1
|
García M, Amayra I, Pérez M, Salgueiro M, Martínez O, López-Paz JF, Allen PA. Cognition in Chiari Malformation Type I: an Update of a Systematic Review. Neuropsychol Rev 2023:10.1007/s11065-023-09622-2. [PMID: 37798373 DOI: 10.1007/s11065-023-09622-2] [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: 03/31/2023] [Accepted: 09/26/2023] [Indexed: 10/07/2023]
Abstract
Chiari malformation has been classified as a group of posterior cranial fossa disorders characterized by hindbrain herniation. Chiari malformation type I (CM-I) is the most common subtype, ranging from asymptomatic patients to those with severe disorders. Research about clinical manifestations or medical treatments is still growing, but cognitive functioning has been less explored. The aim of this systematic review is to update the literature search about cognitive deficits in CM-I patients. A literature search was performed through the following electronic databases: MEDLINE, PsychINFO, Pubmed, Cochrane Library, Scopus, and Web of Science. The date last searched was February 1, 2023. The inclusion criteria were as follows: (a) include pediatric or adult participants with a CM-I diagnosis, (b) include cognitive or neuropsychological assessment with standardized tests, (c) be published in English or Spanish, and (d) be empirical studies. Articles that did not report empirical data, textbooks and conference abstracts were excluded. After the screening, twenty-eight articles were included in this systematic review. From those, twenty-one articles were focused on adult samples and seven included pediatric patients. There is a great heterogeneity in the recruited samples, followed methodology and administered neurocognitive protocols. Cognitive functioning appears to be affected in CM-I patients, at least some aspects of attention, executive functions, visuospatial abilities, episodic memory, or processing speed. However, these results require careful interpretation due to the methodological limitations of the studies. Although it is difficult to draw a clear profile of cognitive deficits related to CM-I, the literature suggests that cognitive dysfunction may be a symptom of CM-I. This suggest that clinicians should include cognitive assessment in their diagnostic procedures used for CM-I. In summary, further research is needed to determine a well-defined cognitive profile related to CM-I, favoring a multidisciplinary approach of this disorder.
Collapse
Affiliation(s)
- Maitane García
- Department of Psychology, Faculty of Health Sciences, Neuro-E-Motion Research Team, University of Deusto, Bilbao, Spain.
| | - Imanol Amayra
- Department of Psychology, Faculty of Health Sciences, Neuro-E-Motion Research Team, University of Deusto, Bilbao, Spain
| | - Manuel Pérez
- Department of Psychology, Faculty of Health Sciences, Neuro-E-Motion Research Team, University of Deusto, Bilbao, Spain
- Faculty of Health Sciences, Isabel I University, Burgos, Spain
| | - Monika Salgueiro
- Department of Clinical and Health Psychology, and Research Methodology, Faculty of Psychology, University of the Basque Country, Donostia, Spain
| | - Oscar Martínez
- Department of Psychology, Faculty of Health Sciences, Neuro-E-Motion Research Team, University of Deusto, Bilbao, Spain
| | - Juan Francisco López-Paz
- Department of Psychology, Faculty of Health Sciences, Neuro-E-Motion Research Team, University of Deusto, Bilbao, Spain
| | - Philip A Allen
- Conquer Chiari Research Center, Department of Psychology, University of Akron, Akron, OH, USA
| |
Collapse
|
2
|
Yılmaz Y, Karademir M, Caygın T, Yağcıoğlu OK, Özüm Ü, Kuğu N. Executive Functions, Intellectual Capacity, and Psychiatric Disorders in Adults with Type 1 Chiari Malformation. World Neurosurg 2022; 168:e607-e612. [DOI: 10.1016/j.wneu.2022.10.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/17/2022] [Indexed: 11/08/2022]
|
3
|
Sari SA, Ozum U. The executive functions, intellectual capacity, and psychiatric disorders in adolescents with Chiari malformation type 1. Childs Nerv Syst 2021; 37:2269-2277. [PMID: 33608747 DOI: 10.1007/s00381-021-05085-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 02/09/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE In the last two decades, the non-motor functions of the cerebellum have become the centre of attention for researchers. Anecdotal observations of cognitive and psychiatric manifestations of cerebellar lesions have increased this interest. We aimed to investigate the executive function (EF), intellectual capacity, and comorbid psychiatric disorders in adolescents with Chiari malformation type 1 (CM1), which is a pathological manifestation of posterior cranial fossa structures include the cerebellum. METHODS The Chiari group consisted of ten adolescents aged 12-18 years old, and the control group consisted of 13 healthy adolescents with similar age and sex with patients. Stroop test (ST), trail making test (TMT), and Behaviour Rating Inventory of Executive Function-Parent form (BRIEF) were used to evaluate EF; Kent EGY and Porteus Maze Test was used to measuring the intelligence quotient (IQ), and a semi-structured interview was used to determine the psychiatric disorders. RESULTS EF test scores were found comparable between the two groups. IQ scores of the Chiari group were found in the normal range, but significantly lower than controls. No significant difference was revealed in terms of comorbid psychiatric disorders between the two groups. CONCLUSION In this study, we did not observe an impairing effect of CM1 on EF and intelligence. Also, we found that CM1 did not cause more psychiatric disorders compared to controls. Further studies need to support our findings in adolescents diagnosed with CM1.
