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Dorich JM, Whiting J, Plano Clark VL, Ittenbach RF, Cornwall R. Impact of brachial plexus birth injury on health-related quality of life in adulthood: a mixed methods survey study. Disabil Rehabil 2024; 46:2042-2055. [PMID: 37199089 DOI: 10.1080/09638288.2023.2212917] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 05/07/2023] [Indexed: 05/19/2023]
Abstract
PURPOSE To describe the scope and nature of health concerns, functional impairments, and quality of life issues among adults with brachial plexus birth injury (BPBI). METHODS A mixed methods study was conducted by surveying two social media networks of adults with BPBI using a combination of closed-ended and open-ended questions regarding the role of BPBI on ones' health, function, and quality of life. Closed-ended responses were compared across ages and genders. Open-ended responses were qualitatively analyzed to expand upon the close-ended responses. RESULTS Surveys were completed by 183 respondents (83% female, age range 20-87 years). BPBI was reported to impact hand and arm use in 80% of participants (including affected and unaffected limbs and bimanual tasks), overall health in 60% (predominantly pain), activity participation in 79% (predominantly activities of daily living and leisure), life roles in 76% (predominantly occupation and parenting), and overall quality of life in 73% (predominantly self-esteem, relationships, and appearance). Significantly more females than males reported other medical conditions and an impact on hand and arm use and life roles. No other responses varied by age or gender. CONCLUSIONS BPBI affects many facets of health related quality of life in adulthood with variability among affected individuals.
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Affiliation(s)
- Jenny M Dorich
- Cincinnati Children's Hospital Medical Center, Departments of Orthopaedic Surgery and Allied Health Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Jordyn Whiting
- Vice-President/Board of Directors, United Brachial Plexus Network, Reading, MA, USA
| | - Vicki L Plano Clark
- School of Education - Research Methods, University of Cincinnati, Cincinnati, OH, USA
| | - Richard F Ittenbach
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
| | - Roger Cornwall
- Cincinnati Children's Hospital Medical Center, Departments of Orthopaedic Surgery and Developmental Biology, University of Cincinnati, Cincinnati, OH, USA
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Socolovsky M, di Masi G, Bonilla G, Lovaglio A, Battaglia D, Rosler R, Malessy M. Brain plasticity in neonatal brachial plexus palsies: quantification and comparison with adults' brachial plexus injuries. Childs Nerv Syst 2024; 40:479-486. [PMID: 37436472 DOI: 10.1007/s00381-023-06072-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 07/05/2023] [Indexed: 07/13/2023]
Abstract
PURPOSE To compare two populations of brachial plexus palsies, one neonatal (NBPP) and the other traumatic (NNBPP) who underwent different nerve transfers, using the plasticity grading scale (PGS) for detecting differences in brain plasticity between both groups. METHODS To be included, all patients had to have undergone a nerve transfer as the unique procedure to recover one lost function. The primary outcome was the PGS score. We also assessed patient compliance to rehabilitation using the rehabilitation quality scale (RQS). Statistical analysis of all variables was performed. A p ≤ 0.050 set as criterion for statistical significance. RESULTS A total of 153 NNBPP patients and 35 NBPP babies (with 38 nerve transfers) met the inclusion criteria. The mean age at surgery of the NBPP group was 9 months (SD 5.42, range 4 to 23 months). The mean age of NNBPP patients was 22 years (SD 12 years, range 3 to 69). They were operated around sixth months after the trauma. All transfers performed in NBPP patients had a maximum PGS score of 4. This was not the case for the NNBPP population that reached a PGS score of 4 in approximately 20% of the cases. This difference was statistically significant (p < 0.001). The RQS was not significantly different between groups. CONCLUSION We found that babies with NBPP have a significantly greater capacity for plastic rewiring than adults with NNBPP. The brain in the very young patient can process the changes induced by the peripheral nerve transfer better than in adults.
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Affiliation(s)
- Mariano Socolovsky
- Peripheral Nerve & Brachial Plexus Surgery Program, Department of Neurosurgery, Hospital de Clínicas, University of Buenos Aires School of Medicine, La Pampa 1175 Torre 2 5A, 1428, Buenos Aires, Argentina.
- Peripheral Nerve & Brachial Plexus Surgery Unit, Division of Neurosurgery, Hospital de Clínicas, University of Buenos Aires School of Medicine, Torre 2 5A, Buenos Aires, Argentina.
