Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that modulates cortical excitability and influences cognition. The role of the primary motor cortex (M1) in cognition is controversial. Here, we investigated the offline effects of anodal and sham tDCS over M1 on cognitive tasks that require comparable motor skills, but different levels of working memory and attention. Twenty healthy young female adults received anodal tDCS and sham tDCS to the M1 on two separate testing days in a counter balanced order. The cognitive functions outcome variables were the response time from the Attention Switching Task (AST) and Motor Screening Task (MST) tests using the Cambridge Neuropsychological Test Automated Battery before and after the anodal/sham tDCS. Anodal tDCS significantly improved AST response times from baseline in congruent and incongruent condition and MST mean correct latency (all p < 0.05). There was a significant difference for AST tasks variable include AST Switching cost (mean, correct), AST Mean correct latency, in congruent, incongruent, blocks 3, 5 (non-switching blocks), block 7 (switching block) (p < 0.01) and MST mean latency (p < 0.05) between anodal and sham conditions. These results indicate that tDCS is a promising tool to an improvement in response time in task related attention and motor speed. However, this study warrants further research to determine the long-term effect on other cognitive functions and in different age and gender groups.
Adult ; Brain ; Cognition ; Female ; Humans ; Mass Screening ; Memory, Short-Term ; Motor Cortex ; Motor Skills ; Neuropsychological Tests ; Reaction Time ; Transcranial Direct Current Stimulation

The syndrome of the trephined is a neurologic phenomenon that manifests as sudden decline in cognition, behavior, and sensorimotor function due to loss of intracranial domain. This scenario typically occurs in the setting of large craniectomy defects, resulting from trauma, infection, and/or oncologic extirpation. Cranioplasty has been shown to reverse these symptoms by normalizing cerebral hemodynamics and metabolism. However, successful reconstruction may be difficult in patients with complex and/or hostile calvarial defects. We present the case of a 48-year-old male with a large cranial bone defect, who failed autologous cranioplasty secondary to infection, and developed rapid neurologic deterioration leading to a near-vegetative state. Following debridement and antibiotic therapy, delayed cranioplasty was accomplished using a polyetheretherketone (PEEK) implant with free chimeric latissimus dorsi/serratus anterior myocutaneous flap transfer for vascularized resurfacing. Significant improvements in cognition and motor skill were noted in the early postoperative period. At 6-month follow-up, the patient had regained the ability to speak, ambulate and self-feed—correlating with evidence of cerebral/ventricular re-expansion on computed tomography. Based on our findings, we advocate delayed alloplastic implantation with total vascularized soft tissue coverage as a viable alternative for reconstructing extensive, hostile calvarial defects in patients with the syndrome of the trephined.
Cognition ; Craniocerebral Trauma ; Debridement ; Follow-Up Studies ; Free Tissue Flaps ; Hemodynamics ; Humans ; Male ; Metabolism ; Middle Aged ; Motor Skills ; Myocutaneous Flap ; Neurologic Manifestations ; Postoperative Period ; Reconstructive Surgical Procedures

OBJECTIVE: To determine effects of copy number variations (CNV) on developmental aspects of children suspected of having delayed development. METHODS: A retrospective chart review was done for 65 children who underwent array-comparative genomic hybridization after visiting physical medicine & rehabilitation department of outpatient clinic with delayed development as chief complaints. Children were evaluated with Denver Developmental Screening Test II (DDST-II), Sequenced Language Scale for Infants (SELSI), or Preschool Receptive-Expressive Language Scale (PRES). A Mann-Whitney U test was conducted to determine statistical differences of developmental quotient (DQ), receptive language quotient (RLQ), and expressive language quotient (ELQ) between children with CNV (CNV(+) group, n=16) and children without CNV (CNV(–) group, n=37). RESULTS: Of these subjects, the average age was 35.1 months (mean age, 35.1±24.2 months). Sixteen (30.2%) patients had copy number variations. In the CNV(+) group, 14 children underwent DDST-II. In the CNV(–) group, 29 children underwent DDST-II. Among variables, gross motor scale was significantly (p=0.038) lower in the CNV(+) group compared with the CNV(–) group. In the CNV(+) group, 5 children underwent either SELSI or PRES. In the CNV(–) group, 27 children underwent above language assessment examination. Both RLQ and ELQ were similar between the two groups. CONCLUSION: The gross motor domain in DQ was significantly lower in children with CNV compared to that in children without CNV. This result suggests that additional genetic factors contribute to this variability. Active detection of genomic imbalance could play a vital role when prominent gross motor delay is presented in children with delayed development.
Ambulatory Care Facilities ; Child ; Comparative Genomic Hybridization ; Developmental Disabilities ; DNA Copy Number Variations ; Humans ; Infant ; Mass Screening ; Motor Skills ; Muscle Hypotonia ; Nucleic Acid Hybridization ; Physical and Rehabilitation Medicine ; Rehabilitation ; Retrospective Studies

