude of frequencies and the existence of two simultaneous oscillators generating complicated movements has been proposed (Johnsson et al. 1999). Darwin (1881) proposed an endogenous nature of the circumnutations while gravity's possible influence has been emphasized by others researchers (review by Johnsson 1997, Mugnai et al. 2007

  15. Movement disorder symptoms associated with Unified ...

    EPA Pesticide Factsheets

    Objectives: The UPDRS is a commonly used neurological measurement to assess the presence and severity of parkinsonian symptoms. It has also been used to assess symptoms associated with Mn exposure. Objectives: to determine 1) if movement disorder symptoms were associated with UPDRS: Activities of Daily Living (ADL) and Motor abnormalities; and 2) which symptoms were most related to increased abnormalities on these UPDRS subscales. Participants & Methods: Correlations between self-reported movement disorder symptoms from a health questionnaire and scores obtained on UPDRS: ADL and Motor subscales, and the Bradykinesia domain of the Motor subscale, were assessed during a medical examination among 185 Mn-exposed participants from two Ohio towns. Partial correlations were used for statistical analyses, controlling for age, sex, education and a history of musculoskeletal disease.Results: The presence of movement disorder symptoms was positively associated with ADL (pr =0.647, p = <0.001), Motor (pr =0.449, p = <0.001), and Bradykinesia (pr =0.418, p = <0.001) domains on the UPDRS. Specific movement disorder symptoms most strongly associated with increased ADL and Motor scores included having difficulty getting out of chairs (pr =0.458, p = <0.001), writing (pr =0.481, p = <0.001), skilled movements (pr =0.478, p = <0.001), loss of coordination/balance (pr =0.457, p = <0.001), changes in walking (pr =0.412, p = <0.001) and slowness of movement (pr =0.539, p = <0.0

  16. Movement disorders and the osmotic demyelination syndrome.

    PubMed

    de Souza, Aaron

    2013-08-01

    With the advent of MRI, osmotic demyelination syndromes (ODS) are increasingly recognised to affect varied sites in the brain in addition to the classical central pontine lesion. Striatal involvement is seen in a large proportion of cases and results in a wide variety of movement disorders. Movement disorders and cognitive problems resulting from ODS affecting the basal ganglia may occur early in the course of the illness, or may present as delayed manifestations after the patient survives the acute phase. Such delayed symptoms may evolve over time, and may even progress despite treatment. Improved survival of patients in the last few decades due to better intensive care has led to an increase in the incidence of such delayed manifestations of ODS. While the outcome of ODS is not as dismal as hitherto believed - with the acute akinetic-rigid syndrome associated with striatal myelinolysis often responding to dopaminergic therapy - the delayed symptoms often prove refractory to medical therapy. This article presents a review of the epidemiology, pathophysiology, clinical features, imaging, and therapy of movement disorders associated with involvement of the basal ganglia in ODS. A comprehensive review of 54 previously published cases of movement disorders due to ODS, and a video recording depicting the spectrum of delayed movement disorders seen after recovery from ODS are also presented.

  17. Playing-related musculoskeletal disorders among icelandic music students: differences between students playing classical vs rhythmic music.

    PubMed

    Arnason, Kári; Arnason, Arni; Briem, Kristín

    2014-06-01

    Most research studies investigating the prevalence of musculoskeletal disorders affecting musicians and music students have focused on classical music, while less is known about their prevalence in other music genres. The purpose of this study was to document cumulative and point prevalence of playing-related musculoskeletal disorders (PRMD) among music students in Iceland and, specifically, to identify differences between those studying classical vs rhythmic music. We hypothesized that students of classical music would report more frequent and more severe musculoskeletal disorders than students involved in rhythmic music, as classical instruments and composition typically require more demanding, sustained postures during practice and performance. A total of 74 students from two classical music schools (schools A and B) and 1 rhythmic school (school C) participated in the study by answering a questionnaire assessing PRMDs. The results showed that 62% of participants had, at some point in their musical career, suffered a PRMD. The cumulative prevalence was highest in music school A (71.4%) and lowest in music school C (38.9%). A statistically significant difference was identified between the cumulative prevalence of PRMD from schools A and B combined compared to music school C (p=0.019). Over 40% of participants reported a "current PRMD," and a significant difference was identified between the three schools (p=0.011), with the highest point prevalence being registered in music school A (66.6%) and the lowest in music school C (22.2%). The prevalence of PRMDs among Icelandic music students was high. The difference found between students who play classical vs rhythmic music may be explained by different demands of the instruments and composition on playing posture.

  18. Periodic Limb Movement Disorder (PLMD) and Restless Legs Syndrome (RLS)

    MedlinePlus

    ... Page Manual of Health Quizzes Self-Assessment Tools Tables Common Medical ... Spinal Cord, and Nerve Disorders Sleep Disorders Periodic Limb Movement Disorder (PLMD) and Restless Legs Syndrome ( ...

  19. Yips and other movement disorders in golfers.

    PubMed

    Dhungana, Samish; Jankovic, Joseph

    2013-05-01

    Golf is a sport that requires perfect motor coordination and a balance between mobility and stability. Golfer's "yips," an intermittent motor disturbance manifested as transient tremor, jerk, or spasm that primarily occurs when the player is trying to chip or make a putt, is a movement disorder frequently encountered in both amateur and professional golfers. In addition, other movement disorders, such as tremors and dystonia, also can interfere with playing golf. Although the pathophysiology of the yips remains poorly understood, recent studies suggest that it may be a form of a task-specific, focal dystonia involving the hand and arm. Because task-specific dystonias and tremors are best treated by botulinum toxin injections, this also may be an effective therapy for the yips. The aim of this article is to systematically review the literature and our own experience with the yips and other movement disorders in golfers.

  20. Movement disorders in women: a review.

    PubMed

    Rabin, Marcie L; Stevens-Haas, Claire; Havrilla, Emilyrose; Devi, Tanvi; Kurlan, Roger

    2014-02-01

    The field of women's health developed based on the recognition that there are important sex-based differences regarding several aspects of medical illnesses. We performed a literature review to obtain information about differences between women and men for neurological movement disorders. We identified important differences in prevalence, genetics, clinical expression, course, and treatment responses. In addition, we found that female life events, including menstruation, pregnancy, breast feeding, menopause, and medications prescribed to women (such as oral contraceptives and hormone-replacement therapy), have significant implications for women with movement disorders. Understanding this biological sex-specific information can help improve the quality and individualization of care for women with movement disorders and may provide insights into neurobiological mechanisms.

  1. Fundamental movement skills and autism spectrum disorders.

    PubMed

    Staples, Kerri L; Reid, Greg

    2010-02-01

    Delays and deficits may both contribute to atypical development of movement skills by children with ASD. Fundamental movement skills of 25 children with autism spectrum disorders (ASD) (ages 9-12 years) were compared to three typically developing groups using the Test of Gross Motor Development (TGMD-2). The group matched on chronological age performed significantly better on the TGMD-2. Another comparison group matched on movement skill demonstrated children with ASD perform similarly to children approximately half their age. Comparisons to a third group matched on mental age equivalence revealed the movement skills of children with ASD are more impaired than would be expected given their cognitive level. Collectively, these results suggest the movement skills of children with ASD reflect deficits in addition to delays.

  2. Circadian rhythmicity in substance use disorder male patients with and without comorbid depression under ambulatory and therapeutic community treatment.

    PubMed

    Antúnez, Juan Manuel; Capella, María Del Mar; Navarro, José Francisco; Adan, Ana

    2016-01-01

    Although there have been described alterations of circadian rhythmicity both in patients with substance use disorder (SUD) and patients with major depressive disorder (MDD), the circadian characteristics of SUD patients with comorbid MDD (SUD-MDD) are unknown. Likewise, the possible influence of the different modalities of treatments (ambulatory or therapeutic community) upon the circadian rhythmicity of SUD patients has not been characterized. Therefore, this study analyzes the circadian rhythmic profiles of SUD and SUD-MDD patients under ambulatory and therapeutic community treatment. The sample was composed of 40 SUD and 40 SUD-MDD men, aged 22-55 yrs, under treatment and with abstinence for at least three months (including each group 20 ambulatory and 20 from therapeutic community). Patients completed a sociodemographic, clinical and sleep-wake schedules interview, the Composite Scale of Morningness, and wore on the wrist an ambulatory device known as iButton® Thermochron DS1921H, which registered their distal skin temperature every two minutes for 48 hours. All the groups showed a tendency to morningness without differences among them in concordance with their sleep-wake schedules. With regard to distal skin temperature circadian rhythm, SUD patients showed higher values than SUD-MDD in amplitude, relative amplitude, percentage rhythm, and first harmonic power, and lower minimum temperature in 10 consecutive hours (p < .043, in all cases). Therapeutic community group values were lower in minimum temperature and higher in amplitude, relative amplitude, and 12 harmonic accumulated power (p < .028, in all cases) as compared to ambulatory ones. Moreover, all groups showed higher Rayleigh vector and rhythm stability as compared to normative population (p < .043, in both cases). The circadian rhythmic differences observed for diagnosis and type of treatment are indicative of a higher circadian rhythmicity robustness in SUD and therapeutic community patients as

  3. Mesencephalic clefts with associated eye movement disorders.

    PubMed

    Lagreze, W D; Warner, J E; Zamani, A A; Gouras, G K; Koralnik, I J; Bienfang, D C

    1996-04-01

    To describe two patients with mesencephalic midline clefts and associated eye movement disorders. Case reports. The first patient developed bilateral internuclear ophthalmoplegia with exotropia, reduced convergence, right ptosis, right fourth-nerve palsy, and right elevator palsy several years after meningitis with hydrocephalus. The second patient had bilateral internuclear ophthalmoplegia with exotropia, reduced convergence, bilateral ptosis, limited upward gaze, and right hypertropia since childhood. In both patients, magnetic resonance imaging showed a midline cleft extending from the cerebral aqueduct into the midbrain. It is likely that the clefts affected the oculomotor nuclei and medial longitudinal fasciculi, accounting for the eye movement disorders.

  4. Neuropathological Diagnostic Considerations in Hyperkinetic Movement Disorders

    PubMed Central

    den Dunnen, Wilfred F. A.

    2013-01-01

    Neuropathology of hyperkinetic movement disorders can be very challenging. This paper starts with basic functional anatomy of the basal ganglia in order to appreciate that focal lesions like for instance tumor or infarction can cause hyperkinetic movement disorders like (hemi)ballism. The neuropathology of different causes of chorea (amongst others Huntington’s disease, neuroacanthosis, and HLD-2) and dystonia (DYT1, PD, and Dopa-Responsive Dystonia) are described. Besides the functional anatomy of the basal ganglia a wider anatomical network view is provided. This forms the basis for the overview of the neuropathology of different forms of tremor. PMID:23420606

  5. Saccadic eye movement applications for psychiatric disorders

    PubMed Central

    Bittencourt, Juliana; Velasques, Bruna; Teixeira, Silmar; Basile, Luis F; Salles, José Inácio; Nardi, Antonio Egídio; Budde, Henning; Cagy, Mauricio; Piedade, Roberto; Ribeiro, Pedro

    2013-01-01

    Objective The study presented here analyzed the patterns of relationship between oculomotor performance and psychopathology, focusing on depression, bipolar disorder, schizophrenia, attention-deficit hyperactivity disorder, and anxiety disorder. Methods Scientific articles published from 1967 to 2013 in the PubMed/Medline, ISI Web of Knowledge, Cochrane, and SciELO databases were reviewed. Results Saccadic eye movement appears to be heavily involved in psychiatric diseases covered in this review via a direct mechanism. The changes seen in the execution of eye movement tasks in patients with psychopathologies of various studies confirm that eye movement is associated with the cognitive and motor system. Conclusion Saccadic eye movement changes appear to be heavily involved in the psychiatric disorders covered in this review and may be considered a possible marker of some disorders. The few existing studies that approach the topic demonstrate a need to improve the experimental paradigms, as well as the methods of analysis. Most of them report behavioral variables (latency/reaction time), though electrophysiological measures are absent. PMID:24072973

  6. Bruxism in Movement Disorders: A Comprehensive Review.

    PubMed

    Ella, Bruno; Ghorayeb, Imad; Burbaud, Pierre; Guehl, Dominique

    2016-04-14

    Bruxism is an abnormal repetitive movement disorder characterized by jaw clenching and tooth gnashing or grinding. It is classified into two overlapping types: awake bruxism (AB) and sleep bruxism (SB). Theories on factors causing bruxism are a matter of controversy, but a line of evidence suggests that it may to some extent be linked to basal ganglia dysfunction although so far, this topic has received little attention. The purpose of this article was to review cases of bruxism reported in various movement disorders. The biomedical literature was searched for publications reporting the association of bruxism with various types of movement disorders. As a whole, very few series were found, and most papers corresponded to clinical reports. In Parkinsonian syndromes, AB was rarely reported, but seems to be exacerbated by medical treatment, whereas SB is mainly observed during non-REM sleep, as in restless leg syndrome. AB is occasionally reported in Huntington's disease, primary dystonia, and secondary dystonia; however, its highest incidence and severity is reported in syndromes combining stereotypies and cognitive impairment, such as Rett's syndrome (97%), Down syndrome (42%), and autistic spectrum disorders (32%). Taken as a whole, AB seems to be more frequent in hyperkinetic movement disorders, notably those with stereotypies, and is influenced by anxiety, suggesting an involvement of the limbic part of the basal ganglia in its pathophysiology.

  7. Spectrum of movement disorders in professional welders.

    PubMed

    Fang, J Y; Phibbs, F T; Davis, T L

    2009-01-01

    To examine the clinical presentation of movement disorder in patients who reported a history of welding. A retrospective chart review during a three-year period was performed on all movement disorders and patients who had been welders were identified. The clinical presentation of these patients was categorized by the movement disorder at the time of the initial neurological evaluation and by the therapy response. A comparison group was created by randomly selecting four non-welders for each welder. Among 1126 charts reviewed, eleven patients presented with a welder history. Parkinsonism was a common presentation in both groups: three of the eleven welders (27%) and five of the forty-one controls (12%). Dystonia was also common with 27% and 20%, respectively. Using the chi-squared analysis, the prevalence rates for both parkinsonism and dystonia were similar to controls. All of the welder patients with parkinsonism responded to dopaminomimetic therapy. Six of the eleven welders had elevated manganese levels in either blood or urine. Welders who present with a movement disorder such as parkinsonism or dystonia, have the prevalence rates for these disorders similar to the non-welder population (Fig. 2, Ref. 15).

  8. Electrophysiologic Evaluation of Psychogenic Movement Disorders

    PubMed Central

    Pal, Pramod Kumar

    2011-01-01

    Psychogenic movement disorders (PMD) are a group of disorders which are in the border zone between neurology and psychiatry. All necessary laboratory investigations should be done to rule out an underlying organic disorder. While clinical acumen of a trained movement disorder specialist may be sufficient to diagnose most PMD, there are clinical situations where electrophysiological tests are required either to rule out an organic movement disorder or even diagnose a PMD. Current electrophysiological test are most useful for tremor, followed by jerks and least for spasms or dystonia. Commonly used electrophysiologic tests include multichannel surface electromyography (EMG), accelerometry, electroencephalography time locked with EMG, premovement potential (Bereitschaftspotential), and somatosensory evoked potentials. Psychogenic tremor is a low frequency tremor with variable frequency and duration of EMG bursts, entrainable, has a high coherence with voluntary movements, and presence of coactivation sign. Patients with psychogenic jerks have well organized triphasic pattern of activation of agonist and antagonist muscles. The jerks are associated with EMG bursts of long duration (usually > 70 ms), long and variable latencies in stimulus induced jerks, absence of craniocaudal pattern of muscle recruitment in apparent startle response, and often a Breitschaftspotential (premovement potential) precedes the jerk. Electrophysiological characterization of psychogenic dystonia is difficult and the tests are usually performed to rule out organic dystonia with characteristic findings. Finally, caution should be exerted in interpreting the electrophysiological tests as both false positive and false negative diagnosis of PMD may still occur. PMID:24868388

  9. Psychogenic nonepileptic seizures and movement disorders

    PubMed Central

    Erro, Roberto; Trinka, Eugen; Turri, Giulia; Edwards, Mark J.; Tinazzi, Michele

    2016-01-01

    Abstract Purpose of review: Neurologic symptoms due to a psychogenic cause are frequently seen in clinical practice. Psychogenic nonepileptic seizures (PNES) and psychogenic movement disorders (PMD) are among the most common psychogenic neurologic disorders. PNES and PMD are usually investigated and managed separately by different neurology subspecialists. We review the main epidemiologic and clinical features of both PNES and PMD, aiming to highlight their similarities and differences and to see whether a common framework for these disorders exists. Recent findings: Data from the literature show that there is a profound overlap between PNES and PMD, which would argue for a larger unifying pathophysiology with variable phenotypic manifestations. Summary: Collaborative and integrated research among epileptologists, movement disorders experts, psychiatrists, psychologists, and physiotherapists may increase our collective knowledge about the pathophysiologic mechanisms of PNES and PMD and therefore improve outcomes for these patients. PMID:27104066

  10. Functional (psychogenic) movement disorders - Clinical presentations.

    PubMed

    Hallett, Mark

    2016-01-01

    Functional or psychogenic movement disorders are common and disabling, and sometime difficult to diagnose. The history and physical exam can give positive features that will support the diagnosis, which should not be based solely on exclusion. Some clues in the history are sudden onset, intermittent time course, variability of manifestation over time, childhood trauma, history of other somatic symptom and secondary gain. Anxiety and depression are common, but not necessarily more than the general population. On examination, distraction and suggestibility may be present. There are specific signs that should be looked for with different types of movements. For example, with tremor, change in frequency over time and entrainment are common features. With myoclonus, the movements might be complex in type with long latencies to stimulus induced jerks. Gait disorders show good balance despite claims to the contrary. Functional dystonia still remains a challenging diagnosis in many circumstances, although fixed dystonia is one sign more likely to be functional.

  11. Chronic Traumatic Encephalopathy and Movement Disorders: Update.

    PubMed

    Tarazi, Apameh; Tator, Charles H; Tartaglia, Maria Carmela

    2016-05-01

    Association of repetitive brain trauma with progressive neurological deterioration has been described since the 1920s. Punch drunk syndrome and dementia pugilistica (DP) were introduced first to explain symptoms in boxers, and more recently, chronic traumatic encephalopathy (CTE) has been used to describe a neurodegenerative disease in athletes and military personal with a history of multiple concussions. Although there are many similarities between DP and CTE, a number of key differences are apparent especially when comparing movement impairments. The aim of this review is to compare clinical and pathological aspects of DP and CTE with a focus on disorders of movement.

  12. Motor sequence learning and movement disorders.

    PubMed

    Doyon, Julien

    2008-08-01

    New insights into the psychophysiological determinants of performance changes and brain plasticity associated with motor sequence learning have recently been gained through behavioral and imaging studies in healthy individuals. In addition, using a variety of motor sequential paradigms in groups of patients affected by a movement disorder, major advances have been achieved in our understanding of the pathophysiological mechanisms underlying Parkinson's and Huntington's diseases, as well as primary forms of dystonia. This review begins by describing the latest findings in normal participants with regards to the dynamic alterations in neural networks observed across the different phases of motor sequence learning. It then focuses on the hotly debated issue of motor memory consolidation, highlighting the results of novel studies that investigated the role of both day and night sleep, the neural substrates and the developmental evolution mediating this process. Finally, this paper addresses current work looking at motor sequence learning in movement disorders that helps to better comprehend the functional contribution of basal ganglia structures to this type of memory, to assess the impact of such diseases on related patterns of brain activation, as well as to identify the neuronal compensatory mechanisms educed by these basal ganglia disorders. Such advances have major implications, not only for optimizing ways to learn new skilled behaviors in real-life situations, but also for guiding therapeutic approaches in patients with movement disorders.

  13. Stable phase-shift despite quasi-rhythmic movements: a CPG-driven dynamic model of active tactile exploration in an insect

    PubMed Central

    Harischandra, Nalin; Krause, André F.; Dürr, Volker

    2015-01-01

    An essential component of autonomous and flexible behavior in animals is active exploration of the environment, allowing for perception-guided planning and control of actions. An important sensory system involved is active touch. Here, we introduce a general modeling framework of Central Pattern Generators (CPGs) for movement generation in active tactile exploration behavior. The CPG consists of two network levels: (i) phase-coupled Hopf oscillators for rhythm generation, and (ii) pattern formation networks for capturing the frequency and phase characteristics of individual joint oscillations. The model captured the natural, quasi-rhythmic joint kinematics as observed in coordinated antennal movements of walking stick insects. Moreover, it successfully produced tactile exploration behavior on a three-dimensional skeletal model of the insect antennal system with physically realistic parameters. The effect of proprioceptor ablations could be simulated by changing the amplitude and offset parameters of the joint oscillators, only. As in the animal, the movement of both antennal joints was coupled with a stable phase difference, despite the quasi-rhythmicity of the joint angle time courses. We found that the phase-lead of the distal scape-pedicel (SP) joint relative to the proximal head-scape (HS) joint was essential for producing the natural tactile exploration behavior and, thus, for tactile efficiency. For realistic movement patterns, the phase-lead could vary within a limited range of 10–30° only. Tests with artificial movement patterns strongly suggest that this phase sensitivity is not a matter of the frequency composition of the natural movement pattern. Based on our modeling results, we propose that a constant phase difference is coded into the CPG of the antennal motor system and that proprioceptors are acting locally to regulate the joint movement amplitude. PMID:26347644

  14. Stable phase-shift despite quasi-rhythmic movements: a CPG-driven dynamic model of active tactile exploration in an insect.

    PubMed

    Harischandra, Nalin; Krause, André F; Dürr, Volker

    2015-01-01

    An essential component of autonomous and flexible behavior in animals is active exploration of the environment, allowing for perception-guided planning and control of actions. An important sensory system involved is active touch. Here, we introduce a general modeling framework of Central Pattern Generators (CPGs) for movement generation in active tactile exploration behavior. The CPG consists of two network levels: (i) phase-coupled Hopf oscillators for rhythm generation, and (ii) pattern formation networks for capturing the frequency and phase characteristics of individual joint oscillations. The model captured the natural, quasi-rhythmic joint kinematics as observed in coordinated antennal movements of walking stick insects. Moreover, it successfully produced tactile exploration behavior on a three-dimensional skeletal model of the insect antennal system with physically realistic parameters. The effect of proprioceptor ablations could be simulated by changing the amplitude and offset parameters of the joint oscillators, only. As in the animal, the movement of both antennal joints was coupled with a stable phase difference, despite the quasi-rhythmicity of the joint angle time courses. We found that the phase-lead of the distal scape-pedicel (SP) joint relative to the proximal head-scape (HS) joint was essential for producing the natural tactile exploration behavior and, thus, for tactile efficiency. For realistic movement patterns, the phase-lead could vary within a limited range of 10-30° only. Tests with artificial movement patterns strongly suggest that this phase sensitivity is not a matter of the frequency composition of the natural movement pattern. Based on our modeling results, we propose that a constant phase difference is coded into the CPG of the antennal motor system and that proprioceptors are acting locally to regulate the joint movement amplitude.

  15. Parasomnias and movement disorders of sleep.

    PubMed

    Avidan, Alon Y

    2009-09-01

    Neurologists are often enlisted to help diagnose, evaluate, and manage a spectrum of abnormal spells during the night ranging from parasomnias to motor disturbance that span the sleep-wake cycle. Parasomnias are undesirable emotional or physical events that accompany sleep. These events typically occur during entry into sleep from wakefulness, or during arousals from sleep, and are often augmented by the sleep state. Some parasomnias, such as the rapid eye movement (REM) sleep behavior disorder may be extremely undesirable, while others such as somniloquy are often of little concern. The parasomnias include a spectrum of abnormal emotions, movements, behaviors, sensory perceptions, dream mentation, and autonomic activity. Basic physiologic drives, such as sex, hunger, and aggression, may manifest as sleep-related eating, sleep-related sexual behaviors, and sleep-related violence. Parasomnias have a very bizarre nature, but are readily explainable, diagnosable, and treatable. They are hypothesized to be due to changes in brain organization across multiple states of being, and are particularly apt to occur during the incomplete transition or oscillation from one sleep state to another. Parasomnias are often explained on the basis that wakefulness and sleep are not mutually exclusive states, and abnormal intrusion of wakefulness into non-REM (NREM) sleep produces arousal disorders, and intrusion of wakefulness into REM sleep produces REM sleep parasomnias and REM sleep behavior disorder (RBD). Restless legs syndrome (RLS) and periodic limb movement disorder (PLMD), two closely related conditions that often result in disturbed sleep onset and sleep maintenance, are also reviewed in this article. Although the mechanisms that underlie idiopathic RLS or PLMD are not fully understood, there is currently substantial evidence that dopaminergic dysfunction is likely involved in both conditions. The discussion will conclude with the "other parasomnias" and sleep

  16. Nomenclature of genetic movement disorders: Recommendations of the international Parkinson and movement disorder society task force.

    PubMed

    Marras, Connie; Lang, Anthony; van de Warrenburg, Bart P; Sue, Carolyn M; Tabrizi, Sarah J; Bertram, Lars; Mercimek-Mahmutoglu, Saadet; Ebrahimi-Fakhari, Darius; Warner, Thomas T; Durr, Alexandra; Assmann, Birgit; Lohmann, Katja; Kostic, Vladimir; Klein, Christine

    2016-04-01

    The system of assigning locus symbols to specify chromosomal regions that are associated with a familial disorder has a number of problems when used as a reference list of genetically determined disorders,including (I) erroneously assigned loci, (II) duplicated loci, (III) missing symbols or loci, (IV) unconfirmed loci and genes, (V) a combination of causative genes and risk factor genes in the same list, and (VI) discordance between phenotype and list assignment. In this article, we report on the recommendations of the International Parkinson and Movement Disorder Society Task Force for Nomenclature of Genetic Movement Disorders and present a system for naming genetically determined movement disorders that addresses these problems. We demonstrate how the system would be applied to currently known genetically determined parkinsonism, dystonia, dominantly inherited ataxia, spastic paraparesis, chorea, paroxysmal movement disorders, neurodegeneration with brain iron accumulation, and primary familial brain calcifications. This system provides a resource for clinicians and researchers that, unlike the previous system, can be considered an accurate and criterion-based list of confirmed genetically determined movement disorders at the time it was last updated.

  17. Use of Botulinum Neurotoxin for the Treatment of Movement Disorders

    MedlinePlus

    ... FAMILIES Use of Botulinum Neurotoxin Injections to Treat Movement Disorders People often associate botulinum neurotoxin (BoNT) with ... studies on the effect of BoNT for treating movement disorders. What is botulinum neurotoxin and how does ...

  18. The history of surgery for movement disorders.

    PubMed

    Gildenberg, P L

    1998-04-01

    Treatment of movement disorders by interruption of pathways within the nervous system has been a goal of neurosurgeons for the past century. When human stereotactic surgery was introduced 50 years ago, a major advance was made in surgical treatment of Parkinson's disease and other disorders of the motor system. Since then, the field has experienced a period of progressive growth, then abrupt decline, and now is more active than ever before and continuing to grow rapidly. Recent progress in computer science, imaging techniques, neurophysiology, and stereotactic targeting has provided the fuel for future progress.

  19. Neurobiology of functional (psychogenic) movement disorders.

    PubMed

    Edwards, Mark J; Fotopoulou, Aikaterini; Pareés, Isabel

    2013-08-01

    This review explores recent developments in understanding the neurobiological mechanism of functional (psychogenic) movement disorders (FMDs). This is particularly relevant given the resurgence of academic and clinical interest in patients with functional neurological symptoms and the clear shift in diagnostic and treatment approaches away from a pure psychological model of functional symptoms. Recent research findings implicate three key processes in the neurobiology of FMD (and by extension other functional neurological symptoms): abnormal attentional focus, abnormal beliefs and expectations, and abnormalities in sense of agency. These three processes have been combined in recent neurobiological models of FMD in which abnormal predictions related to movement are triggered by self-focused attention, and the resulting movement is generated without the normal sense of agency that accompanies voluntary movement. New understanding of the neurobiology of FMD forms an important part of reappraising the way that patients with FMD (and other functional disorders) are characterized and treated. It also provides a testable framework for further exploring the pathophysiology of these common causes of ill health.

  20. Neurobiology of functional (psychogenic) movement disorders

    PubMed Central

    Edwards, Mark J.; Fotopoulou, Aikaterini; Pareés, Isabel

    2013-01-01

    Purpose of review This review explores recent developments in understanding the neurobiological mechanism of functional (psychogenic) movement disorders (FMDs). This is particularly relevant given the resurgence of academic and clinical interest in patients with functional neurological symptoms and the clear shift in diagnostic and treatment approaches away from a pure psychological model of functional symptoms. Recent findings Recent research findings implicate three key processes in the neurobiology of FMD (and by extension other functional neurological symptoms): abnormal attentional focus, abnormal beliefs and expectations, and abnormalities in sense of agency. These three processes have been combined in recent neurobiological models of FMD in which abnormal predictions related to movement are triggered by self-focused attention, and the resulting movement is generated without the normal sense of agency that accompanies voluntary movement. Summary New understanding of the neurobiology of FMD forms an important part of reappraising the way that patients with FMD (and other functional disorders) are characterized and treated. It also provides a testable framework for further exploring the pathophysiology of these common causes of ill health. PMID:23823467

  1. Motor cortex stimulation for movement disorders.

    PubMed

    Cioni, Beatrice; Tufo, Tommaso; Bentivoglio, Annarita; Trevisi, Gianluca; Piano, Carla

    2016-06-01

    Motor cortex stimulation (MCS) was introduced by Tsubokawa in 1991 1 for the treatment of thalamic pain, after coming to the conclusion that the hyperactivity of thalamic neurons after spino-thalamic tractotomy was inhibited by stimulation of the motor cortex. MCS has been reported not only to be effective on pain, but also to improve movement disorders such as Parkinson's disease, tremor, dystonia, poststroke movement disorders and hemiparesis. Most of these publications are case reports or small series, and the real impact of MCS on movement disorders remains to be determined. In order to clarify this point, we conducted a PubMed search from 1991 to 2016 using established MeSH words. A total of 40 papers were selected and examined. Furthermore, personal experience with MCS for Parkinson's disease and akinesia, is reported. Only four studies were randomized controlled clinical trials: three out of four failed to demonstrate the efficacy of MCS at short term. At long term, MCS seems to show a clinical positive effect in the studies prolonged in an open observational trial.

  2. Movement Disorders Following Cerebrovascular Lesions: Etiology, Treatment Options and Prognosis

    PubMed Central

    Kwon, Do-Young

    2016-01-01

    Post-stroke movement disorders are uncommon, but comprise an important part of secondary movement disorders. These exert variable and heterogeneous clinical courses according to the stroke lesion and its temporal relationships. Moreover, the predominant stroke symptoms hinder a proper diagnosis in clinical practice. This article describes the etiology, treatment options and prognosis of post-stroke movement disorders. PMID:27240807

  3. Psychodynamic Psychotherapy for Functional (Psychogenic) Movement Disorders

    PubMed Central

    Sharma, Vibhash D.; Jones, Randi; Factor, Stewart A.

    2017-01-01

    Objective As the literature for the treatment of functional (psychogenic) movement disorders (FMD) is sparse, we assessed clinical outcomes in patients with FMD who underwent treatment with psychodynamic psychotherapy (PDP). Methods A retrospective analysis of the data of patients with FMD who were referred for PDP from 2008−2014 at Emory University Medical Center was performed. Results Thirty patients were included, mean age at presentation was 50 years (SD 13.9) and majority were female (27/30). Most common movement disorder was involuntary shaking/jerky movements (50%) and tremor (43%). Mean duration of symptoms was 3.2 years and mean number of PDP visits was 4.9. PDP lead to good outcomes in 10, modest in 8, and poor in 9. Three patients lost to follow up. Mean duration of symptoms between two groups (good vs. poor) was not statistically significant (p = 0.11), mean number of PDP visits showed a trend towards significance (p = 0.053). In all cases of good outcomes precipitants of the movement disorder were identified and a majority (60%) was receptive of the diagnosis and had good insight. Conclusion PDP lead to improvement in 60% of the patients which is encouraging as the treatment is challenging. This study supports heterogeneous causes of FMD including varied roles of past/recent events and demonstrates importance of psychological approaches such as PDP. Treatment with PDP should be considered in some patients with FMD but predicting who will respond remains a challenge. Further long term prospective studies with large sample size and placebo control are needed. PMID:28122424

  4. Post-stroke Movement Disorders: Clinical Manifestations and Pharmacological Management

    PubMed Central

    Siniscalchi, Antonio; Gallelli, Luca; Labate, Angelo; Malferrari, Giovanni; Palleria, Caterina; Sarro, Giovambattista De

    2012-01-01

    Involuntary abnormal movements have been reported after ischaemic and haemorrhagic stroke. Post stroke movement disorders can appear as acute or delayed sequel. At the moment, for many of these disorders the knowledge of pharmacological treatment is still inadequate. Dopaminergic and GABAergic systems may be mainly involved in post-stroke movement disorders. This article provides a review on drugs commonly used in post-stroke movement disorders, given that some post-stroke movement disorders have shown a partial benefit with pharmacological approach. PMID:23449883

  5. Studies of the phase gradient at the boundary of the phase diffusion equation, motivated by peculiar wave patterns of rhythmic contraction in the amoeboid movement of Physarum polycephalum

    NASA Astrophysics Data System (ADS)

    Iima, Makoto; Kori, Hiroshi; Nakagaki, Toshiyuki

    2017-04-01

    The boundary of a cell is the interface with its surroundings and plays a key role in controlling the cell movement adaptations to different environments. We propose a study of the boundary effects on the patterns and waves of the rhythmic contractions in plasmodia of Physarum polycephalum, a tractable model organism of the amoeboid type. Boundary effects are defined as the effects of both the boundary conditions and the boundary shape. The rhythmicity of contraction can be modulated by local stimulation of temperature, light and chemicals, and by local deformation of cell shape via mechanosensitive ion channels as well. First, we examined the effects of boundary cell shapes in the case of a special shape resembling a tadpole, while requiring that the natural frequency in the proximity of the boundary is slightly higher and uniform. The simulation model reproduced the approximate propagated wave, from the tail to the head, while the inward waves were observed only near the periphery of the head section of the tadpole-shape. A key finding was that the frequency of the rhythmic contractions depended on the local shape of cell boundary. This implies that the boundary conditions of the phase were not always homogeneous. To understand the dependency, we reduced the two-dimensional model into a one-dimensional continuum model with Neumann boundary conditions. Here, the boundary conditions reflect the frequency distribution at the boundary. We described the analytic solutions and calculated the relationship between the boundary conditions and the wave propagation for a one-dimensional model of the continuous oscillatory field and a discrete coupled oscillator system. The results obtained may not be limited to cell movement of Physarum, but may be applicable to the other physical systems since the analysis used a generic phase diffusion equation.

  6. Restless legs syndrome and periodic leg movements in patients with movement disorders: Specific considerations.

    PubMed

    Högl, Birgit; Stefani, Ambra

    2017-05-01

    Restless legs syndrome is a frequent neurological disorder with potentially serious and highly distressing treatment complications. The role and potential implications of periodic leg movements during sleep range from being a genetic risk marker for restless legs syndrome to being a cardiovascular risk factor. The diagnosis of restless legs syndrome in patients with daytime movement disorders is challenging and restless legs syndrome needs to be differentiated from other sleep-related movement disorders. This article provides an update on the diagnosis of restless legs syndrome as an independent disorder and the role of periodic leg movements and reviews the association of restless legs syndrome with Parkinson's disease and other movement disorders. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

  7. Degeneration of rapid eye movement sleep circuitry underlies rapid eye movement sleep behavior disorder.

    PubMed

    McKenna, Dillon; Peever, John

    2017-04-10

    During healthy rapid eye movement sleep, skeletal muscles are actively forced into a state of motor paralysis. However, in rapid eye movement sleep behavior disorder-a relatively common neurological disorder-this natural process is lost. A lack of motor paralysis (atonia) in rapid eye movement sleep behavior disorder allows individuals to actively move, which at times can be excessive and violent. At first glance this may sound harmless, but it is not because rapid eye movement sleep behavior disorder patients frequently injure themselves or the person they sleep with. It is hypothesized that the degeneration or dysfunction of the brain stem circuits that control rapid eye movement sleep paralysis is an underlying cause of rapid eye movement sleep behavior disorder. The link between brain stem degeneration and rapid eye movement sleep behavior disorder stems from the fact that rapid eye movement sleep behavior disorder precedes, in the majority (∼80%) of cases, the development of synucleinopathies such as Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy, which are known to initially cause degeneration in the caudal brain stem structures where rapid eye movement sleep circuits are located. Furthermore, basic science and clinical evidence demonstrate that lesions within the rapid eye movement sleep circuits can induce rapid eye movement sleep-specific motor deficits that are virtually identical to those observed in rapid eye movement sleep behavior disorder. This review examines the evidence that rapid eye movement sleep behavior disorder is caused by synucleinopathic neurodegeneration of the core brain stem circuits that control healthy rapid eye movement sleep and concludes that rapid eye movement sleep behavior disorder is not a separate clinical entity from synucleinopathies but, rather, it is the earliest symptom of these disorders. © 2017 International Parkinson and Movement Disorder Society.

  8. Cyclic modulation of the H-reflex in a wrist flexor during rhythmic flexion-extension movements of the ipsilateral foot.

    PubMed

    Baldissera, F; Cavallari, P; Leocani, L

    1998-02-01

    In 12 subjects, each sitting on an armchair with the right forearm prone, the H-reflex elicited in the resting flexor carpi radialis muscle underwent cyclic excitability changes correlated with rhythmic flexion-extension movements of the ipsilateral foot (frequency of oscillations between 1.5 and 2.5 Hz). During foot plantar flexion, the H-reflex underwent a clear-cut increase, the maximum facilitation falling, in most subjects, within the second half of that phase; then, a gradual reduction in size led the reflex amplitude back to the initial value at the end of foot dorsal extension. If present also when the wrist and the ankle are moved together, this facilitation should favour the in-phase (isodirectional) association between movements and, conversely, hinder the anti-phase coupling.

  9. Seventy years of pallidotomy for movement disorders.

    PubMed

    Cif, Laura; Hariz, Marwan

    2017-07-01

    The year 2017 marks the 70th anniversary of the birth of human stereotactic neurosurgery. The first procedure was a pallidotomy for Huntington's disease. However, it was for Parkinson's disease that pallidotomy was soon adopted worldwide. Pallidotomy was abandoned in the late 1950s in favor of thalamotomy because of the latter's more striking effect on tremor. The advent of levodopa put a halt to all surgery for PD. In the mid-1980s, Laitinen reintroduced the posteroventral pallidotomy of Leksell, and this procedure spread worldwide thanks to its efficacy on most parkinsonian symptoms including levodopa-induced dyskinesias and thanks to basic scientific work confirming the role of the globus pallidus internus in the pathophysiology of PD. With the advent of deep brain stimulation of the subthalamic nucleus, pallidotomy was again abandoned, and even DBS of the GPi has been overshadowed by STN DBS. The GPi reemerged in the late 1990s as a major stereotactic target for DBS in dystonia and, recently, in Tourette syndrome. Lately, lesioning of the GPI is being proposed to treat refractory status dystonicus or to treat DBS withdrawal syndrome in PD patients. Hence, the pallidum as a stereotactic target for either lesioning or DBS has been the phoenix of functional stereotactic neurosurgery, constantly abandoned and then rising again from its ashes. This review is a tribute to the pallidum on its 70th anniversary as a surgical target for movement disorders, analyzing its ebbs and flows and highlighting its merits, its versatility, and its resilience. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

  10. Electrophysiological evaluation of psychogenic movement disorders.

    PubMed

    Kamble, Nitish L; Pal, Pramod Kumar

    2016-01-01

    Psychogenic movement disorders (PMD) include a group of neurological symptoms which cannot be explained by any organic syndrome. The diagnosis of PMD is challenging for both neurologist and psychiatrist. Electrophysiological examination is a useful tool to evaluate and support a diagnosis PMD. It includes a set of tests which are chosen appropriate to the clinical setting that provides objective criteria for the diagnosis of PMD. The various tests available include accelerometry, surface electromyography, electroencephalography, jerk locked back averaging and pre-movement potentials, somatosensory evoked potentials, transcranial magnetic stimulation (TMS) etc. Electrophysiologically psychogenic tremors display features of variability, entrainability, coactivation, distractibility and increase in the amplitude and frequency on mass loading. Movement related cortical potentials such as Bereitschaftspotential is seen in psychogenic myoclonus. Presence of triphasic contraction of muscles and absence of co-contraction suggests psychogenic myoclonus. Latency of C-reflex is longer in psychogenic myoclonus as compared to organic myoclonus. The role of TMS to differentiate psychogenic from organic dystonia is still not clear. In conclusion, electrophysiological tests are most useful for tremor, followed by jerks and least for dystonia. In patients with long-standing PMD or those with mixed pathology, electrophysiological tests may not be very useful.

  11. Rhythmic Gymnastics: A Challenge with Balls and Ropes.

    ERIC Educational Resources Information Center

    Bennett, John P.

    Rhythmic gymnastics is an outgrowth of rhythmic and dance gymnastics and promotes good posture, strength, flexibility, balance, and coordination, along with appreciation of music and movement together. The current status of rhythmic gymnastics and its historical development are briefly discussed. Descriptions are given of rhythmic gymnastic…

  12. Clinical and scientific perspectives on movement disorders: Stanley Fahn's contributions.

    PubMed

    Jankovic, Joseph; Bressman, Susan; Dauer, William; Kang, Un Jung

    2015-12-01

    Dr. Stanley Fahn, the H. Houston Merritt Professor of Neurology and Director Emeritus of the Center for Parkinson's Disease and Other Movement Disorders at Columbia University, one of the founders of the field of movement disorders, was the first president of the Movement Disorders Society (subsequently renamed as the International Parkinson and Movement Disorder Society). Together with his friend and colleague, Professor David Marsden, he also served as the first co-editor of the journal Movement Disorders. By emphasizing phenomenology as the key element in differentiating various hypokinetic and hyperkinetic movement disorders, Dr. Fahn drew attention to the clinical history and the power of observation in the diagnosis of movement disorders. Dr. Fahn had major influence on the development of classifications and assessments of various movement disorders and in organizing various research groups such as the Parkinson Study Group. As the founder and president of the World Parkinson Coalition and an organizer of the initial three World Parkinson Congresses, he has demonstrated his long-standing commitment to the cause of including patients as partners. The primary goal and objective of this invited review is to highlight some of Dr. Fahn's most impactful scientific and clinical contributions to the understanding and treatment of Parkinson's disease, dystonia, and other movement disorders.

  13. Molecular Imaging of Extrapyramidal Movement Disorders.

    PubMed

    Frey, Kirk A

    2017-01-01

    Extrapyramidal movement disorders including Parkinson disease, multiple systems atrophy, progressive supranuclear palsy, and corticobasal degeneration are neurodegenerative syndromes with distinct neuropathological changes, indicating differing underlying etiologies. Clinical features that may distinguish among these conditions are often absent, particularly early after the onset of symptoms. Therapy is presently limited, and there are no established disease-modifying or neuroprotective interventions. Advances in therapeutics will depend on the early and accurate diagnostic classification of patients. Existing molecular imaging approaches demonstrate ability to separate several of these syndromes, but are clinically underutilized or are available only in research settings. The development of additional, specific imaging approaches targeting the misfolded protein deposits that characterize these neurodegenerative pathologies promises to advance not only the sensitive and specific endophenotyping of patients, but may also serve to measure directly potential therapeutic responses in the initial evaluations of new treatments. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Stereotypic movement disorder after acquired brain injury.

    PubMed

    McGrath, Cynthia M; Kennedy, Richard E; Hoye, Wayne; Yablon, Stuart A

    2002-05-01

    Stereotypic movement disorder (SMD) consists of repetitive, non-functional motor behaviour that interferes with daily living or causes injury to the person. It is most often described in patients with mental retardation. However, recent evidence indicates that this condition is common among otherwise normal individuals. This case study describes a patient with new-onset SMD occurring after subdural haematoma and brain injury. SMD has rarely been reported after acquired brain injury, and none have documented successful treatment. The current psychiatric literature regarding neurochemistry, neuroanatomy, and treatment of SMD are reviewed with particular application to one patient. Treatment options include serotonin re-uptake inhibitors, opioid antagonists and dopamine antagonists. SMD has been under-appreciated in intellectually normal individuals, and may also be unrecognized after brain injury. Further investigation is needed in this area, which may benefit other individuals with SMD as well.

  15. The spasticity paradox: movement disorder or disorder of resting limbs?

    PubMed Central

    Burne, J; Carleton, V; O'Dwyer, N

    2005-01-01

    Background: Spasticity is defined/assessed in resting limbs, where increased stretch reflex activity and mechanical joint resistance are evident. Treatment with antispastic agents assumes that these features contribute to the movement disorder, although it is unclear whether they persist during voluntary contraction. Objectives: To compare reflex amplitude and joint resistance in spastic and normal limbs over an equivalent range of background contraction. Methods: Thirteen normal and eight hemiparetic subjects with mild/moderate spasticity and without significant contracture were studied. Reflex and passive joint resistance were compared at rest and during six small increments of biceps voluntary contraction, up to 15% of normal maximum. A novel approach was used to match contraction levels between groups. Results: Reflex amplitude and joint mechanical resistance were linearly related to contraction in both groups. The slopes of these relations were not above normal in the spastic subjects on linear regression. Thus, reflex amplitude and joint resistance were not different between groups over a comparable range of contraction levels. Spastic subjects exhibited a smaller range of reflex modulation than normals because of decreased maximal contraction levels (weakness) and significant increases of resting contraction levels. Conclusions: Spasticity was most evident at rest because subjects could not reduce background contraction to normal. When background contractions were matched to normal levels, no evidence of exaggerated reflex activity or mechanical resistance was found. Instead, reduced capacity to modulate reflex activity dynamically over the normal range may contribute to the movement disorder. This finding does not support the routine use of antispastic agents to treat the movement disorder. PMID:15607994

  16. Functional facial and tongue movement disorders.

    PubMed

    Fasano, A; Tinazzi, M

    2016-01-01

    Functional movement disorders (FMDs) affecting the eyelids, tongue, and other facial muscles are often underrecognized because their phenomenology has not been fully characterized. Nevertheless, these disorders are more common than previously thought. In this chapter we will discuss the phenomenology as well as the clinical and instrumental diagnosis of facial FMDs. Facial FMDs should be considered when a patient exhibits any combination of the following features: (1) fixed unilateral facial contractions, especially with lower lip, with or without ipsilateral jaw involvement, of maximal severity at onset; (2) inconsistent features such as changes in side and pattern during or between examination; (3) associated somatoform or nonphysiologic sensory or motor findings; (4) reduction or abolition of facial spasm with distraction; (5) response to suggestion or psychotherapy; (6) rapid onset and/or spontaneous remissions; and (7) normal neurologic examination. Supportive features are young age, female gender, and associated medical conditions such as depression, headaches, facial pain, fibromyalgia, or irritable-bowel syndrome. Finally, the differential diagnosis with the organic counterparts will be also addressed, particularly with respect to blepharospasm, oromandibular dystonia, and hemifacial spasm. © 2016 Elsevier B.V. All rights reserved.

