Neuromotor Disorders Research Articles

Induced Discomfort Promotes Executive Function While Walking With(out) an Artificial Neuromuscular Impairment.

Neuromotor disorders can degrade one's ability to locomote and attend to salient stimuli in the environment. Many disorders are physiologically complex, making it difficult to tease apart interactions between motor adaptation and executive function processes. We address this challenge by giving participants a controlled artificial impairment, using electrical stimulation to produce an uncomfortable disruption in normal muscular coordination during locomotion. While adapting to this gait perturbation, participants performed an executive function task containing neutral and affectively charged stimuli. The artificial impairment was counterbalanced against control and sham (discomfort-only stimulation) walking conditions. Our twofold hypothesis that discomfort would selectively tax hot, emotionally-charged executive function and motor adaptation would challenge cold, logical executive function was not supported. However, we found that the discomfort experienced with both stimulation conditions improved participants' ability to inhibit distracting information, enhancing this aspect of executive function, and the effect did not depend on whether the task was affectively charged. Moderate discomfort during physical activity may have improved inhibitory control by increasing arousal, a known factor mediating executive function. These results show that using a sensorimotor perturbation that acts internally and bridges multiple physiological domains, including discomfort, can reveal effects not seen with purely environmental manipulations. The broader implications are that when high cognitive performance is needed during physical activity, it may be beneficial to, quite literally, operate outside one's comfort zone.

Integrating Heart Rate Monitoring Into a Camp for Children With Neuromotor Disorders: A Case Series.

This case series investigated the implementation fidelity, feasibility, and effectiveness of integrating continuous heart rate monitoring with visual feedback into an established, intensive physical therapy camp for children with neuromotor disorders. The provision of continuous visual feedback through color-coded, individually calculated heart rate zones was a feasible and effective intervention, encouraging pediatric gait camp participants to exercise at intensities that produced aerobic and functional gains. The use of technology facilitated participation with peers, an outcome equally as important as their endurance and functional improvements. Pediatric physical therapists play a crucial role in enhancing the well-being and physical fitness of children with disabilities. Encouraging regular exercise in a social environment fosters enjoyable, inclusive experiences while promoting overall health. It is important for clinicians in various pediatric rehabilitation settings to establish programs that offer such opportunities for children with neuromotor disorders.

Automated detection of abnormal general movements from pressure and positional information in hospitalized infants.

Prechtl's general movements assessment (GMA) allows visual recognition of movement patterns that, when abnormal (cramped synchronized, or CS), have very high sensitivity in predicting later neuromotor disorders; however, training requirements and subjective perceptions from some clinicians may hinder universal adoption of the GMA in the newborn period. To address this, we used a three-phased approach to design a preliminary and clinically-oriented approach to automated CS GMA detection. 335 hospitalized infants were dually recorded on video and a pressure-sensor mat that collected time, spatial, and pressure data. Video recordings were scored by advanced GMA readers. We then conducted a series of unsupervised machine learning and supervised classification modeling with features extracted from clinician- and mat-driven datasets. Finally, the resulting algorithm was converted to a software interface. A classification model combining normalization, clustering, and decision tree modeling resulted in the highest sensitivity for CS movements (100%). Results were delivered via the software interface within 20 min of data recording. The combination of clinical research, machine learning, and repurposing of existing sensor mat technology produced a feasible preliminary approach to automatically detect abnormal GMA in infants while still in the NICU. Further refinements of software and algorithms are needed. Machine learning can differentiate cramped synchronized general movement patterns in the neonatal intensive care unit with good sensitivity and specificity. Increasing access to the GMA through automated detection methods may allow for earlier identification of a greater number of children at high risk for movement delay. Large studies leveraging new artificial intelligence approaches could increase the impact of such detection.

