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Parent A, Ballaz L, Samadi B, Vocos Pht M, Comtois AS, Pouliot-Laforte A. Static Postural Control Deficits in Adults with Myotonic Dystrophy Type 1, Steinert Disease. J Neuromuscul Dis 2022; 9:311-320. [PMID: 35001896 DOI: 10.3233/jnd-210639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Myotonic dystrophy type 1 (DM1) is characterized by progressive and predominantly distal muscle atrophy and myotonia. Gait and balance impairments, resulting in falls, are frequently reported in this population. However, the extent to which individuals with DM1 rely more on a specific sensory system for balance than asymptomatic individuals (AI) is unknown. OBJECTIVE Evaluate postural control performance in individuals with DM1 and its dependence on vision compared to AI. METHODS 20 participants with DM1, divided into two groups based on their diagnosis, i.e. adult and congenital phenotype, and 12 AI participants were recruited. Quiet standing postural control was assessed in two visual conditions: eyes-open and eyes-closed. The outcomes measures were center of pressure (CoP) mean velocity, CoP range of displacement in anteroposterior and mediolateral axis, and the 95% confidence ellipse's surface. Friedman and Kruskal-Wallis analysis of variance were used to compare outcomes between conditions and groups, respectively. RESULTS Significant group effect and condition effect were observed on postural control performance. No significant difference was observed between the two DM1 groups. The significant differences observed between the AI group and the two DM1 groups in the eyes-open condition were also observed in the eyes-closed condition. CONCLUSIONS The result revealed poorer postural control performance in people with DM1 compared to AI. The DM1 group also showed similar decrease in performance than AI in eyes-closed condition, suggesting no excessive visual dependency.
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Affiliation(s)
- Audrey Parent
- Sainte-Justine UHC Research Center, Centre de Réadaptation Marie Enfant, 5200 rue Bélanger, Montreal (Qc), H1T 1C9, Canada.,Department of Physical Activity Sciences, Université du Québec à Montréal (UQAM), 141 Avenue du Président-Kennedy, Local SB-4290, Montreal (Qc), H2X 1Y4, Canada
| | - Laurent Ballaz
- Sainte-Justine UHC Research Center, Centre de Réadaptation Marie Enfant, 5200 rue Bélanger, Montreal (Qc), H1T 1C9, Canada.,Department of Physical Activity Sciences, Université du Québec à Montréal (UQAM), 141 Avenue du Président-Kennedy, Local SB-4290, Montreal (Qc), H2X 1Y4, Canada
| | - Bahare Samadi
- Sainte-Justine UHC Research Center, Centre de Réadaptation Marie Enfant, 5200 rue Bélanger, Montreal (Qc), H1T 1C9, Canada.,Department of MechanicalEngineering, École Polytechnique de Montréal, 2900 Boulevard Edouard-Montpetit, Montreal (Qc) H3T 1J4, Canada
| | - Maria Vocos Pht
- Centre de réadaptation Lucie-Bruneau du Centreintégré universitaire de santé et services sociaux(CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, 2275 AvenueLaurier E, Montréal (Qc), H2H 2N8, Canada
| | - Alain Steve Comtois
- Department of Physical Activity Sciences, Université du Québec à Montréal (UQAM), 141 Avenue du Président-Kennedy, Local SB-4290, Montreal (Qc), H2X 1Y4, Canada
| | - Annie Pouliot-Laforte
- Sainte-Justine UHC Research Center, Centre de Réadaptation Marie Enfant, 5200 rue Bélanger, Montreal (Qc), H1T 1C9, Canada.,Department of Physical Activity Sciences, Université du Québec à Montréal (UQAM), 141 Avenue du Président-Kennedy, Local SB-4290, Montreal (Qc), H2X 1Y4, Canada
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Hautala S, Tokariev A, Roienko O, Häyrinen T, Ilen E, Haataja L, Vanhatalo S. Recording activity in proximal muscle networks with surface EMG in assessing infant motor development. Clin Neurophysiol 2021; 132:2840-2850. [PMID: 34592561 DOI: 10.1016/j.clinph.2021.07.031] [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: 02/16/2021] [Revised: 06/29/2021] [Accepted: 07/22/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To develop methods for recording and analysing infant's proximal muscle activations. METHODS Surface electromyography (sEMG) of truncal muscles was recorded in three months old infants (N = 18) during spontaneous movement and controlled postural changes. The infants were also divided into two groups according to motor performance. We developed an efficient method for removing dynamic cardiac artefacts to allow i) accurate estimation of individual muscle activations, as well as ii) quantitative characterization of muscle networks. RESULTS The automated removal of cardiac artefacts allowed quantitation of truncal muscle activity, which showed predictable effects during postural changes, and there were differences between high and low performing infants.The muscle networks showed consistent change in network density during spontaneous movements between supine and prone position. Moreover, activity correlations in individual pairs of back muscles linked to infant́s motor performance. CONCLUSIONS The hereby developed sEMG analysis methodology is feasible and may disclose differences between high and low performing infants. Analysis of the muscle networks may provide novel insight to central control of motility. SIGNIFICANCE Quantitative analysis of infant's muscle activity and muscle networks holds promise for an objective neurodevelopmental assessment of motor system.