  17. Parasomnias and movement disorders in children and adolescents.

    PubMed

    Bloomfield, Elana R; Shatkin, Jess P

    2009-10-01

    Childhood parasomnias and movement disorders arise from a variety of etiologic factors. For some children, psychopathology plays a causal role in sleep disorders; in other cases, recurrent parasomnia episodes induce psychopathology. Current research reveals complex interconnections between sleep and mental health. As such, it is important that clinicians consider the impact psychiatric disorders have on childhood parasomnias. This article describes common parasomnias and movement disorders in children and adolescents, with emphasis on psychologic and behavioral comorbidities.

  18. Movement Disorders Following Cerebrovascular Lesion in the Basal Ganglia Circuit.

    PubMed

    Park, Jinse

    2016-05-01

    Movement disorders are primarily associated with the basal ganglia and the thalamus; therefore, movement disorders are more frequently manifest after stroke compared with neurological injuries associated with other structures of the brain. Overall clinical features, such as types of movement disorder, the time of onset and prognosis, are similar with movement disorders after stroke in other structures. Dystonia and chorea are commonly occurring post-stroke movement disorders in basal ganglia circuit, and these disorders rarely present with tremor. Rarer movement disorders, including tic, restless leg syndrome, and blepharospasm, can also develop following a stroke. Although the precise mechanisms underlying the pathogenesis of these conditions have not been fully characterized, disruptions in the crosstalk between the inhibitory and excitatory circuits resulting from vascular insult are proposed to be the underlying cause. The GABA (gamma-aminobutyric acid)ergic and dopaminergic systems play key roles in post-stroke movement disorders. This review summarizes movement disorders induced by basal ganglia and thalamic stroke according to the anatomical regions in which they manifest.

  19. Movement Disorders Following Cerebrovascular Lesion in the Basal Ganglia Circuit

    PubMed Central

    Park, Jinse

    2016-01-01

    Movement disorders are primarily associated with the basal ganglia and the thalamus; therefore, movement disorders are more frequently manifest after stroke compared with neurological injuries associated with other structures of the brain. Overall clinical features, such as types of movement disorder, the time of onset and prognosis, are similar with movement disorders after stroke in other structures. Dystonia and chorea are commonly occurring post-stroke movement disorders in basal ganglia circuit, and these disorders rarely present with tremor. Rarer movement disorders, including tic, restless leg syndrome, and blepharospasm, can also develop following a stroke. Although the precise mechanisms underlying the pathogenesis of these conditions have not been fully characterized, disruptions in the crosstalk between the inhibitory and excitatory circuits resulting from vascular insult are proposed to be the underlying cause. The GABA (gamma-aminobutyric acid)ergic and dopaminergic systems play key roles in post-stroke movement disorders. This review summarizes movement disorders induced by basal ganglia and thalamic stroke according to the anatomical regions in which they manifest. PMID:27240808

  20. Chapter 33: the history of movement disorders.

    PubMed

    Lanska, Douglas J

    2010-01-01

    Role of basal ganglia: Vesalius and Piccolomini distinguished subcortical nuclei from cortex and white matter in the 16th century. Willis' mistaken concept in the late 17th century that the corpus striatum was the seat of motor power persisted for 200 years and formed the basis of mid-19th-century localizations of movement disorders to the striatum (chorea by Broadbent and Jackson, and athetosis by Hammond). By the late 19th century, many movement disorders were described but for most no pathologic correlate was known. Tremor: Descriptions of tremors progressed from Galen's definition in the 2nd century; to Galileo's physiologic tremor in 1610; separation of involuntary movements during action and at rest in the 17th and 18th centuries by de la Boë Sylvius and van Sweiten; description of Parkinson's disease by Parkinson, discrimination of the rest tremor of Parkinson's disease from the intention tremor of multiple sclerosis by Charcot, and recognition of familial action tremors by Dana and others in the late 19th century; and recognition of autosomal dominant essential tremor in the mid-20th century. Parkinsonism: Pathologic changes in Parkinson's disease were recognized in the substantia nigra by Blocq and Marinescu in the late 19th century, and around 1920 Trértiakoff established Lewy bodies in the substantia nigra as a pathologic hallmark while the Vogts instead emphasized pathologic changes in the striatum; it was only in the mid-1960s that a nigrostriatal dopaminergic pathway was demonstrated and found to be critical to pathogenesis. Early treatment approaches with anticholinergic medications or crude neurosurgical ablation procedures were eclipsed in the 1960s by the advent of L-DOPA therapy due to the work of Carlsson and colleagues, Birkmayer and Hornykiewicz, Barbeau, and Cotzias. Later progress in understanding and treating Parkinson's disease included recognition of neuroleptic-induced parkinsonism beginning in the 1950s, development of dopamine

  1. Application of next generation sequencing technology in Mendelian movement disorders.

    PubMed

    Wang, Yumin; Pan, Xuya; Xue, Dan; Li, Yuwei; Zhang, Xueying; Kuang, Biao; Zheng, Jiabo; Deng, Hao; Li, Xiaoling; Xiong, Wei; Zeng, Zhaoyang; Li, Guiyuan

    2016-02-01

    Next generation sequencing (NGS) has developed very rapidly in the last decade. Compared with Sanger sequencing, NGS has the advantages of high sensitivity and high throughput. Movement disorders are a common type of neurological disease. Although traditional linkage analysis has become a standard method to identify the pathogenic genes in diseases, it is getting difficult to find new pathogenic genes in rare Mendelian disorders, such as movement disorders, due to a lack of appropriate families with high penetrance or enough affected individuals. Thus, NGS is an ideal approach to identify the causal alleles for inherited disorders. NGS is used to identify genes in several diseases and new mutant sites in Mendelian movement disorders. This article reviewed the recent progress in NGS and the use of NGS in Mendelian movement disorders from genome sequencing and transcriptome sequencing. A perspective on how NGS could be employed in rare Mendelian disorders is also provided.

  2. Impairment in Movement Skills of Children with Autistic Spectrum Disorders

    ERIC Educational Resources Information Center

    Green, Dido; Charman, Tony; Pickles, Andrew; Chandler, Susie; Loucas, Tom; Simonoff, Emily; Baird, Gillian

    2009-01-01

    Aim: We undertook this study to explore the degree of impairment in movement skills in children with autistic spectrum disorders (ASD) and a wide IQ range. Method: Movement skills were measured using the Movement Assessment Battery for Children (M-ABC) in a large, well defined, population-derived group of children (n=101: 89 males,12 females; mean…

  3. Impairment in Movement Skills of Children with Autistic Spectrum Disorders

    ERIC Educational Resources Information Center

    Green, Dido; Charman, Tony; Pickles, Andrew; Chandler, Susie; Loucas, Tom; Simonoff, Emily; Baird, Gillian

    2009-01-01

    Aim: We undertook this study to explore the degree of impairment in movement skills in children with autistic spectrum disorders (ASD) and a wide IQ range. Method: Movement skills were measured using the Movement Assessment Battery for Children (M-ABC) in a large, well defined, population-derived group of children (n=101: 89 males,12 females; mean…

  4. Genital Autocleaning in the Male Cricket Gryllus bimaculatus (2): Rhythmic Movements of the Genitalia and Their Motor Control.

    PubMed

    Kumashiro, Mikihiko; Sakai, Masaki

    2016-12-01

    Three types of genital movement, their neural controls, and functional roles were investigated to gain a better understanding of the mechanism underlying autocleaning in the male cricket. The membrane complex consisting of the median pouch and genital chamber floor shows peculiar undulation that is composed of two types of movements: a right-left large shift and small crease-like movements. The large shift was caused by contraction of a pair of muscles (MPA) located anterior to the median pouch, while the crease-like movements were caused by numerous muscle fibers extending over the membrane complex. The MPA and muscle fibers were each innervated by efferent neurons in the terminal abdominal ganglion. Experiments with artificial dirt mimicking a foreign object revealed that the crease-like movements were responsible for dirt transport, while the large shift participated in sweeping the dirt into the lateral pouch as a trash container. On the other hand, the dorsal pouch serving as a template for the spermatophore showed a jerky bending movement. Simultaneous monitoring of the membrane complex and dorsal pouch activities suggested that their movements cooperate to enable the efficient evacuation of waste in the dorsal pouch. Based on the results, we conclude that genital autocleaning supports the production of the spermatophore.

  5. Substance of abuse and movement disorders: complex interactions and comorbidities.

    PubMed

    Deik, Andres; Saunders-Pullman, Rachel; Luciano, Marta San

    2012-09-01

    The relationship between movement disorders and substance abuse, which we previously reviewed, is updated. We examine these relationships bidirectionally with focus on drugs of abuse that are known to cause movement disorders, as well as primary movement disorders that are associated with use and abuse of alcohol and dopaminergic medications. First, we review the movement disorders that may develop from the acute use or withdrawal of frequent drugs of abuse, including alcohol, cocaine, heroin, amphetamine and methcathinone. We then comment on the interaction between alcoholism and alcohol-responsive movement disorders, such as essential tremor and myoclonus-dystonia. Lastly, we discuss the potential for abuse of antiparkinsonian dopaminergic agents in patients with Parkinson's disease (PD).

  6. Substances of abuse and movement disorders: complex interactions and comorbidities

    PubMed Central

    Deik, Andres; Saunders-Pullman, Rachel; Luciano, Marta San

    2014-01-01

    The relationship between movement disorders and substance abuse which we previously reviewed are updated. We examine these relationships bidirectionally with focus on drugs of abuse which cause movement disorders, as well as primary movement disorders that are associated with use and abuse of alcohol and dopaminergic medications. First, we review the movement disorders that may develop from the acute use or withdrawal of frequent drugs of abuse, including alcohol, cocaine, heroin, amphetamine and methcathinone. We then comment on the interaction between alcoholism and alcohol-responsive movement disorders, such as essential tremor and myoclonus-dystonia. Lastly, we discuss the potential for abuse of antiparkinsonian dopaminergic agents in patients with Parkinson’s disease (PD). PMID:23030352

  7. From psychogenic movement disorder to functional movement disorder: it's time to change the name.

    PubMed

    Edwards, Mark J; Stone, Jon; Lang, Anthony E

    2014-06-01

    Successive attempts at rebranding may be behind at least some of the proliferation of terms we have at our disposal when describing patients with what are now most often referred to as "psychogenic," "conversion," or "somatoform" symptoms. The most popular term in the movement disorder literature, "psychogenic," provides the aetiology of the disorder within the name, indicating that the symptoms are "born of the mind." Here we argue that it is logical to stop using a term that defines the disorder with regard to a poorly defined aetiology that is not supported by current evidence, and, instead, to use a broad term-functional-not as a "polite eponym" but as a term that is freer from such assumptions and does not reinforce dualistic thinking. The main argument for change is not political or even practical, but scientific.

  8. Delineation of the movement disorders associated with FOXG1 mutations

    PubMed Central

    Papandreou, Apostolos; Schneider, Ruth B.; Augustine, Erika F.; Ng, Joanne; Mankad, Kshitij; Meyer, Esther; McTague, Amy; Ngoh, Adeline; Hemingway, Cheryl; Robinson, Robert; Varadkar, Sophia M.; Kinali, Maria; Salpietro, Vincenzo; O'Driscoll, Margaret C.; Basheer, S. Nigel; Webster, Richard I.; Mohammad, Shekeeb S.; Pula, Shpresa; McGowan, Marian; Trump, Natalie; Jenkins, Lucy; Elmslie, Frances; Scott, Richard H.; Hurst, Jane A.; Perez-Duenas, Belen; Paciorkowski, Alexander R.

    2016-01-01

    Objective: The primary objective of this research was to characterize the movement disorders associated with FOXG1 mutations. Methods: We identified patients with FOXG1 mutations who were referred to either a tertiary movement disorder clinic or tertiary epilepsy service and retrospectively reviewed medical records, clinical investigations, neuroimaging, and available video footage. We administered a telephone-based questionnaire regarding the functional impact of the movement disorders and perceived efficacy of treatment to the caregivers of one cohort of participants. Results: We identified 28 patients with FOXG1 mutations, of whom 6 had previously unreported mutations. A wide variety of movement disorders were identified, with dystonia, choreoathetosis, and orolingual/facial dyskinesias most commonly present. Ninety-three percent of patients had a mixed movement disorder phenotype. In contrast to the phenotype classically described with FOXG1 mutations, 4 patients with missense mutations had a milder phenotype, with independent ambulation, spoken language, and normocephaly. Hyperkinetic involuntary movements were a major clinical feature in these patients. Of the symptomatic treatments targeted to control abnormal involuntary movements, most did not emerge as clearly beneficial, although 4 patients had a caregiver-reported response to levodopa. Conclusions: Abnormal involuntary movements are a major feature of FOXG1 mutations. Our study delineates the spectrum of movement disorders and confirms an expanding clinical phenotype. Symptomatic treatment may be considered for severe or disabling cases, although further research regarding potential treatment strategies is necessary. PMID:27029630

  9. Speech and voice disorders in patients with psychogenic movement disorders.

    PubMed

    Baizabal-Carvallo, José Fidel; Jankovic, Joseph

    2015-11-01

    Psychogenic speech and voice disorders (PSVDs) may occur in isolation but more typically are encountered in the setting of other psychogenic disorders. We aimed to characterize the phenomenology, frequency, and correlates of PSVDs in a cohort of patients with psychogenic movement disorders (PMDs). We studied 182 consecutive patients with PMDs, 30 of whom (16.5 %) also exhibited PSVD. Stuttering was the most common speech abnormality (n = 16, 53.3 %), followed by speech arrests (n = 4, 13.3 %), foreign accent syndrome (n = 2, 6.6 %), hypophonia (n = 2, 6.6 %), and dysphonia (n = 2, 6.6 %). Four patients (13.2 %) had more complex presentations with different combinations of these patterns. No differences in gender, age at onset, and distribution of PMDs were observed between patients with and without PSVD. PSVDs are relatively frequent in patients with PMDs and are manifested by a wide variety of abnormal speech and voice phenomena, with stuttering being the most common presentation. Speech therapy and insight-oriented counseling may be helpful to some patients.

  10. A prospective study of acute movement disorders in children.

    PubMed

    Dale, Russell C; Singh, Harry; Troedson, Christopher; Pillai, Sekhar; Gaikiwari, Shilpa; Kozlowska, Kasia

    2010-08-01

    The purpose of this study was to report a prospective cohort of children with acute-onset movement disorders. We report on 52 individuals (31 females, 21 males; mean age 6y 5mo, range 2mo-15y) with acute-onset movement disorders managed at a busy tertiary paediatric referral hospital over a 40-month period. In descending order of frequency, the movement disorders reported were chorea, dystonia, tremor, myoclonus, and parkinsonism. It was possible to divide the participants into three groups: (1) those with inflammatory or autoimmune disorders (n=22), (2) those with non-inflammatory disorders (n=18), and (3) those with psychogenic disorders (n=12). The inflammatory or autoimmune aetiologies included N-methyl-D-aspartate receptor encephalitis (n=5), opsoclonus-myoclonus syndrome (n=4), Sydenham chorea (n=3), systemic lupus erythematosus (n=3), acute necrotizing encephalopathy (n=3), and other types of encephalitis (n=4). Other important non-inflammatory movement disorder aetiologies included drug-induced movement disorder (n=6), post-pump chorea (n=5), metabolic (n=3) and vascular (n=2) disease. The participants with psychogenic movement disorders (n=12) were all over 10 years of age and were more likely to be female. Tremor and myoclonus were significantly over-represented in the psychogenic movement disorder subgroup. The outcomes of the total cohort were variable, and included full recovery, severe morbidity, and death. Acute-onset movement disorders in children are important and may be treatable. Management should focus upon identifying the cause and treating the underlying disease process, as symptomatic treatment of the abnormal movements is variably effective.

  11. Deep brain stimulation for movement disorders.

    PubMed

    Larson, Paul S

    2014-07-01

    Deep brain stimulation (DBS) is an implanted electrical device that modulates specific targets in the brain resulting in symptomatic improvement in a particular neurologic disease, most commonly a movement disorder. It is preferred over previously used lesioning procedures due to its reversibility, adjustability, and ability to be used bilaterally with a good safety profile. Risks of DBS include intracranial bleeding, infection, malposition, and hardware issues, such migration, disconnection, or malfunction, but the risk of each of these complications is low--generally ≤ 5% at experienced, large-volume centers. It has been used widely in essential tremor, Parkinson's disease, and dystonia when medical treatment becomes ineffective, intolerable owing to side effects, or causes motor complications. Brain targets implanted include the thalamus (most commonly for essential tremor), subthalamic nucleus (most commonly for Parkinson's disease), and globus pallidus (Parkinson's disease and dystonia), although new targets are currently being explored. Future developments include brain electrodes that can steer current directionally and systems capable of "closed loop" stimulation, with systems that can record and interpret regional brain activity and modify stimulation parameters in a clinically meaningful way. New, image-guided implantation techniques may have advantages over traditional DBS surgery.

  12. Controlled Rhythmic Yogic Breathing as Complementary Treatment for Post-Traumatic Stress Disorder in Military Veterans: A Case Series

    PubMed Central

    Pacik, Deborah

    2017-01-01

    Abstract Background: Post-traumatic stress disorder (PTSD) is a cluster of symptoms in which a person persistently relives a traumatic event, through recurring thoughts, nightmares, and flashbacks for at least 1 month or more. There are various behavioral and medical treatment options for PTSD. Mind–body techniques, such as biofeedback and breathing-based stress reduction, have shown some promise in the treatment of PTSD symptoms. The purpose of this case series was to examine controlled yogic breathing as a complementary treatment of PTSD in military veterans. A retrospective review was performed from 2012 to 2016 in 3 cases, and participant demographics, member statements, and PTSD Checklist—Military Version (PCL-M) scores, pre-and-post course, were extracted. Cases: Three military veterans with PTSD participated in a standardized 5-day course designed to teach them controlled rhythmic yogic breathing exercises. Results: Subjectively, all 3 participants reported a decrease in PTSD symptoms after the course. Objectively, all 3 participants had a reduction in their overall PCL-M scores after the course. Among all 3 participants, there were score decreases in the Avoidance and Increased Arousal categories. The most dramatic improvement occurred in the participant with the most severe symptoms. Conclusions: Controlled yogic breathing, specifically Sudarshan Kriya (SKY), appeared to reduce the symptoms of PTSD in 3 veterans of the Armed Services. PMID:28874925

  13. Altered Intermittent Rhythmic Delta and Theta Activity in the Electroencephalographies of High Functioning Adult Patients with Autism Spectrum Disorder

    PubMed Central

    Endres, Dominique; Maier, Simon; Feige, Bernd; Posielski, Nicole A.; Nickel, Kathrin; Ebert, Dieter; Riedel, Andreas; Philipsen, Alexandra; Perlov, Evgeniy; Tebartz van Elst, Ludger

    2017-01-01

    Background: Autism spectrum disorder (ASD) is often associated with epilepsy. Previous studies have also shown increased rates of electroencephalographic (EEG) alteration in ASD patients without epilepsy. The aim of this study was to compare the rate of intermittent rhythmic delta and theta activity (IRDA/IRTA) events between high-functioning adult patients with ASD and matched healthy controls. Materials and Methods: Routine EEG records of 19 ASD patients and 19 matched controls were screened for IRDA/IRTA using a fully data driven analysis with fixed thresholds. IRDA/IRTA rates before and after hyperventilation (HV) as well as the HV-induced difference in IRDA/IRTA rates (HV difference) were analyzed. For inter-group measures, we used the Wilcoxon rank sum test. Results: Significantly increased HV difference was detected in the ASD group (p = 0.0497). However, the groups showed no difference in IRDA/IRTA rates before HV (p = 0.564) and after HV (p = 0.163). Conclusions: The lack of any group differences regarding IRDA/IRTA before HV might be related to the fact that we only studied non-secondary high-functioning autism in a small sample of epilepsy-free adult patients. A significantly increased HV difference might be regarded as a marker of subtle neuronal network instability possibly causing short-term disturbances via local area network inhibition and long-term effects via epileptic encephalopathy. PMID:28265243

  14. Use of Antiepileptic Drugs for Hyperkinetic Movement Disorders

    PubMed Central

    Siniscalchi, A; Gallelli, L; De Sarro, G

    2010-01-01

    Many studies investigated the use of antiepileptic drugs (AEDs) in several neurological diseases other than epilepsy. These neurological disorders, usually, involve neuronal excitability through the modulating of ion channels, receptors and intracellular signaling pathways, and are the targets of the AEDs. This article provides a review of the clinical efficacy of both conventional and newer AEDs in hyperkinetic movement disorders. Some of these indications for AEDs have been established, while others are under investigation. The modulation of GABAergic transmission may explain the neuronal hyper-excitability that underlies some forms of hyperkinetic movement disorders. So, AEDs able to increase GABAergic neurotransmission may play a role in hyperkinetic movement disorders treatment. Therefore, AEDs could represent a useful therapeutic option in the management of hyperkinetic movement disorders where the available treatments are ineffective. PMID:21629443

  15. Movement Disorders: A Brief Guide in Medication Management.

    PubMed

    Julius, Anthony; Longfellow, Katelan

    2016-07-01

    Movement disorders can be challenging to manage and often use a specific set of medications. Because it is a complex and broad field within neurology, many providers are unfamiliar with the classes of medications. This paper details medications used for specific conditions, explains why these medications are helpful, and shares pearls and pitfalls related to each agent, focusing on parameters such as dose titration, side effect profiles, and specific drug-drug interactions and challenges. We focus on the most commonly encountered movement disorders, including essential tremor, Parkinson's disease, rapid eye movement sleep behavior disorder, and restless leg syndrome.

  16. A novel movement disorder of the lower lip.

    PubMed

    Kleopa, Kleopas A; Kyriakides, Theodoros

    2004-06-01

    Four patients, aged 25 to 42 years presented with acute onset of a movement disorder characterized by a tonic, sustained, lateral and outward protrusion of one half of the lower lip. The movement disorder was present at rest, while in some patients, it was also present during speech. In all cases, the abnormal lip posture could be suppressed voluntarily. Neurological examination was otherwise normal. Extensive laboratory investigation failed to reveal any causative factors for secondary focal dystonia. Treatment with oral medications and botulinum toxin was mostly ineffective. Spontaneous remissions were frequent. Copyright 2003 Movement Disorder Society

  17. Psychogenic movement disorders: frequency, clinical profile, and characteristics.

    PubMed Central

    Factor, S A; Podskalny, G D; Molho, E S

    1995-01-01

    Of 842 consecutive patients with movement disorders seen over a 71 month period, 28 (3.3%) were diagnosed as having a documented or clinically established psychogenic movement disorder. Tremor was most common (50%) followed by dystonia, myoclonus, and parkinsonism. Clinical descriptions of various types are reviewed. Clinical characteristics common in these patients included distractability (86%), abrupt onset (54%), and selective disabilities (39%). Distractability seems to be most important in tremor and least important in dystonia. Other diagnostic clues included entrainment of tremor to the frequency of repetitive movements of another limb, fatigue of tremor, stimulus sensitivity, and previous history of psychogenic illness. On examination, 71% had other psychogenic features. Over 60% had a clear history of a precipitating event and secondary gain and 50% had a psychiatric diagnosis (usually depression). Twenty five per cent of patients presented with combined psychogenic movement disorder and organic movement disorder; 35% resolved and this subgroup had a shorter duration of disease than those who are unresolved. Psychogenic movement disorder represents an uncommon diagnosis among patients with movement disorders. The ability to make a diagnosis rests on the presence of a multitude of clinical clues and therapeutic action should be taken as early as possible. PMID:7561921

  18. Trichotillomania (hair pulling disorder), skin picking disorder, and stereotypic movement disorder: toward DSM-V.

    PubMed

    Stein, Dan J; Grant, Jon E; Franklin, Martin E; Keuthen, Nancy; Lochner, Christine; Singer, Harvey S; Woods, Douglas W

    2010-06-01

    In DSM-IV-TR, trichotillomania (TTM) is classified as an impulse control disorder (not classified elsewhere), skin picking lacks its own diagnostic category (but might be diagnosed as an impulse control disorder not otherwise specified), and stereotypic movement disorder is classified as a disorder usually first diagnosed in infancy, childhood, or adolescence. ICD-10 classifies TTM as a habit and impulse disorder, and includes stereotyped movement disorders in a section on other behavioral and emotional disorders with onset usually occurring in childhood and adolescence. This article provides a focused review of nosological issues relevant to DSM-V, given recent empirical findings. This review presents a number of options and preliminary recommendations to be considered for DSM-V: (1) Although TTM fits optimally into a category of body-focused repetitive behavioral disorders, in a nosology comprised of relatively few major categories it fits best within a category of motoric obsessive-compulsive spectrum disorders, (2) available evidence does not support continuing to include (current) diagnostic criteria B and C for TTM in DSM-V, (3) the text for TTM should be updated to describe subtypes and forms of hair pulling, (4) there are persuasive reasons for referring to TTM as "hair pulling disorder (trichotillomania)," (5) diagnostic criteria for skin picking disorder should be included in DSM-V or in DSM-Vs Appendix of Criteria Sets Provided for Further Study, and (6) the diagnostic criteria for stereotypic movement disorder should be clarified and simplified, bringing them in line with those for hair pulling and skin picking disorder. (c) 2010 Wiley-Liss, Inc.

  19. Acute movement disorders in children: experience from a developing country.

    PubMed

    Goraya, Jatinder Singh

    2015-03-01

    We describe acute movement disorders in 92 children, aged 5 days to 15 years, from an Indian tertiary hospital. Eighty-nine children had hyperkinetic movement disorders, with myoclonus in 25, dystonia in 21, choreoathetosis in 19, tremors in 15, and tics in 2. Tetany and tetanus were seen in 5 and 2 children, respectively. Hypokinetic movement disorders included acute parkinsonism in 3 children. Noninflammatory and inflammatory etiology were present in 60 and 32 children, respectively. Benign neonatal sleep myoclonus in 16 and opsoclonus myoclonus syndrome in 7 accounted for the majority of myoclonus cases. Vitamin B12 deficiency in 13 infants was the most common cause of tremors. Rheumatic fever and encephalitis were the most common causes of acute choreoathetosis. Acute dystonia had metabolic etiology in 6 and encephalitis and drugs in 3 each. Psychogenic movement disorders were seen in 4 cases only, although these patients may be underreported.

  20. Charles Dickens: the man, medicine, and movement disorders.

    PubMed

    Schoffer, Kerrie L; O'Sullivan, John D

    2006-11-01

    Nineteenth-century Victorian novelists played an important role in developing our understanding of medicine and illness. With the eye of an expert clinician, Charles Dickens provided several detailed accounts of movement disorders in his literary works, many of which predated medical descriptions. His gift for eloquence, imagery, and precision attest not only to the importance of careful clinical observation, but also provide an insightful and entertaining perspective on movement disorders for modern students of neuroscience.

  1. Movement Disorders Induced by the "Atypical" Antipsychotic Aripiprazole.

    PubMed

    Selfani, Karim; Soland, Valérie L; Chouinard, Sylvain; Huot, Philippe

    2017-01-01

    Aripiprazole is an antipsychotic that acts as a partial agonist at dopamine D2 receptors. Because of its partial agonist activity, it was believed that aripiprazole would be less susceptible than typical antipsychotics to induce extrapyramidal side effects. However, a few case-reports and case-series detailing aripiprazole-induced movement disorders have been published, suggesting that aripiprazole-induced movement disorders may arise. Here, we seek to report further cases of aripiprazole-induced movement disorders to raise the awareness of clinicians on this adverse effect. Patients referred to the André-Barbeau Movement Disorder clinic treated with aripiprazole were enrolled in this study. Their charts were retrospectively reviewed and data regarding past psychiatric history, past antipsychotic medication, duration of aripiprazole treatment, daily dose of aripiprazole administered, and resulting movement disorders were collected. We report 14 cases of parkinsonism, tardive dyskinesia and akathisia induced by aripiprazole. Some of these, mostly the parkinsonian phenotype, abated spontaneously following drug discontinuation, whereas others, mostly related to tardive phenomena, persisted after aripiprazole was discontinued, and required treatment. This case-series adds to the existing literature that suggests that movement disorders may arise following treatment with aripiprazole. Clinicians should be aware of this potential side effect when prescribing aripiprazole to patients.

  2. Cell walls as reservoirs of potassium ions for reversible volume changes of pulvinar motor cells during rhythmic leaf movements.

    PubMed

    Freudling, C; Starrach, N; Flach, D; Gradmann, D; Mayer, W E

    1988-08-01

    The laminar pulvinus of primary leaves of Phaseolus coccineus L. was investigated with respect to the total K(+) content, the apoplastic K(+) content, and the water potential of extensor and flexor sections in relation to the leaf positions in a circadian leaf-movement cycle, as well as the cation-exchange properties of isolated extensor- and flexor-cell walls. Turgid tissue showed a high total but low apoplastic K(+) content, shrunken tissue a low total but high apoplastic K(+) content. Thus, part of the K(+) transported into and out of the swelling or shrinking protoplasts is shuttled between the protoplasts and the surrounding walls, another part between different regions of the pulvinus. The K(+) fraction shuttled between protoplasts and walls was found to be 30-40% of the total transported K(+) fraction. Furthermore, 15-20% of the total K(+) content of the tissue is located in the apoplast when the apoplastic reservoir is filled, 5-10% when the apoplastic reservoir is depleted. The ion-exchange properties of walls of extensor and flexor cells appear identical in situ and in isolated preparations. The walls behave as cation exchangers of hhe weak-acid type with a strong dependence of the activity of fixed negative charges as well as of the K(+)-storing capacity on pH and [K(+)] of the equilibration solution. The high apoplastic K(+) contents of freshly cut tissues reflect the cation-storing capacity of the isolated walls. We suggest that K(+) ions of the Donnan free space are used for the reversible volume changes (mediating the leaf movement) mainly by an electrogenic proton pump which changes the pH and-or the [K(+)] in the water free space of the apoplast.

  3. Movement disorders: why don't those synapses fire?

    PubMed

    Zemlak, V; Woldehana, A

    1992-12-01

    From mobility to disability; this is the plight of the patient with a movement disorder. Alterations in motor functioning may include gait, balance, coordination and tone as well as voluntary and involuntary movements. These changes need to be observed, assessed and monitored, then correlated with the neuropathology and neurochemistry. The nurse, by doing this, provides the physician with the crucial information for successful medical management. This presentation will identify the pathology and required nursing assessment for the more prevalent movement disorders and provide an overview of pharmaceutical management.

  4. Psychogenic Facial Movement Disorders: Clinical Features and Associated Conditions

    PubMed Central

    Fasano, Alfonso; Valadas, Anabela; Bhatia, Kailash P; Prashanth, LK; Lang, Anthony E; Munhoz, Renato P; Morgante, Francesca; Tarsy, Daniel; Duker, Andrew P; Girlanda, Paolo; Bentivoglio, Anna Rita; Espay, Alberto J

    2012-01-01

    The facial phenotype of psychogenic movement disorders has not been fully characterized. Seven tertiary-referral movement disorders centers using a standardized data collection on a computerized database performed a retrospective chart review of psychogenic movement disorders involving the face. Patients with organic forms of facial dystonia or any medical or neurological disorder known to affect facial muscles were excluded. Sixty-one patients fulfilled the inclusion criteria for psychogenic facial movement disorders (91.8% females; age: 37.0 ± 11.3 years). Phasic or tonic muscular spasms resembling dystonia were documented in all patients most commonly involving the lips (60.7%), followed by eyelids (50.8%), perinasal region (16.4%), and forehead (9.8%). The most common pattern consisted of tonic, sustained, lateral, and/or downward protrusion of one side of the lower lip with ipsilateral jaw deviation (84.3%). Ipsi- or contralateral blepharospasm and excessive platysma contraction occurred in isolation or combined with fixed lip dystonia (60.7%). Spasms were reported as painful in 24.6% of cases. Symptom onset was abrupt in most cases (80.3%), with at least 1 precipitating psychological stress or trauma identified in 57.4%. Associated body regions involved included upper limbs (29.5%), neck (16.4%), lower limbs (16.4%), and trunk (4.9%). There were fluctuations in severity and spontaneous exacerbations and remissions (60%). Prevalent comorbidities included depression (38.0%) and tension headache (26.4%). Fixed jaw and/or lip deviation is a characteristic pattern of psychogenic facial movement disorders, occurring in isolation or in combination with other psychogenic movement disorders or other psychogenic features. © 2012 Movement Disorder Society PMID:23033125

  5. Rhythmic engagement with music in infancy

    PubMed Central

    Zentner, Marcel; Eerola, Tuomas

    2010-01-01

    Humans have a unique ability to coordinate their motor movements to an external auditory stimulus, as in music-induced foot tapping or dancing. This behavior currently engages the attention of scholars across a number of disciplines. However, very little is known about its earliest manifestations. The aim of the current research was to examine whether preverbal infants engage in rhythmic behavior to music. To this end, we carried out two experiments in which we tested 120 infants (aged 5–24 months). Infants were exposed to various excerpts of musical and rhythmic stimuli, including isochronous drumbeats. Control stimuli consisted of adult- and infant-directed speech. Infants’ rhythmic movements were assessed by multiple methods involving manual coding from video excerpts and innovative 3D motion-capture technology. The results show that (i) infants engage in significantly more rhythmic movement to music and other rhythmically regular sounds than to speech; (ii) infants exhibit tempo flexibility to some extent (e.g., faster auditory tempo is associated with faster movement tempo); and (iii) the degree of rhythmic coordination with music is positively related to displays of positive affect. The findings are suggestive of a predisposition for rhythmic movement in response to music and other metrically regular sounds. PMID:20231438

  6. Rhythmic engagement with music in infancy.

    PubMed

    Zentner, Marcel; Eerola, Tuomas

    2010-03-30

    Humans have a unique ability to coordinate their motor movements to an external auditory stimulus, as in music-induced foot tapping or dancing. This behavior currently engages the attention of scholars across a number of disciplines. However, very little is known about its earliest manifestations. The aim of the current research was to examine whether preverbal infants engage in rhythmic behavior to music. To this end, we carried out two experiments in which we tested 120 infants (aged 5-24 months). Infants were exposed to various excerpts of musical and rhythmic stimuli, including isochronous drumbeats. Control stimuli consisted of adult- and infant-directed speech. Infants' rhythmic movements were assessed by multiple methods involving manual coding from video excerpts and innovative 3D motion-capture technology. The results show that (i) infants engage in significantly more rhythmic movement to music and other rhythmically regular sounds than to speech; (ii) infants exhibit tempo flexibility to some extent (e.g., faster auditory tempo is associated with faster movement tempo); and (iii) the degree of rhythmic coordination with music is positively related to displays of positive affect. The findings are suggestive of a predisposition for rhythmic movement in response to music and other metrically regular sounds.

  7. Hypnosis and movement disorders: State of the art and perspectives.

    PubMed

    Flamand-Roze, C; Célestin-Lhopiteau, I; Roze, E

    Hypnosis might represent an interesting complementary therapeutic approach to movement disorders, as it takes into account not only symptoms, but also well-being, and empowers patients to take a more active role in their treatment. Our review of the literature on the use of hypnosis to treat movement disorders was done by systematically searching the PubMed database for reports published between 1984 and November 2015. The following variables were extracted from each selected paper: study design; sample size; type of movement disorder; hypnotic procedure; treatment duration; and efficacy. Thirteen papers were selected for detailed analysis. Most concerned tremor in Parkinson's disease and tics in Gilles de la Tourette syndrome. Although promising, the data were insufficient to allow conclusions to be drawn on the efficacy of hypnosis in movement disorders or to recommend its use in this setting. Well-designed studies taking into account some specific methodological challenges are needed to determine the possible therapeutic utility of hypnosis in movement disorders. In addition to the potential benefits for such patients, hypnosis might also be useful for studying the neuroanatomical and functional underpinnings of normal and abnormal movements. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. Kinematic and electromyographic tools for characterizing movement disorders in mice.

    PubMed

    Scholle, Hans C; Jinnah, H A; Arnold, Dirk; Biedermann, Frank H W; Faenger, Bernd; Grassme, Roland; Hess, Ellen J; Schumann, Nikolaus P

    2010-02-15

    Increasing interest in rodent models for movement disorders has led to an increasing need for more accurate and precise methods for both delineating the nature of abnormal movements and measuring their severity. These studies describe application of simultaneous high-speed video kinematics with multichannel electromyography (EMG) to characterize the movement disorder exhibited by tottering mutant mice. These mice provide a uniquely valuable model, because they exhibit paroxysmal dystonia superimposed on mild baseline ataxia, permitting the examination of these two different problems within the same animals. At baseline with mild ataxia, the mutants exhibited poorly coordinated movements with increased variation of stance and swing times, and slower spontaneous walking velocities. The corresponding EMG showed reduced mean amplitudes of biceps femoris and vastus lateralis, and poorly modulated EMG activities during the step cycle. Attacks of paroxysmal dystonia were preceded by trains of EMG bursts with doublets and triplets simultaneously in the biceps femoris and vastus lateralis followed by more sustained coactivation. These EMG characteristics are consistent with the clinical phenomenology of the motor phenotype of tottering mice as a baseline of mild ataxia with intermittent attacks of paroxysmal dystonia. The EMG characteristics of ataxia and dystonia in the tottering mice also are consistent with EMG studies of other ataxic or dystonic animals and humans. These studies provide insights into how these methods can be used for delineating movement disorders in mice and for how they may be compared with similar disorders of humans. (c) 2010 Movement Disorder Society.

  9. Impairment in movement skills of children with autistic spectrum disorders.

    PubMed

    Green, Dido; Charman, Tony; Pickles, Andrew; Chandler, Susie; Loucas, Tom; Simonoff, Emily; Baird, Gillian

    2009-04-01

    We undertook this study to explore the degree of impairment in movement skills in children with autistic spectrum disorders (ASD) and a wide IQ range. Movement skills were measured using the Movement Assessment Battery for Children (M-ABC) in a large, well defined, population-derived group of children (n=101: 89 males,12 females; mean age 11y 4mo, SD 10mo; range 10y-14y 3mo) with childhood autism and broader ASD and a wide range of IQ scores. Additionally, we tested whether a parent-completed questionnaire, the Developmental Coordination Disorder Questionnaire (DCDQ), was useful in identifying children who met criteria for movement impairments after assessment (n=97 with complete M-ABCs and DCDQs). Of the children with ASD, 79% had definite movement impairments on the M-ABC; a further 10% had borderline problems. Children with childhood autism were more impaired than children with broader ASD, and children with an IQ less than 70 were more impaired than those with IQ more than 70. This is consistent with the view that movement impairments may arise from a more severe neurological impairment that also contributes to intellectual disability and more severe autism. Movement impairment was not associated with everyday adaptive behaviour once the effect of IQ was controlled for. The DCDQ performed moderately well as a screen for possible motor difficulties. Movement impairments are common in children with ASD. Systematic assessment of movement abilities should be considered a routine investigation.

  10. Eye Movement Indices in the Study of Depressive Disorder.

    PubMed

    Li, Yu; Xu, Yangyang; Xia, Mengqing; Zhang, Tianhong; Wang, Junjie; Liu, Xu; He, Yongguang; Wang, Jijun

    2016-12-25

    Impaired cognition is one of the most common core symptoms of depressive disorder. Eye movement testing mainly reflects patients' cognitive functions, such as cognition, memory, attention, recognition, and recall. This type of testing has great potential to improve theories related to cognitive functioning in depressive episodes as well as potential in its clinical application. This study investigated whether eye movement indices of patients with unmedicated depressive disorder were abnormal or not, as well as the relationship between these indices and mental symptoms. Sixty patients with depressive disorder and sixty healthy controls (who were matched by gender, age and years of education) were recruited, and completed eye movement tests including three tasks: fixation task, saccade task and free-view task. The EyeLink desktop eye tracking system was employed to collect eye movement information, and analyze the eye movement indices of the three tasks between the two groups. (1) In the fixation task, compared to healthy controls, patients with depressive disorder showed more fixations, shorter fixation durations, more saccades and longer saccadic lengths; (2) In the saccade task, patients with depressive disorder showed longer anti-saccade latencies and smaller anti-saccade peak velocities; (3) In the free-view task, patients with depressive disorder showed fewer saccades and longer mean fixation durations; (4) Correlation analysis showed that there was a negative correlation between the pro-saccade amplitude and anxiety symptoms, and a positive correlation between the anti-saccade latency and anxiety symptoms. The depression symptoms were negatively correlated with fixation times, saccades, and saccadic paths respectively in the free-view task; while the mean fixation duration and depression symptoms showed a positive correlation. Compared to healthy controls, patients with depressive disorder showed significantly abnormal eye movement indices. In addition

  11. Eye Movement Indices in the Study of Depressive Disorder

    PubMed Central

    LI, Yu; XU, Yangyang; XIA, Mengqing; ZHANG, Tianhong; WANG, Junjie; LIU, Xu; HE, Yongguang; WANG, Jijun

    2016-01-01

    Background Impaired cognition is one of the most common core symptoms of depressive disorder. Eye movement testing mainly reflects patients’ cognitive functions, such as cognition, memory, attention, recognition, and recall. This type of testing has great potential to improve theories related to cognitive functioning in depressive episodes as well as potential in its clinical application. Aims This study investigated whether eye movement indices of patients with unmedicated depressive disorder were abnormal or not, as well as the relationship between these indices and mental symptoms. Methods Sixty patients with depressive disorder and sixty healthy controls (who were matched by gender, age and years of education) were recruited, and completed eye movement tests including three tasks: fixation task, saccade task and free-view task. The EyeLink desktop eye tracking system was employed to collect eye movement information, and analyze the eye movement indices of the three tasks between the two groups. Results (1) In the fixation task, compared to healthy controls, patients with depressive disorder showed more fixations, shorter fixation durations, more saccades and longer saccadic lengths; (2) In the saccade task, patients with depressive disorder showed longer anti-saccade latencies and smaller anti-saccade peak velocities; (3) In the free-view task, patients with depressive disorder showed fewer saccades and longer mean fixation durations; (4) Correlation analysis showed that there was a negative correlation between the pro-saccade amplitude and anxiety symptoms, and a positive correlation between the anti-saccade latency and anxiety symptoms. The depression symptoms were negatively correlated with fixation times, saccades, and saccadic paths respectively in the free-view task; while the mean fixation duration and depression symptoms showed a positive correlation. Conclusion Compared to healthy controls, patients with depressive disorder showed significantly

  12. Movement Interference in Autism-Spectrum Disorder

    ERIC Educational Resources Information Center

    Gowen, E.; Stanley, J.; Miall, R. C.

    2008-01-01

    Movement interference occurs when concurrently observing and executing incompatible actions and is believed to be due to co-activation of conflicting populations of mirror neurons. It has also been suggested that mirror neurons contribute towards the imitation of observed actions. However, the exact neural substrate of imitation may depend on task…

  13. Neurobiological foundations of neurologic music therapy: rhythmic entrainment and the motor system

    PubMed Central

    Thaut, Michael H.; McIntosh, Gerald C.; Hoemberg, Volker

    2015-01-01

    Entrainment is defined by a temporal locking process in which one system’s motion or signal frequency entrains the frequency of another system. This process is a universal phenomenon that can be observed in physical (e.g., pendulum clocks) and biological systems (e.g., fire flies). However, entrainment can also be observed between human sensory and motor systems. The function of rhythmic entrainment in rehabilitative training and learning was established for the first time by Thaut and colleagues in several research studies in the early 1990s. It was shown that the inherent periodicity of auditory rhythmic patterns could entrain movement patterns in patients with movement disorders (see for a review: Thaut et al., 1999). Physiological, kinematic, and behavioral movement analysis showed very quickly that entrainment cues not only changed the timing of movement but also improved spatial and force parameters. Mathematical models have shown that anticipatory rhythmic templates as critical time constraints can result in the complete specification of the dynamics of a movement over the entire movement cycle, thereby optimizing motor planning and execution. Furthermore, temporal rhythmic entrainment has been successfully extended into applications in cognitive rehabilitation and speech and language rehabilitation, and thus become one of the major neurological mechanisms linking music and rhythm to brain rehabilitation. These findings provided a scientific basis for the development of neurologic music therapy. PMID:25774137

  14. Acute and subacute drug-induced movement disorders.

    PubMed

    Burkhard, Pierre R

    2014-01-01

    Many pharmacological agents may induce a variety of movement disorders, including dystonia, tremor, parkinsonism, myoclonus and dyskinesia, with an acute, subacute or more chronic time course. Motor symptoms may be isolated or part of a more extensive cerebral or systemic condition, such as the neuroleptic malignant syndrome or the serotonin syndrome. Drug-induced movement disorders share a number of features that should make them easy to identify, including a clear temporal relationship between medication initiation and symptom onset, a dose-effect, and, with the exception of tardive syndromes, complete resolution after discontinuation of the offending agent. Diagnosis relies on a thorough medication history. Medications commonly involved include dopamine receptor blockers, antidepressants and anti-epileptics, among many others. Mechanisms underlying drug-induced movement disorders involve blockade, facilitation or imbalance of dopamine, serotonin, noradrenaline and cholinergic neurotransmission in the basal ganglia. The present review focuses on drug-induced movement disorders that typically develop as an acute (hours to days) or subacute (days to weeks) event, including acute dystonic reactions, akathisia, drug-induced parkinsonism, neuroleptic malignant syndrome, serotonin syndrome, parkinsonism-hyperpyrexia syndrome, drug-induced tremor, drug-induced hyperkinesias and movement disorders associated with the use of recreational drugs.

  15. What Have We Learned About Movement Disorders from Functional Neurosurgery?

    PubMed

    Lozano, Andres M; Hutchison, William D; Kalia, Suneil K

    2017-07-25

    Modern functional neurosurgery for movement disorders such as Parkinson's disease, tremor, and dystonia involves the placement of focal lesions or the application of deep brain stimulation (DBS) within circuits that modulate motor function. Precise targeting of these motor structures can be further refined by the use of electrophysiological approaches. In particular, microelectrode recordings enable the delineation of neuroanatomic structures. In the course of these operations, there is an opportunity not only to map basal ganglia structures but also to gain insights into how disturbances in neural activity produce movement disorders. In this review, we aim to highlight what the field has uncovered thus far about movement disorders through DBS. The work to date lays the foundation for future studies that will shed further light on dysfunctional circuits mediating diseases of the nervous system and how we might modulate these circuits therapeutically.

