Comparison of renal function and psychomotor performance in workers exposed to elemental mercury

Summary Renal function and psychomotor performance (eye-hand coordination, arm-hand steadiness) of a group of 43 workers exposed to mercury vapor were examined. Their mean age and average duration of exposure to mercury were 38 and 5 years, respectively. The results were compared with those obtained in a matched group of 47 control workers. Increased proteinuria and albuminuria were found slightly more prevalent in the Hg-exposed group than in the control workers. These results are in agreement with those found during a previous study carried out in another group of workers also exposed to elemental mercury (Bucket et al. 1980). The scores of the psychomotor tests were less satisfactory in the Hg workers than in the control workers, the arm-hand steadiness test being more discriminative than the eye-hand coordination test. Preclinical changes in psychomotor function can be detected independently of the presence of signs of renal dysfunction. No clear-cut relationships were found between the prevalence of abnormal psychomotor scores and the level of mercury in blood (HgB) or in urine (HgU). Increased prevalences of abnormal psychomotor scores seem however to occur for HgB between 1 and 2 g/100 ml and for HgU between 50 and 100 g/g creatinine. Therefore, a biologic threshold limit value of 50 g/g creatinine is proposed for urinary mercury to prevent the development of preclinical effects on the central nervous system. A similar critical HgU level based on renal dysfunction prevalences has been suggested in a previous study.This study was supported by a grant from the Commission of the European Communities     

Using Psychomotor to Treat Dissociative Identity Disorder

Abstract

Pesso Boyden System Psychomotor Therapy (Psycho-motor) is offered as a useful approach to treating Dissociative Identity Disorder. Originally developed for group work, this therapy can be modified so that the alters can learn to play roles for one another that promote resolution of childhood injury, enhance internal communication and cooperation, and ultimately support the prospect of integration. Psycho-motor is unique in that it helps in the creation of synthesizing memories that provide antidotes for early traumas; not only can childhood abuse and neglect be metabolized, but also images of needs being met can be added. Moreover, Psychomotor develops the “Pilot” or adult functioning so that there is less likelihood of regression or dependence on the therapist. A four-stage progression of treatment is outlined: development of the “Pilot,” teaching the system's adults to engage in parenting the child alters, healing the wounds and the defensiveness of the “Protector/Controller,” and the internalization of the image of “Ideal Parents” so that the client can continue to resolve any surfacing memories of trauma or inadequate rearing.     

Quantifying Auditory Handicap: A New Approach

This report describes a new audiovisual test procedure for the quantification of auditory handicap (QUAH). The QUAH test attempts to recreate in the laboratory a series of everyday listening situations. Individual test items represent psychomotor tasks. Data on 53 normal-hearing listeners described performance as a function of the message-to-competition ratio (MCR). Results indicated that, for further studies, an MCR of 0 dB represents the condition above which the task seemed too easy and below which the task appeared too difficult for normal-hearing subjects.

The QUAH approach to the measurement of auditory handicap seems promising as an experimental tool. Further studies are needed to describe the relation of QUAH results (1) to clinical audiologic measures and (2) to more traditional indices of auditory handicap.

Nous décrivons une épreuve qui a pour but de quantifier l'handicap auditif (QUAH). Le test QUAH est un test audio-visuel et psycho-moteur qui comporte 25 questions et qui essaie de recréer les situations auditives de la vie quotidienne. Nous avons effectué le test chez 53 sujets normaux, utilisant plusieurs rapports signal de message/signal concurrentiel; les résultats nous ont montré qu'un rapport égal à 0 dB était la condition standard à retenir (étant ni trop facile, ni trop difficile).

La méthode QUAH semble bien ětre un instrument d'expérience prometteur pour préciser l'handicap auditif. Des éludes supplémentaires sont cependant nécessaires afin d'établir la relation entre QUAH et 1) les mesures audiologiques cliniques et 2) les autres indices plus traditionnels de l'handicap auditif.     

Posture-cognitive dual-tasking: A relevant marker of depression-related psychomotor retardation. An illustration of the positive impact of repetitive transcranial magnetic stimulation in patients with major depressive disorder

This study examined whether postural control variables, particularly the center-of-pressure (COP) velocity-based parameters, could be a relevant hallmark of depression-related psychomotor retardation (PMR). We first aimed at investigating the interplay between the PMR scores and the COP performance in patients with major depressive disorder (MDD), as compared to age-matched healthy controls; secondly, we focused on the impact of a repetitive transcranial magnetic stimulation (rTMS) treatment on depression, PMR scores and postural performance. 16 MDD patients, and a control group of 16 healthy adults, were asked to maintain quiet standing balance during two trials with or without vision, and while backward counting (dual task). All the position and velocity-based COP variables were computed. Before and after the rTMS session (n eligible MDD = 10), we assessed the depression level with the Montgomery–Asberg Depression Rating Scale (MADRS), the PMR scores with the French Retardation Rating Scale for Depression (ERD), and postural performance. Before the treatment, significant positive partial correlations were found between the pre-ERD scores and the velocity-based COP variables, especially in the dual-task conditions (p < 0.05). In contrast, there was no significant correlation between the post-ERD scores and any postural parameter after the treatment. The MADRS and ERD scores showed a significant decrease between before and after the rTMS intervention. For the first time, the findings clearly validated the view that the assessment of postural performance - easy to envisage in clinical settings-constitutes a reliable and objective marker of PMR in MDD patients.     