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Affiliation(s)
- Sini Hautala
- Baba Center, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Department of Clinical Neurophysiology, HUS Medical Imaging Center, University of Helsinki, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | - Anton Tokariev
- Baba Center, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Neuroscience Center, University of Helsinki, Helsinki, Finland
| | - Oleksii Roienko
- Baba Center, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Taru Häyrinen
- Baba Center, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Elina Ilen
- Department of Design, Aalto University, Espoo, Finland
| | - Leena Haataja
- Baba Center, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Sampsa Vanhatalo
- Baba Center, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Department of Clinical Neurophysiology, HUS Medical Imaging Center, University of Helsinki, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Neuroscience Center, University of Helsinki, Helsinki, Finland
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Simoncini C, Spadoni G, Lai E, Santoni L, Angelini C, Ricci G, Siciliano G. Central Nervous System Involvement as Outcome Measure for Clinical Trials Efficacy in Myotonic Dystrophy Type 1. Front Neurol 2020; 11:624. [PMID: 33117249 PMCID: PMC7575726 DOI: 10.3389/fneur.2020.00624] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 05/28/2020] [Indexed: 01/18/2023] Open
Abstract
Increasing evidences indicate that in Myotonic Dystrophy type 1 (DM1 or Steinert disease), an autosomal dominant multisystem disorder caused by a (CTG)n expansion in DMPK gene on chromosome 19q13. 3, is the most common form of inherited muscular dystrophy in adult patients with a global prevalence of 1/8000, and involvement of the central nervous system can be included within the core clinical manifestations of the disease. Variable in its severity and progression rate over time, likely due to the underlying causative molecular mechanisms; this component of the clinical picture presents with high heterogeneity involving cognitive and behavioral alterations, but also sensory-motor neural integration, and in any case, significantly contributing to the disease burden projected to either specific functional neuropsychological domains or quality of life as a whole. Principle manifestations include alterations of the frontal lobe function, which is more prominent in patients with an early onset, such as in congenital and childhood onset forms, here associated with severe intellectual disabilities, speech and language delay and reduced IQ-values, while in adult onset DM1 cognitive and neuropsychological findings are usually not so severe. Different methods to assess central nervous system involvement in DM1 have then recently been developed, these ranging from more classical psychometric and cognitive functional instruments to sophisticated psycophysic, neurophysiologic and especially computerized neuroimaging techniques, in order to better characterize this disease component, at the same time underlining the opportunity to consider it a suitable marker on which measuring putative effectiveness of therapeutic interventions. This is the reason why, as outlined in the conclusive section of this review, the Authors are lead to wonder, perhaps in a provocative and even paradoxical way to arise the question, whether or not the myologist, by now the popular figure in charge to care of a patient with the DM1, needs to remain himself a neurologist to better appreciate, evaluate and speculate on this important aspect of Steinert disease.
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Affiliation(s)
- Costanza Simoncini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giulia Spadoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elisa Lai
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Lorenza Santoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Giulia Ricci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Kadone H, Kubota S, Abe T, Noguchi H, Miura K, Koda M, Shimizu Y, Hada Y, Sankai Y, Suzuki K, Yamazaki M. Muscular Activity Modulation During Post-operative Walking With Hybrid Assistive Limb (HAL) in a Patient With Thoracic Myelopathy Due to Ossification of Posterior Longitudinal Ligament: A Case Report. Front Neurol 2020; 11:102. [PMID: 32296380 PMCID: PMC7136555 DOI: 10.3389/fneur.2020.00102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 01/29/2020] [Indexed: 01/02/2023] Open
Abstract
Disorders of the central nervous system sometimes cause severe sensory motor paralysis accompanied by gait impairment. Recently, there are several reports on the effectiveness of robot-assisted gait training for patients experiencing these issues. The purpose of this case report was to assess the neuromechanical effect of a wearable robot suit HAL (Hybrid Assistive Limb) during post-operative gait training in a patient with gait impairment due to compressive myelopathy caused by ossification of the posterior longitudinal ligament (OPLL). For this purpose, we compared lower limb muscular activities while the patient was walking with and without the robot through a course of treatment sessions by (i) gait phase-dependent muscle usage analysis, (ii) muscle synergy analysis, and (iii) muscle network analysis. The results show (i) enhanced activity of the extensor muscles for weight-bearing in the initial sessions by using HAL and reduced knee extensor and increased hip extensor activations for achieving larger steps and faster gait in the later sessions; (ii) involvement of a greater number of synergies during walking with HAL than without HAL; and (iii) modulated muscle network property during walking with HAL remaining until the next HAL session. The patient's gait was improved after completing HAL sessions, acquiring close to normal joint profile with greater range of joint movement, faster walking speed, and larger step length. We discuss that the muscular activity modulation during walking with HAL suggests altered control of the muscles by the central nervous system during post-operative walking. Activity-dependent sensorimotor augmentation by HAL is discussed in the context of recovery of gait control by the central nervous system. The relationship between the altered control and the achieved gait recovery requires further investigation.
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Affiliation(s)
- Hideki Kadone
- Center for Innovative Medicine and Engineering, University of Tsukuba Hospital, Tsukuba, Japan
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan
| | - Shigeki Kubota
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tetsuya Abe
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroshi Noguchi
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kousei Miura
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba, Japan
| | - Masao Koda
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yukiyo Shimizu
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba, Japan
| | - Yasushi Hada
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba, Japan
| | - Yoshiyuki Sankai
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan
| | - Kenji Suzuki
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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