  16. Post-stroke movement disorders: report of 56 patients

    PubMed Central

    Alarcon, F; Zijlmans, J; Duenas, G; Cevallos, N

    2004-01-01

    Background: Although movement disorders that occur following a stroke have long been recognised in short series of patients, their frequency and clinical and imaging features have not been reported in large series of patients with stroke. Methods: We reviewed consecutive patients with involuntary abnormal movements (IAMs) following a stroke who were included in the Eugenio Espejo Hospital Stroke Registry and they were followed up for at least one year after the onset of the IAM. We determined the clinical features, topographical correlations, and pathophysiological implications of the IAMs. Results: Of 1500 patients with stroke 56 developed movement disorders up to one year after the stroke. Patients with chorea were older and the patients with dystonia were younger than the patients with other IAMs. In patients with isolated vascular lesions without IAMs, surface lesions prevailed but patients with deep vascular lesions showed a higher probability of developing abnormal movements. One year after onset of the IAMs, 12 patients (21.4%) completely improved their abnormal movements, 38 patients (67.8%) partially improved, four did not improve (7.1%), and two patients with chorea died. In the nested case–control analysis, the patients with IAMs displayed a higher frequency of deep lesions (63% v 33%; OR 3.38, 95% CI 1.64 to 6.99, p<0.001). Patients with deep haemorrhagic lesions showed a higher probability of developing IAMs (OR 4.8, 95% CI 0.8 to 36.6). Conclusions: Chorea is the commonest movement disorder following stroke and appears in older patients. Involuntary movements tend to persist despite the functional recovery of motor deficit. Deep vascular lesions are more frequent in patients with movement disorders. PMID:15489389

  17. Nonspeech Oral Movements and Oral Motor Disorders: A Narrative Review

    PubMed Central

    2015-01-01

    Purpose Speech and other oral functions such as swallowing have been compared and contrasted with oral behaviors variously labeled quasispeech, paraspeech, speechlike, and nonspeech, all of which overlap to some degree in neural control, muscles deployed, and movements performed. Efforts to understand the relationships among these behaviors are hindered by the lack of explicit and widely accepted definitions. This review article offers definitions and taxonomies for nonspeech oral movements and for diverse speaking tasks, both overt and covert. Method Review of the literature included searches of Medline, Google Scholar, HighWire Press, and various online sources. Search terms pertained to speech, quasispeech, paraspeech, speechlike, and nonspeech oral movements. Searches also were carried out for associated terms in oral biology, craniofacial physiology, and motor control. Results and Conclusions Nonspeech movements have a broad spectrum of clinical applications, including developmental speech and language disorders, motor speech disorders, feeding and swallowing difficulties, obstructive sleep apnea syndrome, trismus, and tardive stereotypies. The role and benefit of nonspeech oral movements are controversial in many oral motor disorders. It is argued that the clinical value of these movements can be elucidated through careful definitions and task descriptions such as those proposed in this review article. PMID:26126128

  18. Nonspeech Oral Movements and Oral Motor Disorders: A Narrative Review.

    PubMed

    Kent, Ray D

    2015-11-01

    Speech and other oral functions such as swallowing have been compared and contrasted with oral behaviors variously labeled quasispeech, paraspeech, speechlike, and nonspeech, all of which overlap to some degree in neural control, muscles deployed, and movements performed. Efforts to understand the relationships among these behaviors are hindered by the lack of explicit and widely accepted definitions. This review article offers definitions and taxonomies for nonspeech oral movements and for diverse speaking tasks, both overt and covert. Review of the literature included searches of Medline, Google Scholar, HighWire Press, and various online sources. Search terms pertained to speech, quasispeech, paraspeech, speechlike, and nonspeech oral movements. Searches also were carried out for associated terms in oral biology, craniofacial physiology, and motor control. Nonspeech movements have a broad spectrum of clinical applications, including developmental speech and language disorders, motor speech disorders, feeding and swallowing difficulties, obstructive sleep apnea syndrome, trismus, and tardive stereotypies. The role and benefit of nonspeech oral movements are controversial in many oral motor disorders. It is argued that the clinical value of these movements can be elucidated through careful definitions and task descriptions such as those proposed in this review article.

  19. Spotlight on movement disorders: What optogenetics has to offer.

    PubMed

    Rossi, Mark A; Calakos, Nicole; Yin, Henry H

    2015-04-15

    Elucidating the neuronal mechanisms underlying movement disorders is a major challenge because of the intricacy of the relevant neural circuits, which are characterized by diverse cell types and complex connectivity. A major limitation of traditional techniques, such as electrical stimulation or lesions, is that individual elements of a neural circuit cannot be selectively manipulated. Moreover, available treatments are largely based on trial and error rather than a detailed understanding of the circuit mechanisms. Gaps in our knowledge of the circuit mechanisms for movement disorders, as well as mechanisms underlying known treatments such as deep brain stimulation, make it difficult to design new and improved treatment options. In this perspective, we discuss how optogenetics, which allows researchers to use light to manipulate neuronal activity, can contribute to the understanding and treatment of movement disorders. We outline the advantages and limitations of optogenetics and discuss examples of studies that have used this tool to clarify the role of the basal ganglia circuitry in movement. © 2015 International Parkinson and Movement Disorder Society.

  20. Movement and electromyographic disorders associated with cerebellar dysmetria.

    PubMed

    Flament, D; Hore, J

    1986-06-01

    The objective of these experiments was to determine whether dysmetric elbow flexions, which occurred during cerebellar dysfunction, had the same kinematic and electromyographic characteristics as movements of the same amplitude and velocity performed under normal conditions. Reversible cerebellar lesions were produced by cooling through two probes implanted on either side of the dentate nucleus in five Cebus albifrons monkeys. Normal, fast, and accurate elbow flexions had single-peaked velocities and a bi- or triphasic EMG pattern in agonist and antagonist muscles. During cerebellar dysfunction movements became ataxic. Ataxic movements were classified into two categories: those with oscillations (tremor) during the movement and those without oscillations. A terminal tremor occurred after both types of movements. Oscillations during movements were more likely to occur when a constant force loaded the antagonist. Addition of mass to the handle attenuated or abolished the oscillations. Movements with oscillations reached the target with increased variability of end position, whereas movements without oscillations were often hypermetric. The movement parameters and EMG patterns associated with flexions without oscillations during the movement were studied in detail. A characteristic of these movements was that the acceleration and deceleration phases were asymmetric. Compared with control movements of the same peak velocity, they had smaller magnitudes of acceleration and larger magnitudes of deceleration. The large deceleration was abnormal because it initiated the terminal tremor. The disorder in acceleration was associated with agonist EMG activity that was less abrupt in onset, smaller in magnitude, and more prolonged in duration. The disorder in deceleration was associated with delayed onset of phasic antagonist EMG activity. The results show that hypermetric arm movements without oscillations have different properties than those of normal movements of similar

  1. Recognizing Uncommon Presentations of Psychogenic (Functional) Movement Disorders

    PubMed Central

    Baizabal-Carvallo, José Fidel; Fekete, Robert

    2015-01-01

    Background Psychogenic or functional movement disorders (PMDs) pose a challenge in clinical diagnosis. There are several clues, including sudden onset, incongruous symptoms, distractibility, suggestibility, entrainment of symptoms, and lack of response to otherwise effective pharmacological therapies, that help identify the most common psychogenic movements such as tremor, dystonia, and myoclonus. Methods In this manuscript, we review the frequency, distinct clinical features, functional imaging, and neurophysiological tests that can help in the diagnosis of uncommon presentations of PMDs, such as psychogenic parkinsonism, tics, and chorea; facial, palatal, and ocular movements are also reviewed. In addition, we discuss PMDs at the extremes of age and mass psychogenic illness. Results Psychogenic parkinsonism (PP) is observed in less than 10% of the case series about PMDs, with a female–male ratio of roughly 1:1. Lack of amplitude decrement in repetitive movements and of cogwheel rigidity help to differentiate PP from true parkinsonism. Dopamine transporter imaging with photon emission tomography can also help in the diagnostic process. Psychogenic movements resembling tics are reported in about 5% of PMD patients. Lack of transient suppressibility of abnormal movements helps to differentiate them from organic tics. Psychogenic facial movements can present with hemifacial spasm, blepharospasm, and other movements. Some patients with essential palatal tremor have been shown to be psychogenic. Convergence ocular spasm has demonstrated a high specificity for psychogenic movements. PMDs can also present in the context of mass psychogenic illness or at the extremes of age. Discussion Clinical features and ancillary studies are helpful in the diagnosis of patients with uncommon presentations of psychogenic movement disorders. PMID:25667816

  2. Rapid Eye Movement Sleep Behavior Disorder and Neurodegenerative Disease.

    PubMed

    Howell, Michael Joseph; Schenck, Carlos Hugh

    2015-06-01

    The dream enactment of rapid eye movement sleep behavior disorder (RBD) is often the first indication of an impending α-synuclein disorder, such as Parkinson disease, multiple-system atrophy, or dementia with Lewy bodies. To provide an overview of RBD from the onset of dream enactment through the emergence of a parkinsonian disorder. Peer-reviewed articles, including case reports, case series, retrospective reviews, prospective randomized trials, and basic science investigations, were identified in a PubMed search of articles on RBD from January 1, 1986, through July 31, 2014. Under normal conditions, vivid dream mentation combined with skeletal muscle paralysis characterizes rapid eye movement sleep. In RBD, α-synuclein abnormalities in the brainstem disinhibit rapid eye movement sleep motor activity, leading to dream enactment. The behaviors of RBD are often theatrical, with complexity, aggression, and violence; fighting and fleeing actions can be injurious to patients as well as bed partners. Rapid eye movement sleep behavior disorder is distinguished from other parasomnias by clinical features and the demonstration of rapid eye movement sleep without atonia on polysomnography. Consistent with early neurodegeneration, patients with RBD demonstrate subtle motor, cognitive, and autonomic impairments. Approximately 50% of patients with spontaneous RBD will convert to a parkinsonian disorder within a decade. Ultimately, nearly all (81%-90%) patients with RBD develop a neurodegenerative disorder. Among patients with Parkinson disease, RBD predicts a non-tremor-predominant subtype, gait freezing, and an aggressive clinical course. The most commonly cited RBD treatments include low-dose clonazepam or high-dose melatonin taken orally at bedtime. Treatment of RBD can prevent injury to patients and bed partners. Because RBD is a prodromal syndrome of Parkinson disease (or related disorder), it represents a unique opportunity for developing and testing disease

  3. Oscillations in sensorimotor cortex in movement disorders: an electrocorticography study.

    PubMed

    Crowell, Andrea L; Ryapolova-Webb, Elena S; Ostrem, Jill L; Galifianakis, Nicholas B; Shimamoto, Shoichi; Lim, Daniel A; Starr, Philip A

    2012-02-01

    Movement disorders of basal ganglia origin may arise from abnormalities in synchronized oscillatory activity in a network that includes the basal ganglia, thalamus and motor cortices. In humans, much has been learned from the study of basal ganglia local field potentials recorded from temporarily externalized deep brain stimulator electrodes. These studies have led to the theory that Parkinson's disease has characteristic alterations in the beta frequency band (13-30 Hz) in the basal ganglia-thalamocortical network. However, different disorders have rarely been compared using recordings in the same structure under the same behavioural conditions, limiting straightforward assessment of current hypotheses. To address this, we utilized subdural electrocorticography to study cortical oscillations in the three most common movement disorders: Parkinson's disease, primary dystonia and essential tremor. We recorded local field potentials from the arm area of primary motor and sensory cortices in 31 subjects using strip electrodes placed temporarily during routine surgery for deep brain stimulator placement. We show that: (i) primary motor cortex broadband gamma power is increased in Parkinson's disease compared with the other conditions, both at rest and during a movement task; (ii) primary motor cortex high beta (20-30 Hz) power is increased in Parkinson's disease during the 'stop' phase of a movement task; (iii) the alpha-beta peaks in the motor and sensory cortical power spectra occur at higher frequencies in Parkinson's disease than in the other two disorders; and (iv) patients with dystonia have impaired movement-related beta band desynchronization in primary motor and sensory cortices. The findings support the emerging hypothesis that disease states reflect abnormalities in synchronized oscillatory activity. This is the first study of sensorimotor cortex local field potentials in the three most common movement disorders.

  4. Periodic limb movement disorder : a clinical and polysomnographic study.

    PubMed

    Dhanuka, A K; Singh, G

    2001-12-01

    Periodic limb movement disorder (PLMD) is one of the commonest neurological disorders and causes significant disability, if left untreated. However, it is rarely diagnosed in clinical practice, probably due to lack of awareness and/or lack of necessary diagnostic facilities. Restless leg syndrome (RLS), aging, pregnancy, uraemia, iron deficiency, polyneuropathy are some of the common causes of secondary PLMD. Clinical presentation, polysomnographic findings and management of six patients of PLMD have been discussed in this report.

  5. Neurodevelopmental movement disorders - an update on childhood motor stereotypies.

    PubMed

    Barry, Sinéad; Baird, Gillian; Lascelles, Karine; Bunton, Penny; Hedderly, Tammy

    2011-11-01

    The term 'stereotypies' encompasses a diverse range of movements, behaviours, and/or vocalizations that are repetitive, lack clear function, and sometimes appear to have a negative impact upon an individual's life. This review aims to describe motor stereotypies. This study reviewed the current literature on the nature, aetiology, and treatment of motor stereotypies. Motor stereotypies occur commonly but not exclusively in autistic spectrum disorders. Similar movements are also found in otherwise healthy children and those suffering sensory impairment, social isolation, or severe intellectual disabilities; they may be persistent over time. Although often difficult, it is possible to define and differentiate stereotypies from other movement disorders such as tics through features of the history, such as earlier onset and examination, together with the presence or absence of associated neurological impairment or developmental difficulties. Co-occurrence with other disorders affecting frontostriatal brain systems, including attention-deficit-hyperactivity disorder, obsessive-compulsive disorder, and tic disorders, is common. The underlying function of motor stereotypies remains unclear but may include the maintenance of arousal levels. A neurogenetic aetiology is proposed but requires further study. When treatment is sought, there are both pharmacological and behavioural options. Behavioural treatments for motor stereotypies may in time be shown to be most effective; however, they are difficult to implement in children younger than 7 years old. © The Authors. Developmental Medicine & Child Neurology © 2011 Mac Keith Press.

  6. Neural control of rhythmic arm cycling after stroke

    PubMed Central

    Loadman, Pamela M.; Hundza, Sandra R.

    2012-01-01

    Disordered reflex activity and alterations in the neural control of walking have been observed after stroke. In addition to impairments in leg movement that affect locomotor ability after stroke, significant impairments are also seen in the arms. Altered neural control in the upper limb can often lead to altered tone and spasticity resulting in impaired coordination and flexion contractures. We sought to address the extent to which the neural control of movement is disordered after stroke by examining the modulation pattern of cutaneous reflexes in arm muscles during arm cycling. Twenty-five stroke participants who were at least 6 mo postinfarction and clinically stable, performed rhythmic arm cycling while cutaneous reflexes were evoked with trains (5 × 1.0-ms pulses at 300 Hz) of constant-current electrical stimulation to the superficial radial (SR) nerve at the wrist. Both the more (MA) and less affected (LA) arms were stimulated in separate trials. Bilateral electromyography (EMG) activity was recorded from muscles acting at the shoulder, elbow, and wrist. Analysis was conducted on averaged reflexes in 12 equidistant phases of the movement cycle. Phase-modulated cutaneous reflexes were present, but altered, in both MA and LA arms after stroke. Notably, the pattern was “blunted” in the MA arm in stroke compared with control participants. Differences between stroke and control were progressively more evident moving from shoulder to wrist. The results suggest that a reduced pattern of cutaneous reflex modulation persists during rhythmic arm movement after stroke. The overall implication of this result is that the putative spinal contributions to rhythmic human arm movement remain accessible after stroke, which has translational implications for rehabilitation. PMID:22572949

  7. Gamma knife radiosurgery in movement disorders: Indications and limitations.

    PubMed

    Higuchi, Yoshinori; Matsuda, Shinji; Serizawa, Toru

    2017-01-01

    Functional radiosurgery has advanced steadily during the past half century since the development of the gamma knife technique for treating intractable cancer pain. Applications of radiosurgery for intracranial diseases have increased with a focus on understanding radiobiology. Currently, the use of gamma knife radiosurgery to ablate deep brain structures is not widespread because visualization of the functional targets remains difficult despite the increased availability of advanced neuroimaging technology. Moreover, most existing reports have a small sample size or are retrospective. However, increased experience with intraoperative neurophysiological evaluations in radiofrequency thalamotomy and deep brain stimulation supports anatomical and neurophysiological approaches to the ventralis intermedius nucleus. Two recent prospective studies have promoted the clinical application of functional radiosurgery for movement disorders. For example, unilateral gamma knife thalamotomy is a potential alternative to radiofrequency thalamotomy and deep brain stimulation techniques for intractable tremor patients with contraindications for surgery. Despite the promising efficacy of gamma knife thalamotomy, however, these studies did not include sufficient follow-up to confirm long-term effects. Herein, we review the radiobiology literature, various techniques, and the treatment efficacy of gamma knife radiosurgery for patients with movement disorders. Future research should focus on randomized controlled studies and long-term effects. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

  8. Impaired Awareness of Movement Disorders in Parkinson's Disease

    ERIC Educational Resources Information Center

    Amanzio, Martina; Monteverdi, Silvia; Giordano, Alessandra; Soliveri, Paola; Filippi, Paola; Geminiani, Giuliano

    2010-01-01

    Background: This study analyzed the presence of awareness of movement disorders (dyskinesias and hypokinesias) in 25 patients with Parkinson's disease (PD) and motor fluctuations (dyskinesias, wearing off, on-off fluctuations). Of the few studies that have dealt with this topic, none have analyzed the differences in the awareness of motor deficits…

  9. Impaired Awareness of Movement Disorders in Parkinson's Disease

    ERIC Educational Resources Information Center

    Amanzio, Martina; Monteverdi, Silvia; Giordano, Alessandra; Soliveri, Paola; Filippi, Paola; Geminiani, Giuliano

    2010-01-01

    Background: This study analyzed the presence of awareness of movement disorders (dyskinesias and hypokinesias) in 25 patients with Parkinson's disease (PD) and motor fluctuations (dyskinesias, wearing off, on-off fluctuations). Of the few studies that have dealt with this topic, none have analyzed the differences in the awareness of motor deficits…

  10. Phenotype-specific diagnosis of functional (psychogenic) movement disorders.

    PubMed

    Espay, Alberto J; Lang, Anthony E

    2015-06-01

    Published diagnostic criteria for functional (psychogenic) movement disorders (FMDs) include psychiatric symptoms and some historical variables to affect the threshold between categories of diagnostic certainty. Clinically probable and possible categories, however, do not suffice to rule in FMD or rule out complex organic movement disorders and therefore are of little practical help. In contrast, a handful of unequivocal and reliably incongruent or inconsistent clinical features in each functional movement phenotype, when present, allow a clinically definite diagnosis of FMD, regardless of any psychiatric symptom. We suggest that the use of phenotype-specific clinically definite FMD diagnostic criteria will increase inter-rater reliability and minimize false-positive diagnostic errors. This process involves the ascertainment of core (mandatory) examination features instead of supportive but insufficiently sensitive historical, psychiatric, and inconsistent examination features.

  11. Repetitive Arm Movements During Sleep: A Polysomnographic Assessment

    PubMed Central

    Torabi-Nami, Mohammad; Mehrabi, Samrad; Derman, Sabri

    2016-01-01

    Sleep-related movement disorders should be differentiated from parasomnias, sleep-associated behavioral disorders, and epilepsy. Polysomnography (PSG) is the gold standard in evaluating such disorders. Periodic leg movement disorder during sleep (PLMS), hypnic jerks, bruxism, rhythmic movement disorder, restless legs syndrome, and nocturnal leg cramps have broadly been discussed in the literature. However, periodic arm movement disorder in sleep (PAMS) is a less-appreciated entity perhaps because arm surface electromyography is not an integral part of the standard polysomnography. Results from our PSG study in a case suspected for PAMS prompted us to herewith discuss this problem. PMID:27563420

  12. The pleiotropic movement disorders phenotype of adult ataxia-telangiectasia.

    PubMed

    Méneret, Aurélie; Ahmar-Beaugendre, Yara; Rieunier, Guillaume; Mahlaoui, Nizar; Gaymard, Bertrand; Apartis, Emmanuelle; Tranchant, Christine; Rivaud-Péchoux, Sophie; Degos, Bertrand; Benyahia, Baya; Suarez, Felipe; Maisonobe, Thierry; Koenig, Michel; Durr, Alexandra; Stern, Marc-Henri; Dubois d'Enghien, Catherine; Fischer, Alain; Vidailhet, Marie; Stoppa-Lyonnet, Dominique; Grabli, David; Anheim, Mathieu

    2014-09-16

    To assess the clinical spectrum of ataxia-telangiectasia (A-T) in adults, with a focus on movement disorders. A total of 14 consecutive adults with A-T were included at 2 tertiary adult movement disorders centers and compared to 53 typical patients with A-T. Clinical evaluation, neurophysiologic and video-oculographic recording, imaging, laboratory investigations, and ATM analysis were performed. In comparison with typical A-T cases, our patients demonstrated later mean age at onset (6.1 vs 2.5 years, p < 0.0001), later loss of walking ability (p = 0.003), and longer survival (p = 0.0039). The presenting feature was ataxia in 71% and dysarthria and dystonia in 14% each. All patients displayed movement disorders, among which dystonia and subcortical myoclonus were the most common (86%), followed by tremor (43%). Video-oculographic recordings revealed mostly dysmetric saccades and 46% of patients had normal latencies (i.e., no oculomotor apraxia) and velocities. The α-fetoprotein (AFP) level was normal in 7%, chromosomal instability was found in 29% (vs 100% of typical patients, p = 0.0006), and immunoglobulin deficiency was found in 29% (vs 69%, p = 0.057). All patients exhibited 2 ATM mutations, including at least 1 missense mutation in 79% of them (vs 36%, p = 0.0067). There is great variability of phenotype and severity in A-T, including a wide spectrum of movement disorders. Karyotype and repeated AFP level assessments should be performed in adults with unexplained movement disorders as valuable clues towards the diagnosis. In case of a compatible phenotype, A-T should be considered even if age at onset is late and progression is slow. © 2014 American Academy of Neurology.

  13. Spotlight on Movement Disorders: What optogenetics has to offer

    PubMed Central

    Rossi, Mark A.; Calakos, Nicole; Yin, Henry H.

    2015-01-01

    Elucidating the neuronal mechanisms underlying movement disorders is a major challenge due to the intricacy of the relevant neural circuits, which are characterized by diverse cell types and complex connectivity. A major limitation of traditional techniques, such as electrical stimulation or lesions, is that individual elements of a neural circuit cannot be selectively manipulated. Moreover, available treatments are largely based on trial and error rather than a detailed understanding of the circuit mechanisms. Gaps in our knowledge of the circuit mechanisms for movement disorders, as well as mechanisms underlying known treatments such as deep brain stimulation, make it difficult to design new and improved treatment options. In this perspective, we discuss how optogenetics, which allows researchers to use light to manipulate neuronal activity, can contribute to the understanding and treatment of movement disorders. We outline the advantages and limitations of optogenetics and discuss examples of studies that have used this tool to clarify the role of the basal ganglia circuitry in movement. PMID:25777796

  14. Diagnostic Agreement in Patients with Psychogenic Movement Disorders

    PubMed Central

    Morgante, Francesca; Edwards, Mark J.; Espay, Alberto J.; Fasano, Alfonso; Mir, Pablo; Martino, Davide

    2013-01-01

    Background The reliability and applicability of published diagnostic criteria for psychogenic movement disorders (PMDs) have never been examined. Methods Eight movement disorder and six general neurologists rated 14 patients diagnosed with PMD and 14 patients diagnosed with organic movement disorders. Raters provided a dichotomous judgment (i.e., psychogenic or organic) upon review of video-based movement phenomenology and a category of diagnostic certainty based on the Fahn-Williams and Shill-Gerber criteria after accessing standardized clinical information. We measured interobserver agreement on the diagnosis and clinical certainty judgment of PMD. Results In both groups of raters, agreements were “fair” on the video-based dichotomous judgment, but improved to “substantial” after access to standardized clinical information. “Slight” to “poor” agreement was reached for the “probable” and “possible” categories of diagnostic certainty corresponding to both diagnostic criteria. Conclusions Diagnosis according to clinical available criteria for PMD yields poor diagnostic agreement. PMID:22488862

  15. Cheek-biting disorder: another stereotypic movement disorder?

    PubMed

    Sarkhel, Sujit; Praharaj, Samir Kumar; Akhtar, Sayeed

    2011-12-01

    Recurrent cheek biting, a form of self-injurious behavior is a rare entity which presents mostly to dentists and dermatologists. We report a case of recurrent severe cheek biting in an adult male leading to mucosal ulceration. The stereotypic pattern of cheek biting and associated behavior bears striking resemblance to other impulse control disorders. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. The Effects of Rhythmicity and Amplitude on Transfer of Motor Learning

    PubMed Central

    Ben-Tov, Mor; Levy-Tzedek, Shelly; Karniel, Amir

    2012-01-01

    We perform rhythmic and discrete arm movements on a daily basis, yet the motor control literature is not conclusive regarding the mechanisms controlling these movements; does a single mechanism generate both movement types, or are they controlled by separate mechanisms? A recent study reported partial asymmetric transfer of learning from discrete movements to rhythmic movements. Other studies have shown transfer of learning between large-amplitude to small-amplitude movements. The goal of this study is to explore which aspect is important for learning to be transferred from one type of movement to another: rhythmicity, amplitude or both. We propose two hypotheses: (1) Rhythmic and discrete movements are generated by different mechanisms; therefore we expect to see a partial or no transfer of learning between the two types of movements; (2) Within each movement type (rhythmic/discrete), there will be asymmetric transition of learning from larger movements to smaller ones. We used a learning-transfer paradigm, in which 70 participants performed flexion/extension movements with their forearm, and switched between types of movement, which differed in amplitude and/or rhythmicity. We found partial transfer of learning between discrete and rhythmic movements, and an asymmetric transfer of learning from larger movements to smaller movements (within the same type of movement). Our findings suggest that there are two different mechanisms underlying the generation of rhythmic and discrete arm movements, and that practicing on larger movements helps perform smaller movements; the latter finding might have implications for rehabilitation. PMID:23056549

  17. Rhythmic Engagement with Music in Early Childhood: A Replication and Extension

    ERIC Educational Resources Information Center

    Ilari, Beatriz

    2015-01-01

    The purpose of this study was to replicate and extend previous findings on spontaneous movement and rhythmic engagement with music in infancy. Using the identical stimuli and procedures from the original study, I investigated spontaneous rhythmic movements in response to music, infant-directed speech, and contrasting rhythmic patterns in 30…

  18. Rhythmic Engagement with Music in Early Childhood: A Replication and Extension

    ERIC Educational Resources Information Center

    Ilari, Beatriz

    2015-01-01

    The purpose of this study was to replicate and extend previous findings on spontaneous movement and rhythmic engagement with music in infancy. Using the identical stimuli and procedures from the original study, I investigated spontaneous rhythmic movements in response to music, infant-directed speech, and contrasting rhythmic patterns in 30…

  19. The therapeutic potential of cannabinoids for movement disorders.

    PubMed

    Kluger, Benzi; Triolo, Piera; Jones, Wallace; Jankovic, Joseph

    2015-03-01

    There is growing interest in the therapeutic potential of marijuana (cannabis) and cannabinoid-based chemicals within the medical community and, particularly, for neurological conditions. This interest is driven both by changes in the legal status of cannabis in many areas and increasing research into the roles of endocannabinoids within the central nervous system and their potential as symptomatic and/or neuroprotective therapies. We review basic science as well as preclinical and clinical studies on the therapeutic potential of cannabinoids specifically as it relates to movement disorders. The pharmacology of cannabis is complex, with over 60 neuroactive chemicals identified to date. The endocannabinoid system modulates neurotransmission involved in motor function, particularly within the basal ganglia. Preclinical research in animal models of several movement disorders have shown variable evidence for symptomatic benefits, but more consistently suggest potential neuroprotective effects in several animal models of Parkinson's (PD) and Huntington's disease (HD). Clinical observations and clinical trials of cannabinoid-based therapies suggests a possible benefit of cannabinoids for tics and probably no benefit for tremor in multiple sclerosis or dyskinesias or motor symptoms in PD. Data are insufficient to draw conclusions regarding HD, dystonia, or ataxia and nonexistent for myoclonus or RLS. Despite the widespread publicity about the medical benefits of cannabinoids, further preclinical and clinical research is needed to better characterize the pharmacological, physiological, and therapeutic effects of this class of drugs in movement disorders.

  20. Parkinsonism, movement disorders and genetics in frontotemporal dementia.

    PubMed

    Baizabal-Carvallo, José Fidel; Jankovic, Joseph

    2016-03-01

    Frontotemporal dementia (FTD) refers to a group of clinically and genetically heterogeneous neurodegenerative disorders that are a common cause of adult-onset behavioural and cognitive impairment. FTD often presents in combination with various hyperkinetic or hypokinetic movement disorders, and evidence suggests that various genetic mutations underlie these different presentations. Here, we review the known syndromatic-genetic correlations in FTD. Although no direct genotype-phenotype correlations have been identified, mutations in multiple genes have been associated with various presentations. Mutations in the genes that encode microtubule-associated protein tau (MAPT) and progranulin (PGRN) can manifest as symmetrical parkinsonism, including the phenotypes of Richardson syndrome and corticobasal syndrome (CBS). Expansions in the C9orf72 gene are most frequently associated with familial FTD, typically combined with motor neuron disease, but other manifestations, such as symmetrical parkinsonism, CBS and multiple system atrophy-like presentations, have been described in patients with these mutations. Less common gene mutations, such as those in TARDBP, CHMP2B, VCP, FUS and TREM2, can also present as atypical parkinsonism. The most common hyperkinetic movement disorders in FTD are motor and vocal stereotypies, which have been observed in up to 78% of patients with autopsy-proven FTD. Other hyperkinetic movements, such as chorea, orofacial dyskinesias, myoclonus and dystonia, are also observed in some patients with FTD.

  1. The representation of movement disorders in fictional literature.

    PubMed

    Voss, Hendrik

    2012-10-01

    This review considers novels, plays and poems dealing with movement disorders in order to show the relevance in the literary context. The motifs are arranged and compared following a modern neurological nosology according to Parkinson syndromes, dystonia, myoclonus, tics, hemifacial spasm, Tourette syndrome, Huntington's disease and hyperekplexia. There is considerable variety in how movement disorders are depicted and how much influence they have on the plot structures. Their usage ranges from a brief reference in order to accentuate aspects of a character's personality or social position, such as in Shakespeare, Dickens, Tolstoy or Galdós; to truly constituting one of the plot's main themes as, for example, with the representation of Lewy body disease in Franzen's The Corrections and Huntington's disease in Vonnegut's Galápagos, Sawyer's Frameshift or McEwan's Saturday. The symbolic connotation of the disease is of major importance, as is its social and psychological impact. Some 20th century authors transfer rhythm patterns of specific movement disorders into the textual structure, including, among others, Beckett.

  2. The Therapeutic Potential of Cannabinoids for Movement Disorders

    PubMed Central

    Kluger, Benzi; Triolo, Piera; Jones, Wallace; Jankovic, Joseph

    2014-01-01

    Background There is growing interest in the therapeutic potential of marijuana (cannabis) and cannabinoid-based chemicals within the medical community and particularly for neurologic conditions. This interest is driven both by changes in the legal status of cannabis in many areas and increasing research into the roles of endocannabinoids within the central nervous system and their potential as symptomatic and/or neuroprotective therapies. We review basic science, preclinical and clinical studies on the therapeutic potential of cannabinoids specifically as it relates to movement disorders. Results The pharmacology of cannabis is complex with over 60 neuroactive chemicals identified to date. The endocannabinoid system modulates neurotransmission involved in motor function, particularly within the basal ganglia. Preclinical research in animal models of several movement disorders have shown variable evidence for symptomatic benefits but more consistently suggest potential neuroprotective effects in several animal models of Parkinson’s (PD) and Huntington’s disease (HD). Clinical observations and clinical trials of cannabinoid-based therapies suggests a possible benefit of cannabinoids for tics and probably no benefit for tremor in multiple sclerosis or dyskinesias or motor symptoms in PD. Data are insufficient to draw conclusions regarding HD, dystonia or ataxia and nonexistent for myoclonus or restless legs syndrome. Conclusions Despite the widespread publicity about the medical benefits of cannabinoids, further preclinical and clinical research is needed to better characterize the pharmacological, physiological and therapeutic effects of this class of drugs in movement disorders. PMID:25649017

  3. Cognitive and Psychiatric Phenotypes of Movement Disorders in Children: A Systematic Review

    ERIC Educational Resources Information Center

    Ben-Pazi, Hilla; Jaworowski, Solomon; Shalev, Ruth S

    2011-01-01

    Aim: The cognitive and psychiatric aspects of adult movement disorders are well established, but specific behavioural profiles for paediatric movement disorders have not been delineated. Knowledge of non-motor phenotypes may guide treatment and determine which symptoms are suggestive of a specific movement disorder and which indicate medication…

  4. Cognitive and Psychiatric Phenotypes of Movement Disorders in Children: A Systematic Review

    ERIC Educational Resources Information Center

    Ben-Pazi, Hilla; Jaworowski, Solomon; Shalev, Ruth S

    2011-01-01

    Aim: The cognitive and psychiatric aspects of adult movement disorders are well established, but specific behavioural profiles for paediatric movement disorders have not been delineated. Knowledge of non-motor phenotypes may guide treatment and determine which symptoms are suggestive of a specific movement disorder and which indicate medication…

  5. Attention Deficit Hyperactivity Disorder in a Patient With Congenital Mirror Movement Disorder and Colpocephaly

    PubMed Central

    Yaroglu Kazanci, Selcen

    2015-01-01

    Introduction: Congenital mirror movement disorder designates involuntary movements on one side of the body that occur as mirror of the intentional movements on the contralateral side. Colpocephaly is described as persistence of fetal configuration of lateral ventricles. Case Presentation: A two-month old male infant was brought to the hospital due to bilateral identical movements of the hands. Except for bilateral involuntary synkinetic imitative movements in hands, neurological and physical examination was normal. Cranial MRI showed corpus callosum dysgenesis, hypogenesis and dilation of bilateral lateral ventricular posterior horns (colpocephaly). At the age of 7 years, he was started to use metylphenydate to mitigate attention deficit and hyperactivity disorder. The mirror movements were decreasing in amplitude by years and were not so serious to affect normal life activities. Conclusions: Mirror movements, diagnosed usually during childhood, may be congenital or secondary to neurological diseases. Although they generally do not affect normal life activities, in some cases severity of mirror movements causes a real debilitating disease. In our case the patient was diagnosed at the age of 2 months and on follow-up no debilitating problems were observed. This is the first case to describe the association of colpocephaly and mirror movements. The exact mechanism of this association is not known. Although it is known that mirror movements may be in relation with some pychiatric pathologies, this is the first report of attention deficit and hyperactivity disorder in conjunction with mirror movements and/or colpocephaly. Managing comorbidities, either physical or psyhchological, will help the patient to live in good health without trying to cope with other pathological diseases. PMID:26495087

  6. Activity patterns of leg muscles in periodic limb movement disorder.

    PubMed

    de Weerd, A W; Rijsman, R M; Brinkley, A

    2004-02-01

    The movements of leg muscles in reference to periodic limb movement disorder (PLMD) have only been described in global terms. The sequences of contracting muscles that cause the PLMs are said to be stereotypical. There is, however, doubt about this fixed sequencing in PLMD. Our goal was to define the sequence of muscle movements in PLMs and then analyse their patterns. We recorded with surface EMG all movements of the muscles said to be involved in PLMs (extensor digitorum brevis, EDB; tibialis anterior, TA; biceps femoris, BF; tensor fasciae latae; TFL) as well as the quadriceps (Q) and soleus (S) muscles in 12 patients with restless legs syndrome combined with PLMD. Accompanying polysomnography provided the sleep parameters. In total, 469 movements were analysed. In only 12% was there the appearance of the classic movement (EDB-TA-BF-TFL) or its direct variants. The most frequent sequences were characterised by contraction of only the TA, TA-EDB only, or TA-EDB followed by all other combinations (32%). The pattern EDB only, EDB-TA, or EDB-TA followed by contraction of one or more other muscles, was seen in 18%. All other combinations appeared in much smaller numbers or only once. Eight patients had specific patterns. Three consistently started with the same muscle. One patient always contracted all six muscles. Six patients never contracted more than three muscles. The number of muscles contracted correlated positively with the appearance of arousal from sleep. The interval between onset of contractions within the PLMs varied randomly in a range of 0-1 s. Within PLMs many variations of muscle movements were documented. Patterns were recognisable, individually determined, and related to arousal from sleep.

  7. Functional brain networks and abnormal connectivity in the movement disorders

    PubMed Central

    Poston, Kathleen L.; Eidelberg, David

    2012-01-01

    Clinical manifestations of movement disorders, such as Parkinson’s disease (PD) and dystonia, arise from neurophysiological changes within the cortico-striato-pallidothalamocortical (CSPTC) and cerebello-thalamo-cortical (CbTC) circuits. Neuroimaging techniques that probe connectivity within these circuits can be used to understand how these disorders develop as well as identify potential targets for medical and surgical therapies. Indeed, network analysis of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has identified abnormal metabolic networks associated with the cardinal motor symptoms of PD, such as akinesia and tremor, as well as PD-related cognitive dysfunction. More recent task-based and resting state functional magnetic resonance imaging studies have reproduced several of the altered connectivity patterns identified in these abnormal PD-related networks. A similar network analysis approach in dystonia revealed abnormal disease related metabolic patterns in both manifesting and non-manifesting carriers of dystonia mutations. Other multimodal imaging approaches using magnetic resonance diffusion tensor imaging in patients with primary genetic dystonia suggest abnormal connectivity within the CbTC circuits mediate the clinical manifestations of this inherited neurodevelopmental disorder. Ongoing developments in functional imaging and future studies in early patients are likely to enhance our understanding of these movement disorders and guide novel targets for future therapies. PMID:22206967

  8. The improvement of movement and speech during rapid eye movement sleep behaviour disorder in multiple system atrophy.

    PubMed

    De Cock, Valérie Cochen; Debs, Rachel; Oudiette, Delphine; Leu, Smaranda; Radji, Fatai; Tiberge, Michel; Yu, Huan; Bayard, Sophie; Roze, Emmanuel; Vidailhet, Marie; Dauvilliers, Yves; Rascol, Olivier; Arnulf, Isabelle

    2011-03-01

    Multiple system atrophy is an atypical parkinsonism characterized by severe motor disabilities that are poorly levodopa responsive. Most patients develop rapid eye movement sleep behaviour disorder. Because parkinsonism is absent during rapid eye movement sleep behaviour disorder in patients with Parkinson's disease, we studied the movements of patients with multiple system atrophy during rapid eye movement sleep. Forty-nine non-demented patients with multiple system atrophy and 49 patients with idiopathic Parkinson's disease were interviewed along with their 98 bed partners using a structured questionnaire. They rated the quality of movements, vocal and facial expressions during rapid eye movement sleep behaviour disorder as better than, equal to or worse than the same activities in an awake state. Sleep and movements were monitored using video-polysomnography in 22/49 patients with multiple system atrophy and in 19/49 patients with Parkinson's disease. These recordings were analysed for the presence of parkinsonism and cerebellar syndrome during rapid eye movement sleep movements. Clinical rapid eye movement sleep behaviour disorder was observed in 43/49 (88%) patients with multiple system atrophy. Reports from the 31/43 bed partners who were able to evaluate movements during sleep indicate that 81% of the patients showed some form of improvement during rapid eye movement sleep behaviour disorder. These included improved movement (73% of patients: faster, 67%; stronger, 52%; and smoother, 26%), improved speech (59% of patients: louder, 55%; more intelligible, 17%; and better articulated, 36%) and normalized facial expression (50% of patients). The rate of improvement was higher in Parkinson's disease than in multiple system atrophy, but no further difference was observed between the two forms of multiple system atrophy (predominant parkinsonism versus cerebellar syndrome). Video-monitored movements during rapid eye movement sleep in patients with multiple system

  9. History of Botulinum Toxin Treatment in Movement Disorders

    PubMed Central

    Jabbari, Bahman

    2016-01-01

    Background The frontiers of clinical medicine constantly expand as a result of the innovative efforts of visionary researchers and keen observations of seasoned clinicians. In medicine, rarely has a therapeutic agent been found efficacious in the management of so many symptoms and in such a relatively short time as botulinum toxin. One of the most notable contributions of botulinum toxin therapy in clinical medicine is in the field of movement disorders. Methods The English literature was searched using the Yale search engine including but not limited to PubMed and Ovid. The search includes articles from January 1 1980 to March 1 2016. Results A total of 2055 articles were identified. Of these, 132 met the criteria for this review. Discussion This historical review highlights early and seminal contributions that have introduced the application of botulinum toxins in the field of movement disorders and provides evidence-based contributions that have established botulinum toxin as an effective treatment for abnormal movements. PMID:27917308

  10. Movement disorders induced in monkeys by chronic haloperidol treatment.

    PubMed

    Weiss, B; Santelli, S; Lusink, G

    1977-08-16

    After several months of treatment, Cebus apella, Cebus albifrons, and Saimiri sciurea monkeys maintained on haloperidol, in doses of 0.5 or 1.0 mg/kg orally 5 days per week, began to display severe movement disorders, typically 1-6 h post-drug. Cebus monkeys exhibited violent, uncontrolled movements that flung the animals about the cage. Such episodes usually lasted only a few minutes, recurring several times during the period following drug ingestion. Writhing and bizarre postures dominated the response in S. sciurea. Cessation of drug treatment produced no distinctive after-effects. When tested as long as 508 days after the last administration, however, Cebus monkeys responded to haloperidol with several episodes of hyperkinesis, even at challenge doses considerably lower than those in the original treatment.

  11. Rapid eye movement sleep behavior disorder and rapid eye movement sleep without atonia in narcolepsy.

    PubMed

    Dauvilliers, Yves; Jennum, Poul; Plazzi, Giuseppe

    2013-08-01

    Narcolepsy is a rare disabling hypersomnia disorder that may include cataplexy, sleep paralysis, hypnagogic hallucinations, and sleep-onset rapid eye movement (REM) periods, but also disrupted nighttime sleep by nocturnal awakenings, and REM sleep behavior disorder (RBD). RBD is characterized by dream-enacting behavior and impaired motor inhibition during REM sleep (REM sleep without atonia, RSWA). RBD is commonly associated with neurodegenerative disorders including Parkinsonisms, but is also reported in narcolepsy in up to 60% of patients. RBD in patients with narcolepsy is, however, a distinct phenotype with respect to other RBD patients and characterized also by absence of gender predominance, elementary rather than complex movements, less violent behavior and earlier age at onset of motor events, and strong association to narcolepsy with cataplexy/hypocretin deficiency. Patients with narcolepsy often present dissociated sleep features including RSWA, increased density of phasic chin EMG and frequent shift from REM to NREM sleep, with or without associated clinical RBD. Most patients with narcolepsy with cataplexy lack the hypocretin neurons in the lateral hypothalamus. Tonic and phasic motor activities in REM sleep and dream-enacting behavior are mostly reported in presence of cataplexy. Narcolepsy without cataplexy is a condition rarely associated with hypocretin deficiency. We proposed that hypocretin neurons are centrally involved in motor control during wakefulness and sleep in humans, and that hypocretin deficiency causes a functional defect in the motor control involved in the development of cataplexy during wakefulness and RBD/RSWA/phasic motor activity during REM sleep.

  12. Adult head-banging and stereotypic movement disorders.

    PubMed

    Mendez, M F; Mirea, A

    1998-09-01

    Stereotypic movement disorders (SMD) such as head-banging, which are common among children with mental retardation or pervasive developmental disorders, may also occur in intellectually normal adults. We report a 27-year history of daily head-banging with self-injury in a 49-year-old man with normal cognition. The patient had no personal or family history of Tourette's syndrome, tic disorder, obsessive-compulsive disorder (OCD), or mental retardation. The frequency of his stereotypical head-banging increased with anxiety, loud noises with startle, and boredom. He reported a sense of pleasure from his head-banging, and the frequency of this behavior decreased when he was treated with the opioid antagonist naltrexone. Although not diagnostic, the self-stimulatory or pleasurable component of head-banging, body-rocking, thumb-sucking, and other SMD may help distinguish them from tics, Tourette's syndrome, OCD, and deliberate self-harming behavior. This report reviews the disorders associated with SMD and discusses the potential mechanisms for these behaviors. The treatment of SMD includes drugs that work through opioid, serotonergic, or dopaminergic systems.

  13. Phosphodiesterases: Regulators of cyclic nucleotide signals and novel molecular target for movement disorders.

    PubMed

    Sharma, Sorabh; Kumar, Kushal; Deshmukh, Rahul; Sharma, Pyare Lal

    2013-08-15

    Movement disorders rank among the most common neurological disorders. During the last two decades substantial progress has been made in understanding of the pathological basis of these disorders. Although, several mechanisms have been proposed, downregulation of cyclic nucleotide mediated signaling cascade has consistently been shown to contribute to the striatal dysfunctioning as seen in movement disorders. Thus, counteracting dysregulated cyclic nucleotide signaling has been considered to be beneficial in movement disorders. Cyclic nucleotide phosphodiesterases (PDEs) are the enzymes responsible for the breakdown of cyclic nucleotides and upregulation in PDE activity has been reported in various movement disorders. Thus, PDE inhibition is considered to be a novel strategy to restore cerebral cyclic nucleotide levels and their downstream signalling cascade. Indeed, various PDE inhibitors have been tested pre-clinically and were reported to be neuroprotective in various neurodegenerative disorders associated with movement disabilities. In this review, we have discussed a putative role of PDE inhibitors in movement disorders and associated abnormalities.

  14. Familial dyskinesia and facial myokymia (FDFM): a novel movement disorder.

    PubMed

    Fernandez, M; Raskind, W; Wolff, J; Matsushita, M; Yuen, E; Graf, W; Lipe, H; Bird, T

    2001-04-01

    We describe here familial dyskinesia and facial myokymia (FDFM), a novel autosomal dominant disorder characterized by adventitious movements that sometimes appear choreiform and that are associated with perioral and periorbital myokymia. We report a 5-generation family with 18 affected members (10 males and 8 females) with FDFM. The disorder has an early childhood or adolescent onset. The involuntary movements are paroxysmal at early ages, increase in frequency and severity, and may become constant in the third decade. Thereafter, there is no further deterioration, and there may even be improvement in old age. The adventitious movements are worsened by anxiety but not by voluntary movement, startle, caffeine, or alcohol. The disease is socially disabling, but there is no intellectual impairment or decrease in lifespan. A candidate gene and haplotype analysis was performed in 9 affected and 3 unaffected members from 3 generations of this family using primers for polymorphic loci closely flanking or within genes of interest. We excluded linkage to 11 regions containing genes associated with chorea and myokymia: 1) the Huntington disease gene on chromosome 4p; 2) the paroxysmal dystonic choreoathetosis gene at 2q34; 3) the dentatorubral-pallidoluysian atrophy gene at 12p13; 4) the choreoathetosis/spasticity disease locus on 1p that lies in a region containing a cluster of potassium (K+) channel genes; 5) the episodic ataxia type 1 (EA1) locus on 12p that contains the KCNA1 gene and two other voltage-gated K+ channel genes, KCNA5 and KCNA6; 6) the chorea-acanthocytosis locus on 9q21; 7) the Huntington-like syndrome on 20p; 8) the paroxysmal kinesigenic dyskinesia locus on 16p11.2-q11.2; 9) the benign hereditary chorea locus on 14q; 10) the SCA type 5 locus on chromosome 11; and 11) the chromosome 19 region that contains several ion channels and the CACNA1A gene, a brain-specific P/Q-type calcium channel gene associated with ataxia and hemiplegic migraine. Our results

  15. Neural basis of rhythmic timing networks in the human brain.

    PubMed

    Thaut, Michael H

    2003-11-01

    The study of rhythmicity provides insights into the understanding of temporal coding of music and temporal information processing in the human brain. Auditory rhythms rapidly entrain motor responses into stable steady synchronization states below and above conscious perception thresholds. Studying the neural dynamics of entrainment by measuring brain wave responses (MEG) we found nonlinear scaling of M100 amplitudes generated in primary auditory cortex relative to changes in the period of the rhythmic interval during subliminal and supraliminal tempo modulations. In recent brain imaging studies we have described the neural networks involved in motor synchronization to auditory rhythm. Activated regions include primary sensorimotor and cingulate areas, bilateral opercular premotor areas, bilateral SII, ventral prefrontal cortex, and, subcortically, anterior insula, putamen, and thalamus. Within the cerebellum, vermal regions and anterior hemispheres ipsilateral to the movement became significantly activated. Tracking temporal modulations additionally activated predominantly right prefrontal, anterior cingulate, and intraparietal regions as well as posterior cerebellar hemispheres. Furthermore, strong evidence exists for the substantial benefits of rhythmic stimuli in rehabilitation training with motor disorders.

