Psychomotor retardation

精神运动性迟钝
  • 文章类型: Journal Article
    重度抑郁症(MDD)的特征是精神运动发育迟缓,其潜在的神经来源尚不清楚。精神运动迟缓可能与运动来源如运动皮层有关,或者,或者,在运动区域之外有神经变化的精神运动源,像视觉皮层这样的输入区域。研究了使用7特斯拉MRI的主要(n=41)和复制(n=18)MDD样品中的这两个替代假设。分析初级运动皮层(BA4)的全局和局部连通性,运动网络和颞叶中视皮层复合体(MT+),MDD的主要发现是:1)电机区域的局部和全局同步减少,局部到全局的输出增加,与精神运动迟缓无关,不过。2)减少的局部到局部BA4-MT功能连接(FC),这与精神运动迟缓有关。3)MT中与精神运动迟缓有关的全局同步降低和局部到全局输出增加。4)与精神运动迟缓有关的基于MT的运动知觉的心理物理测量中的变异性降低。一起,研究表明,视皮层MT及其与运动皮层的关系在介导精神运动发育迟缓中起关键作用。这支持关于MDD中精神运动迟缓的神经来源的精神运动过度运动假说。
    Major depressive disorder (MDD) is characterized by psychomotor retardation whose underlying neural source remains unclear. Psychomotor retardation may either be related to a motor source like the motor cortex or, alternatively, to a psychomotor source with neural changes outside motor regions, like input regions such as visual cortex. These two alternative hypotheses in main (n = 41) and replication (n = 18) MDD samples using 7 Tesla MRI are investigated. Analyzing both global and local connectivity in primary motor cortex (BA4), motor network and middle temporal visual cortex complex (MT+), the main findings in MDD are: 1) Reduced local and global synchronization and increased local-to-global output in motor regions, which do not correlate with psychomotor retardation, though. 2) Reduced local-to-local BA4 - MT+ functional connectivity (FC) which correlates with psychomotor retardation. 3) Reduced global synchronization and increased local-to-global output in MT+ which relate to psychomotor retardation. 4) Reduced variability in the psychophysical measures of MT+ based motion perception which relates to psychomotor retardation. Together, it is shown that visual cortex MT+ and its relation to motor cortex play a key role in mediating psychomotor retardation. This supports psychomotor over motor hypothesis about the neural source of psychomotor retardation in MDD.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Case Reports
    里脑畸形是一种非常罕见的临床疾病,会影响大脑的形成并导致严重的精神运动发育迟缓,抽搐和肌肉痉挛或张力减退,通常还与呼吸系统问题有关,面部畸形,手指和脚趾的异常和吞咽困难导致寿命缩短。以下文章中描述的临床病例通过对科学文献的叙述性回顾和这种情况的介绍来证明患者的诊断过程和康复治疗,以提供指导儿童康复治疗的适应症。
    Lissencephaly is a very rare clinical condition that affects the formation of the brain and causes severe psychomotor retardation, convulsions and muscular spasticity or hypotonia, often also associated with respiratory problems, facial dysmorphisms, abnormalities of the fingers and toes and difficulty swallowing resulting in reduced life expectancy. The clinical case described in the following article demonstrates the diagnostic process and rehabilitation treatment of a patient through a narrative review of the scientific literature and the presentation of this condition in order to provide indications to guide rehabilitation treatment in childhood.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    目的:精神运动迟缓是导致残疾的重度抑郁症的核心临床组成部分,被称为抑郁症生物学治疗的治疗反应标志物。我们的目标是描述在治疗难治性抑郁症(TRD)的THETAD-DEP试验中通过重复经颅磁刺激(rTMS)治疗期间的认知和运动测量变化,并比较治疗结束时和应答者之间一个月后的表现(MADRS评分改善>50%),部分反应者(25-50%)和非反应者(无临床相关改善)。我们的次要目的是调查与无反应和反应甚至部分相关的基线精神运动表现。
    方法:54名患有难治性单相抑郁症并接受高频10HzrTMS或iTBS治疗4周(20个疗程)的患者接受了评估,包括法国抑郁延迟量表(ERD)。言语流畅性测试,和跟踪测试A之前,治疗后和一个月后。
    结果:20例患者为应答者(R,21个部分反应者(PR)和13个非反应者(NR)。rTMS治疗可改善R和PR组的精神运动表现,而NR患者的精神运动表现未通过治疗得到改善。在基线,参与者,后来被确定为部分响应者,表现明显高于无反应者。
    结论:较高的基线认知运动表现可能与rTMS治疗后的临床改善有关。这项工作突出了客观精神运动测试对识别rTMS反应者和部分反应者的价值,因此可用于患者选择和方案个体化,例如早期部分反应者的治疗延续。
    OBJECTIVE: Psychomotor retardation is a core clinical component of Major Depressive Disorder responsible for disability and is known as a treatment response marker of biological treatments for depression. Our objective was to describe cognitive and motoric measures changes during a treatment by repetitive Transcranial Magnetic Stimulation (rTMS) within the THETAD-DEP trial for treatment-resistant depression (TRD), and compare those performances at the end of treatment and one month after between responders (>50% improvement on MADRS score), partial responders (25-50%) and non-reponders (no clinically relevant improvement). Our secondary aim was to investigate baseline psychomotor performances associated with non-response and response even partial.
