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Biomedical subjects

N Accornero

Publications and source records attributed to N Accornero.

At least 19 recordsLinked to original sources

Automatic visual field: a software diagnostic procedure.

A recently developed technique for the automatic acquisition of data on visual field losses was tested, with reliable neuro-ophthalmological parameters, on 300 subjects with and without eye disorders. Algorithms for acquisition and processing of the central visual field were implemented on an IBM-AT personal computer with standard peripherals. The contours of scotomata (visual field losses) were best estimated by probabilistic adaptive enhancement of data sampling in those areas with greater visual variability. Image processing tools were specially designed to extract information concerning the size, shape, position and number of scotomata in the visual field. The diagnosis of wider campimetric lesions required parameters such as symmetry or specularity coefficients, obtainable by analysing the visual field of both eyes. Data obtained were correlated to the pathology involved by univariate statistical tools.

Algorithms

Sequential arm movements in patients with Parkinson's disease, Huntington's disease and dystonia.

We studied the performance of sequential arm movements in 14 patients with Parkinson's disease, nine patients with Huntington's disease and seven patients with arm dystonia. The results were compared with those from normal subjects. Subjects had to perform each movement of the sequence as fast as possible, stopping as briefly as possible between two successive movements. In one set of experiments, patients with Parkinson's disease drew four different geometrical patterns in a counter-clockwise direction. The patterns consisted of two, three, four and five segments of identical length. In a second set, the subjects drew a pentagon in a counter-clockwise and a clockwise direction and each side of the pentagon singly in a counter-clockwise direction. All three groups of patients were slow in executing movements and in switching from one movement to the next. Only patients with Parkinson's disease took longer to perform the segments at the end of a sequence. In other words, their movement times lengthened progressively as the sequence progressed. This phenomenon could still be recognized when the direction and position of the segments were changed (pentagon drawn in the counter-clockwise and the clockwise direction) and when the extra-time needed, mainly due to the sequential nature of the task, was considered by computing the differences between movement times obtained during drawing of the pentagon and those obtained when each segment was traced singly. This study demonstrates that sequential movements are abnormal in Parkinson's disease, Huntington's disease and dystonia and that in the performance of long motor sequences, the deficit in sequencing movements is exacerbated only in patients with Parkinson's disease.

Adult

Critical fusion frequency in MS during mild induced hyperthermia.

By raising the body temperature of 0.5 degrees C the critical fusion frequency of a flickering light increases in normal subjects but decreases in multiple sclerosis (MS) patients. The change was present in 14 patients with definite MS and in 5 of 10 patients with probable MS. No clinical worsening was observed during the procedure or in the following hours.

Adult

The first agonist and antagonist burst in patients with an upper motor neuron syndrome.

Rapid elbow flexion movements were studied in patients with an upper motor neuron syndrome following a stroke. The velocity of movements was slower than normal. The initial bursts of electromyographic (EMG) activity in both the agonist and antagonist muscles were prolonged. As in normal subjects, the first agonist burst increased in duration with larger movements, but it generally remained about 40 ms longer than normal. The size of the first agonist burst also increased with larger movements. A fixed linkage between burst duration and level of motor unit recruitment, together with a deficient corticospinal command, could explain the prolonged burst duration with preserved ability to modulate the burst.

Aged

Stimulation of motor tracts in multiple sclerosis.

Percutaneous electrical stimulation of the motor cortex was used to evaluate corticospinal conduction to upper-limb motoneurons in 29 patients with multiple sclerosis. Central motor conduction abnormalities were correlated with clinical signs and somatosensory evoked potentials. Muscle responses to cortical stimulation were altered in 20 patients. The most common abnormality was increased central motor conduction time; in two cases the responses to cortical stimulation were absent. Abnormalities were also present in patients with no clinical evidence of corticomotoneuron deficit. Alterations of muscle responses and of somatosensory evoked potentials were usually correlated, but may appear independently. Both testing methods are useful in the study of patients with multiple sclerosis.

Adult

Stimulation of motor tracts in motor neuron disease.

The muscle responses evoked by cortical and cervical stimulation in 11 patients with motor neuron disease were studied. The muscle potential in the abductor pollicis brevis, evoked by median nerve stimulation and the somatosensory potential evoked by wrist stimulation were also studied. In eight of 11 patients there was absence or increased central delay of the responses evoked by cortical stimulation. In four patients muscle responses on cervical stimulation and muscle action potentials on median nerve stimulation were also altered, indicating peripheral abnormalities. Somatosensory responses evoked by wrist stimulation were normal. Electrophysiological techniques are helpful in estimating the site of motor involvement in motor neuron disease.