  16. Molecular Imaging and Precision Medicine in Dementia and Movement Disorders.

    PubMed

    Mallik, Atul K; Drzezga, Alexander; Minoshima, Satoshi

    2017-01-01

    Precision medicine (PM) has been defined as "prevention and treatment strategies that take individual variability into account." Molecular imaging (MI) is an ideally suited tool for PM approaches to neurodegenerative dementia and movement disorders (MD). Here we review PM approaches and discuss how they may be applied to other associated neurodegenerative dementia and MD. With ongoing major therapeutic research initiatives that include the use of molecular imaging, we look forward to established interventions targeted to specific molecular pathophysiology and expect the potential benefit of MI PM approaches in neurodegenerative dementia and MD will only increase. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Rapid Eye Movement Sleep Behavior Disorder During Childhood.

    PubMed

    Kotagal, Suresh

    2015-06-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) is a type of parasomnia that arises out of REM sleep and is characterized by aggressive or violent motor dream enactment in conjunction with preservation of tonic electromyographic activity (ie, REM sleep without atonia). RBD occurs at all ages and in both sexes, although it remains relatively infrequent during childhood. The literature pertaining to RBD in childhood is scant, and composed only of single case reports or small case series. RBD etiologies include Parkinson disease, multisystem atrophy, and dementia with Lewy body disease. This article presents an updated review of childhood RBD.

  18. Increased rates of intermittent rhythmic delta and theta activity in the electroencephalographies of adult patients with attention-deficit hyperactivity disorder.

    PubMed

    Endres, Dominique; Maier, Simon; Feige, Bernd; Mokhtar, Nora Bel; Nickel, Kathrin; Goll, Peter; Meyer, Simon A; Matthies, Swantje; Ebert, Dieter; Philipsen, Alexandra; Perlov, Evgeniy; Tebartz van Elst, Ludger

    2017-10-01

    Adult attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. In subgroups of patients with a (para)epileptic pathomechanism, this might be due to intermittent rhythmic delta or theta activity (IRDA/IRTA). Using a fully data-driven analysis, we compared the IRDA/IRTA rates in the resting electroencephalography (EEG) results of 97 adult patients with ADHD and 30 control subjects. The IRDA/IRTA rates before hyperventilation (HV) and for HV difference (difference between IRDA/IRTA rate after and before HV) were compared between groups using a linear model. We detected significantly increased rates of IRDA/IRTA before HV (F=4.209, p=0.042) in patients with ADHD but no significant difference between the groups for HV-difference (F=2.46, p=0.119). The increased IRDA/IRTA rates before HV in the group with ADHD might lead to (para)epileptic short-term effects (e.g., impulsivity) via local area network inhibition, and to long-term effects (e.g., cognitive deficits) via connectivistic brain restructuring. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Restless legs syndrome, periodic leg movements, and periodic limb movement disorder in children.

    PubMed

    Durmer, Jeffrey S; Quraishi, Ghazala H

    2011-06-01

    The characteristic symptoms of restless legs syndrome (RLS) have been known for hundreds of years and were first reported in medicine in the 1600s. Clinicians must consider potential mimics, comorbid, and associated conditions when evaluating children with RLS symptoms. The traditional differentiation of RLS from periodic limb movement disorder (PLMD) is noted in children as well as adults. Because current pediatric RLS research is sparse, this article provides the most up-to-date evidence-based as well as consensus opinion-based information on the subject of childhood RLS and PLMD. Prevalence, pathophysiology, diagnosis, treatment, and clinical associations are discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. Restless legs syndrome and periodic limb movement disorder.

    PubMed

    Parker, Kathy P; Rye, David B

    2002-12-01

    Restless leg syndrome and PLMD are nocturnal movement disorders associated with significant adverse effects on the health and well-being of patients and their families [66]. Although the pathophysiological basis remains to be fully described, current research points to abnormalities in CNS function and neurotransmitter systems. The accurate diagnosis of RLS and PMD requires a thorough history, physical examination, diagnostic tests, and often, a referral to a sleep disorders specialist. Considering the prevalence of these conditions and their negative impact, nurses should be well-versed in the assessment and management of these problems as well as in the appropriate education of patients and their families. Nursing research is greatly needed, particularly with regard to the development and testing of biobehavioral interventions designed to decrease associated symptoms and improve clinical outcomes. Finally, because of the complexity of the clinical presentation of RLS and PLMD, this population of patients presents nurse clinicians and researchers alike with an extraordinary opportunity for interdisciplinary collaboration.

  1. Deep brain stimulation for movement and other neurologic disorders.

    PubMed

    DeLong, Mahlon; Wichmann, Thomas

    2012-08-01

    Deep brain stimulation (DBS) was introduced as a treatment for patients with parkinsonism and other movement disorders in the early 1990s. The technique rapidly became the treatment of choice for these conditions, and is now also being explored for other diseases, including Tourette syndrome, gait disorders, epilepsy, obsessive-compulsive disorder, and depression. Although the mechanism of action of DBS remains unclear, it is recognized that DBS works through focal modulation of functionally specific circuits. The fact that the same DBS parameters and targets can be used in multiple diseases suggests that DBS does not counteract the pathophysiology of any specific disorder, but acts to replace pathologic activities in disease-affected brain circuits with activity that is more easily tolerated. Despite the progress made in the use of DBS, much remains to be done to fully realize the potential of this therapy. We describe some of the most active areas of research in this field, both in terms of exploration of new targets and stimulation parameters, and in terms of new electrode or stimulator designs.

  2. Eye Movement Measurement in Diagnostic Assessment of Disorders of Consciousness

    PubMed Central

    Ting, Windsor Kwan-Chun; Perez Velazquez, Jose Luis; Cusimano, Michael D.

    2014-01-01

    We review the literature to appraise the evidence supporting or disputing the use of eye movement measurement in disorders of consciousness (DOC) with low levels of arousal or awareness, such as minimally conscious state (MCS), vegetative state (VS), and coma for diagnostic and prognostic purposes. We will focus on the effectiveness of each technique in the diagnostic classification of these patients and the gradual trend in research from manual to computerized tracking methods. New tools have become available at clinicians’ disposal to assess eye movements with high spatial and temporal fidelity. The close relationship between eye movement generation and organic dysfunction in the brain allows these tools to be applied to the assessment of severe DOC as a unique supplementary toolset. We posit that eye tracking can improve clinical diagnostic precision for DOC, a key component of assessment that often dictates the course of clinical care in DOC patients. We see the emergence of long-term eye-tracking studies with seamless integration of technology in the future to improve the performance of clinical assessment in DOC. PMID:25120529

  3. Impaired visual size-discrimination in children with movement disorders.

    PubMed

    Gori, Monica; Tinelli, Francesca; Sandini, Giulio; Cioni, Giovanni; Burr, David

    2012-07-01

    Multisensory integration of spatial information occurs late in childhood, at around eight years (Gori, Del Viva, Sandini, & Burr, 2008). For younger children, the haptic system dominates size discrimination and vision dominates orientation discrimination: the dominance may reflect sensory calibration, and could have direct consequences on children born with specific sensory disabilities. Here we measure thresholds for visual discrimination of orientation and size in children with movement disorders of upper limbs. Visual orientation discrimination was very similar to the age-matched typical children, but visual size discrimination thresholds were far worse, in all eight individuals with early-onset movement disorder. This surprising and counterintuitive result is readily explained by the cross-sensory calibration hypothesis: when the haptic sense is unavailable for manipulation, it cannot be readily used to estimate size, and hence to calibrate the visual experience of size: visual discrimination is subsequently impaired. This complements a previous study showing that non-sighted children have reduced acuity for haptic orientation, but not haptic size, discriminations (Gori, Sandini, Martinoli, & Burr, 2010). Together these studies show that when either vision or haptic manipulation is impaired, the impairment also impacts on complementary sensory systems that are calibrated by that one.

  4. Functional neurosurgery for movement disorders: a historical perspective.

    PubMed

    Benabid, Alim Louis; Chabardes, Stephan; Torres, Napoleon; Piallat, Brigitte; Krack, Paul; Fraix, Valerie; Pollak, Pierre

    2009-01-01

    Since the 1960s, deep brain stimulation and spinal cord stimulation at low frequency (30 Hz) have been used to treat intractable pain of various origins. For this purpose, specific hardware have been designed, including deep brain electrodes, extensions, and implantable programmable generators (IPGs). In the meantime, movement disorders, and particularly parkinsonian and essential tremors, were treated by electrolytic or mechanic lesions in various targets of the basal ganglia, particularly in the thalamus and in the internal pallidum. The advent in the 1960s of levodopa, as well as the side effects and complications of ablative surgery (e.g., thalamotomy and pallidotomy), has sent functional neurosurgery of movement disorders to oblivion. In 1987, the serendipitous discovery of the effect of high-frequency stimulation (HFS), mimicking lesions, allowed the revival of the surgery of movement disorders by stimulation of the thalamus, which treated tremors with limited morbidity, and adaptable and reversible results. The stability along time of these effects allowed extending it to new targets suggested by basic research in monkeys. The HFS of the subthalamic nucleus (STN) has profoundly challenged the practice of functional surgery as the effect on the triad of dopaminergic symptoms was very significant, allowing to decrease the drug dosage and therefore a decrease of their complications, the levodopa-induced dyskinesias. In the meantime, based on the results of previous basic research in various fields, HFS has been progressively extended to potentially treat epilepsy and, more recently, psychiatric disorders, such as obsessive-compulsive disorders, Gilles de la Tourette tics, and severe depression. Similarly, suggested by the observation of changes in PET scan, applications have been extended to cluster headaches by stimulation of the posterior hypothalamus and even more recently, to obesity and drug addiction. In the field of movement disorders, it has become

  5. Rhythmic neural activity indicates the contribution of attention and memory to the processing of occluded movements in 10-month-old infants.

    PubMed

    Bache, Cathleen; Kopp, Franziska; Springer, Anne; Stadler, Waltraud; Lindenberger, Ulman; Werkle-Bergner, Markus

    2015-11-01

    Infants possess the remarkable capacity to perceive occluded movements as ongoing and coherent. Little is known about the neural mechanisms that enable internal representation of conspecifics' and inanimate objects' movements during visual occlusion. In this study, 10-month-old infants watched briefly occluded human and object movements. Prior to occlusion, continuous and distorted versions of the movement were shown. EEG recordings were used to assess neural activity assumed to relate to processes of attention (occipital alpha), memory (frontal theta), and sensorimotor simulation (central alpha) before, during, and after occlusion. Oscillatory activity was analyzed using an individualized data approach taking idiosyncrasies into account. Results for occipital alpha were consistent with infants' preference for attending to social stimuli. Furthermore, frontal theta activity was more pronounced when tracking distorted as opposed to continuous movement, and when maintaining object as opposed to human movement. Central alpha did not discriminate between experimental conditions. In sum, we conclude that observing occluded movements recruits processes of attention and memory which are modulated by stimulus and movement properties.

  6. Tetrabenazine in treatment of hyperkinetic movement disorders: an observational study

    PubMed Central

    Miguel, Rita; Mendonça, Marcelo D.; Barbosa, Raquel; Ladeira, Filipa; Lampreia, Tânia; Vale, José; Bugalho, Paulo

    2016-01-01

    Background: Tetrabenazine (TBZ) is commonly used in hyperkinetic movement disorders. In this retrospective study, we aimed to assess the TBZ effectiveness and adverse events (AEs) in Huntington disease (HD), vascular chorea, tics, dystonia, tardive oromandibular (OM) dyskinesia and other tardive syndromes (TS). Methods: Qualitative analysis of clinical response was used to estimate TBZ effectiveness. TBZ-associated AE frequency and subsequent discontinuation rate were used to estimate tolerability; the tolerability profile was measured through the TBZ minimal dose and exposure time required to elicit AEs. Results: Of 108 included patients, 87% had a clinically meaningful improvement sustained over a period of 40 months. TBZ-responder rate ranged from 100% in HD to 62.5% and 77.1% in tic disorders and OM dyskinesia, respectively (p < 0.001). TBZ-associated AE frequency ranged from 40.9% in other TS and 41.7% in vascular chorea and HD, to 60% in OM dyskinesia (p < 0.001). The most common AEs were Parkinsonism (51.8%) and psychiatric disorders (25%). The ‘other AEs’ category (mainly somnolence) presented the shortest minimal exposure time (3 months). AE-eliciting dose differed from 18.8 mg and 25 mg in tics and tardive disorders, to 75 mg in HD (p = 0.003). Patients with AEs were tendentiously older at TBZ initiation (p = 0.022). Conclusions: TBZ proved an effective and relatively well tolerated treatment in hyperkinetic disorders, with excellent results in HD. AEs were more common in OM dyskinesia, which may be related to higher age at TBZ initiation. TBZ-associated somnolence and Parkinsonism were more frequent during the titration and maintenance periods, respectively.

  7. Ictal SPECT in patients with rapid eye movement sleep behaviour disorder.

    PubMed

    Mayer, Geert; Bitterlich, Marion; Kuwert, Torsten; Ritt, Philipp; Stefan, Hermann

    2015-05-01

    Rapid eye movement sleep behaviour disorder is a rapid eye movement parasomnia clinically characterized by acting out dreams due to disinhibition of muscle tone in rapid eye movement sleep. Up to 80-90% of the patients with rapid eye movement sleep behaviour disorder develop neurodegenerative disorders within 10-15 years after symptom onset. The disorder is reported in 45-60% of all narcoleptic patients. Whether rapid eye movement sleep behaviour disorder is also a predictor for neurodegeneration in narcolepsy is not known. Although the pathophysiology causing the disinhibition of muscle tone in rapid eye movement sleep behaviour disorder has been studied extensively in animals, little is known about the mechanisms in humans. Most of the human data are from imaging or post-mortem studies. Recent studies show altered functional connectivity between substantia nigra and striatum in patients with rapid eye movement sleep behaviour disorder. We were interested to study which regions are activated in rapid eye movement sleep behaviour disorder during actual episodes by performing ictal single photon emission tomography. We studied one patient with idiopathic rapid eye movement sleep behaviour disorder, one with Parkinson's disease and rapid eye movement sleep behaviour disorder, and two patients with narcolepsy and rapid eye movement sleep behaviour disorder. All patients underwent extended video polysomnography. The tracer was injected after at least 10 s of consecutive rapid eye movement sleep and 10 s of disinhibited muscle tone accompanied by movements registered by an experienced sleep technician. Ictal single photon emission tomography displayed the same activation in the bilateral premotor areas, the interhemispheric cleft, the periaqueductal area, the dorsal and ventral pons and the anterior lobe of the cerebellum in all patients. Our study shows that in patients with Parkinson's disease and rapid eye movement sleep behaviour disorder-in contrast to wakefulness

  8. Markers of neurodegeneration in idiopathic rapid eye movement sleep behaviour disorder and Parkinson's disease.

    PubMed

    Postuma, R B; Gagnon, J F; Vendette, M; Montplaisir, J Y

    2009-12-01

    Idiopathic rapid eye movement sleep behaviour disorder is an important risk factor in the development of Parkinson's disease. Numerous potential predictive markers of Parkinson's disease may present before motor symptoms emerge, but testing of these markers in rapid eye movement sleep behaviour disorder has been performed only in small studies. There has been no comparison of markers between patients with idiopathic rapid eye movement sleep behaviour disorder and Parkinson's disease, and between men and women. We evaluated an array of potential Parkinson's disease predictive markers in 159 patients; including 68 with idiopathic rapid eye movement sleep behaviour disorder, 36 controls, 34 Parkinson's patients with rapid eye movement sleep behaviour disorder and 21 Parkinson's patients without rapid eye movement sleep behaviour disorder. Compared with controls, patients with idiopathic rapid eye movement sleep behaviour disorder demonstrated substantial olfactory loss (P < 0.001). Olfaction was more impaired in Parkinson's disease than idiopathic rapid eye movement sleep behaviour disorder and did not differ between Parkinson's patients with, or without, rapid eye movement sleep behaviour disorder. Numerous measures of motor function including the Unified Parkinson Disease Rating Scale alternate tap, Purdue Peg Board and Timed 'Up and Go' were impaired in idiopathic rapid eye movement sleep behaviour disorder compared with controls (P < 0.01). All of these motor measures were worse with Parkinson's disease than with idiopathic rapid eye movement sleep behaviour disorder, regardless of rapid eye movement sleep behaviour disorder status. Autonomic symptoms and systolic blood pressure drop were impaired in patients with idiopathic rapid eye movement sleep behaviour disorder compared with controls (P = 0.003). Orthostatic abnormalities in Parkinson's disease were found in the group with rapid eye movement sleep behaviour disorder (P < 0.001). However, Parkinson

  9. GBA mutations are associated with Rapid Eye Movement Sleep Behavior Disorder.

    PubMed

    Gan-Or, Ziv; Mirelman, Anat; Postuma, Ronald B; Arnulf, Isabelle; Bar-Shira, Anat; Dauvilliers, Yves; Desautels, Alex; Gagnon, Jean-François; Leblond, Claire S; Frauscher, Birgit; Alcalay, Roy N; Saunders-Pullman, Rachel; Bressman, Susan B; Marder, Karen; Monaca, Christelle; Högl, Birgit; Orr-Urtreger, Avi; Dion, Patrick A; Montplaisir, Jacques Y; Giladi, Nir; Rouleau, Guy A

    2015-09-01

    Rapid eye movement sleep behavior disorder and GBA mutations are both associated with Parkinson's disease. The GBA gene was sequenced in idiopathic rapid eye movement sleep behavior disorder patients (n = 265), and compared to controls (n = 2240). Rapid eye movement sleep behavior disorder questionnaire was performed in an independent Parkinson's disease cohort (n = 120). GBA mutations carriers had an OR of 6.24 (10.2% in patients vs. 1.8% in controls, P < 0.0001) for rapid eye movement sleep behavior disorder, and among Parkinson's disease patients, the OR for mutation carriers to have probable rapid eye movement sleep behavior disorder was 3.13 (P = 0.039). These results demonstrate that rapid eye movement sleep behavior disorder is associated with GBA mutations, and that combining genetic and prodromal data may assist in identifying individuals susceptible to Parkinson's disease.

  10. GBA mutations are associated with Rapid Eye Movement Sleep Behavior Disorder

    PubMed Central

    Gan-Or, Ziv; Mirelman, Anat; Postuma, Ronald B; Arnulf, Isabelle; Bar-Shira, Anat; Dauvilliers, Yves; Desautels, Alex; Gagnon, Jean-François; Leblond, Claire S; Frauscher, Birgit; Alcalay, Roy N; Saunders-Pullman, Rachel; Bressman, Susan B; Marder, Karen; Monaca, Christelle; Högl, Birgit; Orr-Urtreger, Avi; Dion, Patrick A; Montplaisir, Jacques Y; Giladi, Nir; Rouleau, Guy A

    2015-01-01

    Rapid eye movement sleep behavior disorder and GBA mutations are both associated with Parkinson's disease. The GBA gene was sequenced in idiopathic rapid eye movement sleep behavior disorder patients (n = 265), and compared to controls (n = 2240). Rapid eye movement sleep behavior disorder questionnaire was performed in an independent Parkinson's disease cohort (n = 120). GBA mutations carriers had an OR of 6.24 (10.2% in patients vs. 1.8% in controls, P < 0.0001) for rapid eye movement sleep behavior disorder, and among Parkinson's disease patients, the OR for mutation carriers to have probable rapid eye movement sleep behavior disorder was 3.13 (P = 0.039). These results demonstrate that rapid eye movement sleep behavior disorder is associated with GBA mutations, and that combining genetic and prodromal data may assist in identifying individuals susceptible to Parkinson's disease. PMID:26401515

  11. Rapid eye movement sleep behaviour disorder in patients with narcolepsy is associated with hypocretin-1 deficiency.

    PubMed

    Knudsen, Stine; Gammeltoft, Steen; Jennum, Poul J

    2010-02-01

    Rapid eye movement sleep behaviour disorder is characterized by dream-enacting behaviour and impaired motor inhibition during rapid eye movement sleep. Rapid eye movement sleep behaviour disorder is commonly associated with neurodegenerative disorders, but also reported in narcolepsy with cataplexy. Most narcolepsy with cataplexy patients lack the sleep-wake, and rapid eye movement sleep, motor-regulating hypocretin neurons in the lateral hypothalamus. In contrast, rapid eye movement sleep behaviour disorder and hypocretin deficiency are rare in narcolepsy without cataplexy. We hypothesized that rapid eye movement sleep behaviour disorder coexists with cataplexy in narcolepsy due to hypocretin deficiency. In our study, rapid eye movement sleep behaviour disorder was diagnosed by the International Classification of Sleep Disorders (2nd edition) criteria in 63 narcolepsy patients with or without cataplexy. Main outcome measures were: rapid eye movement sleep behaviour disorder symptoms; short and long muscle activations per hour rapid eye movement and non-rapid eye movement sleep; and periodic and non-periodic limb movements per hour rapid eye movement and non-rapid eye movement sleep. Outcome variables were analysed in relation to cataplexy and hypocretin deficiency with uni- and multivariate logistic/linear regression models, controlling for possible rapid eye movement sleep behaviour disorder biasing factors (age, gender, disease duration, previous anti-cataplexy medication). Only hypocretin deficiency independently predicted rapid eye movement sleep behaviour disorder symptoms (relative risk = 3.69, P = 0.03), long muscle activations per hour rapid eye movement sleep (ln-coefficient = 0.81, P < 0.01), and short muscle activations per hour rapid eye movement sleep (ln-coefficient = 1.01, P < 0.01). Likewise, periodic limb movements per hour rapid eye movement and non-rapid eye movement sleep were only associated with hypocretin deficiency (P < 0.01). A significant

  12. Morbidities in rapid eye movement sleep behavior disorder.

    PubMed

    Jennum, Poul; Mayer, Geert; Ju, Yo-El; Postuma, Ron

    2013-08-01

    Idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD, RBD without any obvious comorbid major neurological disease), is strongly associated with numerous comorbid conditions. The most prominent is that with neurodegenerative disorders, especially synuclein-mediated disorders, above all Parkinson disease (PD). Idiopathic RBD is an important risk factor for the development of synucleinopathies. Comorbidity studies suggest that iRBD is associated with a number of other potential pre-motor manifestations of synucleinopathies such as, cognitive and olfactory impairment, reduced autonomic function, neuropsychiatric manifestations and sleep complaints. Furthermore, patients with PD and RBD may have worse prognosis in terms of impaired cognitive function and overall morbidity/mortality; in dementia, the presence of RBD is strongly associated with clinical hallmarks and pathological findings of dementia with Lewy bodies. These findings underline the progressive disease process, suggesting involvement of more brain regions in patients with a more advanced disease stage. RBD is also associated with narcolepsy, and it is likely that RBD associated with narcolepsy is a distinct subtype associated with different comorbidities. RBD is also associated with antidepressant medications, autoimmune conditions, and, in rare cases, brainstem lesions.

  13. [Parkinson Disease With Rapid Eye Movement Sleep Behavior Disorder].

    PubMed

    Hu, Yang; Zhang, Wei

    2015-06-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by lack of muscle atonia during REM sleep and enactment of dream content. RBD is associated with Parkinson disease (PD) and has high incidence in PD patients. PD patient with RBD mainly presents rigid type, has longer disease duration, more severe motor and non-motor symptoms and poorer activity of daily living and life quality. The pathophysiological mechanisms of RBD may be related to dysfunctions of pontine tegmentum, locus coeruleus/sub-locus coeruleus complex and related projections. The diagnosis of RBD depends on clinical histories and video-polysomnography (v-PSG). Besides treatment for PD, protective measures have to be taken for patients and their sleep partners. If abnormal behaviors during sleep cause distress and danger,patients should be given drug therapy.

  14. Low-frequency deep brain stimulation for movement disorders.

    PubMed

    Baizabal-Carvallo, José Fidel; Alonso-Juarez, Marlene

    2016-10-01

    Traditionally, deep brain stimulation (DBS) for movement disorders (MDs) is provided using stimulation frequencies equal to or above 100 Hz. However, recent evidence suggests that relatively low-frequency stimulation (LFS) below 100 Hz is an option to treat some patients with MDs. We aimed to review the clinical and pathophysiological evidence supporting the use of stimulation frequencies below 100 Hz in different MDs. Stimulation of the subthalamic nucleus at 60 Hz has provided benefit in gait and other axial symptoms such as swallowing and speech. Stimulation of the pedunculopontine nucleus between 20 and 45 Hz can provide benefit in freezing of gait, cognition, and sleep quality in select patients with Parkinson's disease. Stimulation of the globus pallidus internus below 100 Hz in patients with dystonia has provided benefit at the beginning of the therapy, although progressively higher stimulation frequencies seem to be necessary to maintain the clinical benefit. Relative LFS can lower energy requirements and reduce battery usage-a useful feature, particularly in patients treated with high current energy. DBS at frequencies below 100 Hz is a therapeutic option in select cases of Parkinson's disease with freezing of gait and other axial symptoms, and in select patients with dystonia and other hyperkinetic movements, particularly those requiring an energy-saving strategy. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Periodic Limb Movements During Sleep Mimicking REM Sleep Behavior Disorder: A New Form of Periodic Limb Movement Disorder.

    PubMed

    Gaig, Carles; Iranzo, Alex; Pujol, Montserrat; Perez, Hernando; Santamaria, Joan

    2017-03-01

    To describe a group of patients referred because of abnormal sleep behaviors that were suggestive of rapid eye movement (REM) sleep behavior disorder (RBD) in whom video-polysomnography ruled out RBD and showed the reported behaviors associated with vigorous periodic limb movements during sleep (PLMS). Clinical history and video-polysomnography review of patients identified during routine visits in a sleep center. Patients were 15 men and 2 women with a median age of 66 (range: 48-77) years. Reported sleep behaviors were kicking (n = 17), punching (n = 16), gesticulating (n = 8), falling out of bed (n = 5), assaulting the bed partner (n = 2), talking (n = 15), and shouting (n = 10). Behaviors resulted in injuries in 3 bed partners and 1 patient. Twelve (70.6%) patients were not aware of displaying abnormal sleep behaviors that were only noticed by their bed partners. Ten (58.8%) patients recalled unpleasant dreams such as being attacked or chased. Video-polysomnography showed (1) frequent and vigorous stereotyped PLMS involving the lower limbs, upper limbs, and trunk (median PLMS index 61.2; median PLMS index in NREM sleep 61.9; during REM sleep only 8 patients had PLMS and their median PLMS index in REM sleep was 39.5); (2) abnormal behaviors (e.g., punching, groaning) during some of the arousals that immediately followed PLMS in NREM sleep; and (3) ruled out RBD and other sleep disorders such as obstructive sleep apnea. Dopaminergic agents were prescribed in 14 out of the 17 patients and resulted in improvement of abnormal sleep behaviors and unpleasant dreams in all of them. After dopaminergic treatment, follow-up video-polysomnography in 7 patients showed a decrease in the median PLMS index from baseline (108.9 vs. 19.2, p = .002) and absence of abnormal behaviors during the arousals. Abnormal sleep behaviors and unpleasant dreams simulating RBD symptomatology may occur in patients with severe PLMS. In these cases, video-polysomnography ruled out RBD and

  16. Surgically treated movement disorders associated with heterotopia: report of 2 cases.

    PubMed

    Mullin, Jeffrey P; Van Gompel, Jamie J; Lee, Kendall H; Meyer, Fredric B; Stead, Matt

    2010-09-01

    Heterotopic gray matter has been implicated in epilepsy; however, not much is known regarding heterotopia beyond epilepsy. Here, the authors describe 2 pediatric patients with deep heterotopias contiguous with basal ganglia structures. These heterotopias appear to have manifested as movement disorders. One patient presented with a left-sided myoclonus and choreiform movements associated with a right caudate heterotopia; she experienced vast improvement after resection of periventricular heterotopia. The other patient presented with progressive dystonia and a ballistic movement disorder. Initial bilateral globus pallidus internus stimulation resulted in successful treatment of the dystonia; however, her movement disorder worsened. After an extensive workup, including STATISCOM (statistical ictal SPECT coregistered to MR imaging), the patient underwent cortical stimulation with improvement in her movement disorder. To the best of our knowledge, these cases are the first reported instances of heterotopic gray matter associated with movement disorders. Both patients experienced significant improvements following resection of their heterotopias.

  17. Rapid eye movement sleep behavior disorder in Parkinson's disease: magnetic resonance imaging study.

    PubMed

    Ford, Andrew H; Duncan, Gordon W; Firbank, Michael J; Yarnall, Alison J; Khoo, Tien K; Burn, David J; O'Brien, John T

    2013-06-01

    Rapid eye movement sleep behavior disorder has poor prognostic implications for Parkinson's disease. The authors recruited 124 patients with early Parkinson's disease to compare clinical and neuroimaging findings based on the presence of this sleep disorder. The presence of rapid eye movement sleep behavior disorder was assessed with the Mayo Sleep Questionnaire. Magnetic resonance imaging sequences were obtained for voxel-based morphometry and diffusion tensor imaging. Patients with sleep disorder had more advanced disease, but groups had similar clinical characteristics and cognitive performance. Those with sleep disorder had areas of reduced cortical grey matter volume and white matter changes compared with those who did not have sleep disorder. However, differences were slight and were not significant when the analyses were adjusted for multiple comparisons. Rapid eye movement sleep behavior disorder was associated with subtle changes in white matter integrity and grey matter volume in patients with early Parkinson's disease. Copyright © 2013 Movement Disorder Society.

  18. Biases in eye movements to threatening facial expressions in generalized anxiety disorder and depressive disorder.

    PubMed

    Mogg, K; Millar, N; Bradley, B P

    2000-11-01

    The study investigated biases in selective attention to emotional face stimuli in generalized anxiety disorder (GAD) and depressive disorder, using a modified probe detection task. There were 4 face types: threatening, sad, happy, and neutral. Measures of attentional bias included (a) the direction and latency of the initial eye movement in response to the faces and (b) manual reaction time (RT) to probes replacing the face stimuli 1,000 ms after their onset. Results showed that individuals with GAD (without depressive disorder) were more likely to look first toward threat faces rather than neutral faces compared with normal controls and those with depressive disorder. They also shifted their gaze more quickly toward threat faces, rather than away from them, relative to the other two groups. There were no significant findings from the manual RT data. Implications of the results for recent theories of clinical anxiety and depression are discussed.

  19. Diagnosis and treatment of impulse control disorders in patients with movement disorders

    PubMed Central

    Mestre, Tiago A.; Strafella, Antonio P.; Thomsen, Teri; Voon, Valerie

    2013-01-01

    Impulse control disorders are a psychiatric condition characterized by the failure to resist an impulsive act or behavior that may be harmful to self or others. In movement disorders, impulse control disorders are associated with dopaminergic treatment, notably dopamine agonists (DAs). Impulse control disorders have been studied extensively in Parkinson’s disease, but are also recognized in restless leg syndrome and atypical Parkinsonian syndromes. Epidemiological studies suggest younger age, male sex, greater novelty seeking, impulsivity, depression and premorbid impulse control disorders as the most consistent risk factors. Such patients may warrant special monitoring after starting treatment with a DA. Various individual screening tools are available for people without Parkinson’s disease. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease has been developed specifically for Parkinson’s disease. The best treatment for impulse control disorders is prevention. However, after the development of impulse control disorders, the mainstay intervention is to reduce or discontinue the offending anti-Parkinsonian medication. In refractory cases, other pharmacological interventions are available, including neuroleptics, antiepileptics, amantadine, antiandrogens, lithium and opioid antagonists. Unfortunately, their use is only supported by case reports, small case series or open-label clinical studies. Prospective, controlled studies are warranted. Ongoing investigations include naltrexone and nicotine. PMID:23634190

  20. Rapid Eye Movement Sleep Behavior Disorder and Other Rapid Eye Movement Sleep Parasomnias.

    PubMed

    Högl, Birgit; Iranzo, Alex

    2017-08-01

    The most common rapid eye movement (REM) parasomnia encountered by neurologists is REM sleep behavior disorder (RBD), and nightmares are so frequent that every neurologist should be able to differentiate them from the dream enactment of RBD. Isolated sleep paralysis is relatively common and is often mistaken for other neurologic disorders. This article summarizes the current state of the art in the diagnosis of RBD, discusses the role of specific questionnaires and polysomnography in the diagnosis of RBD, and reviews recent studies on idiopathic RBD as an early feature of a synucleinopathy, secondary RBD, and its management. Recent diagnostic criteria and implications of nightmares and isolated sleep paralysis are also reviewed. Idiopathic RBD can now be considered as part of the prodromal stage of a synucleinopathy. Therefore, an accurate diagnosis is mandatory, and this implies detection of REM sleep without atonia. The polysomnography montage, including EMG of the submentalis and flexor digitorum superficialis muscles, provides a high sensitivity and specificity for the diagnosis. The exact diagnosis is important for patient counseling and for future neuroprotective trials. REM parasomnias include RBD, sleep paralysis, and nightmares, which have distinct clinical characteristics and different implications regarding diagnostic procedures, management, and prognosis.

  1. Do the eyes scan dream images during rapid eye movement sleep? Evidence from the rapid eye movement sleep behaviour disorder model.

    PubMed

    Leclair-Visonneau, Laurène; Oudiette, Delphine; Gaymard, Bertrand; Leu-Semenescu, Smaranda; Arnulf, Isabelle

    2010-06-01

    Rapid eye movements and complex visual dreams are salient features of human rapid eye movement sleep. However, it remains to be elucidated whether the eyes scan dream images, despite studies that have retrospectively compared the direction of rapid eye movements to the dream recall recorded after having awakened the sleeper. We used the model of rapid eye movement sleep behaviour disorder (when patients enact their dreams by persistence of muscle tone) to determine directly whether the eyes move in the same directions as the head and limbs. In 56 patients with rapid eye movement sleep behaviour disorder and 17 healthy matched controls, the eye movements were monitored by electrooculography in four (right, left, up and down) directions, calibrated with a target and synchronized with video and sleep monitoring. The rapid eye movement sleep behaviour disorder-associated behaviours occurred 2.1 times more frequently during rapid eye movement sleep with than without rapid eye movements, and more often during or after rapid eye movements than before. Rapid eye movement density, index and complexity were similar in patients with rapid eye movement sleep behaviour disorder and controls. When rapid eye movements accompanied goal-oriented motor behaviour during rapid eye movement sleep behaviour disorder (e.g. grabbing a fictive object, hand greetings, climbing a ladder), which happened in 19 sequences, 82% were directed towards the action of the patient (same plane and direction). When restricted to the determinant rapid eye movements, the concordance increased to 90%. Rapid eye movements were absent in 38-42% of behaviours. This directional coherence between limbs, head and eye movements during rapid eye movement sleep behaviour disorder suggests that, when present, rapid eye movements imitate the scanning of the dream scene. Since the rapid eye movements are similar in subjects with and without rapid eye movement sleep behaviour disorder, this concordance can be extended

  2. Genetic control of a central pattern generator: rhythmic oromotor movement in mice is controlled by a major locus near Atp1a2.

    PubMed

    Boughter, John D; Mulligan, Megan K; St John, Steven J; Tokita, Kenichi; Lu, Lu; Heck, Detlef H; Williams, Robert W

    2012-01-01

    Fluid licking in mice is a rhythmic behavior that is controlled by a central pattern generator (CPG) located in a complex of brainstem nuclei. C57BL/6J (B6) and DBA/2J (D2) strains differ significantly in water-restricted licking, with a highly heritable difference in rates (h(2)≥0.62) and a corresponding 20% difference in interlick interval (mean ± SEM = 116.3±1 vs 95.4±1.1 ms). We systematically quantified motor output in these strains, their F(1) hybrids, and a set of 64 BXD progeny strains. The mean primary interlick interval (MPI) varied continuously among progeny strains. We detected a significant quantitative trait locus (QTL) for a CPG controlling lick rate on Chr 1 (Lick1), and a suggestive locus on Chr 10 (Lick10). Linkage was verified by testing of B6.D2-1D congenic stock in which a segment of Chr 1 of the D2 strain was introgressed onto the B6 parent. The Lick1 interval on distal Chr 1 contains several strong candidate genes. One of these is a sodium/potassium pump subunit (Atp1a2) with widespread expression in astrocytes, as well as in a restricted population of neurons. Both this subunit and the entire Na(+)/K(+)-ATPase molecule have been implicated in rhythmogenesis for respiration and locomotion. Sequence variants in or near Apt1a2 strongly modulate expression of the cognate mRNA in multiple brain regions. This gene region has recently been sequenced exhaustively and we have cataloged over 300 non-coding and synonymous mutations segregating among BXD strains, one or more of which is likely to contribute to differences in central pattern generator tempo.

  3. Impulse control disorder and rapid eye movement sleep behavior disorder in Parkinson's disease.

    PubMed

    Bayard, Sophie; Dauvilliers, Yves; Yu, Huan; Croisier-Langenier, Muriel; Rossignol, Alexia; Charif, Mahmoud; Geny, Christian; Carlander, Bertrand; Cochen De Cock, Valérie

    2014-12-01

    The relationship between ICD and RBD is still not yet understood and the results from the current literature are contradictory in PD. We aimed to explore the association between rapid eye movement (REM) sleep behavior disorder (RBD) and impulse control disorder in Parkinson's disease. Ninety-eight non-demented patients with Parkinson's disease underwent one night of video-polysomnography recording. The diagnosis of RBD was established according to clinical and polysomnographic criteria. Impulse control disorders were determined by a gold standard, semi-structured diagnostic interview. Half of the patients (n = 49) reported clinical history of RBD while polysomnographic diagnosis of RBD was confirmed in 31.6% of the patients (n = 31). At least one impulse control disorder was identified in 21.4% of patients, 22.6% with RBD and 20.9% without. Logistic regression controlling for potential confounders indicated that both clinical RBD (OR = 0.34, 95% CI = 0.07-1.48, P = 0.15) and polysomnographic confirmed RBD diagnoses (OR = 0.1.28, 95% CI = 0.31-5.33, P = 0.34) were not associated with impulse control disorder. In Parkinson's disease, REM Sleep Behavior Disorder is not associated with impulse control disorder. The results of our study do not support the notion that PSG-confirmed RBD and ICD share a common pathophysiology. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Hyperkinetic movement disorder in a child treated by globus pallidus stimulation.

    PubMed

    Sato, Ken; Nakagawa, Eiji; Saito, Yoshiaki; Komaki, Hirofumi; Sakuma, Hiroshi; Sugai, Kenji; Sasaki, Masayuki; Kaido, Takanobu; Nakama, Hideyuki; Otsuki, Taisuke

    2009-06-01

    We report herein the case of a 9-year-old girl with life-threatening hyperkinetic involuntary movement of unknown etiology. Medical treatment was ineffective for her stereotypy and choreoathetotic/ballistic movements, but bilateral stimulation of the globus pallidus immediately alleviated these symptoms. Pallidal deep-brain stimulation may be considered the therapy of choice for children with intractable hyperkinetic movement disorders.

  5. Movement Disorders in Adults With Intellectual Disability and Behavioral Problems Associated With Use of Antipsychotics.

    PubMed

    Scheifes, Arlette; Walraven, Sanne; Stolker, Joost Jan; Nijman, Henk L I; Tenback, Diederik E; Egberts, Toine C G; Heerdink, Eibert R

    2016-08-01

    Antipsychotic drugs are prescribed to approximately 30% to 40% of adults with intellectual disability (ID) and behavioral problems despite lack of evidence of effectiveness and potential adverse effects, including movement disorders. The aim of this study was to examine the prevalence of movement disorders (dyskinesia, akathisia, dystonia, and parkinsonism) in in-patient adults with mild to borderline ID and behavioral problems associated with use of antipsychotics. Prevalence of movement disorders was measured with a standardized protocol. The strength of the association between antipsychotic drug use and movement disorders was assessed using logistic regression analysis. Almost half (44.0%) of 134 in-patient adults with ID and behavioral problems had any movement disorder. Parkinsonism, dyskinesia, akathisia, and dystonia were present in, respectively, 36.6%, 11.2%, 9.0%, and 0.7% of patients with ID. It appeared that current use of any antipsychotic drug (odds ratio, 3.0; 95% confidence interval, 1.0-8.4) and a dose in target range (odds ratio, 5.5; 95% confidence interval, 1.5-20.4) were significantly associated with the risk of having movement disorders. The prevalence of movement disorders in people with ID and behavioral problems is high, especially in ID patients using antipsychotics. More attention is needed for these movement disorders and their potential impact.

  6. Dyskinetic Movement Disorder among Adults with Mental Retardation: Phenomenology and Co-occurrence with Stereotypy.

    ERIC Educational Resources Information Center

    Bodfish, James W.; And Others

    1996-01-01

    The occurrence of dyskinetic movement disorder and its co-occurrence with stereotypic behavior among adults with mental retardation were studied in 98 adults with mental retardation. Results indicated that stereotypic movement disorder was associated with increased dyskinesia scores and that dyskinesia and stereotypy may be related by common…

  7. Increased Prevalence of Intermittent Rhythmic Delta or Theta Activity (IRDA/IRTA) in the Electroencephalograms (EEGs) of Patients with Borderline Personality Disorder

    PubMed Central

    Tebartz van Elst, Ludger; Fleck, Max; Bartels, Susanne; Altenmüller, Dirk-Matthias; Riedel, Andreas; Bubl, Emanuel; Matthies, Swantje; Feige, Bernd; Perlov, Evgeniy; Endres, Dominique

    2016-01-01

    Introduction: An increased prevalence of pathological electroencephalography (EEG) signals has been reported in patients with borderline personality disorder (BPD). In an elaborative case description of such a patient with intermittent rhythmic delta and theta activity (IRDA/IRTA), the BPD symptoms where linked to the frequency of the IRDAs/IRTAs and vanished with the IRDAs/IRTAs following anticonvulsive therapy. This observation raised a question regarding the prevalence of such EEG abnormalities in BPD patients. The aim of this retrospective study was to identify the frequency of EEG abnormalities in a carefully analyzed psychiatric collective. Following earlier reports, we hypothesized an increased prevalence of EEG abnormalities in BPD patients. Participants and Methods: We recruited 96 consecutive patients with BPD from the archive of a university clinic for psychiatry and psychotherapy, and compared the prevalence of EEG abnormalities to those of 76 healthy controls subjects. The EEGs were rated by three different blinded clinicians, including a consultant specializing in epilepsy from the local epilepsy center. Results: We found a significant increase in the prevalence of IRDAs and IRTAs in BPD patients (14.6%) compared to the control subjects (3.9%; p = 0.020). Discussion: In this blinded retrospective case-control study, we were able to confirm an increased prevalence of pathological EEG findings (IRDAs/IRTAs only) in BPD patients. The major limitation of this study is that the control group was not matched on age and gender. Therefore, the results should be regarded as preliminary findings of an open uncontrolled, retrospective study. Future research performing prospective, controlled studies is needed to verify our findings and answer the question of whether such EEG findings might predict a positive response to anticonvulsive pharmacological treatment. PMID:26941624

  8. Construction of standardized Arabic questionnaires for screening neurological disorders (dementia, stroke, epilepsy, movement disorders, muscle and neuromuscular junction disorders)

    PubMed Central

    El Tallawy, Hamdy N; Farghaly, Wafaa MA; Rageh, Tarek A; Saleh, Ahmed O; Mestekawy, Taha AH; Darwish, Manal MM; Abd El Hamed, Mohamed A; Ali, Anwar M; Mahmoud, Doaa M

    2016-01-01

    A screening questionnaire is an important tool for early diagnosis of neurological disorders, and for epidemiological research. This screening instrument must be both feasible and valid. It must be accepted by the community and must be sensitive enough. So, the aim of this study was to prepare different Arabic screening questionnaires for screening different neurological disorders. This study was carried out in three stages. During the first stage, construction of separate questionnaires designed for screening the five major neurological disorders: cerebrovascular stroke, dementias, epilepsy, movement disorders, and muscle and neuromuscular disorders were done. Validation of the screening questionnaires was carried out in the second stage. Finally, questionnaire preparation was done in the third stage. Questions with the accepted sensitivity and specificity in each questionnaire formed the refined separate questionnaires. PMID:27621635

  9. The nasal and gut microbiome in Parkinson's disease and idiopathic rapid eye movement sleep behavior disorder.

    PubMed

    Heintz-Buschart, Anna; Pandey, Urvashi; Wicke, Tamara; Sixel-Döring, Friederike; Janzen, Annette; Sittig-Wiegand, Elisabeth; Trenkwalder, Claudia; Oertel, Wolfgang H; Mollenhauer, Brit; Wilmes, Paul

    2017-08-26

    Increasing evidence connects the gut microbiota and the onset and/or phenotype of Parkinson's disease (PD). Differences in the abundances of specific bacterial taxa have been reported in PD patients. It is, however, unknown whether these differences can be observed in individuals at high risk, for example, with idiopathic rapid eye movement sleep behavior disorder, a prodromal condition of α-synuclein aggregation disorders including PD. To compare microbiota in carefully preserved nasal wash and stool samples of subjects with idiopathic rapid eye movement sleep behavior disorder, manifest PD, and healthy individuals. Microbiota of flash-frozen stool and nasal wash samples from 76 PD patients, 21 idiopathic rapid eye movement sleep behavior disorder patients, and 78 healthy controls were assessed by 16S and 18S ribosomal RNA amplicon sequencing. Seventy variables, related to demographics, clinical parameters including nonmotor symptoms, and sample processing, were analyzed in relation to microbiome variability and controlled differential analyses were performed. Differentially abundant gut microbes, such as Akkermansia, were observed in PD, but no strong differences in nasal microbiota. Eighty percent of the differential gut microbes in PD versus healthy controls showed similar trends in idiopathic rapid eye movement sleep behavior disorder, for example, Anaerotruncus and several Bacteroides spp., and correlated with nonmotor symptoms. Metagenomic sequencing of select samples enabled the reconstruction of genomes of so far uncharacterized differentially abundant organisms. Our study reveals differential abundances of gut microbial taxa in PD and its prodrome idiopathic rapid eye movement sleep behavior disorder in comparison to the healthy controls, and highlights the potential of metagenomics to identify and characterize microbial taxa, which are enriched or depleted in PD and/or idiopathic rapid eye movement sleep behavior disorder. © 2017 The Authors. Movement

  10. Increased Risk of Dementia Among Sleep-Related Movement Disorders

    PubMed Central

    Lin, Chun-Chieh; Chou, Chung-Hsing; Fan, Yu-Ming; Yin, Jiu-Haw; Chung, Chi-Hsiang; Chien, Wu-Chien; Sung, Yueh-Feng; Tsai, Chia-Kuang; Lin, Guan-Yu; Lin, Yu-Kai; Lee, Jiunn-Tay

    2015-01-01

    Abstract Sleep-related movement disorders (SRMD) are sleep disorders. As poor sleep quality is associated with cognitive impairment, we hypothesized that SRMD patients were exposed to a great risk for developing dementia. The present study was aimed to retrospectively examine the association of SRMD and dementia risk. A retrospective longitudinal study was conducted using the data obtained from the Longitudinal Health Insurance Database (LHID) in Taiwan. The study cohort enrolled 604 patients with SRMD who were initially diagnosed and 2416 patients who were randomly selected and age/gender matched with the study group. SRMD, dementia, and other confounding factors were defined according to International Classification of Diseases Clinical Modification Codes. Cox proportional-hazards regressions were employed to examine adjusted hazard ratios (HR) after adjusting with confounding factors. Our data revealed that patients with SRMD had a 3.952 times (95% CI = 1.124–4.767) higher risk to develop all-cause dementia compared with individuals without SRMD. The results showed that SRMD patients aged 45 to 64 exhibited highest risk of developing all-cause dementia (HR: 5.320, 95% CI = 1.770–5.991), followed by patients age ≥65 (HR: 4.123, 95% CI = 2.066–6.972) and <45 (HR: 3.170, 95% CI = 1.050–4.128), respectively. Females with SRMD were at greater risk to develop all-cause dementia (HR: 4.372, 95% CI = 1.175–5.624). The impact of SRMD on dementia risk was progressively increased by various follow-up time intervals (<1 year, 1–2 years, and ≥2 years). The results suggest that SRMD is linked to an increased risk for dementia with gender-dependent and time-dependent characteristics. PMID:26705224

  11. Weight change following deep brain stimulation for movement disorders.

    PubMed

    Strowd, Roy E; Cartwright, Michael S; Passmore, Leah V; Ellis, Thomas L; Tatter, Stephen B; Siddiqui, Mustafa S

    2010-08-01

    Patients with Parkinson's disease (PD) and essential tremor (ET) tend to lose weight progressively over years. Weight gain following deep brain stimulation (DBS) of the subthalamic nucleus (STN) for treatment of PD has been documented in several studies that were limited by small sample size and exclusive focus on PD patients with STN stimulation. The current study was undertaken to examine weight change in a large sample of movement disorder patients following DBS. A retrospective review was undertaken of 182 patient charts following DBS of the STN, ventralis intermedius nucleus of the thalamus (VIM), and globus pallidus internus (GPi). Weight was collected preoperatively and postoperatively up to 24 months following surgery. Data were adjusted for baseline weight and multivariate linear regression was performed with repeated measures to assess weight change. Statistically significant mean weight gain of 1.8 kg (2.8% increase from baseline, p = 0.0113) was observed at a rate of approximately 1 kg per year up to 24 months following surgery. This gain was not predicted by age, gender, diagnosis, or stimulation target in a multivariate model. Significant mean weight gain of 2.3 kg (p = 0.0124) or 4.2% was observed in our PD patients. Most patients with PD and ET gain weight following DBS, and this gain is not predicted by age, gender, diagnosis, or stimulation target.