Our experience in the podological analysis of children with motor disorders (20 cases)

Introduction and Importance: Pediatric patients with neuromotor disorders frequently experience various podiatric conditions. The effectiveness and implications of treatments like orthotics and insoles in this demographic are not thoroughly understood, highlighting a significant gap in podiatric research and clinical practice.Case Presentation: This observational study analyzed 20 pediatric patients with neuromotor disorders. The focus was on common foot conditions such as ingrown toenails and hyperhidrosis, and their association with treatments like orthotics, insoles, and surgical interventions like Achilles tendon lengthening.Clinical Discussion: Statistical analysis using chi-square tests revealed significant associations. Notably, orthotic use was linked to a higher incidence of ingrown toenails (χ² = 5.69, p = 0.017). In contrast, insole usage correlated with increased hyperhidrosis (χ² = 4.44, p = 0.035). Additionally, a significant tendency for orthotic use was observed in patients who underwent Achilles tendon lengthening (χ² = 8.15, p = 0.017). The study also highlighted the prevalence of brittle nails and hyperkeratosis among the participants.Conclusion: The findings emphasize the critical role of podiatrists in the management of foot conditions in pediatric neuromotor disorder patients. While interventions like orthotics are generally beneficial, they may also exacerbate or contribute to other conditions, necessitating regular and careful podiatric monitoring. The study advocates for future research with larger sample sizes and controlled study designs to further validate and expand upon these observations.

Generalizability of foot placement control strategies during unperturbed and perturbed gait.

Control of foot placement is an essential strategy for maintaining balance during walking. During unperturbed, steady-state walking, foot placement can be accurately described as a linear function of the body's centre of mass (CoM) state at midstance. However, it is uncertain if this mapping from CoM state to foot placement generalizes to larger perturbations that could potentially cause falls. Recovery from these perturbations may require reactive control strategies not observed during unperturbed walking. Here, we used unpredictable changes in treadmill belt speed to assess the generalizability of foot placement mappings identified during unperturbed walking. We found that foot placement mappings generalized poorly from unperturbed to perturbed walking and differed for forward perturbation versus backward perturbation. We also used the singular value decomposition of the mapping matrix to reveal that people were more sensitive to backward versus forward perturbations. Together, these results indicate that a single linear mapping cannot describe the foot placement control during both forward and backward losses of balance induced by treadmill belt speed perturbations. Better characterization of human balance control strategies could improve our understanding of why different neuromotor disorders result in heightened fall risk and inform the design of controllers for balance-assisting devices.

CEREBRAL PALSY. RISK FACTORS, REHABILITATION FEATURES (LITERATURE REVIEW)

The review presents current data on cerebral palsy, a disease that is quite common and characterized by multifactorial etiology, has a complex pathogenesis mechanism based on neuromotor disorders, resulting in impaired motor function, muscle tone and posture. Motor disorders most often characteristic of this pathology are accompanied by impaired sensitivity, perception and the development of secondary problems – disorders of the musculoskeletal system. Given the relevance and ongoing scientific research in this area, rehabilitation measures to restore functional activity among patients using modern physical methods, physical therapy, kinesiotaping are of great interest. KEYWORDS: cerebral palsy, neuromotor disorders, childhood, kinesiotaping, rehabilitation, physical therapy, physical methods of exposure, muscle tone, spasticity, sensitivity.

Induced Pluripotent Stem Cells and Organoids in Advancing Neuropathology Research and Therapies.

This review delves into the groundbreaking impact of induced pluripotent stem cells (iPSCs) and three-dimensional organoid models in propelling forward neuropathology research. With a focus on neurodegenerative diseases, neuromotor disorders, and related conditions, iPSCs provide a platform for personalized disease modeling, holding significant potential for regenerative therapy and drug discovery. The adaptability of iPSCs, along with associated methodologies, enables the generation of various types of neural cell differentiations and their integration into three-dimensional organoid models, effectively replicating complex tissue structures in vitro. Key advancements in organoid and iPSC generation protocols, alongside the careful selection of donor cell types, are emphasized as critical steps in harnessing these technologies to mitigate tumorigenic risks and other hurdles. Encouragingly, iPSCs show promising outcomes in regenerative therapies, as evidenced by their successful application in animal models.