Collapse
Affiliation(s)
- Seda Aybuke Sari
- Department of Child and Adolescent Psychiatry, Sivas Cumhuriyet University Faculty of Medicine, 58140, Imaret Village, Sivas, Turkey.
| | - Unal Ozum
- Department of Neurosurgery, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| |
Collapse
|
4
|
Neuromuscular Fatigue in Individuals With Intellectual Disability: Comparison Between Sedentary Individuals and Athletes. Motor Control 2021; 25:264-282. [PMID: 33581687 DOI: 10.1123/mc.2020-0036] [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: 05/08/2020] [Revised: 10/16/2020] [Accepted: 12/03/2020] [Indexed: 11/18/2022]
Abstract
The authors explored neuromuscular fatigue in athletes with intellectual disability (AID) compared with sedentary individuals with intellectual disability (SID) and individuals with typical development. Force, voluntary activation level, potentiated resting twitch, and electromyography signals were assessed during isometric maximal voluntary contractions performed before and immediately after an isometric submaximal exhaustive contraction (15% isometric maximal voluntary contractions) and during recovery period. AID presented shorter time to task failure than SID (p < .05). The three groups presented similar isometric maximal voluntary contraction decline and recovery kinetic. Both groups with intellectual disability presented higher voluntary activation level and root mean square normalized to peak-to-peak M-wave amplitude declines (p < .05) compared with individuals with typical development. These declines were more pronounced in SID (p < .05) than in AID. The AID recovered their initial voluntary activation level later than controls, whereas SID did not. SID presented lower potentiated resting twitch decline compared with AID and controls with faster recovery (p < .05). AID presented attenuated central fatigue and accentuated peripheral fatigue compared with their sedentary counterparts, suggesting a neuromuscular profile close to that of individuals with typical development.
Collapse
|
5
|
Jussila MP, Olsén P, Niinimäki J, Suo-Palosaari M. Is Brain MRI Needed in Diagnostic Evaluation of Mild Intellectual Disability? Neuropediatrics 2021; 52:27-33. [PMID: 33111301 DOI: 10.1055/s-0040-1716902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM The purpose of our study was to suggest an imaging strategy and guidelines for the selection of the children with mild intellectual disability (ID) for magnetic resonance imaging (MRI), to avoid unnecessary imaging. METHODS The brain MRIs and patient reports of 471 children were reviewed for the imaging findings and ID severity. The correlation between the clinical and brain MRI findings was analyzed in the 305 children with mild ID. RESULTS Thirty-eight (12.5%) of the children with mild ID had significant abnormal brain MRI findings. Thirty-five of these had other neurological symptoms or diseases in addition to ID, which were an indication for brain MRI. In the logistic regression analysis, seizures (in patients without an epilepsy diagnosis), epilepsy, movement disorders, dysmorphia, encephalitis, traumatic brain injury, and abnormal head size were statistically significant symptoms or comorbidities associated with abnormal MRI findings. Only three children (1.0%) with mild ID had a significant MRI finding without any other clinical symptoms or disease. CONCLUSION Routine MRI in children with mild ID without specific neurological symptoms, dysmorphic features, or related diseases is not suggested for revealing an etiology of mild ID. Since children with ID usually need to be sedated for MRI, routine imaging in the diagnostic evaluation of mild ID should be carefully considered. Clinical examination, other symptoms, and related diseases should be carefully assessed to decide the need for MRI.
