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Sarasso E, Emedoli D, Gardoni A, Zenere L, Canu E, Basaia S, Doretti A, Ticozzi N, Iannaccone S, Amadio S, Del Carro U, Filippi M, Agosta F. Cervical motion alterations and brain functional connectivity in cervical dystonia. Parkinsonism Relat Disord 2024; 120:106015. [PMID: 38325256 DOI: 10.1016/j.parkreldis.2024.106015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/10/2024] [Accepted: 01/26/2024] [Indexed: 02/09/2024]
Abstract
INTRODUCTION Evaluating the neural correlates of sensorimotor control deficits in cervical dystonia (CD) is fundamental to plan the best treatment. This study aims to assess kinematic and resting-state functional connectivity (RS-FC) characteristics in CD patients relative to healthy controls. METHODS Seventeen CD patients and 14 age-/sex-matched healthy controls were recruited. Electromagnetic sensors were used to evaluate dystonic pattern, mean/maximal cervical movement amplitude and joint position error with eyes open and closed, and movement quality during target reaching with the head. RS-fMRI was acquired to compare the FC of brain sensorimotor regions between patients and controls. In patients, correlations between motion analysis and FC data were assessed. RESULTS CD patients relative to controls showed reduced mean and maximal cervical range of motion (RoM) in rotation both towards and against dystonia pattern and reduced total RoM in rotation both with eyes open and closed. They had less severe dystonia pattern with eyes open vs eyes closed. CD patients showed an altered movement quality and sensorimotor control during target reaching and a higher joint position error. Compared to controls, CD patients showed reduced FC between supplementary motor area (SMA), occipital and cerebellar areas, which correlated with lower cervical RoM in rotation both with eyes open and closed and with worse movement quality during target reaching. CONCLUSIONS FC alterations between SMA and occipital and cerebellar areas may represent the neural basis of cervical sensorimotor control deficits in CD patients. Electromagnetic sensors and RS-fMRI might be promising tools to monitor CD and assess the efficacy of rehabilitative interventions.
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Affiliation(s)
- Elisabetta Sarasso
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy
| | - Daniele Emedoli
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Gardoni
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lucia Zenere
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisa Canu
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Basaia
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Doretti
- Department of Neurology, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Nicola Ticozzi
- Department of Neurology, IRCCS Istituto Auxologico Italiano, Milan, Italy; Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milan, Italy
| | - Sandro Iannaccone
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Stefano Amadio
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ubaldo Del Carro
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy; Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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Bleton JP, Portero R, Zuber K, Sangla S, Brandel JP, Vidailhet M, Mesure S, Williams M, Savatovsky J. Assessment of axial rotation movement in cervical dystonia using cone-beam computed tomography. Clin Biomech (Bristol, Avon) 2023; 107:106037. [PMID: 37429102 DOI: 10.1016/j.clinbiomech.2023.106037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Cervical dystonia is a neurological disorder characterized by involuntary muscle contractions and abnormal postures of the head and neck. Botulinum neurotoxin injection is the first-line treatment. Imaging determination of the cervical segments involved (lower or upper according to the torticollis-torticaput [COL-CAP] Classification) is an aid in determining the muscles to be injected. We aimed to clarify the impact of dystonia on posture and rotational movement of cervical vertebrae in the transverse plane. METHODS A comparative study was conducted in a movement disorders department. Ten people with cervical dystonia and 10 matched healthy subjects (without cervical dystonia) were recruited. 3-D images of posture and cervical range of motion in axial rotation in the sitting position were recorded by using a cone-beam CT scanner. Range of rotational motion of the upper cervical spine from the occipital bone to fourth cervical vertebra was measured and compared between the two groups. FINDINGS The head posture analysis showed that the total cervical spine position was more significantly distant from the neutral position for people with dystonia than healthy subjects (p = 0.007). The rotational range of motion of the cervical spine was significantly lower in cervical dystonia participants than in healthy subjects for the total (p = 0.026) and for upper cervical spine (p = 0.004). INTERPRETATION We demonstrated, by means of cone-beam CT, that the disorganization of movements due to cervical dystonia affected the upper cervical spine and mostly the atlantoaxial joint. The involvement of rotator muscles at this cervical level should be considered more in treatments.
