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gait initiation

Wolfgang Hamel, Johannes A Köppen, Dieter Müller, Marwan Hariz, Christian K E Moll, Paul Krack
Before the advent of levodopa, pallidotomy was initially the most effective treatment for Parkinson disease, but it was soon superseded by thalamotomy. It is widely unknown that, similar to Leksell, 2 neurologists from Göttingen, Orthner and Roeder, perpetuated pallidotomy against the mainstream of their time. Postmortem studies demonstrated that true posterior and ventral pallidoansotomy sparing the overwhelming mass of the pallidum was accomplished. This was due to a unique and individually tailored stereotactic technique even allowing bilateral staged pallidotomies...
January 16, 2019: Stereotactic and Functional Neurosurgery
Maheshi P C Wijesekera, Nichola C Wilson, Daniele Trinca, Gillian Holmes, Alfie Bass, David M Wright, Roger Walton
BACKGROUND: Flexion deformity of the knee is a common presentation in children with cerebral palsy with hamstring surgery as an option for addressing this. However, concerns with regard to increased pelvic tilt have been raised. The purpose of this study was to compare preoperative and postoperative pelvic tilt after isolated hamstring lengthening versus combined hamstring lengthening and the influence of Gross Motor Function Classification System (GMFCS) levels on pelvic tilt. METHODS: This retrospective study included 46 ambulatory children with cerebral palsy who had had open medial hamstring lengthening (mean age at surgery, 11 y 11 mo; SD, 2 y 11 mo; GMFCS I, 16; GMFCS II 20; GMFCS III 10)...
January 14, 2019: Journal of Pediatric Orthopedics
Megan Quist, Debra Chopp, Camille M Wilson, Jenny Radesky
Charles is a 10-year-old African-American male who presents to the Developmental Behavioral Pediatrics Clinic for evaluation of his learning. His primary care provider (PCP) was concerned that his developmental delays were negatively affecting his ability to engage in his homeschooling curriculum and also that his mother seemed unaware of the severity of his delays. Neuropsychological evaluation had been recommended by the PCP several times in the past, but the family declined. At one point, the PCP had considered potential child protective services (CPS) referral for medical neglect because of missed appointments and lack of follow-through on recommendations, which motivated the parent to bring him to this appointment...
January 14, 2019: Journal of Developmental and Behavioral Pediatrics: JDBP
Dávid Pintér, Márton Kovács, Márk Harmat, Annamária Juhász, József Janszky, Norbert Kovács
BACKGROUND: Although trimetazidine may induce parkinsonian symptoms in some patients, no systematic characterization has been reported on parkinsonism occurring during trimetazidine treatment since the first case reports. OBJECTIVE: To systematically investigate parkinsonism occurring during trimetazidine use. METHODS: Thirty-three consecutive patients on trimetazidine treatment with previously unrecognized parkinsonian symptoms were enrolled...
January 4, 2019: Parkinsonism & related Disorders
Vikram Karnik, Claudia Del Gamba, Aaron Jesuthasan, Anna Latorre
A 38-year-old woman presented with cervical dystonia in the context of a recent surgery to remove a vestibular schwannoma. She initially presented to neurology with pain in the right arm, and MRI of the brain showed an incidental right-sided vestibular schwannoma (Video 1, Segment 1). An elective gamma-knife procedure was performed, which failed. Hydrocephalus requiring ventriculoperitoneal shunt insertion developed, and 3 years following the initial procedure the lesion was surgically excised. Surgery was further complicated by right middle cerebellar peduncle injury, extending to the cerebellopontine angle and marginally to the right pontine tegmentum, with subsequent mass effect on cerebellum displayed on follow-up MRI (Video 1, Segment 2)...
November 2018: Movement Disorders Clinical Practice
Manuel Martínez Ruiz, Hilda Vargas Robles, Amelia Rios, Daniel Sánchez, Bruno Escalante
Ischemia due to vascular occlusion induces vasodilation as an initial response, followed by arteriogenesis or angiogenesis. Vasodilation through nitric oxide independent and dependent mechanisms may be sufficient to restore the altered neovascularization in pathological situations where the nitric oxide is altered. Using a posterior limb claudication model to evaluate ischemia-induced revascularization in eNOS(-/-) mice, we compared the effects of sodium nitrite, a nitric oxide-dependent vasodilator, and prazocin, an alpha-adrenergic blocker and nitric oxide-independent vasodilator, on hindlimb revascularization...
January 9, 2019: Canadian Journal of Physiology and Pharmacology
Margaret Donovan-Hall, Judy Robison, Mark Cole, Ann Ashburn, Catherine Bowen, Malcolm Burnett, Louis Mamode, Ruth Pickering, Dan Bader, Dorit Kunkel
PURPOSE: Foot problems and suboptimal footwear are risk factors for falls among the elderly. Footwear choice may, therefore, be important for people with balance impairment following stroke, but little is known about their experience. This study explored foot problems experienced following stroke, factors influencing footwear choices and views of footwear in use. METHODS: Semi-structured interviews with 15 people with stroke, purposively sampled from respondents to a screening survey...
