Movement Disturbances Research Articles

Cineradiography in Closed and Open Pharyngeal Swallow

The pattern of swallowing by which the oral bolus reaches an air-containing oropharynx is called an 'open swallow' whereas the sequence in which the oropharynx is collapsed on the arrival of the bolus is called a 'closed swallow'. The significance of this distinction was further analyzed by a correlation with other laryngeal and pharyngeal functions during swallowing in a cineradiologic study in 75 dysphagic patients and 50 asymptomatic volunteers. The relative incidence of open and closed type swallows was similar in the two groups. The maximum elevation of the pharynx and larynx was the same in open and closed swallow, although in individuals with an open swallow the elevation occurred later than in individuals with a closed swallow. Epiglottic movement disturbances, defective closure of the laryngeal vestibule, pharyngeal constrictor muscle paresis, cricopharyngeal incoordination, cervical esophageal webs and Zenker diverticula were significantly more common in individuals with an open pharyngeal swallow than in those with closed swallowing.

Central dysregulations as a cause of movement disorders in performance sports? An analysis of movement in sports with reference to functional anatomic and neurophysiologic viewpoints

Typical orthopaedic findings and typical disturbances of movement in sports point to central dysregulation in motor disturbances in competitive sports compared with the ideal models set up under biomechanical aspects and from the viewpoint of sports practice. Neurophysiological data collected so far confirm this view. The central influence on movement is manifested by a change in peripheral proprioceptive properties, i.e. by a change in the pre-innervation of the musculature. If the musculature is subjected to high strain as in sports aiming at high performance levels, such changes produce an extremely high stretch tone in the phase of dynamic-eccentric muscular contraction resulting in functional reversal of two-joint muscles such as the M.rectus femoris and the M.gastrocnemius. This procedure is manifested in the region of system-immanent weak spots of the positional and locomotor system and, in the pelvic girdle region by tipping of the pelvis in ventral direction, with consecutive evasive shifts of the vertebral column and extremities.

構音失行の純粋例で認められた構音器官の非言語的運動の障害について

構音失行の純粋例３例, 麻痺性構音障害例４例, 健常者８名の構音器官の非言語的くり返し運動を比較した．どの症例にも口腔顔面失行はなかった． 単純な非言語的くり返し運動の検査は, 構音器官の一つの部分の動き, すなわち, (1) 舌を前後に動かす, (2) 舌を左右に動かす, (3) 舌を上下に動かす, (4) 舌打ち, (5) 口唇を左右に引く, (6) 口唇を破裂させる, (7) 噛む, であった．複雑な非言語的くり返し運動の検査は, 構音器官一つ一つの部位の動きを組み合わせたもの, すなわち, (8) 口唇を破裂させてから舌打ち, (9) 口唇を破裂させてから噛む, (10) 舌打ちしてから噛む, であった．以上を５秒間で何回できるか検査した． 単純なくり返し運動の検査では３群間に差はなかった．複雑なくり返し運動の検査では構音失行例は統計的に有意に速度が遅かった． 構音失行例では構音器官の離れた部位の間 (例, 口唇と舌) の動きのタイミングを合わせる機能が障害されており, この非言語的段階の障害が非流暢な構音の一因になっているのではないかと考えられた．

上顎骨全摘出術例における翼突部への到達法と眼か底即時再建について

Total maxillectomy was performed with Fukuda's method which combined Worthington's surgical approach to the pterygoid region with Nasteff's immediate reconstruction of the orbital floor for recurrent advanced carcinoma of hard palate.The advantages of the present method include ready and safe access to the pterygoid region and adequate exposure for the separation of the maxilla from the pterygoid plates. In addition, postoperative face deformity is not so severe and the disturbance of eye movements is not seen owing to the immediate reconstruction of the orbital floor and the preservation of the zygomatic arch.

Gait analysis in labyrinthine disorders

The peculiarities of gait disturbances of patients with labyrinthine disturbances were examined by a 3-step gait test. (1) Information on the characteristics of the gait disturbance was obtained in each examinee. (2) While walking 10 m with the eyes open and closed, the stability of the body, coordination of the head, trunk and extremities, step length, step width, and time required for walking 10 m were recorded. (3) Head movements in the vertical, rightleft and forward-backward directions were recorded by a pen oscillograph on a polygraph and also on a PDP-11 computer disc. The power spectrum and autocorrelation were calculated from the recordings.1. Patients with unilateral labyrinthine disturbances complained of staggering toward the affected side when walking with eyes closed. In the 10m walking, step length was short, gait was slow and step width was broader than in normal subjects. During walking, the vertical head movement was less and the right-left sway more than in normal subjects.2. Patients with bilateral loss of labyrinthine excitability complained of inability to control their legs and staggering. During the 10 m walk, shortness of step, tardiness of gait, and broadness of step width were marked. The right-left sway of the head during walking increased and the vertical movement decreased, and an irregular forward-backward sway of the head appeared, indicating a disturbance of linear progressive movement.