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Affiliation(s)
- Jean-Pierre Bleton
- Neurology Department, Hôpital Fondation Adolphe de Rothschild, Paris, France; Clinical Research Department, Hôpital Fondation Adolphe de Rothschild, Paris, France.
| | - Raphaël Portero
- Clinical Research Department, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Kévin Zuber
- Clinical Research Department, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Sophie Sangla
- Neurology Department, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | | | - Marie Vidailhet
- Sorbonne Université, F-75005 Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France, Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'Hôpital, F-75013 Paris, France; Inserm U1127, CNRS UMR 7225, UM 75, ICM, F-75013 Paris, France
| | - Serge Mesure
- Aix-Marseille University, CNRS, ISM UMR 7287, F-13288 Marseille, France
| | - Marc Williams
- Department of Radiology, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Julien Savatovsky
- Department of Radiology, Hôpital Fondation Adolphe de Rothschild, Paris, France
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Alessandria M, Campisi S, Vieira TM. Can a thin mechanical stimulation on the plantar arch affect the head mobility? A preliminary report. SPORT SCIENCES FOR HEALTH 2023. [DOI: 10.1007/s11332-022-01032-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Zhang Z, Cisneros E, Lee HY, Vu JP, Chen Q, Benadof CN, Whitehill J, Rouzbehani R, Sy DT, Huang JS, Sejnowski TJ, Jankovic J, Factor S, Goetz CG, Barbano RL, Perlmutter JS, Jinnah HA, Berman BD, Richardson SP, Stebbins GT, Comella CL, Peterson DA. Hold that pose: capturing cervical dystonia's head deviation severity from video. Ann Clin Transl Neurol 2022; 9:684-694. [PMID: 35333449 PMCID: PMC9082391 DOI: 10.1002/acn3.51549] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/15/2022] [Accepted: 03/04/2022] [Indexed: 11/07/2022] Open
Abstract
Objective Deviated head posture is a defining characteristic of cervical dystonia (CD). Head posture severity is typically quantified with clinical rating scales such as the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). Because clinical rating scales are inherently subjective, they are susceptible to variability that reduces their sensitivity as outcome measures. The variability could be circumvented with methods to measure CD head posture objectively. However, previously used objective methods require specialized equipment and have been limited to studies with a small number of cases. The objective of this study was to evaluate a novel software system—the Computational Motor Objective Rater (CMOR)—to quantify multi‐axis directionality and severity of head posture in CD using only conventional video camera recordings. Methods CMOR is based on computer vision and machine learning technology that captures 3D head angle from video. We used CMOR to quantify the axial patterns and severity of predominant head posture in a retrospective, cross‐sectional study of 185 patients with isolated CD recruited from 10 sites in the Dystonia Coalition. Results The predominant head posture involved more than one axis in 80.5% of patients and all three axes in 44.4%. CMOR's metrics for head posture severity correlated with severity ratings from movement disorders neurologists using both the TWSTRS‐2 and an adapted version of the Global Dystonia Rating Scale (rho = 0.59–0.68, all p <0.001). Conclusions CMOR's convergent validity with clinical rating scales and reliance upon only conventional video recordings supports its future potential for large scale multisite clinical trials.
