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Strategic hand use preferences and hemispheric specialization in tactual reading: impact of the demands of perceptual encoding.

Four reading-related, information-processing tasks were administered to right-handed blind readers of braille who differed in level of reading skill and in preference for using the right hand or the left hand when required to read text with just one hand. The tasks were letter identification, same-different matching of letters that differed in tactual similarity, short-term memory for lists of words that varied in tactual and phonological similarity, and paragraph reading with and without a concurrent memory load of digits. The results showed interactions between hand preference and the hand that was actually used to read the stimulus materials, such that left preferrers were significantly faster and more accurate with their left hands than with their right hands whereas right preferrers were slightly but usually not significantly faster with their right hands than with their left hands. In all cases, the absolute magnitude of the left-hand advantage among left preferrers was substantially larger than the right-hand advantage among right preferrers. The results suggest that encoding strategies for dealing with braille are reflected in hand preference and that such strategies operate to modify an underlying but somewhat plastic superiority of the right hemisphere for dealing with the perceptual requirements of tactual reading. These requirements are not the same as those of visual reading, leading to some differences in patterns of hemispheric specialization between readers of braille and readers of print.

Adolescent↗

Judging the angles formed by visible and imaginary clock hands: a study of hemispatial effects in healthy volunteers.

Healthy, right-handed volunteers (six male, six female) either saw or imagined the hands of a clock set a particular time. In both conditions, they then judged whether the angle between the clock hands was greater than or less than 90 degrees. Subjects pressed one of two response keys to indicate their decision, and hand of response (left/right) was counterbalanced within and between subjects. The subjects had significantly longer reaction times and made significantly more errors when the imaginary angles formed by the clock hands were located in left hemispace (e.g. 8:30) than right hemispace (e.g. 4:30). With visible hands, there was no reaction time difference between visual hemifields, although significantly more errors were made when the angle formed by the hands fell within the left visual field. In the perceptual task (visible hands), reaction times and error rates increased monotonically as the distance between the hands approximated more closely to 90 degrees. This psychophysical relationship was not found in the representational task (imaginary hands). Rather, there was a significant positive correlation between reaction times/error rates and the magnitude of the number indicative of the position of the minute hand. The latter finding is consistent with the hypothesis that the lateral asymmetry in the representational task (reaction times and error rates are higher in left hemispace) is due to the time taken to mentally rotate the imaginary minute hand in a clockwise direction. No such operation is required in the perceptual condition where the hands are clearly visible.

Adolescent↗

Eye-hand coordination in goal-directed aiming.

In a number of studies, we have demonstrated that the spatial-temporal coupling of eye and hand movements is optimal for the pickup of visual information about the position of the hand and the target late in the hand's trajectory. Several experiments designed to examine temporal coupling have shown that the eyes arrive at the target area concurrently with the hand achieving peak acceleration. Between the time the hand reached peak velocity and the end of the movement, increased variability in the position of the shoulder and the elbow was accompanied by a decreased spatial variability in the hand. Presumably, this reduction in variability was due to the use of retinal and extra-retinal information about the relative positions of the eye, hand and target. However, the hand does not appear to be a slave to the eye. For example, we have been able to decouple eye movements and hand movements using Müller-Lyer configurations as targets. Predictable bias, found in primary and corrective saccadic eye movements, was not found for hand movements, if on-line visual information about the target was available during aiming. That is, the hand remained accurate even when the eye had a tendency to undershoot or overshoot the target position. However, biases of the hand were evident, at least in the initial portion of an aiming movement, when vision of the target was removed and vision of the hand remained. These findings accent the versatility of human motor control and have implications for current models of visual processing and limb control.

Adult↗

Identification of randomized controlled trials from the emergency medicine literature: comparison of hand searching versus MEDLINE searching.

