Abnormal motor surround inhibition associated with cortical and deep grey matter involvement in multiple sclerosis

ObjectiveMotor surround inhibition (mSI) is a physiological mechanism that contributes to hand movement control by focusing voluntary movement. Growing evidence suggests that hand movement control is impaired in multiple sclerosis. The aim of the study was to evaluate mSI in MS and to investigate the brain structures involved in mSI in multiple sclerosis.MethodsWe recruited 33 patients and 23 controls. To investigate mSI, we delivered transcranial magnetic single pulses during index finger flexion. Motor evoked potentials were recorded and first dorsal interosseous (“active muscle”) and from the abductor digiti minimi (“surround muscle”). mSI was expressed as the ratio between Motor evoked potentials recorded from the surround muscle during movement and at rest. Participants underwent a magnetic resonance study.ResultsPatients had impaired mSI as compared with controls. Magnetic resonance showed that basal ganglia had smaller volumes and higher mean diffusivity than controls. Impaired mSI correlated with primary motor cortex and basal ganglia involvement in multiple sclerosis.ConclusionAltered mSI in multiple sclerosis is related to cortical and subcortical grey matter involvement.SignificanceOur study provides the first demonstration of a pathophysiological mechanism underlying hand movement control dysfunction in multiple sclerosis. mSI represents a new therapeutic target of multiple sclerosis rehabilitative approaches.     

Relationship between habitual physical activity,motor capacity,and capability in children with cerebral palsy aged 4–5 years across all functional abilities

Background

Children with cerebral palsy (CP) have lower habitual physical activity (HPA) than their typically developing peers. There are limited studies of HPA in young children with CP under the age of 5 years.

Functional roles of oral reflexes in chewing and biting: phase-, task- and site-dependent reflex sensitivity

Because loading during chewing is not totally predictable and jaw-closing muscles are strong and act over short distances, feedback from oral receptors is important in the control of mastication. Information on such feedback can be obtained by studying reflexes in jaw muscle EMGs. This review will deal with the contribution of reflex mechanisms to modifying motor neuron activity during chewing, and the dependency of reflex sensitivity on motor task, phase of movement, and site of stimulation.     

基于表面电极肌电信号研究平衡功能训练对帕金森患者运动控制能力的影响

目的探讨基于表面电极肌电信号研究平衡功能训练对帕金森(PD)患者运动控制能力的影响。方法选择2019年1月至2020年1月我院收治的PD患者80例作为研究对象,通过计算机产生随机分组列表,并将对应的编号放入密闭不透明的信封中,由试验者拆开信封以确定分组,将受试者随机分对照组(单纯药物治疗组)和功能训练组,两组均为40例。对照组(n=40)按专科医生药物治疗方案进行治疗,功能训练组(n=40)对受试者进行每周5次功能训练,比较两组患者治疗前后表面肌电信号参数、步态参数、平衡功能(BBS评分、UPDRS3.0评分)、睡眠状况、心肺功能、生活质量。结果治疗4周后,功能训练组RMS、iEMG、MNF、MF均高于对照组(P0.05)。治疗4周后,功能训练组步长、步速、BBS评分均高于对照组(P0.05),UPDRS3.0评分低于对照组(t=12.122,P0.05)。治疗4周后,功能训练组PSQI评分、VO_2peak、6MWD、FEV_1、FVC、FEV_1/FV、SF-36评分均高于对照组(P0.05)。结论基于表面电极肌电信号研究平衡功能训练应用于帕金森疾病中,能够改善其步态,进而改善心肺功能,提高生活质量,操作简单,值得推广。     