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Affiliation(s)
- Zheng Zhang
- Institute for Neural Computation, University of California, San Diego, La Jolla, California, USA
| | - Elizabeth Cisneros
- Institute for Neural Computation, University of California, San Diego, La Jolla, California, USA
| | - Ha Yeon Lee
- Institute for Neural Computation, University of California, San Diego, La Jolla, California, USA
| | - Jeanne P Vu
- Institute for Neural Computation, University of California, San Diego, La Jolla, California, USA
| | - Qiyu Chen
- Institute for Neural Computation, University of California, San Diego, La Jolla, California, USA
| | - Casey N Benadof
- Institute for Neural Computation, University of California, San Diego, La Jolla, California, USA
| | - Jacob Whitehill
- Department of Computer Science, Worcester Polytechnic Institute, Worcester, Massachusetts, USA
| | - Ryin Rouzbehani
- Institute for Neural Computation, University of California, San Diego, La Jolla, California, USA
| | - Dominique T Sy
- Institute for Neural Computation, University of California, San Diego, La Jolla, California, USA
| | - Jeannie S Huang
- Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
| | - Terrence J Sejnowski
- Computational Neurobiology Laboratory, Salk Institute for Biological Studies, La Jolla, California, USA
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas, USA
| | - Stewart Factor
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Christopher G Goetz
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Richard L Barbano
- Department of Neurology, University of Rochester, Rochester, New York, USA
| | - Joel S Perlmutter
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.,Departments of Radiology, Neuroscience, Physical Therapy, and Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Hyder A Jinnah
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA.,Departments of Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Brian D Berman
- Department of Neurology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Sarah Pirio Richardson
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.,Neurology Service, New Mexico Veterans Affairs Health Care System, Albuquerque, New Mexico, USA
| | - Glenn T Stebbins
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Cynthia L Comella
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - David A Peterson
- Institute for Neural Computation, University of California, San Diego, La Jolla, California, USA.,Computational Neurobiology Laboratory, Salk Institute for Biological Studies, La Jolla, California, USA
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Park J, Yang KY, Lee J, Youn K, Lee J, Chung SG, Kim HC, Kim K. Objective Evaluation of Cervical Dystonia Using an Inertial Sensor-Based System. J Med Biol Eng 2018. [DOI: 10.1007/s40846-018-0400-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Sohn WJ, Niu CM, Sanger TD. Increased long-latency reflex activity as a sufficient explanation for childhood hypertonic dystonia: a neuromorphic emulation study. J Neural Eng 2015; 12:036010. [PMID: 25946372 PMCID: PMC4475677 DOI: 10.1088/1741-2560/12/3/036010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Childhood dystonia is a movement disorder that interferes with daily movements and can have a devastating effect on quality of life for children and their families. Although injury to basal ganglia is associated with dystonia, the neurophysiological mechanisms leading to the clinical manifestations of dystonia are not understood. Previous work suggested that long-latency stretch reflex (LLSR) is hyperactive in children with hypertonia due to secondary dystonia. We hypothesize that abnormal activity in motor cortices may cause an increase in the LLSR leading to hypertonia. APPROACH We modeled two possibilities of hyperactive LLSR by either creating a tonic involuntary drive to cortex, or increasing the synaptic gain in cortical neurons. Both models are emulated using programmable very-large-scale-integrated-circuit hardware to test their sufficiency for producing dystonic symptoms. The emulation includes a joint with two Hill-type muscles, realistic muscle spindles, and 2,304 Izhikevich-type spiking neurons. The muscles are regulated by a monosynaptic spinal pathway with 32 ms delay and a long-latency pathway with 64 ms loop-delay representing transcortical/supra-spinal connections. MAIN RESULTS When the limb is passively stretched, both models produce involuntary resistance with increased antagonist EMG responses similar to human data; also the muscle relaxation is delayed similar to human data. Both models predict reduced range of motion in voluntary movements. SIGNIFICANCE Although our model is a highly simplified and limited representation of reflex pathways, it shows that increased activity of the LLSR is by itself sufficient to cause many of the features of hypertonic dystonia.