| | - Gilda di Masi
- Peripheral Nerve & Brachial Plexus Surgery Program, Department of Neurosurgery, Hospital de Clínicas, University of Buenos Aires School of Medicine, La Pampa 1175 Torre 2 5A, 1428, Buenos Aires, Argentina
- Peripheral Nerve & Brachial Plexus Surgery Unit, Division of Neurosurgery, Hospital de Clínicas, University of Buenos Aires School of Medicine, Torre 2 5A, Buenos Aires, Argentina
| | - Gonzalo Bonilla
- Peripheral Nerve & Brachial Plexus Surgery Program, Department of Neurosurgery, Hospital de Clínicas, University of Buenos Aires School of Medicine, La Pampa 1175 Torre 2 5A, 1428, Buenos Aires, Argentina
- Peripheral Nerve & Brachial Plexus Surgery Unit, Division of Neurosurgery, Hospital de Clínicas, University of Buenos Aires School of Medicine, Torre 2 5A, Buenos Aires, Argentina
| | - Ana Lovaglio
- Peripheral Nerve & Brachial Plexus Surgery Program, Department of Neurosurgery, Hospital de Clínicas, University of Buenos Aires School of Medicine, La Pampa 1175 Torre 2 5A, 1428, Buenos Aires, Argentina
- Peripheral Nerve & Brachial Plexus Surgery Unit, Division of Neurosurgery, Hospital de Clínicas, University of Buenos Aires School of Medicine, Torre 2 5A, Buenos Aires, Argentina
| | - Danilo Battaglia
- Peripheral Nerve & Brachial Plexus Surgery Program, Department of Physiotherapy and Rehabilitation, Hospital de Clínicas, University of Buenos Aires School of Medicine, Buenos Aires, Argentina
| | - Roberto Rosler
- Department of Neurology, Universidad Abierta Interamericana, Buenos Aires, Argentina
| | - Martijn Malessy
- Department of Neurosurgery, University of Leiden School of Medicine, Leiden, Holland
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3
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Yao C, Song J, Sun J, Tang W, Chen L, Gu Y. Changing handedness after nerve reconstruction in brachial plexus birth palsy. Front Neurol 2024; 14:1284945. [PMID: 38259660 PMCID: PMC10800742 DOI: 10.3389/fneur.2023.1284945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
Purpose Right obstetric brachial plexus injuries (OBPI) often lead to left-handedness before limb function is restored post-surgery. A pertinent question arises about promoting a transition from left to right-handedness. We hypothesized that, with the decrease in neuroplasticity, handedness switching is not only difficult, but also reduces handedness-speech lateralization, impaired motor adaptability, and compromised language proficiency. Methods We retrospectively analyzed clinical data from January 1996 to January 2012 at our hospital. Participants were divided into intervention or control groups based on handedness switching. We compared handedness and computed lateral quotient (LQ) and lateralization index (LI) for handedness-speech center. Additionally, we assessed dominant hand's writing speed, language function, and IQ. Associations between absolute LI and LQ values, writing speed, language scores, and IQ were examined. Results Nineteen extended Erb's palsy participants were enrolled, eight in the intervention group, and 11 in the control. No right-handed individuals were found in either cohort. The intervention group had significantly lower LQ and LI values, and fewer achieved normal writing speed. Yet, no notable disparities in language scores or IQ emerged. Notably, we established correlations between motor finesse, handedness degree, and handedness-speech lateralization. Conclusion For right extended Erb's palsy, shifting handedness is nearly unfeasible, and such an endeavor could trigger a reduction in handedness-speech lateralization magnitude and diminished motor finesse.
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Affiliation(s)
- Chenglun Yao
- Department of Hand Surgery, Huashan Hospital and Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hand Reconstruction (Fudan University), Shanghai, China
- Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
- Institute of Hand Surgery, Fudan University, Shanghai, China
| | - Jie Song
- Department of Hand Surgery, Huashan Hospital and Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hand Reconstruction (Fudan University), Shanghai, China
- Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
- Institute of Hand Surgery, Fudan University, Shanghai, China
| | - Jiayu Sun
- Department of Hand Surgery, Huashan Hospital and Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hand Reconstruction (Fudan University), Shanghai, China
- Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
- Institute of Hand Surgery, Fudan University, Shanghai, China
| | - Weijun Tang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Liang Chen
- Department of Hand Surgery, Huashan Hospital and Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hand Reconstruction (Fudan University), Shanghai, China
- Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
- Institute of Hand Surgery, Fudan University, Shanghai, China
| | - Yudong Gu
- Department of Hand Surgery, Huashan Hospital and Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hand Reconstruction (Fudan University), Shanghai, China
- Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
- Institute of Hand Surgery, Fudan University, Shanghai, China
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Koshinski JL, Russo SA, Zlotolow DA. Brachial Plexus Birth Injury: A Review of Neurology Literature Assessing Variability and Current Recommendations. Pediatr Neurol 2022; 136:35-42. [PMID: 36084421 DOI: 10.1016/j.pediatrneurol.2022.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Publications regarding the epidemiology and management of brachial plexus birth injury (BPBI) were evaluated to investigate treatment guidelines for children with BPBI. METHODS A search of neurology literature from 1990 to 2019 was performed using PubMed, Scopus, and Medline. Data including incidence, risk factors, spontaneous recovery rates, imaging studies, treatment recommendations, and indications and timing for surgery were collected. RESULTS A total of 46 total studies were reviewed. Reported incidence rates for BPBI ranged from 0.3 to 3 per 1000 births. Spontaneous recovery rates had an average reported range from 66% to 75%. Physical and occupational therapy were recommended in 37% of articles. Computed tomographic myelogram and magnetic resonance imaging of the brachial plexus were the most commonly recommended imaging studies for BPBI. Timelines for surgical interventions ranged from age three to nine months. Early referral was recommended in 28% of the articles included in the review. CONCLUSIONS Given the inconsistencies in spontaneous recovery rates, imaging recommendations, and timing of referral, establishing consistent clinical guidelines for patients with BPBI is crucial for management. Early referral to specialists for evaluation and treatment may improve outcomes in children with BPBI.