Collapse
Affiliation(s)
- Miro Pekka Jussila
- Department of Diagnostic Radiology, Oulu University Hospital and Research Unit of Medical Imaging, Physics and Technology, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Päivi Olsén
- Department of Pediatrics and Adolescence, Oulu University Hospital and PEDEGO Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jaakko Niinimäki
- Department of Diagnostic Radiology, Oulu University Hospital and Research Unit of Medical Imaging, Physics and Technology, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Maria Suo-Palosaari
- Department of Diagnostic Radiology, Oulu University Hospital and Research Unit of Medical Imaging, Physics and Technology, Oulu University Hospital and University of Oulu, Oulu, Finland
| |
Collapse
|
6
|
Affes S, Borji R, Zarrouk N, Sahli S, Rebai H. Effects of running exercises on reaction time and working memory in individuals with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:99-112. [PMID: 33164281 DOI: 10.1111/jir.12798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 10/11/2020] [Accepted: 10/12/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND This study explored the effect of running exercises at low [30% heart rate reserve (HRR)] and moderate (60%HRR) intensities on cognitive performances in individuals with intellectual disability (ID). METHODS Participants performed randomly reaction time (RT) tests: visual RT [simple RT (SRT) and choice RT (CRT)], auditory SRT (ASRT) and working memory (WM) (Corsi test) before and after the exercises. RESULTS The results showed that after both exercises, SRT decreased significantly (P < 0.001) in both groups with higher extent (P < 0.05) at 60%HRR compared with 30%HRR. CRT decreased (P < 0.01), similarly, after the both exercises in both groups with higher (P < 0.001) extent in the intellectual disability group (IDG). ASRT decreased significantly, at 30%HRR, in IDG (P < 0.001) and in control group (CG) (P < 0.01) with greater extent in IDG (P < 0.001). At 60%HRR, ASRT decreased significantly in both groups (P < 0.001) with greater extent in IDG (P < 0.001). The ΔASRT% was significantly (P < 0.05) higher at 30%HRR compared with 60%HRR in IDG. In CG, no significant (P = 0.21) difference was reported between intensities. The Corsi forward and the Corsi backward scores increased significantly (P < 0.01) in both groups after both intensities with higher extent in IDG (P < 0.01). CONCLUSIONS Our results suggest that low and moderate running exercises improve similarly simple and choice visual RT as well as WM in individuals with ID. Furthermore, low-intensity exercise could be more appropriate to enhance ASRT compared the moderate one in these individuals. Therefore, low-intensity exercise seems to be an efficient strategy to improve cognitive performances in individuals with ID.
Collapse
Affiliation(s)
- S Affes
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - R Borji
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - N Zarrouk
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - S Sahli
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - H Rebai
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| |
Collapse
|
7
|
Zghal F, Borji R, Colson SS, Sahli S, Rebai H. Neuromuscular characteristics in trained vs. sedentary male adults with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:1334-1345. [PMID: 31342612 DOI: 10.1111/jir.12674] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 06/27/2019] [Accepted: 07/02/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND This study aimed to explore muscle strength production and its underlying neuromuscular characteristics in sedentary and trained individuals with intellectual disability (ID) compared with healthy sedentary individuals. METHODS Three adult groups (age: 25.07 ± 0.70) consisting of sedentary individuals with ID (IDSG), trained individuals with ID (IDTG) and a control group (CONT) participated in the present study. Peak torque (PT) during maximal voluntary isometric contraction, voluntary activation level (VAL), surface electromyography (sEMG) recordings, electrophysiological (Mmax ) and potentiated twitch torque (PTT responses) of the knee extensor muscles and thigh muscle volume were assessed. RESULTS Compared with CONT and IDTG, respectively, IDSG presented significantly lower PT (-48% and -42%), VAL (-24% and -9%), sEMG (-49% and -29%), Mmax (-41% and -39%) and PTT (-32% and -28%) values. These deficits were reduced between IDTG compared with CONT (i.e. PT: -10%; VAL: -16%; and sEMG: -28%) or did not differ anymore (PTT and Mmax ). Normalising PT to thigh muscle volume and/or computing theoretical PT value overwhelm strength production differences between IDTG and CONT. Training background influences the outcomes with IDTG exhibiting greater PT, VAL, sEMG, Mmax and PTT than IDSG. CONCLUSIONS Strength production deficit in IDSG was related to both muscular and neural characteristics compared with healthy controls whereas this deficit mainly arises from neural characteristics for IDTG.