    METHODS: Fifty-four patients with treatment-resistant unipolar depression and treated by either high frequency 10 Hz rTMS or iTBS for 4 weeks (20 sessions) underwent assessment including French Retardation Rating Scale for Depression (ERD), Verbal Fluency test, and Trail Making Test A. before, just after treatment and one month later.
    RESULTS: 20 patients were responders (R, 21 partial responders (PR) and 13 non-responders (NR). rTMS treatment improved psychomotor performances in the R and PR groups unlike NR patients whose psychomotor performance was not enhanced by treatment. At baseline, participants, later identified as partial responders, showed significantly higher performances than non-responders.
    CONCLUSIONS: Higher cognitivo-motor performances at baseline may be associated with clinical improvement after rTMS treatment. This work highlights the value of objective psychomotor testing for the identification of rTMS responders and partial responders, and thus may be useful for patient selection and protocol individualization such as treatment continuation for early partial responders.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    运动蛋白,由Kinesin超家族(KIF)基因编码,对大脑发育和可塑性至关重要。越来越多的研究报道了KIF在神经发育障碍中的作用。这里,一个6岁零3个月的中国男孩,患有明显症状性癫痫,智力残疾,脑萎缩,并对精神运动迟缓进行了调查。他的父母和妹妹表型正常,没有疾病相关的家族史。全外显子组测序在先证中KIF5C的外显子3中发现了一个新的杂合框内缺失(c.265_267delTCA),导致去除位于其ATP结合域中的进化高度保守的p.Ser90。Sanger测序排除了先证者的父母和家庭成员携带这种变异。如预测的,体外ATP水解的活性显著降低。免疫荧光研究显示野生型KIF5C广泛分布在整个细胞质中,而突变型KIF5C与微管共定位。货物运输测定的活细胞成像显示,突变体KIF5C失去了过氧化物酶体运输能力。果蝇模型也证实了p.Ser90del在神经系统发育中的重要作用。这项研究强调了KIF5C基因在细胞内货物运输以及导致神经发育障碍的种系变异中的重要性,并可能使临床医生能够在未来进行及时准确的诊断和疾病管理。
    Motor proteins, encoded by Kinesin superfamily (KIF) genes, are critical for brain development and plasticity. Increasing studies reported KIF\'s roles in neurodevelopmental disorders. Here, a 6 years and 3 months-old Chinese boy with markedly symptomatic epilepsy, intellectual disability, brain atrophy, and psychomotor retardation was investigated. His parents and younger sister were phenotypically normal and had no disease-related family history. Whole exome sequencing identified a novel heterozygous in-frame deletion (c.265_267delTCA) in exon 3 of the KIF5C in the proband, resulting in the removal of evolutionarily highly conserved p.Ser90, located in its ATP-binding domain. Sanger sequencing excluded the proband\'s parents and family members from harboring this variant. The activity of ATP hydrolysis in vitro was significantly reduced as predicted. Immunofluorescence studies showed wild-type KIF5C was widely distributed throughout the cytoplasm, while mutant KIF5C was colocalized with microtubules. The live-cell imaging of the cargo-trafficking assay revealed that mutant KIF5C lost the peroxisome-transporting ability. Drosophila models also confirmed p.Ser90del\'s essential role in nervous system development. This study emphasized the importance of the KIF5C gene in intracellular cargo-transport as well as germline variants that lead to neurodevelopmental disorders and might enable clinicians for timely and accurate diagnosis and disease management in the future.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Review