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Affiliation(s)
- Won J. Sohn
- Department of Biomedical Engineering, University of Southern California, 1042 Downey Way, Los Angeles, California, 90089
| | - Chuanxin M. Niu
- Department of Rehabilitation, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Terence D. Sanger
- Department of Biomedical Engineering, University of Southern California, 1042 Downey Way, Los Angeles, California, 90089
- Department of Biokinesiology, University of Southern California, 1042 Downey Way, Los Angeles, California, 90089
- Department of Neurology, University of Southern California, 1042 Downey Way, Los Angeles, California, 90089
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Shaikh AG, Wong A, Zee DS, Jinnah HA. Why are voluntary head movements in cervical dystonia slow? Parkinsonism Relat Disord 2015; 21:561-6. [PMID: 25818535 DOI: 10.1016/j.parkreldis.2015.03.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 02/11/2015] [Accepted: 03/05/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Rapid head movements associated with a change in fixation (head saccades) have been reported to be slow in cervical dystonia (CD). Such slowing is typically measured as an increase in time to complete a movement. The mechanisms responsible for this slowing are poorly understood. METHODS We measured head saccades in 11 CD patients and 11 healthy subjects using a magnetic search coil technique. RESULTS Head saccades in CD took longer to reach a desired target location. This longer duration was due to multiple pauses in the trajectory of the head movement. The head velocity of each segment of the (interrupted) head movement was appropriate for the desired total movement amplitude. The head velocity was, however, higher for the amplitude of the individual interrupted movements. These results suggest that brain programs the proper head movement amplitude, but the movement is interrupted by pathological pauses. CONCLUSION Voluntary head saccades have a longer duration in CD due to frequent pauses. The frequent pauses reflect pathological interruptions of normally programmed intended head movement.
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Affiliation(s)
- Aasef G Shaikh
- Department of Neurology, Emory University, Atlanta, GA, USA; Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA.
| | - Aaron Wong
- Department of Neurology, The Johns Hopkins University, Baltimore, MD, USA
| | - David S Zee
- Department of Neurology, The Johns Hopkins University, Baltimore, MD, USA
| | - H A Jinnah
- Department of Neurology, Emory University, Atlanta, GA, USA
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Jang SJ, Choi JY, Sung DH, Park KH, Lee JY, Cho SK, Yu J, Lee KH, Kim BT. Comparison between (18)F-FDG PET/CT and EMG Mapping for Identifying Dystonic Superficial Muscles in Primary Cervical Dystonia: Preliminary Results. Nucl Med Mol Imaging 2010; 44:33-8. [PMID: 24899935 DOI: 10.1007/s13139-009-0004-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Revised: 11/04/2009] [Accepted: 12/01/2009] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study was conducted to compare (18)F-FDG PET/CT and electromyography (EMG) mapping in patients with primary cervical dystonia (PCD) to find dystonic superficial cervical muscles. METHODS Ten consecutive patients with PCD (M:F = 5:5, age 44 ± 13 years) whose dystonic posture was not relieved with conventional muscle relaxant therapy were included. Target cervical muscles for the comparison between (18)F-FDG PET/CT and EMG mapping were four representative superficial bilateral cervical muscles: splenius capitis muscle, sternocleidomstoid muscle, upper trapezius muscle, and leavator scapulae muscle. The diagnostic efficacy was compared between (18)F-FDG PET/CT and EMG mapping using physical exam and measurement of rotation angle as the gold standard. RESULTS Among 80 muscles evaluated, there were 21 (26%) dystonic superficial cervical muscles assessed with physical exam and motion analysis. The sensitivity, specificity, and accuracy for localizing dystonic muscles were 76, 92, and 88% for (18)F-FDG PET/CT, and 95, 66, and 74% for EMG mapping, respectively. The sensitivity of EMG mapping was significantly higher than that of (18)F-FDG PET/CT. In contrast, (18)F-FDG PET/CT was significantly superior to EMG mapping for specificity and accuracy. CONCLUSIONS (18)F-FDG PET/CT is more specific and accurate than EMG mapping for finding superficial dystonic cervical muscles. The high sensitivity of EMG mapping suggests that (18)F-FDG PET/CT and EMG mapping are complementary for finding dystonic superficial cervical muscles.
