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Biomedical subjects

J G Phillips

Publications and source records attributed to J G Phillips.

At least 73 records · Page 4Linked to original sources

Characteristics of handwriting of patients with Huntington's disease.

Patients with Huntington's disease exhibit poorer-quality handwriting, sometimes clinically exhibiting macrographia, an increase in the size of handwriting. To characterize deficits in handwriting of patients with Huntington's disease, we compared the writing of 12 young, 12 age-matched controls, and 12 patients with Huntington's disease. Subjects were asked to write the letter "l" four times, at a constant length, on a graphics tablet that sampled pen position at 200 Hz. Huntington's disease causes chorea (involuntary movement), akinesia (difficulty in initiating voluntary movement), and bradykinesia (slowness and difficulty in maintaining voluntary movement). To distinguish changes in handwriting quality due to involuntary movement from impairments of voluntary movement, handwriting samples with obvious choreic movements were analyzed separately from other handwriting samples. Several measures of quality of handwriting were considered, based on: the regularity and consistency of handwriting, the efficiency of movement trajectories, and the proportions of movement occurring at specific frequencies. Results suggested that Huntington's disease increases variability of movement parameters, and causes problems in producing smooth movements. Choreic movement was best characterized by the number of zero crossings in the velocity function relative to the prescribed number of writing strokes. We hypothesize that macrographia in Huntington's disease occurs when chorea predominates over bradykinesia. Comparisons were made between the handwriting of patients with Huntington's and Parkinson's diseases.

Adolescent↗

Effects of hand and age upon abductive and adductive movements: a kinematic analysis.

Older and younger dextral subjects performed targeting movements to left and right with their preferred and nonpreferred hands upon a computer graphics tablet. Kinematic analysis revealed that older subjects produced larger constant errors than younger, paused more, and differed from younger individuals in a number of ways with respect to adductive/abductive asymmetries. The right hand was associated with shorter stroke durations and higher peak velocities, and both shorter times to peak velocity and from peak velocity to zero, suggesting superior ballistic preprogramming by the preferred right hand which was also more accurate. While both hands showed small abductive superiorities in terms of peak velocity and time from peak to zero, the largest directional asymmetries, stroke duration, showed leftward superiorities by both hands. We cannot therefore conclude either that experience with the rightward patterns of writing or that a reported tendency towards mirror-symmetrical movements by the two hands can account for the present results. Rather a right-hemisphere mediation of visually directed movements into left hemispace, along with a left-hemisphere mediation of fast, precise, temporal sequencing may jointly determine observable asymmetries. These may appear as a vector representing the opposing contributions of the two specialized hemispheres.

Adolescent↗

Inaccuracy and instability of sequential movements in Parkinson's disease.

Animal studies suggest that the basal ganglia (BG) provide internal cues to trigger submovements in a movement sequence, with Parkinson's disease (PD) involving a deficiency in this cueing mechanism. However, it is not clear why defective internal cues can produce slow movements, or the extent to which slow movements are indeed the basic movement abnormality or are perhaps a compensatory mechanism for some other primary deficit. In this study we examined a number of the kinematic indices of matched fast movements between PD patients and age-matched controls, performed with and without reductions in visual cues for guidance, in order to delineate the relationship between the internal cue and the kinematic characteristics of these movements. Fourteen patients with PD, and their matched controls, used an electronic pen, which sampled pen-tip position at 200 Hz, and performed a sequence of drawing movements to nine targets upon a WACOM SD 420 graphics tablet. Subjects were trained to perform the movement sequence at a fast speed and were then required to perform the same movement at the same speed with reduced visual cues. Kinematic analysis indicated that, when visual cues were reduced, movements of PD patients became spatially and temporally unstable as they were progressively performed down the sequence. The instability was associated with an abnormal force profile increase in peak movement velocity and target overshoot, which became additive as the submovements progressed. We suggest that defective cue production is the basic deficit in parkinsonian hypokinesia. The defective cue leads to problems synchronising preparatory activity, which then results in abnormalities in movement forces which are characterised by unpredictable and inaccurate movement endpoints. When movements are strung together in a sequence the inaccuracy is additive leading to motor instability.