Collapse
Affiliation(s)
- F Zghal
- Faculté des Sciences du Sport, Université Côte d'Azur, LAMHESS, Nice, France
- Research Unit: "Education, Motricity, Sports and Health" (UR 15JS01), Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - R Borji
- Research Unit: "Education, Motricity, Sports and Health" (UR 15JS01), Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - S S Colson
- Faculté des Sciences du Sport, Université Côte d'Azur, LAMHESS, Nice, France
| | - S Sahli
- Research Unit: "Education, Motricity, Sports and Health" (UR 15JS01), Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - H Rebai
- Research Unit: "Education, Motricity, Sports and Health" (UR 15JS01), Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| |
Collapse
|
8
|
Borji R, Zghal F, Zarrouk N, Martin V, Sahli S, Rebai H. Neuromuscular fatigue and recovery profiles in individuals with intellectual disability. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:242-248. [PMID: 31193221 PMCID: PMC6523034 DOI: 10.1016/j.jshs.2017.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 01/01/2017] [Accepted: 02/14/2017] [Indexed: 06/09/2023]
Abstract
PURPOSE This study aimed to explore neuromuscular fatigue and recovery profiles in individuals with intellectual disability (ID) after exhausting submaximal contraction. METHODS Ten men with ID were compared to 10 men without ID. The evaluation of neuromuscular function consisted in brief (3 s) isometric maximal voluntary contraction (IMVC) of the knee extension superimposed with electrical nerve stimulation before, immediately after, and during 33 min after an exhausting submaximal isometric task at 15% of the IMVC. Force, voluntary activation level (VAL), potentiated twitch (Ptw), and electromyography (EMG) signals were measured during IMVC and then analyzed. RESULTS Individuals with ID developed lower baseline IMVC, VAL, Ptw, and RMS/Mmax ratio (root-mean-square value normalized to the maximal peak-to-peak amplitude of the M-wave) than controls (p < 0.05). Nevertheless, the time to task failure was significantly longer in ID vs. controls (p < 0.05). The 2 groups presented similar IMVC decline and recovery kinetics after the fatiguing exercise. However, individuals with ID presented higher VAL and RMS/Mmax ratio declines but lower Ptw decline compared to those without ID. Moreover, individuals with ID demonstrated a persistent central fatigue but faster recovery from peripheral fatigue. CONCLUSION These differences in neuromuscular fatigue profiles and recovery kinetics should be acknowledged when prescribing training programs for individuals with ID.
Collapse
Affiliation(s)
- Rihab Borji
- Research Unit Education, Motor Skills, Sports and Health (EM2S, UR15JS01), Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia
| | - Firas Zghal
- Research Unit Education, Motor Skills, Sports and Health (EM2S, UR15JS01), Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia
| | - Nidhal Zarrouk
- Research Unit Education, Motor Skills, Sports and Health (EM2S, UR15JS01), Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia
| | - Vincent Martin
- Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions, Blaise Pascal University, Clermont-Ferrand 63000, France
| | - Sonia Sahli
- Research Unit Education, Motor Skills, Sports and Health (EM2S, UR15JS01), Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia
| | - Haithem Rebai
- Research Unit Education, Motor Skills, Sports and Health (EM2S, UR15JS01), Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia
| |
Collapse
|
9
|
Rogers JM, Savage G, Stoodley MA. A Systematic Review of Cognition in Chiari I Malformation. Neuropsychol Rev 2018; 28:176-187. [PMID: 29468516 DOI: 10.1007/s11065-018-9368-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 02/01/2018] [Indexed: 11/25/2022]
Abstract
Displacement of the cerebellar tonsils in Chiari type I malformation (CMI) can affect functions controlled by the cerebellum and brainstem. While playing an integral role in the control of movement, the cerebellum also has widespread cortical connections, influencing a range of cognitive process. A systematic literature review was conducted to examine the relationship between cognition and CMI, assessing evidence for general or domain-specific cognitive change. The search protocol examined the AMED, CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, and Scopus databases. Articles meeting the following criteria were included in this review (i) examined children or adults with a clinically defined diagnosis of CMI, (ii) assessed cognitive function with a prospective examination, (iii) included at least one standardized instrument designed to measure general or specific domains of cognitive function, and (iv) were published in English in a peer-reviewed journal. Twelve articles were identified, including 783 cases aged 3 months to 64 years. General cognition, processing speed, and learning and memory appeared less affected, while language deficits appeared to diminish with age. Executive dysfunction was the most commonly reported cognitive impairment, while attention and working memory, and visuospatial and perceptual skills also appeared vulnerable. Numerous methodological limitations were identified that should be considered in interpreting the impact of CMI and planning future investigations. Overall, there is currently insufficient evidence to describe a valid and reliable profile of cognitive impairment in CMI. Further research is required to confirm these preliminary psychometric results and integrate them with pathophysiological models.