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Affiliation(s)
- Su Jin Jang
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University School of Medicine, Seoul, Korea
| | - Joon Young Choi
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkawn University School of Medicine, #50 Ilwon-dong, Gangnam-gu, Seoul, 135-710 Korea
| | - Duk Hyun Sung
- Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Sungkyunkawn University School of Medicine, Seoul, Korea
| | - Kwang Hong Park
- Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Sungkyunkawn University School of Medicine, Seoul, Korea
| | - Ji Young Lee
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkawn University School of Medicine, #50 Ilwon-dong, Gangnam-gu, Seoul, 135-710 Korea
| | - Sook Kyung Cho
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkawn University School of Medicine, #50 Ilwon-dong, Gangnam-gu, Seoul, 135-710 Korea
| | - Jang Yu
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkawn University School of Medicine, #50 Ilwon-dong, Gangnam-gu, Seoul, 135-710 Korea
| | - Kyung-Han Lee
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkawn University School of Medicine, #50 Ilwon-dong, Gangnam-gu, Seoul, 135-710 Korea
| | - Byung-Tae Kim
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkawn University School of Medicine, #50 Ilwon-dong, Gangnam-gu, Seoul, 135-710 Korea
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Martelloni C, Carpaneto J, Micera S. Characterization of EMG patterns from proximal arm muscles during object- and orientation-specific grasps. IEEE Trans Biomed Eng 2009; 56:2529-36. [PMID: 19605312 DOI: 10.1109/tbme.2009.2026470] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Reach-to-grasp tasks are composed of several actions that are more and more considered as simultaneously controlled by the central nervous system in a feedforward manner (at least for well-known activities). If this hypothesis is correct, during prehension tasks, the activity of proximal muscles (and not only of the distal ones used to control finger movements) is modulated according to the kind of object to be grasped and its position. This means that different objects could be identified by processing the electromyographic (EMG) signals recorded from proximal muscles. In this paper, specific experiments have been carried out to support this hypothesis in able-bodied subjects. The results achieved seem to confirm this possibility by showing that the activation of proximal muscles can be statistically different for different grip types. This finding supports the hypothesis that proximal and distal muscles are simultaneously controlled during reaching and grasping. Moreover, this kind of information could allow the development of an EMG-based control strategy based on the natural muscular activities selected by the central nervous system.
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Affiliation(s)
- Chiara Martelloni
- Advanced Robotics Technology and Systems (ARTS) Laboratory, Scuola Superiore Sant'Anna, Pisa 56127,Italy
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Cattrysse E, Provyn S, Kool P, Gagey O, Clarys JP, Van Roy P. Reproducibility of kinematic motion coupling parameters during manual upper cervical axial rotation mobilization: A 3-dimensional in vitro study of the atlanto-axial joint. J Electromyogr Kinesiol 2009; 19:93-104. [PMID: 17728151 DOI: 10.1016/j.jelekin.2007.06.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2007] [Revised: 06/21/2007] [Accepted: 06/21/2007] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The reproducibility of the 3-dimensional (3D) kinematic aspects of motion coupling patterns of segmental manual mobilizing techniques is not yet known. This study analyzes the segmental 3D aspects of manual mobilization of the atlanto-axial joint in vitro. METHODS AND MATERIALS Twenty fresh human cervical specimens were studied in a test-retest situation with two examiners. The specimens were manually mobilized using three different techniques: a regional mobilization technique, a segmental mobilization technique on the atlas with manual fixation of the axis and a segmental mobilization applying a locking technique. Segmental kinematics were registered with a Zebris CMS20 ultrasound-based tracking system. The 3D aspects of motion coupling between main axial rotation and coupled lateral bending were analyzed by six parameters: the range of motion the three motion components, the cross-correlation, the ratio and the shift. RESULTS The results indicate stronger intra- than inter-examiner reproducibility. The range of motion of the axial rotation component shows a substantial level of intra- and inter-examiner reproducibility (ICC's 0.67-0.76). The parameters describing the coupling patterns show only moderate to substantial intra-examiner reproducibility for the more experienced of the two examiners (ICC's 0.55-0.68). All other correlations were not significant and no differences could be observed between regional versus segmental techniques. CONCLUSION Reproducibility of segmental 3D-aspects of manual mobilization of the atlanto-axial joint in an in vitro situation can differ between examiners. The results of the present study may indicate a possible tendency to higher reproducibility if mobilizations are performed by an examiner with high expertise and experience in applying the specific techniques. Continued investigation including more examiners with different levels of experience and different techniques is necessary to confirm these observations.
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Affiliation(s)
- E Cattrysse
- Vrije Universiteit Brussel, Faculty of Physical Education and Physiotherapy, Department of Experimental Anatomy, Laarbeeklaan 103, B1090 Brussels, Belgium.