  12. Sex differences in Parkinson's disease and other movement disorders.

    PubMed

    Smith, Kara M; Dahodwala, Nabila

    2014-09-01

    Movement disorders including Parkinson's disease (PD), Huntington's disease (HD), chorea, tics, and Tourette's syndrome (TS) display sex differences in disease susceptibility, disease pathogenesis, and clinical presentation. PD is more common in males than in females. Epidemiologic studies suggest that exposure to endogenous and exogenous estrogen contributes to these sex differences. There is extensive evidence that estrogen prevents dopaminergic neuron depletion induced by neurotoxins in PD animal models and therefore is neuroprotective. Estrogen may also decrease the efficacy of other neuroprotective substances such as caffeine in females but not males. Sex chromosomes can exert effects independent of sex steroid hormones on the development and maintenance of the dopamine system. As a result of hormone, chromosome and other unknown effects, there are sexual dimorphisms in the basal ganglia, and at the molecular levels in dopaminergic neurons that may lead to distinct mechanisms of pathogenesis in males and females. In this review, we summarize the evidence that estrogen and selective estrogen receptor modulators are neuroprotective in PD and discuss potential mechanisms of action. We also briefly review how sex differences in basal ganglia function and dopaminergic pathways may impact HD, chorea, and tics/Tourette's syndrome. Further understanding of these sex differences may lead to novel therapeutic strategies for prevention and treatment of these diseases.

  13. Periodic Limb Movements during Sleep Mimicking REM Sleep Behavior Disorder.

    PubMed

    Gaig, Carles; Iranzo, Alex; Pujo, Montserrat; Perez, Hernando; Santamaria, Joan

    2016-11-28

    prominent PLMS followed by arousals containing abnormal behaviors. Our cases represent an objectively documented subtype of periodic limb movement disorder causing abnormal sleep behaviors.

  14. High Incidence and Prevalence of Drug-Related Movement Disorders in Young Patients With Psychotic Disorders.

    PubMed

    Mentzel, Thierry Q; Lieverse, Ritsaert; Bloemen, Oswald; Viechtbauer, Wolfgang; van Harten, Peter N

    2017-04-01

    Drug-related movement disorders (DRMDs) reduce quality of life and contribute to medication noncompliance of patients with psychotic disorders. Little is known about the epidemiology of DRMDs in relatively young patients a few years after onset of psychosis. This is an important period to study, as the impact of the antipsychotic treatment on the long-term potentiation of the neural pathways associated with psychotic disorders and DRMDs is still minimal. This study investigated the prevalence, incidence, persistence, and clinical correlates of DRMDs in patients during their first years after disease onset. The Genetic Risk and Outcome of Psychosis study is a longitudinal study of 1120 relatively young patients with nonaffective psychosis and a mean age and illness duration of 27 and 4 years, respectively. The following drug-related movement disorders were assessed at baseline and at the 3-year follow-up: parkinsonism, akathisia, tardive dyskinesia, and tardive dystonia. We determined prevalence, incidence, and persistence and investigated clinical correlates at and over the baseline and follow-up assessment. Patients' mean age and illness duration at baseline were 27.1 and 4.3 years, respectively. In 4 patients, 1 developed a DRMD over the 3-year study period. Prevalence, incidence, and persistence rates were highest for parkinsonism (32%, 21%, and 53%) followed by akathisia (9%, 5%, and 17%) and tardive dyskinesia (4%, 3%, and 20%). Significant associations were found between DRMDs and the patients' age, IQ, and psychopathology. The prevalence, persistence, and incidence of DRMDs in this sample were high despite the relatively young age, recent onset of the disorder, and treatment primarily with second-generation antipsychotics. These findings emphasize that screening, diagnosis, and treatment of DRMDs are still important.

  15. Movement disorders in GLUT1 deficiency syndrome respond to the modified Atkins diet.

    PubMed

    Leen, Wilhelmina G; Mewasingh, Leena; Verbeek, Marcel M; Kamsteeg, Erik-Jan; van de Warrenburg, Bart P; Willemsen, Michel A

    2013-09-01

    Movement disorders are a prominent feature of glucose transporter-1 (GLUT1) deficiency syndrome (GLUT1DS). First-choice treatment is a ketogenic diet, but compliance is poor. We have investigated the effect of the modified Atkins diet as an alternative treatment for movement disorders in GLUT1DS. Four patients with GLUT1DS ages 15 to 30 years who had movement disorders as the most prominent feature were prospectively evaluated after initiation of the modified Atkins diet. Movement disorders included dystonia, ataxia, myoclonus, and spasticity, either continuous or paroxysmal, triggered by action or exercise. Duration of treatment ranged from 3 months to 16 months. All patients reached mild to moderate ketosis and experienced remarkable improvement in the frequency and severity of paroxysmal movement disorders. Cognitive function also improved subjectively. The modified Atkins diet is an effective and feasible alternative to the ketogenic diet for the treatment of GLUT1DS-related paroxysmal movement disorders in adolescence and adulthood. © 2013 International Parkinson and Movement Disorder Society.

  16. Uncommon Applications of Deep Brain Stimulation in Hyperkinetic Movement Disorders

    PubMed Central

    Smith, Kara M.; Spindler, Meredith A.

    2015-01-01

    Background In addition to the established indications of tremor and dystonia, deep brain stimulation (DBS) has been utilized less commonly for several hyperkinetic movement disorders, including medication-refractory myoclonus, ballism, chorea, and Gilles de la Tourette (GTS) and tardive syndromes. Given the lack of adequate controlled trials, it is difficult to translate published reports into clinical use. We summarize the literature, draw conclusions regarding efficacy when possible, and highlight concerns and areas for future study. Methods A Pubmed search was performed for English-language articles between January 1980 and June 2014. Studies were selected if they focused primarily on DBS to treat the conditions of focus. Results We identified 49 cases of DBS for myoclonus-dystonia, 21 for Huntington's disease, 15 for choreacanthocytosis, 129 for GTS, and 73 for tardive syndromes. Bilateral globus pallidus interna (GPi) DBS was the most frequently utilized procedure for all conditions except GTS, in which medial thalamic DBS was more common. While the majority of cases demonstrate some improvement, there are also reports of no improvement or even worsening of symptoms in each condition. The few studies including functional or quality of life outcomes suggest benefit. A limited number of studies included blinded on/off testing. There have been two double-blind controlled trials performed in GTS and a single prospective double-blind, uncontrolled trial in tardive syndromes. Patient characteristics, surgical target, stimulation parameters, and duration of follow-up varied among studies. Discussion Despite these extensive limitations, the literature overall supports the efficacy of DBS in these conditions, in particular GTS and tardive syndromes. For other conditions, the preliminary evidence from small studies is promising and encourages further study. PMID:25713746

  17. Technological Advances In The Surgical Treatment Of Movement Disorders

    PubMed Central

    Gross, Robert E.; McDougal, Margaret E.

    2013-01-01

    Technological innovations have driven the advancement of the surgical treatment of movement disorders, from the invention of the stereotactic frame to the adaptation of deep brain stimulation (DBS). Along these lines, this review will describe recent advances in getting neuromodulation modalities, including DBS, to the target; and in the delivery of therapy at the target. Recent radiological advances are altering the way that DBS leads are targeted and inserted, by refining the ability to visualize the subcortical targets using high-field strength MRI and other innovations such as diffusion tensor imaging, and the development of novel targeting devices enabling purely anatomical implantations without the need for neurophysiological monitoring. New portable CT scanners also are facilitating lead implantation without monitoring as well as improving radiological verification of DBS lead location. Advances in neurophysiological mapping include efforts to develop automatic target verification algorithms, and probabilistic maps to guide target selection. The delivery of therapy at the target is being improved by the development of the next generation of internal pulse generators (IPGs). These include constant current devices that mitigate the variability introduced by impedance changes of the stimulated tissue, and in the near future, devices that deliver novel stimulation patterns with improved efficiency. Closed-loop adaptive IPGs are being tested, which may tailor stimulation to ongoing changes in the nervous system reflected in Œbiomarkers1 continuously recorded by the devices. Finer grained DBS leads, in conjunction with new IPGs and advanced programming tools, may offer improved outcomes via Œcurrent steering1 algorithms. Finally, even thermocoagulation - essentially replaced by DBS - is being advanced by new Œminimally-invasive1 approaches that may improve this therapy for selected patients in whom it may be preferred. Functional neurosurgery has a history of

  18. Stereotypy and Motor Control: Differences in the Postural Stability Dynamics of Persons with Stereotyped and Dyskinetic Movement Disorders.

    ERIC Educational Resources Information Center

    Bodfish, James W.; Parker, Dawn E.; Lewis, Mark H.; Sprague, Robert L.; Newell, Karl M.

    2001-01-01

    This study examined whether dynamic measures of postural stability differentiated stereotyped movement disorder from dyskinetic movement disorder in a severely mentally retarded population. Participants (N=20) with either stereotypy or dyskinesia movement disorders and a control group were given a goal-oriented postural stability task. Both groups…

  19. Stereotypy and Motor Control: Differences in the Postural Stability Dynamics of Persons with Stereotyped and Dyskinetic Movement Disorders.

    ERIC Educational Resources Information Center

    Bodfish, James W.; Parker, Dawn E.; Lewis, Mark H.; Sprague, Robert L.; Newell, Karl M.

    2001-01-01

    This study examined whether dynamic measures of postural stability differentiated stereotyped movement disorder from dyskinetic movement disorder in a severely mentally retarded population. Participants (N=20) with either stereotypy or dyskinesia movement disorders and a control group were given a goal-oriented postural stability task. Both groups…

  20. The Moving Rubber Hand Illusion Reveals that Explicit Sense of Agency for Tapping Movements Is Preserved in Functional Movement Disorders

    PubMed Central

    Marotta, Angela; Bombieri, Federica; Zampini, Massimiliano; Schena, Federico; Dallocchio, Carlo; Fiorio, Mirta; Tinazzi, Michele

    2017-01-01

    Functional movement disorders (FMD) are characterized by motor symptoms (e.g., tremor, gait disorder, and dystonia) that are not compatible with movement abnormalities related to a known organic cause. One key clinical feature of FMD is that motor symptoms are similar to voluntary movements but are subjectively experienced as involuntary by patients. This gap might be related to abnormal self-recognition of bodily action, which involves two main components: sense of agency and sense of body ownership. The aim of this study was to systematically investigate whether this function is altered in FMD, specifically focusing on the subjective feeling of agency, body ownership, and their interaction during normal voluntary movements. Patients with FMD (n = 21) and healthy controls (n = 21) underwent the moving Rubber Hand Illusion (mRHI), in which passive and active movements can differentially elicit agency, ownership or both. Explicit measures of agency and ownership were obtained via a questionnaire. Patients and controls showed a similar pattern of response: when the rubber hand was in a plausible posture, active movements elicited strong agency and ownership; implausible posture of the rubber hand abolished ownership but not agency; passive movements suppressed agency but not ownership. These findings suggest that explicit sense of agency and body ownership are preserved in FMD. The latter finding is shared by a previous study in FMD using a static version of the RHI, whereas the former appears to contrast with studies demonstrating altered implicit measures of agency (e.g., sensory attenuation). Our study extends previous findings by suggesting that in FMD: (i) the sense of body ownership is retained also when interacting with the motor system; (ii) the subjective experience of agency for voluntary tapping movements, as measured by means of mRHI, is preserved. PMID:28634447

  1. The Moving Rubber Hand Illusion Reveals that Explicit Sense of Agency for Tapping Movements Is Preserved in Functional Movement Disorders.

    PubMed

    Marotta, Angela; Bombieri, Federica; Zampini, Massimiliano; Schena, Federico; Dallocchio, Carlo; Fiorio, Mirta; Tinazzi, Michele

    2017-01-01

    Functional movement disorders (FMD) are characterized by motor symptoms (e.g., tremor, gait disorder, and dystonia) that are not compatible with movement abnormalities related to a known organic cause. One key clinical feature of FMD is that motor symptoms are similar to voluntary movements but are subjectively experienced as involuntary by patients. This gap might be related to abnormal self-recognition of bodily action, which involves two main components: sense of agency and sense of body ownership. The aim of this study was to systematically investigate whether this function is altered in FMD, specifically focusing on the subjective feeling of agency, body ownership, and their interaction during normal voluntary movements. Patients with FMD (n = 21) and healthy controls (n = 21) underwent the moving Rubber Hand Illusion (mRHI), in which passive and active movements can differentially elicit agency, ownership or both. Explicit measures of agency and ownership were obtained via a questionnaire. Patients and controls showed a similar pattern of response: when the rubber hand was in a plausible posture, active movements elicited strong agency and ownership; implausible posture of the rubber hand abolished ownership but not agency; passive movements suppressed agency but not ownership. These findings suggest that explicit sense of agency and body ownership are preserved in FMD. The latter finding is shared by a previous study in FMD using a static version of the RHI, whereas the former appears to contrast with studies demonstrating altered implicit measures of agency (e.g., sensory attenuation). Our study extends previous findings by suggesting that in FMD: (i) the sense of body ownership is retained also when interacting with the motor system; (ii) the subjective experience of agency for voluntary tapping movements, as measured by means of mRHI, is preserved.

  2. The coeruleus/subcoeruleus complex in rapid eye movement sleep behaviour disorders in Parkinson's disease.

    PubMed

    García-Lorenzo, Daniel; Longo-Dos Santos, Clarisse; Ewenczyk, Claire; Leu-Semenescu, Smaranda; Gallea, Cecile; Quattrocchi, Graziella; Pita Lobo, Patricia; Poupon, Cyril; Benali, Habib; Arnulf, Isabelle; Vidailhet, Marie; Lehericy, Stéphane

    2013-07-01

    In Parkinson's disease, rapid eye movement sleep behaviour disorder is an early non-dopaminergic syndrome with nocturnal violence and increased muscle tone during rapid eye movement sleep that can precede Parkinsonism by several years. The neuronal origin of rapid eye movement sleep behaviour disorder in Parkinson's disease is not precisely known; however, the locus subcoeruleus in the brainstem has been implicated as this structure blocks muscle tone during normal rapid eye movement sleep in animal models and can be damaged in Parkinson's disease. Here, we studied the integrity of the locus coeruleus/subcoeruleus complex in patients with Parkinson's disease using combined neuromelanin-sensitive, structural and diffusion magnetic resonance imaging approaches. We compared 24 patients with Parkinson's disease and rapid eye movement sleep behaviour disorder, 12 patients without rapid eye movement sleep behaviour disorder and 19 age- and gender-matched healthy volunteers. All subjects underwent clinical examination and characterization of rapid eye movement sleep using video-polysomnography and multimodal imaging at 3 T. Using neuromelanin-sensitive imaging, reduced signal intensity was evident in the locus coeruleus/subcoeruleus area in patients with Parkinson's disease that was more marked in patients with than those without rapid eye movement sleep behaviour disorder. Reduced signal intensity correlated with the percentage of abnormally increased muscle tone during rapid eye movement sleep. The results confirmed that this complex is affected in Parkinson's disease and showed a gradual relationship between damage to this structure, presumably the locus subcoeruleus, and abnormal muscle tone during rapid eye movement sleep, which is the cardinal marker of rapid eye movement sleep behaviour disorder. In longitudinal studies, the technique may also provide early markers of non-dopaminergic Parkinson's disease pathology to predict the occurrence of Parkinson's disease.

  3. Fun with Rhythmic Notation.

    ERIC Educational Resources Information Center

    Leto, Frank

    1996-01-01

    Presenting music and notation to elementary school children exposes them to musical concepts and inspires them to take an interest in music throughout their lives. Nine lessons demonstrate how to introduce rhythmic notation to elementary-age children while utilizing percussion instruments such as timpani drums, tambourines, and rhythm sticks. (TJQ)

  4. Guide to "Rhythmically Moving."

    ERIC Educational Resources Information Center

    Carlton, Elizabeth B.; Weikart, Phyllis S.

    This guide accompanies a series of recordings called "Rhythmically Moving." The series of nine recordings is a rare collection of international folk music designed to aid students as they learn to develop basic timing and musicianship. This guide helps the user of the series to receive maximum benefit from the first of the recordings (RM1). Using…

  5. Movement disorders in adult surviving patients with maple syrup urine disease.

    PubMed

    Carecchio, Miryam; Schneider, Susanne A; Chan, Heidi; Lachmann, Robin; Lee, Philip J; Murphy, Elaine; Bhatia, Kailash P

    2011-06-01

    Maple syrup urine disease is a rare metabolic disorder caused by mutations in the branched-chain α-keto acid dehydrogenase complex gene. Patients generally present early in life with a toxic encephalopathy because of the accumulation of the branched-chain amino acids leucine, isoleucine, and valine and the corresponding ketoacids. Movement disorders in maple syrup urine disease have typically been described during decompensation episodes or at presentation in the context of a toxic encephalopathy, with complete resolution after appropriate dietary treatment. Movement disorders in patients surviving childhood are not well documented. We assessed 17 adult patients with maple syrup urine disease (mean age, 27.5 years) with a special focus on movement disorders. Twelve (70.6%) had a movement disorder on clinical examination, mainly tremor and dystonia or a combination of both. Parkinsonism and simple motor tics were also observed. Pyramidal signs were present in 11 patients (64.7%), and a spastic-dystonic gait was observed in 6 patients (35.2%). In summary, movement disorders are common in treated adult patients with maple syrup urine disease, and careful neurological examination is advisable to identify those who may benefit from specific therapy. © 2011 Movement Disorder Society.

  6. Transitions between discrete and rhythmic primitives in a unimanual task

    PubMed Central

    Sternad, Dagmar; Marino, Hamal; Charles, Steven K.; Duarte, Marcos; Dipietro, Laura; Hogan, Neville

    2013-01-01

    Given the vast complexity of human actions and interactions with objects, we proposed that control of sensorimotor behavior may utilize dynamic primitives. However, greater computational simplicity may come at the cost of reduced versatility. Evidence for primitives may be garnered by revealing such limitations. This study tested subjects performing a sequence of progressively faster discrete movements in order to “stress” the system. We hypothesized that the increasing pace would elicit a transition to rhythmic movements, assumed to be computationally and neurally more efficient. Abrupt transitions between the two types of movements would support the hypothesis that rhythmic and discrete movements are distinct primitives. Ten subjects performed planar point-to-point arm movements paced by a metronome: starting at 2 s, the metronome intervals decreased by 36 ms per cycle to 200 ms, stayed at 200 ms for several cycles, then increased by similar increments. Instructions emphasized to insert explicit stops between each movement with a duration that equaled the movement time. The experiment was performed with eyes open and closed, and with short and long metronome sounds, the latter explicitly specifying the dwell duration. Results showed that subjects matched instructed movement times but did not preserve the dwell times. Rather, they progressively reduced dwell time to zero, transitioning to continuous rhythmic movements before movement times reached their minimum. The acceleration profiles showed an abrupt change between discrete and rhythmic profiles. The loss of dwell time occurred earlier with long auditory specification, when subjects also showed evidence of predictive control. While evidence for hysteresis was weak, taken together, the results clearly indicated a transition between discrete and rhythmic movements, supporting the proposal that representation is based on primitives rather than on veridical internal models. PMID:23888139

  7. Chronic posttraumatic movement disorder alleviated by insertion of meso-diencephalic deep brain stimulating electrode.

    PubMed

    Hooper, J; Simpson, P; Whittle, I R

    2001-10-01

    Incapacitating and drug-resistant posttraumatic movement disorders have successfully been treated by stereotactic thalamotomy. We describe the case of a young man with a posttraumatic hemiballismoid type movement disorder of the left arm, persistent for 2 years, who was selected for treatment with a thalamic deep brain stimulator. However, placement of the stimulating electrode tip at the junction of the zona incerta and subthalamic regions caused abolition of the movement disorder, and the pulse generator was not required. Reassessment over a 44-month period using multiple clinical and functional tests has confirmed continued benefit. This case adds to the reports of alleviation of movement disorders following either stereotactic thalamic mapping or placement of stimulating electrodes without macroscopic thalamic lesioning.

  8. Are movement disorders and sensorimotor injuries pathologic synergies? When normal multi-joint movement synergies become pathologic.

    PubMed

    Santello, Marco; Lang, Catherine E

    2014-01-01

    The intact nervous system has an exquisite ability to modulate the activity of multiple muscles acting at one or more joints to produce an enormous range of actions. Seemingly simple tasks, such as reaching for an object or walking, in fact rely on very complex spatial and temporal patterns of muscle activations. Neurological disorders such as stroke and focal dystonia affect the ability to coordinate multi-joint movements. This article reviews the state of the art of research of muscle synergies in the intact and damaged nervous system, their implications for recovery and rehabilitation, and proposes avenues for research aimed at restoring the nervous system's ability to control movement.

  9. Chronic Temporomandibular Disorders: disability, pain intensity and fear of movement.

    PubMed

    Gil-Martínez, Alfonso; Grande-Alonso, Mónica; López-de-Uralde-Villanueva, Ibai; López-López, Almudena; Fernández-Carnero, Josué; La Touche, Roy

    2016-12-01

    The objective was to compare and correlate disability, pain intensity, the impact of headache on daily life and the fear of movement between subgroups of patients with chronic temporomandibular disorder (TMD). A cross-sectional study was conducted in patients diagnosed with chronic painful TMD. Patients were divided into: 1) joint pain (JP); 2) muscle pain (MP); and 3) mixed pain. The following measures were included: Craniomandibular pain and disability (Craniofacial pain and disability inventory), neck disability (Neck Dsiability Index), pain intensity (Visual Analogue Scale), impact of headache (Headache Impact Test 6) and kinesiophobia (Tampa Scale of Kinesiophobia-11). A total of 154 patients were recruited. The mixed pain group showed significant differences compared with the JP group or MP group in neck disability (p < 0.001, d = 1.99; and p < 0.001, d = 1.17), craniomandibular pain and disability (p < 0.001, d = 1.34; and p < 0.001, d = 0.9, respectively), and impact of headache (p < 0.001, d = 1.91; and p < 0.001, d = 0.91, respectively). In addition, significant differences were observed between JP group and MP group for impact of headache (p < 0.001, d = 1.08). Neck disability was a significant covariate (37 % of variance) of craniomandibular pain and disability for the MP group (β = 0.62; p < 0.001). In the mixed chronic pain group, neck disability (β = 0.40; p < 0.001) and kinesiophobia (β = 0.30; p = 0.03) were significant covariate (33 % of variance) of craniomandibular pain and disability. Mixed chronic pain patients show greater craniomandibular and neck disability than patients diagnosed with chronic JP or MP. Neck disability predicted the variance of craniofacial pain and disability for patients with MP. Neck disability and kinesiophobia predicted the variance of craniofacial pain and disability for those with chronic mixed pain.

  10. Movement Disorders From the Use of Metoclopramide and Other Antiemetics in the Treatment of Migraine.

    PubMed

    Wijemanne, Subhashie; Jankovic, Joseph; Evans, Randolph W

    2016-01-01

    Nausea and vomiting are a frequent accompaniment of migraine and anti-nausea medications are frequently used in its management. The majority of anti-nausea medications that are used in migraine are dopamine receptor blocking agents and therefore have the potential to cause drug-induced movement disorders. This article explores the risk of such drug-induced movement disorders in migraineurs who were treated with these medications. © 2015 American Headache Society.

  11. Fundamental Movement Skills and Children with Attention-Deficit Hyperactivity Disorder: Peer Comparisons and Stimulant Effects

    ERIC Educational Resources Information Center

    Harvey, William J.; Reid, Greg; Grizenko, Natalie; Mbekou, Valentin; Ter-Stepanian, Marina; Joober, Ridha

    2007-01-01

    The purpose of this study was to compare the fundamental movement skills of 22 children with attention-deficit hyperactivity disorder (ADHD), from 6 to 12 years of age, to gender- and age-matched peers without ADHD and assess the effects of stimulant medication on the movement skill performance of the children with ADHD. Repeated measures analyses…

  12. Fundamental Movement Skills and Children with Attention-Deficit Hyperactivity Disorder: Peer Comparisons and Stimulant Effects

    ERIC Educational Resources Information Center

    Harvey, William J.; Reid, Greg; Grizenko, Natalie; Mbekou, Valentin; Ter-Stepanian, Marina; Joober, Ridha

    2007-01-01

    The purpose of this study was to compare the fundamental movement skills of 22 children with attention-deficit hyperactivity disorder (ADHD), from 6 to 12 years of age, to gender- and age-matched peers without ADHD and assess the effects of stimulant medication on the movement skill performance of the children with ADHD. Repeated measures analyses…

  13. Mitchell's case of "pendulum spasms": psychogenic movement disorder considered as male hysteria.

    PubMed

    Lanska, Douglas J

    2015-01-27

    In the late 19th century, a man with a psychogenic movement disorder was evaluated by many of the Philadelphia neurologists associated with Silas Weir Mitchell. In 1885, prior to the development of movie cameras or projectors, the patient was photographed by pioneering photographer Eadweard Muybridge, in collaboration with neurologist Francis Dercum, using arrays of sequentially triggered single-image cameras. The photographic sequences are among the first motion picture sequences of patients with neurologic disorders. Examination of extant primary source documents concerning this patient, including published writings and photographic sequences by Muybridge and Dercum, the original clinical descriptions, Mitchell's documentation of the patient's later clinical course, and results of the autopsy. Mitchell and his colleagues concluded that this was a "case of undoubted hysteria" in a man. Support for this contention includes the following: protracted course, spanning decades with temporary remissions; inconsistent character of the movement and features incongruous with typical "organic" tremors; complex, bizarre movements that are difficult to classify; increase in movements with attention; alteration in frequency of the movements with movement of the opposite arm; ability to trigger or temporarily stop the movements with unusual or nonphysiologic interventions; involvement of the opposite arm in a synchronous abnormal movement later in the course; remission with hypnotic suggestion; absence of other neurologic signs; and normal brain autopsy. The clinical history, serial examinations, photographic documentation, and autopsy results support Mitchell's contention that this was a case of male hysteria, or, in modern terminology, a psychogenic movement disorder. © 2015 American Academy of Neurology.

  14. Dance-Like Movements in Obsessive Compulsive Disorder

    PubMed Central

    Bavle, Amar; Kumar, Kottur; Sharath, Vishwaraj

    2016-01-01

    The presentation of Obsessive Compulsive Disorder (OCD) is sometimes unusual and can mimic other disorders. There are a number of rare and varied manifestations of this disorder, reported in literature. The case reported here, presented with a hitherto unreported symptom; a dance-like compulsion in a case of OCD. This symptom is notable for the influence of cultural environment, on the content of symptom manifestation, in a psychiatric disorder. When one symptom in a disorder presents itself very prominently, the other symptoms, which are less prominent become masked; and need to be elicited by detailed assessment. PMID:27114632

  15. [Sleep-wake transition disorders].

    PubMed

    Honma, H; Kobayashi, R; Koyama, T

    1998-02-01

    The term sleep-wake transition disorders refers to a group of parasomnias that occur during the transition from wakefulness to sleep or from one sleep stage to another. Rhythmic movement disorder, sleep starts, sleep talking, and nocturnal leg cramps--these four disorders belong to sleep-wake transition disorders in the International Classification of Sleep Disorders. Although these are common disorders, little attention is given to them and their mechanisms are remain unclear. The majority of patients are not so severe as to require any treatment. Their prognosis are usually well. This article describes sleep-wake transition disorders concerning the clinical features, differential diagnosis, treatment, etc.

  16. Consistent abnormalities in metabolic network activity in idiopathic rapid eye movement sleep behaviour disorder.

    PubMed

    Wu, Ping; Yu, Huan; Peng, Shichun; Dauvilliers, Yves; Wang, Jian; Ge, Jingjie; Zhang, Huiwei; Eidelberg, David; Ma, Yilong; Zuo, Chuantao

    2014-12-01

    Rapid eye movement sleep behaviour disorder has been evaluated using Parkinson's disease-related metabolic network. It is unknown whether this disorder is itself associated with a unique metabolic network. 18F-fluorodeoxyglucose positron emission tomography was performed in 21 patients (age 65.0±5.6 years) with idiopathic rapid eye movement sleep behaviour disorder and 21 age/gender-matched healthy control subjects (age 62.5±7.5 years) to identify a disease-related pattern and examine its evolution in 21 hemi-parkinsonian patients (age 62.6±5.0 years) and 16 moderate parkinsonian patients (age 56.9±12.2 years). We identified a rapid eye movement sleep behaviour disorder-related metabolic network characterized by increased activity in pons, thalamus, medial frontal and sensorimotor areas, hippocampus, supramarginal and inferior temporal gyri, and posterior cerebellum, with decreased activity in occipital and superior temporal regions. Compared to the healthy control subjects, network expressions were elevated (P<0.0001) in the patients with this disorder and in the parkinsonian cohorts but decreased with disease progression. Parkinson's disease-related network activity was also elevated (P<0.0001) in the patients with rapid eye movement sleep behaviour disorder but lower than in the hemi-parkinsonian cohort. Abnormal metabolic networks may provide markers of idiopathic rapid eye movement sleep behaviour disorder to identify those at higher risk to develop neurodegenerative parkinsonism.

  17. Patterns of cortical thinning in idiopathic rapid eye movement sleep behavior disorder.

    PubMed

    Rahayel, Shady; Montplaisir, Jacques; Monchi, Oury; Bedetti, Christophe; Postuma, Ronald B; Brambati, Simona; Carrier, Julie; Joubert, Sven; Latreille, Véronique; Jubault, Thomas; Gagnon, Jean-François

    2015-04-15

    Idiopathic rapid eye movement sleep behavior disorder is a parasomnia that is a risk factor for dementia with Lewy bodies and Parkinson's disease. Brain function impairments have been identified in this disorder, mainly in the frontal and posterior cortical regions. However, the anatomical support for these dysfunctions remains poorly understood. We investigated gray matter thickness, gray matter volume, and white matter integrity in patients with idiopathic rapid eye movement sleep behavior disorder. Twenty-four patients with polysomnography-confirmed idiopathic rapid eye movement sleep behavior disorder and 42 healthy individuals underwent a 3-tesla structural and diffusion magnetic resonance imaging examination using corticometry, voxel-based morphometry, and diffusion tensor imaging. In the patients with idiopathic rapid eye movement sleep behavior disorder, decreased cortical thickness was observed in the frontal cortex, the lingual gyrus, and the fusiform gyrus. Gray matter volume was reduced in the superior frontal sulcus only. Patients showed no increased gray matter thickness or volume. Diffusion tensor imaging analyses revealed no significant white matter differences between groups. Using corticometry in patients with idiopathic rapid eye movement sleep behavior disorder, several new cortical regions with gray matter alterations were identified, similar to those reported in dementia with Lewy bodies and Parkinson's disease. These findings provide some anatomical support for previously identified brain function impairments in this disorder.

  18. Music Games: Potential Application and Considerations for Rhythmic Training

    PubMed Central

    Bégel, Valentin; Di Loreto, Ines; Seilles, Antoine; Dalla Bella, Simone

    2017-01-01

    Rhythmic skills are natural and widespread in the general population. The majority can track the beat of music and move along with it. These abilities are meaningful from a cognitive standpoint given their tight links with prominent motor and cognitive functions such as language and memory. When rhythmic skills are challenged by brain damage or neurodevelopmental disorders, remediation strategies based on rhythm can be considered. For example, rhythmic training can be used to improve motor performance (e.g., gait) as well as cognitive and language skills. Here, we review the games readily available in the market and assess whether they are well-suited for rhythmic training. Games that train rhythm skills may serve as useful tools for retraining motor and cognitive functions in patients with motor or neurodevelopmental disorders (e.g., Parkinson’s disease, dyslexia, or ADHD). Our criteria were the peripheral used to capture and record the response, the type of response and the output measure. None of the existing games provides sufficient temporal precision in stimulus presentation and/or data acquisition. In addition, games do not train selectively rhythmic skills. Hence, the available music games, in their present form, are not satisfying for training rhythmic skills. Yet, some features such as the device used, the interface or the game scenario provide good indications for devising efficient training protocols. Guidelines are provided for devising serious music games targeting rhythmic training in the future. PMID:28611610

  19. Music Games: Potential Application and Considerations for Rhythmic Training.

    PubMed

    Bégel, Valentin; Di Loreto, Ines; Seilles, Antoine; Dalla Bella, Simone

    2017-01-01

    Rhythmic skills are natural and widespread in the general population. The majority can track the beat of music and move along with it. These abilities are meaningful from a cognitive standpoint given their tight links with prominent motor and cognitive functions such as language and memory. When rhythmic skills are challenged by brain damage or neurodevelopmental disorders, remediation strategies based on rhythm can be considered. For example, rhythmic training can be used to improve motor performance (e.g., gait) as well as cognitive and language skills. Here, we review the games readily available in the market and assess whether they are well-suited for rhythmic training. Games that train rhythm skills may serve as useful tools for retraining motor and cognitive functions in patients with motor or neurodevelopmental disorders (e.g., Parkinson's disease, dyslexia, or ADHD). Our criteria were the peripheral used to capture and record the response, the type of response and the output measure. None of the existing games provides sufficient temporal precision in stimulus presentation and/or data acquisition. In addition, games do not train selectively rhythmic skills. Hence, the available music games, in their present form, are not satisfying for training rhythmic skills. Yet, some features such as the device used, the interface or the game scenario provide good indications for devising efficient training protocols. Guidelines are provided for devising serious music games targeting rhythmic training in the future.

  20. Movement disorders are associated with schizotypy in unaffected siblings of patients with non-affective psychosis.

    PubMed

    Koning, J P; Tenback, D E; Kahn, R S; Vollema, M G; Cahn, W; van Harten, P N

    2011-10-01

    Movement disorders and schizotypy are both prevalent in unaffected siblings of patients with schizophrenia and both are associated with the risk of developing psychosis or schizophrenia. However, to date there has been no research into the association between these two vulnerability factors in persons with an increased genetic risk profile. We hypothesized that unaffected siblings of patients with non-affective psychosis have more movement disorders and schizotypy than healthy controls and that these co-occur. In a cross-sectional design we assessed the prevalence and inter-relationship of movement disorders and schizotypy in 115 unaffected siblings (mean age 27 years, 44% males) and 100 healthy controls (mean age 26 years, 51% males). Movement disorders were measured with the Abnormal Involuntary Movement Scale (AIMS), the Unified Parkinson Disease Rating Scale (UPDRS), the Barnes Akathisia Rating Scale (BARS), and one separate item for dystonia. Schizotypy was assessed with the Structured Interview for Schizotypy--Revised (SIS-R). There were significant differences in the prevalence of movement disorders in unaffected siblings versus healthy controls (10% v. 1%, p<0.01) but not in the prevalence of schizotypy. Unaffected siblings with a movement disorder displayed significantly more positive and total schizotypy (p=0.02 and 0.03 respectively) than those without. In addition, dyskinesia correlated with positive schizotypy (r=0.51, p=0.02). The association between movement disorders (dyskinesia in particular) with positive and total schizotypy in unaffected siblings suggests that certain vulnerability factors for psychosis or schizophrenia cluster in a subgroup of subjects with an increased genetic risk of developing the disease.

  1. Recent data on rapid eye movement sleep behavior disorder in patients with Parkinson disease: analysis of behaviors, movements, and periodic limb movements.

    PubMed

    Cochen De Cock, Valérie

    2013-08-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) is a fascinating parasomnia in which patients are able to enact their dreams because of a lack of muscle atonia during REM sleep. RBD represents a unique window into the dream world. Frequently associated with Parkinson's disease (PD), RBD raises various issues about dream modifications in this pathology and about aggressiveness during RBD episodes in placid patients during wakefulness. Studies on these behaviors have underlined their non-stereotyped, action-filled and violent characteristics but also their isomorphism with dream content. Complex, learnt behaviors may reflect the cortical involvement in this parasomnia but the more frequent elementary movements and the associated periodic limb movements during sleep also implicate the brainstem. Surprisingly, patients with PD have an improvement of their movements during their RBD as if they were disease-free. Also not yet understood, this improvement of movement during REM sleep raises issues about the pathways involved in RBD and about the possibility of using this pathway to improve movement in PD during the day. Copyright © 2012 Elsevier B.V. All rights reserved.

  2. Post-traumatic shoulder movement disorders: A challenging differential diagnosis between organic and functional

    PubMed Central

    Pandey, Sanjay; Nahab, Fatta; Aldred, Jason; Nutt, John; Hallett, Mark

    2014-01-01

    Peripheral trauma may be a trigger for the development of various movement disorders though the pathophysiology remains controversial and some of these patients have a functional (psychogenic) disorder. We report 3 cases of shoulder movement disorders following trauma to the shoulder region. Physiology was done in all the patients to extend the physical examination. Two patients had history of recurrent shoulder dislocation and were diagnosed with Ehlers-Danlos syndrome. One patient had shoulder injury following repeated falls while performing as a cheerleader. In two patients there were some clinical features suggesting a functional etiology, but physiological studies in all three failed to produce objective evidence of a functional nature. Shoulder movement following trauma is uncommon. Diagnosis in such cases is challenging considering the complex pathophysiology. The movements can be associated with prolonged pain and handicap, and once established they appear resistant to treatment. PMID:25197686

  3. Post-traumatic shoulder movement disorders: A challenging differential diagnosis between organic and functional.

    PubMed

    Pandey, Sanjay; Nahab, Fatta; Aldred, Jason; Nutt, John; Hallett, Mark

    2014-06-01

    Peripheral trauma may be a trigger for the development of various movement disorders though the pathophysiology remains controversial and some of these patients have a functional (psychogenic) disorder. We report 3 cases of shoulder movement disorders following trauma to the shoulder region. Physiology was done in all the patients to extend the physical examination. Two patients had history of recurrent shoulder dislocation and were diagnosed with Ehlers-Danlos syndrome. One patient had shoulder injury following repeated falls while performing as a cheerleader. In two patients there were some clinical features suggesting a functional etiology, but physiological studies in all three failed to produce objective evidence of a functional nature. Shoulder movement following trauma is uncommon. Diagnosis in such cases is challenging considering the complex pathophysiology. The movements can be associated with prolonged pain and handicap, and once established they appear resistant to treatment.

  4. Movement disorders and other motor abnormalities in adults with 22q11.2 deletion syndrome.

    PubMed

    Boot, Erik; Butcher, Nancy J; van Amelsvoort, Thérèse A M J; Lang, Anthony E; Marras, Connie; Pondal, Margarita; Andrade, Danielle M; Fung, Wai Lun Alan; Bassett, Anne S

    2015-03-01

    Movement abnormalities are frequently reported in children with 22q11.2 deletion syndrome (22q11.2DS), but knowledge in this area is scarce in the increasing adult population. We report on five individuals illustrative of movement disorders and other motor abnormalities in adults with 22q11.2DS. In addition to an increased susceptibility to neuropsychiatric disorders, seizures, and early-onset Parkinson disease, the underlying brain dysfunction associated with 22q11.2DS may give rise to an increased vulnerability to multiple movement abnormalities, including those influenced by medications. Movement abnormalities may also be secondary to treatable endocrine diseases and congenital musculoskeletal abnormalities. We propose that movement abnormalities may be common in adults with 22q11.2DS and discuss the implications and challenges important to clinical practice.

  5. Movement Disorders and Other Motor Abnormalities in Adults With 22q11.2 Deletion Syndrome

    PubMed Central

    Boot, Erik; Butcher, Nancy J; van Amelsvoort, Thérèse AMJ; Lang, Anthony E; Marras, Connie; Pondal, Margarita; Andrade, Danielle M; Fung, Wai Lun Alan; Bassett, Anne S

    2015-01-01

    Movement abnormalities are frequently reported in children with 22q11.2 deletion syndrome (22q11.2DS), but knowledge in this area is scarce in the increasing adult population. We report on five individuals illustrative of movement disorders and other motor abnormalities in adults with 22q11.2DS. In addition to an increased susceptibility to neuropsychiatric disorders, seizures, and early-onset Parkinson disease, the underlying brain dysfunction associated with 22q11.2DS may give rise to an increased vulnerability to multiple movement abnormalities, including those influenced by medications. Movement abnormalities may also be secondary to treatable endocrine diseases and congenital musculoskeletal abnormalities. We propose that movement abnormalities may be common in adults with 22q11.2DS and discuss the implications and challenges important to clinical practice. PMID:25684639

  6. Sleep medicine pharmacotherapeutics overview: today, tomorrow, and the future (part 2: hypersomnia, parasomnia, and movement disorders).

    PubMed

    Gulyani, Seema; Salas, Rachel E; Gamaldo, Charlene E

    2013-01-01

    Over the past 10 years, significant strides have been made in therapeutics for sleep disorders. In this second installment of a two-part review series, we discuss the current evidence surrounding the mechanisms of actions, indications, efficacy, and adverse side effects associated with the current over-the-counter and pharmacotherapeutics for hypersomnia, parasomnias, and movement disorders of sleep.

  7. Rapid eye movement sleep behavior disorder and subtypes in autopsy-confirmed dementia with Lewy bodies.

    PubMed

    Dugger, Brittany N; Boeve, Bradley F; Murray, Melissa E; Parisi, Joseph E; Fujishiro, Hiroshige; Dickson, Dennis W; Ferman, Tanis J

    2012-01-01

    The purpose of this study was to determine whether dementia with Lewy bodies with and without probable rapid eye movement sleep behavior disorder differ clinically or pathologically. Patients with dementia with Lewy bodies (DLB) with probable rapid eye movement sleep behavior sleep disorder (n = 71) were compared with those without it (n = 19) on demographics, clinical variables (core features of dementia with Lewy bodies, dementia duration, rate of cognitive/motor changes), and pathologic indices (Lewy body distribution, neuritic plaque score, Braak neurofibrillary tangle stage). Individuals with probable rapid eye movement sleep behavior disorder were predominantly male (82% vs 47%) and had a shorter duration of dementia (mean, 8 vs 10 years), earlier onset of parkinsonism (mean, 2 vs 5 years), and earlier onset of visual hallucinations (mean, 3 vs 6 years). These patients also had a lower Braak neurofibrillary tangle stage (stage IV vs stage VI) and lower neuritic plaque scores (18% vs 85% frequency), but no difference in Lewy body distribution. When probable rapid eye movement sleep behavior disorder developed early (at or before dementia onset), the onset of parkinsonism and hallucinations was earlier and Braak neurofibrillary tangle stage was lower compared with those who developed the sleep disorder after dementia onset. Women with autopsy-confirmed DLB without a history of dream enactment behavior during sleep had a later onset of hallucinations and parkinsonism and a higher Braak NFT stage. Probable rapid eye movement sleep behavior disorder is associated with distinct clinical and pathologic characteristics of dementia with Lewy bodies.

