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Hand Movements (hand + movement)
Selected AbstractsEye,hand coordination in essential tremorMOVEMENT DISORDERS, Issue 3 2006Peter Trillenberg MD Abstract Patients with essential tremor (ET) or with cerebellar lesions have in common oculomotor abnormalities, with the exception of saccadic eye movements, which do not seem to be involved in ET. Since grasping is prolonged in ET and might be related to saccadic dysmetria, we tested whether simultaneous hand pointing could unmask it. Twelve ET patients and 14 controls performed saccades with and without simultaneous pointing movements to the same targets, and with and without a gap between the disappearance of the fixation point and the appearance of the target. Eye movements were recorded with the magnetic search-coil method, hand movements with an ultrasound-emitting probe. ET patients did not have saccadic dysmetria, and contrary to normal subjects their saccadic latency did not decrease during combined eye,hand movements compared with saccades performed in isolation. Hand movements had a longer duration in ET patients, with decreased peak acceleration, an increased latency of the peak velocity, and peak deceleration. In conclusion, this first study on eye,hand coordination in ET revealed abnormal kinematic changes in the early phase of pointing movements. These changes might be related to cerebellar disease but they are independent of the intention tremor component and saccade performance. © 2005 Movement Disorder Society [source] Load force during manual transport in Parkinson's diseaseACTA NEUROLOGICA SCANDINAVICA, Issue 6 2004X. Guo Objectives , To search for a physiological method for the measurement of upper extremity dexterity during activities of daily life in Parkinson's disease (PD). Materials and methods , We examined load force output during manual transport in seven patients with PD and 10 healthy controls. PD patients were measured in both the non-medicated and medicated states. The test movement included two continuous sub-movements: an upward-forward transport of an object from the table to the stand, and a downward-backward transport of the object from the stand to the table. Hand movements were recorded using an optoelectronic camera, and load force was measured using a force sensor installed in the test object. Results , Compared with the controls, PD patients had a different pattern of load force output characterized by slower force development and release, lower peak force, and less dynamic force generation during movement. After medication, the speed of force development and the level of peak force increased in the patients. Conclusions , These findings suggest that PD impairs the production of preprogrammed movements. The movements observed in the PD patients may result from compensatory strategies relying more on feedback mechanisms. [source] Task-dependent modulation of functional connectivity between hand motor cortices and neuronal networks underlying language and music: a transcranial magnetic stimulation study in humansEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 1 2007R. Sparing Abstract Although language functions are, in general, attributed to the left hemisphere, it is still a matter of debate to what extent the cognitive functions underlying the processing of music are lateralized in the human brain. To investigate hemispheric specialization we evaluated the effect of different overt musical and linguistic tasks on the excitability of both left and right hand motor cortices using transcranial magnetic stimulation (TMS). Task-dependent changes of the size of the TMS-elicited motor evoked potentials were recorded in 12 right-handed, musically naive subjects during and after overt speech, singing and humming, i.e. the production of melody without word articulation. The articulation of meaningless syllables served as control condition. We found reciprocal lateralized effects of overt speech and musical tasks on motor cortex excitability. During overt speech, the corticospinal projection of the left (i.e. dominant) hemisphere to the right hand was facilitated. In contrast, excitability of the right motor cortex increased during both overt singing and humming, whereas no effect was observed on the left hemisphere. Although the traditional concept of hemispheric lateralization of music has been challenged by recent neuroimaging studies, our findings demonstrate that right-hemisphere preponderance of music is nevertheless present. We discuss our results in terms of the recent concepts on evolution of language and gesture, which hypothesize that cerebral networks mediating hand movement and those subserving language processing are functionally linked. TMS may constitute a useful tool to further investigate the relationship between cortical representations of motor functions, music and language using comparative approaches. [source] Endophthalmitis in the western