不同运动亚型早期帕金森病的非运动症状研究

背景　帕金森病（PD）是一种常见的老年期神经退行性疾病,具有高发病率、高患病率和高致残率的特点,PD患者的临床表现多样,包括运动症状和非运动症状,根据不同运动症状可将PD分为不同亚型,不同运动分型PD患者在发病因素、病理生理过程等方面存在差异。然而,目前对于PD,尤其是早期PD的非运动症状研究较少。目的　通过比较不同运动亚型早期PD患者在认知功能、额叶功能、情绪和睡眠情况、自主神经功能等非运动症状方面的差别,探讨非运动症状与早期PD运动亚型之间的关系。方法　选取2017年1月-2020年3月浙江医院神经内科门诊和病房收治的116例早期PD患者为研究对象,采用运动障碍学会-统一帕金森病评估量表（MDS-UPDRS）将其分为震颤为主型（TD）组、姿势不稳/步态障碍型（PIGD）组及混合型（IT）组。比较三组早期PD患者一般临床资料、MDS-UPDRS、非运动症状量表（NMSS）、简易智力状态检查量表（MMSE）、额叶功能评定量表（FAB）、老年抑郁量表（GDS-30）、情感淡漠评定量表（MAES）、帕金森病睡眠量表（PDSS）、自主神经量表（SCOPA-AUT）的评估结果。结果　TD组、PIGD组、IT组分别为76例、32例、8例。三组患者非运动症状的出现频率和严重程度得分比较,差异有统计学意义（P<0.05）;三组患者的FAB、GDS-30、MAES、SCOPA-AUT得分比较,差异有统计学意义（P<0.05）。结论　PD的非运动症状是PD的常见症状,在PD早期就可以出现,PIGD型和IT型的非运动症状较TD型严重,对早期PD患者进行合理的运动分型有助于在临床诊疗中更有效地评估PD患者的病情和预后并制定更合理的治疗方案。     

磁刺激神经调控对运动发育迟缓患儿粗大运动功能及Gesell评分的影响

目的探讨磁刺激神经调控治疗对运动发育迟缓患儿粗大运动功能及格赛尔发展量表(Gesell)评分的影响。方法回顾性分析2018年1月至2019年6月本院收治的49例运动发育迟缓患儿的临床资料,根据治疗方式的不同分为对照组(采用传统康复治疗,n=24)和观察组(采用磁刺激神经调控治疗,n=25)。比较两组患儿粗大运动功能及Gesell评分改善情况。结果治疗后,两组患儿粗大运动功能及Gesell评分均有升高,且观察组高于对照组,差异均有统计学意义(P<0.05)。结论磁刺激神经调控对运动发育迟缓患儿粗大运动功能及Gesell评分具有较好的改善作用,利于改善患儿预后。     

CMAP scan discontinuities: Automated detection and relation to motor unit loss

ObjectiveTo evaluate an automated method that extracts motor unit (MU) information from the CMAP scan, a high-detail stimulus–response curve recorded with surface EMG. Discontinuities in the CMAP scan are hypothesized to result from MU loss and reinnervation.MethodsWe introduce the parameter D50 to quantify CMAP scan discontinuities. D50 was compared with a previously developed manual score in 253 CMAP scans and with a simultaneously obtained motor unit number estimate (MUNE) in 173 CMAP scans. The effect of MU loss on D50 was determined with a simulation model.ResultsWe found a high agreement (sensitivity = 86.8%, specificity = 96.6%) between D50 and the manual score. D50 and MUNE were significantly correlated below 80 MUs (r = 0.65, n = 68, p < 0.001), but not when MUNE was larger than 120 MUs (r = 0.23, n = 59, p = 0.08).ConclusionsDiscontinuities in the CMAP scan as expressed by a decreased D50 are related to significant MU loss. The determination of D50 is objective, quantitative, and less time-consuming than both manual scoring and many existing MUNE methods.SignificanceD50 is potentially useful to monitor neurogenic disorders and moderate to severe MU loss.     

汉语失语症测评软件在脑出血后失语评定中的应用

目的探讨中康法汉语标准失语症电脑软件测评系统(CRRCAE)在左侧基底节区脑出血患者语言功能评定及疗效观察中的应用价值。方法对24例左侧基底节区脑出血患者行微创手术治疗,术后行语言康复训练等治疗,并在术前、术后4 w,8 w应用CRRCAE(电脑版)行语言功能评定。结果治疗后与治疗前相比,CRRCAE测评系统各项评分均有明显提高,且随着时间的推移,患者的语言功能明显提高。结论CRRCAE电脑软件测评系统可用于评定脑出血患者语言恢复的程度和特点,能有效的鉴别其改善的程度,具有较好的临床应用价值。