Internal Languages of Finitely Complete (∞,1)(\infty, 1)-categories

We prove that the homotopy theory of Joyal's tribes is equivalent to that of fibration categories. As a consequence, we deduce a variant of the conjecture asserting that Martin-L\"of Type Theory with dependent sums and intensional identity types is the internal language of $(\infty, 1)$-categories with finite limits.Comment: 41 pages, minor revision

The impact of brain lesion characteristics and the corticospinal tract wiring on mirror movements in unilateral cerebral palsy.

Mirror movements (MM) influence bimanual performance in children with unilateral cerebral palsy (uCP). Whilst MM are related to brain lesion characteristics and the corticospinal tract (CST) wiring pattern, the combined impact of these neurological factors remains unknown. Forty-nine children with uCP (mean age 10y6mo) performed a repetitive squeezing task to quantify similarity (MM-similarity) and strength (MM-intensity) of the MM activity. We used MRI data to evaluate lesion type (periventricular white matter, N = 30; cortico-subcortical, N = 19), extent of ipsilesional damage, presence of bilateral lesions, and damage to basal ganglia, thalamus and corpus callosum. The CST wiring was assessed with Transcranial Magnetic Stimulation (17 CSTcontralateral, 16 CSTipsilateral, 16 CSTbilateral). Data was analyzed with regression analyses. In the more-affected hand, MM-similarity and intensity were higher with CSTbilateral/ipsilateral. In the less-affected hand, MM-similarity was higher in children with (1) CSTcontra with CSC lesions, (2) CSTbilat/ipsi with PVL lesions and (3) CSTbilat/ipsi with unilateralized lesions. MM-intensity was higher with larger damage to the corpus callosum and unilateral lesions. A complex combination of neurological factors influences MM characteristics, and the mechanisms differ between hands

Macro- and microstructural brain damage underlying impaired upper limb function in children with unilateral cerebral palsy

In children with unilateral cerebral palsy (CP), sensory and motor impairments are often more pronounced in the upper limb (UL) than in the lower limb, though the variability in outcome is large. This is not surprising since these children present with various brain lesions. So far, it is still unclear which neurological factors determine UL function in these children. Further research is necessary to unravel the complex neuropathophysiology underlying UL dysfunction. Magnetic resonance imaging (MRI) is the standard clinical technique to investigate brain lesions in children with CP. However, more recently developed medical imaging techniques can provide a more complete picture of the brain lesion. Diffusion tensor imaging (DTI) is found to be superior to structural MRI to identify white matter tract injury in children with CP. Limited studies using DTI have focused on the associations with UL function in children with unilateral CP presenting contradicting results on the importance of the corticospinal versus thalamocortical tracts. Recently, diffusion kurtosis imaging (DKI) was suggested as a minimal extensionof DTI as it provides a more accurate quantification of water diffusion in the brain. Until know, DKI still has not been used in the research are of CP. Furthermore, there is increasing evidence that constrained-induced movement therapy and intensive bimanual training are efficient for improving UL function in children with unilateral CP. However, until now no one treatment modality has shown to be superior. Moreover, studies reported large variability which cannot befully explained based on age or initial severity.15 Therefore, it has become an intriguing question whether the efficacy of therapy models depends on brain lesion characteristics and this requires further investigation. The overall aim of this project is to investigate which neurological factors determine UL sensorimotor outcome as well as treatment response via a clinical and biomechanical approach in children with unilateral CP. In a first study, we will try to get a betterinsight in the relation between clinical and biomechanical measures of UL function. Secondly, we will explore in how far sensorimotor function depends on white matter tract integrity (DKI) combined with brain lesioncharacteristics (MRI). Finally, we will conduct an intervention study to identify neurological predictors for treatment response. Most neuroimaging studies investigated the association between imaging findings and motor function, while we will emphasize more on identifying neurological predictors of UL function as well as treatment response. This project is, to our knowledge, the first to use DKI in children with CP also combined with the neuroanatomical characterization of the lesion and relate this to UL function. Secondly, studies using UL kinematics in combination with neuroimaging findings do not exist yet. Sothis project will provide new knowledge in this field which will help us to better understand the neuropathophysiology underlying UL dysfunction.status: publishe

