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motor disorders 2 Huntington & Multiple sclerosis, Hierachal motor…
motor disorders 2 Huntington & Multiple sclerosis
actions are based on integrated perception of
somatosensory input
visual input (external targets)
vestibular input
these 3 are necessary to program any motor actions
come together in the
posterior partial lobe
(interface between sensory & motor networks)
uses several " reference frames"
egocentric (retina, head, body)
allocentric (outside world)
the motor system - cortex
Primary & secondary somatosensory cortex
proprioception, tactile perception (pressure)
Primary & secondary visual cortex
visual perception (where pathway)
Premotor cortex, supplementary motor area, anterior cingulate cortex
action schema, planning, selection, start & inhibition of motor behavior
Primary motor cortex (motor strip)
motor commands regulation of muscle strength
Motor system - motor representation
Mirror neurons
still controversial
direct link between perception and action (understanding others motor actions & carriyng out those)
motor planning in the
premotor cortex
motion sequences
ex.: "end-state comfort"
motor system
Basal ganglia:
general motor functions coordination and execution
integrated network of several nuclei
caudate nucleus
putamen
globus pallidus
Cerebellar system:
global motor functions
balance
fast fine-tunning
planning of action patterns
Motor disorders
Loss of strength:
damage to primary motor strip
-deficit mainly contralesional & in a limited fashion
Paresis
Hemiparesis
Anosognosia
Paralysis
Control & coordination:
cortical processing is alright only control and coordination is impaired
damage to basal ganglia/ cerebellum and white matter tracts
Cerebral Palsy: poorly controlled movement
Development Coordination Disorder or minimal cerebral palsy
"clumbsiness" or delay in movement
Alien hand syndrom
Anarchic hand syndrom
Ataxia
disorder of balance & motor coordination
Cerebellar Ataxia
Sensory Ataxia
Vestibular Ataxia
Optic Ataxia
Apraxia
disorder of wilful learned actions
caused by lesions in the
left parietal or frontal lobe
ideational Aprexia
Ideamotor Aprexia
constructional Aprexia
Unimodel Apraxia
tactile apraxia
Limb apraxia
optic or. occulosmotr apraxia
Buccofacial apraxia
progressive neuro-degenerative disease
too many repetitions of a single gene on chromosome 4
slowly progressing start btw. 30 & 40
Juvenile HD: before age 20
Degeneration of Basal Ganglia mostly the
striatum
Symptoms
Motor symptoms (dyskinesias)
Chorea (increase in involuntary movement)
ataxia
disturbed muscle tone (dystonia)
Rigidity
later stages: difficulty with speech or swallowing
Cognitive Symptoms:
variable progression of the illness (from mild to full dementia)
reduced mental speed
attention deficit
executive problems
memory problems
poor insight
language production problem
Affective & Psychiatric Symptoms:
depression
anxiety
apathy
irritability
loss of decorum
compulsive thoughts & actions
Psychotic behavior (relatively rare)
Treatment:
antidepressants & antipsychotic medication
occupational therapy
language & speech therapy
Physiotherapy
MULTIPLE SCLEROSIS
Progressive disease of
the brain & spinal cord
immune system attacks myelin sheath causes inflammation
detention of signal transfer in the brain & spinal cord
relapsing & remitting disease
Primary progressive MS:
constant
progression
Secondary progressive MS: after several years pattern changes
prevalence
about 2.500.000 people
women > men
increase if you move away from the equator
diagnosis
early stages:
Peripheral: electophysiology
central: TMS
Later stages: brain imaging
Symptoms
sensory motor symptoms:
numbness / weakness in limbs
fatigue
tremor
lack of coordination
electric shock sensation
Visual Symptoms:
partial or complete loss of sight
blurry
blind spots / double vission
eye pain
Neuropsychological Symptoms:
slowed processing/ thinking
memory impairment
attention concentration
visuspaital functions
language deficits
Treatment
Treating relapses: steroid medication
treating specific symptoms
treatment to reduce number of relapses: subcutaneous interferon beta 1a
Hierachal motor control