January 8, 2019: Disability and Rehabilitation
Diana Angelika Olszewska, E M Fallon, G M Pastores, K Murphy, A Blanco, T Lynch, S M Murphy
SCA 17 is a rare, autosomal dominant disorder caused by TBP gene CAG/CAA repeat expansion. Ataxia and dementia are common. The presence of frontal dysfunction at outset of the disease may mimic frontotemporal dementia (FTD). Parkinsonism, chorea, dystonia, and pyramidal signs may occur. We report an Irish family with autosomal dominant partially penetrant frontal dementia with cerebellar atrophy due to SCA17 and present detailed neuropsychological assessment for the first time. A 44-year-old doctor presented with 18-month history of behavioral problems...
January 8, 2019: Cerebellum
Jamie N Justice, Anoop M Nambiar, Tamar Tchkonia, Nathan K LeBrasseur, Rodolfo Pascual, Shahrukh K Hashmi, Larissa Prata, Michal M Masternak, Stephen B Kritchevsky, Nicolas Musi, James L Kirkland
BACKGROUND: Cellular senescence is a key mechanism that drives age-related diseases, but has yet to be targeted therapeutically in humans. Idiopathic pulmonary fibrosis (IPF) is a progressive, fatal cellular senescence-associated disease. Selectively ablating senescent cells using dasatinib plus quercetin (DQ) alleviates IPF-related dysfunction in bleomycin-administered mice. METHODS: A two-center, open-label study of intermittent DQ (D:100 mg/day, Q:1250 mg/day, three-days/week over three-weeks) was conducted in participants with IPF (n = 14) to evaluate feasibility of implementing a senolytic intervention...
January 4, 2019: EBioMedicine
Paige E Lin, Susan M Sigward
BACKGROUND: Clinically, normalization of gait following anterior cruciate ligament reconstruction (ACLr) is defined as the absence of observable deviations. However, biomechanical studies report altered knee mechanics during loading response (LR); a time of double limb support and weight transfer between limbs. It is conceivable that subtle adjustments in whole body mechanics, including center of mass (COM) velocity and ground reaction force (GRF) peaks and timing, are present. RESEARCH QUESTION: The purpose was to compare limb and whole body mechanics during LR of gait in the surgical and non-surgical limbs post-ACLr...
December 29, 2018: Gait & Posture
Noémie C Duclos, Cyril Duclos, Sylvie Nadeau
BACKGROUND: Braking forces absorbed by the leading paretic limb are greater than expected with regard to gait speed and not correlated with propulsive forces generated by the non-paretic limb in individuals with severe hemiparesis. Altered foot placement due to poor sensorimotor capacities may explain excessive braking forces. RESEARCH QUESTION: The main objective of this study was to determine whether paretic foot placement was related to paretic braking forces in post-stroke individuals with various self-selected walking speeds and motor deficits...
December 26, 2018: Gait & Posture
Alessandra Donato, Konstantinos Kagias, Yun Zhang, Massimo A Hilliard
Neurons are highly polarized cells that consist of three main structural and functional domains: a cell body or soma, an axon, and dendrites. These domains contain smaller compartments with essential roles for proper neuronal function, such as the axonal presynaptic boutons and the dendritic postsynaptic spines. The structure and function of these compartments have now been characterized in great detail. Intriguingly, however, in the last decade additional levels of compartmentalization within the axon and the dendrites have been identified, revealing that these structures are much more complex than previously thought...
January 4, 2019: Biological Reviews of the Cambridge Philosophical Society
Wolfgang Teufl, Michael Lorenz, Markus Miezal, Bertram Taetz, Michael Fröhlich, Gabriele Bleser
The aim of this study was to assess the validity and test-retest reliability of an inertial measurement unit (IMU) system for gait analysis. Twenty-four healthy subjects conducted a 6-min walking test and were instrumented with seven IMUs and retroreflective markers. A kinematic approach was used to estimate the initial and terminal contact events in real-time. Based on these events twelve spatio-temporal parameters (STP) were calculated. A marker based optical motion capture (OMC) system provided the reference...
December 22, 2018: Sensors
Matthias König, Gaspar Epro, John Seeley, Philip Catalá-Lehnen, Wolfgang Potthast, Kiros Karamanidis
Perturbation training is an emerging approach to reduce fall risk in the elderly. This study examined potential differences in retention of improvements in reactive gait stability over 14 weeks resulting from unexpected trip-like gait perturbations. Twenty-four healthy middle-aged adults (41-62 years) were assigned randomly to either a single perturbation group (SINGLE, n = 9) or a group subjected to eight trip-like gait perturbations (MULTIPLE, n = 15). While participants walked on a treadmill a custom-built brake-and-release system was used to unexpectedly apply resistance during swing phase to the lower right limb via an ankle strap...
