stereotypy

刻板印象
  • 文章类型: Journal Article
    与具有其他典型发育的儿童相比,具有智力和发育障碍的青年通常有更高的抽动率和陈规定型观念。由于重叠的临床特征,区分这两种儿科运动障碍可能具有挑战性。但由于不同的治疗方式而相关。目前的研究评估了抽动筛查措施的敏感性和特异性,儿童样本中的运动型或声乐抽动量表(MOVEIT),富含刻板印象和抽动。在发育行为儿科诊所接受护理的儿童(n=199,年龄2-15岁)接受了tic专家的黄金标准诊断评估;这些评估与MOVeIT进行了比较。与tic专家相比,MOVeIT在检测整个样品中的tic表现出良好的灵敏度(89.8%)和相对较低的特异性(57.1%)。当排除具有共同发生的刻板印象的儿童时,MOVeIT识别抽动的特异性提高到75%。对于有抽搐和共存刻板印象的孩子,敏感性仍然较高(91.9%),但特异性较低(39.1%).与tic专家金标准相比,在MOVeIT上检测tic的曲线下面积(AUC)值对于没有刻板印象的儿童(AUC=85.7%)明显高于有刻板印象的儿童(AUC=64.3%,p<0.01)。总的来说,在没有共同发生的刻板印象症状的人群中,抽动的检测能力更好。需要进一步的工作来确定MOVeIT在很有可能同时发生抽动和刻板印象的人群以及一般人群环境中的实用性。准确区分抽搐和刻板印象将指导家庭的干预选择和预期指导。
    Youth with intellectual and developmental disabilities typically have higher rates of tics and stereotypies compared to children with otherwise typical development. Differentiating between these two pediatric movement disorders can be challenging due to overlapping clinical features, but is relevant due to distinct treatment modalities. The current study evaluated sensitivity and specificity of a tic screening measure, the Motor or Vocal Inventory of Tics (MOVeIT) in a pediatric sample enriched for stereotypy and tics. Children (n=199, age 2-15 years old) receiving care in a developmental-behavioral pediatrics clinic underwent a gold-standard diagnostic assessment by a tic expert; these evaluations were compared to the MOVeIT. The MOVeIT demonstrated good sensitivity (89.8%) and relatively lower specificity (57.1%) compared to tic expert for detecting tics in the overall sample. Specificity of the MOVeIT to identify tics improved to 75% when excluding children with co-occurring stereotypy. For children with tics and co-occurring stereotypy, sensitivity remained high (91.9%) but specificity was low (39.1%). The area under the curve (AUC) value to detect tics on the MOVeIT compared to the tic expert gold standard was significantly higher for children without stereotypy (AUC=85.7%) than those with stereotypy (AUC=64.3%, p <0.01). Overall, the ability to detect tics was better in those without co-occurring stereotypy symptoms. Further work is needed to establish the utility of the MOVeIT in populations where there is a high likelihood of co-occurring tics and stereotypy and in general population settings. Accurate distinction between tics and stereotypy will guide choices for intervention and anticipatory guidance for families.
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  • 文章类型: Journal Article
    背景:智障人士,包括唐氏综合症(DS)患者,经常表现出受限和重复行为(RRB)。然而,在患有DS的儿童和青少年中,RRB尚未得到深入的表征。
    方法:该研究包括151名4至18岁DS患者的队列。使用修订的重复行为量表评估RRB。此外,有关认知和适应性功能的数据,语言能力,收集了睡眠模式和情绪/行为问题。
    结果:自我伤害行为的报道频率较低,而父母最常认可与需要相同和仪式性行为相关的行为。我们观察到很少的性别差异,虽然出现了一些与年龄相关的差异,青少年在与较高水平RRB相关的项目中得分较高。对RRB与临床特征之间的关联分析显示,RRB与父母报告的睡眠困难有关,以及内部化和外部化问题。我们还观察到与智商呈负相关,而与适应性技能的关联主要出现在较低级别的RRB,比如运动刻板印象。最后,RRB与语言能力呈负相关,既有表现性又有接受性。
    结论:RRB在DS儿童和青少年中具有重要的临床意义,因为它们与各种临床维度相关。因此,心理和神经精神评估应包括对青少年DS患者的RRB的准确评估.