Indications and practice of home invasive mechanical ventilation in children.

Developments and technological advances in neonatal and pediatric intensive care units have led to a prolonged life expectancy of pediatric patients with chronic respiratory failure. Therefore, the number of hemodynamically stable pediatric patients with chronic respiratory failure who need mechanical ventilator assistance throughout the day has significantly increased. Numerous conditions, including parenchymal lung diseases, airway disorders, neuromotor disorders, or respiratory defects, can lead to chronic respiratory failure. For individuals who cannot tolerate non-invasive mechanical ventilation (NIMV), invasive mechanical ventilation (IMV) is the only suitable choice. Due to increasing need, mechanical ventilator technology is continuously evolving. As a result of this process, home-type mechanical ventilators have been produced for patients requiring long-term IMV. Patients with chronic respiratory failure can be safely monitored at home with these ventilators. Home follow-up of these patients has many benefits such as an increase in general quality of life and a positive contribution to their emotional and cognitive development. In this compilation, indications for home-based IMV, features of home invasive mechanical ventilators (HMVs), patient monitoring, and the detailed advantages of using IMV at home will be elucidated.

The psychometric properties and feasibility of the Alberta infant motor scale used in telehealth: A scoping review

BackgroundTelehealth can be a viable option for improving equitable access to early motor assessment for financially vulnerable individuals. AimThis review aimed to identify the psychometric properties of the Alberta Infant Motor Scale (AIMS) when applied via telehealth and assess its feasibility. MethodsPapers were systematically retrieved from electronic databases until October 4, 2023. We included studies that assessed the motor development of infants using the AIMS through telehealth. ResultsThirteen studies, encompassing 897 infants (449 male and 396 female), were included in this review. Among them, 805 were typical infants and 92 were at risk of motor delay. The age range of participants spanned from 4.9 weeks to 20 months. The studies found good concurrent validity between telehealth and in-person assessments (ICC > 0.98, SEM < 1.6, mean difference = 0.5) and good to excellent reliability (ICC > 0.80) using home videos recorded by parents or video calls with researchers. Telehealth was perceived as feasible by parents, who expressed high satisfaction, and the quality of images and assessments met commendable standards. ConclusionConsidering the limited number of studies that have assessed infants with neuromotor disorders, this scale has the potential for telehealth application in evaluating typical infants.

In vivo parcellation of the human spinal cord functional architecture

Abstract The spinal cord is a critical component of the central nervous system, transmitting and integrating signals between the brain and the periphery via topographically organized functional levels. Despite its central role in sensorimotor processes and several neuromotor disorders, mapping the functional organization of the spinal cord in vivo in humans has been a long-standing challenge. Here, we test the efficacy of two data-driven connectivity approaches to produce a reliable and temporally stable functional parcellation of the cervical spinal cord through resting-state networks in two different functional magnetic resonance imaging (fMRI) datasets. Our results demonstrate robust and replicable patterns across methods and datasets, effectively capturing the spinal functional levels. Furthermore, we present the first evidence of spinal resting-state networks organized in functional levels in individual participants, unveiling personalized maps of the spinal functional organization. These findings underscore the potential of non-invasive, data-driven approaches to reliably outline the spinal cord’s functional architecture. The implications are far-reaching, from spinal cord fMRI processing to personalized investigations of healthy and impaired spinal cord function.

Impaired communication at the neuromotor axis during Degenerative Cervical Myelopathy.