Aged↗

Hand-hemispace spatial compatibility, precueing, and stimulus-onset asynchrony.

The role of attention and the resolution of coding conflicts in hand-hemispace spatial-compatibility effects was examined in a precueing experiment in which visual and vibrotactile precues, with various stimulus-onset asynchronies (SOAs), were presented in blocked and random order. It was expected that precues at the shorter SOAs would fail to facilitate the shifting of attention, as they occur too close to the imperative stimulus to be informative. The task would therefore approximate one of choice reaction time (RT), resulting in a hand-hemispace spatial-compatibility effect. Conversely, the longer SOAs would provide the subject with sufficient time in which to shift attention fully, and would therefore result in a task more like that of simple reaction time (SRT). It was expected that the hand-hemispace spatial-compatibility effect would then be absent. As was expected, this effect was present at the shorter SOAs, and absent at the longer SOAs. In Experiments 2 and 3, provision of a visual precue further facilitated attentional deployment, as did blocking the presentation of various SOAs in Experiment 3. Vibrotactile and visual precues did not differ in their ability to direct attention, implying that these modalities orient attention and precue location in essentially similar ways. These findings are discussed within the context of the mechanisms though to underlie the time course of spatial compatibility and the dissipation of a fading trace of interfering spatial codes.

Adult↗

Could bradykinesia in Parkinson's disease simply be compensation?

Even normal movements can be slow and hesitant. To distinguish between bradykinesia and the simple slow inefficiency sometimes seen in normal movement, we matched the movement durations of 12 patients with Parkinson's disease (PD) and 12 age-matched controls and examined end-point accuracy, number of submovements, force inefficiency, and relative duration of acceleration and deceleration phases of movement. Subjects used an electronic pen which sampled pen-tip position at 200 Hz, and performed a sequence of drawing movements to nine targets (0.5, 1, or 2 cm diameter) upon a WACOM SD420 graphics tablet. Patients could be trained to move at the preferred speed of controls (and vice versa). When moving at the same fast speed as controls, patient's movements were less accurate (increased end-point spread). Even when moving at their own preferred speed, patients' movements were less efficient (more submovements, more zero crossings in acceleration function) than controls moving at the same speed. If bradykinesia simply reflected increased caution and visual guidance, we would expect patients to exhibit prolonged decelerative phases of movement associated with terminal guidance. However, patients consistently required prolonged accelerative phases of movement, suggesting that there was a problem in generating appropriate movement forces to produce the required end-point accuracy. It is hypothesised that bradykinesia is not simply a compensation for defective preparatory processes, but may reflect a defective internal cue in PD which disrupts and impairs the outflow of motor responses.

Adaptation, Physiological↗

Parkinsonian patients without dementia or depression do not suffer from bradyphrenia as indexed by performance in mental rotation tasks with and without advance information.

A predominant symptom of Parkinson's disease is akinesia and bradykinesia, slowing in the initiation and execution of voluntary movement. There has long been speculation as to whether cognitive processes undergo similar processes, but findings may be confounded by the frequent co-occurrence of dementia and/or depression. Mental rotation provides an internal or cognitive analogue of real movement, and enables us to determine the speed of such mental processes independent of any concurrent motor slowing in response initiation and execution. Medicated patients with Parkinson's disease who were free of dementia and depression were found to be able to mentally rotate alphanumeric or figural stimuli, with and without advance information as to the view (front or back) of a stick figure shortly to be shown, as rapidly as normal healthy controls. We conclude that cognitive processes involved in mental rotation are not necessarily slowed in Parkinson's disease.

Aged↗

Impairments of movement execution in unilateral neglect: a kinematic analysis of directional bradykinesia.

