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Motor fluctuations

Yi-Ching Chen, Linda L Lin, Ing-Shiou Hwang
This study investigated age-related changes in behavioral and neural complexity for a polyrhythmic movement, which appeared to be an exception to the loss of complexity hypothesis. Young (n = 15; age = 24.2 years) and older (15; 68.1 years) adults performed low-level force-tracking with isometric index abduction to couple a compound sinusoidal target. Multi-scale entropy (MSE) of tracking force and inter-spike interval (ISI) of motor unit (MU) in the first dorsal interosseus muscle were assessed. The MSE area of tracking force at shorter time scales of older adults was greater (more complex) than that of young adults, whereas an opposite trend (less complex for the elders) was noted at longer time scales...
February 17, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Thibault Warlop, Christine Detrembleur, Gaëtan Stoquart, Thierry Lejeune, Anne Jeanjean
Variability raises considerable interest as a promising and sensitive marker of dysfunction in physiology, in particular in neurosciences. Both internally (e.g., pathology) and/or externally (e.g., environment) generated perturbations and the neuro-mechanical responses to them contribute to the fluctuating dynamics of locomotion. Defective internal gait control in Parkinson's disease (PD), resulting in typical timing gait disorders, is characterized by the breakdown of the temporal organization of stride duration variability...
2018: Frontiers in Physiology
Sara Parmigiani, Benedetta Zattera, Guido Barchiesi, Luigi Cattaneo
The capacity to produce movements only at appropriate times is fundamental in successful behavior and requires a fine interplay between motor inhibition and facilitation. Evidence in humans indicates that the dorsal premotor cortex (PMCd) is involved in such preparatory and inhibitory processes, but how PMCd modulates motor output in humans is still unclear. We investigated this issue in healthy human volunteers, using a variant of the dual-coil transcranial magnetic stimulation (TMS) technique that allows testing the short-latency effects of conditioning TMS to the left PMCd on test TMS applied to the ipsilateral orofacial primary motor cortex (M1)...
February 19, 2018: Brain Topography
Sarah E Berger, Regina T Harbourne, Melissa N Horger
This chapter discusses what cognition-action trade-offs in infancy reveal about the organization and developmental trajectory of attention. We focus on internal attention because this aspect is most relevant to the immediate concerns of infancy, such as fluctuating levels of expertise, balancing multiple taxing skills simultaneously, learning how to control attention under variable conditions, and coordinating distinct psychological domains. Cognition-action trade-offs observed across the life span include perseveration during skill emergence, errors and inefficient strategies during decision making, and the allocation of resources when attention is taxed...
2018: Advances in Child Development and Behavior
Jaime S Ide, Chiang-Shan R Li
Functional connectivity analysis is an essential tool for understanding brain function. Previous studies showed that brain regions are functionally connected through low-frequency signals both within the default mode network (DMN) and task networks. However, no studies have directly compared the time scale (frequency) properties of network connectivity during task versus rest, or examined how they relate to task performance. Here, using fMRI data collected from sixty-eight subjects at rest and during a stop signal task, we addressed this issue with a novel functional connectivity measure based on detrended partial cross-correlation analysis (DPCCA)...
February 15, 2018: NeuroImage
Eugénie Lhommée, Lars Wojtecki, Virginie Czernecki, Karsten Witt, Franziska Maier, Lisa Tonder, Lars Timmermann, Thomas D Hälbig, Fanny Pineau, Franck Durif, Tatiana Witjas, Marcus Pinsker, Maximilian Mehdorn, Friederike Sixel-Döring, Andreas Kupsch, Rejko Krüger, Saskia Elben, Stephan Chabardès, Stéphane Thobois, Christine Brefel-Courbon, Fabienne Ory-Magne, Jean-Marie Regis, David Maltête, Anne Sauvaget, Jörn Rau, Alfons Schnitzler, Michael Schüpbach, Carmen Schade-Brittinger, Gunther Deuschl, Jean-Luc Houeto, Paul Krack
BACKGROUND: Although subthalamic stimulation is a recognised treatment for motor complications in Parkinson's disease, reports on behavioural outcomes are controversial, which represents a major challenge when counselling candidates for subthalamic stimulation. We aimed to assess changes in behaviour in patients with Parkinson's disease receiving combined treatment with subthalamic stimulation and medical therapy over a 2-year follow-up period as compared with the behavioural evolution under medical therapy alone...
March 2018: Lancet Neurology
Diana Henz, Alexander John, Christian Merz, Wolfgang I Schöllhorn
A large body of research has shown superior learning rates in variable practice compared to repetitive practice. More specifically, this has been demonstrated in the contextual interference (CI) and in the differential learning (DL) approach that are both representatives of variable practice. Behavioral studies have indicate different learning processes in CI and DL. Aim of the present study was to examine immediate post-task effects on electroencephalographic (EEG) brain activation patterns after CI and DL protocols that reveal underlying neural processes at the early stage of motor consolidation...