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Affiliation(s)
| | - Stephanie A Russo
- Department of Orthopaedic Surgery, Akron Children's Hospital, Akron, Ohio.
| | - Dan A Zlotolow
- Department of Orthopaedic Surgery, Shriners Hospital for Children, Philadelphia, Pennsylvania; The Hospital for Special Surgery, New York, New York
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Socolovsky M, Barillaro K, Bonilla G, Masi GD, Malessy M. Nerve transfers for brachial plexus injuries: grading of volitional control. J Neurosurg 2022; 138:1419-1425. [PMID: 36115049 DOI: 10.3171/2022.7.jns22887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/15/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE After brachial plexus injuries (BPIs), nerve transfers are used to restore lost muscle function. Brain plasticity underlies the process of regaining volitional control, which encompasses disconnection of the original donor nerve-related programs and reconnection to acceptor nerve programs. To the authors' knowledge, the levels of disconnection and reconnection have never been studied systematically. In this study, the authors developed a novel 4-point plasticity grading scale (PGS) and assessed the degree of volitional control achieved, identifying clinical correlations with this score. METHODS Patients with BPI who underwent a phrenic, spinal accessory, median, and/or ulnar fascicle nerve transfer to restore biceps and deltoid function were asked to maximally contract their target muscle as follows: 1) by using only the donor nerve program, and 2) by activating the target muscle while consciously trying to avoid using the donor nerve, with assessment each time of the Medical Research Council (MRC) scale grade for muscle strength. The authors' PGS was used to rate the level of volitional control achieved. PGS grade 1 represented the lowest independent volitional control, with MRC grade 4 obtained in response to the donor command and MRC grade 0 in response to the acceptor command (minimum brain plasticity), whereas PGS grade 4 was no noticeable contraction in response to the donor command and MRC grade 4 in response to the acceptor command (maximum brain plasticity). RESULTS In total, 153 patients were studied. For biceps restoration, the phrenic nerve was used as a donor in 44 patients, the spinal accessory nerve in 40 patients, and the median and/or ulnar fascicles in 44 patients. A triceps branch was used to restore deltoid function in 25 patients. The level of volitional control achieved was PGS grade 1 in 1 patient (0.6%), grade 2 in 21 patients (13.7%), grade 3 in 103 patients (67.3%), and grade 4 in 28 patients (18.3%). The median PGS grade did not differ significantly between the four donor nerves. No correlations were observed between age, time from BPI to surgery, duration of follow-up, or compliance with rehabilitation and PGS grade. CONCLUSIONS Just around 20% of the authors' patients developed a complete disconnection of the donor program along with complete independent control over the reinnervated muscle. Incomplete disconnection was present in the vast majority of the patients, and the level of disconnection and control was poor in approximately 15% of patients. Brain plasticity underlies patient ability to regain volitional control after a nerve transfer, but this capacity is limited.
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Affiliation(s)
- Mariano Socolovsky
- 1Department of Neurosurgery, University of Buenos Aires School of Medicine, Buenos Aires, Argentina; and
| | - Karina Barillaro
- 1Department of Neurosurgery, University of Buenos Aires School of Medicine, Buenos Aires, Argentina; and
| | - Gonzalo Bonilla
- 1Department of Neurosurgery, University of Buenos Aires School of Medicine, Buenos Aires, Argentina; and
| | - Gilda Di Masi
- 1Department of Neurosurgery, University of Buenos Aires School of Medicine, Buenos Aires, Argentina; and
| | - Martijn Malessy
- 2Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands
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6
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Yuan YS, Xu HL, Liu ZD, Kou YH, Jin B, Zhang PX. Brain functional remodeling caused by sciatic nerve transposition repair in rats identified by multiple-model resting-state blood oxygenation level-dependent functional magnetic resonance imaging analysis. Neural Regen Res 2022; 17:418-426. [PMID: 34269218 PMCID: PMC8464002 DOI: 10.4103/1673-5374.317991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/24/2020] [Accepted: 04/16/2021] [Indexed: 11/29/2022] Open
Abstract
Lower extremity nerve transposition repair has become an important treatment strategy for peripheral nerve injury; however, brain changes caused by this surgical procedure remain unclear. In this study, the distal stump of the right sciatic nerve in a rat model of sciatic nerve injury was connected to the proximal end of the left sciatic nerve using a chitin conduit. Neuroelectrophysiological test showed that the right lower limb displayed nerve conduction, and the structure of myelinated nerve fibers recovered greatly. Muscle wet weight of the anterior tibialis and gastrocnemius recovered as well. Multiple-model resting-state blood oxygenation level-dependent functional magnetic resonance imaging analysis revealed functional remodeling in multiple brain regions and the re-establishment of motor and sensory functions through a new reflex arc. These findings suggest that sciatic nerve transposition repair induces brain functional remodeling. The study was approved by the Ethics Committee of Peking University People's Hospital on December 9, 2015 (approval No. 2015-50).