Sydney region: a case-control studyCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 6 2001Somsak Lertsumitkul FRACO ABSTRACT Background: A retrospective case-control study was conducted to investigate risk factors for endophthalmitis following routine intraocular surgery. Methods: A review was performed of consecutive cases of endophthalmitis from three teaching hospitals in the western Sydney region and matched controls from the same institutions between 1996 and 1998. Results: There were 31 cases and 66 controls. Eighty procedures were phacoemulsification, 15 conventional extracapsular cataract extraction, and two were penetrating keratoplasties. Of the 80 patients who had phacoemulsification surgery, 50 had a clear corneal incision, and 26 had a scleral incision (four were unknown). Logistic regression showed an increased risk of endophthalmitis with surgical complications (P = 0.002) and clear cornea temporal incisions (P = 0.007). Risk of endophthalmitis was reduced with use of subconjunctival injections (P = 0.008). The yield for the Gram stain was 47% and for culture was 67%. Anterior chamber tap in addition to vitreous biopsy alone did not increase the yield for microorganism (P = 0.78). Mean visual acuity on presentation was hand movement with 13 patients (50%) showing visual improvement following intravitreal injections of antibiotics (P = 0.003). Visual prognosis did not correlate with presenting visual acuity but appeared to be better in those who grew Staphylococcus epidermidis or were culture negative. Conclusions: Although this study is unable to draw definite conclusions regarding risk of endophthalmitis in clear corneal temporal cataract surgery, sufficient data suggest the importance of incision type and location. Surgical complication is an important risk factor for endophthalmitis. Use of subconjunctival antibiotic injections at the conclusion of the procedure is recommended. [source] Findings from a multidisciplinary clinical case series of females with Rett syndromeDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 5 2003Hilary Cass BSc FRCPCH Systematic data from a multidisciplinary clinical assessment of a large series of females with Rett syndrome (RS; n=87) is presented. Participants' ages ranged from 2 years 1 month to 44 years 10 months. Areas assessed included oromotor skills, feeding problems, growth, breathing abnormalities, mobility, postural abnormalities and joint deformities, epilepsy, hand use and stereotypies, self-care, and cognitive and communication skills. Many previously reported trends in the presentation of RS over time were confirmed, notably the increasingly poor growth and near pervasiveness of fixed joint deformities and scoliosis in adulthood. In contrast, there was a slight trend towards improved autonomic function in adulthood, whereas feeding difficulties increased into middle childhood and then reached a plateau. Improvements in mobility into adolescence were followed by a decline in those skills in adulthood. Levels of dependency were high, confirming findings from previous studies. Despite the presence of repetitive hand movements, a range of hand-use skills was seen in individuals of all ages. Cognitive and communication skills were limited, but there was little evidence of deterioration of these abilities with age. These findings confirm that RS is not a degenerative condition and indicate that intervention and support to maintain and increase motor skills, daily living skills, and cognitive and communicative functioning are appropriate targets for individuals with RS. [source] ,Seeing voices': fused visual/auditory verbal hallucinations reported by three persons with schizophrenia-spectrum disorderACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2006R. E. Hoffman Objective:, The neurocognitive basis of verbal/auditory hallucinations remains uncertain. A leading hypothesis is that these hallucinations correspond to ordinary inner speech mislabeled as non-self. However, some studies suggest pathogenic activation of receptive language neurocircuitry as the cause. A form of visualized verbal hallucinations not previously reported in the literature is described that may shed light on this controversy. Method:, Review of three cases. Results:, Two patients described visual hallucinations of speech-like lip and mouth movements fused with simultaneous auditory verbal hallucinations superimposed on perceptions of faces of actual persons in their immediate environment. A third patient described similar experiences incorporated into visual hallucinations of human figures who also exhibited finger and hand movements corresponding to American Sign Language. Conclusion:, These fused, multimodal verbal hallucinations seem unlikely to be due to inner speech mislabeled as non-self, and instead suggest top-down re-shaping of activation in visual processing brain centers by pathogenically active receptive language neurocircuitry. [source] Does