Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0026838 (spasticity)
 6,471 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In two groups of patients posterior tibial nerve (PTN) and sural nerve (SN) somatosensory evoked potentials (SEPs) were compared to each other and related to classified neurological signs. Group A consisted of 7 patients with hereditary spastic paraparesis (HSP) and 8 with primary lateral sclerosis (PLS), with solely or primarily motor deficits. Group B consisted of 12 patients with different spinal cord diseases causing variable mixed sensory and motor impairments. Normal values were derived from 39 controls. A clear trend towards more frequently prolonged PTN SEP than SN SEP latencies was found in both groups and appears to make PTN SEPs more useful for clinical application than SN SEPs. No significant differences were found in SEP abnormalities when the two patient groups were compared to each other. No relationships were found between SEP abnormalities and spasticity, weakness or any single sensory modality, making the two SEPs questionable as a quantitative test for neurological deficits in our patients.
Electroencephalogr Clin Neurophysiol 1993 Dec
PMID:Posterior tibial and sural nerve somatosensory evoked potentials: a study in spastic paraparesis and spinal cord lesions. 750 31

Over recent years botulinum toxin type A has emerged as a safe and effective treatment for a number of previously refractory conditions associated with excessive muscle activity. The list of indications is expanding, but at present it is generally considered to be the treatment of choice for focal dystonias such as blepharospasm, torticollis, laryngeal dystonia, and oromandibular dystonia, as well as hemifacial spasm, strabismus, and some forms of limb spasticity. Carefully targeted intramuscular injections of a small amount of the toxin block the release of acetylcholine at the neuromuscular junction, producing a chemical denervation, with the aim of reducing excessive muscle activity without producing significant functional weakness. In some situations electrophysiological assessment and localisation of the muscles for injection is necessary. Treatment is symptomatic, with effects lasting 3 to 4 months and most patients requiring up to 4 injections per year to maintain the beneficial effect. Appropriate use of the toxin requires both an understanding of the physiological action of the potential muscles involved in each situation, together with a knowledge of the likely dose necessary to reduce muscle activity to the required level. Botulinum toxin represents a major advance in the management of these conditions, many of which responded poorly to previously available forms of therapy.
Drugs 1994 Dec
PMID:Botulinum toxin in clinical practice. 753 96

X-linked adrenomyeloneuropathy (AMN) is a phenotypic variant of adrenoleukodystrophy (ADL) presenting in early adult life with progressive ataxia and spasticity, and on occasion with adrenal insufficiency. We describe a 26-year-old Chinese man with a 2-year history of gait difficulty due to spasticity, absent pattern shift visual evoked (VER) responses and posterior white matter lesions on T2 weighted brain magnetic resonance images. His parents are clinically normal and his 24-year-old brother has hyperreflexia in the legs but normal VER latencies. The patient's ACTH levels were elevated and the serum cortisol did not rise with either Synacthen or corticotropin releasing hormone. Assay of his plasma confirmed elevation of very long chain fatty acids (VLCFA) consistent with a defect in peroxisomal VLCFA metabolism. This is the first local report of a patient with AMN.
Singapore Med J 1994 Dec
PMID:An index case of adrenomyeloneuropathy in a Chinese man. 776 96

Soleus H-reflex facilitation evoked by a supramaximal conditioning stimulation to the femoral nerve was investigated in 28 healthy control subjects and 35 spastic patients of whom 17 were paraplegics with bilateral spinal cord lesion and 18 were hemiplegics with unilateral cerebral lesion. Heteronymous facilitation from quadriceps to soleus was measured 0.4 ms after onset, while the monosynaptic Ia excitation is still uncontaminated by any non-monosynaptic effect and can be used to assess ongoing presynaptic inhibition on Ia terminals to soleus motor neurons. In paralegics, this heteronymous Ia facilitation was significantly larger than in control subjects (all individual results in these patients being above the mean observed in controls). This must reflect a decrease in presynaptic inhibition of Ia terminals in the paraplegics explored here. There was no correlation between this decreased presynaptic inhibition of Ia terminals and the degree of spasticity measured by Ashworth's scale. Surprisingly, the amount of heteronymous Ia facilitation in hemiplegics was the same as in normal subjects. This indicates that presynaptic inhibition of Ia terminals is unchanged in these patients and disagrees with the usual interpretation of reduced vibratory inhibition of the soleus H-reflex in hemiplegics. It is argued that this disagreement is due to the fact that vibratory inhibition of the reflex also depends on post-activation depression following repetitive synaptic transmission.
Brain 1994 Dec
PMID:A quantitative assessment of presynaptic inhibition of Ia afferents in spastics. Differences in hemiplegics and paraplegics. 782 May 79

The spinal stretch reflex (SSR), or tendon jerk, is the simplest behavior of the vertebrate nervous system. It is mediated primarily by a wholly spinal, two-neuron pathway. Recent studies from several laboratories have shown that primates, human and nonhuman, can gradually increase or decrease the size of the SSR when reward depends on such change. Evidence of this training remains in the spinal cord after all supraspinal influence is removed. Thus, the learning of this simple motor skill changes the spinal cord itself. Comparable spinal plasticity probably plays a role in the acquisition of many complex motor skills. Intracellular physiological and anatomical studies are seeking the location and nature of this spinal cord plasticity. Attention focuses on the most probable sites of change, the group Ia afferent synapse on the alpha motoneuron and the motoneuron itself. Results to date indicate that modifications are present at several places in the spinal cord. Current clinical studies are investigating the use of spinal cord adaptive plasticity as a basis for a new therapeutic approach to spasticity and other forms of abnormal spinal reflex function that result from spinal cord injury, stroke, or other neurological disorders. In the future, understanding of spinal reflex plasticity may lead to development of improved training methods for a variety of motor skills.
Med Sci Sports Exerc 1994 Dec
PMID:Acquisition and maintenance of the simplest motor skill: investigation of CNS mechanisms. 786 82