The relationship of dystonia and choreoathetosis with activity, participation and quality of life in children and youth with dyskinetic cerebral palsy

Aim To relate dystonia and choreoathetosis with activity, participation and quality of life (QOL) in children and youth with dyskinetic Cerebral Palsy (CP). Methods Fifty-four participants with dyskinetic CP (mean age 14y6m, SD 4y2m, range 6–22y) were included. The Dyskinesia Impairment Scale (DIS) was used to evaluate dystonia and choreoathetosis. Activity, participation and quality of life (QOL) were assessed with the Gross Motor Function Measure (GMFM), the Functional Mobility Scale (FMS), the Jebsen-Taylor Hand Function Test (JTT), the ABILHAND-Kids Questionnaire (ABIL-K), the Life Habits Kids (LIFE-H) and the Quality of Life Questionnaire for children with CP (CP-QOL). Spearman's rank correlation coefficient (rs) was used to assess the relationship between the movement disorders and activity, participation and QOL measures. Results Significant negative correlations were found between dystonia and the activity scales with Spearman's rank correlation coefficient (rs) varying between −0.65 (95% CI = −0.78 to −0.46) and −0.71 (95% CI = −0,82 to −0.55). Correlations were also found with the LIFE-H (rs = −0.43; 95%CI = −0.64 to −0.17) and the CP-QOL (rs = −0.32; 95%CI = −0.56 to −0.03). As far as choreoathetosis is concerned, no or only weak relationships were found with the activity, participation and quality of life scales. Interpretation This cross-sectional study is the first to examine the relationship of dystonia and choreoathetosis in dyskinetic CP with the level of activity, participation and QOL. The results revealed dystonia has a higher impact on activity, participation and quality of life than choreoathetosis. These findings seem to suggest it is necessary to first focus on dystonia reducing intervention strategies and secondly on choreoathetosis.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

The relationship of dystonia and choreoathetosis with activity, participation and quality of life in children and youth with dyskinetic cerebral palsy

Aim: To relate dystonia and choreoathetosis with activity, participation and quality of life (QOL) in children and youth with dyskinetic Cerebral Palsy (CP). Methods: Fifty-four participants with dyskinetic CP (mean age 14y6m, SD 4y2m, range 6 e22y) were included. The Dyskinesia Impairment Scale (DIS) was used to evaluate dystonia and choreoathetosis. Activity, participation and quality of life (QOL) were assessed with the Gross Motor Function Measure (GMFM), the Functional Mobility Scale (FMS), the Jebsen- Taylor Hand Function Test (JTT), the ABILHAND-Kids Questionnaire (ABIL-K), the Life Habits Kids (LIFE-H) and the Quality of Life Questionnaire for children with CP (CP-QOL). Spearman's rank correlation coefficient (rs) was used to assess the relationship between the movement disorders and activity, participation and QOL measures. Results: Significant negative correlations were found between dystonia and the activity scales with Spearman's rank correlation coefficient (rs) varying between -0.65 (95%CI=-0.78 to -0.46) and -0.71 (95% CI=-0,82 to -0.55). Correlations were also found with the LIFE-H (rs=-0.43; 95%CI=-0.64 to -0.17) and the CP-QOL (rs=-0.32; 95%CI =-0.56 to -0.03). As far as choreoathetosis is concerned, no or only weak relationships were found with the activity, participation and quality of life scales. Interpretation: This cross-sectional study is the first to examine the relationship of dystonia and choreoathetosis in dyskinetic CP with the level of activity, participation and QOL. The results revealed dystonia has a higher impact on activity, participation and quality of life than choreoathetosis. These findings seem to suggest it is necessary to first focus on dystonia reducing intervention strategies and secondly on choreoathetosis.publisher: Elsevier articletitle: The relationship of dystonia and choreoathetosis with activity, participation and quality of life in children and youth with dyskinetic cerebral palsy journaltitle: European Journal of Paediatric Neurology articlelink: http://dx.doi.org/10.1016/j.ejpn.2016.09.003 content_type: article copyright: © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.status: publishe