STUDY OBJECTIVE: As part of an ongoing project to identify all the randomized controlled trials (RCTs) in the emergency medicine literature, in association with the Cochrane Collaboration, 2 discrete studies were undertaken; the first, to compare motives for active participation in hand searching of the literature by emergency medicine professionals, and the second, to compare hand searching with MEDLINE searching of a number of emergency medicine journals. METHODS: All listed members of the British Association for Emergency Medicine (BAEM) and the Society for Academic Emergency Medicine (SAEM) received a standard letter outlining the objectives of the project, with 1 of 3 headings assigned on an alternate basis. Recruited volunteers hand searched journals prioritized from the emergency medicine literature. Each issue of each journal was hand searched for RCTs. In addition, a comprehensive MEDLINE search was conducted for each journal. The yields of RCTs from the 2 searching methods were compared for all journals and for each journal individually. RESULTS: No clear motivation for participation in this work could be ascertained because of the low response rates from BAEM and SAEM (10.1% and 1.8%, respectively). Only 18 (29.0%) of the 62 journals identified were indexed by MEDLINE. In the 14 journals indexed by MEDLINE for which hand searching was completed, a total of 710 RCTs were identified by a combination of the 2 approaches; of these, 592 (83.4%) were identified by hand searching alone and 483 (68.0%) by MEDLINE searching alone. Both methods identified 365 (51. 4%) RCTs; hand searching revealed an additional 227 (32.0%) that were not identified by MEDLINE searching, and MEDLINE searching found 118 (16.6%) that were not identified by hand searching. The difference between the proportions identified by hand searching and by MEDLINE searching (15.4%; 95% confidence interval [CI], 12.7% to 17.9%) was statistically significant (McNemar's chi2 test, 1 df, 33. 8; P <.0001). This difference was not significant for 8 of the journals. CONCLUSION: The response rates from mailing to members of the relevant professional organizations letters requesting participation in this work were very low and suggested that such an approach was not cost-effective. However, no formal costing exercise was undertaken. Searching results showed that, in the 14 emergency medicine journals indexed by MEDLINE for which hand searching was completed, hand searching led to identification of additional RCTs (primary articles) not found through MEDLINE searching. However, hand searching, although statistically significantly better than MEDLINE searching, failed to identify some of the RCTs found by MEDLINE searching, suggesting that hand searching is not a "gold standard" method and that the dual approach, promoted by the Cochrane Collaboration, may be the optimal approach for journals indexed by MEDLINE.

Attitude of Health Personnel↗

Interaction of drugs with Z-DNA: cooperative binding of actinomycin D or actinomine to the left-handed forms of poly(dG-dC).poly(dG-dC) and poly(dG-m5dC).poly(dG-m5dC) reverses the conformation of the helix.

The interaction of actinomycin D and actinomine with poly(dG-dC).poly(dG-dC) and poly(dG-m5dC).poly(dG-m5dC) under B- and Z-form conditions has been investigated by optical and phase partition techniques. Circular dichroism data show that the conformation at the binding site is right-handed, even though adjacent regions of the polymer have a left-handed conformation. Actinomycin D binds in a cooperative manner to poly(dG-dC).poly(dG-dC) under both B-form and Z-form conditions. Analysis of the circular dichroism data shows that 5 +/- 1 base pairs of left-handed poly(dG-dC).poly(dG-dC) in 4.4 M NaCl switch to a right-handed conformation for each bound actinomycin D. When the left-handed form of poly(dG-dC).poly(dG-dC) is stabilized by the presence of 40 microM [Co(NH3)6]Cl3, 25 +/- 5 base pairs switch from a left-handed to a right-handed conformation for each bound actinomycin D. Actinomine binds cooperatively to left-handed poly(dG-dC).poly(dG-dC) in 40 microM [Co(NH3)6]Cl3 and to left-handed poly(dG-m5dC).poly(dG-m5dC) in 2 mM MgCl2. Actinomine does not bind to left-handed poly(dG-dC).poly(dG-dC) in 4.4 M NaCl at concentrations as high as 100 microM. Each bound actinomine converts 11 +/- 3 base pairs of left-handed poly(dG-dC).poly(dG-dC) in 40 microM [Co(NH3)6]Cl3 and 7 +/- 2 base pairs of left-handed poly(dG-m5dC).poly(dG-m5dC) in 2 mM MgCl2. The binding isotherm data also indicate that the binding site has a right-handed conformation.(ABSTRACT TRUNCATED AT 250 WORDS)

Circular Dichroism↗

Temporal regularity of tapping by the left and right hands in timed and untimed finger tapping.