Collapse
Affiliation(s)
- Jeffrey M Rogers
- Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Level 1, 75 Talavera Rd, New South Wales, 2109, Australia.
| | - Greg Savage
- ARC Centre of Excellence in Cognition and its Disorders, Department of Psychology, Macquarie University, New South Wales, 2109, Australia
| | - Marcus A Stoodley
- Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Level 1, 75 Talavera Rd, New South Wales, 2109, Australia
| |
Collapse
|
10
|
Borji R, Zghal F, Zarrouk N, Sahli S, Rebai H. Individuals with intellectual disability have lower voluntary muscle activation level. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:3574-3581. [PMID: 25241117 DOI: 10.1016/j.ridd.2014.08.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 08/26/2014] [Accepted: 08/28/2014] [Indexed: 06/03/2023]
Abstract
The aim of this study was to explore the voluntary activation level during maximal voluntary contraction (MVC) in individuals with intellectual disability (ID) versus individuals without ID using the twitch interpolation technique. Ten individuals with mild ID (ID group) and 10 sedentary men without ID (control group) participated in this study. The evaluation of neuromuscular function consisted in three brief MVCs (3s) of the knee extension superimposed with electrical nerve stimulation (NES) to measure voluntary activation. Muscle activity levels were also measured with surface EMG. The root mean square (RMS) was extracted from the EMG signal. The RMS/Mmax ratio and the neuromuscular efficiency (NME) were calculated. Our results reported that individuals with ID present lower muscle strength (p < 0.001), lower voluntary activation level (p < 0.001), lower RMS values of vastus lateralis (p < 0.05), vastus medialis (p < 0.05), and rectus femoris (p < 0.001) muscles. In addition, our results showed lower RMS/Mmax values in the ID group than in the control group for the VM (0.05 ± 0.01 mV vs. 0.04 ± 0.01 mV; p < 0.05) and the RF (0.06 ± 0.02 mV vs. 0.05 ± 0.02 mV; p < 0.05) muscles. However, no significant difference was reported for the VL muscle (0.05 ± 0.02 mV vs. 0.05 ± 0.02 mV; p=0.463). Moreover, Individuals with ID present smaller potentiated twitch (p < 0.001). However, no significant difference was reported in the NME ratio. These results suggest that the lower muscle strength known in individuals with ID is related to a central nervous system failure to activate motor units and to some abnormal intrinsic muscle properties. It seems that the inactive lifestyle adopted by individuals with ID is one of the most important factors of their lower voluntary activation levels. Therefore, physical activities should be introduced in life style of individuals with ID to improve their neuromuscular function.
Collapse
Affiliation(s)
- Rihab Borji
- Unité de Recherche Education, Motricité, Sports et santé, Institut Supérieur du Sport et de l'Education Physique de Sfax, Université de Sfax, Tunisia.
| | - Firas Zghal
- Laboratoire Adaptations Métaboliques à l'Exercice en Conditions Physiologiques et Pathologiques (AME2P, EA 3533), Université Blaise Pascal, Clermont-Ferrand, France.
| | - Nidhal Zarrouk
- Laboratoire des techniques d'imagerie médicale (LR 12ES06, LTIM), Faculté de Médicine de Monastir, Université de Monastir, Tunisia.
| | - Sonia Sahli
- Unité de Recherche Education, Motricité, Sports et santé, Institut Supérieur du Sport et de l'Education Physique de Sfax, Université de Sfax, Tunisia.
| | - Haithem Rebai
- Unité de Recherche Education, Motricité, Sports et santé, Institut Supérieur du Sport et de l'Education Physique de Sfax, Université de Sfax, Tunisia.
| |
Collapse
|
11
|
Borji R, Sahli S, Zarrouk N, Zghal F, Rebai H. Neuromuscular fatigue during high-intensity intermittent exercise in individuals with intellectual disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:4477-4484. [PMID: 24139713 DOI: 10.1016/j.ridd.2013.09.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 09/12/2013] [Accepted: 09/13/2013] [Indexed: 06/02/2023]
Abstract
This study examined neuromuscular fatigue after high-intensity intermittent exercise in 10 men with mild intellectual disability (ID) in comparison with 10 controls. Both groups performed three maximal voluntary contractions (MVC) of knee extension with 5 min in-between. The highest level achieved was selected as reference MVC. The fatiguing exercise consists of five sets with a maximal number of flexion-extension cycles at 80% of the one maximal repetition (1RM) for the right leg at 90° with 90 s rest interval between sets. The MVC was tested again after the last set. Peak force and electromyography (EMG) signals were measured during the MVC tests. Root Mean Square (RMS) and Median Frequency (MF) were calculated. Neuromuscular efficiency (NME) was calculated as the ratio of peak force to the RMS. Before exercise, individuals with ID had a lower MVC (p<0.05) and a lower RMS (p<0.05). No significant difference between groups in MF and NME. After exercise, MVC decreases significantly in both groups (p<0.001). Individuals with ID have greater force decline (p<0.001 vs. p<0.01). RMS decreased significantly (p<0.001) whereas the NME increased significantly (p<0.05) in individuals with ID, but both remained unchanged in controls. The MF decreased significantly in both groups (p<0.001). In conclusion, individuals with ID presented a lower peak force than individuals without ID. After a high-intensity intermittent exercise, individuals with ID demonstrated a greater force decline caused by neural activation failure. When rehabilitation and sport train ID individuals, they should consider this nervous system weakness.
