Swallowing in hereditary sensory ataxia

The oral, pharyngeal, and esophageal stages of swallowing were evaluated in 8 patients with recessively or dominantly inherited pure sensory ataxia. Six patients had swallowing difficulties: solid bolus obstruction, coughs during eating, and choking episodes. One patient had chronic bronchitis and another had recurrent pneumonia. The patients underwent a biphasic radiological barium swallow, including videofluoroscopy. No patient had a completely normal swallow. All had normal oral function, whereas pharyngeal function was abnormal in 6 patients. Esophageal function was abnormal in 6 patients. The swallowing dysfunction did not correlate with the severity of motor or sensory dysfunction in the limbs, nor with age or duration of ataxia. Our study shows that swallowing dysfunction is common in hereditary sensory ataxia. This dysfunction is likely to be due to involvement of the nucleus of the solitary tract in the brainstem. Despite some of the patients having suffered from choking episodes and others from bronchopulmonary complications, they did not spontaneously admit dysphagia. Swallowing should be evaluated thoroughly in patients with hereditary sensory ataxia since dysphagia in these patients might bring serious and potentially fatal complications.     

Group III/IV muscle afferents impair limb blood in patients with chronic heart failure

Objective

To better understand the hemodynamic and autonomic reflex abnormalities in heart-failure patients (HF), we investigated the influence of group III/IV muscle afferents on their cardiovascular response to rhythmic exercise.

Methods

Nine HF-patients (NYHA class-II, mean left ventricular ejection-fraction: 27 ± 3%) performed single leg knee-extensor exercise (25/50/80% peak-workload) under control conditions and with lumbar intrathecal fentanyl impairing μ-opioid receptor-sensitive muscle afferents.

Results

Cardiac-output (Q) and femoral blood-flow (Q_L) were determined, and arterial/venous blood samples collected at each workload. Exercise-induced fatigue was estimated via pre/post-exercise changes in quadriceps strength. There were no hemodynamic differences between conditions at rest. During exercise, Q was 8–13% lower with Fentanyl-blockade, secondary to significant reductions in stroke volume and heart rate. Lower norepinephrine spillover during exercise with Fentanyl revealed an attenuated sympathetic outflow that likely contributed to the 25% increase in leg vascular conductance (p < 0.05). Despite a concomitant 4% reduction in blood pressure, Q_L was 10–14% higher and end-exercise fatigue attenuated by 30% with Fentanyl-blockade (p < 0.05).

Conclusion/practice/implications

Although group III/IV muscle afferents play a critical role for central hemodynamics in HF-patients, it also appears that these sensory neurons cause excessive sympatho-excitation impairing Q_L which likely contributes to the exercise intolerance in this population.     

多媒体感觉统合训练配合言语训练对伴智力低下孤独症谱系障碍儿童智力发育和事件相关电位的影响

目的 探讨多媒体感觉统合训练配合言语训练对伴智力低下孤独症谱系障碍(ASD)儿童智力发育和事件相关电位(ERP)的影响。方法 将三门峡市中心医院接诊的82例伴智力低下ASD病儿采用随机数字表法等分为联合组和常规组,常规组接受常规康复治疗,联合组在常规组基础上给予多媒体感觉统合训练+言语训练,均治疗6个月,比较两组治疗前后孤独症行为评定量表(ABC)、视听整合连续执行测试(ⅣA-CPT)、中国韦氏儿童智力量表(WISC-R)评分及ERP P3潜伏期、波幅的变化。结果 治疗后,两组ABC各维度评分、ERP P3潜伏期均明显降低(P<0.05),ⅣA-CPT评分、WISC-R评分和ERP P3波幅均明显升高(P<0.05);联合组ABC[(45.51±7.58)比(52.83±8.54)分]、ⅣA-CPT、WISC-R评分及ERP P3潜伏期[(426.88±23.71)比(439.72±24.49)ms]、波幅变化幅度[(7.23±1.67)比(6.35±1.40)μV]均大于常规组。结论 多媒体感觉统合训练配合言语训练可有效改善伴智力低下ASD病儿的认知功能、执行功能,促进病儿智力发育和语言发育。     

Gathering your ‘sea legs’: Extended durations in an offshore environment increases postural sway excursions