The temporal characteristics of repetitive finger tapping by the left and right hands were examined in two experiments. In the first experiment, interresponse intervals (IRIs) were recorded while right-handed male subjects tapped in synchrony with an auditory timing pulse (the synchronization phase) and then attempted to maintain the same tapping rate without the timing pulses (the continuation phase). The left and right hands performed separately, at four different rates (interpulse intervals of 250, 500, 750, and 1500 ms). There was no asymmetry of the asynchronies of the timing pulses and the associated responses in the synchronization phase or of the IRIs in either phase, but there was an asymmetry of chronization phase or of the IRIs in either phase, but there was an asymmetry in the temporal dispersion of the responses in both phases. in the second experiment, right-handed males tapped separately with each hand at three different speeds: as quickly as possible, at a fast but steady rate, and at a slow rhythmical rate. The speed asymmetry present when tapping as quickly as possible (with the preferred hand tapping more quickly ) was reduced when tapping at the fast steady rate and was absent when tapping at the slow rhythmical rate. The temporal dispersion of the IRIs produced by the nonpreferred hand was greater than the temporal dispersion of those produced by the preferred hand in all speed conditions. These results show smaller temporal dispersion of tapping by the preferred hand in right-handed males under different conditions, including submaximal speeds at which both hands respond at the same rate. This suggests that the motor system controlling the preferred hand in right-handers had more precise timing of response output than that controlling the nonpreferred hand.

Journal Article↗

Unimanual and bimanual simultaneous fingertapping in schoolchildren: developmental aspects and hand preference-related asymmetries.

Computerised analysis of finger tapping was performed in 233 normal 5- to 12-year-old children whose hand preference was assessed with six demonstration actions. Performance with both hands became more rapid with age when tapping unimanually or simultaneously in phase with two hands as quickly as possible. There were no differences between the sexes. Performance with both hands also acquired more tapping regularity with age during unimanual tapping, whereas only the left hand did so during bimanual tapping. There was no age effect on the dexterity (speed) difference between unimanually tapping hands, nor on the relative time lag and the degree of synchrony between the hands in bimanual tapping. The degree of synchrony, however, becomes more stable in older children. The more righthanded children are, the faster the right hand is in unimanual tapping, and the more the right hand is ahead of the left hand during bimanual tapping. However, there is a right shift for both of these variables which makes them poor predictors of hand preference. These results suggest that there is a strong bias towards the right hand in complete righthanders as well as--to a lesser extent--in all others, which might be connected to the leading role of the left hemisphere for the performance aspects of hand motor function under study.

Journal Article↗

The alien hand sign. Localization, lateralization and recovery.

