- Predictors of activities of daily living outcomes after upper limb robot-assisted therapy in subacute stroke patients. [Journal Article]
- PlosPLoS One 2018; 13(2):e0193235
- CONCLUSIONS: Stroke patients with greater manual dexterity and less impairment appear to have a higher probability of achieving clinically significant ADL outcomes after upper limb RT. The obtained results can help to optimise the management of RT treatment planning. Further studies on a larger number of patients with a long-term follow up are recommended in order to evaluate other potential predictors and to validate the results.
- A Comparison of Spastic Diplegia in Term and Preterm-Born Children. [Journal Article]
- JCJ Child Neurol 2018 Jan 01; :883073817754175
- This study compared the risk factors and clinical and radiologic profile of children with spastic diplegic cerebral palsy born at term (≥37 weeks) with those born preterm. Children (2-14 years) with ...
This study compared the risk factors and clinical and radiologic profile of children with spastic diplegic cerebral palsy born at term (≥37 weeks) with those born preterm. Children (2-14 years) with cerebral palsy meeting the study criteria for spastic diplegia were enrolled. Antecedent risk factors, clinical profile, and magnetic resonance imaging (MRI) findings were recorded. Spasticity, functional ability, intellectual ability, and social quotient were assessed using standard scales. Ninety-three children met the study inclusion criteria (45 term, 48 preterm). Moderate to severe intellectual disability (53% vs 21%, P = .001) and epilepsy (51% vs 33%) were significantly more common in term-born children, whereas periventricular white matter injury was less common in term-born children (64%vs 89.4%, P = .004). Term spastic diplegia was associated with cortical/subcortical involvement in (11/42 (26%) vs 3/47(6.4%); P = .01). We conclude that term-spastic-diplegia is clinicopathologically different from preterm-spastic-diplegia. Their neuroradiologic pattern also differs with more frequent involvement of cortical/subcortical areas.
- Clinical and genetic spectrum of AMPD2-related pontocerebellar hypoplasia type 9. [Journal Article]
- EJEur J Hum Genet 2018 Feb 20
- Pontocerebellar hypoplasia (PCH) represents a group of autosomal-recessive progressive neurodegenerative disorders of prenatal onset. Eleven PCH subtypes are classified according to clinical, neuroim...
Pontocerebellar hypoplasia (PCH) represents a group of autosomal-recessive progressive neurodegenerative disorders of prenatal onset. Eleven PCH subtypes are classified according to clinical, neuroimaging and genetic findings. Individuals with PCH type 9 (PCH9) have a unique combination of postnatal microcephaly, hypoplastic cerebellum and pons, and hypoplastic or absent corpus callosum. PCH9 is caused by biallelic variants in AMPD2 encoding adenosine monophosphate deaminase 2; however, a homozygous AMPD2 frameshift variant has recently been reported in two family members with spastic paraplegia type 63 (SPG63). We identified homozygous or compound heterozygous AMPD2 variants in eight PCH-affected individuals from six families. The eight variants likely affect function and comprise one frameshift, one nonsense and six missense variants; seven of which were novel. The main clinical manifestations in the eight new patients and 17 previously reported individuals with biallelic AMPD2 variants were postnatal microcephaly, severe global developmental delay, spasticity, and central visual impairment. Brain imaging data identified hypomyelination, hypoplasia of the cerebellum and pons, atrophy of the cerebral cortex, complete or partial agenesis of the corpus callosum and the "figure 8" shape of the hypoplastic midbrain as consistent features. We broaden the AMPD2-related clinical spectrum by describing one individual without microcephaly and absence of the characteristic "figure 8" shape of the midbrain. The existence of various AMPD2 isoforms with different functions possibly explains the variability in phenotypes associated with AMPD2 variants: variants leaving some of the isoforms intact may cause SPG63, while those affecting all isoforms may result in the severe and early-onset PCH9.
- Prenatal diagnosis of fetal glutaric aciduria type 1 with rare compound heterozygous mutations in GCDH gene. [Journal Article]
- TJTaiwan J Obstet Gynecol 2018; 57(1):137-140
- CONCLUSIONS: Glutaric acidemia type 1 is an autosomal recessive disorder because of pathogenic mutations in the GCDH gene. Early diagnosis and therapy of glutaric acidemia type 1 can reduce the risk of neuronal damage and acute dystonia. We report a case of prenatal diagnosis of fetal glutaric aciduria type 1 with rare compound heterozygous GCDH gene mutation at IVS 3 + 1 G > A and c. 1240 G > A mutations, which provide better genetic counselling for the couples.