  8. Fixing the Mirrors: A Feasibility Study of the Effects of Dance Movement Therapy on Young Adults with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Koch, Sabine C.; Mehl, Laura; Sobanski, Esther; Sieber, Maik; Fuchs, Thomas

    2015-01-01

    From the 1970s on, case studies reported the effectiveness of therapeutic mirroring in movement with children with autism spectrum disorder. In this feasibility study, we tested a dance movement therapy intervention based on mirroring in movement in a population of 31 young adults with autism spectrum disorder (mainly high-functioning and…

  9. Fixing the Mirrors: A Feasibility Study of the Effects of Dance Movement Therapy on Young Adults with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Koch, Sabine C.; Mehl, Laura; Sobanski, Esther; Sieber, Maik; Fuchs, Thomas

    2015-01-01

    From the 1970s on, case studies reported the effectiveness of therapeutic mirroring in movement with children with autism spectrum disorder. In this feasibility study, we tested a dance movement therapy intervention based on mirroring in movement in a population of 31 young adults with autism spectrum disorder (mainly high-functioning and…

  10. Answering Hard Questions: "Wh"-Movement across Dialects and Disorder

    ERIC Educational Resources Information Center

    De Villiers, Jill; Roeper, Thomas; Bland-Stewart, Linda; Pearson, Barbara

    2008-01-01

    A large-scale study of complex "wh"-questions with 1,000 subjects aged 4-9 years is reported. The subjects' dialects were Mainstream American English or African American English, and approximately one-third were language impaired. The study examined when children permit long distance "wh"-movement, and when they respect a variety of syntactic…

  11. A biological measure of stress levels in patients with functional movement disorders.

    PubMed

    Maurer, Carine W; LaFaver, Kathrin; Ameli, Rezvan; Toledo, Ryan; Hallett, Mark

    2015-09-01

    While the presence of co-existing psychological stressors has historically been used as a supportive factor in the diagnosis of functional neurological disorders, many patients with functional neurological disorders deny the presence of these stressors. The stress response circuitry in these patients remains largely unexplored. We performed an observational study examining biological stress levels in patients with functional movement disorders as compared with matched healthy controls. Specifically, we compared levels of circulating cortisol, the end-product of the hypothalamic-pituitary-adrenal axis. Salivary cortisol samples were collected from patients with "clinically definite" functional movement disorders (n = 33) and their age- and sex-matched controls (n = 33). Collections were performed at five standardized time points, reflecting participants' diurnal cortisol cycles. To rule out confounders, participants also underwent extensive psychological assessment including Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Hamilton Anxiety Rating Scale, and Hamilton Rating Scale for Depression. Patients with functional movement disorders did not differ from matched controls with respect to levels of circulating cortisol. We demonstrate that current stress levels are not altered in patients with functional movement disorders. Our results warrant careful review of current management of patients with functional neurological symptoms, and suggest that the insistence on heightened stress levels in these patients is unjustified. Published by Elsevier Ltd.

  12. More Than Ataxia: Hyperkinetic Movement Disorders in Childhood Autosomal Recessive Ataxia Syndromes

    PubMed Central

    Pearson, Toni S.

    2016-01-01

    Background The autosomal recessive ataxias are a heterogeneous group of disorders that are characterized by complex neurological features in addition to progressive ataxia. Hyperkinetic movement disorders occur in a significant proportion of patients, and may sometimes be the presenting motor symptom. Presentations with involuntary movements rather than ataxia are diagnostically challenging, and are likely under-recognized. Methods A PubMed literature search was performed in October 2015 utilizing pairwise combinations of disease-related terms (autosomal recessive ataxia, ataxia–telangiectasia, ataxia with oculomotor apraxia type 1 (AOA1), ataxia with oculomotor apraxia type 2 (AOA2), Friedreich ataxia, ataxia with vitamin E deficiency), and symptom-related terms (movement disorder, dystonia, chorea, choreoathetosis, myoclonus). Results Involuntary movements occur in the majority of patients with ataxia–telangiectasia and AOA1, and less frequently in patients with AOA2, Friedreich ataxia, and ataxia with vitamin E deficiency. Clinical presentations with an isolated hyperkinetic movement disorder in the absence of ataxia include dystonia or dystonia with myoclonus with predominant upper limb and cervical involvement (ataxia–telangiectasia, ataxia with vitamin E deficiency), and generalized chorea (ataxia with oculomotor apraxia type 1, ataxia-telangiectasia). Discussion An awareness of atypical presentations facilitates early and accurate diagnosis in these challenging cases. Recognition of involuntary movements is important not only for diagnosis, but also because of the potential for effective targeted symptomatic treatment. PMID:27536460

  13. The coeruleus/subcoeruleus complex in idiopathic rapid eye movement sleep behaviour disorder.

    PubMed

    Ehrminger, Mickael; Latimier, Alice; Pyatigorskaya, Nadya; Garcia-Lorenzo, Daniel; Leu-Semenescu, Smaranda; Vidailhet, Marie; Lehericy, Stéphane; Arnulf, Isabelle

    2016-04-01

    Idiopathic rapid eye movement sleep behaviour disorder is characterized by nocturnal violence, increased muscle tone during rapid eye movement sleep and the lack of any other neurological disease. However, idiopathic rapid eye movement sleep behaviour disorder can precede parkinsonism and dementia by several years. Using 3 T magnetic resonance imaging and neuromelanin-sensitive sequences, we previously found that the signal intensity was reduced in the locus coeruleus/subcoeruleus area of patients with Parkinson's disease and rapid eye movement sleep behaviour disorder. Here, we studied the integrity of the locus coeruleus/subcoeruleus complex with neuromelanin-sensitive imaging in 21 patients with idiopathic rapid eye movement sleep behaviour disorder and compared the results with those from 21 age- and gender-matched healthy volunteers. All subjects underwent a clinical examination, motor, cognitive, autonomous, psychological, olfactory and colour vision tests, and rapid eye movement sleep characterization using video-polysomnography and 3 T magnetic resonance imaging. The patients more frequently had preclinical markers of alpha-synucleinopathies, including constipation, olfactory deficits, orthostatic hypotension, and subtle motor impairment. Using neuromelanin-sensitive imaging, reduced signal intensity was identified in the locus coeruleus/subcoeruleus complex of the patients with idiopathic rapid eye movement sleep behaviour. The mean sensitivity of the visual analyses of the signal performed by neuroradiologists who were blind to the clinical diagnoses was 82.5%, and the specificity was 81% for the identification of idiopathic rapid eye movement sleep behaviour. The results confirm that this complex is affected in idiopathic rapid eye movement sleep behaviour (to the same degree as it is affected in Parkinson's disease). Neuromelanin-sensitive imaging provides an early marker of non-dopaminergic alpha-synucleinopathy that can be detected on an individual

  14. Disrupted rapid eye movement sleep predicts poor declarative memory performance in post-traumatic stress disorder.

    PubMed

    Lipinska, Malgorzata; Timol, Ridwana; Kaminer, Debra; Thomas, Kevin G F

    2014-06-01

    Successful memory consolidation during sleep depends on healthy slow-wave and rapid eye movement sleep, and on successful transition across sleep stages. In post-traumatic stress disorder, sleep is disrupted and memory is impaired, but relations between these two variables in the psychiatric condition remain unexplored. We examined whether disrupted sleep, and consequent disrupted memory consolidation, is a mechanism underlying declarative memory deficits in post-traumatic stress disorder. We recruited three matched groups of participants: post-traumatic stress disorder (n = 16); trauma-exposed non-post-traumatic stress disorder (n = 15); and healthy control (n = 14). They completed memory tasks before and after 8 h of sleep. We measured sleep variables using sleep-adapted electroencephalography. Post-traumatic stress disorder-diagnosed participants experienced significantly less sleep efficiency and rapid eye movement sleep percentage, and experienced more awakenings and wake percentage in the second half of the night than did participants in the other two groups. After sleep, post-traumatic stress disorder-diagnosed participants retained significantly less information on a declarative memory task than controls. Rapid eye movement percentage, wake percentage and sleep efficiency correlated with retention of information over the night. Furthermore, lower rapid eye movement percentage predicted poorer retention in post-traumatic stress disorder-diagnosed individuals. Our results suggest that declarative memory consolidation is disrupted during sleep in post-traumatic stress disorder. These data are consistent with theories suggesting that sleep benefits memory consolidation via predictable neurobiological mechanisms, and that rapid eye movement disruption is more than a symptom of post-traumatic stress disorder.

  15. Brain perfusion and markers of neurodegeneration in rapid eye movement sleep behavior disorder.

    PubMed

    Vendette, Mélanie; Gagnon, Jean-François; Soucy, Jean-Paul; Gosselin, Nadia; Postuma, Ronald B; Tuineag, Maria; Godin, Isabelle; Montplaisir, Jacques

    2011-08-01

    Potential early markers of neurodegeneration such as subtle motor signs, reduced color discrimination, olfactory impairment, and brain perfusion abnormalities have been reported in idiopathic rapid eye movement sleep behavior disorder, a risk factor for Parkinson's disease and Lewy body dementia. The aim of this study was to reproduce observations of regional cerebral blood flow abnormalities in a larger independent sample of patients and to explore correlations between regional cerebral blood flow and markers of neurodegeneration. Twenty patients with idiopathic rapid eye movement sleep behavior disorder and 20 healthy controls were studied by single-photon emission computerized tomography. Motor examination, color discrimination, and olfactory identification were examined. Patients with rapid eye movement sleep behavior disorder showed decreased regional cerebral blood flow in the frontal cortex and in medial parietal areas and increased regional cerebral blood flow in subcortical regions including the bilateral pons, putamen, and hippocampus. In rapid eye movement sleep behavior disorder, brain perfusion in the frontal cortex and occipital areas was associated with poorer performance in the color discrimination test. Moreover, a relationship between loss of olfactory discrimination and regional cerebral blood flow reduction in the bilateral anterior parahippocampal gyrus, a region known to be involved in olfactory functions, was found. This study provides further evidence of regional cerebral blood flow abnormalities in rapid eye movement sleep behavior disorder that are similar to those seen in Parkinson's disease and Lewy body dementia. Moreover, regional cerebral blood flow anomalies were associated with markers of neurodegeneration.

  16. [Motor disorders in neurodevelopmental disorders. Tics and stereotypies].

    PubMed

    Eirís-Puñal, Jesús

    2014-02-24

    Tics are repetitive, sharp, rapid, non-rhythmic movements or utterances that are the result of sudden, abrupt and involuntary muscular contractions. Stereotypies are repetitive, apparently impulsive, rhythmic, purposeless movements that follow an individual repertoire that is specific to each individual and that occur under a variable time pattern, which may be either transient or persistent. Both are included in the Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5), among the neurodevelopmental disorders, and together with coordination development disorder go to make up the group of motor disorders. For tics, the categories of 'Tourette's disorder', 'chronic motor or vocal tic disorder' and 'unspecified tic disorder' have been maintained, whereas the category 'transient tics' has disappeared and 'provisional tic disorder' and 'other specified tic disorders' have been incorporated. Within stereotypic movement disorder, the DSM-5 replaces 'non-functional' by 'apparently purposeless'; the thresholds of the need for medical care are withdrawn and replaced with the manual's standard involvement criterion; mental retardation is no longer mentioned and emphasis is placed on the severity of the stereotypic movement; and a criterion concerning the onset of symptoms and specifiers of the existence or not of self-injurious behaviours have been added, together with the association with genetic or general medical diseases or extrinsic factors. Moreover, a categorisation depending on severity has also been included.

  17. Deep Brain Stimulation for Movement Disorders of Basal Ganglia Origin: Restoring Function or Functionality?

    PubMed

    Wichmann, Thomas; DeLong, Mahlon R

    2016-04-01

    Deep brain stimulation (DBS) is highly effective for both hypo- and hyperkinetic movement disorders of basal ganglia origin. The clinical use of DBS is, in part, empiric, based on the experience with prior surgical ablative therapies for these disorders, and, in part, driven by scientific discoveries made decades ago. In this review, we consider anatomical and functional concepts of the basal ganglia relevant to our understanding of DBS mechanisms, as well as our current understanding of the pathophysiology of two of the most commonly DBS-treated conditions, Parkinson's disease and dystonia. Finally, we discuss the proposed mechanism(s) of action of DBS in restoring function in patients with movement disorders. The signs and symptoms of the various disorders appear to result from signature disordered activity in the basal ganglia output, which disrupts the activity in thalamocortical and brainstem networks. The available evidence suggests that the effects of DBS are strongly dependent on targeting sensorimotor portions of specific nodes of the basal ganglia-thalamocortical motor circuit, that is, the subthalamic nucleus and the internal segment of the globus pallidus. There is little evidence to suggest that DBS in patients with movement disorders restores normal basal ganglia functions (e.g., their role in movement or reinforcement learning). Instead, it appears that high-frequency DBS replaces the abnormal basal ganglia output with a more tolerable pattern, which helps to restore the functionality of downstream networks.

  18. Movement.

    ERIC Educational Resources Information Center

    Roberts, Lynda S.

    This document summarizes 20 articles and books which stress the importance of movement in the overall development of the human species. Each summary ranges in length from 100 to 200 words and often includes direct quotations. A wide range of movement activities suitable for people of all ages (from infants to adults) are discussed. Many summaries…

  19. Are Movement Disorders and Sensorimotor Injuries Pathologic Synergies? When Normal Multi-Joint Movement Synergies Become Pathologic

    PubMed Central

    Santello, Marco; Lang, Catherine E.

    2015-01-01

    The intact nervous system has an exquisite ability to modulate the activity of multiple muscles acting at one or more joints to produce an enormous range of actions. Seemingly simple tasks, such as reaching for an object or walking, in fact rely on very complex spatial and temporal patterns of muscle activations. Neurological disorders such as stroke and focal dystonia affect the ability to coordinate multi-joint movements. This article reviews the state of the art of research of muscle synergies in the intact and damaged nervous system, their implications for recovery and rehabilitation, and proposes avenues for research aimed at restoring the nervous system’s ability to control movement. PMID:25610391

  20. Coherence analysis for movement disorder motion captured by six degree-of-freedom inertial sensing

    NASA Astrophysics Data System (ADS)

    Teskey, Wesley J. E.; Elhabiby, Mohamed; El-Sheimy, Naser; MacIntosh, Brian

    2012-06-01

    The use of inertial sensors (accelerometer and gyroscopes) for evaluation of movement disorder motion, including essential tremor (ET) and Parkinson's disease (PD), is becoming prevalent. This paper uses a novel combination of six degree-of-freedom motion analysis and coherence based processing methodologies to uncover differences in the signature of motion for the ET and PD movement disorders. This is the first analysis of such motions utilizing the novel methodology outlined, and it displays a distinct motion profile differentiating between these two groups. Such an analysis can be used to assist medical professionals in diagnosing movement disorders given a currently high error rate of diagnosis. As well, the Kalman smoothing analysis performed in this paper can be quite useful for any application when tracking of human motion is required. Another contribution of the work is the use of wavelets in zero phase lag filtering, which helped in preparing the data for analysis by removing unwanted frequencies without introducing distortions into the data.

  1. Successful Treatment of Paroxysmal Movement Disorders of Infancy With Dimenhydrinate and Diphenhydramine.

    PubMed

    Sawicka, Katherine M; Goez, Helly; Huntsman, Richard J

    2016-03-01

    Paroxysmal movement disorders including paroxysmal tonic upward gaze of infancy and paroxysmal dystonia of infancy are benign but uncommon movement disorders seen in young children. Although symptoms are intermittent and resolve spontaneously, they can cause discomfort and distress for the child. Current treatment options are limited to dopaminergic agents or anticonvulsants with limited efficacy. The authors present a child with paroxysmal tonic upward gaze of infancy and another with paroxysmal dystonia of infancy, both of whom responded successfully to treatment with low-dose dimenhydrinate or diphenhydramine, respectively. Dimenhydrinate and diphenhydramine both exert anticholinergic activity and have limited toxicity at low doses. This property makes either compound an attractive therapeutic option for paroxysmal movement disorders in infancy. These agents are generally well tolerated. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Group rhythmic synchrony and attention in children

    PubMed Central

    Khalil, Alexander K.; Minces, Victor; McLoughlin, Grainne; Chiba, Andrea

    2013-01-01

    Synchrony, or the coordinated processing of time, is an often-overlooked yet critical context for human interaction. This study tests the relationship between the ability to synchronize rhythmically in a group setting with the ability to attend in 102 elementary schoolchildren. Impairments in temporal processing have frequently been shown to exist in clinical populations with learning disorders, particularly those with Attention Deficit Hyperactivity Disorder (ADHD). Based on this evidence, we hypothesized that the ability to synchronize rhythmically in a group setting—an instance of the type of temporal processing necessary for successful interaction and learning—would be correlated with the ability to attend across the continuum of the population. A music class is an ideal setting for the study of interpersonal timing. In order to measure synchrony in this context, we constructed instruments that allowed the recording and measurement of individual rhythmic performance. The SWAN teacher questionnaire was used as a measurement of attentional behavior. We find that the ability to synchronize with others in a group music class can predict a child's attentional behavior. PMID:24032021

  3. Stability and composition of functional synergies for speech movements in children with developmental speech disorders.

    PubMed

    Terband, H; Maassen, B; van Lieshout, P; Nijland, L

    2011-01-01

    The aim of this study was to investigate the consistency and composition of functional synergies for speech movements in children with developmental speech disorders. Kinematic data were collected on the reiterated productions of syllables spa(/spaː/) and paas(/paːs/) by 10 6- to 9-year-olds with developmental speech disorders (five with speech sound disorder [SSD] and five with subtype childhood apraxia of speech [CAS]) and six normally speaking children using electro-magnetic midsagittal articulography (EMMA). Results showed a higher variability of tongue tip movement trajectories and a larger contribution of the lower lip relative to the jaw in oral closures for the five children with CAS compared to normally developing controls, indicating that functional synergies for speech movements in children with CAS may be both delayed and less stable. Furthermore, the SSD group showed a composition of tongue tip movements that is different from both CAS and controls. These results suggest that the differences in speech motor characteristics between SSD and subtype CAS are qualitative rather than quantitative. At the same time, the results suggest that both SSD and subtype CAS increase movement amplitude as an adaptive strategy to increase articulatory stability. Although in direct comparison no exclusive characteristics were found to differentiate subtype CAS from the group of children with SSD and from normally developing children, these preliminary results are promising for quantifying the role of speech motor processes in childhood speech sound disorders. The reader will be able to: (1) describe the development of speech motor control and explain the role of functional synergies/coordinative structures; (2) explain the measurement of the stability and composition of speech movements; (3) identify the difficulties in studying disordered speech motor development; (4) describe the differences in speech motor characteristics between SSD and subtype CAS; (5) describe

  4. Illusory movements of the contralesional hand in patients with body image disorders

    PubMed Central

    Zampini, M; Moro, V; Aglioti, S

    2004-01-01

    Methods: Ten RBD patients (three with disorders of bodily representations) were asked to report whether movements of their right hand induced any illusory somatic or motor sensations. Inquiries on anomalous sensation of movement of the left hand were carried out while subjects: 1) observed the moving hand in a mirror propped vertically along the parasagittal plane; 2) looked directly at the moving hand; 3) looked at the still hand; 4) kept their eyes closed. Twelve healthy subjects served as controls. Results: Movement of the right hand induced a very clear sensation of movement of the left, contralesional hand in two patients affected by body image disorders. Remarkably, this occurred mainly while subjects were looking in the mirror, that is, when conflicts between visual, somatic, and motor information were maximal. In no condition did control subjects report any consistent anomalous evoked movement or sensation. Conclusions: Illusory movements of the left, plegic hand contingent upon sensorimotor conflicts can be evoked in brain damaged patients with body image disorders. PMID:15489402

  5. Selective dysfunction of basal ganglia subterritories: From movement to behavioral disorders.

    PubMed

    Tremblay, Léon; Worbe, Yulia; Thobois, Stéphane; Sgambato-Faure, Véronique; Féger, Jean

    2015-08-01

    Historically, Parkinson's disease (PD) was defined as a pure movement disorder. Currently, it is widely accepted that this disease is also characterized by nonmotor signs, such as depression, apathy, and anxiety. On the other hand, the consideration of Gilles de la Tourette syndrome (GTS) as a neuropsychiatric disorder has also been debated. In this review, we will focus on these two disorders, which combine both motor and behavioral features and in which dysfunction of cortical and subcortical regions was suggested. Anatomical, experimental, and clinical data are reported to support the involvement of basal ganglia (BG) in cognitive and motivational functions in addition to motor control. In PD, the nonmotor signs could result from the heterogeneity of dopaminergic lesions and excessive activation of the dopamine receptors, particularly within the limbic neuronal networks. Experimental results obtained on nonhuman primates using local disinhibition within functional territories of BG allowed the precise mapping of their motor and nonmotor functions. Thus, impairment of inhibitory control inside specific striatal territories induced behavioral disorders and abnormal movements, which had striking similarities to clinical expressions of GTS. Establishing such a relationship between BG subterritories and motor and behavioral disorders could potentially be helpful for future target choices for DBS in many neuropsychiatric disorders. Furthermore, it is also of great interest for therapeutic research and for the efficient targeting of symptom relief to determine the precise pharmacological effects of the two main modulators of BG function, which are dopamine and serotonin. © 2015 International Parkinson and Movement Disorder Society.

  6. Is there a place for placebo in management of psychogenic movement disorders?

    PubMed

    Lim, Erle C H; Ong, Benjamin K C; Seet, Raymond C S

    2007-03-01

    The management of psychogenic movement disorders is fraught with difficulties. Empathy and a non-judgmental manner are essential in dealing with patients, and a neurobiological explanation of the symptoms may help to foster trust, acceptance, understanding and recovery. We report a 17-year-old Chinese girl with psychogenic blepharospasm. Her parents refused psychotherapy and pharmacotherapy. Placebo therapy (with parental consent) was prescribed with favourable results. We examine the ethical considerations for and against placebo therapy, and explore the role of placebo therapy in the management of psychogenic movement disorders.

  7. Experimental treatment of antipsychotic-induced movement disorders

    PubMed Central

    Shireen, Erum

    2016-01-01

    Antipsychotic drugs are extensively prescribed for the treatment of schizophrenia and other related psychiatric disorders. These drugs produced their action by blocking dopamine (DA) receptors, and these receptors are widely present throughout the brain. Therefore, extended antipsychotic use also leads to severe extrapyramidal side effects. The short-term effects include parkinsonism and the later appearing tardive dyskinesia. Currently available treatments for these disorders are mostly symptomatic and insufficient, and are often linked with a number of detrimental side effects. Antipsychotic-drug-induced tardive dyskinesia prompted researchers to explore novel drugs with fewer undesirable extrapyramidal side effects. Preclinical studies suggest a role of 5-hydroxytryptamine (serotonin)-1A and 2A/2C receptors in the modulation of dopaminergic neurotransmission and motivating a search for better therapeutic strategies for schizophrenia and related disorders. In addition, adjunctive treatment with antioxidants such as vitamin E, red rice bran oil, and curcumin in the early phases of illness may prevent additional oxidative injury, and thus improve and prevent further possible worsening of related neurological and behavioral deficits in schizophrenia. This review explains the role of serotonergic receptors and oxidative stress, with the aim of providing principles for prospect development of compounds to improve therapeutic effects of antischizophrenic drugs. PMID:27540314

  8. Closed-loop Brain-Machine-Body Interfaces for Noninvasive Rehabilitation of Movement Disorders

    PubMed Central

    Broccard, Frédéric D.; Mullen, Tim; Chi, Yu Mike; Peterson, David; Iversen, John R.; Arnold, Mike; Kreutz-Delgado, Kenneth; Jung, Tzyy-Ping; Makeig, Scott; Poizner, Howard; Sejnowski, Terrence; Cauwenberghs, Gert

    2014-01-01

    Traditional approaches for neurological rehabilitation of patients affected with movement disorders, such as Parkinson's disease (PD), dystonia, and essential tremor (ET) consist mainly of oral medication, physical therapy, and botulinum toxin injections. Recently, the more invasive method of deep brain stimulation (DBS) showed significant improvement of the physical symptoms associated with these disorders. In the past several years, the adoption of feedback control theory helped DBS protocols to take into account the progressive and dynamic nature of these neurological movement disorders that had largely been ignored so far. As a result, a more efficient and effective management of PD cardinal symptoms has emerged. In this paper, we review closed-loop systems for rehabilitation of movement disorders, focusing on PD, for which several invasive and noninvasive methods have been developed during the last decade, reducing the complications and side effects associated with traditional rehabilitation approaches and paving the way for tailored individual therapeutics. We then present a novel, transformative, noninvasive closed-loop framework based on force neurofeedback and discuss several future developments of closed-loop systems that might bring us closer to individualized solutions for neurological rehabilitation of movement disorders. PMID:24833254

  9. Closed-loop brain-machine-body interfaces for noninvasive rehabilitation of movement disorders.

    PubMed

    Broccard, Frédéric D; Mullen, Tim; Chi, Yu Mike; Peterson, David; Iversen, John R; Arnold, Mike; Kreutz-Delgado, Kenneth; Jung, Tzyy-Ping; Makeig, Scott; Poizner, Howard; Sejnowski, Terrence; Cauwenberghs, Gert

    2014-08-01

    Traditional approaches for neurological rehabilitation of patients affected with movement disorders, such as Parkinson's disease (PD), dystonia, and essential tremor (ET) consist mainly of oral medication, physical therapy, and botulinum toxin injections. Recently, the more invasive method of deep brain stimulation (DBS) showed significant improvement of the physical symptoms associated with these disorders. In the past several years, the adoption of feedback control theory helped DBS protocols to take into account the progressive and dynamic nature of these neurological movement disorders that had largely been ignored so far. As a result, a more efficient and effective management of PD cardinal symptoms has emerged. In this paper, we review closed-loop systems for rehabilitation of movement disorders, focusing on PD, for which several invasive and noninvasive methods have been developed during the last decade, reducing the complications and side effects associated with traditional rehabilitation approaches and paving the way for tailored individual therapeutics. We then present a novel, transformative, noninvasive closed-loop framework based on force neurofeedback and discuss several future developments of closed-loop systems that might bring us closer to individualized solutions for neurological rehabilitation of movement disorders.

  10. Movement.

    ERIC Educational Resources Information Center

    Online-Offline, 1998

    1998-01-01

    Focuses on movement: movable art, relocating families, human rights, and trains and cars. Describes educational resources for elementary and middle school students, including Web sites, CD-ROMs and software, videotapes, books, additional resources and activities (PEN)

  11. Sex Differences in Rhythmic Preferences in the Budgerigar (Melopsittacus undulatus): A Comparative Study with Humans.

    PubMed

    Hoeschele, Marisa; Bowling, Daniel L

    2016-01-01

    A variety of parrot species have recently gained attention as members of a small group of non-human animals that are capable of coordinating their movements in time with a rhythmic pulse. This capacity is highly developed in humans, who display unparalleled sensitivity to musical beats and appear to prefer rhythmically organized sounds in their music. Do parrots also exhibit a preference for rhythmic over arrhythmic sounds? Here, we presented humans and budgerigars (Melopsittacus undulatus) - a small parrot species that have been shown to be able to align movements with a beat - with rhythmic and arrhythmic sound patterns in an acoustic place preference paradigm. Both species were allowed to explore an environment for 5 min. We quantified how much time they spent in proximity to rhythmic vs. arrhythmic stimuli. The results show that humans spent more time with rhythmic stimuli, and also preferred rhythmic stimuli when directly asked in a post-test survey. Budgerigars did not show any such overall preferences. However, further examination of the budgerigar results showed an effect of sex, such that male budgerigars spent more time with arrthymic stimuli, and female budgerigars spent more time with rhythmic stimuli. Our results support the idea that rhythmic information is interesting to budgerigars. We suggest that future investigations into the temporal characteristics of naturalistic social behaviors in budgerigars, such as courtship vocalizations and head-bobbing displays, may help explain the sex difference we observed.

  12. Sex Differences in Rhythmic Preferences in the Budgerigar (Melopsittacus undulatus): A Comparative Study with Humans

    PubMed Central

    Hoeschele, Marisa; Bowling, Daniel L.

    2016-01-01

    A variety of parrot species have recently gained attention as members of a small group of non-human animals that are capable of coordinating their movements in time with a rhythmic pulse. This capacity is highly developed in humans, who display unparalleled sensitivity to musical beats and appear to prefer rhythmically organized sounds in their music. Do parrots also exhibit a preference for rhythmic over arrhythmic sounds? Here, we presented humans and budgerigars (Melopsittacus undulatus) – a small parrot species that have been shown to be able to align movements with a beat – with rhythmic and arrhythmic sound patterns in an acoustic place preference paradigm. Both species were allowed to explore an environment for 5 min. We quantified how much time they spent in proximity to rhythmic vs. arrhythmic stimuli. The results show that humans spent more time with rhythmic stimuli, and also preferred rhythmic stimuli when directly asked in a post-test survey. Budgerigars did not show any such overall preferences. However, further examination of the budgerigar results showed an effect of sex, such that male budgerigars spent more time with arrthymic stimuli, and female budgerigars spent more time with rhythmic stimuli. Our results support the idea that rhythmic information is interesting to budgerigars. We suggest that future investigations into the temporal characteristics of naturalistic social behaviors in budgerigars, such as courtship vocalizations and head-bobbing displays, may help explain the sex difference we observed. PMID:27757099

  13. Subliminal gait initiation deficits in rapid eye movement sleep behavior disorder: A harbinger of freezing of gait?

    PubMed

    Alibiglou, Laila; Videnovic, Aleksandar; Planetta, Peggy J; Vaillancourt, David E; MacKinnon, Colum D

    2016-11-01

    Muscle activity during rapid eye movement sleep is markedly increased in people with rapid eye movement sleep behavior disorder and people with Parkinson's disease (PD) who have freezing of gait. This study examined whether individuals with rapid eye movement sleep behavior disorder who do not have a diagnosis of PD show abnormalities in gait initiation that resemble the impairments observed in PD and whether there is a relationship between these deficits and the level of rapid eye movement sleep without atonia. Gait initiation and polysomnography studies were conducted in 4 groups of 10 participants: rapid eye movement sleep behavior disorder, PD with and without freezing of gait, and controls. Significant reductions were seen in the posterior shift of the center of pressure during the propulsive phase of gait initiation in the groups with rapid eye movement sleep behavior disorder and PD with freezing of gait when compared with controls and PD nonfreezers. These reductions negatively correlated with the amount of rapid eye movement sleep without atonia. The duration of the initial dorsiflexor muscle burst during gait initiation was significantly reduced in both PD groups and the rapid eye movement sleep behavior disorder cohort. These results provide evidence that people with rapid eye movement sleep behavior disorder, prior to a diagnosis of a degenerative neurologic disorder, show alterations in the coupling of posture and gait similar to those seen in PD. The correlation between increased rapid eye movement sleep without atonia and deficits in forward propulsion during the push-off phase of gait initiation suggests that abnormities in the regulation of muscle tone during rapid eye movement sleep may be related to the pathogenesis of freezing of gait. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

  14. Effects of Kindermusik Training on Infants' Rhythmic Enculturation

    ERIC Educational Resources Information Center

    Gerry, David W.; Faux, Ashley L.; Trainor, Laurel J.

    2010-01-01

    Phillips-Silver and Trainor (2005) demonstrated a link between movement and the metrical interpretation of rhythm patterns in 7-month-old infants. Infants bounced on every second beat of a rhythmic pattern with no auditory accents later preferred to listen to an accented version of the pattern with accents every second beat (duple or march meter),…

  15. Effects of Kindermusik Training on Infants' Rhythmic Enculturation

    ERIC Educational Resources Information Center

    Gerry, David W.; Faux, Ashley L.; Trainor, Laurel J.

    2010-01-01

    Phillips-Silver and Trainor (2005) demonstrated a link between movement and the metrical interpretation of rhythm patterns in 7-month-old infants. Infants bounced on every second beat of a rhythmic pattern with no auditory accents later preferred to listen to an accented version of the pattern with accents every second beat (duple or march meter),…

  16. Some anthropologic factors of performance in rhythmic gymnastics novices.

    PubMed

    Miletić, Durdica; Katić, Ratko; Males, Boris

    2004-12-01

    The aim of the study was to determine motor and morphological factors, and to assess their impact on specific motor skill performance in rhythmic gymnastics (RG). Experimental training process aimed at learning and improving basic movement structures of rhythmic gymnastics was performed for nine months in a sample of 50 female rhythmic gymnastics novices (mean age 7.1 +/- 0.3 years). Seven dimensions in total were isolated by factorial analysis of 13 motor, 11 morphological, and 20 specific rhythmic gymnastics tests. The factors of flexibility (Beta = 0.26; p < 0.05), explosive strength (Beta = 0.25; p < 0.05) and adipose voluminosity (Beta = -0.42; p < 0.001) explains 41% of the success in performing RG basic body elements--jumps, rotations, balance and flexibility (R = 0.64), while the frequency of movement (Beta = 0.44; p < 0.001) and non-adipose voluminosity (Beta = 0.26; p < 0.05) explains 26% of RG-specific manipulations with the apparatus--club, ribbon and ball wrist manipulation (R = 0.52; p < 0.01). According to study results, the RG-training process intended for rhythmic gymnastics novices should be programmed, with preset objectives for the development of flexibility and explosive strength, speed and peripheral joint strength and adipose tissue reduction.

  17. Quality of life in patients with an idiopathic rapid eye movement sleep behaviour disorder in Korea.

    PubMed

    Kim, Keun Tae; Motamedi, Gholam K; Cho, Yong Won

    2017-08-01

    There have been few quality of life studies in patients with idiopathic rapid eye movement sleep behaviour disorder. We compared the quality of life in idiopathic rapid eye movement sleep behaviour disorder patients to healthy controls, patients with hypertension, type 2 diabetes mellitus without complication and idiopathic restless legs syndrome. Sixty patients with idiopathic rapid eye movement sleep behaviour disorder (24 female; mean age: 61.43 ± 8.99) were enrolled retrospectively. The diagnosis was established based on sleep history, overnight polysomnography, neurological examination and Mini-Mental State Examination to exclude secondary rapid eye movement sleep behavior disorder. All subjects completed questionnaires, including the Short Form 36-item Health Survey for quality of life. The total quality of life score in idiopathic rapid eye movement sleep behaviour disorder (70.63 ± 20.83) was lower than in the healthy control group (83.38 ± 7.96) but higher than in the hypertension (60.55 ± 24.82), diabetes mellitus (62.42 ± 19.37) and restless legs syndrome (61.77 ± 19.25) groups. The total score of idiopathic rapid eye movement sleep behaviour disorder patients had a negative correlation with the Pittsburg Sleep Quality Index (r = -0.498, P < 0.001), Insomnia Severity Index (r = -0.645, P < 0.001) and the Beck Depression Inventory-2 (r = -0.694, P < 0.001). Multiple regression showed a negative correlation between the Short Form 36-item Health Survey score and the Insomnia Severity Index (β = -1.100, P = 0.001) and Beck Depression Inventory-2 (β = -1.038, P < 0.001). idiopathic rapid eye movement sleep behaviour disorder had a significant negative impact on quality of life, although this effect was less than that of other chronic disorders. This negative effect might be related to a depressive mood associated with the disease. © 2016 European Sleep Research Society.

  18. Antibody binding to neuronal surface in movement disorders associated with lupus and antiphospholipid antibodies.

    PubMed

    Dale, Russell C; Yin, Katie; Ding, Alice; Merheb, Vera; Varadkhar, Sophie; McKay, Damien; Singh-Grewal, Davinder; Brilot, Fabienne

    2011-06-01

    Systemic lupus erythematosus is a multi-organ autoimmune disorder associated with autoantibodies of complex diversity. Antiphospholipid antibodies (aPL), which are commonly associated with lupus, create a pro-thrombotic tendency, but are also associated with non-thrombotic neurological features. Movement disorders are rare neuropsychiatric complications of lupus and antiphospholipid syndrome, and autoimmune and thromboembolic disease mechanisms have been proposed. We describe the clinical features, investigation findings, treatment, and outcome of six paediatric participants with movement disorders associated with lupus and/or aPL (six females, median age 13 y, range 8-15). To examine the autoantibody hypothesis, we used a neuronal cell line with dopaminergic characteristics and measured serum antibody binding to neuronal cell-surface antigens using flow cytometry. For comparison with the six participants, we used serum from healthy individuals (n=12, six females, median age 11 y, range 9-13) and children with other neurological diseases (n=13, seven females, median age 7 y, range 2-15). Of the six participants, two had lupus only, two had lupus with aPL, and two had aPL only. The movement disorder was chorea in four and parkinsonism in two. All four participants with chorea had aPL and movement disorder relapses. The two participants with parkinsonism did not have aPL, but had a progressive course until rituximab or plasma exchange resulted in neuropsychiatric remission. All six participants demonstrated elevated serum antibody binding to neuronal cell-surface antigens compared with healthy individuals and those with other neurological diseases. This report supports the association of chorea with aPL, but suggests a different autoimmune mechanism operates in lupus parkinsonism. The presence of antibody binding to neuronal cell-surface antigens supports a possible direct action of autoantibodies on neurons in patients with movement disorders associated with lupus

  19. Real-time gait analysis for diagnosing movement disorders

    NASA Astrophysics Data System (ADS)

    Green, Richard D.; Guan, Ling; Burne, J. A.

    1998-06-01

    This paper describes a video analysis system, free of markers and set-up procedures, that quantitatively identified gait abnormalities in real-time from standard video images. A novel color 3D body model was sized and texture mapped to the exact characteristics of a person from video images. The kinematics of the body model was represented by a transformation tree to track the position and orientation of a person relative to the camera. Joint angles were used to track the location and orientation of each body part, with the range of joint angles being constrained by associating degrees of freedom with each joint. To stabilize tracking, the joint angles were estimated for the next frame. The calculation of joint angles, for the next frame, was cast as an estimation problem which was solved using an iterated extended Kalman filter. Patients with dopa-responsive parkinsonism, and age matched normals, were video taped during several gait cycles with walking movements successfully tracked and classified. The results suggested that this approach has the potential to guide clinicians on the relative sensitivity of specific postural/gait features in diagnosis.

  20. Dopamine depleters in the treatment of hyperkinetic movement disorders.

    PubMed

    Jankovic, Joseph

    2016-12-01

    Abnormal involuntary movements often improve in response to anti-dopaminergic drugs. In contrast to classic neuroleptics that block dopamine receptors, drugs that deplete presynaptic dopamine by blocking vesicular monoamine transporter type 2 (VMAT2) seem to be safer and have little or no risk of tardive dyskinesia. This is one reason why there has been a recent emergence of novel VMAT2 inhibitors. Areas covered: Since the approval of tetrabenazine, the classic VMAT2 inhibitor, in the treatment of chorea associated with Huntington disease (HD), other VMAT2 inhibitors (e.g. deutetrabenazine and valbenazine) have been studied in the treatment of HD-related chorea, tardive dyskinesia and tics associated with Tourette syndrome. This review, based largely on a detailed search of PubMed, will summarize the pharmacology and clinical experience with the various VMAT2 inhibitors. Expert commentary: Because of differences in pharmacology and pharmacokinetics these new VMAT2 inhibitors promise to be at least as effective as tetrabenazine but with a lower risk of adverse effects, such as sedation, insomnia, depression, parkinsonism, and akathisia.

  1. Electrophysiological and behavioral measures of visuo-motor learning for application in movement disorders.

    PubMed

    Quinlivan, Brendan T; Butler, John S; Hutchinson, Michael K; O'Riordan, Sean; Ridwan, Raquib A; Reilly, Richard B

    2014-01-01

    Dystonia is the third most common movement disorder worldwide and drastically reduces the quality of life of those who are affected. Despite its prevalence, very little is known about the underlying pathology of the disorder. Recent literature has suggested that abnormal processing in the superior colliculus (SC) may play a role in Dystonia. The SC is known to be an important hub in the neural network that is used when learning a novel movement and therefore we would postulate that a disorder of SC should result in abnormal movement learning. Here 9 participants completed learning and non-learning movement tasks while behavioural and electrophysiological data were acquired. The results of this study show that there is a significant relationship between the behavioural and electrophysiological data (R(2) = 0.19, F(1, 46) =10.88, p < 0.002) during the learning task but not in the non-learning task (p > 0.05). The developed paradigm is ideally suited for probing the underlying pathology of Dystonia via movement learning.

  2. Spontaneously hypertensive rats: possible animal model of sleep-related movement disorders.

    PubMed

    Esteves, Andrea M; Lopes, Cleide; Frussa-Filho, Roberto; Frank, Miriam K; Cavagnolli, Daniel; Arida, Ricardo M; Tufik, Sergio; de Mello, Marco Tulio

    2013-01-01

    Clinical experience suggests that restless legs syndrome (RLS), periodic leg movement (PLM), and attention-deficit hyperactivity disorder (ADHD) may co-occur in both children and adults. The purpose of the present study was to provide an electrocorticography and electromyography evaluation of the spontaneously hypertensive rat (SHR) to investigate the potential of this rat strain as an animal model of RLS-PLM. Initial work focused on evaluating sleep patterns and limb movements during sleep in SHR, having normotensive Wistar rats (NWR) as control, followed by comparison of two treatments (pharmacological-dopaminergic agonist treatment and nonpharmacological-chronic physical exercise), known to be clinically beneficial for sleep-related movement disorders. The captured data strengthen the association between SHR and RLS-PLM, revealing a significant reduction on sleep efficiency and slow wave sleep and an increase on wakefulness and limb movements for the SHR group during the dark period, as compared to the NWR group, effects that have characteristics that are strikingly consistent with RLS-PLM. The pharmacological and nonpharmacological manipulations validated these results. The present findings suggest that the SHR may be a useful putative animal model to study sleep-related movement disorders mechanisms.

  3. Diagnostic performance of the “Huffing and Puffing” sign in psychogenic (functional) movement disorders

    PubMed Central

    Laub, Holly N.; Dwivedi, Alok K.; Revilla, Fredy J.; Duker, Andrew P.; Pecina-Jacob, Cara; Espay, Alberto J.

    2014-01-01

    Objective To determine the diagnostic value of effort-associated behaviors (“huffing and puffing” spectrum) in patients with psychogenic movement disorders. Methods Three blinded clinicians rated presence, severity, and duration of effort-associated features during standing and walking tasks on edited videos of 131 patients with psychogenic gait disorders and 37 patients with organic gait disorders. Results Huffing, grunting, grimacing, and breath holding were the most common effort-associated behaviors in patients with psychogenic gait disorders, with a combined prevalence of 44% and disproportionate to the severity of gait impairment compared to organic gait disorders. The presence of “huffing and puffing”-type behaviors yielded a relatively low sensitivity but high specificity for the diagnosis of psychogenic movement disorders, increasing the odds of diagnosis 13-fold (95%, CI: 4.2–43.8) compared to organic gait disorders. Conclusions Demonstration of effort-associated behaviors during standing and walking strongly supports the psychogenic nature of disorders when gait is involved. PMID:25961068

  4. Loss of sensory attenuation in patients with functional (psychogenic) movement disorders.

    PubMed

    Pareés, Isabel; Brown, Harriet; Nuruki, Atsuo; Adams, Rick A; Davare, Marco; Bhatia, Kailash P; Friston, Karl; Edwards, Mark J

    2014-11-01

    Functional movement disorders require attention to manifest yet patients report the abnormal movement to be out of their control. In this study we explore the phenomenon of sensory attenuation, a measure of the sense of agency for movement, in this group of patients by using a force matching task. Fourteen patients and 14 healthy control subjects were presented with forces varying from 1 to 3 N on the index finger of their left hand. Participants were required to match these forces; either by pressing directly on their own finger or by operating a robot that pressed on their finger. As expected, we found that healthy control subjects consistently overestimated the force required when pressing directly on their own finger than when operating a robot. However, patients did not, indicating a significant loss of sensory attenuation in this group of patients. These data are important because they demonstrate that a fundamental component of normal voluntary movement is impaired in patients with functional movement disorders. The loss of sensory attenuation has been correlated with the loss of sense of agency, and may help to explain why patients report that they do not experience the abnormal movement as voluntary.

  5. Parasomnias and other sleep-related movement disorders.

    PubMed

    Lee-Chiong, Teofilo L

    2005-06-01

    Parasomnias are common clinical complaints. Formal sleep evaluation including PSG is indicated for parasomnias that are violent and potentially injurious; disruptive to the bed partner or other household members; accompanied by excessive daytime sleepiness; or associated with medical,psychiatric, or neurologic symptoms or findings [2]. Multiple sleep latency testing should be considered for patients who have complaints of excessive daytime sleepiness. An extensive history, including medical, neurologic,psychiatric, and sleep disorder, and a review of medication, alcohol, illicit drug use, and family history of parasomnias, may provide useful clues. Distinguishing between a parasomnia and a seizure may be difficult as both can present as recurrent, stereotypical behaviors. Evaluation may be aided by an expanded EEG montage during overnight PSG studies.

  6. Reply to: Spontaneous Intracranial Hypotension and its Association with Movement Disorders?

    PubMed Central

    Salazar, Richard

    2016-01-01

    In Response To: Onder H. Spontaneous intracranial hypotension and its association with movement disorders? Tremor Other Hyperkinet Mov. 2016; 6. doi: 10.7916/D84B31NS Original Article: Salazar R. Spontaneous intracranial hypotension associated with kinetic tremor and ataxia. Tremor Other Hyperkinet Mov. 2016; 6. doi: 10.7916/D8HQ3ZN5 PMID:27905574

  7. Arm and Hand Movement in Children Suspected of Having Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Braddock, Barbara A.; Hilton, Jane C.

    2016-01-01

    The aim of this study was to describe arm and hand movement in children suspected of having autism spectrum disorder (ASD; age range 29-43 months). A videotaped retrospective review of five children with symptoms of ASD during "Communication Temptation Tasks" was completed at two time points (pre-testing and 6 weeks later). Categories of…

  8. Eye-Movement Patterns Are Associated with Communicative Competence in Autistic Spectrum Disorders

    ERIC Educational Resources Information Center

    Norbury, Courtenay Frazier; Brock, Jon; Cragg, Lucy; Einav, Shiri; Griffiths, Helen; Nation, Kate

    2009-01-01

    Background: Investigations using eye-tracking have reported reduced fixations to salient social cues such as eyes when participants with autism spectrum disorders (ASD) view social scenes. However, these studies have not distinguished different cognitive phenotypes. Methods: The eye-movements of 28 teenagers with ASD and 18 typically developing…

  9. Using Constraints to Design Developmentally Appropriate Movement Activities for Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Pope, Michelle; Breslin, Casey M.; Getchell, Nancy; Liu, Ting

    2012-01-01

    Some of the characteristics and behaviors of children with autism spectrum disorder (ASD), such as difficulty with social interactions and sensory integration, make physical education instruction difficult. Children with ASD also encounter movement difficulties, such as motor-planning and anticipatory deficits. One way to enhance the ability of…

  10. Stability and Composition of Functional Synergies for Speech Movements in Children with Developmental Speech Disorders

    ERIC Educational Resources Information Center

    Terband, H.; Maassen, B.; van Lieshout, P.; Nijland, L.

    2011-01-01

    The aim of this study was to investigate the consistency and composition of functional synergies for speech movements in children with developmental speech disorders. Kinematic data were collected on the reiterated productions of syllables spa(/spa[image omitted]/) and paas(/pa[image omitted]s/) by 10 6- to 9-year-olds with developmental speech…

  11. The promises of stem cells: stem cell therapy for movement disorders.

    PubMed

    Mochizuki, Hideki; Choong, Chi-Jing; Yasuda, Toru

    2014-01-01

    Despite the multitude of intensive research, the exact pathophysiological mechanisms underlying movement disorders including Parkinson's disease, multiple system atrophy and Huntington's disease remain more or less elusive. Treatments to halt these disease progressions are currently unavailable. With the recent induced pluripotent stem cells breakthrough and accomplishment, stem cell research, as the vast majority of scientists agree, holds great promise for relieving and treating debilitating movement disorders. As stem cells are the precursors of all cells in the human body, an understanding of the molecular mechanisms that govern how they develop and work would provide us many fundamental insights into human biology of health and disease. Moreover, stem-cell-derived neurons may be a renewable source of replacement cells for damaged neurons in movement disorders. While stem cells show potential for regenerative medicine, their use as tools for research and drug testing is thought to have more immediate impact. The use of stem-cell-based drug screening technology could be a big boost in drug discovery for these movement disorders. Particular attention should also be given to the involvement of neural stem cells in adult neurogenesis so as to encourage its development as a therapeutic option.

