Movement dysfunction following repetitive hand opening and closing: anatomical analysis in Owl monkeys

Repetitive strain injuries are thought to result from biomechanical stress and tissue microtrauma. The purpose of this study was to investigate the presence of local inflammation, scarring or anatomical variations of the flexor tendons and the median and ulnar nerves in four Owl monkeys behaviorally trained at a repetitive motor or sensory task. Three monkeys were trained to repetitively open and close a handpiece. The two monkeys that used rapid, stereotypical hand squeezing developed a task-specific movement dysfunction (one in 5 weeks and one in 24 weeks). The third monkey used a variable shoulder-pulling strategy and did not develop movement problems. The fourth monkey served as a control subject for the repetitive motor movements, trained on a repetitive sensory task, and did not develop a task-specific movement dysfunction. On dissection and histologic staining, there were no signs of active inflammation in the median nerve, the ulnar nerve, or the flexor tendons in any of the monkeys. However, the monkey that developed movement problems after 5 weeks of repetitive hand squeezing had an anatomical restriction of the flexor profundus tendon on the fourth digit of the trained side and the third digit of the untrained side. Reorganization of the representation of the hand on the contralateral somatosensory cortex (area 3b) was noted in the two monkeys that developed motor control problems and in the monkey performing the repetitive sensory task. These findings suggest that repetitive, stereotypical motor behaviors can lead to motor control problems without local signs of tendon or nerve inflammation. Preexisting anatomical restrictions may modify the time course for the development of movement dysfunction under conditions of stressful repetition. This animal model may simulate clinical focal hand dystonia (or occupational hand cramps) which can develop in human subjects who perform prolonged, repetitive, stereotypical movements.

Immunohistochemical and neurochemical studies on nigral and striatal functions in the circling (ci) rat, a genetic animal model with spontaneous rotational behavior

Asymmetrical spontaneous turning behavior or circling phenomena are often related to components of the dopaminergic system, particularly to an imbalance of nigrostriatal function. When a rotational preference is observed, it is typically in a direction away from the brain hemisphere with higher striatal dopaminergic transmission. We have recently described a rat mutant (ci) with spontaneous circling behavior and other signs of functional brain asymmetry. Neurochemical determinations showed that mutants of both genders have significantly lower concentrations of dopamine and dopamine metabolites in the striatum ipsilateral to the preferred direction of rotation. In the present study, we used immunohistochemical, neurochemical, and autoradiographic techniques to characterize the dopaminergic abnormalities of the ci rat mutant in more detail. Age-matched non-affected controls of the same strain were used for comparison. Immunohistochemical labeling of dopaminergic neurons and fibers in substantia nigra pars compacta, ventral tegmental area, and striatum did not indicate any significant neurodegeneration or asymmetry that could explain the lateralization in dopamine levels in striatum of ci rats. Neurochemical determinations substantiated that ci rats of both genders have a significant imbalance in striatal dopamine metabolism, but a similar significant lateralization was also seen in non-affected female controls. Comparison of dopamine, serotonin, noradrenaline and several monoamine metabolite levels in substantia nigra, striatum, nucleus accumbens and frontal cortex of ci rats and controls did not disclose any marked difference between affected and non-affected animals which was consistently found in both genders. Quantitative autoradiographic determination of binding densities of dopamine transporter and D1 and D2 receptors in several parts of the striatum and substantia nigra indicated that ci rats have a significantly higher binding density of dopamine transporter and receptors than controls. Taken together, ci mutant rats of both genders exhibit an asymmetry in striatal dopamine and metabolite levels and an enhanced dopamine transporter and receptor binding, but the link of these differences in dopaminergic parameters with the rotational behavior of the animals is not clear yet. The lack of any significant dopaminergic cell loss in the substantia nigra and the locomotor hyperactivity observed in the mutants clearly suggest that the ci rat is not suited as a model of Parkinsonism but rather constitutes a model of a hyperkinetic motor syndrome.

Dynamics of self-injurious behaviors

Self-injurious behavior was examined in a case study of head-banging by an 8-year-old girl with profound mental retardation and an autistic disorder. Trajectories of the arm movements and impact forces of the head blows were determined from a dynamic analysis of videotapes. Results revealed a high degree of cycle-to-cycle consistency in the qualitative dynamics of the limb motions, with one hand motions being faster than those with two hands (inphase and antiphase) and the motions with the helmet about 25% faster than those without the helmet. The impact force of SIBs as a percentage of body weights are near the low end of forces generated in boxing blows and karate hits.