Degenerative Cervical Myelopathy (DCM) is a progressive neurological condition characterized by structural alterations in the cervical spine, resulting in compression of the spinal cord. While clinical manifestations of DCM are well-documented, numerous unanswered questions persist at the molecular and cellular levels. In this study, we sought to investigate the neuromotor axis during DCM. We use a clinically relevant mouse model, where after 3 months of DCM induction, the sensorimotor tests revealed a significant reduction in both locomotor activity and muscle strength compared to the control group. Immunohistochemical analyses showed alterations in the gross anatomy of the cervical spinal cord segment after DCM. These changes were concomitant with the loss of motoneurons and a decrease in the number of excitatory synaptic inputs within the spinal cord. Additionally, the DCM group exhibited a reduction in the endplate surface, which correlated with diminished presynaptic axon endings in the supraspinous muscles. Furthermore, the biceps brachii (BB) muscle exhibited signs of atrophy and impaired regenerative capacity, which inversely correlated with the transversal area of remnants of muscle fibers. Additionally, metabolic assessments in BB muscle indicated an increased proportion of oxidative skeletal muscle fibers. In line with the link between neuromotor disorders and gut alterations, DCM mice displayed smaller mucin granules in the mucosa layer without damage to the epithelial barrier in the colon. Notably, a shift in the abundance of microbiota phylum profiles reveals an elevated Firmicutes-to-Bacteroidetes ratio-a consistent hallmark of dysbiosis that correlates with alterations in gut microbiota-derived metabolites. Additionally, treatment with short-chain fatty acids stimulated the differentiation of the motoneuron-like NSC34 cell line. These findings shed light on the multifaceted nature of DCM, resembling a synaptopathy that disrupts cellular communication within the neuromotor axis while concurrently exerting influence on other systems. Notably, the colon emerges as a focal point, experiencing substantial perturbations in both mucosal barrier integrity and the delicate balance of intestinal microbiota.

Effects of Vojta Therapy on the Motor Function of Children with Neuromotor Disorders: Study Protocol for a Randomized Controlled Trial

Background: Infantile cerebral palsy is a neurological pathology that causes great morbidity, mortality, and disability in people who suffer from it, mainly affecting motor development. There are a multitude of non-pharmacological methods or therapies for its treatment. One of the main methods is Vojta therapy. This methodology acts on ontogenetic postural function and automatic postural control. Objective: This study aims to demonstrate that there are changes in the motor development of children with cerebral palsy with the application of Vojta therapy. Methods and analysis: This is a randomized controlled trial on the effectiveness of two neurorehabilitation techniques in patients with cerebral palsy conducted at the Physical Medicine and Rehabilitation Service of the Teresa Herrera Maternal and Child Hospital of the A Coruña and Cee Health Area. The study will be conducted from January 2023 to December 2024. There will be two groups: the Vojta therapy group (n = 30) and the conventional physiotherapy group (n = 30). The measurement variables will be gross motor function as measured by the Gross Motor Function Measure (GMFM) and Infant Motor Profile (IMP) scales. Ethics and dissemination: The study was approved by the Research Ethics Committee of the University of Murcia (1823/2018) and Comité de Ética de la Investigación de A Coruña-Ferrol (2022/099). Trial registration number: ClinicalTrials.gov; identifier: NCT06092619.

Comparison of synergy patterns between the right and left hand while performing postures and object grasps

The human hand, with many degrees of freedom, serves as an excellent tool for dexterous manipulation. Previous research has demonstrated that there exists a lower-dimensional subspace that synergistically controls the full hand kinematics. The elements of this subspace, also called synergies, have been viewed as the strategy developed by the CNS in the control of finger movements. Considering that the control of fingers is lateralized to the contralateral hemisphere, how the synergies differ for the control of the dominant and the non-dominant hand has not been widely addressed. In this paper, hand kinematics was recorded using electromagnetic tracking system sensors as participants made various postures and object grasps with their dominant hand and non-dominant hand separately. Synergies that explain 90% of variance in data of both hands were analyzed for similarity at the individual level as well as at the population level. The results showed no differences in synergies between the hands at both these levels. PC scores and cross-reconstruction errors were analyzed to further support the prevalence of similarity between the synergies of the hands. Future work is proposed, and implications of the results to the treatment and diagnosis of neuromotor disorders are discussed.