motor activity during psychophysiological paradigms confound the quantification and interpretation of heart rate and heart rate variability measures in young children?DEVELOPMENTAL PSYCHOBIOLOGY, Issue 5 2007Stephen W. Porges Abstract Respiratory sinus arrhythmia (RSA), heart period, and motor activity were monitored in preschoolers during a variety of tasks varying in required movement. The data analyses indicate: (1) that when activity increases during tasks, there are synchronous decreases in heart period and RSA; (2) that correlations between changes in RSA and heart period are related to activity only during exercise when there is a major demand for increased metabolic resources; and (3) that the covariation among the variables within each condition is low except during exercise. These findings suggest that the slight increases in motor activity (i.e., hand movements) often required in attention demanding psychophysiological protocols are not related to RSA and heart period responses. However, when tasks necessitate large increases in motor activity (e.g., exercise), the decreases in heart period and RSA are related to the change in motor activity. © 2007 Wiley Periodicals, Inc. Dev Psychobiol 49: 485-494, 2007. [source] Basal ganglia and frontal involvement in self-generated and externally-triggered finger movements in the dominant and non-dominant handEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 6 2009Félix-Etienne François-Brosseau Abstract Although there are a number of functional neuroimaging studies that have investigated self-initiated and externally-triggered movements, data directly comparing right and left hands in this context are very scarce. The goal of this study was to further understand the role of the basal ganglia and prefrontal cortex in the realm of self-initiated and externally-triggered right and left hand movements. Young healthy right-handed adults performed random, follow and repeat conditions of a finger moving task with their right and left hands, while being scanned with functional magnetic resonance imaging. Significant activation of the dorsolateral prefrontal cortex was observed when comparing the self-initiated movements with the repeated control and externally-triggered movements when using either hand in agreement with its role in monitoring. The caudate nucleus activation was found during self-initiated conditions compared with the control condition when either hand was used, showing that it is particularly involved when a new movement needs to be planned. Significant putamen activation was observed in all within-hand contrasts except for the externally-triggered vs. control condition when using the left hand. Furthermore, greater putaminal activation was found for the left vs. the right hand during the control condition, but for the right vs. the left hand subtraction for the self-initiated condition. Our results show that the putamen is particularly involved in the execution of non-routine movements, especially if those are self-initiated. Furthermore, we propose that, for right-handed people performing fine movements, as far as putamen involvement is concerned, the lack of proficiency of the non-dominant hand may prevail over other task demands. [source] The role of V5 (hMT+) in visually guided hand movements: an fMRI studyEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 11 2004C. Oreja-Guevara Abstract Electrophysiological studies in animals suggest that visuomotor control of forelimb and eye movements involves reciprocal connections between several areas (striate, extrastriate, parietal, motor and premotor) related to movement performance and visuospatial coding of movement direction. The extrastriate area MT [V5 (hMT+) in humans] located in the ,dorsal pathway' of the primate brain is specialized in the processing of visual motion information. The aim of our study was to investigate the functional role of V5 (hMT+) in the control of visually guided hand movements and to identify the corresponding cortex activation implicated in the visuomotor tasks using functional magnetic resonance imaging. Eight human subjects performed visually guided hand movements, either continuously tracking a horizontally moving target or performing ballistic tracking movements of a cursor to an eccentric stationary target while fixating a central fixation cross. The tracking movements were back-projected onto the screen using a cursor which was moved by an MRI-compatible joystick. Both conditions activated area V5 (hMT+), right more than left, particularly during continuous tracking. In addition, a large-scale sensorimotor circuit which included sensorimotor cortex, premotor cortex, striatum, thalamus and cerebellum as well as a number of cortical areas along the intraparietal sulcus in both hemispheres were activated. Because activity was increased in V5 (hMT+) during continuous tracking but not during ballistic tracking as compared to motion perception, it