The alien hand sign was first described by Brion and Jedynak as a "feeling of estrangement between the patient and one of his hands." The affected hand frequently shows a grasp reflex and an instinctive grasp reaction as well as elements of what Denny-Brown referred to as a "magnetic apraxia" associated with frontal lobe damage. Most notably, however, the affected hand is observed to perform apparently purposive behaviors that are perceived as being outside the volitional control of the patient. The patients interpret the behavior of their own affected limb as being controlled by an external agent. They do not feel that they are initiating or controlling the behavior of the hand and often express dismay at the hand's "extravolitional" activity. The patients attempt to control behavior of the alien hand with the unimpaired hand by forcibly restraining the affected limb, an act that may be termed "self-restriction." In this paper, we report an additional four cases of alien hand sign in right-handed subjects: two involving the right hand and two involving the left hand. In each case, the clinical findings were associated with extensive unilateral damage of the medial frontal cortex of the hemisphere contralateral to the affected hand. Furthermore, the alien movement gradually disappears over the course of 6-12 months after the stroke. These clinical case studies are presented and discussed in the context of the "dual premotoer systems hypothesis," an anatomicophysiological model that proposes that action is organized by two separate but interactive premotor brain systems corresponding to evolutionarily defined medial and lateral cortical moieties. It is hypothesized that the alien mode behavior results from unconstrained activity of the lateral premotor system in the damaged hemisphere. The residual volitional control in the limb occurs through the activity of the intact medial premotor system of the ipsilateral hemisphere. Recovery may occur through extension of these ipsilateral control mechanisms by compensatory changes in subcortical systems controlling hemispheric activation associated with adaptive behavior. This observation may be important in understanding mechanisms involved in motor recovery after stroke.

Aged↗

Hand preference and approval among Hindus and Muslims in India.

Two forms (hand-preference and hand-approval) of a 87-item handedness questionnaire were administered to eighty subjects including both Hindus and Muslims. Both male and female subjects were included in the sample. Factor analysis for both forms of the questionnaires revealed different factor structure for hand preference and hand approval patterns. These patterns were found to be similar for right- and left-handed but differed in case of weak-versus strong-handed subjects. For hand preference scores there were minimal differences between Hindus and Muslims. However, female subjects (more in the case of Hindus) showed higher preference for right hand use than their male counterparts. The analyses of hand approval scores, on the other hand, indicated that Muslims were more insistent upon using the right hand, especially activities related to eating behavior than Hindus. These results are discussed in terms of cultural influences on hand preference and hand approval.

Adolescent↗

Performance difference between hands in children on the motor accuracy test-revised.

This study was designed to determine the developmental trends in the difference between right-hand and left-hand skill development in children ages 4 to 9 as measured by the Motor Accuracy Test-Revised (MAC-R). There were 120 right handers (60 males, 60 females), with 20 subjects at each age interval, and 68 left handers (36 males, 32 females), with no less than 8 and no more than 20 subjects at each age interval. Performance was analyzed by sex, age, and handedness for the difference scores between the two hands, and the preferred and nonpreferred hand adjusted scores. The difference scores were obtained by subtracting the nonpreferred hand scores from the preferred hand scores. Results showed the mean difference between hands for all children to be 6.7 points with a standard deviation of 4.8. This data suggests that a normative range of difference between right-hand and left-hand skill performance on the MAC-R may be from 2 to 11 points. Left-handed children performed very similarly to right-handed children, supporting the use of right-handed norms for left-handed subjects. No significant differences in sex or handedness were found in the adjusted or difference scores. Comparison of the means and standard deviations of MAC-R normative data with these data showed no consistent significant differences.

Child↗

Effects of object shape and visual feedback on hand configuration during grasping.