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Affiliation(s)
- Yu-Song Yuan
- Department of Trauma and Orthopedics, Peking University People's Hospital, Peking University, Beijing, China
- Key Laboratory of Trauma and Neural Regeneration (Peking University), Ministry of Education, Beijing, China
- National Center for Trauma Medicine, Beijing, China
| | - Hai-Lin Xu
- Department of Trauma and Orthopedics, Peking University People's Hospital, Peking University, Beijing, China
- National Center for Trauma Medicine, Beijing, China
| | - Zhong-Di Liu
- National Center for Trauma Medicine, Beijing, China
| | - Yu-Hui Kou
- Department of Trauma and Orthopedics, Peking University People's Hospital, Peking University, Beijing, China
- Key Laboratory of Trauma and Neural Regeneration (Peking University), Ministry of Education, Beijing, China
- National Center for Trauma Medicine, Beijing, China
| | - Bo Jin
- Department of Trauma and Orthopedics, Peking University People's Hospital, Peking University, Beijing, China
- Key Laboratory of Trauma and Neural Regeneration (Peking University), Ministry of Education, Beijing, China
- National Center for Trauma Medicine, Beijing, China
| | - Pei-Xun Zhang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Peking University, Beijing, China
- Key Laboratory of Trauma and Neural Regeneration (Peking University), Ministry of Education, Beijing, China
- National Center for Trauma Medicine, Beijing, China
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Socolovsky M, Malessy M. Brain changes after peripheral nerve repair: limitations of neuroplasticity. J Neurosurg Sci 2021; 65:421-430. [PMID: 33709667 DOI: 10.23736/s0390-5616.21.05298-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Neuroplasticity is the capacity of the central nervous system to adapt to external or internal stimuli. It is being increasingly recognized as an important factor which contributes to the successful outcome of nerve transfers. Other much more well-known factors are the number of axons that cross the coaptation site, the interval between trauma and repair, and age. Neuroplasticity is mediated by synaptic and neurotransmitter changes which underlie activation of previously existing but low-active connections in the brain. Dendritic sprouting and axonal elongation might also take place, but is likely less prominent. We review different factors that play a role in neuroplasticity and functional regeneration after specific nerve transfers. These factors include, amongst others, the distance between cortical areas of the donor and receptor neurons; the presence versus absence of pre-existing low-active inter-neuronal connections; gross versus fine movement restoration; rehabilitation; brain trauma and also very important: the age. The potential for plastic adaptation should be taken into consideration if the surgical strategy and post-operative rehabilitation are planned, as its influence on results cannot be denied.
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Affiliation(s)
- Mariano Socolovsky
- Peripheral Nerve & Plexus Surgery Unit, University of Buenos Aires School of Medicine, Buenos Aires, Argentina -
| | - Martijn Malessy
- Department of Neurosurgery, University of Leiden Medical Center, Leiden, the Netherlands
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Labache L, Mazoyer B, Joliot M, Crivello F, Hesling I, Tzourio-Mazoyer N. Typical and atypical language brain organization based on intrinsic connectivity and multitask functional asymmetries. eLife 2020; 9:e58722. [PMID: 33064079 PMCID: PMC7605859 DOI: 10.7554/elife.58722] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 10/16/2020] [Indexed: 01/23/2023] Open
Abstract
Based on the joint investigation in 287 healthy volunteers (150 left-Handers (LH)) of language task-induced asymmetries and intrinsic connectivity strength of the sentence-processing supramodal network, we show that individuals with atypical rightward language lateralization (N = 30, 25 LH) do not rely on an organization that simply mirrors that of typical leftward lateralized individuals. Actually, the resting-state organization in the atypicals showed that their sentence processing was underpinned by left and right networks both wired for language processing and highly interacting by strong interhemispheric intrinsic connectivity and larger corpus callosum volume. Such a loose hemispheric specialization for language permits the hosting of language in either the left and/or right hemisphere as assessed by a very high incidence of dissociations across various language task-induced asymmetries in this group.
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Affiliation(s)
- Loïc Labache
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CNRS, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CEA, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- Université de Bordeaux, Institut de Mathématiques de Bordeaux, UMR 5251BordeauxFrance
- Bordeaux INP, Institut de Mathématiques de Bordeaux, UMR 5251BordeauxFrance
- INRIA Bordeaux Sud-Ouest, Institut de Mathématiques de Bordeaux, UMR 5251, Contrôle de Qualité et Fiabilité DynamiqueTalenceFrance
| | - Bernard Mazoyer
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CNRS, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CEA, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- Centre Hospitalier Universitaire de BordeauxBordeauxFrance
| | - Marc Joliot
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CNRS, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CEA, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
| | - Fabrice Crivello
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CNRS, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CEA, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
| | - Isabelle Hesling
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CNRS, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CEA, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
| | - Nathalie Tzourio-Mazoyer
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CNRS, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CEA, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
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Smith BW, Chulski NJ, Little AA, Chang KWC, Yang LJS. Effect of fascicle composition on ulnar to musculocutaneous nerve transfer (Oberlin transfer) in neonatal brachial plexus palsy. J Neurosurg Pediatr 2018; 22:181-188. [PMID: 29856295 DOI: 10.3171/2018.3.peds17529] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Neonatal brachial plexus palsy (NBPP) continues to be a problematic occurrence impacting approximately 1.5 per 1000 live births in the United States, with 10%-40% of these infants experiencing permanent disability. These children lose elbow flexion, and one surgical option for recovering it is the Oberlin transfer. Published data support the use of the ulnar nerve fascicle that innervates the flexor carpi ulnaris as the donor nerve in adults, but no analogous published data exist for infants. This study investigated the association of ulnar nerve fascicle choice with functional elbow flexion outcome in NBPP. METHODS The authors conducted a retrospective study of 13 cases in which infants underwent ulnar to musculocutaneous nerve transfer for NBPP at a single institution. They collected data on patient demographics, clinical characteristics, active range of motion (AROM), and intraoperative neuromonitoring (IONM) (using 4 ulnar nerve index muscles). Standard statistical analysis compared pre- and postoperative motor function improvement between specific fascicle transfer (1-2 muscles for either wrist flexion or hand intrinsics) and nonspecific fascicle transfer (> 2 muscles for wrist flexion and hand intrinsics) groups. RESULTS The patients' average age at initial clinic visit was 2.9 months, and their average age at surgical intervention was 7.4 months. All NBPPs were unilateral; the majority of patients were female (61%), were Caucasian (69%), had right-sided NBPP (61%), and had Narakas grade I or II injuries (54%). IONM recordings for the fascicular dissection revealed a donor fascicle with nonspecific innervation in 6 (46%) infants and specific innervation in the remaining 7 (54%) patients. At 6-month follow-up, the AROM improvement in elbow flexion in adduction was 38° in the specific fascicle transfer group versus 36° in the nonspecific fascicle transfer group, with no statistically significant difference (p = 0.93). CONCLUSIONS Both specific and nonspecific fascicle transfers led to functional recovery, but that the composition of the donor fascicle had no impact on early outcomes. In young infants, ulnar nerve fascicular dissection places the ulnar nerve at risk for iatrogenic damage. The data from this study suggest that the use of any motor fascicle, specific or nonspecific, produces similar results and that the Oberlin transfer can be performed with less intrafascicular dissection, less time of surgical exposure, and less potential for donor site morbidity.