OBJECTIVE: To evaluate the clinical usefulness of the Korean Developmental Screening Test (K-DST) via comparison with Korean Ages and Stages Questionnaire (K-ASQ) for the diagnosis of developmental delay in pediatric patients. METHODS: The K-DST and K-ASQ were used to screen pediatric patients who visited the hospital for evaluation and diagnosis of delayed development. Korean Bayley Scales of Infant Development-II (K-BSID-II) or Korean Wechsler Preschool and Primary Scale of Intelligence III (K-WPPSI-III) were used for the standardized assessment. Moreover, the final clinical diagnosis was confirmed by three expert physicians (rehabilitation doctor, psychiatrist, and neurologist). The sensitivity and specificity of each screening tool for the final diagnosis were investigated and correlated with standardized assessments. RESULTS: A total of 145 pediatric consultations were conducted, which included 123 developmental disorders (40 autism spectrum disorders, 46 global developmental delay/intellectual disability, and 37 developmental language disorders) and another 22 that were not associated with any such disorders. The sensitivity and specificity of K-DST based on the final clinical diagnosis were 82.9% and 90.9%, respectively, which were not significantly different from that of K-ASQ (83.7% and 77.3%). Both K-DST and K-ASQ showed good correlation with K-BSID-II and K-WPPSI-III. No significant difference was found between the K-DST and K-ASQ measures. CONCLUSION: K-DST is an excellent screening tool and is expected to replace K-ASQ with high validity.
Autism Spectrum Disorder ; Communication Disorders ; Developmental Disabilities ; Diagnosis ; Humans ; Infant ; Intellectual Disability ; Intelligence ; Mass Screening ; Motor Skills Disorders ; Psychiatry ; Referral and Consultation ; Sensitivity and Specificity ; Weights and Measures

PURPOSE: This study examined whether there is a difference in motor learning through short-term repetitive movement practice in stroke survivors with a unilateral brain injury compared to normal elderly participants. METHODS: Twenty-six subjects who were divided into a stroke group (n=13) or sex-aged matched normal elder group (n=13) participated in this study. To evaluate the effects of motor learning, the participants conducted a tracking task for visuomotor coordination. The accuracy index was calculated for each trial. Both groups received repetitive tracking task training of metacarpophalangeal joint for 50 trials. The stroke group performed a tracking task in the upper extremity insi-lesional to the damaged hemisphere, and the normal elder group performed the upper extremity matched for the same side. RESULTS: Two-way repetitive ANOVA revealed a significant difference in the interactions (time×group) and time effects. These results indicated that the motor skill improved in both the stroke and normal elder group with a tracking task. On the other hand, the stroke group showed lesser motor learning skill than the normal elder group, in comparison with the amount of motor learning improvement. CONCLUSION: These results provide novel evidence that stroke survivors with unilateral brain damage might have difficulty in performing ipsilateral movement as well as in motor learning with the ipsilateral upper limb, compared to normal elderly participants.
Aged ; Brain ; Brain Injuries ; Hand ; Humans ; Learning ; Metacarpophalangeal Joint ; Motor Skills ; Stroke ; Survivors ; Upper Extremity

OBJECTIVE: To evaluate the validity of the Test of Infant Motor Performance (TIMP) and general movements (GMs) assessment for predicting Alberta Infant Motor Scale (AIMS) score at 12 months in preterm infants. METHODS: A total of 44 preterm infants who underwent the GMs and TIMP at 1 month and 3 months of corrected age (CA) and whose motor performance was evaluated using AIMS at 12 months CA were included. GMs were judged as abnormal on basis of poor repertoire or cramped-synchronized movements at 1 month CA and abnormal or absent fidgety movement at 3 months CA. TIMP and AIMS scores were categorized as normal (average and low average and >5th percentile, respectively) or abnormal (below average and far below average or < 5th percentile, respectively). Correlations between GMs and TIMP scores at 1 month and 3 months CA and the AIMS classification at 12 months CA were examined. RESULTS: The TIMP score at 3 months CA and GMs at 1 month and 3 months CA were significantly correlated with the motor performance at 12 months CA. However, the TIMP score at 1 month CA did not correlate with the AIMS classification at 12 months CA. For infants with normal GMs at 3 months CA, the TIMP score at 3 months CA correlated significantly with the AIMS classification at 12 months CA. CONCLUSION: Our findings suggest that neuromotor assessment using GMs and TIMP could be useful to identify preterm infants who are likely to benefit from intervention.
Alberta ; Classification ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Motor Skills