    巨脑症综合征,大型call体(MEG-MegaCC)伴有完全缺乏运动发育是一种罕见的疾病,文献中只有很少的零星病例报道。在本文中,我们描述了一个来自非近亲父母的孩子,精神运动性迟钝,和语言障碍与MEG-MegaCC综合征有关。基因分析,放射学发现,MEG-MegaCC综合征及其重叠综合征的详细神经系统表型将有助于更好地对疾病谱进行分类。
    The syndrome of megalencephaly, mega corpus callosum (MEG-MegaCC) accompanied by complete lack of motor development is a rare condition with only few sporadic cases having been reported in the literature. In this paper, we describe a child from non-consanguineous parents presenting with MegaCC, psychomotor retardation, and language impairment linked to MEG-MegaCC syndrome. Genetic analysis, radiological findings, and detailed neurological phenotype of MEG-MegaCC syndrome with its overlapping syndromes would allow for a better classification of the disease spectrum.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Case Reports
    我们报告了一名24岁的男性,患有眼睑炎,精神运动性迟钝,短头畸形,微小口腔,不动的脸,高拱形腭,单掌折痕,脊柱侧后凸,马蹄足,腹股沟疝,幽门狭窄,反复感染,双边坎普蒂,宽大的眼睛,肌肉质量下降,低张力,外斜视,和左眼的眼睑下垂,生长迟缓,多发性先天性挛缩,和反射过敏。随着年龄的增长,挛缩得到改善,但是智力残疾和眼睑萎缩仍然存在。他还提出了癫痫,爆发的笑声,和药物不良反应的易感性(卡马西平和继发性帕金森病的皮肤病变)。
    We report a 24-year-old male with blepharophimosis, psychomotor retardation, brachycephaly, microstomia, immobile face, high arched palate, single palmar crease, kyphoscoliosis, talipes equinovarus, inguinal hernia, pyloric stenosis, recurrent infections, bilateral camptodactyly, wide-set eyes, decreased muscle mass, hypotonia, exotropia, and ptosis in the left eye, growth retardation, multiple congenital contractures, and hyporreflexia. Contractures improved with aging, but intellectual disability and blepharophimosis remained. He also presented epilepsy, outbursts of laughter, and predisposition to drug adverse effects (skin lesions with carbamazepine and secondary parkinsonism).
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    37种人类氨酰基tRNA合成酶中的大多数已被证明是不同的,主要是隐性的,遗传性疾病。据此,我们发现了一个新的纯合缬氨酸-tRNA合成酶1(VARS1)基因变体,导致p.T1068M突变。正如之前报道的VARS1突变,患有p.T1068M的患者正在经历神经发育障碍并伴有顽固性癫痫发作,精神运动性迟钝,和小头畸形。为了将这种表型结果与观察到的基因型联系起来,我们对人类VARS1进行了结构建模,并在先前报道的VARS1变异体的空间分布内解释了p.T1068M.因此,我们发现p.T1068M在VARS1反密码子结合域的15个氨基酸长的一段中与其他三个致病性突变成簇。在反密码子结合域内形成螺旋-转角-螺旋基序时,这段区域有1/4的VARS1突变.这里,我们认为,这些成簇突变可以破坏反密码子结合和tRNA合成酶结构域之间的相互作用,从而阻碍VARS1的最佳酶活性。我们希望这种突变簇的描述将为药物的开发铺平道路,能够减轻这些突变的功能影响。
    Majority of 37 human aminoacyl tRNA synthetases have been incriminated in diverse, mostly recessive, genetic diseases. In accordance with this, we uncovered a novel homozygous valyl-tRNA synthetase 1 (VARS1) gene variant, leading to p.T1068M mutation. As in the previously reported VARS1 mutations, the affected individual harboring p.T1068M was experiencing a neurodevelopmental disorder with intractable seizures, psychomotor retardation, and microcephaly. To link this phenotypic outcome with the observed genotype, we structurally modeled human VARS1 and interpreted p.T1068M within the spatial distribution of previously reported