    BACKGROUND: Individuals with intellectual disability, including people with Down syndrome (DS), often exhibit restricted and repetitive behaviours (RRBs). However, RRBs have not been deeply characterised in children and adolescents with DS.
    METHODS: The study encompassed a cohort of 151 participants aged 4 to 18 years with DS. RRBs were assessed utilising the Repetitive Behaviour Scale-Revised. Additionally, data pertaining to cognitive and adaptive functioning, linguistic abilities, sleep patterns and emotional/behavioural issues were gathered.
    RESULTS: Self-injurious behaviours were reported less frequently whereas parents most commonly endorsed items related to behaviours associated with the need for sameness and ritualistic behaviours. We observed very few gender differences, whereas some age-related differences emerged, with adolescents exhibiting higher scores in items related with higher-level RRBs. The analysis of the association between RRBs and clinical features revealed that RRBs were associated with parent-reported sleep difficulties, as well as with internalising and externalising problems. We also observed a negative correlation with IQ whereas associations with adaptive skills emerged mainly for lower-level RRBs, such as motor stereotypies. Finally, RRBs were negatively associated with linguistic abilities, both expressive and receptive.
    CONCLUSIONS: RRBs in children and adolescents with DS are of significant clinical interest due to their associations with various clinical dimensions. Therefore, psychological and neuropsychiatric assessment should include an accurate evaluation of RRBs for young people with DS.
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    文章类型: Case Reports
    兴奋剂是注意力缺陷多动障碍(ADHD)的一线药物治疗。我们介绍了一个独特的病例,该患者在服用混合苯丙胺盐(MAS)时产生了咀嚼强迫。一名32岁女性患者,既往有胃食管反流病(GERD)病史,胃轻瘫,由于担心易怒,偏头痛被用于初步的精神病评估。她被诊断为创伤后应激障碍(PTSD);广泛性焦虑症;多动症,注意力不集中的类型;和未指明的双相情感障碍。开始服用拉莫三嗪,每天两次滴定至25mg,改善情绪稳定性。MAS立即释放(IR)从2.5mg开始,并滴定至每天5mg用于ADHD。然后她经历了一种无法控制的咀嚼冲动,在咀嚼孩子的出牙项链时找到解脱,这提供了满足感和焦虑感的减少。她否认颌骨紧绷或牙齿磨损。MASIR的剂量减少到每天2.5mg,症状改善,后来又增加到每天5mg,这是她当时能够容忍的。在使用苯丙胺的大鼠中观察到定型的咬人行为,在使用右旋苯丙胺的儿童中出现了强迫行为的发作。然而,这是在使用MAS的人类中报道的第一个已知的强迫性咀嚼或咬咬动作的病例。该案例强调了评估患者不良事件的必要性,如强迫性咬咬和咀嚼动作或其他口腔面部刻板印象,兴奋剂开始后,包括MAS。
    Stimulants are the first-line pharmacological treatment for attention deficit hyperactivity disorder (ADHD). We present the unique case of a patient who developed a chewing compulsion when taking mixed amphetamine salts (MAS). A 32-year-old female patient with a past medical history of gastroesophageal reflux disease (GERD), gastroparesis, and migraines was seen for initial psychiatric assessment due to concerns for irritability. She was diagnosed with post-traumatic stress disorder (PTSD); generalized anxiety disorder; ADHD, inattentive type; and unspecified bipolar disorder. Lamotrigine was started and titrated to 25mg twice per day, with improved mood stability. MAS immediate-release (IR) was started at 2.5mg and titrated to 5mg daily for ADHD. She then experienced an uncontrollable urge to chew, finding relief when chewing on a child\'s teething necklace, which provided satisfaction and a reduction in anxiety. She denied jaw tightness or teeth grinding. The dose of MAS IR was reduced to 2.5mg daily with improvement in symptoms and later increased again to 5mg daily, which she was then able to tolerate. Stereotyped biting behaviors have been observed in rats with the use of amphetamines, and the onset of compulsive behavior has emerged in children with the use of dextroamphetamine. However, this is the first known case of compulsive chewing or biting movements reported in humans with MAS use. This case highlights the need to assess patients for adverse events, such as compulsive biting and chewing movements or other oral facial stereotypies, after commencement of stimulants, including MAS.