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Affiliation(s)
| | | | - Ann A Little
- 2Neurology, University of Michigan, Ann Arbor, Michigan
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10
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Feng JT, Liu HQ, Hua XY, Gu YD, Xu JG, Xu WD. Brain functional network abnormality extends beyond the sensorimotor network in brachial plexus injury patients. Brain Imaging Behav 2017; 10:1198-1205. [PMID: 26630882 DOI: 10.1007/s11682-015-9484-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Brachial plexus injury (BPI) is a type of severe peripheral nerve trauma that leads to central remodeling in the brain, as revealed by functional MRI analysis. However, previously reported remodeling is mostly restricted to sensorimotor areas of the brain. Whether this disturbance in the sensorimotor network leads to larger-scale functional remodeling remains unknown. We sought to explore the higher-level brain functional abnormality pattern of BPI patients from a large-scale network function connectivity dimension in 15 right-handed BPI patients. Resting-state functional MRI data were collected and analyzed using independent component analysis methods. Five components of interest were recognized and compared between patients and healthy subjects. Patients showed significantly altered brain local functional activities in the bilateral fronto-parietal network (FPN), sensorimotor network (SMN), and executive-control network (ECN) compared with healthy subjects. Moreover, functional connectivity between SMN and ECN were significantly less in patients compared with healthy subjects, and connectivity strength between ECN and SMN was negatively correlated with patients' residual function of the affected limb. Functional connectivity between SMN and right FPN were also significantly less than in controls, although connectivity between ECN and default mode network (DMN) was greater than in controls. These data suggested that brain functional disturbance in BPI patients extends beyond the sensorimotor network and cascades serial remodeling in the brain, which significantly correlates with residual hand function of the paralyzed limb. Furthermore, functional remodeling in these higher-level functional networks may lead to cognitive alterations in complex tasks.
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Affiliation(s)
- Jun-Tao Feng
- Department of Hand Surgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Han-Qiu Liu
- Department of Radiology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xu-Yun Hua
- Department of Hand Surgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,Key Laboratory, Jing'an District Central Hospital, Shanghai, China
| | - Yu-Dong Gu
- Department of Hand Surgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jian-Guang Xu
- Department of Hand Surgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wen-Dong Xu
- Department of Hand Surgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China. .,Key Laboratory, Jing'an District Central Hospital, Shanghai, China. .,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China.
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Socolovsky M, Malessy M, Lopez D, Guedes F, Flores L. Current concepts in plasticity and nerve transfers: relationship between surgical techniques and outcomes. Neurosurg Focus 2017; 42:E13. [PMID: 28245665 DOI: 10.3171/2016.12.focus16431] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Neuroplasticity is analyzed in this article as the capacity of the CNS to adapt to external and internal stimuli. It is being increasingly recognized as an important factor for the successful outcome of nerve transfers. Better-known factors are the number of axons that cross the coaptation site, the time interval between trauma and repair, and age. Neuroplasticity is mediated initially by synaptic and neurotransmitter changes. Over time, the activation of previously existing but lowly active connections in the brain cortex contributes further. Dendritic sprouting and axonal elongation might also take place but are less likely to be prominent. METHODS The authors reviewed different factors that play roles in neuroplasticity and functional regeneration after specific nerve transfers. RESULTS The authors found that these different factors include, among others, the distance between cortical areas of the donor and receptor neurons, the presence versus absence of preexisting lowly active interneuronal connections, gross versus fine movement restoration, rehabilitation, brain trauma, and age. CONCLUSIONS The potential for plasticity should be taken into consideration by surgeons when planning surgical strategy and postoperative rehabilitation, because its influence on results cannot be denied.
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Affiliation(s)
- Mariano Socolovsky
- Peripheral Nerve and Plexus Surgery Unit, University of Buenos Aires School of Medicine, Buenos Aires, Argentina
| | - Martijn Malessy
- Department of Neurosurgery, University of Leiden Medical Center, Leiden, The Netherlands
| | - Dan Lopez
- Department of Neurosurgery, Hospital Juarez de México, México City, México
| | - Fernando Guedes
- Department of Neurosurgery, Hospital Universitário Gaffré e Guinle, Federal University of Rio de Janeiro, Rio de Janeiro; and
| | - Leandro Flores
- Department of Neurosurgery, Hospital das Forças Armadas, Brasília, Brazil
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12
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Simon NG, Franz CK, Gupta N, Alden T, Kliot M. Central Adaptation following Brachial Plexus Injury. World Neurosurg 2016; 85:325-32. [DOI: 10.1016/j.wneu.2015.09.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 09/14/2015] [Accepted: 09/15/2015] [Indexed: 12/11/2022]
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Somers M, Aukes MF, Ophoff RA, Boks MP, Fleer W, de Visser KCL, Kahn RS, Sommer IE. On the relationship between degree of hand-preference and degree of language lateralization. BRAIN AND LANGUAGE 2015; 144:10-5. [PMID: 25880901 DOI: 10.1016/j.bandl.2015.03.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 01/07/2015] [Accepted: 03/17/2015] [Indexed: 05/08/2023]
Abstract
Language lateralization and hand-preference show inter-individual variation in the degree of lateralization to the left- or right, but their relation is not fully understood. Disentangling this relation could aid elucidating the mechanisms underlying these traits. The relation between degree of language lateralization and degree of hand-preference was investigated in extended pedigrees with multi-generational left-handedness (n=310). Language lateralization was measured with functional Transcranial Doppler, hand-preference with the Edinburgh Handedness Inventory. Degree of hand-preference did not mirror degree of language lateralization. Instead, the prevalence of right-hemispheric and bilateral language lateralization rises with increasing strength of left-handedness. Degree of hand-preference does not predict degree of language lateralization, thus refuting genetic models in which one mechanism defines both hand-preference and language lateralization. Instead, our findings suggest a model in which increasing strength of left-handedness is associated with increased variation in directionality of cerebral dominance.