Tyneside Pegboard Test for unimanual and bimanual dexterity in unilateral cerebral palsy ::association with sensorimotor impairment

Aim : We explored the psychometric properties of the recently developed Tyneside Pegboard Test (TPT) for unimanual and bimanual dexterity in children with unilateral cerebral palsy (CP) and investigated the impact of sensorimotor impairments on manual dexterity. Method : In this cross-sectional study, the TPT was assessed in 49 children with unilateral CP (mean age 9y 8mo, SD 1y 11mo, range 6–15y; 30 males, 19 females; 23 with right unilateral CP). All participants additionally underwent a standardized upper limb evaluation at body function and activity level. We investigated: (1) known-group, concurrent, and construct validity and (2) impact of sensorimotor impairments including spasticity, grip force, stereognosis, and mirror movements using analysis of covariance, Spearman’s rank correlation (r), and multiple linear regression (R2) respectively. Results : TPT outcomes significantly differed according to the Manual Ability Classification System (p<0.001, known-group validity). Relationships were found between the unimanual TPT tasks and the Jebsen-Taylor Hand Function Test (r=0.86–0.88, concurrent validity). Bimanual TPT tasks were negatively correlated with the Assisting Hand Assessment, ABILHAND-Kids, and Children’s Hand-use Experience Questionnaire (r=−0.38 to −0.78, construct validity). Stereognosis was the main determinant influencing all tasks (p<0.001, R2=37–50%). Unimanual dexterity was additionally determined by grip strength (p<0.05, R2=8–9%) and mirror movements in the more impaired hand (p<0.05, R2=4–8%). Bimanual dexterity was also explained by mirror movements in the more impaired hand (p<0.01, R2=10–16%) and spasticity (p=0.04, R2=5%). Interpretation : The TPT is a valid test to measure unimanual and bimanual dexterity in unilateral CP. The results further emphasize the importance of somatosensory impairments in children with unilateral CP

Mirror movements and their relation to hand function and brain lesions in children with unilateral cerebral palsy

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Mirror movements and their relation to hand function and brain lesions in children with unilateral cerebral palsy

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Effects of a novel intervention approach combining Modified Constraint-Induced Movement Therapy and Action-Observation Training on upper limb function in children with unilateral cerebral palsy

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The role of corticospinal tract wiring in determining upper limb function in children with unilateral cerebral palsy

Introduction Children with unilateral cerebral palsy (uCP) show a variety of sensorimotor problems in their affected upper limb (UL) due to a brain injury. Brain lesion characteristics (timing, location and extent) have been proposed as predictors of UL function, albeit with large variability in results. Recently, corticospinal tract (CST) reorganization has also been put forward as an important determinant, although its impact has not yet been systematically explored. Here, we investigated differences in unimanual and bimanual UL function between children with uCP with different CST wiring patterns. Patients and methods CST wiring patterns were defined using single-pulse Transcranial Magnetic Stimulation. Unimanual capacity was assessed with grip strength, the Melbourne Assessment 2 (MA2, subscales: range of motion, accuracy, dexterity and fluency) and Jebsen-Taylor Hand Function (JTHF) test. Bimanual performance was measured with the Assisting Hand Assessment (AHA) and ABILHAND-Kids. Results Fifty-six children were included (mean age (SD): 11y1m (3y6m); 28 girls).Twenty showed contralateral wiring, 17bilateraland 19ipsilateral. Compared to the ipsilateral wiring group, children with a contralateral wiring showed better unimanual capacity (grip strength, all MA2-subscales, JTHF; p<0.005) and bimanual performance (ABILHAND-Kids, AHA; p<0.001). Compared to those with bilateral wiring, children with contralateral wiring also showed preserved unimanual (grip strength, MA2-range-of-motion, MA2-dexterity, MA2-fluency, and JTHF; p<0.001) and bimanual function (ABILHAND-Kids, AHA; p<0.007). Interestingly, children with bilateral and ipsilateral CST wiring did not differ in UL function. Conclusion A preserved contralateral CST wiring favors the development of UL function in children with uCP.status: publishe