  12. Stability and Composition of Functional Synergies for Speech Movements in Children with Developmental Speech Disorders

    ERIC Educational Resources Information Center

    Terband, H.; Maassen, B.; van Lieshout, P.; Nijland, L.

    2011-01-01

    The aim of this study was to investigate the consistency and composition of functional synergies for speech movements in children with developmental speech disorders. Kinematic data were collected on the reiterated productions of syllables spa(/spa[image omitted]/) and paas(/pa[image omitted]s/) by 10 6- to 9-year-olds with developmental speech…

  13. What Do Repetitive and Stereotyped Movements Mean for Infant Siblings of Children with Autism Spectrum Disorders?

    ERIC Educational Resources Information Center

    Damiano, Cara R.; Nahmias, Allison; Hogan-Brown, Abigail L.; Stone, Wendy L.

    2013-01-01

    Repetitive and stereotyped movements (RSMs) in infancy are associated with later diagnoses of autism spectrum disorder (ASD), yet this relationship has not been fully explored in high-risk populations. The current study investigated how RSMs involving object and body use are related to diagnostic outcomes in infant siblings of children with ASD…

  14. Eye-Movement Patterns Are Associated with Communicative Competence in Autistic Spectrum Disorders

    ERIC Educational Resources Information Center

    Norbury, Courtenay Frazier; Brock, Jon; Cragg, Lucy; Einav, Shiri; Griffiths, Helen; Nation, Kate

    2009-01-01

    Background: Investigations using eye-tracking have reported reduced fixations to salient social cues such as eyes when participants with autism spectrum disorders (ASD) view social scenes. However, these studies have not distinguished different cognitive phenotypes. Methods: The eye-movements of 28 teenagers with ASD and 18 typically developing…

  15. Arm and Hand Movement in Children Suspected of Having Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Braddock, Barbara A.; Hilton, Jane C.

    2016-01-01

    The aim of this study was to describe arm and hand movement in children suspected of having autism spectrum disorder (ASD; age range 29-43 months). A videotaped retrospective review of five children with symptoms of ASD during "Communication Temptation Tasks" was completed at two time points (pre-testing and 6 weeks later). Categories of…

  16. Using Constraints to Design Developmentally Appropriate Movement Activities for Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Pope, Michelle; Breslin, Casey M.; Getchell, Nancy; Liu, Ting

    2012-01-01

    Some of the characteristics and behaviors of children with autism spectrum disorder (ASD), such as difficulty with social interactions and sensory integration, make physical education instruction difficult. Children with ASD also encounter movement difficulties, such as motor-planning and anticipatory deficits. One way to enhance the ability of…

  17. Importance of Rapid Eye Movement Sleep Behavior Disorder to the Primary Care Physician.

    PubMed

    McCarter, Stuart J; Howell, Michael J

    2016-10-01

    Sleep disorders and neurodegenerative diseases are commonly encountered in primary care. A common, but underdiagnosed sleep disorder, rapid eye movement sleep behavior disorder (RBD), is highly associated with Parkinson disease and related disorders. Rapid eye movement sleep behavior disorder is common. It is estimated to affect 0.5% of the general population and more than 7% of individuals older than 60 years; however, most cases go unrecognized. Rapid eye movement sleep behavior disorder presents as dream enactment, often with patients thrashing, punching, and kicking while they are sleeping. Physicians can quickly assess for the presence of RBD with high sensitivity and specificity by asking patients the question "Have you ever been told that you act out your dreams, for example by punching or flailing your arms in the air or screaming and shouting in your sleep?" Patients with RBD exhibit subtle signs of neurodegenerative disease, such as mild motor slowing, constipation, or changes in sense of smell. These signs and symptoms may predict development of a neurodegenerative disease within 3 years. Ultimately, most patients with RBD develop a neurodegenerative disease, highlighting the importance of serial neurological examinations to assess for the presence of parkinsonism and/or cognitive impairment and prognostic counseling for these patients. Rapid eye movement sleep behavior disorder is treatable with melatonin (3-6 mg before bed) or clonazepam (0.5-1 mg before bed) and may be the most common, reversible cause of sleep-related injury. Thus, it is important to identify patients at risk of RBD in a primary care setting so that bedroom safety can be addressed and treatment may be initiated.

  18. Pedunculopontine nucleus microelectrode recordings in movement disorder patients.

    PubMed

    Weinberger, Moran; Hamani, Clement; Hutchison, William D; Moro, Elena; Lozano, Andres M; Dostrovsky, Jonathan O

    2008-06-01

    The pedunculopontine nucleus (PPN) lies within the brainstem reticular formation and is involved in the motor control of gait and posture. Interest has focused recently on the PPN as a target for implantation of chronic deep brain stimulation (DBS) electrodes for Parkinson's disease (PD) and progressive supranuclear palsy (PSP) therapy. The aim of this study was to examine the neurophysiology of the human PPN region and to identify neurophysiological landmarks that may aid the proper placement of DBS electrodes in the nucleus for the treatment of PD and PSP. Neuronal firing and local field potentials were recorded simultaneously from two independently driven microelectrodes during stereotactic neurosurgery for implantation of a unilateral DBS electrode in the PPN in five PD patients and two PSP patients. Within the PPN region, the majority (57%) of the neurons fired randomly while about 21% of the neurons exhibited 'bursty' firing. In addition, 21% of the neurons had a long action potential duration and significantly lower firing rate suggesting they were cholinergic neurons. A change in firing rate produced by passive and/or active contralateral limb movement was observed in 38% of the neurons that were tested in the PPN region. Interestingly, oscillatory local field potential activity in the beta frequency range ( approximately 25 Hz) was also observed in the PPN region. These electrophysiological characteristics of the PPN region provide further support for the proposed role of this region in motor control. It remains to be seen to what extent the physiological characteristics of the neurons and the stimulation-evoked effects will permit reliable identification of PPN and determination of the optimal target for DBS therapy.

  19. Role for the nicotinic cholinergic system in movement disorders; therapeutic implications.

    PubMed

    Quik, Maryka; Zhang, Danhui; Perez, Xiomara A; Bordia, Tanuja

    2014-10-01

    A large body of evidence using experimental animal models shows that the nicotinic cholinergic system is involved in the control of movement under physiological conditions. This work raised the question whether dysregulation of this system may contribute to motor dysfunction and whether drugs targeting nicotinic acetylcholine receptors (nAChRs) may be of therapeutic benefit in movement disorders. Accumulating preclinical studies now show that drugs acting at nAChRs improve drug-induced dyskinesias. The general nAChR agonist nicotine, as well as several nAChR agonists (varenicline, ABT-089 and ABT-894), reduces l-dopa-induced abnormal involuntary movements or dyskinesias up to 60% in parkinsonian nonhuman primates and rodents. These dyskinesias are potentially debilitating abnormal involuntary movements that arise as a complication of l-dopa therapy for Parkinson's disease. In addition, nicotine and varenicline decrease antipsychotic-induced abnormal involuntary movements in rodent models of tardive dyskinesia. Antipsychotic-induced dyskinesias frequently arise as a side effect of chronic drug treatment for schizophrenia, psychosis and other psychiatric disorders. Preclinical and clinical studies also show that the nAChR agonist varenicline improves balance and coordination in various ataxias. Lastly, nicotine has been reported to attenuate the dyskinetic symptoms of Tourette's disorder. Several nAChR subtypes appear to be involved in these beneficial effects of nicotine and nAChR drugs including α4β2*, α6β2* and α7 nAChRs (the asterisk indicates the possible presence of other subunits in the receptor). Overall, the above findings, coupled with nicotine's neuroprotective effects, suggest that nAChR drugs have potential for future drug development for movement disorders.

  20. Rapid eye movement sleep behavior disorder in adults younger than 50 years of age.

    PubMed

    Ju, Yo-El S

    2013-08-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) occurring prior to age 50 is termed early-onset RBD. Early-onset RBD comprises a substantial minority of cases, and demonstrates the differences in demographics, comorbidities, and clinical considerations from previously described typical RBD with onset >50years. The world literature on RBD is reviewed with specific focus on features that distinguish early-onset RBD, including more gender parity, increased proportion of idiopathic cases, increased proportion of cases associated with narcolepsy, parasomnia overlap disorder, antidepressants, and possibly autoimmune disorders, and clinical presentation.

  1. Movement disorders associated with moyamoya disease: a report of 4 new cases and a review of literatures.

    PubMed

    Baik, Jong Sam; Lee, Myung Sik

    2010-07-30

    The aim of this study was to define the clinical characteristics of patients who developed movement disorders in association with moyamoya disease (MMD). Using PubMed and medical records of our hospital from 1985 to 2008, we searched for patients who developed movement disorders in association with MMD. This study included 38 patients described in previous studies and 4 patients found in the medical records. The onset of movement disorders was thought to be sudden. In 13 patients, the movement disorders were precipitated by hyperventilation or emotional stress. Twenty-seven of the 42 patients developed chorea, 4 patients developed dystonia, and 4 developed a mixture of both. The movement disorders of the remaining 7 patients were described as dyskinesia. A third of the 42 patients developed bilateral movement disorders, and their mean age was younger than that of those with unilateral movement disorders. In 37 of the 42 patients, brain imaging studies showed ischemic lesions, but the remaining 5 patients showed no parenchymal lesions. Cerebral perfusion studies showed hypoperfusion in the basal ganglia and in the cerebral cortical areas. Most patients improved whether they were treated or not. MMD must be included in the differential diagnosis of the sudden onset of dyskinesias, particularly chorea and focal dystonia. Even in patients with no parenchymal lesion in brain imaging studies, cerebral angiography and cerebral blood perfusion studies must be performed, if they develop a sudden onset or recurrent movement disorders preceded by emotional stress or hyperventilation.

  2. [One of the approaches to psychological-pedagogical help to children with severe movement disorders].

    PubMed

    Levchenko, I Iu; Simonova, T N

    2012-01-01

    The objective of the study was to work out an effective model of complex help to children with severe movement disorders. We examined 440 preschoolers with children cerebral palsy with severe movement disorders and 70 children with mild movement disorders. Functions of motor, emotional-personal and cognitive spheres and independence status with determination of 5 levels were studied in 47 patients. Three groups (from the group without concomitant (sensor, intellectual etc) disorders to the group with most severe disorders) were singled out. The authors characterize the model as an open integral system of methods, tools and ways providing the adaptation of children in response to external circumstances and changes in the state of patients. The creation of a correction-developing environment, consisting of 3 components: spatial-objective, technological (methodological) and social, is discussed. We present results of the development of children, evaluated by the following indices: general technique, sensory perceptive development, social adaptation, anxiety, cognitive activity, from 1997 to 2008. The 15 year follow-up demonstrated the stability of achieved positive results.

  3. Anti-basal ganglia antibodies: a possible diagnostic utility in idiopathic movement disorders?

    PubMed Central

    Church, A; Dale, R; Giovannoni, G

    2004-01-01

    Background: The spectrum of post-streptococcal brain disorders includes chorea, tics, and dystonia. The proposed mediators of disease are anti-basal ganglia (neuronal) antibodies (ABGA). Aim: To evaluate ABGA as a potential diagnostic marker in a cohort of UK post-streptococcal movement disorders. Methods: Forty UK children presenting with movement disorders associated with streptococcal infection were recruited. ABGA was measured using ELISA and Western immunoblotting. To determine ABGA specificity and sensitivity, children with neurological diseases (n = 100), children with uncomplicated streptococcal infection (n = 40), and children with autoimmune disease (n = 50) were enrolled as controls. Results: The mean ELISA result was increased in the post-streptococcal movement disorder group compared to all controls and derived a sensitivity of 82.4% and specificity of 79%. The Western immunoblotting method to detect ABGA derived a sensitivity and specificity of 92.5% and 94.7% respectively. There was common binding to basal ganglia antigens of 40, 45, and 60 kDa. Immunofluorescence localised the antibody binding to basal ganglia neurones. Conclusion: ABGA appears to be a potentially useful diagnostic marker in post-streptococcal neurological disorders. Western immunoblotting appears to be the preferred method due to good sensitivity and specificity and the ability to test several samples at once. PMID:15210488

  4. Rapid Eye Movement Sleep Behavior Disorder in Paraneoplastic Cerebellar Degeneration: Improvement with Immunotherapy

    PubMed Central

    Vale, Thiago Cardoso; Fernandes do Prado, Lucila Bizari; do Prado, Gilmar Fernandes; Povoas Barsottini, Orlando Graziani; Pedroso, José Luiz

    2016-01-01

    Study Objectives: To report two female patients with paraneoplastic cerebellar degeneration (PCD) related to breast cancer that presented with rapid eye movement-sleep behavior disorder (RBD) and improved sleep symptoms with immunotherapy. Methods: The two patients were evaluated through clinical scale and polysomnography before and after therapy with intravenous immunoglobulin. Results: RBD was successfully treated with immunotherapy in both patients. Score on the RBD screening questionnaire dropped from 10 to 1 or 0, allied with the normalization of polysomnographic findings. Conclusions: A marked improvement in RBD after immunotherapy in PCD raises the hypothesis that secondary RBD may be an immune-mediated sleep disorder. Citation: Vale TC, do Prado LB, do Prado GF, Barsottini OG, Pedroso JL. Rapid eye movement sleep behavior disorder in paraneoplastic cerebellar degeneration: improvement with immunotherapy. SLEEP 2016;39(1):117–120. PMID:26414894

  5. Movement disorders in adult patients with classical galactosemia.

    PubMed

    Rubio-Agusti, Ignacio; Carecchio, Miryam; Bhatia, Kailash P; Kojovic, Maja; Parees, Isabel; Chandrashekar, Hoskote S; Footitt, Emma J; Burke, Derek; Edwards, Mark J; Lachmann, Robin H L; Murphy, Elaine

    2013-06-01

    Classical galactosemia is an autosomal recessive inborn error of metabolism leading to toxic accumulation of galactose and derived metabolites. It presents with acute systemic complications in the newborn. Galactose restriction resolves these symptoms, but long-term complications, such as premature ovarian failure and neurological problems including motor dysfunction, may occur despite adequate treatment. The objective of the current study was to determine the frequency and phenotype of motor problems in adult patients with classical galactosemia. In this cross-sectional study, adult patients with a biochemically confirmed diagnosis of galactosemia attending our clinic were assessed with an interview and neurological examination and their notes retrospectively reviewed. Patients were classified according to the presence/absence of motor dysfunction on examination. Patients with motor dysfunction were further categorized according to the presence/absence of reported motor symptoms. Forty-seven patients were included. Thirty-one patients showed evidence of motor dysfunction including: tremor (23 patients), dystonia (23 patients), cerebellar signs (6 patients), and pyramidal signs (4 patients). Tremor and dystonia were often combined (16 patients). Thirteen patients reported motor symptoms, with 8 describing progressive worsening. Symptomatic treatment was effective in 4 of 5 patients. Nonmotor neurological features (cognitive, psychiatric, and speech disorders) and premature ovarian failure were more frequent in patients with motor dysfunction. Motor dysfunction is a common complication of classical galactosemia, with tremor and dystonia the most frequent findings. Up to one third of patients report motor symptoms and may benefit from appropriate treatment. Progressive worsening is not uncommon and may suggest ongoing brain damage in a subset of patients.

  6. Thoughts on Selected Movement Disorder Terminology and a Plea for Clarity

    PubMed Central

    Walker, Ruth H.

    2013-01-01

    Description of the phenomenology of movement disorders requires precise and accurate terminology. Many of the terms that have been widely used in the literature are imprecise and open to interpretation. An examination of these terms and the assumptions implicit in their usage is important to improve communication and hence the definition, diagnosis, and treatment of movement disorders. I recommend that the term dyskinesia should be used primarily in the settings of Parkinson's disease and tardive dyskinesia, in which its clinical implications are relatively clear; it should not be used in other situations where a precise description could more usefully facilitate diagnosis and treatment. In general dyskinesia should be used in the singular form. Extrapyramidal is based upon obsolete anatomical concepts, is uninformative, and should be discarded. The term abnormal involuntary movements (AIMs) is similarly vague and uninformative, although is unlikely to be eliminated from the psychiatric literature. Movement disorder neurologists as teachers, clinicians, article reviewers, and journal editors have the responsibility to educate our colleagues regarding appropriate usage and the importance of employing correct descriptors. PMID:24396709

  7. Moving forward: advances in the treatment of movement disorders with deep brain stimulation.

    PubMed

    Schiefer, Terry K; Matsumoto, Joseph Y; Lee, Kendall H

    2011-01-01

    The modern era of stereotactic and functional neurosurgery has ushered in state of the art technologies for the treatment of movement disorders, particularly Parkinson's disease (PD), tremor, and dystonia. After years of experience with various surgical therapies, the eventual shortcomings of both medical and surgical treatments, and several serendipitous discoveries, deep brain stimulation (DBS) has risen to the forefront as a highly effective, safe, and reversible treatment for these conditions. Idiopathic advanced PD can be treated with thalamic, globus pallidus internus (GPi), or subthalamic nucleus (STN) DBS. Thalamic DBS primarily relieves tremor while GPi and STN DBS alleviate a wide range of Parkinsonian symptoms. Thalamic DBS is also used in the treatment of other types of tremor, particularly essential tremor, with excellent results. Both primary and various types of secondary dystonia can be treated very effectively with GPi DBS. The variety of anatomical targets for these movement disorders is indicative of the network-level dysfunction mediating these movement disturbances. Despite an increasing understanding of the clinical benefits of DBS, little is known about how DBS can create such wide sweeping neuromodulatory effects. The key to improving this therapeutic modality and discovering new ways to treat these and other neurologic conditions lies in better understanding the intricacies of DBS. Here we review the history and pertinent clinical data for DBS treatment of PD, tremor, and dystonia. While multiple regions of the brain have been targeted for DBS in the treatment of these movement disorders, this review article focuses on those that are most commonly used in current clinical practice. Our search criteria for PubMed included combinations of the following terms: DBS, neuromodulation, movement disorders, PD, tremor, dystonia, and history. Dates were not restricted.

  8. Moving Forward: Advances in the Treatment of Movement Disorders with Deep Brain Stimulation

    PubMed Central

    Schiefer, Terry K.; Matsumoto, Joseph Y.; Lee, Kendall H.

    2011-01-01

    The modern era of stereotactic and functional neurosurgery has ushered in state of the art technologies for the treatment of movement disorders, particularly Parkinson’s disease (PD), tremor, and dystonia. After years of experience with various surgical therapies, the eventual shortcomings of both medical and surgical treatments, and several serendipitous discoveries, deep brain stimulation (DBS) has risen to the forefront as a highly effective, safe, and reversible treatment for these conditions. Idiopathic advanced PD can be treated with thalamic, globus pallidus internus (GPi), or subthalamic nucleus (STN) DBS. Thalamic DBS primarily relieves tremor while GPi and STN DBS alleviate a wide range of Parkinsonian symptoms. Thalamic DBS is also used in the treatment of other types of tremor, particularly essential tremor, with excellent results. Both primary and various types of secondary dystonia can be treated very effectively with GPi DBS. The variety of anatomical targets for these movement disorders is indicative of the network-level dysfunction mediating these movement disturbances. Despite an increasing understanding of the clinical benefits of DBS, little is known about how DBS can create such wide sweeping neuromodulatory effects. The key to improving this therapeutic modality and discovering new ways to treat these and other neurologic conditions lies in better understanding the intricacies of DBS. Here we review the history and pertinent clinical data for DBS treatment of PD, tremor, and dystonia. While multiple regions of the brain have been targeted for DBS in the treatment of these movement disorders, this review article focuses on those that are most commonly used in current clinical practice. Our search criteria for PubMed included combinations of the following terms: DBS, neuromodulation, movement disorders, PD, tremor, dystonia, and history. Dates were not restricted. PMID:22084629

  9. Feedback Signal from Motoneurons Influences a Rhythmic Pattern Generator.

    PubMed

    Rotstein, Horacio G; Schneider, Elisa; Szczupak, Lidia

    2017-09-20

    Motoneurons are not mere output units of neuronal circuits that control motor behavior but participate in pattern generation. Research on the circuit that controls the crawling motor behavior in leeches indicated that motoneurons participate as modulators of this rhythmic motor pattern. Crawling results from successive bouts of elongation and contraction of the whole leech body. In the isolated segmental ganglia, dopamine can induce a rhythmic antiphasic activity of the motoneurons that control contraction (DE-3 motoneurons) and elongation (CV motoneurons). The study was performed in isolated ganglia where manipulation of the activity of specific motoneurons was performed in the course of fictive crawling (crawling). In this study, the membrane potential of CV was manipulated while crawling was monitored through the rhythmic activity of DE-3. Matching behavioral observations that show that elongation dominates the rhythmic pattern, the electrophysiological activity of CV motoneurons dominates the cycle. Brief excitation of CV motoneurons during crawling episodes resets the rhythmic activity of DE-3, indicating that CV feeds back to the rhythmic pattern generator. CV hyperpolarization accelerated the rhythm to an extent that depended on the magnitude of the cycle period, suggesting that CV exerted a positive feedback on the unit(s) of the pattern generator that controls the elongation phase. A simple computational model was implemented to test the consequences of such feedback. The simulations indicate that the duty cycle of CV depended on the strength of the positive feedback between CV and the pattern generator circuit.SIGNIFICANCE STATEMENT Rhythmic movements of animals are controlled by neuronal networks that have been conceived as hierarchical structures. At the basis of this hierarchy, we find the motoneurons, few neurons at the top control global aspects of the behavior (e.g., onset, duration); and within these two ends, specific neuronal circuits control the

  10. Stem cell reprogramming: basic implications and future perspective for movement disorders.

    PubMed

    Brändl, Björn; Schneider, Susanne A; Loring, Jeanne F; Hardy, John; Gribbon, Philip; Müller, Franz-Josef

    2015-03-01

    The introduction of stem cell-associated molecular factors into human patient-derived cells allows for their reprogramming in the laboratory environment. As a result, human induced pluripotent stem cells (hiPSC) can now be reprogrammed epigenetically without disruption of their overall genomic integrity. For patients with neurodegenerative diseases characterized by progressive loss of functional neurons, the ability to reprogram any individual's cells and drive their differentiation toward susceptible neuronal subtypes holds great promise. Apart from applications in regenerative medicine and cell replacement-based therapy, hiPSCs are increasingly used in preclinical research for establishing disease models and screening for drug toxicities. The rapid developments in this field prompted us to review recent progress toward the applications of stem cell technologies for movement disorders. We introduce reprogramming strategies and explain the critical steps in the differentiation of hiPSCs to clinical relevant subtypes of cells in the context of movement disorders. We summarize and discuss recent discoveries in this field, which, based on the rapidly expanding basic science literature as well as upcoming trends in personalized medicine, will strongly influence the future therapeutic options available to practitioners working with patients suffering from such disorders. © 2014 International Parkinson and Movement Disorder Society.

  11. Movement - uncontrollable

    MedlinePlus

    ... peripheral nervous system References Jankovic J, Lang AE. Movement disorders: diagnosis and assessment. In: Daroff RB, Fenichel GM, ... Elsevier Saunders; 2012:chap 21. Lang AE. Other movement disorders. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  12. Eye movement desensitization and reprocessing therapy for personality disorders in older adults?

    PubMed

    Gielkens, E M J; Sobczak, S; Van Alphen, S P J

    2016-10-01

    Eye Movement Desensitization and Reprocessing (EMDR) is a kind of psychotherapy, which is growing in popularity, particularly for treatment of post-traumatic stress disorder (PTSD). When Shapiro first introduced EMDR in 1989, it was approached as a controversial treatment because of lack of evidence. However, nowadays there is growing evidence for EMDR efficacy in PTSD (Mc Guire et al., 2014) and EMDR is recommended by international and national treatment guidelines for PTSD. Moreover, EMDR is also used for the treatment of other anxiety disorders, such as panic disorders (De Jongh et al., 2002). Furthermore, research continues on effects of EMDR in addiction, somatoform disorders and psychosis. So far, there is no empirical research on the efficacy of EMDR treatment in older adults.

  13. General movements: A window for early identification of children at high risk for developmental disorders.

    PubMed

    Hadders-Algra, Mijna

    2004-08-01

    Detection of children with a developmental disorder, such as cerebral palsy, at an early age is notoriously difficult. Recently, a new form of neuromotor assessment of young infants was developed, based on the assessment of the quality of general movements (GMs). GMs are movements of the fetus and young infant in which all parts of the body participate. The technique of GM assessment is presented and the features of normal, mildly abnormal, and definitely abnormal GMs discussed. Essential to GM assessment is the Gestalt evaluation of movement complexity and variation. The quality of GMs at 2 to 4 months postterm (so-called fidgety GM age) has been found to have the highest predictive value. The presence of definitely abnormal GMs at this age--that is, GMs devoid of complexity and variation--puts a child at very high risk for cerebral palsy. This implies that definitely abnormal GMs at fidgety age are an indication for early physiotherapeutic intervention.

  14. Video assessment of finger tapping for Parkinson's disease and other movement disorders.

    PubMed

    Criss, Kjersten; McNames, James

    2011-01-01

    Functional motor impairment due to Parkinson's disease and other movement disorders are currently assessed with visual rating scales such as the Unified Parkinson's Disease Rating Scale (UPDRS). These methods rely on the subjective judgment of a rater to assign scores representing the extent of impairment while subjects perform prescribed activities. We describe a new model-based framework that uses statistical video processing to automatically track movement during prescribed activities. This approach has many advantages over traditional clinical rating scales. It can completely characterize movement during prescribed tasks over time objectively and precisely using hardware that is inexpensive and readily available. We demonstrate the potential of this framework with a simple statistical model applied to a paced finger tapping test. This technology could be deployed in a natural home environment for frequent assessments. This technology could ultimately improve both clinical practice and clinical trials.

  15. MicroRNA association with synucleinopathy conversion in rapid eye movement behavior disorder.

    PubMed

    Fernández-Santiago, Rubén; Iranzo, Alex; Gaig, Carles; Serradell, Mónica; Fernández, Manel; Tolosa, Eduardo; Santamaría, Joan; Ezquerra, Mario

    2015-05-01

    Recently, we reported downregulated circulating levels of the microRNAs miR-19b, miR-29a, and miR-29c in Parkinson disease. Here we investigated the expression of these microRNAs in serum samples from 56 patients with idiopathic rapid eye movement sleep behavior disorder, before and after their conversion into a synucleinopathy. Compared to controls, we found that the expression level of miR-19b is downregulated in patients with idiopathic rapid eye movement sleep behavior disorder and antedates the diagnosis of Parkinson disease and dementia with Lewy bodies after 4.67 ± 2.61 years of follow-up. Our findings indicate that dysregulation of the microRNA miR-19b occurs in the prodromal stage of synucleinopathies. © 2015 American Neurological Association.

  16. Borderline personality disorder is associated with lower confidence in perception of emotional body movements

    PubMed Central

    Kaletsch, Morten; Krüger, Britta; Pilgramm, Sebastian; Stark, Rudolf; Lis, Stefanie; Gallhofer, Bernd; Zentgraf, Karen; Munzert, Jörn; Sammer, Gebhard

    2014-01-01

    Much recent research has shown that personality disorders are associated with an altered emotion perception. Whereas most of this research was conducted with stimuli such as faces, the present study examined possible differences in the perception of emotions expressed via body language and body movements. 30 patients with borderline personality disorder (BPD) and 30 non-patients observed video scenes of emotional human interactions conveyed by point–light displays, rated the depicted valence, and judged their confidence in this rating. Patients with BPD showed no altered emotion perception (i.e., no biased perception in either a negative or a positive direction). They did not perceive and evaluate depicted emotions as being more extreme than healthy controls. However, patients with BPD showed less confidence in their perception of depicted emotions, especially when these were difficult to identify. The findings extend insights on altered emotion perception in persons with BPD to include the field of body movements. PMID:25408679

  17. Rapid Eye Movement Sleep Behavior Disorder in Paraneoplastic Cerebellar Degeneration: Improvement with Immunotherapy.

    PubMed

    Vale, Thiago Cardoso; Fernandes do Prado, Lucila Bizari; do Prado, Gilmar Fernandes; Povoas Barsottini, Orlando Graziani; Pedroso, José Luiz

    2016-01-01

    To report two female patients with paraneoplastic cerebellar degeneration (PCD) related to breast cancer that presented with rapid eye movement-sleep behavior disorder (RBD) and improved sleep symptoms with immunotherapy. The two patients were evaluated through clinical scale and polysomnography before and after therapy with intravenous immunoglobulin. RBD was successfully treated with immunotherapy in both patients. Score on the RBD screening questionnaire dropped from 10 to 1 or 0, allied with the normalization of polysomnographic findings. A marked improvement in RBD after immunotherapy in PCD raises the hypothesis that secondary RBD may be an immune-mediated sleep disorder. © 2016 Associated Professional Sleep Societies, LLC.

  18. Performance-based robotic assistance during rhythmic arm exercises.

    PubMed

    Leconte, Patricia; Ronsse, Renaud

    2016-09-13

    Rhythmic and discrete upper-limb movements are two fundamental motor primitives controlled by different neural pathways, at least partially. After stroke, both primitives can be impaired. Both conventional and robot-assisted therapies mainly train discrete functional movements like reaching and grasping. However, if the movements form two distinct neural and functional primitives, both should be trained to recover the complete motor repertoire. Recent studies show that rhythmic movements tend to be less impaired than discrete ones, so combining both movement types in therapy could support the execution of movements with a higher degree of impairment by movements that are performed more stably. A new performance-based assistance method was developed to train rhythmic movements with a rehabilitation robot. The algorithm uses the assist-as-needed paradigm by independently assessing and assisting movement features of smoothness, velocity, and amplitude. The method relies on different building blocks: (i) an adaptive oscillator captures the main movement harmonic in state variables, (ii) custom metrics measure the movement performance regarding the three features, and (iii) adaptive forces assist the patient. The patient is encouraged to improve performance regarding these three features with assistance forces computed in parallel to each other. The method was tested with simulated jerky signals and a pilot experiment with two stroke patients, who were instructed to make circular movements with an end-effector robot with assistance during half of the trials. Simulation data reveal sensitivity of the metrics for assessing the features while limiting interference between them. The assistance's effectiveness with stroke patients is established since it (i) adapts to the patient's real-time performance, (ii) improves patient motor performance, and (iii) does not lead the patient to slack. The smoothness assistance was by far the most used by both patients, while it provided

  19. Movement disorder in GNAO1 encephalopathy associated with gain-of-function mutations.

    PubMed

    Feng, Huijie; Sjögren, Benita; Karaj, Behirda; Shaw, Vincent; Gezer, Aysegul; Neubig, Richard R

    2017-08-22

    To define molecular mechanisms underlying the clinical spectrum of epilepsy and movement disorder in individuals with de novo mutations in the GNAO1 gene. We identified all GNAO1 mutations reported in individuals with epilepsy (early infantile epileptiform encephalopathy 17) or movement disorders through April 2016; 15 de novo mutant alleles from 25 individuals were introduced into the Gαo subunit by site-directed mutagenesis in a mammalian expression plasmid. We assessed protein expression and function in vitro in HEK-293T cells by Western blot and determined functional Gαo-dependent cyclic adenosine monophosphate (cAMP) inhibition with a coexpressed α2A adrenergic receptor. Of the 15 clinical GNAO1 mutations studied, 9 show reduced expression and loss of function (LOF; <90% maximal inhibition). Six other mutations show variable levels of expression but exhibit normal or even gain-of-function (GOF) behavior, as demonstrated by significantly lower EC50 values for α2A adrenergic receptor-mediated inhibition of cAMP. The GNAO1 LOF mutations are associated with epileptic encephalopathy while GOF mutants (such as G42R, G203R, and E246K) or normally functioning mutants (R209) were found in patients with movement disorders with or without seizures. Both LOF and GOF mutations in Gαo (encoded by GNAO1) are associated with neurologic pathophysiology. There appears to be a strong predictive correlation between the in vitro biochemical phenotype and the clinical pattern of epilepsy vs movement disorder. © 2017 American Academy of Neurology.

  20. Complex movement disorders at disease onset in childhood narcolepsy with cataplexy

    PubMed Central

    Pizza, Fabio; Palaia, Vincenzo; Franceschini, Christian; Poli, Francesca; Moghadam, Keivan K.; Cortelli, Pietro; Nobili, Lino; Bruni, Oliviero; Dauvilliers, Yves; Lin, Ling; Edwards, Mark J.; Mignot, Emmanuel; Bhatia, Kailash P.

    2011-01-01

    Narcolepsy with cataplexy is characterized by daytime sleepiness, cataplexy (sudden loss of bilateral muscle tone triggered by emotions), sleep paralysis, hypnagogic hallucinations and disturbed nocturnal sleep. Narcolepsy with cataplexy is most often associated with human leucocyte antigen-DQB1*0602 and is caused by the loss of hypocretin-producing neurons in the hypothalamus of likely autoimmune aetiology. Noting that children with narcolepsy often display complex abnormal motor behaviours close to disease onset that do not meet the classical definition of cataplexy, we systematically analysed motor features in 39 children with narcolepsy with cataplexy in comparison with 25 age- and sex-matched healthy controls. We found that patients with narcolepsy with cataplexy displayed a complex array of ‘negative’ (hypotonia) and ‘active’ (ranging from perioral movements to dyskinetic–dystonic movements or stereotypies) motor disturbances. ‘Active’ and ‘negative’ motor scores correlated positively with the presence of hypotonic features at neurological examination and negatively with disease duration, whereas ‘negative’ motor scores also correlated negatively with age at disease onset. These observations suggest that paediatric narcolepsy with cataplexy often co-occurs with a complex movement disorder at disease onset, a phenomenon that may vanish later in the course of the disease. Further studies are warranted to assess clinical course and whether the associated movement disorder is also caused by hypocretin deficiency or by additional neurochemical abnormalities. PMID:21930661

  1. Deep brain stimulation for movement disorders: update on recent discoveries and outlook on future developments.

    PubMed

    Mahlknecht, Philipp; Limousin, Patricia; Foltynie, Thomas

    2015-11-01

    Modern deep brain stimulation (DBS) has become a routine therapy for patients with movement disorders such as Parkinson's disease, generalized or segmental dystonia and for multiple forms of tremor. Growing numbers of publications also report beneficial effects in other movement disorders such as Tourette's syndrome, various forms of chorea and DBS is even being studied for Parkinson's-related dementia. While exerting remarkable effects on many motor symptoms, DBS does not restore normal neurophysiology and therefore may also have undesirable side effects including speech and gait deterioration. Furthermore, its efficacy might be compromised in the long term, due to progression of the underlying disease. Various programming strategies have been studied to try and address these issues, e.g., the use of low-frequency rather than high-frequency stimulation or the targeting of alternative brain structures such as the pedunculopontine nucleus. In addition, further technical developments will soon provide clinicians with an expanded choice of hardware such as segmented electrodes allowing for a steering of the current to optimize beneficial effects and reduce side effects as well as the possibility of adaptive stimulation systems based on closed-loop concepts with or without accompanying advances in programming and imaging software. In the present article, we will provide an update on the most recent achievements and discoveries relevant to the application of DBS in the treatment of movement disorder patients and give an outlook on future clinical and technical developments.

  2. Transcranial sonography (TCS) of brain parenchyma in movement disorders: quality standards, diagnostic applications and novel technologies.

    PubMed

    Walter, U; Školoudík, D

    2014-08-01

    Transcranial B-mode sonography (TCS) of brain parenchyma is being increasingly used as a diagnostic tool in movement disorders. Compared to other neuroimaging modalities such as magnetic resonance imaging (MRI) and computed tomography, TCS can be performed today with portable machines and has the advantages of noninvasiveness and high resistance to movement artifacts. In distinct brain disorders TCS detects abnormalities that cannot be visualized or can only be visualized with significant effort with other imaging methods. In the field of movement disorders, TCS has been established mainly as a tool for the early and differential diagnosis of Parkinson's disease. The postoperative position control of deep brain stimulation electrodes, especially in the subthalamic nucleus, can reliably and safely be performed with TCS.  The present update review summarizes the current methodological standards and defines quality criteria of adequate TCS imaging and assessment of diagnostically relevant deep brain structures such as substantia nigra, brainstem raphe, basal ganglia and ventricles. Finally, an overview is given on recent technological advances including TCS-MRI fusion imaging and upcoming technologies of digitized image analysis aiming at a more investigator-independent assessment of deep brain structures on TCS.

  3. A novel quality of life instrument for deep brain stimulation in movement disorders

    PubMed Central

    Kuehler, A; Henrich, G; Schroeder, U; Conrad, B; Herschbach, P; Ceballos-Baumann, A

    2003-01-01

    Objective: To develop a short instrument to examine quality of life (QoL) which specifically addresses patients with movement disorders treated by deep brain stimulation (DBS). Design: The instrument was developed within an existing concept of a modular questionnaire (questions on life satisfaction: "general life satisfaction" QLSM-A, and "satisfaction with health" QLSM-G), in which each item is weighted according to its relative importance to the individual. Methods: Items were generated by interviews with 20 DBS patients, followed by item reduction and scale generation, factor analysis to determine relevant and final questionnaire items, estimation of reliability, and validation based on the medical outcome study 36 item short form health survey (SF-36) and the EuroQol (EQ-5D) (data from 152 patients with Parkinson's disease, essential tremor, or idiopathic torsion dystonia, including 75 patients with DBS). Results: Initial questionnaires were reduced to 12 items for a "movement disorder module" (QLSM-MD), and five items for a "deep brain stimulation module" (QLSM-DBS). Psychometric analysis revealed Cronbach's α values of of 0.87 and 0.73, and satisfactory correlation coefficients for convergent validity with SF-36 and EQ-5D. Conclusions: QLSM-MD and QLSM-DBS can evaluate quality of life aspects of DBS in movement disorders. Psychometric evaluation showed the questionnaires to be reliable, valid, and well accepted by the patients. PMID:12876228

  4. DEFINITION AND CLASSIFICATION OF HYPERKINETIC MOVEMENTS IN CHILDHOOD

    PubMed Central

    Sanger, Terence D.; Chen, Daofen; Fehlings, Darcy L.; Hallett, Mark; Lang, Anthony E.; Mink, Jonathan W.; Singer, Harvey; Alter, Katharine; Ben-Pazi, Hilla; Butler, Erin; Chen, Robert; Collins, Abigail; Dayanidhi, Sudarshan; Forssberg, Hans; Fowler, Eileen; Gilbert, Donald L.; Gorman, Sharon L.; Gormley, Mark E.; Jinnah, H. A.; Kornblau, Barbara; Krosschell, Kristin; Lehman, Rebecca K.; MacKinnon, Colum; Malanga, C. J.; Mesterman, Ronit; Michaels, Margaret Barry; Pearson, Toni S.; Rose, Jessica; Russman, Barry; Sternad, Dagmar; Swoboda, Kathy; Valero-Cuevas, Francisco

    2010-01-01

    Hyperkinetic movements are unwanted or excess movements that are frequently seen in children with neurologic disorders. They are an important clinical finding with significant implications for diagnosis and treatment. However, the lack of agreement on standard terminology and definitions interferes with clinical treatment and research. We describe definitions of dystonia, chorea, athetosis, myoclonus, tremor, tics, and stereotypies that arose from a consensus meeting in June 2008 of specialists from different clinical and basic science fields. Dystonia is a movement disorder in which involuntary sustained or intermittent muscle contractions cause twisting and repetitive movements, abnormal postures, or both. Chorea is an ongoing random-appearing sequence of one or more discrete involuntary movements or movement fragments. Athetosis is a slow, continuous, involuntary writhing movement that prevents maintenance of a stable posture. Myoclonus is a sequence of repeated, often non-rhythmic, brief shock-like jerks due to sudden involuntary contraction or relaxation of one or more muscles. Tremor is a rhythmic back-and-forth or oscillating involuntary movement about a joint axis. Tics are repeated, individually recognizable, intermittent movements or movement fragments that are almost always briefly suppressible and are usually associated with awareness of an urge to perform the movement. Stereotypies are repetitive, simple movements that can be voluntarily suppressed. We provide recommended techniques for clinical examination and suggestions for differentiating between the different types of hyperkinetic movements, noting that there may be overlap between conditions. These definitions and the diagnostic recommendations are intended to be reliable and useful for clinical practice, communication between clinicians and researchers, and for the design of quantitative tests that will guide and assess the outcome of future clinical trials. PMID:20589866

  5. An integrative neurocircuit perspective on psychogenic nonepileptic seizures and functional movement disorders: neural functional unawareness.

    PubMed

    Perez, David L; Dworetzky, Barbara A; Dickerson, Bradford C; Leung, Lorene; Cohn, Rachel; Baslet, Gaston; Silbersweig, David A

    2015-01-01

    Functional neurological disorder (conversion disorder) is a neurobehavioral condition frequently encountered by neurologists. Psychogenic nonepileptic seizure (PNES) and functional movement disorder (FMD) patients present to epileptologists and movement disorder specialists respectively, yet neurologists lack a neurobiological perspective through which to understand these enigmatic groups. Observational research studies suggest that PNES and FMD may represent variants of similar (or the same) conditions given that both groups exhibit a female predominance, have increased prevalence of mood-anxiety disorders, frequently endorse prior abuse, and share phenotypic characteristics. In this perspective article, neuroimaging studies in PNES and FMD are reviewed, and discussed using studies of emotional dysregulation, dissociation and psychological trauma in the context of motor control. Convergent neuroimaging findings implicate alterations in brain circuits mediating emotional expression, regulation and awareness (anterior cingulate and ventromedial prefrontal cortices, insula, amygdala, vermis), cognitive control and motor inhibition (dorsal anterior cingulate, dorsolateral prefrontal, inferior frontal cortices), self-referential processing and perceptual awareness (posterior parietal cortex, temporoparietal junction), and motor planning and coordination (supplementary motor area, cerebellum). Striatal-thalamic components of prefrontal-parietal networks may also play a role in pathophysiology. Aberrant medial prefrontal and amygdalar neuroplastic changes mediated by chronic stress may facilitate the development of functional neurological symptoms in a subset of patients. Improved biological understanding of PNES and FMD will likely reduce stigma and aid the identification of neuroimaging biomarkers guiding treatment development, selection, and prognosis. Additional research should investigate neurocircuit abnormalities within and across functional neurological disorder

  6. [Therapeutic effects of the Feldenkrais method "awareness through movement" in patients with eating disorders].

    PubMed

    Laumer, U; Bauer, M; Fichter, M; Milz, H

    1997-05-01

    Based on the movement-pedagogical concept of Feldenkrais and the findings-of disturbed body perception by eating disordered patients this research aimed at studying the therapeutical effects of the Feldenkrais Method "Awareness through Movement" with eating disorder patients, 15 eating disordered patients treated at the Roseneck hospital for behavioural medicine rated-by means of a questionnaire consisting of scales of the Body Cathexis Scale (BCS), the Body Parts Satisfaction Scale (BPSS), the questionnaire for body perception (Fragebogen zum Körpererleben; FKE), the Emotion inventory (Emotionalitätsinventar; EMI-B), the Anorexia-Nervosa-Inventory for Self-rating (ANIS) and the Eating Disorder Inventory-2 (EDI)-various aspects of their eating disorder before and after participating in a nine hour course of the Feldenkrais Method. The data of these patients were compared to those of the members of a control group, also consisting of 15 eating disordered patients who did not participate in a Feldenkrais course. The participants of the Feldenkrais-course showed increasing contentment with regard to problematic zones of their body and their own health as well as concerning acceptance and familiarity with their own body. Other results were a more spontaneous, open and self-confident behaviour, the decrease of feelings of helplessness and decrease of the wish to return to the security of the early childhood, which indicates the development of felt sense of self, self-confidence and a general process of maturation of the whole personality. The outcome points to the therapeutical effectiveness of the Feldenkrais Method with eating-disorder patients within a multimodal treatment program.

  7. Detection of mental imagery and attempted movements in patients with disorders of consciousness using EEG

    PubMed Central

    Horki, Petar; Bauernfeind, Günther; Klobassa, Daniela S.; Pokorny, Christoph; Pichler, Gerald; Schippinger, Walter; Müller-Putz, Gernot R.

    2014-01-01

    Further development of an EEG based communication device for patients with disorders of consciousness (DoC) could benefit from addressing the following gaps in knowledge—first, an evaluation of different types of motor imagery; second, an evaluation of passive feet movement as a mean of an initial classifier setup; and third, rapid delivery of biased feedback. To that end we investigated whether complex and/or familiar mental imagery, passive, and attempted feet movement can be reliably detected in patients with DoC using EEG recordings, aiming to provide them with a means of communication. Six patients in a minimally conscious state (MCS) took part in this study. The patients were verbally instructed to perform different mental imagery tasks (sport, navigation), as well as attempted feet movements, to induce distinctive event-related (de)synchronization (ERD/S) patterns in the EEG. Offline classification accuracies above chance level were reached in all three tasks (i.e., attempted feet, sport, and navigation), with motor tasks yielding significant (p < 0.05) results more often than navigation (sport: 10 out of 18 sessions; attempted feet: 7 out of 14 sessions; navigation: 4 out of 12 sessions). The passive feet movements, evaluated in one patient, yielded mixed results: whereas time-frequency analysis revealed task-related EEG changes over neurophysiological plausible cortical areas, the classification results were not significant enough (p < 0.05) to setup an initial classifier for the detection of attempted movements. Concluding, the results presented in this study are consistent with the current state of the art in similar studies, to which we contributed by comparing different types of mental tasks, notably complex motor imagery and attempted feet movements, within patients. Furthermore, we explored new venues, such as an evaluation of passive feet movement as a mean of an initial classifier setup, and rapid delivery of biased feedback. PMID:25566029

  8. Dystonia and Paroxysmal Dyskinesias: Under-Recognized Movement Disorders in Domestic Animals? A Comparison with Human Dystonia/Paroxysmal Dyskinesias.

    PubMed

    Richter, Angelika; Hamann, Melanie; Wissel, Jörg; Volk, Holger A

    2015-01-01

    Dystonia is defined as a neurological syndrome characterized by involuntary sustained or intermittent muscle contractions causing twisting, often repetitive movements, and postures. Paroxysmal dyskinesias are episodic movement disorders encompassing dystonia, chorea, athetosis, and ballism in conscious individuals. Several decades of research have enhanced the understanding of the etiology of human dystonia and dyskinesias that are associated with dystonia, but the pathophysiology remains largely unknown. The spontaneous occurrence of hereditary dystonia and paroxysmal dyskinesia is well documented in rodents used as animal models in basic dystonia research. Several hyperkinetic movement disorders, described in dogs, horses and cattle, show similarities to these human movement disorders. Although dystonia is regarded as the third most common movement disorder in humans, it is often misdiagnosed because of the heterogeneity of etiology and clinical presentation. Since these conditions are poorly known in veterinary practice, their prevalence may be underestimated in veterinary medicine. In order to attract attention to these movement disorders, i.e., dystonia and paroxysmal dyskinesias associated with dystonia, and to enhance interest in translational research, this review gives a brief overview of the current literature regarding dystonia/paroxysmal dyskinesia in humans and summarizes similar hereditary movement disorders reported in domestic animals.

  9. Dystonia and Paroxysmal Dyskinesias: Under-Recognized Movement Disorders in Domestic Animals? A Comparison with Human Dystonia/Paroxysmal Dyskinesias

    PubMed Central

    Richter, Angelika; Hamann, Melanie; Wissel, Jörg; Volk, Holger A.