Normal subjects gradually preshape their hands during a grasping movement in order to conform the hand to the shape of a target object. The evolution of hand preshaping may depend on visual feedback about arm and hand position as well as on target shape and location at specific times during the movement. The present study manipulated object shape in order to produce differentiable patterns of finger placement along two orthogonal "dimensions" (flexion/extension and abduction/adduction), and manipulated the amount of available visual information during a grasp. Normal subjects were asked to reach to and grasp a set of objects presented in a randomized fashion at a fixed spatial location in three visual feedback conditions: Full Vision (both hand and target visible), Object Vision (only the object was visible but not the hand) and No Vision (vision of neither the hand nor the object during the movement). Flexion/extension angles of the metacarpophalangeal and proximal interphalangeal joints of the index, ring, middle and pinkie fingers as well as the abduction/adduction angles between the index-middle and middle-ring fingers were recorded. Kinematic analysis revealed that as visual feedback was reduced, movement duration increased and time to peak aperture of the hand decreased, in accord with previously reported studies. Analysis of the patterns of joint flexion/extension and abduction/adduction per object shape revealed that preshaping based on the abduction/adduction dimension occurred early during the reach for all visual feedback conditions (approximately 45% of normalized movement time). This early preshaping across visual feedback conditions suggests the existence of mechanisms involved in the selection of basic hand configurations. Furthermore, while configuration changes in the flexion/extension dimension resulting in well-defined hand configurations occurred earlier during the movement in the Object Vision and No Vision conditions (45%), those in the Full Vision condition were observed only after 75% of the movement, as the moving hand entered the central region of the visual field. The data indicate that there are at least two control mechanisms at work during hand preshaping, an early predictive phase during which grip selection is attained regardless of availability of visual feedback and a late responsive phase during which subjects may use visual feedback to optimize their grasp.

Adult↗

Coupling between reaching movement direction and hand orientation for grasping.

In a previous work, we demonstrated that orientation of the hand in the horizontal plane (azimuth) at the time of grasping depends on the direction of the reaching movement in the horizontal plane. Here we report three experiments to further investigate the generality of this coupling. Azimuth of the hand for grasping was studied while subjects were reaching for objects placed at various locations on a horizontal board. Hand movements were recorded with an electromagnetic sensor giving information about hand 3D position and orientation. As expected, hand azimuth for grasping was coupled with movement direction in the central part of the workspace (but reached a limit for rightmost reaching directions). The coupling did not depend on the direction of where the object had to be put after grasping. Various initial positions and azimuths of the hand were compared to the most comfortable initial hand posture. The coupling between hand azimuth and movement direction remained whatever the initial hand azimuth. This demonstrates that reaching movement direction is coupled with azimuth at the time of grasping and not with a rotational hand movement. The coupling between hand azimuth and movement direction subsisted when the initial upper trunk orientation was changed. Thus our results cannot be explained by an invariance of the coupling coded in hand-centered or shoulder-centered coordinates. They rather suggest that the movement is produced in a frame of reference associated with the environment.

Adult↗

Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs.

The etiology of nosocomial infections, the frequency of contaminated hands with the different nosocomial pathogens, and the role of health care workers' hands during outbreaks suggest that a hand hygiene preparation should at least have activity against bacteria, yeasts, and coated viruses. The importance of efficacy in choosing the right hand hygiene product is reflected in the new Centers for Disease Control and Prevention guideline on hand hygiene (J. M. Boyce and D. Pittet, Morb. Mortal. Wkly. Rep. 51:1-45, 2002). The best antimicrobial efficacy can be achieved with ethanol (60 to 85%), isopropanol (60 to 80%), and n-propanol (60 to 80%). The activity is broad and immediate. Ethanol at high concentrations (e.g., 95%) is the most effective treatment against naked viruses, whereas n-propanol seems to be more effective against the resident bacterial flora. The combination of alcohols may have a synergistic effect. The antimicrobial efficacy of chlorhexidine (2 to 4%) and triclosan (1 to 2%) is both lower and slower. Additionally, both agents have a risk of bacterial resistance, which is higher for chlorhexidine than triclosan. Their activity is often supported by the mechanical removal of pathogens during hand washing. Taking the antimicrobial efficacy and the mechanical removal together, they are still less effective than the alcohols. Plain soap and water has the lowest efficacy of all. In the new Centers for Disease Control and Prevention guideline, promotion of alcohol-based hand rubs containing various emollients instead of irritating soaps and detergents is one strategy to reduce skin damage, dryness, and irritation. Irritant contact dermatitis is highest with preparations containing 4% chlorhexidine gluconate, less frequent with nonantimicrobial soaps and preparations containing lower concentrations of chlorhexidine gluconate, and lowest with well-formulated alcohol-based hand rubs containing emollients and other skin conditioners. Too few published data from comparative trials are available to reliably rank triclosan. Personnel should be reminded that it is neither necessary nor recommended to routinely wash hands after each application of an alcohol-based hand rub. Long-lasting improvement of compliance with hand hygiene protocols can be successful if an effective and accessible alcohol-based hand rub with a proven dermal tolerance and an excellent user acceptability is supplied, accompanied by education of health care workers and promotion of the use of the product.