OBJECTIVES: The objective of this study was to investigate the effect of pharmacological treatments for attention-deficit hyperactivity disorder (ADHD) on motor coordination, using the Developmental Coordination Disorder Questionnaire (DCDQ). METHODS: The participants were recruited from April 2015 to November 2016 from the Department of Psychiatry of Asan Medical Center and were treated for 3 months with methylphenidate or atomoxetine. The illness severity at baseline and 3 months were scored using the ADHD Rating Scale (ARS), Clinical Global Impression-Severity Scale (CGI-S) and/or Clinical Global Impression-Improvement Scale (CGI-I). A total of 39 children with ADHD (age 8.0±1.4 years, 36 boys) completed the Advanced Test of Attention (ATA) and their parents completed the DCDQ at baseline and 3 months. The paired t-test, mixed between-within analysis of variance and correlation analysis were used. RESULTS: The CGI-S (p<0.001), ARS (p<0.001), and fine motor/hand writing (p=0.005) on the DCDQ were significantly changed between pre-treatment and post-treatment. When the participants were divided into those who were suspected of having developmental coordination disorder (DCD) (n=23) and those who probably did not (n=16), the control during movement, fine motor/hand writing and general coordination scores on the DCDQ showed the main effects for group (p<0.001, p<0.001 and p<0.001, respectively). The fine motor/hand writing on the DCDQ has a significant main effect for time [F(1,37)=7.31, p=0.010, η2=0.405] and the interaction effect between group and time was also significant [F(1,37)=4.63, p=0.038, η2=0.111]. The baseline visual commission error on the ATA is significantly correlated with the changes in the DCDQ total scores (r=0.330, p=0.040). CONCLUSION: Our results provide preliminary evidence that pharmacological treatment for ADHD improves not only the core symptoms of ADHD, but also the motor coordination. Further studies are needed to confirm the effect of the pharmacological treatment for ADHD on the motor coordination.
Atomoxetine Hydrochloride ; Child ; Chungcheongnam-do ; Drug Therapy ; Humans ; Methylphenidate ; Motor Skills Disorders ; Parents ; Writing

Infants with Sandhoff disease typically appear normal until 3–6 months of age. As the disease progresses, they present with symptoms such as loss of motor skills, exaggerated startle response to loud noise, seizures, visual loss, and paralysis. We encountered a rare case of a 22-month-old girl with Sandhoff disease characterized by progressive motor weakness and dysphagia, who initially showed signs of aspiration at 20 months of age. The major problems related to dysphagia were oromotor dysfunction and abnormal feeding posture. Within 3 months of identification of difficulty in swallowing, the patient showed a significant decrease in food intake, with rapid deterioration of nutritional status. We report our case with a review of the literature.
Deglutition Disorders ; Deglutition* ; Eating ; Female ; Humans ; Infant ; Motor Skills ; Noise ; Nutritional Status ; Paralysis ; Posture ; Reflex, Startle ; Sandhoff Disease* ; Seizures

OBJECTIVETo investigate the differences between the Test of Infant Motor Performance (TIMP) data from the infants at 38-58 weeks of postconceptual age in three hospitals in Chongqing, China and the America norms, and to provide a reference for the introduction and application of TIMP in China.

METHODSTIMP was used to assess 642 infants with 38-58 weeks of postconceptual age who visited the departments of preterm infants or child healthcare in the Second Affiliated Hospital of Army Medical University, Shapingba Maternal and Child Health Hospital in Chongqing, and Chongqing Maternal and Child Health Hospital between January and December, 2016. The assessment scores were analyzed and compared with the America norms.

RESULTSThe TIMP scores increased with the increasing postconceptual age, with 37±5 points in the 38-39week group and 83±12 points in the 56-57week group. All age groups had a significantly lower mean score than the America norms (P<0.001).

CONCLUSIONSTIMP scores can reflect the motor performance in infants with various postconceptual ages. The TIMP scores from the infants with a postconceptual age of 38-58 weeks in three hospitals in Chongqing are significantly different from the America norms, suggesting that it is very necessary in China to establish the Chinese norms for assessing motor performance in infants using TIMP.

OBJECTIVES: Data is necessary for a hospital-wide cerebral palsy (CP) profile, this being the leading pediatric diagnosis at the PGH Rehabilitation Medicine Out Patient clinic. This study aims to identify clinical features, severity of disability and common interventions in pediatric CP patients.

METHODS: CP profile data collection forms were accomplished from September 2014 to December 2015.

PRIMARY RESULTS: Among 125 participants: 55% were < 5 years old, 47% were delivered vaginally, 42% had perinatal onset of condition, 34% had normal birth weight and 23% were moderately preterm. Most were quadriplegic (36%) and spastic (50%). Primary caregivers were mostly mothers (45%) and

CONCLUSION: A hospital-wide cerebral palsy profile should be established to monitor CP, given its multifactorial cause and complex functional impact. Trends should be correlated with maternal and patient factors, healthcare provision and socioeconomics