2018: Frontiers in Human Neuroscience
Mattia Arlotti, Sara Marceglia, Guglielmo Foffani, Jens Volkmann, Andres M Lozano, Elena Moro, Filippo Cogiamanian, Marco Prenassi, Tommaso Bocci, Francesca Cortese, Paolo Rampini, Sergio Barbieri, Alberto Priori
OBJECTIVES: To assess the feasibility and clinical efficacy of local field potentials (LFPs)-based adaptive deep brain stimulation (aDBS) in patients with advanced Parkinson disease (PD) during daily activities in an open-label, nonblinded study. METHODS: We monitored neurophysiologic and clinical fluctuations during 2 perioperative experimental sessions lasting for up to 8 hours. On the first day, the patient took his/her daily medication, while on the second, he/she additionally underwent subthalamic nucleus aDBS driven by LFPs beta band power...
February 14, 2018: Neurology
Francesca Mancini, Alessio Di Fonzo, Giulia Lazzeri, Linda Borellini, Vincenzo Silani, Marco Lacerenza, Cristoforo Comi
In this retrospective study, we evaluated both efficacy and effectiveness of safinamide 50 and 100 mg in the treatment of motor fluctuations and disabling dyskinesias in a cohort of patients with idiopathic Parkinson's disease (PD). Ninety-one PD patients were evaluated during the first year of commercialization of the drug, both prior to starting safinamide and at the last available follow-up. Evaluations were based on the Unified Parkinson's Disease Scale part III (UPDRS III), Hoehn & Yahr (HY), Unified Dyskinesia Rating Scale (UDysRS) walking and balance item 9 score, daily time spent in OFF and in ON with disabling dyskinesias (1 week diary), mean daily dose of levodopa (LD), dopamine-agonists (DA), catechol-O-methyl transferase inhibitor (COMT-I), monoamine oxidase B inhibitor (MAOB-I), and their LD equivalent dose (LEDD)...
February 13, 2018: Neurological Sciences
Michele Matarazzo, Alexandra Perez-Soriano, A Jon Stoessl
Throughout the years there has been a longstanding discussion on whether levodopa therapy in Parkinson's disease should be started in early vs. later stages, in order to prevent or delay motor complications such as fluctuations and dyskinesias. This controversial topic has been extensively debated for decades, and the prevailing view today is that levodopa should not be postponed. However, there is still fear associated with its use in early stages, especially in younger patients, who are more prone to develop dyskinesias...
February 10, 2018: Journal of Neural Transmission
Eliana María Cano Londoño, Isabel Cristina Mejía Gil, Katerine Uribe Hernández, Carmenza Ricardo Ramírez, Matilde Ligia Álvarez Gómez, Ricardo Antonio Consuegra Peña, Camilo Andrés Agudelo Vélez, Susana Zuluaga Penagos, Mussatye Elorza Parra, José G Franco Vásquez
OBJECTIVES: To describe the prevalence and characteristics of delirium during the initial evaluation of critically ill patients aged 5-14 years. METHOD/DESIGN: This is a cross-sectional descriptive study in a critical care unit. For six months, all patients were evaluated within the first 24-72 hours or when sedation permitted the use of the paediatric confusion assessment method for the intensive care unit (PCAM-ICU) and the Delirium Rating Scale-Revised-98 items #7 and #8 to determine motor type...
February 7, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Fatemeh Khademi, Vladimir Royter, Alireza Gharabaghi
Rhythmic synchronization of neurons is known to affect neuronal interactions. In the motor system, oscillatory power fluctuations modulate corticospinal excitability. However, previous research addressing phase-specific gain modulation in the motor system has resulted in contradictory findings. It remains unclear how many time windows of increased responsiveness each oscillatory cycle provides. Moreover, we still lack conclusive evidence as to whether the motor cortex entails an intrinsic response modulation along the rhythm cycle, as shown for spinal neurons...
February 3, 2018: Cerebral Cortex
Lixia Tian, Qizhuo Li, Chaomurilige Wang, Jian Yu
Despite numerous studies on age-related changes in static functional connections (FCs), the available literature on the changes in dynamic FCs with aging is lacking. This study investigated the changes in dynamic FCs with aging based on resting state fMRI data of 61 healthy adults aged 30-85 years. The time-resolved FCs among 160 pre-defined regions of interest (ROIs) were first estimated using sliding-window correlation. Based on the dynamic FC matrices, we then analyzed the dynamic switches between different FC states using k-means clustering, and correlated age with the dwell time of each FC state across subjects...