Collapse
Affiliation(s)
- Rihab Borji
- Unité de Recherche Adaptations Cardio-circulatoires, Respiratoires, Métaboliques et Hormonales à l'Exercice Musculaire, Faculté de Médecine Ibn El Jazzar, Université du Centre, Sousse, Tunisia.
| | | | | | | | | |
Collapse
|
12
|
Abstract
The diagnosis of Chiari type I malformation (CIM) is more and more frequent in clinical practice due to the wide diffusion of magnetic resonance imaging. In many cases, such a diagnosis is made incidentally in asymptomatic patients, as including children investigated for different reasons such as mental development delay or sequelae of brain injury. The large number of affected patients, the presence of asymptomatic subjects, the uncertainties surrounding the pathogenesis of the malformation, and the different options for its surgical treatment make the management of CIM particularly controversial.This paper reports on the state of the art and the recent achievements about CIM aiming at providing further information especially on the pathogenesis, the natural history, and the management of the malformation, which are the most controversial aspects. A historial review introduces and explains the current classification. Furthermore, the main clinical, radiological, and neurophysiological findings of CIM are described to complete the picture of this heterogeneous and complex disease.
Collapse
Affiliation(s)
- L Massimi
- Pediatric Neurosurgery, Catholic University Medical School, Rome, Italy
| | | | | |
Collapse
|
13
|
Magnetic resonance imaging and proton magnetic resonance spectroscopy of the brain in the diagnostic evaluation of developmental delay. Eur J Paediatr Neurol 2009; 13:181-90. [PMID: 18579422 DOI: 10.1016/j.ejpn.2008.04.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2008] [Accepted: 04/07/2008] [Indexed: 12/17/2022]
Abstract
AIM To assess the contribution of MRI and proton spectroscopy (1HMRS) in establishing an etiological diagnosis in children with developmental delay (DD) and to assess whether the chance of finding specific abnormalities correlates with the presence of neurological signs and/or abnormal head circumference (HC). METHODS Patients were derived from a cohort of 325 consecutive patients with DD receiving structured multidisciplinary evaluation in our centre. Patients had MRI/1HMRS if a diagnosis could not be made clinically and if additional neurological signs and/or abnormal HC and/or an IQ below 50 were present. The MRI protocol consisted of axial IR, T2, FLAIR, sagittal T1 and coronal T2 sequences. Multivoxel 1HMRS was located in a plane superior to the lateral ventricles with voxels in both grey matter and white matter. RESULTS One hundred and nine children were scanned, 80 of them because of neurological signs and/or abnormal HC. Although minor abnormalities were noted in the vast majority of patients, MRI and/or 1HMRS really contributed to an etiological diagnosis in only 10 (9%) patients, all of whom were scanned because of neurological signs. In these 10 patients, 1HMRS was diagnostic in one patient and of additional value to MRI findings in 3 patients. CONCLUSIONS MRI and 1HMRS may contribute to the diagnostic evaluation of DD, especially if applied specifically to patients with neurological signs, whereas its role is very limited in children without these signs.
