The inflow of sensory information for the control of standing is graded and bidirectional

Influence of postural control difficulty on changes in spatial orienting of attention after leftward prism adaptation

Prism adaptation (PA) affects visuospatial attention such as spatial orienting in both the right and left hemifields; however, the systematic after-effects of PA on visuospatial attention remain unclear. Visuospatial attention can be affected by non-spatial attentional factors, and postural control difficulty, which delays the reaction time (RT) to external stimulation, may be one such factor. Therefore, we aimed to investigate the influence of postural control difficulty on changes in spatial orienting of attention after leftward PA. Seventeen healthy young adults underwent 15-min and 5-min PA procedures for a leftward visual shift (30 diopters). Participants underwent the Posner cueing test immediately before (pre-evaluation) and in between and after the PA procedures (post-evaluations) while standing barefoot on the floor (normal standing condition) and on a balance-disc (balance standing condition). In the pre-evaluation, RTs in the balance standing condition were significantly longer compared to those in the normal standing condition for targets appearing in both the right and left hemifields. Leftward PA improved the RT for targets appearing in the right, but no left, hemifield in the balance standing condition, such that RTs for targets in the right hemifield in the post-evaluation were not significantly different between the two standing conditions. However, leftward PA did not significantly change RTs for targets in both hemifields in the normal standing condition. Therefore, postural control difficulty may enhance sensitivity to the features of the visuospatial cognitive after-effects of leftward PA.

Evaluation of the Effect of Reduction Mammoplasty on Body Posture in Patients with Macromastia

BACKGROUND

Breast hypertrophy is a significant health problem with both physiological and psychological impacts on the patients' lives. Patients with macromastia adopt a corrective posture due to the effect of the breast on the center of gravity and possibly in a subconscious effort to conceal their breasts.

OBJECTIVE

This study aimed to evaluate whether the posture of patients with macromastia changed after the reduction of mammoplasty.

MATERIAL AND METHODS

In this prospective study, patients with breast cup sizes C, D, and DD were scheduled for reduction mammoplasty in 3 Shiraz University Hospitals. Age, weight, height, and preoperative cup sizes of the breasts were recorded for every patient, and all patients underwent posture analysis with forceplate before and after reduction mammoplasty. Finally, the preoperative and postoperative data were compared.

RESULTS

Mean age at the time of reduction mammaplasty was 43.57±9.1; the mean pre-operation, such as weight, height, and mean the body mass index (BMI) was 76.57±10 kg, 158.28±6 cm and 30.57±4.1, respectively. The average Anterior-posterior (AP) direction velocity before and after the surgery was 0.85±0.12 cm/s and 0.79±0.098, respectively. These values were 0.83±0.09 and 0.81±0.10 for the mediolateral direction. The Detrended Fluctuation Analysis (DFA) value for the AP direction was 1.63±0.3 and 1.60±0.2 for pre-and post-surgery, respectively, which was not statistically different. The DFA value for maximum likelihood (ML) direction was 1.65±0.2 and 1.48±0.2 in pre-op and post-op, respectively, which was statistically significantly different.

CONCLUSION

Reducing the weight of enlarged breasts can correct disturbed sagittal balance and postural sway.

Postural displacement induced by electrical stimulation; A new approach to examine postural recovery

Background

Controlling upright posture entails acute adjustments by the neuromuscular system to keep the center of mass (COM) within the limits of a relatively small base of support. Sudden displacement of the COM triggers several strategies and balance recovery mechanisms to prevent excessive COM displacement.

New method

We have examined and quantified a new approach to induce an internal neuromuscular perturbation in standing posture on 15 healthy individuals to provide an insight into the mechanism of loss of balance (LOB). The method comprises eliciting an H-reflex protocol while subjects are standing which produces a contraction in soleus and gastrocnemius muscles. We have also defined analytical techniques to provide biomarkers of balance control during perturbation. We used M-Max unilaterally or bilaterally and induced a forward or sideway perturbation. The vector analysis and the Equilibrium Point calculations defined here can quantify the amplitude, direction, and evolution of the perturbation.