has a pivotal role during the visual control of forelimb movements as well. [source] The human mirror neuron system in a population with deficient self-awareness: An fMRI study in alexithymiaHUMAN BRAIN MAPPING, Issue 7 2009Yoshiya Moriguchi Abstract The mirror neuron system (MNS) is considered crucial for human imitation and language learning and provides the basis for the development of empathy and mentalizing. Alexithymia (ALEX), which refers to deficiencies in the self-awareness of emotional states, has been reported to be associated with poor ability in various aspects of social cognition such as mentalizing, cognitive empathy, and perspective-taking. Using functional magnetic resonance imaging (fMRI), we measured the hemodynamic signal to examine whether there are functional differences in the MNS activity between participants with ALEX (n = 16) and without ALEX (n = 13), in response to a classic MNS task (i.e., the observation of video clips depicting goal-directed hand movements). Both groups showed increased neural activity in the premotor and the parietal cortices during observation of hand actions. However, activation was greater for the ALEX group than the non-ALEX group. Furthermore, activation in the left premotor area was negatively correlated with perspective-taking ability as assessed with the interpersonal reactivity index. The signal in parietal cortices was negatively correlated with cognitive facets assessed by the stress coping inventory and positively correlated with the neuroticism scale from the NEO five factor personality scale. In addition, in the ALEX group, activation in the right superior parietal region showed a positive correlation with the severity of ALEX as measured by a structured interview. These results suggest that the stronger MNS-related neural response in individuals scoring high on ALEX is associated with their insufficient self-other differentiation. Hum Brain Mapp, 2009. © 2008 Wiley-Liss, Inc. [source] Motion analysis of stereotyped hand movements in Rett syndromeJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 2 2003M. Wright Abstract Background Rett syndrome is a genetic developmental disorder, and stereotyped hand movements are a striking feature of this condition. The aim of the present study was to subject these movements to objective analysis and compare the results in one girl at different ages. Method The hand movements of a 10-year-old girl with Rett syndrome were subjected to accurate, three-dimensional (3D) computerized motion analysis and compared to two-dimensional (2D) video analysis of the same girl at 3 years of age. Results Three-dimensional computerized analysis revealed regular patterns with strong coupling between the hands. Frequency analysis showed a dominant frequency at 1.2 Hz, with a higher component at 2.4 Hz that may relate to the activity of basic rhythm generators. The same coupling characteristics were extracted from standard, 2D video recordings made at the same time as the 3D capture. Conclusion An informal video of the same girl taken when she was 3 years of age was analysed in the same way as the 2D video and showed the same characteristics, indicating the possible future use of automated video analysis for early screening and intervention evaluation. [source] Gesture Gives a Hand to Language and Learning: Perspectives from Cognitive Neuroscience, Developmental Psychology and EducationLINGUISTICS & LANGUAGE COMPASS (ELECTRONIC), Issue 4 2008Spencer D. Kelly People of all ages, cultures and backgrounds gesture when they speak. These hand movements are so natural and pervasive that researchers across many fields , from linguistics to psychology to neuroscience , have claimed that the two modalities form an integrated system of meaning during language production and comprehension. This special relationship has implications for a variety of research and applied domains. Gestures may provide unique insights into language and cognitive development, and also help clinicians identify, understand and even treat developmental disorders in childhood. In addition, research in education suggests that teachers can use gesture to become even more effective in several fundamental aspects of their profession, including communication, assessment of student knowledge, and the ability to instill a profound understanding of abstract concepts in traditionally difficult domains such as language and mathematics. This work converging from multiple perspectives will push researchers and practitioners alike to view hand gestures in a new and constructive way. [source] Impaired rhythm generation in essential tremorMOVEMENT DISORDERS, Issue 8 2006Zsuzsanna Farkas MD Abstract It has been suggested that the cerebellum plays a role in the event-based timing of synchronized repetitive movements. We hypothesized that regularity of rhythmic movements in essential tremor (ET) is impaired, since several lines of evidence suggest the involvement of