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PubMed2005

The Dubowitz neurological examination of the full-term newborn.

In an ideal world, each neonate should have a comprehensive neurological examination but in practice this is often difficult. In this review we will describe what a routine neurological evaluation in the full-term neonate should consist of and how the Dubowitz examination is performed. The examination has been used for over 20 years and can be easily performed in a short time as the recording sheet provides simple instructions together with simple diagrams to make the recording and the scoring easier. We will also indicate how the examination can be used to identify infants with neurological abnormalities, describing clinical signs which can help to differentiate infants with peripheral neuromuscular disorders from those with central nervous system involvement. The correlation between clinical and imaging findings in infants with neonatal brain lesions will also be reported. Finally we will briefly describe how and when to apply an optimality scoring system in a research setting.

Humans↗
PubMed1983

Influence of walking on swimmeret beating in the lobster Homarus gammarus.

Influence of walking on swimmeret beating in intact lobsters, Homarus gammarus, has been analyzed using a treadmill experimental device. Belt movement activates both leg stepping and swimmeret beating. The simultaneity of the onset of the two motor systems in this situation is demonstrated to be the result of a startle response initiated when the belt begins to move. This reaction consists of a non-specific motor activity involving several antagonist postural and dynamic muscles. Abdominal extension and vigorous swimmeret beating are the main features of this reaction. The main characteristics of the swimmeret beating as defined by Davis (1969) has been observed here in sequences without walking. However during long walking sequences a very different swimmeret beating pattern occurs. It is suggested that this slow swimmeret beating is completely subordinate to the walking rhythm during sequences of absolute coordination. In more rapid swimmeret beating a relative coordination with leg stepping is very common. The functional meaning of this linkage between legs and swimmerets is discussed.

Animals↗
PubMed1991

New posture equilibrometer for the diagnosis of vestibular disease.

The vestibulospinal level of vestibular function is commonly neglected in the evaluation of vertiginous patients. We have now developed a new posture equilibrometer. A transducer is placed on the head of the subject being tested. With this meter we can record body swaying, X (left-right) and Y (fore-aft) components of angular displacement, angular velocity, and angular acceleration. A detailed analysis of the data can be made by having patients keep their eyes either open or closed during the Romberg test. The head is turned left or right in this test, while the eyes are opened and closed in the Mann test. The posture equilibrometer has enabled us to evaluate more precisely vestibulospinal function and sensory interactions.

Adolescent↗
PubMed1992

The influence of head position and head reorientation on the axis of eye rotation and the vestibular time constant during postrotatory nystagmus.

Reorienting the head with respect to gravity during the postrotatory period alters the time course of postrotatory nystagmus (PRN), hastening its decline and thereby reducing the calculated vestibular time constant. One explanation for this phenomenon is that the head reorientation results in a corresponding reorientation of the axis of eye rotation with respect to head coordinates. This possibility was investigated in 10 human subjects whose eye movements were monitored with a three-dimensional magnetic field - search - coil technique using a variety of head reorientation paradigms in a randomized order during PRN following the termination of a 90 degrees/s rotation about earth vertical. Average eye velocities were calculated over two time intervals: from 1 s to 2 s and from 7 s to 8 s after cessation of head rotation. The time constant was estimated as one third of the duration of PRN. For most conditions, a reorientation of the head with respect to gravity 2 s after the rotation had stopped did not significantly alter the direction of the eye velocity vector of PRN with respect to head coordinates. This strongly indicates that, in humans, PRN is mainly stabilized in head coordinates and not in space coordinates, even if the otolith input changes. This finding invalidates the notion that the shortening of PRN due to reorientation of the head could be due to a change of the eye velocity vector towards a direction (torsion), which is not detectable with the eye recording methods (electrooculography) used in earlier studies.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Postural strategies associated with somatosensory and vestibular loss.

This study examines the roles of somatosensory and vestibular information in the coordination of postural responses. The role of somatosensory information was examined by comparing postural responses of healthy control subjects prior to and following somatosensory loss due to hypoxic anesthesia of the feet and ankles. The role of vestibular information was evaluated by comparing the postural responses of control subjects and patients with bilateral vestibular loss. Postural responses were quantified by measuring 1) spatial and temporal characteristics of leg and trunk EMG activation; 2) ankle, knee, and hip joint kinematics, and 3) surface forces in response to anterior and posterior surface translations under different visual and surface conditions. Results showed that neither vestibular nor somatosensory loss resulted in delayed or disorganized postural responses. However, both types of sensory deficits altered the type of postural response selected under a given set of conditions. Somatosensory loss resulted in an increased hip strategy for postural correction, similar to the movement strategy used by control subjects while standing across a shortened surface. Vestibular loss resulted in a normal ankle strategy but lack of a hip strategy, even when required for the task of maintaining equilibrium on a shortened surface. Neither somatosensory nor vestibular loss resulted in difficulty in utilizing remaining sensory information for orientation during quiet stance. These results support the hypothesis that cutaneous and joint somatosensory information from the feet and ankles may play an important role in assuring that the form of postural movements are appropriate for the current biomechanical constraints of the surface and/or foot. The results also suggest that vestibular information is necessary in controlling equilibrium in a task requiring use of the hip strategy. Thus, both somatosensory and vestibular sensory information play important roles in the selection of postural movement strategies appropriate for their environmental contexts.

Adult↗
PubMed1987

Automatic postural responses in the cat: responses of proximal and distal hindlimb muscles to drop of support from a single hind- or forelimb.