Investigating the roles of reflexes and central pattern generators in the control and modulation of human locomotion using a physiologically plausible neuromechanical model

Objective. Studying the neural components regulating movement in human locomotion is obstructed by the inability to perform invasive experimental recording in the human neural circuits. Neuromechanical simulations can provide insights by modeling the locomotor circuits. Past neuromechanical models proposed control of locomotion either driven by central pattern generators (CPGs) with simple sensory commands or by a purely reflex-based network regulated by state-machine mechanisms, which activate and deactivate reflexes depending on the detected gait cycle phases. However, the physiological interpretation of these state machines remains unclear. Here, we present a physiologically plausible model to investigate spinal control and modulation of human locomotion. Approach. We propose a bio-inspired controller composed of two coupled CPGs that produce the rhythm and pattern, and a reflex-based network simulating low-level reflex pathways and Renshaw cells. This reflex network is based on leaky-integration neurons, and the whole system does not rely on changing reflex gains according to the gait cycle state. The musculoskeletal model is composed of a skeletal structure and nine muscles per leg generating movement in sagittal plane. Main results. Optimizing the open parameters for effort minimization and stability, human kinematics and muscle activation naturally emerged. Furthermore, when CPGs were not activated, periodic motion could not be achieved through optimization, suggesting the necessity of this component to generate rhythmic behavior without a state machine mechanism regulating reflex activation. The controller could reproduce ranges of speeds from 0.3 to 1.9 m s−1. The results showed that the net influence of feedback on motoneurons (MNs) during perturbed locomotion is predominantly inhibitory and that the CPGs provide the timing of MNs’ activation by exciting or inhibiting muscles in specific gait phases. Significance. The proposed bio-inspired controller could contribute to our understanding of locomotor circuits of the intact spinal cord and could be used to study neuromotor disorders.

Assessment of the clinical and hematological status in acute radiation damage of Leningrad calico chickens

The problem of radiation damage to the human body, animals, birds and its individual systems and organs against the background of the use of ionizing radiation sources has acquired relevance throughout the world over the past decades. In the event of an emergency, acute radiation damage in poultry will be massive and increase the risks of developing infectious and noninfectious diseases, due to a decrease in the level of specific resistance, low effectiveness of therapeutic and preventive measures and, as a result, will lead to a decrease in the quality of the resulting product. In view of this, studies aimed at studying the features of the course of radiation pathology in chickens are very relevant and will be taken into account when developing and applying radioprotective formulations.The study of the features of the course of acute radiation damage caused by uniform single irradiation at doses of 7 Gy; 9 Gy; 11 Gy and 13 Gy, at a power of 0.99 Gy/min, was carried out on Leningrad calico chickens. Resistance to ionizing radiation was assessed by generally accepted clinical and hematological methods. Pronounced changes in clinical manifestations and shifts in morphological parameters of peripheral blood were noted under the influence of gamma radiation. Thus, irradiation of chickens with doses of 11 Gy and 13 Gy caused the development of acute radiation damage of an extremely severe degree, which led to severe depression, refusal of feed, shortening the duration or absence of a latent period, against the background of severe leuko- and erythropenia. Irradiation with a dose of 9 Gy caused severe acute radiation damage characterized by adynamia, reduced feed intake, diarrhea with an admixture of blood. Leukopenia was noted in the blood, which by day 12 values were lower than before irradiation by 41.9% and erythropenia. During acute radiation damage in chickens, when irradiated at a dose of 7 Gy, the development of the initial, latent, peak and recovery period in the surviving individuals was clearly traced. The clinical manifestation was characterized by a complex of dyspeptic and neuromotor disorders, moderate leukopenia was noted in the blood. In all experimental chickens, a violation of egg production was noted, up to complete cessation against the background of irradiation at doses of 11 Gy and 13 Gy. It is concluded that uniform single irradiation of chickens in doses from 7 Gy to 13 Gy leads to acute radiation damage and negatively affects the productive qualities of poultry. In order to conduct the experiment on the principle of pairs of analogues, 5 groups of animals were formed, 10 chickens in each. Determination of the content of erythrocytes, leukocytes and platelets in the blood was determined by counting in the Goryaev chamber. External total single exposure to gamma radiation at doses of 7 Gy, 9 Gy, 11 Gy and 13 Gy led to the development of acute radiation exposure of medium, severe and extremely severe degrees, respectively.