Changes in strategy of aiming tasks in Parkinson's disease.

Fundamental differences in bradykinesia in parkinsonian patients and nonparkinsonian elderly subjects were analysed. Our method was an aiming task in which the coordination of eye and hand movements was measured when the subject attempted to catch up with a visual target. The coordinated eye and hand movements started towards the target almost simultaneously in the normal subjects when the target was in the periphery of the visual area. The initial abnormality in parkinsonian patients was an isolated delay of coordinated hand movement. In the typical bradykinetic patients, the hand movement did not start while the target was still in the peripheral visual area but only when the image of the target was near or on the fovea. The aiming tasks were then performed step by step following visual confirmation. Thus patients with typical bradykinesia showed a failure of ballistic hand movement preprogrammed to the visual target in the peripheral visual area, and the strategy of coordination was changed. In contrast, the disturbance of the ballistic hand movement in the nonparkinsonian elderly subjects had no consistent strategy for coordination of the visually guided eye and hand movements.

A study on the causative mechanism of occlusal interference on the balancing side

Recently there are many patients who complain of pain in the TMJs and inthe head and neck muscles as well as of jaw movement disturbances. Some of these patients exhibit the occlusal interferences in the molar region on the balancing side of the dentitions. The causative mechanism of the occurrence of the occlusal interferences on the balancing side were surveyed in the 26 cases of TMJ patients with the occlusal interferences on the balancing sideof the dentitions, who were treated effectively by the occlusal adjustment.The occlusal interferences on the balancing side have been shown only in the molarregion, particularly in the farthest rearward teeth in the dentitions.The occlusal interferences on the balancing side were caused by the following factors:1. The defect of continuity and the difference in level on the occlusal plane caused by the tooth malalignment.2. The steepness of the curve of the occlusion.3. The tooth malalignment was caused by the missing, the extrusion, and the tilting of the adjacent teeth, and by the malalignment of canines and premolars.

Plant communities, landforms, and soils of a geomorphically active drainage basin, Southern Alps, New Zealand

Abstract The plant commumtles in a mountainous drainage basin in the Southern Alps, Westland, New Zealand, were classified from 92 vegetation descriptions. Nine forest and shrubland communities were defined from the presence/absence of 264 species and from differences in canopy cover. Their composition and distribution, inferred from ordination and descriptions of landforms and soils, were determined primarily by the influences of mass movement disturbance and elevation. Erosional and depositional landform units of varying age and surface stability contained soils of different stages of development. Seral communities occupied well-drained and often frequently disturbed recent soils. Mature forest/shrubland dominated stable landforms characterised by yellow-brown earths or gley podzol soils. Although specific relationships of individual species with factors such as soil nutrient status are consistent with other studies in Westland, landform age and surface stability, soil depth, soil drainage, and other physical disturbances, such as treefalls, appear to be equally critical determinants.

The contribution of afferent information on position and velocity to the control of slow and fast human forearm movements

We applied vibration at various rates to the biceps tendon of a passive, restrained arm in normal human subjects and measured its effect on the perception of forearm position and the perception of forearm velocity. The disturbances of limb position perception and limb velocity perception depended on the vibration rate in distinctly different ways. We thereupon applied vibration at various rates to the biceps tendon during the performances of non-visually-guided slow and fast forearm movements. The vibration-rate-dependence of the disturbance of slow movements matched the vibration-rate-dependence of the disturbance of limb position perception. The vibration-rate-dependence of the disturbance of fast limb movements matched the vibration-rate-dependence of the disturbance of limb velocity perception. It is concluded that afferent position information is dominant in the control of slow movements, whereas mainly afferent velocity information is used in the control of fast movements.

Eye-movement disorders in brain-stem and cerebellar stroke.

Vertebrobasilar strokes can yield varied disturbances of eye movements, by affecting specific centers and pathways contained in the brain stem and cerebellum. Unique disorders combining supranuclear, nuclear, and infranuclear syndromes may occur. Some eye-movement abnormalities are useful localizing signs (eg, gaze palsies, rotatory nystagmus, and ipsilateral saccadic bias), but many others are not. The use of techniques such as magnetic resonance imaging may provide new insights in clinicotopographic correlations in patients with good recovery, in the absence of pathologic verification.