A kinematic analysis was performed on goal-directed movements made by 14 patients with right hemisphere damage and left unilateral neglect (seven mild, seven severe), and 14 healthy controls. Leftward and rightward pen strokes of varying extents were made to targets of varying size on a centrally located digitising tablet. While mild unilateral neglect patients performed like controls, patients with severe unilateral neglect were slower to initiate leftward than rightward strokes and were slow and inefficient in movement execution. Leftward strokes made by severe unilateral neglect patients were characterised by prolonged movement time, lower peak velocity and departed from optimal bell-shaped velocity profiles. Their leftward strokes also showed prolonged accelerative phases, implying difficulties in force production, while the high proportion of their total movement time spent in decelerating with rightward strokes suggested an abnormal emphasis on terminal visual guidance. Leftward strokes made by these patients also contained more submovements than rightward strokes, suggesting poor force control. An impaired internal representation of the location of left-sided targets and desired movement trajectories in severe unilateral neglect causes breakdown in the temporal control of goal-directed movements.

Aged↗

Response surface model of the effect of pH, sodium chloride and sodium nitrite on growth of Yersinia enterocolitica at low temperatures.

A fractional factorial design was used to measure the effects and interactions of temperature (5, 12, 19 degrees C), pH (4.5-8.5), sodium chloride (0.5-5%) and sodium nitrite (0-200 micrograms/ml) on the aerobic growth of Y. enterocolitica in brain heart infusion broth. Growth curves were modeled by fitting plate count data to the Gompertz equation. Quadratic models of natural logarithm transformations of the Gompertz B and M values and the derived values for lag phase durations and generation times were obtained using response surface analysis. Predictions based on the models for B and M values were comparable to predictions based on the derived values. These models provide a means for rapidly estimating how the bacterium is likely to respond to any combination of the four variables within the specified ranges.

Cold Temperature↗

Model for the combined effects of temperature, initial pH, sodium chloride and sodium nitrite concentrations on anaerobic growth of Shigella flexneri.

A fractional factorial design was used to measure the effects and interactions of temperature (12-37 degrees C), initial pH (5.5-7.5), NaCl (0.5-4.0%) and NaNO2 (0-1000 ppm) on the anaerobic growth kinetics of Shigella flexneri in Brain-Heart Infusion broth. Anaerobic conditions were established by flushing the culture flasks with N2. A total of 375 cultures representing 124 variable combinations were analyzed, with growth curves being generated using the Gompertz equation. Growth rates decreased with decreasing temperature, decreasing pH and increasing NaCl level. NaNO2 in combination with low temperature, low pH and high NaCl content effectively inhibited S. flexneri. Response surface analysis was used to obtain models for estimating the growth of S. flexneri in terms of temperature, initial pH, and NaCl and NaNO2 concentrations. A third-order equation using the natural logarithm transformations for the Gompertz B and M terms gave reasonable estimates of bacterial growth in response to any combination of the variables studied within the specified ranges.

Anaerobiosis↗

Allocation of attention to programming of movement sequences in Parkinson's disease.

The allocation of attention to the programming and execution of movement sequences was examined in Parkinson's disease (PD). The time taken to initiate and execute sequences of one, three, and five button taps was examined, while also varying the hand used (left or right) and the attentional resources that could be allocated to sequencing (using single- versus dual-task conditions). These results showed that performance anomalies in PD were most apparent with the preferred right hand under single-rather than dual-task conditions. Subjects suffering from PD may tend to divert attention from the right hand under single-task conditions, and perhaps with short sequences, as well as being less likely to prepare sequences of more than three movements in advance with that hand. These effects were unlikely to reflect asymmetric pathology. If the right hand of such subjects has in some respects now come to behave more like a "clumsy" left hand, this may reflect a deliberate strategic choice in an attempt to cope with a movement impairment.

Aged↗

Age-related motor slowness: simply strategic?

BACKGROUND: While older adults typically exhibit slower hesitant movements, this may simply reflect a preference for a cautious movement strategy, rather than any pathological process. METHOD: To separate strategic preferences from any impairment in the coordination of movement, the present experiment trained older adults to move at the preferred speed of younger adults (and vice versa) in a simple zigzag drawing task on a digitizing tablet which sampled pen position at 200 Hz. Twelve older adults (mean age 69 yrs 8 mo) and 12 young adults (mean age 21 yrs) joined 9 targets 125 mm apart, of either 5, 10 or 20 mm diameter. Once the age groups were matched for movement duration, movement kinematics were examined to determine whether there were differences in the quality or accuracy of their movements. RESULTS: When strategic differences are controlled for, older adults performed the task with comparable overall accuracy, but exhibited greater hesitancy and more submovements. CONCLUSION: The results suggest a decline in motor coordination rather than any simple strategic preference for caution in movement. The hesitancy of movement to some extent parallels that seen in Parkinson's disease.