VARS1 variants. As a result, we uncovered that p.T1068M is clustered with three other pathogenic mutations in a 15 amino acid long stretch of the VARS1 anticodon-binding domain. While forming a helix-turn-helix motif within the anticodon-binding domain, this stretch harbors one-fourth of the reported VARS1 mutations. Here, we propose that these clustered mutations can destabilize the interactions between the anticodon-binding and the tRNA synthetase domains and thus hindering the optimal enzymatic activity of VARS1. We expect that the depiction of this mutation cluster will pave the way for the development of drugs, capable of alleviating the functional impact of these mutations.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    需要客观的,容易和相对短的方法来诊断抑郁症的认知。我们使用三种不同的速度测量方法构建了一组简单的视觉任务:基于纸笔,基于计算机,基于眼动追踪。我们使用了22名参与者的单个案例设计。临床组统计了11名重度抑郁症患者的两次检查(第一次检查没有药物治疗,第二次在药物治疗三个月后)以及一组11名匹配的健康对照。在所有检查的表现水平中都可以观察到认知困难。所有任务中最弱的是服药前的病人,治疗后观察到一些改善,但不符合健康控制的水平。认知障碍并没有像情绪障碍那样迅速通过药物治疗消除。观察到的困难可以用精神运动迟缓来解释,抑郁症的典型症状,事实证明,这主要是认知的,因为对反应时间和第一次扫视延迟的差异的分析得出了结论。对几个阶段的简单视觉反应时间的分析被证明是一种有前途的方法,可以测量患有严重抑郁症治疗期间情绪障碍和认知康复的人的认知状态。
    There is a need for objective, easy and relatively short methods to diagnose cognition in depression. We have constructed a set of simple visual tasks using three different ways of speed measuring: paper-pencil-based, computer-based, and eye-tracking based. We used a single case design with 22 participants. A clinical group counted 11 patients with major depression examined two times (first examination without medication and second after three months of medical treatment) together with a group of 11 matched healthy controls. Cognitive difficulties were observable in all the checked levels of performance. The weakest in all tasks were patients before medication, some improvement was observed after medical treatment, but not matching the level of healthy controls. Cognitive difficulties were not eliminated by medical treatment as quickly as emotional disturbances were. The observed difficulties could be interpreted in terms of psychomotor retardation, a typical symptom in depression, which proved to be mainly cognitive as the analysis of differences in reaction times and the first saccade latencies concluded. The analysis of simple visual reaction times on several stages turned out to be a promising method to measure the cognitive state in persons with mood disorders and cognitive convalescence during major depressive disorder treatment.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Review
    部分16p三体综合征是一种罕见的疾病,通常以精神运动迟缓为特征,产前和产后生长不足,腭裂,和面部畸形,一些患者还出现心脏缺陷和泌尿生殖系统异常。纯16p13.3重复通常从头发生,而那些与部分一元性相关的重复则是由亲本染色体易位引起的。由于大尺寸的像差,大多数患者通过标准染色体分析进行鉴定。在所有公开的案例中,最小致病重复区域包括CREBBP基因。这里,我们报告了患者出现精神运动性迟钝,股骨发育不全,以及部分16p三体综合征的一些特征,携带复杂的从头末端16p13.3微重复,具有重叠的扩增区域,没有易位或相关的一元性。与以前报道的病例相比,患者的重复区域不涉及CREBBP和其他邻近基因;仍然,所观察到的指数的畸形特征模式是所描述的综合征的特征。根据动物研究和其他已发表的案例,我们讨论了PDK1和IGFALS基因在肢体异常发育中的可能作用,而IFT140可能导致患者的股骨表型和心脏异常。据我们所知,我们提出了一个具有最小终端16p13.3重复的概率,其大小在3Mb以下。因此,我们的先证者和她详细的表型描述可能对咨询该综合征患者的临床医生有帮助.