Results

Clear patterns of loss of balance due to stimulation was observed. Compared to quiet standing, the density of the EPs substantially increased in the perturbation phase. Leftward stimulation produced significantly higher number of EPs compared to the bilateral stimulation condition which could be due to the fact that the left leg was the nondominant side in all our subjects.

Comparison and conclusion

In this study we provide a proof-of-concept technique for examining recovery from perturbation. The advantage of this technique is that it provides a safe perturbation, is internally induced at the spinal cord level, and is free from other factors that might complicate the recovery analysis (e.g., locomotion and the integration of the spinal pattern generator and cutaneous pathways in mediating changes). We have shown that the perturbation induced by this method can be quantified as vectors. We have also shown that the density of instantaneous equilibrium points (EPs) could be a good biomarker for defining and examining the perturbation phase. Thus, this protocol and analysis provides a unique individual assessment of recovery which can be used to assess interventions. Finally, given that the maximal motor response is used as the perturbation (e.g., M-max) it is highly reliable and reproducible within an individual patient.

Pathogenesis of cerebral palsy through the prism of immune regulation of nervous tissue homeostasis: literature review

BACKGROUND

The cerebral palsy is highly actual issue of pediatrics, causing significant neurological disability. Though the great progress in the neuroscience has been recently achieved, the pathogenesis of cerebral palsy is still poorly understood.

METHODS

In this work, we reviewed available experimental and clinical data concerning the role of immune cells in pathogenesis of cerebral palsy. Maintaining of homeostasis in nervous tissue and its transformation in case of periventricular leukomalacia were analyzed.

RESULTS

The reviewed data demonstrate involvement of immune regulatory cells in the formation of nervous tissue imbalance and chronicity of inborn brain damage. The supported opinion, that periventricular leukomalacia is not a static phenomenon, but developing process, encourages our optimism about the possibility of its correction.

CONCLUSIONS

The further studies of changes of the nervous and immune systems in cerebral palsy are needed to create fundamentally new directions of the specific therapy and individual schemes of rehabilitation.

After stroke bidirectional modulation of soleus stretch reflex amplitude emerges during rhythmic arm cycling

OBJECTIVES

after stroke a typical presentation is exaggerated stretch reflexes (SRs) on the more affected (MA) side. The present study evaluated the contribution of presynaptic inhibition (PSI) induced by arm cycling and homosynaptic depression (HD) to the modulation of hyperreflexia at the ankle after stroke. Possible asymmetry of these effects between the MA and less affected (LA) legs was also assessed.

METHODS

soleus SR was conditioned by: arm cycling at 1 Hz (to increase Ia PSI); or, a preceding conditioning tendon tap applied 1 s before the test stimulus (to induce HD). The extent of conditioning effects was compared between the MA and the LA legs.

RESULTS

for both MA and LA legs, rhythmic arm movement induced a bidirectional effect in different participants, either increasing or decreasing SR amplitude (p < 0.05). HD had a significant effect in both legs (p < 0.05), however, the effect of both a previous muscle stretch and arm cycling was not different between the MA and the LA legs.

CONCLUSION

our data reveal a bidirectional reflex modulation induced by arm cycling that produced facilitation in some and suppression in other participants after stroke. Relative SR amplitude modulation did not differ between the LA and MA legs. We speculate that alterations in SR amplitude modulation after stroke may reflect specific changes in both presynaptic afferent transmission mechanisms and fusimotor control.

SIGNIFICANCE

the present findings open new perspectives on the characterization of pathophysiology of stroke during the performance of functionally relevant motor tasks.

Input-output characteristics of soleus homonymous Ia afferents and corticospinal pathways during upright standing differ between young and elderly adults

AIM

This study investigated the effects of ageing on the excitability of soleus homonymous Ia afferents and corticospinal pathways during bipedal upright standing.