    2015-01-01

    Dystonia is defined as a neurological syndrome characterized by involuntary sustained or intermittent muscle contractions causing twisting, often repetitive movements, and postures. Paroxysmal dyskinesias are episodic movement disorders encompassing dystonia, chorea, athetosis, and ballism in conscious individuals. Several decades of research have enhanced the understanding of the etiology of human dystonia and dyskinesias that are associated with dystonia, but the pathophysiology remains largely unknown. The spontaneous occurrence of hereditary dystonia and paroxysmal dyskinesia is well documented in rodents used as animal models in basic dystonia research. Several hyperkinetic movement disorders, described in dogs, horses and cattle, show similarities to these human movement disorders. Although dystonia is regarded as the third most common movement disorder in humans, it is often misdiagnosed because of the heterogeneity of etiology and clinical presentation. Since these conditions are poorly known in veterinary practice, their prevalence may be underestimated in veterinary medicine. In order to attract attention to these movement disorders, i.e., dystonia and paroxysmal dyskinesias associated with dystonia, and to enhance interest in translational research, this review gives a brief overview of the current literature regarding dystonia/paroxysmal dyskinesia in humans and summarizes similar hereditary movement disorders reported in domestic animals. PMID:26664992

  10. Origins of Balance Disorders during a Daily Living Movement in Obese: Can Biomechanical Factors Explain Everything?

    PubMed Central

    Mignardot, Jean-Baptiste; Olivier, Isabelle; Promayon, Emmanuel; Nougier, Vincent

    2013-01-01

    Obese people suffer from postural deficits and are more subject to falls than their lean counterpart. To improve prevention and post-fall rehabilitation programs, it seems important to better understand the posturo-kinetic disorders in daily life situations by determining the contribution of some key factors, mainly morphological characteristics and physical activity level, in the apparition of these disorders. Twelve severe android obese and eight healthy non obese adults performed a reaching task mobilizing the whole body. To further determine the origin of the postural and motor behavior differences, non obese individuals also performed an experimental session with additional constraints which simulated some of the obese morphological characteristics. Impact of the sedentary lifestyle was also studied by dissociation of the obese in two subgroups: physically « active » and physically « inactive ». Movement kinetics and kinematics were characterized with an optoelectronic system synchronized to a force platform. The mechanical equilibrium pattern was evaluated through the displacements of the Centre of Mass (CoM) and the centre of foot pressure within the Base of Support (BoS). Results showed that obesity decreased movement speed (≈−23%, p<0.01), strongly increased CoM displacement (≈+30%, p<0.05) and induced an important spatio-temporal desynchronization (≈+40%, p<0.05) of the focal and postural components of the movement during the transition between the descending and ascending movements. The role of some morphological characteristics and of physical activity on obese patients' postural control disorder is discussed and set back in the more general context of overall factors contributing to postural deficits with obesity. PMID:23560097

  11. Behavioral Sleep Medicine Interventions for Restless Legs Syndrome and Periodic Limb Movement Disorder

    PubMed Central

    Pigeon, Wilfred R.; Yurcheshen, Michael

    2009-01-01

    SYNOPSIS Restless Legs Syndrome (RLS) and Periodic Limb Movement Disorder (PLMD) are sleep disorders that are commonly seen in clinical practice. The standard treatment recommendations for these disorders are pharmacologic; most recently both conditions are most typically managed with pramipexole or ropinerole, which are FDA approved for the treatment of RLS. A mix of behavioral suggestions is included in treatment algorithms for providers as well as in patient education materials. While these suggestions have considerable merit, they are typically not delivered as an intervention, but instead provided as a series of helpful tips. There is emerging evidence for providing such suggestions as a more active and comprehensive intervention as part of a cognitive-behavioral package as well as for exercise therapy and cognitive behavioral therapy for insomnia to be delivered as active treatments for RLS and/or PLMD. PMID:20161553

  12. Investigating rapid eye movement sleep without atonia in Parkinson's disease using the rapid eye movement sleep behavior disorder screening questionnaire.

    PubMed

    Bolitho, Samuel J; Naismith, Sharon L; Terpening, Zoe; Grunstein, Ron R; Melehan, Kerri; Yee, Brendon J; Coeytaux, Alessandra; Gilat, Moran; Lewis, Simon J G

    2014-05-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) is frequently observed in patients with Parkinson's disease (PD). Accurate diagnosis is essential for managing this condition. Furthermore, the emergence of idiopathic RBD in later life can represent a premotor feature, heralding the development of PD. Reliable, accurate methods for identifying RBD may offer a window for early intervention. This study sought to identify whether the RBD screening questionnaire (RBDSQ) and three questionnaires focused on dream enactment were able to correctly identify patients with REM without atonia (RWA), the neurophysiological hallmark of RBD. Forty-six patients with PD underwent neurological and sleep assessment in addition to completing the RBDSQ, the RBD single question (RBD1Q), and the Mayo Sleep Questionnaire (MSQ). The REM atonia index was derived for all participants as an objective measure of RWA. Patients identified to be RBD positive on the RBDSQ did not show increased RWA on polysomnography (80% sensitivity and 55% specificity). However, patients positive for RBD on questionnaires specific to dream enactment correctly identified higher degrees of RWA and improved the diagnostic accuracy of these questionnaires. This study suggests that the RBDSQ does not accurately identify RWA, essential for diagnosing RBD in PD. Furthermore, the results suggest that self-report measures of RBD need to focus questions on dream enactment behavior to better identify RWA and RBD. Further studies are needed to develop accurate determination and quantification of RWA in RBD to improve management of patients with PD in the future.

  13. Use of eye movement desensitization and reprocessing (EMDR) in the treatment of dermatologic disorders.

    PubMed

    Gupta, Madhulika A; Gupta, Aditya K

    2002-01-01

    The use of psychological therapies in dermatology is being increasingly recognized because stress and negative emotions are major factors in a wide range of dermatologic disorders. Eye movement desensitization and reprocessing (EMDR) is a relatively new psychological intervention which was first described to be effective in post-traumatic stress disorder, a condition associated with extremely stressful life situations. We evaluated the efficacy of EMDR in primary dermatologic disorders where psychological stress plays an important part in the pathogenesis of the disorder, and in clinical situations where the dermatologic symptom is the feature of a stress-related psychiatric disorder. Four patients (two patients with atopic dermatitis and psoriasis, respectively, whose symptoms were exacerbated by stress, one patient with acne excoríee associated with body image pathology as a result of childhood emotional abuse, and one patient with generalized urticaria associated with post-traumatic stress disorder) were treated using the standard EMDR protocol with 3-6 sessions for a period ranging from 4 to 12 weeks, and followed up for 6-12 months after the end of EMDR therapy. All 4 patients experienced a marked improvement in their symptoms after 3-6 sessions of EMDR, within a period of

  14. The Effectiveness of Transcranial Brain Stimulation in Improving Clinical Signs of Hyperkinetic Movement Disorders

    PubMed Central

    Obeso, Ignacio; Cerasa, Antonio; Quattrone, Aldo

    2016-01-01

    Repetitive transcranial magnetic stimulation (rTMS) is a safe and painless method for stimulating cortical neurons. In neurological realm, rTMS has prevalently been applied to understand pathophysiological mechanisms underlying movement disorders. However, this tool has also the potential to be translated into a clinically applicable therapeutic use. Several available studies supported this hypothesis, but differences in protocols, clinical enrollment, and variability of rTMS effects across individuals complicate better understanding of efficient clinical protocols. The aim of this present review is to discuss to what extent the evidence provided by the therapeutic use of rTMS may be generalized. In particular, we attempted to define optimal cortical regions and stimulation protocols that have been demonstrated to maximize the effectiveness seen in the actual literature for the three most prevalent hyperkinetic movement disorders: Parkinson's disease (PD) with levodopa-induced dyskinesias (LIDs), essential tremor (ET) and dystonia. A total of 28 rTMS studies met our search criteria. Despite clinical and methodological differences, overall these studies demonstrated that therapeutic applications of rTMS to “normalize” pathologically decreased or increased levels of cortical activity have given moderate progress in patient's quality of life. Moreover, the present literature suggests that altered pathophysiology in hyperkinetic movement disorders establishes motor, premotor or cerebellar structures as candidate regions to reset cortico-subcortical pathways back to normal. Although rTMS has the potential to become a powerful tool for ameliorating the clinical outcome of hyperkinetic neurological patients, until now there is not a clear consensus on optimal protocols for these motor disorders. Well-controlled multicenter randomized clinical trials with high numbers of patients are urgently required. PMID:26778947

  15. GRIN1 mutations cause encephalopathy with infantile-onset epilepsy, and hyperkinetic and stereotyped movement disorders.

    PubMed

    Ohba, Chihiro; Shiina, Masaaki; Tohyama, Jun; Haginoya, Kazuhiro; Lerman-Sagie, Tally; Okamoto, Nobuhiko; Blumkin, Lubov; Lev, Dorit; Mukaida, Souichi; Nozaki, Fumihito; Uematsu, Mitsugu; Onuma, Akira; Kodera, Hirofumi; Nakashima, Mitsuko; Tsurusaki, Yoshinori; Miyake, Noriko; Tanaka, Fumiaki; Kato, Mitsuhiro; Ogata, Kazuhiro; Saitsu, Hirotomo; Matsumoto, Naomichi

    2015-06-01

    Recently, de novo mutations in GRIN1 have been identified in patients with nonsyndromic intellectual disability and epileptic encephalopathy. Whole exome sequencing (WES) analysis of patients with genetically unsolved epileptic encephalopathies identified four patients with GRIN1 mutations, allowing us to investigate the phenotypic spectrum of GRIN1 mutations. Eighty-eight patients with unclassified early onset epileptic encephalopathies (EOEEs) with an age of onset <1 year were analyzed by WES. The effect of mutations on N-methyl-D-aspartate (NMDA) receptors was examined by mapping altered amino acids onto three-dimensional models. We identified four de novo missense GRIN1 mutations in 4 of 88 patients with unclassified EOEEs. In these four patients, initial symptoms appeared within 3 months of birth, including hyperkinetic movements in two patients (2/4, 50%), and seizures in two patients (2/4, 50%). Involuntary movements, severe developmental delay, and intellectual disability were recognized in all four patients. In addition, abnormal eye movements resembling oculogyric crises and stereotypic hand movements were observed in two and three patients, respectively. All the four patients exhibited only nonspecific focal and diffuse epileptiform abnormality, and never showed suppression-burst or hypsarrhythmia during infancy. A de novo mosaic mutation (c.1923G>A) with a mutant allele frequency of 16% (in DNA of blood leukocytes) was detected in one patient. Three mutations were located in the transmembrane domain (3/4, 75%), and one in the extracellular loop near transmembrane helix 1. All the mutations were predicted to impair the function of the NMDA receptor. Clinical features of de novo GRIN1 mutations include infantile involuntary movements, seizures, and hand stereotypies, suggesting that GRIN1 mutations cause encephalopathy resulting in seizures and movement disorders. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

  16. The gap between clinical gaze and systematic assessment of movement disorders after stroke

    PubMed Central

    2012-01-01

    Background Movement disorders after stroke are still captured by clinical gaze and translated to ordinal scores of low resolution. There is a clear need for objective quantification, with outcome measures related to pathophysiological background. Neural and non-neural contributors to joint behavior should be separated using different measurement conditions (tasks) and standardized input signals (force, position and velocity). Methods We reviewed recent literature for the application of biomechanical and/or elektromyographical (EMG) outcome measures under various measurement conditions in clinical research. Results Since 2005, 36 articles described the use of biomechanical and/or EMG outcome measures to quantify post-stroke movement disorder. Nineteen of the articles strived to separate neural and non-neural components. Only 6 of the articles measured biomechanical and EMG outcome measures simultaneously, while applying active and passive tasks and multiple velocities. Conclusion The distinction between neural and non-neural components to separately assess paresis, stiffness and muscle overactivity is not commonplace yet, while a large gap is to be bridged to attain reproducible and comparable results. Pathophysiologically clear concepts, substantiated with a comprehensive and concise measuring protocol will help professionals to identify and treat limiting factors in movement capabilities of post-stroke patients. PMID:22925463

  17. Nicotine and Nicotinic Receptor Drugs: Potential for Parkinson's Disease and Drug-Induced Movement Disorders.

    PubMed

    Quik, Maryka; Bordia, Tanuja; Zhang, Danhui; Perez, Xiomara A

    2015-01-01

    Parkinson's disease is a progressive neurodegenerative disorder associated with tremor, rigidity, and bradykinesia, as well as nonmotor symptoms including autonomic impairments, olfactory dysfunction, sleep disturbances, depression, and dementia. Although the major neurological deficit is a loss of nigrostriatal dopaminergic neurons, multiple neurotransmitters systems are compromised in Parkinson's disease. Consistent with this observation, dopamine replacement therapy dramatically improves Parkinson's disease motor symptoms. Additionally, drugs targeting the serotonergic, glutamatergic, adenosine, and other neurotransmitter systems may be beneficial. Recent evidence also indicates that nicotinic cholinergic drugs may be useful for the management of Parkinson's disease. This possibility initially arose from the results of epidemiological studies, which showed that smoking was associated with a decreased incidence of Parkinson's disease, an effect mediated in part by the nicotine in smoke. Further evidence for this idea stemmed from preclinical studies which showed that nicotine administration reduced nigrostriatal damage in parkinsonian rodents and monkeys. In addition to a potential neuroprotective role, emerging work indicates that nicotinic receptor drugs improve the abnormal involuntary movements or dyskinesias that arise as a side effect of l-dopa treatment, the gold standard therapy for Parkinson's disease. Both nicotine and nicotinic receptor drugs reduced l-dopa-induced dyskinesias by over 50% in parkinsonian rodent and monkey models. Notably, nicotine also attenuated the abnormal involuntary movements or tardive dyskinesias that arise with antipsychotic treatment. These observations, coupled with reports that nicotinic receptor drugs have procognitive and antidepressant effects, suggest that central nervous system (CNS) nicotinic receptors may represent useful targets for the treatment of movement disorders.

  18. Human movement stochastic variability leads to diagnostic biomarkers In Autism Spectrum Disorders (ASD)

    NASA Astrophysics Data System (ADS)

    Wu, Di; Torres, Elizabeth B.; Jose, Jorge V.

    2015-03-01

    ASD is a spectrum of neurodevelopmental disorders. The high heterogeneity of the symptoms associated with the disorder impedes efficient diagnoses based on human observations. Recent advances with high-resolution MEM wearable sensors enable accurate movement measurements that may escape the naked eye. It calls for objective metrics to extract physiological relevant information from the rapidly accumulating data. In this talk we'll discuss the statistical analysis of movement data continuously collected with high-resolution sensors at 240Hz. We calculated statistical properties of speed fluctuations within the millisecond time range that closely correlate with the subjects' cognitive abilities. We computed the periodicity and synchronicity of the speed fluctuations' from their power spectrum and ensemble averaged two-point cross-correlation function. We built a two-parameter phase space from the temporal statistical analyses of the nearest neighbor fluctuations that provided a quantitative biomarker for ASD and adult normal subjects and further classified ASD severity. We also found age related developmental statistical signatures and potential ASD parental links in our movement dynamical studies. Our results may have direct clinical applications.

  19. Eye Movement Sequences during Simple versus Complex Information Processing of Scenes in Autism Spectrum Disorder

    PubMed Central

    Au-Yeung, Sheena K.; Benson, Valerie; Castelhano, Monica; Rayner, Keith

    2011-01-01

    Minshew and Goldstein (1998) postulated that autism spectrum disorder (ASD) is a disorder of complex information processing. The current study was designed to investigate this hypothesis. Participants with and without ASD completed two scene perception tasks: a simple “spot the difference” task, where they had to say which one of a pair of pictures had a detail missing, and a complex “which one's weird” task, where they had to decide which one of a pair of pictures looks “weird”. Participants with ASD did not differ from TD participants in their ability to accurately identify the target picture in both tasks. However, analysis of the eye movement sequences showed that participants with ASD viewed scenes differently from normal controls exclusively for the complex task. This difference in eye movement patterns, and the method used to examine different patterns, adds to the knowledge base regarding eye movements and ASD. Our results are in accordance with Minshew and Goldstein's theory that complex, but not simple, information processing is impaired in ASD. PMID:22937254

  20. Rating scale for psychogenic movement disorders: scale development and clinimetric testing.

    PubMed

    Hinson, Vanessa K; Cubo, Esther; Comella, Cynthia L; Goetz, Christopher G; Leurgans, Sue

    2005-12-01

    We developed and tested the clinimetric properties of a scale for psychogenic movement disorders (PMDs). PMDs are disabling but lack any generally accepted treatment strategies. To develop treatments, means of assessing disease severity must be provided. No scale to assess PMDs existed. The PMD scale developed here rates 10 phenomena (rest tremor, action tremor, dystonia, chorea, bradykinesia, myoclonus, tics, athetosis, ballism, cerebellar incoordination), 2 functions (gait, speech), and 14 body regions. To study interrater agreement, three movement disorder neurologists independently rated 88 videotapes of PMD patients. Data analysis was performed using a kappa coefficient of agreement, Kendall's coefficient of concordance, Spearman correlations, and intraclass correlation coefficients. Validity and scale responsiveness were tested as well. All phenomena and speech and gait dysfunction occurred in the patient sample. A wide range of affected body regions, severity, and incapacitation was captured. Ratings showed excellent interrater reliability for presence or absence of each phenomenon (kappa range, 0.63 to 0.86). Kendall's concordance coefficients for phenomenology, function, and total PMD scores were 0.92, 0.93, and 0.91. Spearman correlations between raters ranged from 0.86 to 0.90. The scale was responsive to changes that occurred as a result of a neuropsychiatric intervention. The PMD scale adequately captures the complex movements of PMDs and can be used to assess PMDs and test the efficacy of intervention strategies.

  1. An Evaluation of Educational Neurological Eye Movement Disorder Videos Posted on Internet Video Sharing Sites.

    PubMed

    Hickman, Simon J

    2016-03-01

    Internet video sharing sites allow the free dissemination of educational material. This study investigated the quality and educational content of videos of eye movement disorders posted on such sites. Educational neurological eye movement videos were identified by entering the titles of the eye movement abnormality into the search boxes of the video sharing sites. Also, suggested links were followed from each video. The number of views, likes, and dislikes for each video were recorded. The videos were then rated for their picture and sound quality. Their educational value was assessed according to whether the video included a description of the eye movement abnormality, the anatomical location of the lesion (if appropriate), and the underlying diagnosis. Three hundred fifty-four of these videos were found on YouTube and Vimeo. There was a mean of 6,443 views per video (range, 1-195,957). One hundred nineteen (33.6%) had no form of commentary about the eye movement disorder shown apart from the title. Forty-seven (13.3%) contained errors in the title or in the text. Eighty (22.6%) had excellent educational value by describing the eye movement abnormality, the anatomical location of the lesion, and the underlying diagnosis. Of these, 30 also had good picture and sound quality. The videos with excellent educational value had a mean of 9.84 "likes" per video compared with 2.37 for those videos without a commentary (P < 0.001). The videos that combined excellent educational value with good picture and sound quality had a mean of 10.23 "likes" per video (P = 0.004 vs videos with no commentary). There was no significant difference in the mean number of "dislikes" between those videos that had no commentary or which contained errors and those with excellent educational value. There are a large number of eye movement videos freely available on these sites; however, due to the lack of peer review, a significant number have poor educational value due to having no commentary

  2. Evaluation of the effect of treatment on movement disorders in astrocytomas of the basal ganglia and the thalamus.

    PubMed Central

    Krauss, J K; Braus, D F; Mohadjer, M; Nobbe, F; Mundinger, F

    1993-01-01

    Twenty patients with movement disorders associated with astrocytomas (grade I-IV according to the WHO tumour classification) of the basal ganglia and the thalamus were evaluated for the effects of treatment. Five patients had more than one movement disorder when the histological diagnosis was verified by stereotactic biopsy. Twelve had tremors, eight hemidystonia, three hemichorea, and one hemichorea/ballismus, and myoclonus respectively. Ten patients died during the follow up period, and for the surviving patients follow up periods ranged from 6-21 years. The movement disorders changed over long periods of time related to therapeutic interventions. CSF shunt operations and percutaneous radiotherapy had no definite effect on the movement disorders. There was a moderate response to medical treatment in a few patients. Stereotactic aspiration of tumour cysts had a marked influence on the movement disorder in two patients, and functional stereotactic surgery abolished tumour induced tremor in one. Interstitial radiotherapy was performed in fifteen patients for treatment of the underlying neoplasm and resulted in different and variable alterations of the movement disorders. These differences may be explained by complex interactions involving structures affected primarily by the tumour, as well as by secondary functional lesions of adjacent structures. Images PMID:8410011

  3. Clinical characteristics, management and long-term outcome of suspected rapid eye movement sleep behaviour disorder in 14 dogs.

    PubMed

    Schubert, T A; Chidester, R M; Chrisman, C L

    2011-02-01

    To describe the clinical characteristics, management and long-term outcome in dogs with suspected rapid eye movement sleep behaviour disorder. Medical records and video recordings of 14 dogs with suspected rapid eye movement sleep behaviour disorder were reviewed and the owners were contacted via telephone or email for further information. Clinical signs included episodes of violent limb movements, howling, barking, growling, chewing, or biting during sleep. Episodes occurred at night and during daytime naps. The age at onset ranged from 8 weeks to 7·5 years with a median of 6 years but 64% of dogs were one year or less. There was no apparent sex or breed predisposition. Rapid eye movement sleep behaviour disorder events were reduced in severity and frequency in 78% of the dogs treated with 40 mg/kg/day oral potassium bromide. One dog was euthanized within 3 months of the onset of signs because of their severity. The duration of the disorder in the 13 surviving dogs ranged from 1·5 to 9 years. None of the dogs spontaneously recovered. Rapid eye movement sleep behaviour disorder is suspected to occur in dogs, as it does in human beings. It causes concern to the owners and disrupts the home environment. Unlike human beings, rapid eye movement sleep behaviour disorder of dogs often has a juvenile onset. © 2011 British Small Animal Veterinary Association.

  4. Movement disorders in Rett syndrome: an analysis of 60 patients with detected MECP2 mutation and correlation with mutation type.

    PubMed

    Temudo, Teresa; Ramos, Elisabete; Dias, Karin; Barbot, Clara; Vieira, Jose P; Moreira, Ana; Calado, Eulalia; Carrilho, Ines; Oliveira, Guiomar; Levy, Antonio; Fonseca, Maria; Cabral, Alexandra; Cabral, Pedro; Monteiro, Joao P; Borges, Luis; Gomes, Roseli; Santos, Manuela; Sequeiros, Jorge; Maciel, Patricia

    2008-07-30

    Rett syndrome (RS) is one of the best human models to study movement disorders. Patients evolve from a hyperkinetic to a hypokinetic state, and a large series of abnormal movements may be observed along their lives such as stereotypies, tremor, chorea, myoclonus, ataxia, dystonia, and rigidity. The aim of this work was to analyze movement disorders in RS patients with a detected MECP2 mutation, as well as their correlation with genotype, in a clinically and genetically well-characterized sample of patients, and thus contribute to redefine the clinical profile of this disease. In this study, we included 60 patients with detected MECP2 mutations. These were categorized and grouped for analysis, according to (1) type of change (missense or truncating, including nonsense and frameshift but also large deletions) and (2) location of the mutation. Differences were found concerning the frequency of independent gait, dystonia, type of tremor, and global score severity when comparing the group of patients with missense and truncating mutations. We also found differences in the presence, distribution, severity, or type of movement disorders in the two groups of patients according to the median duration of the disease (less than 60 months; 60 months or more). We conclude that movement disorders seem to reflect the severity and rate of progression of Rett disorder, patients with truncating mutations presenting a higher rate and more severe dystonia and rigid-akinetic syndrome, when comparing groups with similar time of disease evolution. Copyright 2008 Movement Disorder Society.

  5. Cognitive Control of Saccadic Eye Movements in Children with Developmental Coordination Disorder

    PubMed Central

    Gonzalez, Claudia C.; Mon-Williams, Mark; Burke, Siobhan; Burke, Melanie R.

    2016-01-01

    The ability to use advance information to prepare and execute a movement requires cognitive control of behaviour (e.g., anticipation and inhibition). Our aim was to explore the integrity of saccadic eye movement control in developmental coordination disorder (DCD) and typically developing (TD) children (8–12 years) and assess how these children plan and inhibit saccadic responses, the principal mechanisms within visual attention control. Eye movements and touch responses were measured (separately and concurrently) in Cued and Non-Cued conditions. We found that children with DCD had similar saccade kinematics to the TD group during saccade initiation. Advance information decreased hand movement duration in both groups during Cued trials, but decrements in accuracy were significantly worse in the DCD group. In addition, children with DCD exhibited greater inhibitory errors and inaccurate fixation during the Cued trials. Thus, children with DCD were reasonably proficient in executing saccades during reflexive (Non-Cued) conditions, but showed deficits in more complex control processes involving prediction and inhibition. These findings have implications for our understanding of motor control in children with DCD. PMID:27812128

  6. Therapeutic Eurythmy-movement therapy for children with attention deficit hyperactivity disorder (ADHD): a pilot study.

    PubMed

    Majorek, Magdalena; Tüchelmann, Tobias; Heusser, Peter

    2004-02-01

    This paper considers Therapeutic Eurythmy (TE) as a possible therapy for children with attention deficit hyperactivity disorder (ADHD).ADHD manifests as a complex psychological disturbance in which deficit of attention such as forgetfulness or distraction is the main symptom. It would seem that a growing number of children seem to be affected by this syndrome and an increasing number of alternative approaches to treatment are being sought. Therapeutic Eurythmy is a movement Therapy in the context of anthroposophical medicine. As a holistic therapy TE affects both physical and spiritual aspects of illness. TE entails the practice of movement exercises learned from a trained therapist. In this exploratory study, the effects of TE on behavioural functioning were examined.This paper addresses five single cases where the therapy induced positive changes to client's attention span, concentration, tempo of work and motor skills such as coordination, dexterity and social behaviour. Standard psychological tests parameters for movement, and for attention were used to assess aspects of performance.A positive shift was observed with reference to concentration and development of movement skills. Results were less pronounced but showed positive improvements on working speed and social behaviour problems. Hyperactivity also diminished to some extent. Generally, children were considered to be more mature in their development after therapy. The results of these case studies suggest that TE may be helpful for children with ADHD. However, more systematic research is warranted.

  7. Cognitive Control of Saccadic Eye Movements in Children with Developmental Coordination Disorder.

    PubMed

    Gonzalez, Claudia C; Mon-Williams, Mark; Burke, Siobhan; Burke, Melanie R

    2016-01-01

    The ability to use advance information to prepare and execute a movement requires cognitive control of behaviour (e.g., anticipation and inhibition). Our aim was to explore the integrity of saccadic eye movement control in developmental coordination disorder (DCD) and typically developing (TD) children (8-12 years) and assess how these children plan and inhibit saccadic responses, the principal mechanisms within visual attention control. Eye movements and touch responses were measured (separately and concurrently) in Cued and Non-Cued conditions. We found that children with DCD had similar saccade kinematics to the TD group during saccade initiation. Advance information decreased hand movement duration in both groups during Cued trials, but decrements in accuracy were significantly worse in the DCD group. In addition, children with DCD exhibited greater inhibitory errors and inaccurate fixation during the Cued trials. Thus, children with DCD were reasonably proficient in executing saccades during reflexive (Non-Cued) conditions, but showed deficits in more complex control processes involving prediction and inhibition. These findings have implications for our understanding of motor control in children with DCD.

  8. Movement disorders in a twins pair: a casual expression or genetic determination?

    PubMed

    Gennaro, Leonarda; Russo, Luigi; Losito, Luciana; Zaccaria, Alessia; De Rinaldis, Marta; Trabacca, Antonio

    2010-01-01

    A twin study is an excellent means of assessing the contribution of heritability to motor behaviour. We present a movement video-analysis of a monozygotic twins pair with a motor repertoire which is almost totally constituted by persistent and subcontinuous motor stereotypies. The specific aim of this study is to verify the heritable quantum of motor behaviour and to determine which among the motor patterns we analysed are more likely to be conditioned by inheritance. Stereotyped movements were videotaped in two standardized sessions: at rest and in relation to preordained sensory stimulations. We estimated the concordance index (CI) between the observers to evaluate the reliability of the observations. The validity was accepted as being CI>0.80. The results showed a very high concordance rate (>90%) for all the stereotypies analysed. An almost superimposable trend of the stereotyped movements was found both at rest and in relation to the sensory stimulations. Such strong data suggest that genetic factors have a primary influence on all the movement disorders analysed. This study contributes to a better understanding of the complex relationships between genes and functions. 2010 Elsevier Ltd. All rights reserved.

  9. Smooth pursuit eye movement (SPEM) in patients with multiple complex developmental disorder (MCDD), a subtype of the pervasive developmental disorder.

    PubMed

    Lahuis, Bertine E; Van Engeland, Herman; Cahn, Wiepke; Caspers, Esther; Van der Geest, Jos N; Van der Gaag, Rutger Jan; Kemner, Chantal

    2009-01-01

    Multiple complex developmental disorder (MCDD) is a well-defined and validated behavioural subtype of pervasive developmental disorder-not otherwise specified (PDD-NOS) and is thought to be associated with a higher risk of developing a schizophrenic spectrum disorder. The question was addressed whether patients with MCDD show the same psychophysiological abnormalities as seen in patients with schizophrenia. Smooth pursuit eye movement (pursuit gain and saccadic parameters) was measured in children with either MCDD (n=18) or autism (n=18), and in age- and IQ-matched controls (n=36), as well as in a group of adult patients with schizophrenia (n=14) and a group of adult controls (n=17). We found the expected effect of lower velocity gain and increased number of saccades in schizophrenic patients. Children with MCDD also showed a lower velocity gain compared to controls children. In contrast, velocity gain was similar in autistic subjects and controls. No differences for velocity gain were found in a direct comparison between MCDD and autism. Saccadic parameters were not significantly different from controls in either MCDD or autistic subjects. Children with MCDD, like schizophrenic adults, show a reduced velocity gain, which could indicate that schizophrenia spectrum disorders and MCDD share (at least to some degree) a common neurobiological background.

  10. Evidence for Multiple Rhythmic Skills

    PubMed Central

    Tierney, Adam; Kraus, Nina

    2015-01-01

    Rhythms, or patterns in time, play a vital role in both speech and music. Proficiency in a number of rhythm skills has been linked to language ability, suggesting that certain rhythmic processes in music and language rely on overlapping resources. However, a lack of understanding about how rhythm skills relate to each other has impeded progress in understanding how language relies on rhythm processing. In particular, it is unknown whether all rhythm skills are linked together, forming a single broad rhythmic competence, or whether there are multiple dissociable rhythm skills. We hypothesized that beat tapping and rhythm memory/sequencing form two separate clusters of rhythm skills. This hypothesis was tested with a battery of two beat tapping and two rhythm memory tests. Here we show that tapping to a metronome and the ability to adjust to a changing tempo while tapping to a metronome are related skills. The ability to remember rhythms and to drum along to repeating rhythmic sequences are also related. However, we found no relationship between beat tapping skills and rhythm memory skills. Thus, beat tapping and rhythm memory are dissociable rhythmic aptitudes. This discovery may inform future research disambiguating how distinct rhythm competencies track with specific language functions. PMID:26376489

  11. Evidence for Multiple Rhythmic Skills.

    PubMed

    Tierney, Adam; Kraus, Nina

    2015-01-01

    Rhythms, or patterns in time, play a vital role in both speech and music. Proficiency in a number of rhythm skills has been linked to language ability, suggesting that certain rhythmic processes in music and language rely on overlapping resources. However, a lack of understanding about how rhythm skills relate to each other has impeded progress in understanding how language relies on rhythm processing. In particular, it is unknown whether all rhythm skills are linked together, forming a single broad rhythmic competence, or whether there are multiple dissociable rhythm skills. We hypothesized that beat tapping and rhythm memory/sequencing form two separate clusters of rhythm skills. This hypothesis was tested with a battery of two beat tapping and two rhythm memory tests. Here we show that tapping to a metronome and the ability to adjust to a changing tempo while tapping to a metronome are related skills. The ability to remember rhythms and to drum along to repeating rhythmic sequences are also related. However, we found no relationship between beat tapping skills and rhythm memory skills. Thus, beat tapping and rhythm memory are dissociable rhythmic aptitudes. This discovery may inform future research disambiguating how distinct rhythm competencies track with specific language functions.

  12. Gamma-Rhythmic Gain Modulation.

    PubMed

    Ni, Jianguang; Wunderle, Thomas; Lewis, Christopher Murphy; Desimone, Robert; Diester, Ilka; Fries, Pascal

    2016-10-05

    Cognition requires the dynamic modulation of effective connectivity, i.e., the modulation of the postsynaptic neuronal response to a given input. If postsynaptic neurons are rhythmically active, this might entail rhythmic gain modulation, such that inputs synchronized to phases of high gain benefit from enhanced effective connectivity. We show that visually induced gamma-band activity in awake macaque area V4 rhythmically modulates responses to unpredictable stimulus events. This modulation exceeded a simple additive superposition of a constant response onto ongoing gamma-rhythmic firing, demonstrating the modulation of multiplicative gain. Gamma phases leading to strongest neuronal responses also led to shortest behavioral reaction times, suggesting functional relevance of the effect. Furthermore, we find that constant optogenetic stimulation of anesthetized cat area 21a produces gamma-band activity entailing a similar gain modulation. As the gamma rhythm in area 21a did not spread backward to area 17, this suggests that postsynaptic gamma is sufficient for gain modulation. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. [Movement therapy and depression--evaluation study of a disorder-oriented and an unspecific movement-therapeutic support in clinical context].

    PubMed

    Heimbeck, Alexander; Hölter, Gerd

    2011-05-01

    In recent years body-orientated concepts have gained more and more importance in the therapy of mental disorders. But there is still a widespread skepticism about the effectiveness of movement-therapeutic measures. In the present study the effectiveness of an unspecific versus a disorder-orientated movement-therapy was tested in the clinical setting including a 6-month catamnesis with depressive patients (n=103) with a BDI >18. The results show, at every data point, the effectiveness of the measures for all investigated parameters. Both forms of movement-orientated interventions differ only slightly with regard to the therapeutic success. The catamnesis shows a big gap between resolution and actually realized activities. On the basis of the results it can be assumed that mainly general unspecific determinants play a more important role for the therapeutic success than assumed so far.

  14. Characterization of Movement Disorder Phenomenology in Genetically Proven, Familial Frontotemporal Lobar Degeneration: A Systematic Review and Meta-Analysis

    PubMed Central

    Gasca-Salas, Carmen; Masellis, Mario; Khoo, Edwin; Shah, Binit B.; Fisman, David; Lang, Anthony E.; Kleiner-Fisman, Galit

    2016-01-01

    Background Mutations in granulin (PGRN) and tau (MAPT), and hexanucleotide repeat expansions near the C9orf72 genes are the most prevalent genetic causes of frontotemporal lobar degeneration. Although behavior, language and movement presentations are common, the relationship between genetic subgroup and movement disorder phenomenology is unclear. Objective We conducted a systematic review and meta-analysis of the literature characterizing the spectrum and prevalence of movement disorders in genetic frontotemporal lobar degeneration. Methods Electronic databases were searched using terms related to frontotemporal lobar degeneration and movement disorders. Articles were included when cases had a proven genetic cause. Study-specific prevalence estimates for clinical features were transformed using Freeman-Tukey arcsine transformation, allowing for pooled estimates of prevalence to be generated using random-effects models. Results The mean age at onset was earlier in those with MAPT mutations compared to PGRN (p<0.001) and C9orf72 (p = 0.024). 66.5% of subjects had an initial non-movement presentation that was most likely a behavioral syndrome (35.7%). At any point during the disease, parkinsonism was the most common movement syndrome reported in 79.8% followed by progressive supranuclear palsy (PSPS) and corticobasal (CBS) syndromes in 12.2% and 10.7%, respectively. The prevalence of movement disorder as initial presentation was higher in MAPT subjects (35.8%) compared to PGRN subjects (10.1). In those with a non-movement presentation, language disorder was more common in PGRN subjects (18.7%) compared to MAPT subjects (5.4%). Summary This represents the first systematic review and meta-analysis of the occurrence of movement disorder phenomenology in genetic frontotemporal lobar degeneration. Standardized prospective collection of clinical information in conjunction with genetic characterization will be crucial for accurate clinico-genetic correlation. PMID:27100392

  15. Sensorimotor integration: basic concepts, abnormalities related to movement disorders and sensorimotor training-induced cortical reorganization.

    PubMed

    Machado, Sergio; Cunha, Marlo; Velasques, Bruna; Minc, Daniel; Teixeira, Silmar; Domingues, Clayton A; Silva, Julio G; Bastos, Victor H; Budde, Henning; Cagy, Mauricio; Basile, Luis; Piedade, Roberto; Ribeiro, Pedro

    2010-10-01

    Sensorimotor integration is defined as the capability of the central nervous system to integrate different sources of stimuli, and parallelly, to transform such inputs in motor actions. To review the basic principles of sensorimotor integration, such as, its neural bases and its elementary mechanisms involved in specific goal-directed tasks performed by healthy subjects, and the abnormalities reported in the most common movement disorders, such as, Parkinson' disease, dystonia and stroke, like the cortical reorganization-related mechanisms. Whether these disorders are associated with an abnormal peripheral sensory input or defective central processing is still unclear, but most of the data support a central mechanism. We found that the sensorimotor integration process plays a potential role in elementary mechanisms involved in specific goal-directed tasks performed by healthy subjects and in occurrence of abnormalities in most common movement disorders and, moreover, play a potential role on the acquisition of abilities that have as critical factor the coupling of different sensory data which will constitute the basis of elaboration of motor outputs consciously goal-directed.

  16. Primary bowing tremor: a task-specific movement disorder of string instrumentalists.

    PubMed

    Lederman, Richard J

    2012-12-01

    Fear of a tremulous or unsteady bow is widespread among string instrumentalists. Faulty technique and performance anxiety have generally been blamed. The cases of 4 high-level violinists and 1 violist, 3 women and 2 men, with uncontrollable bow tremor are presented. Age at onset was from 16 to 75 years, and symptom duration 8 months to 20 years at the time of neurological evaluation. The degree of tremor varied with type of bow stroke and even the portion of the bow contacting the string. Only 1 patient had a slight postural tremor of the opposite limb. In 3 of 5 the tremor was task-specific; the other 2 had mild and nontroubling tremor with other activities. The tremor appeared to worsen over time but then seemed to stabilize. The characteristics of this tremor appear to be distinguishable from the features of both essential tremor and focal dystonia; comparison is made with representative string players afflicted by these other disorders. Analogy of this tremor is made with primary writing tremor, a well-defined task-specific movement disorder also sharing at least some features with both essential tremor and writers' cramp, a focal dystonia. Hence, it was decided to call this primary bowing tremor. Clinical features, family history, diagnostic studies, and responsiveness to treatment of primary writing tremor are discussed to emphasize the similarity to primary bowing tremor. This appears to represent a previously unreported form of task-specific movement disorder of string instrumentalists.

  17. Inhaled hydrogen sulfide prevents neurodegeneration and movement disorder in a mouse model of Parkinson's disease.

    PubMed

    Kida, Kotaro; Yamada, Marina; Tokuda, Kentaro; Marutani, Eizo; Kakinohana, Manabu; Kaneki, Masao; Ichinose, Fumito

    2011-07-15

    Parkinson's disease is one of the major neurodegenerative disorders. Neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) can cause Parkinson's disease-like symptoms and biochemical changes in humans and animals. Hydrogen sulfide (H(2)S) has been shown to protect neurons. The goal of this study was to examine the effects of inhaled H(2)S in a mouse model of Parkinson's disease induced by MPTP. Male C57BL/6J mice received MPTP at 80 mg/kg and breathed air with or without 40 ppm H(2)S for 8 h/day for 7 days. Administration of MPTP induced movement disorder and decreased tyrosine hydroxylase (TH)-containing neurons in the substantia nigra and striatum in mice that breathed air. Inhalation of H(2)S prevented the MPTP-induced movement disorder and the degeneration of TH-containing neurons. Inhaled H(2)S also prevented apoptosis of the TH-containing neurons and gliosis in nigrostriatal region after administration of MPTP. The neuroprotective effect of inhaled H(2)S after MPTP administration was associated with upregulation of genes encoding antioxidant proteins, including heme oxygenase-1 and glutamate-cysteine ligase. These observations suggest that inhaled H(2)S prevents neurodegeneration in a mouse model of Parkinson's disease induced by MPTP, potentially via upregulation of antioxidant defense mechanisms and inhibition of inflammation and apoptosis in the brain.

  18. [Descriptive analysis of the activity in a movement disorder unit in a tertiary hospital in Catalonia].

    PubMed

    Ribosa-Nogué, Roser; Gironell, Alexandre; Pagonabarraga, Javier; Villa-Bonomo, Carolina; Pascual-Sedano, Berta; Kulisevsky, Jaume

    2012-09-16

    Movement disorders are an important part of the activity of a Neurology service, but there are few studies examining their health care demand. To analyze the first visits of the Movement Disorders Unit of the Hospital de la Santa Creu i Sant Pau in Barcelona and to compare the results with those of previous studies. Prospective study of the first neurological assessments carried out during 2010. Demographic variables of patients were collected and diagnoses were reviewed 12 months later. 423 first visits were done (application rate of 1.41 per 1000 inhabitants-year): 54% females, median age 68.8 ± 14.2 years-old. 74.3% of referrals came from the family doctor. The most frequent reasons for consultation were tremor (40%) and parkinsonism-motor clumsiness (26%). The most prevalent diagnoses were Parkinson's disease (36%) and essential tremor (19%). After the first assessment, 84% of patients continued controls in the Unit. One year later, in the 8% of cases there was a change in the initial diagnosis. Taking into account the incidence of each disorder, the number of patients seen was fewer compared to the estimated (19.5 times lower), especially marked in cases of restless legs syndrome, essential tremor and Tourette syndrome. In our Unit the most frequent reason for consultation is tremor and the most prevalent diagnosis is Parkinson's disease. The number of patients treated is clearly lower than the estimated according to the incidence of the diseases in the population.

  19. New horizons in the pathogenesis, assessment and management of movement disorders.

    PubMed

    Duncan, Gordon W; Yarnall, Alison J; Marrinan, Sarah; Burn, David J

    2013-01-01

    In this review, we shall outline recent advances in our understanding of the movement disorders which geriatricians encounter in their clinical practice. Many of these diseases are no longer simply considered disorders of movement: carefully conducted longitudinal studies have shown that concomitant cognitive dysfunction, neuropsychiatric disturbance and behavioural issues are frequent and exert a heavy burden on the individual and their carers. Great progress has been made in understanding the molecular and cellular processes that drive the pathological changes in these conditions, as have advances in neuroimaging and preclinical drug discovery programmes. Unfortunately, this is yet to translate into disease-modifying therapies for these progressive disorders. Advances have been also made in non-pharmacological interventions such as tailored physiotherapy and speech therapy programmes. The important contribution of palliative care has been recognised and increasingly incorporated into the multidisciplinary approach. The UK is at the forefront of research into these conditions and geriatricians are well placed to contribute to research through recruiting patients to observational studies or therapeutic trials, particularly with the support of agencies such as the National Institute for Health Research-Dementias & Neurodegenerative Diseases Research Network (NIHR-DeNDRoN).

  20. Paroxysmal non-kinesigenic dyskinesia, post-streptococcal syndromes and psychogenic movement disorders: a diagnostic challenge

    PubMed Central

    Peila, Elena; Mortara, Paolo; Cicerale, Alessandro; Pinessi, Lorenzo

    2015-01-01

    We report a case of a 15-year-old boy presenting with sudden attacks of hyperkinetic movements of the limbs, trunk and neck. Clinical features were suggestive of paroxysmal non-kinesigenic dyskinesia, but the elevated antistreptolysin O antibody titre and history of recurrent upper airways infection led us to consider a post-streptococcal syndrome as a possible diagnosis. The patient started therapy with benzathine penicillin, sodium valproate and clonazepam without any significant improvement. A successive psychiatric assessment revealed the presence of a psychogenic movement disorder. Psychodynamic psychotherapy and individual counselling were started with progressive improvement of psychological symptoms and gradual resolution of hyperkinetic episodes, without any recurrence recorded during the follow-up (10 months). PMID:25795754

  1. Paroxysmal non-kinesigenic dyskinesia, post-streptococcal syndromes and psychogenic movement disorders: a diagnostic challenge.

    PubMed

    Peila, Elena; Mortara, Paolo; Cicerale, Alessandro; Pinessi, Lorenzo

    2015-03-20

    We report a case of a 15-year-old boy presenting with sudden attacks of hyperkinetic movements of the limbs, trunk and neck. Clinical features were suggestive of paroxysmal non-kinesigenic dyskinesia, but the elevated antistreptolysin O antibody titre and history of recurrent upper airways infection led us to consider a post-streptococcal syndrome as a possible diagnosis. The patient started therapy with benzathine penicillin, sodium valproate and clonazepam without any significant improvement. A successive psychiatric assessment revealed the presence of a psychogenic movement disorder. Psychodynamic psychotherapy and individual counselling were started with progressive improvement of psychological symptoms and gradual resolution of hyperkinetic episodes, without any recurrence recorded during the follow-up (10 months).

  2. Drug repositioning for treatment of movement disorders: from serendipity to rational discovery strategies.

    PubMed

    Bolgár, Bence; Arany, Ádám; Temesi, Gergely; Balogh, Balázs; Antal, Péter; Mátyus, Péter

    2013-01-01

    Movement disorders are a heterogeneous group of both common and rare neurological conditions characterized by abnormalities of motor functions and movement patterns. This work overviews recent successes and ongoing studies of repositioning relating to this disease group, which underscores the challenge of integrating the voluminous and heterogeneous findings required for making suitable drug repositioning decisions. In silico drug repositioning methods hold the promise of automated fusion of heterogeneous information sources, but the controllable, flexible and transparent incorporation of the expertise of medicinal chemists throughout the repositioning process remains an open challenge. In support of a more systematic approach toward repositioning, we summarize the application of a computational repurposing method based on statistically rooted knowledge fusion. To foster the spread of this technique, we provide a step-by-step guide to the complete workflow, together with a case study in Parkinson's disease.

  3. Genetic deficiency of the mitochondrial protein PGAM5 causes a Parkinson’s-like movement disorder

    PubMed Central

    Lu, Wei; Karuppagounder, Senthilkumar S.; Springer, Danielle A.; Allen, Michele D.; Zheng, Lixin; Chao, Brittany; Zhang, Yan; Dawson, Valina L.; Dawson, Ted M.; Lenardo, Michael

    2015-01-01

    Mitophagy is a specialized form of autophagy that selectively disposes of dysfunctional mitochondria. Delineating the molecular regulation of mitophagy is of great importance because defects in this process lead to a variety of mitochondrial diseases. Here we report that mice deficient for the mitochondrial protein, phosphoglycerate mutase family member 5 (PGAM5), displayed a Parkinson’s-like movement phenotype. We determined biochemically that PGAM5 is required for the stabilization of the mitophagy-inducing protein PINK1 on damaged mitochondria. Loss of PGAM5 disables PINK1-mediated mitop