Anti-Infective Agents, Local↗

Effects of hand shape on maximal isometric grip strength and its reliability in teenagers.

Hands can be classified by their shape; width divided by length. This study examined the impact of shape of the hand (as relatively long, average, or square shaped) on maximal voluntary isometric grip strength and test-retest reliability in a group of healthy teenagers aged 13 to 17 years. When 116 boys and 112 girls were measured with a GripTrack (a computer-linked Jamar-like isometric hand grip dynamometer; JTech Medical Industries, Salt Lake City, UT), boys were significantly stronger than girls (by 11.02 kg force, p < 0.01), and dominant hands were significantly stronger than nondominant hands (by 2.53 kg force, p < 0.01). There were no significant differences due to hand shape. To examine the reliability of the grip strength test, 74 boys and 75 girls were retested, with a mean retest time interval of 15.5 days. There was a small but significant improvement in grip strength (by 0.62 kg force, p < 0.01). Regarding male subjects, the test-retest intraclass correlation coefficients (ICC 3,1) for both hands of the three hand-shape groups were excellent, with ICC values ranging from 0.954 to 0.973. For the female subjects, however, reliability values declined across the three hand-shape groups from long to square (ICC 0.920-0.476), such that compared with their male counterparts, strength test reliability examined by the 95% confidence intervals (CIs) was significantly lower for average and square hand shapes. Although there may be several factors contributing to this difference between boys and girls in strength test reliability for different hand-shape groups, it is possible that Jamar-like handgrip dynamometers have a handle shape that impedes those girls with relatively square hands from giving reliable grip strength readings over time.

Adolescent↗

[Psychology during the process of human hand allograft].

OBJECTIVE: To study the psychology and its management during the process of hand allograft. METHODS: One psychologist participated through the whole process of the present hand allograft. 12 potential candidates of hand transplant were interviewed during the selection of patients to evaluate the state of psychiatry and their abilities to manage stressors like cooperation with medical workers and medical interventions, waiting for donors, adaptation to a new hand and post operation depression. The psychological state of 11 patients were believed to be able to receive hand transplant, and they are further prepared psychologically by the psychologist while waiting for a donor. Two lucky candidates were decided by tissue typing and received hand allograft simultaneously. After the operation, the two patients psychotherapy assisted with effective analgesia, supporting from family and environmental improvement. RESULTS: One out of 12 patients was found not suitable for the transplantation because of psychiatric problem. One week postoperation, the 2 patients were anxious, lack of patience, and horrified at seeing the long-expected grafted hand. After 1 week of treatments and adapation the patients managed to settle with the new hand, and accepted the hand as a whole 1 month postoperation. With the recovery of the hand sensation and motion 4 to 5 months postoperation, the patients held the hand as his own. CONCLUSION: Psychologists are required in the hand transplantation team during the pre-transplant selection of patients and post-transplant rehabilitation.

Adaptation, Psychological↗

[Application of pedicled anterolateral thigh flap transferring for coverage of oversized skin defect of hand].