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Gregori B, Agostino R, Bologna M, Dinapoli L, Colosimo C, Accornero N, Berardelli A. Fast voluntary neck movements in patients with cervical dystonia: A kinematic study before and after therapy with botulinum toxin type A. Clin Neurophysiol 2008; 119:273-80. [PMID: 18063411 DOI: 10.1016/j.clinph.2007.10.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2007] [Revised: 09/25/2007] [Accepted: 10/06/2007] [Indexed: 10/22/2022]
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Cappa P, Patanè F, Rossi S. A Redundant Accelerometric Cluster for the Measurement of Translational and Angular Acceleration and Angular Velocity of the Head. J Med Device 2006. [DOI: 10.1115/1.2355685] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This paper reports the development and the experimental verification of a new helmet based on the use of a redundant array of accelerometers (ACs) which enables the measurement of angular velocity, angular acceleration and translational (a−g) component of the head during normal activity through an unconstrained workspace. Taking into account the outcome of a numerical simulation previously conducted, a lightweight foam bicycle helmet is equipped with ten biaxial, low-cost MEMS ACs. Validation tests were carried out by means of an instrumented pendulum, which allows the evaluation of the accuracy in the measurement of angular velocity, angular acceleration and (a−g) component over a range of 300deg∕s, 1300deg∕s2, and 7m∕s2. The effects induced by the sensor redundancy in the metrological performances of the helmet were also analyzed; in fact, by adopting an optimal selection criterion, some of the cemented ACs were ignored in the data processing, so that, in addition to the 20 axis configuration, also the clusters equipped by a total number of 18, 16, 14, or 12 sensing axes were analyzed and comparatively examined. The results clearly indicate that the redundancy reduces the effect of the noise level of the single transducers to the acceleration measurements; consequently the bandwidth of the device may be increased, because higher cutoff frequency can be chosen for the low pass filtering. The redundancy is also useful to reduce the angular velocity drift that is further decreased by adopting a drift compensation method. The results of the present experiments revealed that the presented helmet can be considered a viable tool in the measurement of head angular and translational acceleration for the assessment of equilibrium control capability. In case the evaluation of the angular velocity is required, time-limited routine clinical application (few seconds) must be performed due to the presence of relevant drift.
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Affiliation(s)
- Paolo Cappa
- Department of Mechanics and Aeronautics, University of Rome “La Sapienza,” Via Eudossiana, 18-00184 Rome, Italy and Paediatric Neuro-Rehabilitation Division, Children’s Hospital “Bambino Gesù” IRCCS, Via Torre di Palidoro, 00050 Passoscuro (Fiumicino) Rome, Italy
| | - Fabrizio Patanè
- Department of Mechanics and Aeronautics, University of Rome “La Sapienza,” Via Eudossiana, 18-00184 Rome, Italy and Paediatric Neuro-Rehabilitation Division, Children’s Hospital “Bambino Gesù” IRCCS, Via Torre di Palidoro, 00050 Passoscuro (Fiumicino) Rome, Italy
| | - Stefano Rossi
- Department of Mechanics and Aeronautics, University of Rome “La Sapienza,” Via Eudossiana, 18-00184 Rome, Italy and Paediatric Neuro-Rehabilitation Division, Children’s Hospital “Bambino Gesù” IRCCS, Via Torre di Palidoro, 00050 Passoscuro (Fiumicino) Rome, Italy
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Cappa P, Masia L, Patanè F. Numerical validation of linear accelerometer systems for the measurement of head kinematics. J Biomech Eng 2006; 127:919-28. [PMID: 16438228 DOI: 10.1115/1.2049329] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this study was to analytically exploit the capabilities of head-mounted systems instrumented with linear accelerometers (ACs) for field use in redundant configurations. We simulated different headsets equipped with uni-, bi- or triaxial sensors with a number of axes that lie in the range of 12-24; the ACs were located on a hemispherical surface by adopting a priori criterion while their orientation was randomized. In addition, for a comparative purpose the nine accelerometer scheme (one triaxial AC and three biaxial ACs addressed in the following as "3-2-2-2 configuration") was also analyzed in the present paper. We simulated and statistically assessed the performances of hemispherical headsets in the test case of a healthy subject walking freely at normal pace over level ground. The numerical results indicated that a well designed instrumented headset can retrieve the angular acceleration and (a0-g) component with rms errors of about 2% and 0.5%, respectively, and angular velocity with a drift error of about 20% in a 6 s trial. On the contrary, the pose of the headset cannot be evaluated because of the drift induced by the integration process. In general, we can state that headsets with uni-, bi- or triaxial ACs have comparable performances. The main implications of the above-mentioned observations are (a) neither expensive triaxial ACs nor assembling procedure based on the use of orthogonal mounting blocks are needed; (b) redundant arrays of low-cost uni- or biaxial ACs can effectively be used to reach adequate performances in biomechanical studies where head acceleration and velocity are investigated; (c) while estimates of angular acceleration with accelerometers are accurate, estimations of angular velocities, linear velocities and pose are not.