METHODS

The input-output relations for the Hoffmann (H) reflex and motor-evoked potential (MEP) were computed for the soleus in response to electrical nerve stimulation and transcranial magnetic stimulation, respectively, in young (n = 16) and elderly (n = 16) adults. In subsets of subjects, the input-output relations were compared between normal and supported upright standing, and corticomotoneuronal excitability was assessed during upright standing with an H-reflex conditioning method. For the H-reflex and MEP threshold, maximal amplitude (Hmax , MEPmax ) and the slope of the input-output relation (Hslope , MEPslope ) were measured and normalized to the corresponding M-wave value.

RESULTS

In normal standing, the Hmax /Mmax [mean (SD); young: 48.3 (14.2)%; elderly: 17.3 (6.4)%] and Hslope /Mslope were significantly (P < 0.05) lower in elderly than in young adults, whereas the MEPmax /Mmax [young: 13.6 (7.5)%; elderly: 24.5 (12.8)%] and MEPslope /Mslope were greater in elderly adults (P < 0.05). The Hslope /Mslope and MEPslope /Mslope decreased and increased, respectively, from supported to normal standing for both age groups but more so in elderly adults. Furthermore, the conditioned H reflex was greater (P < 0.05) in elderly [175.1 (34.3)%] than in young adults [141.8 (29.8)%] during normal standing.

CONCLUSION

This is the first study that clearly indicates lower efficacy of Ia afferents to discharge spinal motor neurones accompanied by greater corticospinal excitability in elderly adults, suggesting an increased contribution of the descending drive in controlling soleus activity during upright standing with ageing.

Cognitive demand does not influence the responsiveness of homonymous Ia afferents pathway during postural dual task in young and elderly adults

PURPOSE

This study was designed to investigate the influence of a cognitive task on the responsiveness of the homonymous Ia afferents pathway during upright standing in young and elderly adults.

METHODS

Twelve young and twelve elderly adults stood upright on a foam surface positioned over a force platform, and performed a colour-naming test (cognitive task) with two cognitive loads: congruent and incongruent colour conditions. The rate of correct response in naming colour (accuracy) and associated reaction time (RT) were recorded for the cognitive task. The excursion of the centre of pressure and surface electromyogramme (EMG) of leg muscles were measured. Modulation in the efficacy of homonymous Ia afferents to discharge spinal motor neurones was assessed by means of the Hoffmann (H) reflex method.

RESULTS

The accuracy and RT were similar in the congruent condition between young and elderly adults (p > 0.05), and increased for both age groups in the incongruent condition, but more so for elderly adults (p = 0.014). In contrast, the H reflex amplitude did not change with the cognitive load. The excursions of the centre of pressure in the sagittal plane and muscle EMG did not vary with colour conditions in both groups (p > 0.05).

CONCLUSION

This study indicates a lack of modulation in the efficacy of group Ia afferent to activate soleus motor neurones with the cognitive demand of a concurrent task during upright standing in young and elderly adults.

Activity-dependent plasticity of spinal circuits in the developing and mature spinal cord

Part of the development and maturation of the central nervous system (CNS) occurs through interactions with the environment. Through physical activities and interactions with the world, an animal receives considerable sensory information from various sources. These sources can be internally (proprioceptive) or externally (such as touch and pressure) generated senses. Ample evidence exists to demonstrate that the sensory information originating from large diameter afferents (Ia fibers) have an important role in inducing essential functional and morphological changes for the maturation of both the brain and the spinal cord. The Ia fibers transmit sensory information generated by muscle activity and movement. Such use or activity-dependent plastic changes occur throughout life and are one reason for the ability to acquire new skills and learn new movements. However, the extent and particularly the mechanisms of activity-dependent changes are markedly different between a developing nervous system and a mature nervous system. Understanding these mechanisms is an important step to develop strategies for regaining motor function after different injuries to the CNS. Plastic changes induced by activity occur both in the brain and spinal cord. This paper reviews the activity-dependent changes in the spinal cord neural circuits during both the developmental stages of the CNS and in adulthood.