Thalamic diffusion differences related to cognitive function in white matter lesions

Cerebral white matter lesions (WMLs) are related to cognitive deficits, probably due to a disruption of frontal–subcortical circuits. We explored thalamic diffusion differences related to white matter lesions (WMLs) and their association with cognitive function in middle-aged individuals. Ninety-six participants from the Barcelona-AsIA Neuropsychology Study were included. Participants were classified into groups based on low grade and high grade of periventricular hyperintensities (PVHs) and deep white matter hyperintensities (DWMHs). Tract-Based Spatial Statistics was used to study thalamic diffusion differences between groups. Mean fractional anisotropy (FA) values in significant areas were calculated for each subject and correlated with cognitive performance. Participants with high-grade PVHs and DWMHs showed lower FA thalamic values compared to those with low-grade PVHs and DWMHs, respectively. Decreased FA thalamic values in high-grade DWMHs, but not high-grade PVH, were related to lower levels of performance in psychomotor speed, verbal fluency, and visuospatial skills. Thalamic diffusion differences are related to lower cognitive function only in participants with high-grade DWMHs. These results support the hypothesis that fronto–subcortical disruption is associated with cognitive function only in DWMHs.     

Does increased gait variability improve stability when faced with an expected balance perturbation during treadmill walking?

BackgroundCurrently, there is uncertainty as to whether movement variability is errorful or exploratory.Research questionThis study aimed to determine if gait variability represents exploration to improve stability. We hypothesized that 1) spatiotemporal gait features will be more variable prior to an expected perturbation than during unperturbed walking, and 2) increased spatiotemporal gait variability pre-perturbation will correlate with improved stability post-perturbation.MethodsSixteen healthy young adults completed 15 treadmill walking trials within a motion simulator under two conditions: unperturbed and expecting a perturbation. Participants were instructed not to expect a perturbation for unperturbed trials, and to expect a single transient medio-lateral balance perturbation for perturbed trials. Kinematic data were collected during the trials. Twenty steps were recorded post-perturbation. Unperturbed and pre-perturbation gait variabilities were defined by the short- and long-term variabilities of step length, width, and time, using 100 steps from pre-perturbation and unperturbed trials. Paired t-tests identified between-condition differences in variabilities. Stability was defined as the number of steps to centre of mass restabilization post-perturbation. Multiple regression analyses determined the effect of pre-perturbation variability on stability.ResultsLong-term step width variability was significantly higher pre-perturbation compared to unperturbed walking (mean difference = 0.28 cm, p = 0.0073), with no significant differences between conditions for step length or time variabilities. There was no significant relationship between pre-perturbation variability and post-perturbation restabilization.SignificanceIncreased pre-perturbation step width variability was neither beneficial nor detrimental to stability. However, the increased variability in medio-lateral foot placement suggests that participants adopted an exploratory strategy in anticipation of a perturbation.     

On the physiology of cognitive decline in type 1 diabetes

ObjectivesType 1 diabetes mellitus (T1DM) may be associated with cognitive impairment and notably a decline in psychomotor speed, information processing speed and attention. The mechanism for this decline is uncertain. Previous studies by our group and others have demonstrated a decline in EEG-power and event-related potential amplitude in T1DM. The objectives of the present study were to explore whether 1) the association between event-related potential (N100) amplitude and psychomotor speed is different between T1DM and healthy subjects, and 2) the decline in N100 amplitude depends on duration of diabetes.MethodsPatients with T1DM (N = 204) and healthy control subjects (N = 358) were included in a cross-sectional study. Event-related brain potentials were recorded with auditory reaction tasks. Psychomotor speed was evaluated with the Grooved Pegboard test in a subset of the patients (N = 70) and the healthy control subjects (N = 89).ResultsPatients with T1DM had a decrease in the N100 amplitude that correlated with a decline in psychomotor speed, longer duration of diabetes and increasing age. In healthy controls, the N100 amplitude did not decrease with age and the association between psychomotor speed and N100 amplitude was absent.ConclusionThe association between psychomotor speed and N100 amplitude is likely to be a specific trait for T1DM since it was not found in healthy controls and was dependent on diabetes duration. Our findings indicate that the pathogenesis of cognitive decline in T1DM may involve a disease-related factor with a long-term influence on the N100 amplitude.     

