Doenças neuromusculares: rediscutindo o overtraining

Centro Universitário Augusto MottaUniversidade de São Paulo School of Medicine Department of Physical TherapyUniversidade Federal FluminenseUniversidade Federal de São Paulo (UNIFESP) Neurology DepartmentUNIFESP, Neurology DepartmentSciEL

The influence of visual and tactile perception on hand control in\ud children with Duchenne muscular dystrophy

Aim\ud To investigate tactile perception and manual dexterity, with or without visual feedback, in males with Duchenne muscular dystrophy (DMD).\ud \ud Method\ud Forty males with DMD (mean age 9y 8mo, SD 2y 3mo; range 5–14y), recruited from the teaching hospital of the School of Medicine of the University of São Paulo, with disease severity graded as ‘1’ to ‘6’ on the Vignos Scale and ‘1’ on Brooke's Scale, and 49 healthy males (mean age 8y 2mo; range 5–11y; SD 1y 11mo), recruited from a local education center, participated in the study. We assessed tactile perception using two-point discrimination and stereognosis tests, and manual dexterity using the Pick-Up test with the eyes either open or closed. Analysis of variance was used to compare groups; a p value of less than 0.05 was considered statistically significant.\ud \ud Results\ud Males with DMD exhibited no impairment in tactile perception, as measured by the two-point discrimination test and the number of objects correctly named in the stereognosis test. Manipulation during stereognosis was statistically slower with both hands (p<0.001), and manual dexterity was much worse in males with DMD when there was no visual feedback (p<0.001).\ud \ud Interpretation\ud Males with DMD exhibited disturbances in manipulation during stereognosis and dexterity tests. Hand control was highly dependent on visual information rather than on tactile perception. Motor dysfunction in males with DMD, therefore, might be related to altered neural control

Neurodevelopment in the third year of life in children with antenatal ZIKV-exposure

We report cognitive, language and motor neurodevelopment, assessed by the Bayley-III test, in 31 non-microcephalic children at age 3 with PCR-confirmed maternal Zika virus exposure (Rio de Janeiro, 2015–2016). Most children had average neurodevelopmental scores, however, 8 children (26%) presented delay in some domain. Language was the most affected: 7 children (22.6%) had a delay in this domain (2 presenting severe delay). Moderate delay was detected in the cognitive (3.2%) and motor (10%) domains. Maternal illness in the third trimester of pregnancy and later gestational age at birth were associated with higher Bayley-III scores. Zika-exposed children require long-term follow-up until school age

Neurodevelopment of children exposed intra-uterus by Zika virus: A case series.

The main goal of this manuscript was to investigate the neurodevelopment of children exposed by Zika virus in the intrauterine period who are asymptomatic at birth. Newborns with documented Zika virus exposure during the intrauterine period who were asymptomatic at birth were followed in the first two years of life for neurodevelopment using Bayley III test. Children were classified as having normal or delayed neurodevelopment for age based on most recent Bayley III evaluation results. Eighty-four infants were included in the study. The first Bayley III evaluation was performed at a mean chronological age of 9.7±3.1 month; 13 children (15%) had a delay in one of the three domains, distributed as follow: 10 (12%) in the language domain and 3 (3.5%) in the motor domain. The most recent Bayley III evaluation was performed at a mean age 15.3±3.1 months; 42 children (50%) had a delay in one of the three domains: 4 (5%) in cognition, 31 (37%) in language, and 20 (24%) in motor performance. There were no statistical differences in Gender, Gestational Age, Birth Weight and Head Circurference at birth between children with normal and delayed neurodevelopment for age. A very high proportion of children exposed ZIKV during pregnancy who were asymptomatic at birth demonstrated a delay in neurodevelopment, mainly in the language domain, the first two years of life

Origin of dopaminergic fibers to the central extended amygdala and nucleus accumbens shell in the rat.