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  • 文章类型: Journal Article
    背景:腿部刻板印象综合征(LSS)是非常常见的,但未被认可的情况。该病症的病理生理学尚不清楚。
    目的:评估和描述LSS患者腿部重复运动的视觉运动学特征。
    方法:在本研究中,我们在帕金森氏病中心和运动障碍诊所确定并拍摄了诊断为LSS的个体,贝勒医学院,休斯顿,德克萨斯州2000年至2023年。本研究仅包括患有LSS且没有任何合并症的患者。他们的医疗记录被仔细审查了,并将人口统计学和临床数据输入数据库.然后使用TremAn软件分析重复腿部运动的视频记录。
    结果:我们确定了14名在我们中心拍摄的LSS患者。这5例的视频过于简短,因此不适合进行TremAn定量分析。其余9个人表现出腿部有规律的节律性振荡。其中,两个人只在他们的腿处于交叉位置的视频片段中显示有节奏的运动。其他7个人有规律的节律振荡,总是脚趾放在地板上,脚跟抬起。频率分析显示值在4.5和6.5Hz之间,在个别情况下,与低于0.5Hz的方差相当一致。振荡频率在静置时从5.7Hz变为2.7Hz。
    结论:在这项研究中,9名LSS患者中有6名表现出4.5-6.5Hz有规律的有节奏的腿部运动。需要涉及更大的LSS群体进行额外的电生理评估的研究,以获得对这种常见运动障碍的进一步见解。
    BACKGROUND: Leg stereotypy syndrome (LSS) is a very common, yet underrecognized condition. The pathophysiology of the condition is not well understood.
    OBJECTIVE: To evaluate and describe the visual kinematic characteristics of the repetitive leg movements in individuals with LSS.
    METHODS: In this study, we identified and videotaped individuals diagnosed with LSS at the Parkinson\'s Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas between 2000 and 2023. Only patients with LSS and without any co-morbidities were included in the study. Their medical records were carefully reviewed, and the demographic and clinical data were entered into a database. Video recordings of the repetitive leg movements were then analyzed using TremAn software.
    RESULTS: We identified 14 individuals with LSS who were videotaped at our center. The videos of the 5 cases were too brief and therefore not suitable for TremAn quantitative analysis. The remaining 9 individuals exhibited regular rhythmic oscillations of the legs. Among these, two individuals displayed rhythmic movements only in video segments where their legs were in crossed positions. The other 7 individuals had regular rhythmic oscillations, always with the toes resting on the floor with the heels raised. Frequency analysis showed values between 4.5 and 6.5 Hz, fairly consistent with a variance below 0.5 Hz in individual cases. The oscillation frequency changed from 5.7 Hz to 2.7 Hz while standing.
    CONCLUSIONS: In this study, 6 of 9 individuals with LSS showed 4.5-6.5 Hz regular rhythmic leg movements. Studies involving a larger LSS population with additional electrophysiological evaluations are needed to obtain further insights into this common movement disorder.