January 27, 2018: NeuroImage
Francisco Velasco, Mauricio Esqueda-Liquidano, Ana Luisa Velasco, Maria Guadalupe García-Gomar
BACKGROUND: Selective improvement of symptoms may be required when treating Parkinson disease (PD) patients with a predominantly monosymptomatic clinical picture. OBJECTIVE: To define a target in prelemniscal radiation fibers (Raprl) related to the physiopathology of tremor evidenced by tractography. CASE REPORT: We report a patient with predominant unilateral rest and postural tremor, diagnosed as PD based on 80% improvement induced by the administration of L-DOPA/carbidopa, subsequently complicated by motor fluctuations, L-DOPA dyskinesia, and a reduced ON period...
February 6, 2018: Stereotactic and Functional Neurosurgery
Cristina Agliardi, Franca Rosa Guerini, Milena Zanzottera, Giulio Riboldazzi, Roberta Zangaglia, Giorgio Bono, Carlo Casali, Cherubino Di Lorenzo, Claudio Pacchetti, Raffaello Nemni, Mario Clerici
The etiology of sporadic Parkinson's disease is (PD) still not understood but it is believed that a complex interplay between environmental and genetic factors could trigger the pathology. Pro-inflammatory TNF-α is released by activated microglia and is up-regulated in the brain and cerebrospinal fluid of PD patients; TNF-α modulates neuroinflammation and can activate the molecular mechanisms that lead to neurotoxicity and neuronal death. We analyzed two functional SNPs within the TNF-α gene promoter (rs361525 and rs1800629) in 354 Italian PD patients and 443 healthy controls (HC)...
February 15, 2018: Journal of the Neurological Sciences
Asuka Nakajima, Yasushi Shimo, Satoko Sekimoto, Koji Kamagata, Takayuki Jo, Genko Oyama, Atsushi Umemura, Nobutaka Hattori
Imaging studies are necessary prior to subthalamic deep brain stimulation (STN-DBS). Dopamine transporter (DAT) imaging is a powerful tool for visualizing dopamine terminals in the striatum, but its usefulness in STN-DBS is unclear. Here, we retrospectively investigated the relationship between motor symptoms and the specific binding ratio (SBR) on DAT imaging in patients with Parkinson's disease (PD). We included 23 consecutive patients (9 female; 14 male) who were evaluated for DBS eligibility between October 2013 and October 2014 and subsequently received bilateral STN-DBS...
February 15, 2018: Journal of the Neurological Sciences
Jason Margolesky, Carlos Singer
Motor fluctuations complicate the treatment of patients with Parkinson's disease receiving levodopa. Extended-release carbidopa-levodopa has a pharmacokinetic profile that provides a more continuous levodopa serum concentration. Patients taking this formulation can expect longer duration of action and fewer doses per day, similar clinical improvement when compared to other levodopa formulations, and with a theoretically lower risk of developing motor fluctuations. Several studies, including three randomized control trials provide evidence for the efficacy, safety and tolerability of extended release carbidopa-levodopa in patients with both early and advanced Parkinson's disease are reviewed here...
2018: Therapeutic Advances in Neurological Disorders
Annalisa Pinna, Marcello Serra, Micaela Morelli, Nicola Simola
Adenosine is an endogenous purine nucleoside that regulates several physiological functions, at the central and peripheral levels. Besides, adenosine has emerged as a major player in the regulation of motor behavior. In fact, adenosine receptors of the A 2A subtype are highly enriched in the caudate-putamen, which is richly innervated by dopamine. Moreover, several studies in experimental animals have consistently demonstrated that the pharmacological antagonism of A 2A receptors has a facilitatory influence on motor behavior...
February 2, 2018: Journal of Neural Transmission
David G Standaert, James T Boyd, Per Odin, Weining Z Robieson, Jorge Zamudio, Krai Chatamra
Levodopa-carbidopa intestinal gel (LCIG, carbidopa-levodopa enteral suspension in the United States) is a treatment option for advanced Parkinson's disease (PD) patients with motor fluctuations. The objective of this investigation was to identify the baseline characteristics predictive of treatment response, measured by improvement in motor symptom severity, in advanced PD patients treated with LCIG during a 54-week, open-label phase 3 study. Patients with ≥1 h improvement from baseline in "Off" time were categorized as "Responders"; whereas those with <1 h improvement, any worsening, or no post-baseline assessment were "Non-Responders"...
2018: NPJ Parkinson's Disease
Peter Christoph Reinacher, Florian Amtage, Michel Rijntjes, Tobias Piroth, Thomas Prokop, Carolin Jenkner, Jürgen Kätzler, Volker Arnd Coenen
BACKGROUND: Besides fluctuations, therapy refractory tremor is one of the main indications of deep brain stimulation (DBS) in patients with idiopathic Parkinson syndrome (IPS). Although thalamic DBS (ventral intermediate nucleus [Vim] of thalamus) has been shown to reduce tremor in 85-95% of patients, bradykinesia and rigidity often are not well controlled. The dentato-rubro-thalamic tract (DRT) that can directly be targeted with special diffusion tensor magnetic resonance imaging sequences has been shown as an efficient target for thalamic DBS...
January 30, 2018: JMIR Research Protocols
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