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Affiliation(s)
- Metten Somers
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Maartje F Aukes
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Roel A Ophoff
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Human Genetics, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA, USA; Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Marco P Boks
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Willemien Fleer
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Kees C L de Visser
- Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - René S Kahn
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Iris E Sommer
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
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Differences in Brain Adaptive Functional Reorganization in Right and Left Total Brachial Plexus Injury Patients. World Neurosurg 2015; 84:702-8. [PMID: 25936903 DOI: 10.1016/j.wneu.2015.04.046] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 04/21/2015] [Accepted: 04/22/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Total brachial plexus avulsion injury (BPAI) results in the total functional loss of the affected limb and induces extensive brain functional reorganization. However, because the dominant hand is responsible for more cognitive-related tasks, injuries on this side induce more adaptive changes in brain function. In this article, we explored the differences in brain functional reorganization after injuries in unilateral BPAI patients. METHODS We applied resting-state functional magnetic resonance imaging scanning to 10 left and 10 right BPAI patients and 20 healthy control subjects. The amplitude of low-frequency fluctuation (ALFF), which is a resting-state index, was calculated for all patients as an indication of the functional activity level of the brain. Two-sample t-tests were performed between left BPAI patients and controls, right BPAI patients and controls, and between left and right BPAI patients. RESULTS Two-sample t-tests of the ALFF values revealed that right BPAIs induced larger scale brain reorganization than did left BPAIs. Both left and right BPAIs elicited a decreased ALFF value in the right precuneus (P < 0.05, Alphasim corrected). In addition, right BPAI patients exhibited increased ALFF values in a greater number of brain regions than left BPAI patients, including the inferior temporal gyrus, lingual gyrus, calcarine sulcus, and fusiform gyrus. CONCLUSION Our results revealed that right BPAIs induced greater extents of brain functional reorganization than left BPAIs, which reflected the relatively more extensive adaptive process that followed injuries of the dominant hand.
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Chang KWC, Yang LJS, Driver L, Nelson VS. High prevalence of early language delay exists among toddlers with neonatal brachial plexus palsy. Pediatr Neurol 2014; 51:384-9. [PMID: 25160543 PMCID: PMC4792271 DOI: 10.1016/j.pediatrneurol.2014.04.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 04/17/2014] [Accepted: 04/20/2014] [Indexed: 11/28/2022]
Abstract
AIM An association of language impairment with neonatal brachial plexus palsy has not been reported in the literature. The current treatment paradigm for neonatal brachial plexus palsy focuses on upper extremity motor recovery with little formal assessment of other aspects of development, such as language. We performed a cross-sectional pilot study to investigate early language delay prevalence in toddlers with neonatal brachial plexus palsy and potential neonatal brachial plexus palsy-related factors involved. METHOD Twenty toddlers with neonatal brachial plexus palsy were consecutively recruited (12 males and eight females; mean age, 30 months). Preschool Language Scale Score (4th edition), demographics, and socioeconomic status were collected. Neonatal brachial plexus palsy-related factors such as palsy side, treatment type, Narakas grade, muscle Medical Research Council score, and Raimondi hand score were reported. Student t test, chi-square test, or Fisher exact test were applied. Statistical significance level was established at P < 0.05. RESULTS Of study participants, 30% had language delay, whereas the prevalence of language delay in the population with normal development in this age range was approximately 5-15%. INTERPRETATION We observed high language delay prevalence among toddlers with neonatal brachial plexus palsy. Although our subject sample is small, our findings warrant further study of this phenomenon. Early identification and timely intervention based on type of language impairment may be critical for improving communication outcome in this population.
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Affiliation(s)
| | - Lynda J-S Yang
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan
| | - Lynn Driver
- Department of Speech-Language Pathology, University of Michigan, Ann Arbor, Michigan
| | - Virginia S Nelson
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan.