Disturbance of sequential movements in patients with Parkinson's disease.

The following sequences of two single movements were examined in 10 patients with Parkinson's disease and compared with the performance of 9 normal subjects of similar age. Isometric opposition of thumb and fingers to a force of 30 N ('squeeze'), followed by isotonic elbow flexion ('flex') through 15 degrees with the same arm. 'Squeeze' with the left hand followed by 'flex' with the right elbow. Isotonic opposition of thumb and fingers ('cut') through 90 degrees followed by isotonic 'flex' with the same arm. Isotonic elbow 'flex' followed by isometric 'squeeze' with the same arm. All movements were self-paced. Subjects were given instructions to move as rapidly as possible and to start the second movement immediately after the end of the first. Patients were slower than normal when each single movement was performed separately. There was a further decrease in speed when two movements were executed sequentially. This was due to an increase in movement duration of each of the component movements, especially the second, and to an increase in the pause between the first and second movements. In both normals and patients, there was no correlation between the times taken to perform the first and second movements of any of the four sequences that were studied. Because of this we suggest that the two components of the sequence remained under the control of two separate motor programs. When performing the sequential tasks, normal subjects automatically chose an interval between the onsets of the two separate movements of about 230 ms, even in tasks in which the duration of the first movement was less than 200 ms. If normal subjects were instructed to begin the second movement with an interonset interval of less than 200 ms, the speed of the second movement was much slower. Patients with Parkinson's disease automatically chose a much longer interonset interval of 400-500 ms. In addition, they exhibited difficulty in switching from the first to the second movement in the sequence. We suggest that the problems exhibited by patients with Parkinson's disease when they try to perform two rapid sequential movements can be seen as a deficit in the capacity to switch from one motor program to another within an overall motor plan.

痴呆と眼球運動

Eye movements were studied in 18 cases of cerebral lesions with dementia. Spontaneous nystagmus and gaze nystagmus were observed, and recorded by electronystagmography (ENG). Pursuit, optokinetic nystagmus, caloric nystagmus and visual suppression were examined. Disturbances of eye movements were seen in all cases of dementia.1. Alzheimer type dementiaThere was no gaze or spontaneous nystagmus. Very mild vertical postitioning nystagmus was seen, as well as saccadic and ataxic pursuit. Optokinetic nystagmus and visual suppression were normal.2. Multiple infarct dementiaDisturbance of eye movements increased with the severing of the mental disorders. Pursuit eye movements, optokinetic nystagmus and visual suppression were greatly impaired in cases with lower parietal lobe lesions. There were no voluntary eye movements in the most severe cases. Eye movement disturbance was related to lower parietal lobe leisons.

Sleep and depression.

Manifestations of sleep disturbances can potentially serve as external criteria for the diagnosis of specific subtypes of major depressive disorder (MDD). Depressed patients generally experience disturbances of sleep continuity and rapid eye movement (REM) sleep. Disturbances in nonrapid eye movement (NREM) sleep (stages III and IV) also occur. Characteristic of primary sleep disturbance in many depressed patients are shortened REM latency periods and instabilities in NREM sleep identified by increases in the number of stage shifts, decreases in the duration of stage III and IV sleep, and a shift towards lighter sleep stages (sleep efficiency disturbances). Treatment modalities for these sleep disturbances include sleep deprivation therapy and antidepressant therapy. Sleep deprivation alone has been only moderately successful, while antidepressant therapy usually results in symptomatic improvement. To restore normative sleep, REM sleep periods and stage III and IV sleep must be returned to normal. Trazodone therapy has been shown to reduce the frequency of arousals, the severity of drowsiness, and the duration of REM sleep, and increase restorative slow wave sleep and stage III and IV NREM sleep.

下顎骨骨折患者の治療前後における下顎頭の位置関係 Ｓｃｈｕｅｌｌｅｒ氏変法撮影による検討

In cases of mandibular fracture, there are many variations in the condylar position in glenoid fossa. However, most show practically no functional disturbances in jaw movements. So the authors studied the relation between the radiological condylar position and clinical features.The objects were 87 patients seen at the Department of Oral Surgery, Kyushu University Dental Hospital, between 1978 and 1983, and had taken in pre-. and post-treatment temporomandibular joint radiographs by modified Schaller's projection.The results were as follows:The condylar position in pre-. and post-treatment showed many variations, but we couldn't find a characteristic change in the condylar position at mouth close after treatment. The relation between functional disturbances and the condylar position were still not clarified. In our estimation after treatment, the jaw function seemed to be good in most cases because the condyles were situated at the anterior to the articular tubercle in the opening position. These results showed that the functional adaptation of the TMJ came about post operatively.

