Document Detail

Correlation between impaired dexterity and corticospinal tract dysgenesis in congenital hemiplegia.
MedLine Citation:
PMID:  12566293     Owner:  NLM     Status:  MEDLINE    
One of the most devastating consequences of early corticospinal lesions is the impaired dexterity that results in a noticeable deficit while manipulating small objects. One purpose of the present study was to investigate the extent to which a deficit in the coordination of fingertip forces when grasping and lifting an object between the thumb and index finger could account for the impaired dexterity in patients with congenital hemiplegia (CH). A second objective was to examine whether, in these patients, deficits in skilled hand movements are correlated with the importance of structural damage to the corticospinal tract. The scaling and coordination of fingertip forces during precision grip was investigated in 16 CH patients (aged 8-19 years) and 16 age- and sex-matched control subjects. Proprioception, stereognosis, pressure sensitivity and motor upper limb function (including digital and manual dexterity) were also assessed quantitatively. The structural damage of the corticospinal tract was estimated by measuring the cross-sectional area of cerebral peduncles with MRI and by calculating an index of symmetry between the two peduncles. In CH patients, a large number of parameters measured during the grip-lift task were significantly different when compared with those found in control subjects. Among those, the duration of the preloading and loading phases was significantly longer in CH patients. In addition, both the dissimilarity and time-shift between the profiles of the grip and load force rates, quantified with the cross-correlation method, were also significantly larger in CH patients; the time-shift was strongly correlated with impaired dexterity. These findings suggest that impaired dextrous finger movements in CH patients may specifically result from their inability to ensure a precise synergy between fingertip forces while manipulating an object. Finally, the finding that the time-shift also correlated with the corticospinal tract dysgenesis, as estimated with the cerebral peduncle asymmetry, argues in favour of a critical role of the corticospinal system in the temporal coordination between different muscles involved in dextrous hand movements. Both digital and manual dexterity were also altered in the non-paretic hand of CH patients. This deficit may reveal the contribution of the lesioned hemisphere to the control of ipsilateral skilled finger movements.
Julie Duque; Jean-Louis Thonnard; Yves Vandermeeren; Guillaume Sébire; Guy Cosnard; Etienne Olivier
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Brain : a journal of neurology     Volume:  126     ISSN:  0006-8950     ISO Abbreviation:  Brain     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-02-04     Completed Date:  2003-05-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372537     Medline TA:  Brain     Country:  England    
Other Details:
Languages:  eng     Pagination:  732-47     Citation Subset:  AIM; IM    
Laboratory of Neurophysiology, School of Medicine, Université catholique de Louvain, Brussels, Belgium.
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MeSH Terms
Case-Control Studies
Hand Strength*
Hemiplegia / congenital*,  pathology,  psychology
Magnetic Resonance Imaging*
Psychomotor Performance
Pyramidal Tracts / abnormalities*

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