December 12, 2018: Journal of Biomechanics
Divyanshu Dubey, Sean J Pittock, Karl N Krecke, Padraig P Morris, Elia Sechi, Nicholas L Zalewski, Brian G Weinshenker, Eslam Shosha, Claudia F Lucchinetti, James P Fryer, A Sebastian Lopez-Chiriboga, John C Chen, Jiraporn Jitprapaikulsan, Andrew McKeon, Avi Gadoth, B Mark Keegan, Jan-Mendelt Tillema, Elie Naddaf, Marc C Patterson, Kevin Messacar, Kenneth L Tyler, Eoin P Flanagan
Importance: Recognizing the characteristics of myelin oligodendrocyte glycoprotein autoantibody (MOG-IgG) myelitis is essential for early accurate diagnosis and treatment. Objective: To evaluate the clinical, radiologic, and prognostic features of MOG-IgG myelitis and compare with myelitis with aquaporin-4-IgG (AQP4-IgG) and multiple sclerosis (MS). Design, Setting, and Participants: We retrospectively identified 199 MOG-IgG-positive Mayo Clinic patients from January 1, 2000, through December 31, 2017, through our neuroimmunology laboratory...
December 21, 2018: JAMA Neurology
Melanie K Fleming, Tim Theologis, Rachel Buckingham, Heidi Johansen-Berg
Transcranial direct current stimulation (tDCS) has the potential to improve motor function in a range of neurological conditions, including Cerebral Palsy (CP). Although there have been many studies assessing tDCS in adult stroke, the literature regarding the efficacy of tDCS in CP is more limited. This review therefore focuses on the neurophysiological and clinical findings in children and adolescents with CP. Initial studies applying anodal tDCS to promote lower limb function are promising, with improvements in gait, mobility and balance reported...
December 20, 2018: Journal of Neuroengineering and Rehabilitation
Philipp Wanner, Thomas Schmautz, Felix Kluge, Björn Eskofier, Klaus Pfeifer, Simon Steib
BACKGROUND: Individuals with chronic ankle instability (CAI) demonstrate altered ankle kinematics during running compared to uninjured individuals; however, little is known about differences between individuals with CAI and those who recover successfully from an index sprain (copers). METHODS: Thirty-two young male athletes with prior ankle sprain were investigated, eighteen with CAI and fourteen copers. Instrumented running analysis was performed on a treadmill at two velocities: moderate (2...
December 4, 2018: Gait & Posture
Melisa Osborne, Nicole M Mueske, Susan A Rethlefsen, Robert M Kay, Tishya A L Wren
BACKGROUND: Hamstring lengthening surgery (HSL) is often performed to correct crouch gait in patients with cerebral palsy (CP). However, crouch can recur over time, and repeat HSL may be ineffective. One possible reason is that the hamstrings in repeat HSL patients are neither short nor lengthening slowly and would therefore not benefit from HSL. RESEARCH QUESTION: This study aimed to determine whether the hamstrings are short and/or slow preoperatively only in patients with primary, and not repeat, HSL...
November 28, 2018: Gait & Posture
Julia Manasson, Jonathan Howard, Johannes Nowatzky
A 58-year-old man with a history of recurrent aphthous ulcers since childhood was admitted to the hospital with acute neurological decline characterised by loss of motor dexterity, dysarthria, dysphagia and unsteady gait. MRI brain was significant for symmetrical hyperintense T2 fluid attenuated inversion recovery (FLAIR) in the corticospinal tracts, including parts of the pons and the mesodiencephalic junction. Though initial concern was for neuro-Behçet's disease, brain biopsy ultimately revealed a diagnosis of astrocytoma...
December 7, 2018: BMJ Case Reports
Marco Kaufmann, Jens Kuhle, Milo A Puhan, Christian P Kamm, Andrew Chan, Anke Salmen, Jürg Kesselring, Pasquale Calabrese, Claudio Gobbi, Caroline Pot, Nina Steinemann, Stephanie Rodgers, Viktor von Wyl
Background: Recent studies emphasise the importance of timely diagnosis and early initiation of disease-modifying treatment in the long-term prognosis of multiple sclerosis. Objectives: The objective of this study was to investigate factors associated with extended time to diagnosis and time to disease-modifying treatment initiation in the Swiss Multiple Sclerosis Registry. Methods: We used retrospective data (diagnoses 1996-2017) of the survey-based Swiss Multiple Sclerosis Registry and fitted logistic regression models (extended time to diagnosis ≥2 years from first symptoms, extended time to disease-modifying treatment initiation ≥1 year from diagnosis) with demographic and a priori defined variables...
October 2018: Multiple Sclerosis Journal—Experimental, Translational and Clinical
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