Electrooculographic findings in progressive supranuclear palsy

Progressive supranuclear palsy is a heterogeneous system degeneration. We studied three patients by means of electrooculography. There were severe disturbances in saccadic and smooth pursuit eye movements, and optokinetic nystagmus in both vertical and horizontal planes. Caloric reactions were absent in all patients. The absence of vestibular reflex responses in contrast to the normal results in doll's head manoeuvre seems contradictory and is discussed. From the results in our patients it is concluded that E.O.G. is an essential contribution in proving a multiple system pathology.

周期性方向交代性眼振の一症例 その臨床所見と薬物の効果

We analyzed periodic alternating nystagmus (PAN) in a 47-year-old male with spinocerebellar degeneration of three years duration. The neurological examination revealed normal mental status and higher cerebral functions, spontaneous and gaze nystagmus, neck tremor, scanning speech, ataxic gait, mild weakness of the proximal lower extremities, hypotonia, dysmetria and decomposition of limb movements, generalized hyperactive deep tendon reflexes and Babinski's sign.Neuroophthalmological examination showed gaze nystagmus on both lateral and downward gaze, hypermetria of saccadic eye movements, disturbance of pursuit eye movements, poor optokinetic response and normal caloric response with absent visual suppression.The effects of fixation, eye position and drugs on the period of oscillation and maximum slow phase velocity of nystagmus were evaluated. Eye movements were recorded by an oculotracker and DC-EOG. The slow phase velocity of PAN was calculated by a computer.The period of oscillation and maximum slow phase velocity of nystagmus did not differ in forward gaze with and without visual fixation. Maximum velocity of nystagmus tended to increase as the eyes deviate laterally. However, on upward gaze, nystagmus was suppressed. Eye position did not affect the period of oscillation of PAN. Baclofen 30 mg/day did not stop PAN, but tended to decrease the maximum velocity of PAN without changing the period of oscillation. Chlordiazepoxide 30 mg/day or baclofen 15 mg/day had no effect on PAN.We concluded that the PAN of this patient was probably related to lesions of the brain stem and cerebellum with sparing of the vestibuloocular reflex pathway and that PAN was influenced by eye position. The hypothetical model of PAN proposed by Leigh et al. resembled the findings in this case.

MPTP primate model of Parkinson's disease: a mechanographic and electromyographic study

Movement parameters and electromyographic (EMG) studies were carried out in two macaque monkeys performing a rapid arm movement before and after administration of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Hypokinesia and rigidity were seen after repeated doses. Disturbances in both movements and EMG activity were similar to those reported in Parkinsonian patients.

Defects in embryogenesis in mutants associated with the antennapedia gene complex of Drosophila melanogaster

Embryogenesis in individuals with mutations or deficiencies of the genes in the polytene interval 84A–84B1,2 of Drosophila melanogaster was examined using scanning electron microscopy (SEM). The developmental function of this region of chromosome 3 is of particular interest since it contains the Antennapedia Gene Complex (ANT-C), a gene cluster that includes the homoeotic proboscipedia ( pb), Sex combs reduced ( Scr), and Antennapedia ( Antp) loci. The results of SEM studies, clonal analyses, and temperature-shift experiments show that the fushi tarazu ( ftz) and zerknullt ( zen) genes, which map between pb and Scr, are involved in processes initiated during embryogenesis. The activity of ftz + appears to be required within the first 4 hr of development for the establishment of the proper number of segments in the embryonic germ band. Individuals with ftz mutations or deficiencies produce only half the normal number of segments. Each of the segments is twice the normal width and is apparently comprised of cells that would normally form two separate metameres. The zen allele is required from about 2–4 hr of embryogenesis. Mutations of this gene result in disturbances of morphogenetic movements during gastrulation. The mutant phenotype is characterized by the absence of the optic lobe, defects in involution of the head segments, and in some cases, failure of germ band elongation. A requirement during embryogenesis for the activities of other genes residing in the 84A–84B1,2 polytene interval is suggested by the phenotypes of individuals heterozygous or homozygous for chromosomal deficiencies. Using the deficiencies Df(3R)Antp Ns+R17, Df(3R)Scr , and Df(3R)Scx W+RX2 , we examined the effects of deleting the distal portions or all of the 84A–84B1,2 interval. The defects in deletion heterozygotes suggest that the wild-type activity of some gene(s) other than zen, within or just adjacent to the 84B1,2 doublet, is required to complete normal head involution. The deletion of all the loci in the 84A5–84B1,2 interval results in grossly abnormal morphology and morphogenesis of the gnathocephalic appendages of the embryo. From these studies we conclude that mutations and deficiencies of genes associated with the ANT-C have profound effects on embryogenesis. The mutant phenotypes suggest, in addition to ensuring proper segment identity, the wild-type alleles of the 84A–84B1,2 genes are necessary for normal segmentation and elongation of the germ band and normal head involution.