Cats respond to drop of the support from beneath a single limb with the "diagonal stance response" (Coulmance et al. 1979). They load the limbs on the diagonal opposite to the one containing the dropped limb and unload the third supporting limb in the diagonal containing the dropped limb. Characteristic biomechanical delays in limb motion and in vertical force changes imposed upon the limbs are observed. These delays range from 30 to 45 ms, depending upon the location of the dropped limb. This study describes the kinematics of the "diagonal stance response" and the activation of selected agonist-antagonist muscle pairs acting on the joints of the hindlimb during the response. Proximal and distal hindlimb muscles respond to perturbations in groups that are appropriate to the vertical forces imposed upon the limb. When the hindlimb containing the recording electrodes is loaded by drop of the contralateral hindlimb or the ipsilateral forelimb medium latency (25-45 ms) EMG responses occur in the extensors. This response serves to stiffen the limb against the increased vertical force of loading. A similar response is observed when the hindlimb is reloaded after being dropped. In this case, however, short latency responses precede the medium latency responses in muscles that are passively stretched by the limb drop. When drop of the diagonal forelimb unloads the hindlimb containing the electrodes, medium latency responses are observed in the distal hindlimb flexors, which indicates that the unloading is evoked in part by active lifting of the limb. In most cases, the medium latency responses precede or are coincident with the changes in force imposed on the limb, suggesting that the observed responses are centrally programmed.

Animals↗
PubMed1984

Changes in bladder volumes with repetition of water cystometry.

Fifty-six patients were investigated by repetitive cystometry in the supine or sitting position. The incidence of detrusor hyperreflexia and the circumstances under which it was found did not differ from previous studies. The cystometry data concerning volumes showed a remarkable degree of variability. Values for first sensation and maximal capacity could vary more than 500%. An increment from the first cystometry to the fourth was consistently found. The increments were most pronounced when cystometry with fast filling followed cystometry with medium filling regardless of the patient's position. The major factor in the changes is considered to be the patient's adaptation to the investigational situation. This finding might have major significance in the evaluation of drug studies where repeated cystometries with different time intervals are used.

Adaptation, Physiological↗
PubMed1984

Detrusor activity at rest in patients with idiopathic detrusor hyperreflexia.

The detrusor activity of the bladder at rest was investigated in the supine position for one hour following instillation of 100 cc of saline in 8 patients with idiopathic hyperreflexia. During the investigation, 5 patients showed bladder hyperreflexia. In 4 cases the activity was accompanied by an increase in the anal sphincter activity, while 1 case showed decreasing sphincteric activity prior to contractions. An analysis of the distribution of the contractions revealed a predominant frequency. The frequency and the amplitude of the detrusor contractions were independent of the bladder volume. Low provocation prolonged cystometry might be a future method of studying bladder activity and bladder pharmacology.

Adult↗
PubMed1991

The shadow of movement.

Movement is preceded, accompanied and followed by reactions which give to the primary action its correct execution and ensure that the body's axis, together with the limbs, maintains the right balance. If these reactions are interfered with, incoordination of movement, lack of balance, hypertonia or dystonia may all appear. In the case of dystonia, postural mechanisms tend to become dominant and take over from the kinetic component of movement. In the upper limbs, the dystonic posture follows patterns analogous to those used by monkeys for postural purposes. Thus, while the initial mechanisms of movement represent highly sophisticated processes thoroughly adapted to living in an upright state, the reactions that go with the movement are more primitive and probably have a less helpful role.

Animals↗
PubMed1987

Effects of stimulation of vestibular and neck receptors on Deiters neurons projecting to the lumbosacral cord.

The activity of lateral vestibular nucleus (LVN) neurons, antidromically identified by stimulation of the spinal cord at T12 and L1, thus projecting to the lumbosacral segments of the spinal cord (IVS neurons), was recorded in precollicular decerebrate cats during rotation about the longitudinal axis either of the whole animal (labyrinth input) or of the body only while the head was kept stationary (neck input). Among the IVS neurons tested for vestibular stimulation, 76 of 129 units (i.e. 58.9%) responded to roll tilt of the animal at the standard parameters of 0.026 Hz, +/- 10 degrees. The gain and the sensitivity of the first harmonic responses corresponded on the average to 0.47 +/- 0.44, SD, impulses X s-1 X deg-1 and 3.24 +/- 3.15, SD, %/deg, respectively. As to the response patterns, 51 of 76 units (i.e. 67.1%) were excited during side-down and depressed during side-up tilt, whereas 15 (i.e. 19.7%) showed the opposite behavior. In both instances the peak of the responses occurred with an average phase lead of about +21.0 +/- 27.2, SD, deg with respect to the extreme side-down or side-up position of the animal. Moreover, the former group of units showed almost a twofold larger gain with respect to the latter group (t-test, p less than 0.05). Among the IVS neurons tested for neck stimulation, 75 of 109 units (68.8%) responded to neck rotation at the standard parameters. The gain and the sensitivity of the first harmonic responses corresponded on the average to 0.49 +/- 0.40, SD, impulses X s-1 X deg-1 and 3.30 +/- 3.42, SD, %/deg, respectively, thus being similar to the values obtained for the labyrinth responses. However, 59 of 75 units (i.e. 78.6%) were excited during side-up neck rotation and depressed during side-down neck rotation, while 8 of 75 units (i.e. 10.7%) showed the opposite pattern. In both instances the peak of the responses occurred with an average phase lead of +52.0 +/- 18.3, SD, deg for the extreme side-up or side-down neck displacements. Further, the former group of units showed a larger gain than the latter group. Histological controls indicated that 102 of 129 (i.e. 79.0%) IVS neurons tested for labyrinth stimulation and 86 of 109 (i.e. 78.9%) IVS neurons tested for neck stimulation were located in the dorsocaudal part of LVN, the remaining IVS neurons being located in the rostroventral part of LVN.(ABSTRACT TRUNCATED AT 400 WORDS)

Action Potentials↗