Adolescent↗

Reduction in external cues and movement sequencing in Parkinson's disease.

To identify the focus of impairment in the performance of sequential movements of patients with Parkinson's disease, the extent of their reliance on external cues was examined. Eighteen patients with idiopathic Parkinson's disease and their matched controls performed a series of button presses at sequential choice points along a response board. The illuminated pathway to be followed successively extinguished ahead of each move according to three levels of reduction of external cues. Patients with Parkinson's disease were particularly disadvantaged with high levels of reduction of external cueing in terms both of movement preparation time (button down time) and movement execution time (movement time between buttons). Moreover, with high levels of reduction of external cueing, patients with Parkinson's disease were particularly subject to progressive slowing (movement time, not down time) further down the sequence. The basal ganglia may help generate internal cues for releasing successive stages of a predefined movement sequence.

Aged↗

Mercy mission to Guatemala.

The author joined an American team on one of their regular 'Mercy Missions' to Third World countries to treat underprivileged children. The patients' gratitude, the absence of complaining, operating conditions and quality of life were in stark contrast to that often seen in the UK. It was a heart warming experience for all members of the team.

Dental Health Services↗

Reversed perceptual asymmetry for faces in left unilateral neglect.

Twelve patients with left unilateral neglect and 12 matched controls were examined on two tests of face perception. In the chimeric faces task, subjects were required to make a judgement of happiness on pairs of photographic chimeras, while in the face-matching task, they were required to indicate which of two symmetrical face composites more closely resembled the original. Whereas controls showed a significant leftward perceptual bias on both tasks, left neglect patients showed an even stronger rightward (reversed) perceptual bias. Patients with and without left-sided visual field defects exhibited the reversed asymmetry, and the degree of perceptual bias shown by patients was not related to the severity of their symptoms as measured by standard clinical tasks. There was no relationship between the extent of rightward bias exhibited by patients or controls on the two tasks. These results contribute to our understanding of the mechanisms underlying unilateral neglect. Moreover, the tasks themselves may be employed as a simple and sensitive adjunct to the clinical assessment of this disorder.

Adult↗

Motor functions of the basal ganglia.

A study of movement disorders such as Parkinson's disease and Huntington's disease can provide an indication of the motor functions of the basal ganglia. Basal-ganglia diseases affect voluntary movement and can cause involuntary movement. Deficits are often manifested during the coordination of fine multi-joint movements (e.g., handwriting). The disturbances of motor control (e.g. akinesia, bradykinesia) caused by basal-ganglia disorders are illustrated. Data suggest that the basal ganglia play an important role in the automatic execution of serially ordered complex movements.

Basal Ganglia↗

To see or not to see: the effects of visible and invisible cues on line bisection judgements in unilateral neglect.

Patients with left unilateral neglect and matched controls were tested in two experiments to examine the effects of lateralized cues on line bisection judgements. Unlike previous studies in which letter or number cues were placed beyond the endpoint(s) of each line, we adopted a procedure which maintained the perceptual point of balance in the horizontal axis of each line. We also related the cueing task more closely to the act of bisection by requiring subjects to place a small mark in direct alignment with the endpoint(s) of each line. In the first experiment, it was found that, for controls, the presence or absence of visible lateralized cues did not differentially affect the magnitude of bisection errors. However, the magnitude of bisection errors made by neglect patients was significantly reduced (and reversed) in the presence of a visible left-sided cue, but remained well to the right of the midpoint in the absence of such cues. In a second experiment, subjects engaged in an otherwise identical cueing procedure, except that no visible marks appeared on the stimulus lines. Neither subject group was affected by the presence or absence of right-sided cues. However, the presence of left-sided cues again reduced the magnitude of bisection errors in neglect patients, but not in controls. These results indicate that the extent of the attentional bias exhibited by neglect patients can be ameliorated even in the absence of lateralized visible cues.

Aged↗