Sensory-motor processing in substantia nigra pars reticulata in conscious cats.

Extracellular recordings were made with chronically implanted micro-electrodes from 109 substantia nigra neurones in conscious cats. Ninety-six of 109 neurones met the criteria of presumed non-dopaminergic pars reticulata (s.n.r.) neurones. Background discharge, in animals in a state of relaxed wakefulness and in the absence of overt movements, was in the range of 11-37 impulses/s, mean 19.2 impulses/s. The discharges of fifty-two of ninety-six neurones tested were modified by innocuous mechanical skin stimulation. Neurones responded chiefly to stimuli delivered to the contralateral body side. Responses generally comprised net excitation and occurred with short latency (range 10-34 ms; mean 17.3 ms). Convergence from both forelimbs or the contralateral fore- and hind limbs was evident in a few cases. One-fourth (twenty-four out of ninety-six) of the s.n.r. neurones tested were sensitive to passive manipulation of limb joints in the quiet, conscious cat and responded exclusively to angular displacement of one contralateral joint. Responses were directional and phasic. None of the s.n.r. neurones tested responded to clicks and/or light flashes. However, stimuli moving across the contralateral visual field substantially modified the discharge rate of ten out of ninety-six s.n.r. neurones. Responses were directional and invariably associated with eye movements. Animals were also trained to walk on a treadmill and to perform certain self-generated limb movements. S.n.r. neurones with a receptive field on a limb regularly showed modulations in discharge during locomotion, phase-related to the step cycle, and also short-latency responses during disturbance of such movements. Ten out of ninety-six s.n.r. neurones discharged almost exclusively prior to and during self-generated movements of a single limb. Their most powerful modulations in firing rate occurred, whenever an animal tried to overcome an external impediment or to resist an imposed movement. These observations on s.n.r. neurones, taken together with previous findings on nigral influences on spinal motor circuitry, indicate that the s.n.r. represents an output station of the basal ganglia which is involved in the subconscious processing of convergent multimodal sensory information and which participates in setting appropriate gains and biasses of spinal motor neuronal systems to adequately deal with changing motor requirements.

Analysis of the directed and nondirected movement of human granulocytes: influence of temperature and ECHO 9 virus on N-formylmethionylleucylphenylalanine-induced chemokinesis and chemotaxis.

The directed movement of human polymorphonuclear leukocytes (PMN) in a plane (Zigmond chamber assay) is described by a statistical model. We demonstrate that (a) the movement of a single cell is a superposition of a directed and a random movement, and (b) the degree of orientation, P1, of moving cells in a chemotactic gradient can be determined either by the time average of a single cell or by the average of movement of multiple cells at a fixed time (Ergoden hypothesis). However, an homogeneous cell population is a necessary condition. P1, which is identical with the McCutcheon index, is derived from the measured angular distribution function of moving cells. The statistical model allows one to distinguish between chemotaxis and chemokinesis. Applying this model to the temperature-dependent changes of cell movement, we found that P1 = 0.82 (37 degrees C) decreased to P1 = 0.4 (22 degrees C). The average speed of moving cells exhibits a very strong temperature-dependent variation from 30 microns/min (37 degrees C) to 5 microns/min (22 degrees C), indicating a different temperature dependence of chemotaxis and chemokinesis. At a fixed temperature (37 degrees C) the stability of the chemotactic gradient can also be checked by the angular distribution function. In addition, this model was applied to investigate the enteric cytopathogenic human orphan, strain 9 (ECHO 9) virus-induced disturbances of cell movement. We found: (a) The average speed of cell movement is not affected by the virus. (b) The degree of orientation is not affected for virus doses below a critical virus dose, ao (virus/PMN = 0.8:1). (c) The degree of orientation above this critical value exhibits a time- and virus-dose-dependence. (d) At a fixed viral dose, the time-dependent decrease of P1 is described by an exponential law (virus/PMN = 5:1, the characteristic time is 110 min). (e) This characteristic time investigated as a function of viral dose results in a logarithmic law analogous with the Weber-Fechner law. These findings indicate that only chemotactic and not chemokinetic response is disturbed by ECHO 9 virus.