    Partial 16p trisomy syndrome is a rare disorder typically characterized by psychomotor retardation, prenatal and postnatal growth deficiency, cleft palate, and facial dysmorphism, with some patients also presenting with heart defects and urogenital anomalies. Pure 16p13.3 duplications usually occur de novo, while those duplications that associate with partial monosomy result rather from parental chromosomal translocations. Due to the large size of the aberrations, the majority of patients are identified by standard chromosome analysis. In all published cases, the minimal-causative duplicated region encompasses the CREBBP gene. Here, we report on the patient presenting with psychomotor retardation, femoral hypoplasia, and some features of the partial 16p trisomy syndrome, who carries a complex de novo terminal 16p13.3 microduplication with an overlapping region of amplification without translocation or associated monosomy. In contrast to the previously reported cases, the duplicated region of the patient does not involve CREBBP and other neighboring genes; still, the observed pattern of dysmorphic features of the index is characteristic of the described syndrome. Based on the animal studies and other published cases, we discuss the possible role of the PDK1 and IGFALS genes in the development of limb anomalies, while IFT140 could contribute both to the observed femoral phenotype and heart abnormalities in the patient. To the best of our knowledge, we present a proband harboring the smallest terminal 16p13.3 duplication of the size below 3 Mb. Therefore, our proband with her detailed phenotypic description may be helpful for clinicians who consult patients with this syndrome.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    目的:多达一半的精神分裂症患者发生精神运动减慢(PS),并与较差的预后有关。由于标准治疗未能改善PS,需要新的方法。这里,我们使用3个分析单元应用了RDoC框架,ie,行为,自我报告,和生理学测试,PS患者是否与无PS患者和对照组不同。
    方法:比较了71例精神分裂症伴PS患者的运动行为,25没有PS,和42名健康对照(HC)使用5种不同的措施:(1)行为,专家评定量表:Salpétrière延迟评定量表的运动评分,(2)对于自我报告,国际身体活动问卷;以及生理学,(3)活动,这解释了粗大的运动行为,(4)步态速度,和(5)硬币旋转任务,以评估手的灵活性。
    结果:比较3组的ANCOVA显示PS和HC患者在专家评分方面存在差异,自我报告,和仪器措施(所有P≤0.001)。与没有PS的患者相比,有PS的患者在专家评分中得分也更高,仪器活动水平也更低(所有P≤0.045)。仪器活动水平与PS的专家评级相关(rho=-0.51,P-fdr校正<.001),并以72%的准确率进行类似分类。
    结论:PS的特征是步态较慢,较低的活动水平,与HC相比,手指运动较慢。然而,只有肌动描记术和观察者评级才能清楚地将PS与非PS患者分开。在神经影像学研究和临床试验中,活动成像可能成为PS的标准评估。
    Psychomotor slowing (PS) occurs in up to half of schizophrenia patients and is linked to poorer outcomes. As standard treatment fails to improve PS, novel approaches are needed. Here, we applied the RDoC framework using 3 units of analysis, ie, behavior, self-report, and physiology to test, whether patients with PS are different from patients without PS and controls.
    Motor behavior was compared between 71 schizophrenia patients with PS, 25 without PS, and 42 healthy controls (HC) using 5 different measures: (1) for behavior, an expert rating scale: Motor score of the Salpêtrière Retardation Rating Scale, (2) for self-report, the International Physical Activity Questionnaire; and for physiology, (3) Actigraphy, which accounts for gross motor behavior, (4) Gait velocity, and (5) coin rotation task to assess manual dexterity.
    The ANCOVAs comparing the 3 groups revealed differences between patients with PS and HC in expert ratings, self-report, and instrumental measures (all P ≤ .001). Patients with PS also scored higher in expert ratings and had lower instrumental activity levels compared to patients without PS (all P ≤ .045). Instrumental activity levels correlated with an expert rating of PS (rho = -0.51, P-fdr corrected <.001) and classified similarly at 72% accuracy.
    PS is characterized by slower gait, lower activity levels, and slower finger movements compared to HC. However, only actigraphy and observer ratings enable to clearly disentangle PS from non-PS patients. Actigraphy may become the standard assessment of PS in neuroimaging studies and clinical trials.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

公众号