Possible role of neuropeptides in obsessive compulsive disorder

The most consistent finding in clinical research of obsessive compulsive disorder (OCD) is the significant treatment advantage of potent serotonin uptake inhibitors (SUIs) over other classes of antidepressant and antianxiety drugs. Clinical neurobiological studies of OCD, however, have yielded limited and inconsistent evidence for significant fundamental abnormalities in monoamine systems including serotonin, norepinephrine and dopamine. Furthermore, one-third to one-half of OCD patients do not experience a clinically meaningful improvement with SUI treatment. Investigation beyond the monoamine systems may be necessary in order to more fully understand the pathophysiology of obsessive-compulsive symptoms and develop improved treatments. Evidence from preclinical studies suggests that neuropeptides may have important influences on memory acquisition, maintenance and retrieval; grooming, maternal, sexual and aggressive behavior; fixed action patterns; and stereotyped behavior; these phenomena may relate to some features of OCD. In addition, extensive interactions have been identified in the brain between neuropeptidergic and monoaminergic systems, including co-localization among specific populations of neurons. The purpose of this review is to present the current knowledge of the role of neuropeptides in the clinical neurobiology of children, adolescents and adults with OCD focusing primarily on results from pharmacological challenge and cerebrospinal fluid studies. Where evidence exists, developmentally regulated differences in neuropeptide function between children and adolescents versus adults with OCD will be emphasized; these data are intended to underscore the potential importance of establishing the age of symptom onset (childhood versus adult) in individual patients with OCD participating in clinical neurobiological investigations. Likewise, where information is available, differences in measures of neuropeptides between patients with non-tic-related OCD versus tic-related OCD will be highlighted; these data will demonstrate the critical value of diagnostic precision, as these two particular subtypes of OCD may have different neurochemical underpinnings.

The role of dopamine in the mouse frontal cortex: a new hypothesis of behavioral sensitization to amphetamine and cocaine

In previous studies we demonstrated that dopamine, specifically a D2-receptor system, in the frontal cortex of the mouse functions to inhibit the motor response elicited by systemically administered amphetamine or cocaine; the inhibition appears to be the result of the dopaminergic activation of a GABAergic system. In the present study the inhibitory role of dopamine and GABA in the cortex was investigated in animals that were behaviorally sensitized to stimulant-induced stereotypy. For these studies various dopaminergic and GABAergic drugs were injected intracortically (i.c.) and their effects on stimulant-induced stereotypy were compared in nonsensitized and sensitized mice. The results indicate that the dopaminergic system in the cortex of sensitized animals, in contrast to nonsensitized controls, no longer functions to inhibit the motor response to the stimulants. The change in dopaminergic function in sensitized animals appears to be the result of a qualitative change in the D2 dopamine receptor system and not the result of a change in the associated GABA system. The loss of the inhibitory activity of dopamine in the cortex correlated with the persistence of sensitization. These results suggest a new mechanism to account for behavioral sensitization; that is, the phenomenon is the result of a loss of stimulant-induced dopaminergic inhibition of motor activity normally mediated by the frontal cortex.

D-amphetamine and L-5-hydroxytryptophan-induced behaviours in mice with genetically-altered expression of the alpha2C-adrenergic receptor subtype