A amígdala expandida central (EAc) inclui os núcleos central da amígdala (CeA), intersticial lateral da estria terminal (BSTl), intersticial do ramo posterior da comissura anterior (IPAC) e amígdala expandida sublenticular (SLEA). A EAc e a concha do acumbens possuem densa inervação dopaminérgica, implicada em processos motivacionais, e cuja origem foi estudada com a técnica de dupla marcação celular, combinando-se imunofluorescência para o traçador retrógrado Fluoro-Gold e para a tirosina hidroxilase. Nossos resultados indicam que a inervação dopaminérgica do CeA e BSTl é semelhante, se originando em igual proporção da área tegmental ventral (A10) e do núcleo dorsal da rafe/substância cinzenta periaquedutal (A10dc). A inervação dopaminérgica da SLEA, IPAC e concha do acumbens se origina principalmente do grupo A10. Com um anticorpo específico para dopamina vimos que parte da projeção do A10dc para o CeA é de fato dopaminérgica. Os grupos dopaminérgicos diencefálicos não inervam a EAc e a concha do acumbens.The central extended amygdala (EAc) includes the central amygdaloid nucleus (CeA), lateral bed nucleus of the stria terminalis (BSTl), interstitial nucleus of the posterior limb of the anterior commissure (IPAC) and sublenticular extended amygdala (SLEA). The dopaminergic innervation of the EAc and nucleus accumbens shell is functionally related to motivational processes. Its origin was studied by combining immunofluorescence to tyrosine hydroxylase and Fluoro-Gold, used as retrograde tracer. Our results show that dopaminergic fibers to the CeA and BSTl derive in equal proportion from neurons in ventral tegmental area (A10) and in dorsal raphe nucleus/periaqueductal gray (A10dc). Dopaminergic inputs to SLEA, IPAC and accumbens shell arise mainly from A10 neurons. Using a dopamine antibody, we confirmed that A10dc projections to CeA are in part dopaminergic. Futhermore, the present data indicate that the diencephalic dopaminergic groups do not project to EAc and accumbens shell

Origin of dopaminergic fibers to the central extended amygdala and nucleus accumbens shell in the rat.

A amígdala expandida central (EAc) inclui os núcleos central da amígdala (CeA), intersticial lateral da estria terminal (BSTl), intersticial do ramo posterior da comissura anterior (IPAC) e amígdala expandida sublenticular (SLEA). A EAc e a concha do acumbens possuem densa inervação dopaminérgica, implicada em processos motivacionais, e cuja origem foi estudada com a técnica de dupla marcação celular, combinando-se imunofluorescência para o traçador retrógrado Fluoro-Gold e para a tirosina hidroxilase. Nossos resultados indicam que a inervação dopaminérgica do CeA e BSTl é semelhante, se originando em igual proporção da área tegmental ventral (A10) e do núcleo dorsal da rafe/substância cinzenta periaquedutal (A10dc). A inervação dopaminérgica da SLEA, IPAC e concha do acumbens se origina principalmente do grupo A10. Com um anticorpo específico para dopamina vimos que parte da projeção do A10dc para o CeA é de fato dopaminérgica. Os grupos dopaminérgicos diencefálicos não inervam a EAc e a concha do acumbens.The central extended amygdala (EAc) includes the central amygdaloid nucleus (CeA), lateral bed nucleus of the stria terminalis (BSTl), interstitial nucleus of the posterior limb of the anterior commissure (IPAC) and sublenticular extended amygdala (SLEA). The dopaminergic innervation of the EAc and nucleus accumbens shell is functionally related to motivational processes. Its origin was studied by combining immunofluorescence to tyrosine hydroxylase and Fluoro-Gold, used as retrograde tracer. Our results show that dopaminergic fibers to the CeA and BSTl derive in equal proportion from neurons in ventral tegmental area (A10) and in dorsal raphe nucleus/periaqueductal gray (A10dc). Dopaminergic inputs to SLEA, IPAC and accumbens shell arise mainly from A10 neurons. Using a dopamine antibody, we confirmed that A10dc projections to CeA are in part dopaminergic. Futhermore, the present data indicate that the diencephalic dopaminergic groups do not project to EAc and accumbens shell

Hip Mobilization at Preterm Age May Accelerate Developmental Dysplasia Recovery

Purpose. Few studies have described mobilization approaches in developmental dysplasia of the hip (DDH). The present study describes the hip mobilization of a preterm infant (born at 33 6/7 weeks of gestational age) diagnosed with DDH. Design and Methods. During the 43-day hospital stay, the infant was seen twice a week (ten sessions, 20 minutes each). All sessions included hip approximation maneuvers, with the hip positioned in abduction, lateral rotation and flexion, and lower limbs passive mobilization, which were taught to the mother. Early intervention with auditory, tactile, visual, and vestibular stimulations was also performed. The infant was assessed with hip ultrasound before and after treatment. Results. At 34 2/7 weeks of gestational age, she was classified as Graf IIa (left: alpha: 55°, beta: 68°; right: alpha: 59°, beta: 64°). At 40 5/7 weeks, she was classified as Graf I for left (alpha: 67°; beta: 42°) and right (alpha: 66°; beta: 42°) hips. Practical Implications. The intervention seemed to accelerate the acquisition of stability of dysplasic hips in a preterm infant. The outcome supports further investigation of hip approximation maneuvers as part of early stimulation in preterm infants with DDH during hospital stay