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  • 文章类型: Journal Article
    吸羽毛,或者舔羽毛,据报道,澳大利亚肉鸡饲养业的员工有轶事,但在科学文献中几乎没有。因此,在肉鸡种鸡中这种行为的原因和含义相对未知。我们调查了17位行业专家,以产生有关羽毛吸吮行为的假设。我们的目的是了解频率和它发生的时间,并试图了解可能导致“爆发”的原因。招募参与者故意偏向澳大利亚的观点;17名参与者中只有5名是国际参与者。所有参与者,除1外,观察过吸吮/舔羽毛行为(94.1%),大多数参与者(80%)认为该行为在饲养过程中最常见。参与者对这种行为提出了不同的担忧,从“正常”和对福利没有影响的角度来看,担心羽毛受损导致的交配伤害,增加了啄食羽毛和自相残杀的风险,和心理压力表现为重复(看似)无功能行为。\"舔羽毛,\"\"吸羽毛,\"\"吃羽毛,“”和“羽毛啄食”是互换使用的术语,导致参与者对目标行为的原因和影响感到困惑。报告的原因最常见的因素是无聊(52.9%),营养缺乏(47.1%),和饲料限制(41.2%),超过80%的受访者同意压力会导致羽毛吸吮。这项研究的成果只反映了一小部分,但是专家,澳大利亚肉鸡饲养员行业对羽毛吸吮/舔行为的意见。需要对这种行为有系统的了解,以提供对因果关系和对福利的影响的见解。
    Feather sucking, or feather licking, has been reported anecdotally by employees in the Australian meat chicken breeder industry, but scarcely in the scientific literature. Consequently, the causes and implications of this behavior in meat chicken breeding chickens is relatively unknown. We surveyed 17 industry experts to generate hypotheses about feather sucking behavior. We aimed to understand the frequency and when it occurs, and attempted to understand what may cause an \"outbreak\". The recruitment of participants was intentionally biased towards Australian perspectives; only 5 of the 17 participants were international. All participants, except 1, had seen feather sucking/licking behavior (94.1%) and most participants (80%) suggested that the behavior was most frequently observed during rearing. Participants presented varying concerns about this behavior, ranging from the perspective that it was \"normal\" and had no impact on welfare, to concerns about mating injuries due to damaged feathers, increased risk of feather pecking and cannibalism, and psychological stress indicated by expression of repetitive (seemingly) functionless behavior. \"Feather licking,\" \"feather sucking,\" \"feather eating,\" and \"feather pecking\" were terms used interchangeably, leading to confusion by participants about the cause and implications of the target behavior. The most common factors reported as the cause were boredom (52.9%), nutritional deficiencies (47.1%), and feed restriction (41.2%) and more than 80% of respondents agreed that stress contributes to feather sucking. The outputs from this study reflect only a small, but expert, number of opinions on feather sucking/licking behaviors in the Australian meat chicken breeder industry. A systematic understanding of this behavior is needed to provide insight into causation and the implications for welfare.
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  • 文章类型: Journal Article
    环境的丰富可能会减少皮毛水貂的刻板印象。北美水貂标准要求笼子内的可操作富集对象。然而,水貂可以快速破坏抑制持续富集存在的物体,这可能会产生负面的福利影响。这项实验研究确定了去除简单的笼子可操作富集(塑料链和哑铃)的效果,短期或长期,关于皮毛养殖水貂福利的行为表达。运动刻板印象,正常活动,与无聊有关的不活动的子类型,和尾毛皮咀嚼记录在四个治疗组(1)没有富集,(2)连续富集,(3)短(临时),或(4)长期富集去除。与预测相反,运动刻板印象,拼凑并没有因为丰富而减少,也不受浓缩去除的影响。试验开始时的观察显示,未富集的水貂睁开眼睛躺着的时间最少(即,最不无聊)。缺乏富集可能会增加尾巴上的毛皮咀嚼,但统计确认需要更大的样本量。这项研究有助于文献评估简单,改善皮毛养殖水貂福利的实际丰富。
    Environmental enrichment may reduce stereotypies in fur-farmed mink. North American mink standards require manipulable enrichment objects within cages. However, mink can rapidly destroy objects inhibiting continuous enrichment presence, which may have negative welfare impacts. This experimental study determined the effects of removing simple cage manipulable enrichments (plastic chains and dumbbells), either short-term or longer-term, on the behavioral expression of welfare in fur-farmed mink. Locomotor stereotypies, normal activity, sub-types of inactivity related to boredom, and tail fur-chewing were recorded across four treatment groups with either (1) no enrichment, (2) continuous enrichment, (3) short (temporary), or (4) long-term enrichment removal. Contrary to predictions, locomotor stereotypies, and scrabbling were not reduced by the enrichments, nor affected by the enrichment removal. Observations at the beginning of the trial showed the non-enriched mink spent the least amount of time lying with their eyes open (i.e., the least bored). The lack of enrichment may have increased fur-chewing on the tail, but larger sample sizes would be needed for statistical confirmation. This research contributes to the literature on evaluating simple, practical enrichments for improving fur-farmed mink welfare.