BackgroundMal de debarquement (MdD), or often called ‘sea legs’, is the perception of self-motion after exposure to passive movement such as being on a boat at sea. Previous studies highlight sensory re-organization difficulties and postural control impairments after disembarking from sea travel in experienced crew members. However, the impact of MdD in individuals with minimal offshore experience, defined as participating in less than 2 offshore excursions per year, has not been investigated.Research questionDoes exposure to boat motion while at sea alter static postural control after disembarking in individuals with minimal offshore experience?MethodsHealthy adults (n = 24) with minimal offshore experience had their static balance assessed on a force platform before (PRE) and after (POST) a 7-h deep sea fishing excursion. Static balance was tested in eyes open (EO), eyes closed (EC), eyes open on a foam surface (EOF), and eyes closed on a foam surface (ECF) conditions. Sway excursions, sway velocity and sway variability in the medial-lateral (ML) and anterior-posterior (AP) directions were computed and then compared PRE/POST using a paired t-test (p < 0.05).ResultsSignificant increases in ML sway excursion (p = 0.004), ML sway range (p < 0.001), ML sway variability (p < 0.001), AP sway excursion (p = 0.045), AP sway range (p = 0.020), and AP sway variability (p = 0.030) were observed at POST during EOF. Significant increases in ML sway excursion (p = 0.027), AP sway excursion (p = 0.020), and AP sway variability (p = 0.014) at POST were also observed during ECF. No differences were found in the EO condition (p > 0.05).SignificanceIncreases in postural sway excursion and variability were observed in individuals with minimal offshore experience after disembarking. Our findings suggest sensory re-organization difficulties in order to maintain an upright posture in challenging sensory conditions are dependent on vestibular and somatosensory inputs following exposure to boat motion at sea.     

Does age increase auditory distraction? Electrophysiological correlates of high and low performance in seniors

Aging usually affects the ability to focus attention on a given task and to ignore distractors. However, aging is also associated with increased between-subject variability, and it is unclear in which features of processing older high-performing and low-performing human beings may differ in goal-directed behavior. To study involuntary shifts in attention to task-irrelevant deviant stimuli and subsequent reorientation, we used an auditory distraction task and analyzed event-related potential measures (mismatch negativity), P3a and reorienting negativity) of 35 younger, 32 older high-performing, and 32 older low-performing participants. Although both high and low performing elderly individuals showed a delayed reorienting to the primary stimulus feature, relative to young participants, poor performance of the elderly participants in processing of deviant stimuli was associated with strong involuntary attention capture by task-irrelevant features. In contrast, high performance of the elderly group was associated with intensified attentional shifting toward the target features. Thus, it appears that performance deficits in aging are due to higher distractibility in combination with deficits in the orienting–reorienting mechanisms.     

高压氧在脊柱骨折合并脊髓损伤术后的应用效果分析

【摘要】 目的 观察高压氧辅助治疗脊柱骨折合并脊髓损伤的临床效果。方法 选取2017年3月至2020年3月河源市人民医院收治的52例脊柱骨折合并脊髓损伤患者作为研究对象,并按照治疗方法将其分为研究组与对照组,每组26例,两组患者入院后均予以常规手术治疗。术后,对照组患者予以常规治疗,研究组患者在常规治疗的基础上应用高压氧治疗,对比观察两组患者主观功能障碍恢复情况、感觉及运动功能恢复情况、临床疗效及生活质量。结果 治疗后,研究组患者汉译Roland-Morris功能障碍调查表(CRMDQ)评分明显低于对照组(t =7.515, P <0.001),美国脊髓损伤协会(ASIA)感觉及运动功能评分均明显高于对照组(t = 4.113?7.995, P均<0.001);治疗结束后,研究组患者中显效13例、有效10例、无效3例,明显优于对照组患者的显效6例、有效11例、无效9例(Z=-2.340,P =0.019),生活质量为优12例、良12例?差2例,明显优于对照组患者的优7例、良11例、差8例(Z=-2.015,P=0.044)。结论 脊柱骨折合并脊髓损伤术后辅以高压氧治疗,有利于患者损伤神经的修复,改善机体感觉及运动功能障碍,提高临床疗效及生活质量。     

Age-dependent alterations in the number,volume, and localization of islands of Calleja within the olfactory tubercle

The incidence of olfactory perceptual dysfunction increases substantially with aging. Putative mechanisms for olfactory sensory loss are surfacing, including neuroanatomical modifications within brain regions responsible for odor information processing. The islands of Calleja (IC) are dense cell clusters localized within the olfactory tubercle, a cortical structure receiving monosynaptic input from the olfactory bulb. The IC are hypothesized to be important for intra- and extra-olfactory tubercle information processing, and thus olfaction. However, whether the anatomy of the IC are affected throughout normal aging remains unclear. By examining the IC of C57bl/6 mice throughout adulthood and early aging (4–18 months of age), we found that the number of IC decreases significantly with aging. Stereological analysis revealed that the remaining IC in 18-month-old mice were significantly reduced in estimated volume compared with those in 4- month-old mice. We additionally found that whereas young adults (4 months of age) possess greater numbers of IC within the posterior parts of the olfactory tubercle, by 18 months of age, a greater percentage of IC are found within the anterior-most part of the olfactory tubercle, perhaps providing a substrate for the differential access of the IC to odor information throughout aging. These results show that the IC are highly plastic components of the olfactory cortex, changing in volume, localization, and even number throughout normal aging. We predict that modifications among the IC throughout aging and age-related neurodegenerative disorders might be a novel contributor to pathological changes in olfactory cortex function and olfactory perception.