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Affiliation(s)
- Paolo Cappa
- Department of Mechanics and Aeronautics, University of Rome La Sapienza, Via Eudossiana, 18-00184 Rome, Italy.
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Micera S, Carpaneto J, Posteraro F, Cenciotti L, Popovic M, Dario P. Characterization of upper arm synergies during reaching tasks in able-bodied and hemiparetic subjects. Clin Biomech (Bristol, Avon) 2005; 20:939-46. [PMID: 16061318 DOI: 10.1016/j.clinbiomech.2005.06.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2004] [Revised: 06/10/2005] [Accepted: 06/10/2005] [Indexed: 02/07/2023]
Abstract
BACKGROUND In the past, several studies showed the existence of a synergistic behavior between elbow and shoulder joints during reaching movements in able-bodied subjects. The aim of this paper was to characterize the modifications of upper arm synergies during reaching induced by stroke. METHODS Ten able-bodied right-handed subjects, eight right-handed subjects with hemiparesis affecting the right (dominant) upper limb participated in the experiments. The kinematics of shoulder and elbow joints have been recorded in all the participants during selected reaching movements. From the eight-like plots characterizing the relationship between shoulder and elbow angular velocities, a topological parameter (named as C approximately ) representing the linear approximation of the synergy between the two angular velocities has been extracted. FINDINGS The results of these experiments showed that C approximately could be used as a figure of merit for the comparison of performance in able-bodied and hemiparetic persons. The hemiparetic subjects showed a significantly higher spreading of the values of C approximately for the different reaching movements when compared with the performance of able-bodied subjects. INTERPRETATION This work showed that hemiparesis modified upper arm synergies and could provide a protocol for the assessment of upper limb function. Moreover, important applications of this method could be found in the development of biomimetic algorithms for the control of upper extremities during reaching in humanoid robots, and in the design of customized "games" in neurorehabilitation procedures implemented by using robotic and mechatronic platforms.
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Affiliation(s)
- S Micera
- ARTS Lab, Scuola Superiore Sant'Anna, Piazza Martiri della Liberta' 56127, Pisa, Italy.
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Zetterberg L, Halvorsen K, Färnstrand C, Lundström E, Lindmark B, Aquilonius SM. Objective assessment of cervical dystonia: a pilot study. Acta Neurol Scand 2005; 112:248-53. [PMID: 16146495 DOI: 10.1111/j.1600-0404.2005.00472.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aims were to characterize the movements in cervical dystonia (CD) by using an estimate of the mechanical power and work involved in the movements and to describe this through a movement energy index (MEI). MATERIALS AND METHODS The subjects (patients n = 6, controls n = 6) were seated in front of a screen with a laser pointer attached to a headband while they performed standardized movements. A three-dimensional motion capture system was used and a test-retest was performed. RESULTS The mean value of MEI was significantly higher for the patients than for the controls. There was no significant difference between MEI from test to retest for the patients but there was a significant difference between MEI from test to retest for the controls. CONCLUSION This study suggests that MEI could be a useful measure for the quantification of movement dysfunction in CD and thus an objective outcome measure in comparison of different therapies.
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Affiliation(s)
- L Zetterberg
- Department of Neuroscience, Section of Physiotherapy, University of Uppsala, Uppsala, Sweden.
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