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  • 文章类型: Journal Article
    果蝇的头部修饰包括重复扫过头部的腿,包括定期周期。WeusedtheGAL4-UASsystemtostudytheeffectsofoverexpressingshibirets1andofAdarknockdownviaRNAinterference,在果蝇头部修饰周期期间。过表达shibirets1会干扰突触小泡的再循环,从而干扰细胞通讯,而Adar敲除减少了大量基因的神经元转录本的RNA编辑。所有转基因果蝇及其对照在22°下进行测试,以避免温度影响;在野生型中,周期频率随温度变化,Q10为1.3。用转基因shibirets1进行了两个实验:(1)在22°测试之前,将每只苍蝇在30°下热休克10分钟,以及(2)没有热休克。在这两个实验中,当shibirets1在所有神经元中过度表达时,周期周期增加,但当shibirets1仅在运动神经元中过表达时并未增加。我们假设,由于控制头部梳理周期的神经回路中的突触损伤,过度表达shibirets1的苍蝇的梳理周期被延长。在具有本构的苍蝇中,泛神经元Adar击倒,周期在个体内部的变化更大,但平均周期没有显著改变。我们得出的结论是,RNA编辑对于维持头部修饰周期的个体内部刻板印象至关重要。
    Head grooming in Drosophila consists of repeated sweeps of the legs across the head, comprising regular cycles. We used the GAL4-UAS system to study the effects of overexpressing shibirets1 and of Adar knockdown via RNA interference, on the period of head-grooming cycles in Drosophila. Overexpressing shibirets1 interferes with synaptic vesicle recycling and thus with cell communication, while Adar knockdown reduces RNA editing of neuronal transcripts for a large number of genes. All transgenic flies and their controls were tested at 22° to avoid temperature effects; in wild type, cycle frequency varied with temperature with a Q10 of 1.3. Two experiments were performed with transgenic shibirets1: (1) each fly was heat-shocked for 10 min at 30° immediately before testing at 22° and (2) flies were not heat shocked. In both experiments, cycle period was increased when shibirets1 was overexpressed in all neurons, but was not increased when shibirets1 was overexpressed in motoneurons alone. We hypothesize that grooming cycles in flies overexpressing shibirets1 are lengthened because of synaptic impairment in neural circuits that control head-grooming cycles. In flies with constitutive, pan-neuronal Adar knockdown, cycle period was more variable within individuals, but mean cycle period was not significantly altered. We conclude that RNA editing is essential for the maintenance of within-individual stereotypy of head-grooming cycles.