Infant movement classification through pressure distribution analysis

BackgroundAiming at objective early detection of neuromotor disorders such as cerebral palsy, we propose an innovative non-intrusive approach using a pressure sensing device to classify infant general movements. Here we differentiate typical general movement patterns of the “fidgety period” (fidgety movements) vs. the “pre-fidgety period” (writhing movements).MethodsParticipants (N = 45) were sampled from a typically-developing infant cohort. Multi-modal sensor data, including pressure data from a pressure sensing mat with 1024 sensors, were prospectively recorded for each infant in seven succeeding laboratory sessions in biweekly intervals from 4 to 16 weeks of post-term age. 1776 pressure data snippets, each 5 s long, from the two targeted age periods were taken for movement classification. Each snippet was pre-annotated based on corresponding synchronised video data by human assessors as either fidgety present or absent. Multiple neural network architectures were tested to distinguish the fidgety present vs. fidgety absent classes, including support vector machines, feed-forward networks, convolutional neural networks, and long short-term memory networks.ResultsHere we show that the convolution neural network achieved the highest average classification accuracy (81.4%). By comparing the pros and cons of other methods aiming at automated general movement assessment to the pressure sensing approach, we infer that the proposed approach has a high potential for clinical applications.ConclusionsWe conclude that the pressure sensing approach has great potential for efficient large-scale motion data acquisition and sharing. This will in return enable improvement of the approach that may prove scalable for daily clinical application for evaluating infant neuromotor functions.

Sitting Capacity and Performance in Infants with Typical Development and Infants with Motor Delay

Aims Infants with neuromotor disorders demonstrate delays in sitting skills (decreased capacity) and are less likely to maintain independent sitting during play than their peers with typical development (decreased performance). This study aimed to quantify developmental trajectories of sitting capacity and sitting performance in infants with typical development and infants with significant motor delay and to assess whether the relationship between capacity and performance differs between the groups. Methods Typically developing infants (n = 35) and infants with significant motor delay (n = 31) were assessed longitudinally over a year following early sitting readiness. The Gross Motor Function Measure (GMFM) Sitting Dimension was used to assess sitting capacity, and a 5-min free play observation was used to assess sitting performance. Results Both capacity and performance increased at a faster rate initially, with more deceleration across time, in infants with typical development compared to infants with motor delay. At lower GMFM scores, changes in GMFM sitting were associated with larger changes in independent sitting for infants with typical development, and the association between GMFM sitting and independent sitting varied more across GMFM scores for typically developing infants. Conclusions Intervention and assessment for infants with motor delay should target both sitting capacity and sitting performance.