the cerebellum in the pathomechanism of ET. To test this assumption, we examined the regularity and the maximum frequency of auditory paced repetitive movements at slow and fast stimulus rate in 34 ET patients. Variability of rhythmic finger tapping and alternating hand movements, defined by the standard deviation of movement offset before or after the pacing signal, was significantly higher compared to healthy controls. Timing of rhythmic movements of the two hands was disturbed to the same degree. Our results suggest a severe deficit of event-based rhythm generation on both sides in ET, supporting the presumed bilateral cerebellar dysfunction in this disorder. © 2006 Movement Disorder Society [source] Eye,hand coordination in essential tremorMOVEMENT DISORDERS, Issue 3 2006Peter Trillenberg MD Abstract Patients with essential tremor (ET) or with cerebellar lesions have in common oculomotor abnormalities, with the exception of saccadic eye movements, which do not seem to be involved in ET. Since grasping is prolonged in ET and might be related to saccadic dysmetria, we tested whether simultaneous hand pointing could unmask it. Twelve ET patients and 14 controls performed saccades with and without simultaneous pointing movements to the same targets, and with and without a gap between the disappearance of the fixation point and the appearance of the target. Eye movements were recorded with the magnetic search-coil method, hand movements with an ultrasound-emitting probe. ET patients did not have saccadic dysmetria, and contrary to normal subjects their saccadic latency did not decrease during combined eye,hand movements compared with saccades performed in isolation. Hand movements had a longer duration in ET patients, with decreased peak acceleration, an increased latency of the peak velocity, and peak deceleration. In conclusion, this first study on eye,hand coordination in ET revealed abnormal kinematic changes in the early phase of pointing movements. These changes might be related to cerebellar disease but they are independent of the intention tremor component and saccade performance. © 2005 Movement Disorder Society [source] Manually controlled human balancing using visual, vestibular and proprioceptive senses involves a common, low frequency neural processTHE JOURNAL OF PHYSIOLOGY, Issue 1 2006Martin Lakie Ten subjects balanced their own body or a mechanically equivalent unstable inverted pendulum by hand, through a compliant spring linkage. Their balancing process was always characterized by repeated small reciprocating hand movements. These bias adjustments were an observable sign of intermittent alterations in neural output. On average, the adjustments occurred at intervals of ,400 ms. To generate appropriate stabilizing bias adjustments, sensory information about body or load movement is needed. Subjects used visual, vestibular or proprioceptive sensation alone and in combination to perform the tasks. We first ask, is the time between adjustments (bias duration) sensory specific? Vision is associated with slow responses. Other senses involved with balance are known to be faster. Our second question is; does bias duration depend on sensory abundance? An appropriate bias adjustment cannot occur until unplanned motion is unambiguously perceived (a sensory threshold). The addition of more sensory data should therefore expedite action, decreasing the mean bias adjustment duration. Statistical analysis showed that (1) the mean bias adjustment duration was remarkably independent of the sensory modality and (2) the addition of one or two sensory modalities made a small, but significant, decrease in the mean bias adjustment duration. Thus, a threshold effect can alter only a very minor part of the bias duration. The bias adjustment duration in manual balancing must reflect something more than visual sensation and perceptual thresholds; our suggestion is that it is a common central motor planning process. We predict that similar processes may be identified in the control of standing. [source] The graphemic/motor frontal area Exner's area revisited,ANNALS OF NEUROLOGY, Issue 4 2009Franck-Emmanuel Roux MD Objective In 1881, Exner first described a "graphic motor image center" in the middle frontal gyrus. Current psycholinguistic models of handwriting involve the conversion of abstract, orthographic representations into motor representations before a sequence of appropriate hand movements is produced. Direct cortical stimulation and functional magnetic resonance imaging (fMRI) were used to study the human frontal areas involved in writing. Methods Cortical electrical stimulation mapping was used intraoperatively in 12 patients during the removal of brain tumors to identify the areas involved in oral language (sentence reading and naming) and writing, and to spare them during surgery. The fMRI activation experiment involved 12 right-handed and 12 left-handed healthy volunteers using word dictation (without