An acute animal model (dorsal hemisection of the spinal cord in the decerebrate cat preparation) has been developed that closely mimics the spasticity in humans that occurs subsequent to partial spinal cord injury and hemiparetic stroke. In this animal model, there are severe disruptions in the pattern of recruitment and rate modulation of motoneurons. The cellular mechanisms of these deficits are being studied with a combined experimental/computer simulation approach. The initial studies indicate that changes in the intrinsic properties of motoneurons are not important, which means the mechanism for changes in recruitment and rate patterns must reside in an alteration in the organization of the synaptic input to motoneurons. Computer simulation studies of the effects of different synaptic inputs on motoneuron outputs show that inhibitory inputs can, under certain conditions, generate substantial disruptions in recruitment and rate modulation. Recent data indicate that the monoamines noradrenalin and serotonin, which are released by fiber tracts originating in the brainstem, may play an important role in maintaining normal levels of inhibition in spinal circuits. Pharmacological interventions based on the monoamines may provide effective means of reducing the deficits in recruitment and rate modulation.
Med Sci Sports Exerc 1994 Dec
PMID:Alterations in synaptic input to motoneurons during partial spinal cord injury. 786 83

The administration of baclofen, a GABAb agonist, by direct infusion into the CSF by means of a programmable device, may avoid the undesired side effects of the oral administration of both the same and other antispastic drugs while giving a marked reduction of spasticity. The preliminary results on 12 patients show the total efficacy of this procedure in reducing spasticity markedly.
J Neurosurg Sci 1993 Dec
PMID:The treatment of spasticity by intrathecal administration of baclofen: a preliminary personal experience. 793 43

The increasing interest in selective posterior rhizotomy for reduction of spasticity in children with cerebral palsy and other neurological disorders comes from the selectivity that this procedure has achieved with intraoperative electromyographic monitoring. Thirty patients were operated on between April 1989 and October 1991. Spasticity was of cerebral origin in 27 cases and secondary to spinal cord lesion in 3 others. A reduction in the abnormally high muscle tone was observed in all cases, mainly in the lower extremities, but also, to a lesser degree, in the upper extremities. All patients showed functional improvements that depended on the individual preoperative condition. Even severely disabled patients with quadriplegia and intellectual impairment, whose spasticity interfered with their daily care, had a significantly improved quality of life after rhizotomy. These patients became much looser, with better swallowing and less drooling, and were much more easily managed by their caretakers. Preliminary results with follow-up from 1 to 30 months indicates that selective posterior rhizotomy is a safe procedure which contributes to significant functional improvement in spastic patients.
Childs Nerv Syst 1993 Dec
PMID:Selective posterior rhizotomy: experience of 30 cases. 812 76

Fitts' Law was applied to the evaluation of discrete aimed arm movements in one dimension performed by 6 adults with cerebral palsy and 6 adults with normal movement. Targets (1.27, 3.81, 6.35, 8.89 cm in width) placed at distances of 20.32, 30.48, 40.64, and 50.80 cm provided Indices of Difficulty of 2.19 to 6.32 bits. A video game was used for the signal to move. The t tests for corrected means showed that the cerebral palsied group had greater reaction and movement times than than the normal group. Linear regression analyses for pooled data and for the individual cerebral palsied subjects showed (a) no relationship between reaction time and Index of Difficulty for either group and (b) a negative, linear relationship between reaction time and Index of Difficulty for 1 cerebral palsied subject. Movement time was linearly and positively related to the Index of Difficulty for the normal group but not for the cerebral palsied group. Two cerebral palsied subjects had movement times which conformed to Fitts' Law. While the exceptions to Fitts' Law may be due to the limited range of movement and spasticity caused by severe cerebral palsy, there are indications that two of the cerebral palsied subjects were performing ballistic rather than visually guided aimed movements. Fitts' Law may still apply when the distances and target positions are individualized to conform to subjects' specific limitations and when the signal to move is auditory rather than visual.
Percept Mot Skills 1993 Dec
PMID:A study of the application of Fitts' law to selected cerebral palsied adults. 817 Jul 56

To study gene loci and disease phenotypes, 18 families with dominant OPCA were subjected for linkage analysis to SCA1- or SCA2-linked microsatellites. Total individuals consisted of 190. Among them, 77 were affected. Consequently, 10 families were 6p-linked, 7 were 12q-linked, and one was type-undetermined. These results indicate that the majority of dominant OPCA in Japan are composed with these two genotypes. Clinically, these two disorders show progressive ataxia, Babinski reflexes, and terminal amyotrophy. Other common features in SCA1 were hyperreflexia, spasticity, mild nystagmus at early stage, slow saccade, and external ophthalmoparesis (EOP) at advanced stage. In contrast SCA2 showed progressive hyporeflexia and slow saccade from early stage. Moreover, choreiform movement, tremor, and rhythmic myoclonus were more frequent in the latter. Neuropathologically, dentate nucleus, brainstem motor nuclei, spinocerebellar tract were involved more severely in SCA1 than SCA2. Degeneration of substantia nigra is more marked in SCA2 than SCA1. These observations strongly indicate that there are correlations between genotypes and phenotypes in dominant OPCAs. Conversely, it is possible to diagnose these two genetic disorders from the clinico-pathological findings.
Rinsho Shinkeigaku 1993 Dec
PMID:[Linkage study of hereditary spinocerebellar ataxia, and probable correlation for the loci to the disease phenotypes]. 817 26


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