Ecological Barriers and Challenges Affecting the Socioemotional Development of Children with Cerebral Palsy: Opinion Review

Cerebral Palsy (CP) is a group of neuromotor disorders that affects 1 to 4 in every 1000 youth worldwide. Both physical and socioemotional challenges may arise due to physical ability, environmental context, and negative social attitudes around disability. In this article, elements of Urie Bronfenbrenner’s ‘Ecological Systems Theory’ are used to explore the systems and contexts that children grow up in, with the purpose of demonstrating how these factors affect children’s socioemotional development. Literature expanding on three major microsystems (the home environment, the school environment, and the medical environment) are examined, connecting individual challenges to broader systemic barriers. Within the home environment, factors such as caregiver well-being, community support, and sociocultural perceptions of CP are significantly related to socioemotional challenges. In the school environment, exclusionary behavior by both peers and teachers as well as need for CP-specific accommodation often lead to feelings of isolation and reduced participation. Finally, the medical environment poses systemic barriers in the form of financial and logistical challenges, stigma around disability, as well as inadequate support in the transition to adulthood. The presence of these barriers further emphasizes the importance of considering socioemotional challenges as an integral part of the experience of CP, and the need for further research and reform within the systems that produce these challenges.

A Serious Game for the Assessment of Visuomotor Adaptation Capabilities during Locomotion Tasks Employing an Embodied Avatar in Virtual Reality.

The study of visuomotor adaptation (VMA) capabilities has been encompassed in various experimental protocols aimed at investigating human motor control strategies and/or cognitive functions. VMA-oriented frameworks can have clinical applications, primarily in the investigation and assessment of neuromotor impairments caused by conditions such as Parkinson's disease or post-stroke, which affect the lives of tens of thousands of people worldwide. Therefore, they can enhance the understanding of the specific mechanisms of such neuromotor disorders, thus being a potential biomarker for recovery, with the aim of being integrated with conventional rehabilitative programs. Virtual Reality (VR) can be entailed in a framework targeting VMA since it allows the development of visual perturbations in a more customizable and realistic way. Moreover, as has been demonstrated in previous works, a serious game (SG) can further increase engagement thanks to the use of full-body embodied avatars. Most studies implementing VMA frameworks have focused on upper limb tasks and have utilized a cursor as visual feedback for the user. Hence, there is a paucity in the literature about VMA-oriented frameworks targeting locomotion tasks. In this article, the authors present the design, development, and testing of an SG-based framework that addresses VMA in a locomotion activity by controlling a full-body moving avatar in a custom VR environment. This workflow includes a set of metrics to quantitatively assess the participants' performance. Thirteen healthy children were recruited to evaluate the framework. Several quantitative comparisons and analyses were run to validate the different types of introduced visuomotor perturbations and to evaluate the ability of the proposed metrics to describe the difficulty caused by such perturbations. During the experimental sessions, it emerged that the system is safe, easy to use, and practical in a clinical setting. Despite the limited sample size, which represents the main limitation of the study and can be compensated for with future recruitment, the authors claim the potential of this framework as a useful instrument for quantitatively assessing either motor or cognitive impairments. The proposed feature-based approach gives several objective parameters as additional biomarkers that can integrate the conventional clinical scores. Future studies might investigate the relation between the proposed biomarkers and the clinical scores for specific disorders such as Parkinson's disease and cerebral palsy.

Inhibitory Synaptic Influences on Developmental Motor Disorders.

During development, GABA and glycine play major trophic and synaptic roles in the establishment of the neuromotor system. In this review, we summarise the formation, function and maturation of GABAergic and glycinergic synapses within neuromotor circuits during development. We take special care to discuss the differences in limb and respiratory neuromotor control. We then investigate the influences that GABAergic and glycinergic neurotransmission has on two major developmental neuromotor disorders: Rett syndrome and spastic cerebral palsy. We present these two syndromes in order to contrast the approaches to disease mechanism and therapy. While both conditions have motor dysfunctions at their core, one condition Rett syndrome, despite having myriad symptoms, has scientists focused on the breathing abnormalities and their alleviation-to great clinical advances. By contrast, cerebral palsy remains a scientific quagmire or poor definitions, no widely adopted model and a lack of therapeutic focus. We conclude that the sheer abundance of diversity of inhibitory neurotransmitter targets should provide hope for intractable conditions, particularly those that exhibit broad spectra of dysfunction-such as spastic cerebral palsy and Rett syndrome.