Action Potentials

Fast complex arm movements in Parkinson's disease.

Fast arm movements involving the shoulder and elbow joints have been analysed in normal controls and in patients with Parkinson's disease. The subjects were requested to draw on a graphic tablet triangles and squares of different size and shape. The patients produced a larger number of EMG burst compared with controls. The movements were accurate, and each segment of the geometric figures was performed with a roughly straight trajectory, but the time necessary to trace the geometric figures and the pauses at the vertices were prolonged. We conclude that in Parkinson's disease the disability in generating two joint ballistic movements depends on a difficulty in running motor programmes for complex trajectories.

Adult

The orbicularis oculi response after hemispheral damage.

The corneal and blink reflexes were evaluated in 20 normal subjects and in 30 patients with motor deficits secondary to unilateral hemispheral lesions of vascular origin. In the normal population there were no differences between subjects below and subjects above 50 years of age. In the patients the reflex evoked by electrical stimulation of the cornea of the clinically affected side was depressed in 24 out of 30 cases. The depression mainly affected the afferent branch of the circuit, which triggers both homolateral and contralateral orbicularis oculi discharge (afferent abnormality). In three cases the depression was exerted concomitantly on the efferent branch (afferent and efferent abnormality) and only in one case was it limited to the efferent branch (efferent abnormality). The late R2 component of the blink reflex was depressed in 15 out of 30 patients. The early R1 component was slightly facilitated on the affected side. The changes of the corneal reflex and of the R2 component of blink reflex were similar, but the blink reflex had a greater safety factor. The patients with an abnormal corneal reflex had more extensive damage than had the patients with normal corneal response, as shown by computer tomography, but the site of the lesion was comparable in the two groups. Conduction through the brain stem circuits mediating the orbicularis oculi response is normally under pyramidal facilitatory influences while facial motoneurons are subjected to pyramidal inhibition. After pyramidal damage the transmission of impulses in the brain stem was slowed down, ultimately to a degree that abolished the reflex. Removal of pyramidal inhibition on facial motoneurons is probably the basis of the slight facilitation of the R1 component of the blink reflex.

Adult

Congenital absence of pain.

A 16-year-old boy had congenital absence of pain sensitivity and no impairment of other sensory modalities. Routine electrophysiologic investigation showed no abnormalities. The threshold and latency of electrically elicited corneal reflex and cortical potentials evoked by tooth pulp stimulation were normal, but suprathreshold electric stimulation of corneal mucosa and dental pulp, as well as electric stimulation of dorsal roots, did not elicit pain. The total CSF opioid activity was raised. However, naloxone hydrochloride administration failed to reverse the analgesia. The axon reflex to intradermal injection of histamine dihydrochloride was absent. Cutaneous nerve branches showed unspecific changes affecting part of unmyelinated axons. most of the unmyelinated as well as the myelinated axons were normal. We consider the case an example of congenital indifference to pain.

Adolescent

Active surface EMG probe and contour follower.

Simple and reliable electronic equipment to detect and process EMG surface signals is described. A first stage of differential amplification built upon the electrodes is connected by a multiple cable to a second unit for further amplification, full wave rectification and integration.

Amplifiers, Electronic

Selective Activation of peripheral nerve fibre groups of different diameter by triangular shaped stimulus pulses.

1. The differential block of cutaneous nerve fibres has been achieved with a simple method of electrical stimulation, employing a single pair of active electrodes. 2. The method allows the selective activation of 95% of small myelinated (delta) axons, without activation of the larger (beta) ones; and activation of unmyelinated (C) fibres, without A fibre activation. Asynchronous firing of myelinated axons was absent in the majority of the experiments. 3. The method employs triangularly shaped electrical pulses, with a steep rise front and a slow exponential decay. The outward flow of current at the cathode fires conducted impulses in both larger and smaller axons, and the inward flow inactivates differentially the conduction in the smaller ones. 4. The differential effect of anodal currents rests upon the greater internal conductance and greater conduction velocity of larger fibres. 5. The method has the advantage over the conventional polarization block of simpler surgical preparation, longer nerve survival and minimal latency distortion. However, it cannot be applied in experiments requiring physiological stimulation of peripheral receptors.

Action Potentials