Is motor learning of stroke patients in non-immersive virtual environment influenced by laterality of injury? A preliminary study

BackgroundStroke is the leading cause of long-term disability in adults, causing residual sensorimotor deficits in many survivors. Patients may have different impairments according to laterality of injury, as well as different responses to some therapies.ObjectiveThis preliminary study sought to investigate motor learning in rehabilitation of stroke patients with non-immersive virtual environment by process (electroencephalography) and product (performance) measures in stroke patients with left and right cerebral hemispheres damage.MethodsThe study included 10 chronic stroke patients; 5 with left brain injury (LI), mean age 48.8 years (±4.76), and 5 with right brain injury (RI), mean age 52 years (±10.93). Patients were evaluated for electroencephalographic activity (alpha and beta frequencies) and performance (absolute error) in a darts game on XBOX Kinect (Microsoft®). Then they underwent a virtual darts game training task, 12 sessions for 4 weeks (acquisition stage). After training, they were revaluated (long-term retention).ResultsRI group increased alpha power and decreased beta in ipsilesional areas, increased activation on left hemisphere and decreased the absolute error of performance; LI group increased right hemisphere activation and did not decrease the absolute error.ConclusionsPatients with right brain injury reduce neural effort and errors after virtual darts training, which did not happen to patients with left brain injury. Therefore, the laterality of lesion should be considered in studies that use virtual reality for stroke rehabilitation.     

Neonatal sepsis as a risk factor for neurodevelopmental changes in preterm infants with very low birth weight

Objectiveto evaluate neonatal sepsis as a risk factor for abnormal neuromotor and cognitive development in very low birth weight preterm infants at 12 months of corrected age.Methodsthis was a prospective cohort study that followed the neuromotor and cognitive development of 194 very low birth weight preterm infants discharged from a public neonatal intensive care unit. The Bayley Scale of Infant Development (second edition) at 12 months of corrected age was used. The outcomes were the results of the clinical/neurological evaluation and the scores of the psychomotor development index (PDI) and mental development index (MDI) of the Bayley Scale of Infant Development II. The association between neonatal sepsis and neuromotor development and between neonatal sepsis and cognitive development was verified by logistic regression analysis.Resultsmean birth weight was 1,119 g (SD: 247) and mean gestational age was 29 weeks and 6 days (SD: 2). Approximately 44.3%(n = 86) of the infants had neonatal sepsis and 40.7% (n = 79) had abnormal neuromotor development and/or abnormal psychomotor development index (PDI < 85) at 12 months of corrected age. On the mental scale, 76 (39.1%) children presented abnormal cognitive development (MDI < 85). Children with neonatal sepsis were 2.5 times more likely to develop changes in neuromotor development (OR: 2.50; CI: 1.23‐5.10). There was no association between neonatal sepsis and cognitive development impairment.Conclusionneonatal sepsis was an independent risk factor for neuromotor development impairment at 12 months of corrected age, but not for mental development impairment.     

纳布啡联合利多卡因切口浸润多模式镇痛对小儿外科单孔腹腔镜手术患者全麻苏醒期躁动的影响

目的 探讨纳布啡联合利多卡因切口浸润多模式镇痛对接受单孔腹腔镜手术患儿全麻苏醒期躁动的影响。方法 选取2018 年12 月～2019 年12 月在牡丹江医学院附属红旗医院行单孔腹腔镜手术的全麻患儿150 例,随机分成3 组,每组50 例。纳布啡组（N 组）于手术结束前15 min 静注0.2 mg/kg 纳布啡,关闭腹膜后在切口推注生理盐水10 mL;利多卡因组（L 组）于术毕缝皮前在切口推注0.5%的利多卡因10 mL;纳布啡+利多卡因组（N+L 组）于手术结束前15 min 静注0.2 mg/kg 纳布啡,术毕缝皮前在切口推注0.5%的利多卡因10 mL。记录患儿在PACU的PAED 躁动评分、拔管后的Ramsay 镇静评分及VAS 疼痛评分;记录入室时（T0）、停药时（T1）、拔管时（T2）、拔管后10 min（T3）患儿MAP 和HR 的变化;记录患儿的苏醒时间和拔管时间及不良反应。结果 N 组和L 组的PAED躁动评分分数和VAS 疼痛评分分数均高于N+L 组,差异有统计学意义（P＜0.05）;N 组和N+L 组的Ramsay 镇静评分均高于L 组,差异有统计学意义（P＜0.05）;在T0 和T1 时刻,N 组、L 组和N+L 组患儿的MAP 和HR 的数值比较,差异均无统计学意义（P＞0.05）;在T2 和T3 时刻,N 组和L 组的MAP 和HR 的数值明显高于N+L 组,差异有统计学意义（P＜0.05）;在N 组和L 组中,T0、T1、T2 和T3 四个时刻的MAP 和HR 的数值比较,差异有统计学意义（P＜0.05）;在N+L 组中,T1 和T3 时刻的MAP 和HR 的数值比较,T1 和T2 时刻的HR 的数值比较,差异均无统计学意义（P＞0.05）,其他时刻的MAP 和HR 的数值比较,差异均有统计学意义（P＜0.05）;三组患儿的苏醒时间和拔管时间比较,差异均无统计学意义（P＞0.05）;三组患儿在拔管后均未发生恶心、呕吐、嗜睡、喉痉挛、皮肤瘙痒和呼吸循环抑制等不良反应。结论 纳布啡联合利多卡因镇痛方法效果确切,可有效抑制患儿全麻苏醒期躁动的发生,并对其血流动力学影响小、不良反应少、不会明显延长苏醒时间和拔管时间。