Collapse
|
14
|
Yu C, Li J, Liu Y, Qin W, Li Y, Shu N, Jiang T, Li K. White matter tract integrity and intelligence in patients with mental retardation and healthy adults. Neuroimage 2008; 40:1533-41. [PMID: 18353685 DOI: 10.1016/j.neuroimage.2008.01.063] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2007] [Revised: 01/06/2008] [Accepted: 01/25/2008] [Indexed: 11/30/2022] Open
Abstract
It is well known that brain structures correlate with intelligence but the association between the integrity of brain white matter tracts and intelligence in patients with mental retardation (MR) and healthy adults remains unknown. The aims of this study are to investigate whether the integrity of corpus callosum (CC), cingulum, uncinate fasciculus (UF), optic radiation (OR) and corticospinal tract (CST) are damaged in patients with MR, and to determine the correlations between the integrity of these tracts and full scale intelligence quotient (FSIQ) in both patients and controls. Fifteen MR patients and 79 healthy controls underwent intelligence tests and diffusion tensor imaging examinations. According to the FSIQ, all healthy controls were divided into general intelligence (GI: FSIQ<120; n=42) and high intelligence (HI: FSIQ> or =120; n=37) groups. Intelligence was assessed by Chinese Revised Wechsler Adult Intelligence Scale, and white matter tract integrity was assessed by fractional anisotropy (FA). MR patients showed significantly lower FA than healthy controls in the CC, UF, OR and CST. However, GI subjects only demonstrated lower FA than HI subjects in the right UF. Partial correlation analysis controlling for age and sex showed that FSIQ scores were significantly correlated with the FA of the bilateral UF, genu and truncus of CC, bilateral OR and left CST. While FSIQ scores were only significantly correlated with the FA of the right UF when further controlling for group. This study indicate that MR patients show extensive damage in the integrity of the brain white matter tracts, and the right UF is an important neural basis of human intelligence.
Collapse
Affiliation(s)
- Chunshui Yu
- Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing 100053, People's Republic of China
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Abstract
Chiari I malformations are congenital abnormalities that are etiologically heterogeneous. Some studies recognize a probable association between Chiari 1 malformation, delayed language or motor development, and mental retardation with or without epilepsy. The present patient appeared to have an isolated cleft palate and Chiari 1 malformation with co-existing functional and behavioral disorders (i.e., speech delay, mental retardation, and deviant electroencephalography [EEG]). In consideration of the cleft palate population, the implication of the present case study is that more attention should be paid to the developmental milestones in children with cleft palate. Because several cases of Chiari I anomaly co-occurring with mental retardation and deviant EEG or epilepsy have been recognized, it appears justified to identify a syndrome, which is here called CHERI (Chiari 1 malformation with or without cleft palate, deviant EEG or epilepsy, and retarded intelligence with delayed language development). It will be important in the future to describe those cases identified to delineate the clinical picture and to estimate the frequency of the occurrence of various characteristics.
Collapse
Affiliation(s)
- Marja-Leena Haapanen
- Department of Otorhinolaryngology, Helsinki University Central Hospital, Helsinki, Finland.
| |
Collapse
|
16
|
Spencer MD, Moorhead TWJ, Lymer GKS, Job DE, Muir WJ, Hoare P, Owens DGC, Lawrie SM, Johnstone EC. Structural correlates of intellectual impairment and autistic features in adolescents. Neuroimage 2006; 33:1136-44. [PMID: 16996749 DOI: 10.1016/j.neuroimage.2006.08.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2006] [Revised: 06/13/2006] [Accepted: 08/11/2006] [Indexed: 11/23/2022] Open
Abstract
Intellectual disability, a common but under-researched condition, is strongly associated with autism spectrum disorders (ASD). Although studies have investigated the neural correlates of intelligence quotient (IQ) and ASD in intellectually unimpaired subjects, these issues have not been addressed in intellectually impaired subjects. We studied 63 intellectually disabled adolescents receiving additional learning support and 72 controls using whole brain tissue volumes extracted from native space and voxel-based morphometry (VBM) in normalised space. We applied a qualitative and quantitative review of VBM preprocessing and modified the optimised method to establish optimum co-registration of the brains in normalised space. We report tissue density differences at cluster level with adjustment for underlying smoothness. Individuals with intellectual disability had smaller total white matter and total brain tissue volumes than controls, as well as reduced grey matter density in the right cerebellar hemisphere and left temporo-parietal cortex, and reduced white matter density in the posterior corpus callosum. Intellectually disabled subjects were additionally subgrouped according to their degree of reported autistic features. Reduced grey matter density was detected in the thalamus of subjects with autistic features scoring within the pervasive developmental disorder range as compared to subjects below the threshold for ASD, and increased white matter density was detected in the left superior temporal gyrus of subjects scoring above the threshold for autism as compared to subjects below the threshold for ASD.
Collapse
Affiliation(s)
- Michael D Spencer
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, UK.