OBJECTIVE: To introduce the application of the pedicled anterolateral thigh flap transferring for coverage of the oversized skin defect of the hand. METHODS: The pedicled anterolateral thigh flap was transferred to cover the large skin defects of the hands or the skin defects of the abdomen after the abdominal flap transferred to the hand in 5 male patients aged 16-44 years from April 2002 to August 2005. The injured sites were as follows:4 right hands and 1 left hand, including 2 hands injured by a machine and 3 hands injured by burning. The mechanically injured patients underwent an operation within 6 hours after the injury. The burned patients were reconstructed by the flap transferring 4-7 days after the burn when the decayed tissues could be clearly indentified. The areas of the hand defects were 12-19 cm x 18-22 cm. The areas of the pedicled anterolateral thigh flaps were 7-12 cm x 16-24 cm. The areas of the abdominal flaps were 13-20 cm x 19-23 cm. The pedicles were separated 3 weeks after the repairing operation. RESULTS: All the flaps survived well and there was no vascular crisis, with the wound healing of the first intention. The skin defects of the hand were covered completely. Five patients were followed up for 6-12 months. The texture of the flaps was soft and the flaps had a good blood circulation. Of the patients, 3 underwent the finger exclusion and degreasing operation 4-7 months after operation. All the flaps of the hands had protective sensation, which could meet the requirement of the daily life. CONCLUSION: The pedicled anterolateral thigh flap can provide the large coverage for the skin defects of the hands. The risk of the operation can be greatly decreased by obviation of the vessel anastomosis. It can be an optimal choice for the management of the oversized skin defects of the hands.

Adolescent↗

Bone mineral density of the hand in rheumatoid arthritis.

OBJECTIVE: To determine the reproducibility, accuracy, and linearity of hand bone mineral content (BMC) measurements, and to evaluate the influence of hand posture; to determine the relationship of hand bone mineral density (BMD) to generalized osteopenia in rheumatoid arthritis (RA); and to determine the relationship between hand BMD and disease severity in early RA. METHODS: Hand BMD was measured by dual-energy x-ray absorptiometry (DXA). We studied 70 postmenopausal women with steroid-treated RA (established RA), ages 49-79, and 20 age-matched healthy controls to determine the relationship to generalized osteoporosis; we also studied 20 patients aged 23-74 years with early RA to determine the relationship between disease severity and hand BMD. RESULTS: Reproducibility of hand BMD was to within 1%. In established RA, there was a greater decrease in juxtaarticular BMD (23% at the hand) than in generalized BMD (16% at the femoral neck, 11% at the lumbar spine, and 11% total body) compared with that in age-matched controls. Hand BMD correlated with skeletal size and BMD at other skeletal sites. In established RA, there was no effect of disease duration, disability, or steroid therapy. In early RA, hand BMD correlated with age and disease activity. CONCLUSION: Measurement of hand BMD by DXA is accurate and precise. Hand BMD reflects BMD at other skeletal sites in patients with RA, and is a marker of disease severity in patients with early disease. It may be a sensitive marker of disease progression and response to therapeutic intervention.

Aged↗

Few intrinsic connections cross the hand-face border of area 3b of New World monkeys.

After long-standing loss of afferents from the hand, the hand representation in area 3b of the somatosensory cortex of monkeys becomes responsive to touch on the face. Because the reactivation of deprived hand cortex by the face inputs could depend on axonal connections across the hand-face border, we determined the extent of such connections in New World marmosets, owl monkeys, and squirrel monkeys. Small injections of anatomic tracers were placed in the hand or the face representations after these representations were identified by microelectrode recordings. The positions of retrogradely labeled neurons were plotted in processed brain sections cut parallel to the brain surface, and their locations were related to anatomic isomorphs of the hand and face representations revealed in adjacent brain sections stained for myelin. In these sections, the hand-face border was clearly visualized as a myelin-poor septum. The intrinsic connections of area 3b labeled by injections in either the hand or face representations were almost completely confined to their respective representation, and very few neurons projected across the border. In addition, neurons in the somatosensory thalamus labeled by injections in either face or hand representations were confined to either VPM, representing the face, or the hand subnucleus of VPL. Thus the reactivation of hand cortex by face stimulation does not depend on a previously existing network of intrinsic cortical connections across the hand-face border, or mismatched thalamocortical projections.

Afferent Pathways↗