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  • 文章类型: Journal Article
    竞争刺激评估(CSA)是识别与自动强化行为竞争的刺激的有效工具。然而,Jennett等人。表明在某些情况下,非偶然获得竞争性刺激不足以降低目标反应,并且可能需要额外的治疗组件。当前研究的目的是检查程序变化(即,旋转竞争项目并促使参与)在增加功能参与和减少刻板印象时呈现竞争刺激。在功能分析之后,进行了CSA以确定4名自闭症患者的竞争性刺激。然后将确定的项目与两个程序变体一起使用。刻板印象的水平,功能参与,和项目接触进行了测量。结果显示,对于两名参与者来说,两种治疗都是有效的,而对于其他两名参与者,提示功能参与更有效。提示功能参与可能是一种有效的策略,可以增强与自动增强问题行为的竞争刺激的参与,因为它可能导致功能参与本身变得增强。
    Competing stimulus assessments (CSA) are effective tools for identifying stimuli that compete with automatically reinforced behavior. However, Jennett et al. suggests there are cases for which non-contingent access to competing stimuli are insufficient at decreasing target responding and additional treatment components may be necessary. The purpose of the current study was to examine procedural variations (i.e., rotating competing items and prompted engagement) when presenting competing stimuli on increasing functional engagement and decreasing stereotypy. Following a functional analysis, a CSA was conducted to identify competing stimuli for four individuals with autism. Items identified were then used with two procedural variations. Levels of stereotypy, functional engagement, and item contact were measured. Results showed that for two participants both treatments were effective, while for the other two participants prompting functional engagement was more effective. Prompting functional engagement is likely a productive strategy for enhancing engagement with competing stimuli for automatically reinforced problem behavior as it may result in functional engagement becoming reinforcing in and of itself.
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  • 文章类型: Journal Article
    背景:我们先前的研究表明,在单次视频EEG监测(VEEG)期间,同一患者的功能性癫痫发作(FS)是一致的。这项研究旨在检查即使在几年后,FS是否在VEEG会议上保持一致。
    方法:该研究使用五个标准评估了不同VEEG会话中FS的一致性:FS类型,涉及的主要解剖区域(具体来说,癫痫发作期间受影响最大的身体部位),其他涉及的解剖区域,运动的频率,和FS的持续时间。一致性级别被归类为低(一个一致轴),中等(两个一致的轴),和高(三个或更多一致的轴)。
    结果:14例患者被纳入最终分析。监测之间的平均时间为3.8±2.5年(0.5-8年)。14名患者中有13名,第一次和第二次监测事件被归类为相同的FS类别.在12例运动性FS患者中,有9例涉及的主要解剖区域具有一致性。在12名运动性FS患者中,有9名两个疗程中涉及的其他解剖区域一致.在大多数患者中,疗程之间的平均FS持续时间不一致。10例患者分类一致性高,一名中度一致性的患者,两名一致性低的患者,一个病人,事件被归类为不一致.
    结论:我们的结果表明,即使几年后,单个患者的FS也趋于保持一致,一致性程度和VEEG会议之间的时间之间可能没有相关性。这些发现对于支持FS的概念是一个一致的现象具有重要意义。此外,他们可能为未来的研究提供潜在的途径,以阐明FS的起源。后续研究对于验证和扩展这些初步观察至关重要。
    Our previous study showed that functional seizures (FS) are consistent in the same patient during a single video EEG monitoring (VEEG). This study aimed to check whether FS remains consistent across VEEG sessions even after several years.
    The study evaluated the consistency of FS across different VEEG sessions using five criteria: FS type, the main anatomical region involved (specifically, the body part most affected during the seizure), other involved anatomical regions, frequency of movements, and duration of FS. Consistency levels were categorized as low (one consistent axis), moderate (two consistent axes), and high (three or more consistent axes).
    Fourteen patients were included in the final analysis. The mean time between monitoring was 3.8 ± 2.5 years (0.5-8 year). In 13 of 14 patients, the first and second monitoring events were classified into the same FS category. There was consistency in the main anatomical region involved in 9 out of 12 patients with motor FS. In 9 out of 12 patients with motor FS, the other anatomical regions involved were consistent in both sessions. The mean duration of the FS between sessions was inconsistent in most of the patients. Ten patients were classified with high consistency, one patient with moderate consistency, two patients with low consistency, and in one patient, the events were classified as inconsistent.
    Our results show that FS tends to remain consistent in a single patient even after several years, and there is probably no correlation between the degree of consistency and the time between VEEG sessions. These findings have implications for supporting the concept of FS as a consistent phenomenon. Additionally, they may suggest potential avenues for future research to elucidate the origins of FS. Subsequent studies are essential to validate and expand upon these preliminary observations.
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