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Abstract
Successful treatment of patients with neonatal brachial plexus palsy (NBPP) begins with a thorough understanding of the anatomy of the brachial plexus and of the pathophysiology of nerve injury via which the brachial plexus nerves stretched in the perinatal period manifest as a weak or paralyzed upper extremity in the newborn. NBPP can be classified by systems that can guide the prognosis and the management as these systems are based on the extent and severity of nerve injury, anatomy of nerve injury, and clinical presentation. Serial physical examinations, supplemented by a thorough maternal and perinatal history, are critical to the formulation of the treatment plan that relies upon occupational/physical therapy and rehabilitation management but may include nerve reconstruction and secondary musculoskeletal surgeries. Adjunctive imaging and electrodiagnostic studies provide additional information to guide prognosis and treatment. As research improves not only the technical aspects of NBPP treatment but also the ability to assess the activity and participation as well as body structure and function of NBPP patients, the functional outcomes for affected infants have an overall optimistic prognosis, with the majority recovering adequate functional use of the affected arm. Of importance are (i) early referral to interdisciplinary specialty clinics that can provide up-to-date advances in clinical care and (ii) increasing research/awareness of the psychosocial and patient-reported quality-of-life issues that surround the chronic disablement of NBPP.
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Affiliation(s)
- Lynda J-S Yang
- Department of Neurosurgery, University of Michigan, 1500 E. Medical Center Dr, Room 3552 TC, Ann Arbor, MI 48109-5338.
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Perlaki G, Horvath R, Orsi G, Aradi M, Auer T, Varga E, Kantor G, Altbäcker A, John F, Doczi T, Komoly S, Kovacs N, Schwarcz A, Janszky J. White-matter microstructure and language lateralization in left-handers: a whole-brain MRI analysis. Brain Cogn 2013; 82:319-28. [PMID: 23792788 DOI: 10.1016/j.bandc.2013.05.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2012] [Revised: 05/17/2013] [Accepted: 05/20/2013] [Indexed: 01/19/2023]
Abstract
Most people are left-hemisphere dominant for language. However the neuroanatomy of language lateralization is not fully understood. By combining functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI), we studied whether language lateralization is associated with cerebral white-matter (WM) microstructure. Sixteen healthy, left-handed women aged 20-25 were included in the study. Left-handers were targeted in order to increase the chances of involving subjects with atypical language lateralization. Language lateralization was determined by fMRI using a verbal fluency paradigm. Tract-based spatial statistics analysis of DTI data was applied to test for WM microstructural correlates of language lateralization across the whole brain. Fractional anisotropy and mean diffusivity were used as indicators of WM microstructural organization. Right-hemispheric language dominance was associated with reduced microstructural integrity of the left superior longitudinal fasciculus and left-sided parietal lobe WM. In left-handed women, reduced integrity of the left-sided language related tracts may be closely linked to the development of right hemispheric language dominance. Our results may offer new insights into language lateralization and structure-function relationships in human language system.
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Affiliation(s)
- Gabor Perlaki
- Department of Neurology, University of Pecs, Ret U. 2, 7623 Pecs, Hungary
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Spaargaren E, Ahmed J, van Ouwerkerk WJR, de Groot V, Beckerman H. Aspects of activities and participation of 7-8 year-old children with an obstetric brachial plexus injury. Eur J Paediatr Neurol 2011; 15:345-52. [PMID: 21511503 DOI: 10.1016/j.ejpn.2011.03.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 03/04/2011] [Accepted: 03/21/2011] [Indexed: 11/25/2022]
Abstract
BACKGROUND Children with an obstetric brachial plexus injury (OBPI) can experience problems in the performance of meaningful activities such as writing, bimanual activities, and participation in sports and leisure activities. AIMS To quantify the everyday functioning and participation of 7-8 year-old children with an OBPI, with special emphasis on writing, and to investigate associated characteristics. METHODS Parents of children with an OBPI were sent a self-report questionnaire regarding the school performance, writing abilities, bimanual hand use, and participation in sports and leisure activities of their child, assessed with the Vineland Adaptive Behavior Scales (VABS sub-scale writing), the ABILHAND-kids, and the Children's Assessment of Participation and Enjoyment (CAPE). Furthermore, questions were asked about socio-demographic variables, medical history, pain, and the use of assistive devices. RESULTS Fifty three questionnaires were filled in (response 61%). According to the parents, 66% of their children were almost completely recovered, and 58% had a near normal arm function. Most of the children preferred to use their non-involved hand. More than 45% of the children complained about pain, and 39.6% had difficulties with writing, which resulted in a mean developmental delay of 8 months on the VABS sub-scale. Children with writing problems significantly more often had neurosurgery, were living with a single parent, more often received assistance at school, and had a significantly lower ABILHAND-kids score, compared to children with no writing problems. CONCLUSIONS Large percentages of 7-8 year-old children with an OBPI experience difficulties with writing and have musculoskeletal pain. Restrictions in participation were less pronounced.
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Affiliation(s)
- Els Spaargaren
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands
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Perlaki G, Orsi G, Kovacs N, Schwarcz A, Pap Z, Kalmar Z, Plozer E, Csatho A, Gabriel R, Komoly S, Janszky I, Janszky J. Coffee consumption may influence hippocampal volume in young women. Brain Imaging Behav 2011; 5:274-84. [DOI: 10.1007/s11682-011-9131-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Auer T, Schweizer R, Frahm J. An iterative two-threshold analysis for single-subject functional MRI of the human brain. Eur Radiol 2011; 21:2369-87. [PMID: 21710268 DOI: 10.1007/s00330-011-2184-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Revised: 05/03/2011] [Accepted: 05/05/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Current thresholding strategies for the analysis of functional MRI (fMRI) datasets may suffer from specific limitations (e.g. with respect to the required smoothness) or lead to reduced performance for a low signal-to-noise ratio (SNR). Although a previously proposed two-threshold (TT) method offers a promising solution to these problems, the use of preset settings limits its performance. This work presents an optimised TT approach that estimates the required parameters in an iterative manner. METHODS The iterative TT (iTT) method is compared with the original TT method, as well as other established voxel-based and cluster-based thresholding approaches and spatial mixture modelling (SMM) for both simulated data and fMRI of a hometown walking task at different experimental settings (spatial resolution, filtering and SNR). RESULTS In general, the iTT method presents with remarkable sensitivity and good specificity that outperforms all conventional approaches tested except for SMM in a few cases. This also holds true for challenging conditions such as high spatial resolution, the absence of filtering, high noise level, or a low number of task repetitions. CONCLUSION Thus, iTT emerges as a good candidate for both scientific fMRI studies at high spatial resolution and more routine applications for clinical purposes.