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Decobert F, Grabar S, Merzoug V, Kalifa G, Ponsot G, Adamsbaum C, des Portes V. Unexplained mental retardation: is brain MRI useful? Pediatr Radiol 2005; 35:587-96. [PMID: 15739114 DOI: 10.1007/s00247-005-1406-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2004] [Accepted: 12/28/2004] [Indexed: 10/25/2022]
Abstract
BACKGROUND Mental retardation (MR), defined as an IQ below 70, is a frequent cause of consultation in paediatrics. OBJECTIVE To evaluate the yield of brain MRI in the diagnostic work-up of unexplained MR in children. PATIENTS AND METHODS The MRI features and clinical data of 100 patients (age 1-18 years) affected with non-progressive MR of unknown origin were compared to an age-matched control group (n=100). Two radiologists conducted an independent review of the MRI scans. RESULTS Univariate and multivariate analyses showed a higher incidence of brain anomalies in the MR group than in the control group (53 vs 17, OR=5.7 [2.9-11.1]), for signal abnormalities within the periventricular white matter (OR=20.3 [2.6-155.3]), lateral ventricular dilatation (OR=15.6 [2.0-124]), mild corpus callosum abnormalities (shortness, atrophy) (OR=6.8 [1.8-25.6]) and subtle cerebellar abnormalities, including fissure enlargement (OR=5.2 [1.1-26.2]). The diagnostic value of MRI abnormalities was considered good in 5% of patients (Alexander disease n=1, diffuse cortical malformation n=1, leukomalacia n=1, vermian agenesis n=1, commissural agenesis n=1), and weak in 48% of patients, in whom non-specific abnormalities did not lead to a diagnosis. Some clinical features resulted in a significantly higher percentage of abnormal MRI scans: abnormal neurological examination (82% vs 47%, P=0.008), abnormal skull circumference (66% vs 49%, P=0.04). Motor delay was associated with cerebellar abnormalities (P=0.01). CONCLUSIONS This study confirms the weak diagnostic yield of MRI in mentally retarded children. The use of a control group has enabled us to identify the neuroimaging markers frequently associated with MR. Subgrouping patients according to neuroimaging markers and clinical signs should help identify those who would benefit from molecular studies.
Collapse
Affiliation(s)
- Fabrice Decobert
- Department of Radiology, Saint Vincent de Paul Hospital, 82 Avenue Denfert Rochereau, 75674 Paris Cedex 14, France
| | | | | | | | | | | | | |
Collapse
|
18
|
Grosso S, Scattolini R, Paolo G, Di Bartolo RM, Morgese G, Balestri P. Association of Chiari I malformation, mental retardation, speech delay, and epilepsy: a specific disorder? Neurosurgery 2001; 49:1099-103; discussion 1103-4. [PMID: 11846903 DOI: 10.1097/00006123-200111000-00015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2000] [Accepted: 07/05/2001] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The Chiari I malformation is defined as tonsillar herniation of at least 3 to 5 mm below the foramen magnum. Although Chiari I malformation is considered to derive from a mesodermal disorder resulting in underdevelopment of the posterior fossa relative to its content, evidence for a possible heterogeneous etiology also has been reported. The aim of the present study is to elucidate the relationship between Chiari I malformation and mental retardation, speech delay, and epilepsy to consider a possible specific pathogenetic background. METHODS Thirty-five patients with Chiari I malformations were identified by use of magnetic resonance imaging during a period between 1993 and 1999. The study consisted of nine patients (four boys and five girls) who were affected by mental retardation, speech delay, and epilepsy. All patients underwent electroencephalography and brain and cervical spine magnetic resonance imaging. RESULTS All patients were mentally retarded with a mean intelligence quotient of 50. Seven patients had a positive history for speech delay, and five were epileptic. Electroencephalograms demonstrated abnormalities in seven patients. The mean tonsillar displacement was 10.1 mm. A thin corpus callosum and a wide cavum septum pellucidum were present in three patients. Neither hydromyelia nor scoliosis was observed. No correlation between the degree of the ectopia and clinical manifestation was noted. CONCLUSION The association of Chiari I malformation with epilepsy, speech delay, and mental retardation may not be a mere incidental finding but may be a marker for a different pathogenetic background.
Collapse
Affiliation(s)
- S Grosso
- Department of Pediatrics, University of Siena, Viale M. Bracci, Le Scotte, 53100 Siena, Italy
| | | | | | | | | | | |
Collapse
|
19
|
Grosso S, Scattolini R, Paolo G, Di Bartolo RM, Morgese G, Balestri P. Association of Chiari I Malformation, Mental Retardation, Speech Delay, and Epilepsy: A Specific Disorder? Neurosurgery 2001. [DOI: 10.1227/00006123-200111000-00015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|