- Comments on: "Positive Effects of Extracorporeal Shock Wave Therapy on Spasticity in Post-Stroke Patients: A Meta-Analysis". [Letter]
- JSJ Stroke Cerebrovasc Dis 2018 Feb 15
- Systematic review of systematic reviews for medical cannabinoids: Pain, nausea and vomiting, spasticity, and harms. [Journal Article]
- CFCan Fam Physician 2018; 64(2):e78-e94
- CONCLUSIONS: There is reasonable evidence that cannabinoids improve nausea and vomiting after chemotherapy. They might improve spasticity (primarily in multiple sclerosis). There is some uncertainty about whether cannabinoids improve pain, but if they do, it is neuropathic pain and the benefit is likely small. Adverse effects are very common, meaning benefits would need to be considerable to warrant trials of therapy.
- Simplified guideline for prescribing medical cannabinoids in primary care. [Journal Article]
- CFCan Fam Physician 2018; 64(2):111-120
- CONCLUSIONS: Recommendations include limiting medical cannabinoid use in general, but also outline potential restricted use in a small subset of medical conditions for which there is some evidence (neuropathic pain, palliative and end-of-life pain, chemotherapy-induced nausea and vomiting, and spasticity due to multiple sclerosis or spinal cord injury). Other important considerations regarding prescribing are reviewed in detail, and content is offered to support shared, informed decision making.This simplified medical cannabinoid prescribing guideline provides practical recommendations for the use of medical cannabinoids in primary care. All recommendations are intended to assist with, not dictate, decision making in conjunction with patients.
- The Use of Cannabis and Cannabinoids in Treating Symptoms of Multiple Sclerosis: a Systematic Review of Reviews. [Review]
- CNCurr Neurol Neurosci Rep 2018 Feb 13; 18(2):8
- Pharmaceutical cannabinoids such as nabiximols, nabilone and dronabinol, and plant-based cannabinoids have been investigated for their therapeutic potential in treating multiple sclerosis (MS) sympto...
Pharmaceutical cannabinoids such as nabiximols, nabilone and dronabinol, and plant-based cannabinoids have been investigated for their therapeutic potential in treating multiple sclerosis (MS) symptoms. This review of reviews aimed to synthesise findings from high quality systematic reviews that examined the safety and effectiveness of cannabinoids in multiple sclerosis. We examined the outcomes of disability and disability progression, pain, spasticity, bladder function, tremor/ataxia, quality of life and adverse effects.
- Voluntary contraction enhances spinal reciprocal inhibition induced by patterned electrical stimulation in patients with stroke. [Journal Article]
- RNRestor Neurol Neurosci 2018; 36(1):99-105
- CONCLUSIONS: VC enhanced the PES-induced plastic changes in RI in patients with stroke. This effect can potentially increase the success rate of newer neurorehabilitative approaches in achieving functional recovery after stroke.
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- Early movement restriction leads to enduring disorders in muscle and locomotion. [Journal Article]
- BPBrain Pathol 2018 Feb 13
- Motor control and body representation in the central nervous system (CNS) as well as musculoskeletal architecture and physiology are shaped during development by sensorimotor experience and feedback,...
Motor control and body representation in the central nervous system (CNS) as well as musculoskeletal architecture and physiology are shaped during development by sensorimotor experience and feedback, but the emergence of locomotor disorders during maturation and their persistence over time remain a matter of debate in the absence of brain damage. By using transient immobilization of the hind limbs, we investigated the enduring impact of postnatal sensorimotor restriction (SMR) on gait and posture on treadmill, age-related changes in locomotion, musculoskeletal histopathology and Hoffmann reflex in adult rats without brain damage. SMR degrades most gait parameters and induces overextended knees and ankles, leading to digitigrade locomotion that resembles equinus. Based on variations in gait parameters, SMR appears to alter age-dependent plasticity of treadmill locomotion. SMR also leads to small but significantly decreased tibial bone length, chondromalacia, degenerative changes in the knee joint, gastrocnemius myofiber atrophy and muscle hyperreflexia, suggestive of spasticity. We showed that reduced and atypical patterns of motor outputs, and somatosensory inputs and feedback to the immature CNS, even in the absence of perinatal brain damage, play a pivotal role in the emergence of movement disorders and musculoskeletal pathologies, and in their persistence over time. Understanding how atypical sensorimotor development likely contributes to these degradations may guide effective rehabilitation treatments in children with either acquired (i.e., with brain damage) or developmental (i.e., without brain injury) motor disabilities. This article is protected by copyright. All rights reserved.