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Affiliation(s)
- Tibor Auer
- Biomedizinische NMR Forschungs GmbH am Max-Planck-Institut für biophysikalische Chemie, Am Fassberg 11, 37070 Göttingen, Germany.
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Horváth RA, Schwarcz A, Aradi M, Auer T, Fehér N, Kovács N, Tényi T, Szalay C, Perlaki G, Orsi G, Komoly S, Dóczi T, Woermann FG, Gyimesi C, Janszky J. Lateralisation of non-metric rhythm. Laterality 2011; 16:620-35. [PMID: 21424982 DOI: 10.1080/1357650x.2010.515990] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
There are contradictory results on lateralisation and localisation of rhythm processing. Our aim was to test whether there is a hemispheric dissociation of metric and non-metric rhythm processing. We created a non-metric rhythm stimulus without a sense of metre and we measured brain activities during passive rhythm perception. A total of 11 healthy, right-handed, native female Hungarian speakers aged 21.3 ± 1.1 were investigated by functional magnetic resonance imaging (fMRI) using a 3T MR scanner. The experimental acoustic stimulus consisted of comprehensive sentences transformed to Morse code, which represent a non-metric rhythm with irregular perceptual accent structure. Activations were found in the right hemisphere, in the posterior parts of the right-sided superior and middle temporal gyri and temporal pole as well as in the orbital part of the right inferior frontal gyrus. Additional activation appeared in the left-sided superior temporal region. Our study suggests that non-metric rhythm with irregular perceptual accents structure is confined to the right hemisphere. Furthermore, a right-lateralised fronto-temporal network extracts the continuously altering temporal structure of the non-metric rhythm.
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Kalmar Z, Kovacs N, Perlaki G, Nagy F, Aschermann Z, Kerekes Z, Kaszas B, Balas I, Orsi G, Komoly S, Schwarcz A, Janszky J. Reorganization of Motor System in Parkinson’s Disease. Eur Neurol 2011; 66:220-6. [DOI: 10.1159/000330658] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Accepted: 06/22/2011] [Indexed: 11/19/2022]
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Maitre NL, Marshall DD, Price WA, Slaughter JC, O’Shea TM, Maxfield C, Goldstein RF. Neurodevelopmental outcome of infants with unilateral or bilateral periventricular hemorrhagic infarction. Pediatrics 2009; 124:e1153-60. [PMID: 19948617 PMCID: PMC4000308 DOI: 10.1542/peds.2009-0953] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Periventricular hemorrhagic infarction (PVHI) is a major contributing factor to poor neurodevelopmental outcomes in preterm infants. We hypothesized that surviving infants with unilateral PVHI would have more favorable outcomes than those with bilateral PVHI. METHODS This was a multicenter, retrospective study of infants who were admitted to 3 NICUs in North Carolina from 1998 to 2004. The clinical course and late neuroimaging studies and neurodevelopmental outcomes of 69 infants who weighed <1500 g and had confirmed PVHI on early cranial ultrasonography were reviewed. A predictive model for Bayley Scales of Infant Development, Second Edition, Mental Developmental Index (MDI) <70 was constructed by using radiologic and clinical variables. RESULTS Infants with unilateral PVHI had higher median MDI (82 vs 49) and Psychomotor Developmental Index (53 vs 49) than infants with bilateral PVHI. Infants with unilateral PVHI were less likely to have severe cerebral palsy (adjusted odds ratio: 0.15 [95% confidence interval (CI): 0.05-0.45]) than infants with bilateral PVHI. Infants who had unilateral PVHI and developed periventricular leukomalacia and retinopathy of prematurity that required surgery had an increased probability of having MDI <70 compared with those without these complications (probability of MDI <70: 89% [95% CI: 0.64-1.00] vs 11% [95% CI: 0.01-0.28]). CONCLUSIONS Infants with unilateral PVHI had better motor and cognitive outcomes than infants with bilateral PVHI. By combining laterality of PVHI, periventricular leukomalacia, and retinopathy of prematurity it is possible to estimate the probability of having an MDI <70, which will assist clinicians when counseling families.
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Affiliation(s)
- Nathalie L. Maitre
- Department of Pediatrics, Monroe Carell Children’s Hospital at Vanderbilt, Nashville, Tennessee
| | - Diane D. Marshall
- Department of Pediatrics, University of North Carolina Hospital, Chapel Hill, North Carolina
| | - Wayne A. Price
- Department of Pediatrics, University of North Carolina Hospital, Chapel Hill, North Carolina
| | - James C. Slaughter
- Department of Biostatistics, Vanderbilt University, Nashville, Tennessee
| | - Thomas M. O’Shea
- Department of Pediatrics, Wake Forest University, Winston Salem, North Carolina
| | - Charles Maxfield
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
,Department of Radiology, Duke University Medical Center, Durham, North Carolina
| | - Ricki F. Goldstein
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
,Department of Radiology, Duke University Medical Center, Durham, North Carolina
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