Three human and mouse genes encoding alpha2-adrenoceptor subtypes (alpha2A, alpha2B, and alpha2C) have been cloned. The alpha2C-adrenoceptor is the most abundant alpha2-adrenoceptor subtype in the striatum and modulates metabolism of both dopamine and serotonin. To investigate the possible involvement of the alpha2C-adrenoceptor subtype in behaviours regulated by dopamine and serotonin, two strains of genetically-engineered mice were examined. One had a targeted inactivation of the alpha2C-adrenoceptor gene, and the other had tissue-specific over-expression of alpha2C-adrenoceptors. The locomotor activity of the mice was evaluated after stimulation with D-amphetamine, and the behavioural serotonin syndrome and head twitches were investigated after L-5-hydroxytryptophan treatment. In addition, the effects of D-amphetamine and L-5-hydroxytryptophan were studied after pretreatment with dexmedetomidine, a subtype-nonselective alpha2-adrenoceptor agonist. The lack of alpha2C-adrenoceptor expression increased and the over-expression of alpha2C-adrenoceptors decreased the response to D-amphetamine stimulation. The effect of alpha2C-adrenoceptor gene inactivation was more prominent in D-amphetamine-treated males than in females. Dexmedetomidine inhibited D-amphetamine-induced hyperlocomotion and the L-5-hydroxytryptophan-induced serotonin syndrome, but the inhibition was attenuated in mice lacking alpha2C-adrenoceptors. However, the head twitches induced by L-5-hydroxytryptophan were effectively inhibited by dexmedetomidine in all studied mice, which suggests that alpha2A-adrenoceptors mediate the inhibition of the head twitch response. The results lend further support to the proposed existence of functionally distinct alpha2-adrenoceptor subtypes that can serve as new and specific therapeutic targets in various neuropsychiatric diseases.

Nocturnal paroxysmal arousals with motor behaviors during sleep: frontal lobe epilepsy or parasomnia?

Nocturnal paroxysmal arousals with motor behaviors have been described in a few individuals, and their possible epileptic origin as nocturnal frontal lobe seizures has been suggested. However, the clinical and polysomnographic differentiation from parasomnias and physiologic movements during sleep have not been clarified yet. In this study, we evaluated a group of patients with nocturnal motor behaviors and tried to characterize paroxysmal arousals. Thirty-four participants (mean [+/-SD] age 22.7 [+/-12.9] years) noting nocturnal motor agitation or behaviors and 12 healthy controls (mean age 24.1 [+/-3.1] years) underwent nocturnal polysomnography with video-tape recording and motor behaviors analysis. Arousals with motor attacks were classified as minimal, minor, or major depending on semiology, complexity, and duration of behaviors. All patients showed several minimal (e.g., scratching or rubbing the nose and the head) and minor (e.g., pelvic thrusting or swinging with dystonic component) attacks, and 53% also had major episodes (e.g., sudden elevation of the head and trunk from the bed with complex behaviors) occurring mainly in non-rapid eye movement sleep. In all the patients, motor attacks were characterized by stereotypy, sudden onset, short duration, and repetitiveness. In 80%, epileptiform abnormalities were found. All control subjects showed motor events, but they were fewer, slower, nonstereotyped, and semiologically different from the patients'. No significant difference in conventional sleep parameters between the two groups were found. Paroxysmal arousals with motor behaviors probably represent a particular form of nocturnal frontal lobe epilepsy rather than an unusual parasomnia. The semiologic characteristics of these type of arousals are difficult to recognize and differentiate from physiologic movements or parasomnias without video-polygraphic analysis.

Cyclic alternating pattern as a provocative factor in nocturnal paroxysmal dystonia

PURPOSE

We made a polygraphic study of 6 patients with nocturnal paroxysmal dystonia (NPD) in which the cyclic alternating pattern (CAP) parameters were compared with those of a group of age- and sex-matched controls.

METHODS

All patients met the requirements for NPD diagnosis, characterized by generalized stereotyped movements (dystonic-dyskinetic), with a 1-min centered duration but with no clear evidence of epileptic abnormalities in the waking EEG and during nocturnal recordings.

RESULTS

Besides the major events, the NPD polysomnograms also showed shorter, repeated episodes of shorter duration (generally <20 s) consisting of abrupt movements involving one or more body segments. Overall, the motor events in patients with NPD were closely related to periods of unstable non-REM (NREM) sleep, as evidenced by the sequences of CAP, and began during an A phase. According to the conventional scoring parameters, NPD and controls differed only in sleep latency (+14 min in the NPD patients: p < 0.04). However, the architecture of sleep in the group with NPD was characterized by prolonged and irregular NREM/REM cycles. In addition, the NPD recordings showed significantly higher values of CAP rate (p < 0.0001). When major motor attacks were suppressed by medication, sleep was characterized by a decrease in the excessive amounts of CAP rate and by a more regular architecture.

CONCLUSIONS

The modulatory role of CAP on nocturnal motor events is reported.