visual control) and 2 control tasks. Results Direct cortical electrical stimulation of restricted areas rostral to the primary motor hand area (Brodmann area [BA] 6) impaired handwriting in 6 patients, without disturbing hand movements or oral language tasks. In 6 other patients, stimulation of lower frontal regions showed deficits combining handwriting with other language tasks. fMRI also revealed selective activation during word handwriting in left versus right BA6 depending on handedness. This area was anatomically matched to those areas that affected handwriting on electrical stimulation. Interpretation An area in middle frontal gyrus (BA6) that we have termed the graphemic/motor frontal area supports bridging between orthography and motor programs specific to handwriting. Ann Neurol 2009;66:537,545 [source] Assessment of the upper limb in acute stroke: The validity of hierarchal scoring for the Motor Assessment ScaleAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 3 2010Rebekah L. Pickering Background/aim:, Stroke is the greatest contributor to disability in Australian adults and much of this disability results from a stroke-affected upper limb. This study aimed to determine the validity of hierarchal scoring for the upper limb subscale of the Motor Assessment Scale (UL-MAS) in acute stroke using Rasch analysis. Method:, This study applied Rasch analysis to 40 UL-MAS assessment results across 25 subjects to determine the validity of the hierarchy of the three upper limb subsets: upper arm function (six), hand movements (seven) and advanced hand activities (eight). Rasch analysis examines the relationship between ,item difficulty' and ,person ability' and produces an output which represents the difficulty of each item in relation to each other. Results:, As hypothesised, the hierarchy was upheld within subset 6. In subset 7, the hierarchy was not upheld. Results indicated that item 3 was the least difficult, followed by items 1, 4, 2, 5 and 6 in order of increasing difficulty. In subset 8 the hierarchy was not upheld. Results indicated that item 1 was the least difficult, followed by item 6, then 2 and 5 of equal value and then 3 and 4 of equal value. Conclusions:, The hierarchal scoring is not supported for subsets 7 and 8 and future research is required to explore the validity of alternate scoring methods. At present, the authors recommend that the UL-MAS should be scored non-hierarchally, meaning that every item within the subsets should be scored regardless of its place within the hierarchy (UL-MAS-NH). [source] Maternal Analgesia During Labor Disturbs Newborn Behavior: Effects on Breastfeeding, Temperature, and CryingBIRTH, Issue 1 2001Anna-Berit Ransjö-Arvidson RNMTD Background:Newborns not exposed to analgesia, when placed on the mother's chest, exhibit an inborn prefeeding behavior. This study was performed to assess the effects of different types of analgesia during labor on the development of spontaneous breastfeeding movements, crying behavior, and skin temperature during the first hours of life in healthy term newborns.Methods:Video recordings were made of 28 newborns who had been dried and placed in skin-to-skin contact between their mother's breasts immediately after delivery. The video recordings were analyzed blindly with respect to infant exposure to analgesia. Defined infant behaviors were assessed every 30 seconds. Group 1 mothers (n = 10) had received no analgesia during labor, group 2 mothers (n= 6) had received mepivacaine via pudendal block, and group 3 mothers (n= 12) had received pethidine or bupivacaine or more than one type of analgesia during labor.Results:All infants made finger and hand movements, but the infant's massagelike hand movements were less frequent in infants whose mothers had received labor analgesia. A significantly lower proportion of group 3 infants made hand-to-mouth movements (p < 0.001), and a significantly lower proportion of the infants in groups 2 and 3 touched the nipple with their hands before suckling (p < 0.01), made licking movements (p < 0.01), and sucked the breast (p < 0.01). Nearly one-half of the infants, all in groups 2 or 3, did not breastfeed within the first 2.5 hour of life. The infants whose mothers had received analgesia during labor had higher temperatures (p= 0.03) and they cried more (p= 0.05) than infants whose mothers had not received any analgesia.Conclusions:The present data indicate that several types of analgesia given to the mother during labor may interfere with the newborn's spontaneous breast-seeking and breastfeeding behaviors and increase the newborn's temperature and crying. [source] Postpartum Maternal Oxytocin Release by Newborns: Effects of Infant Hand Massage and SuckingBIRTH, Issue 1 2001Ann-Sofi Matthiesen BSc Background:Newborns placed skin-to-skin with their mothers show an inborn sequence of behavior similar to that seen in other mammals. The purpose of this study was to make a detailed exploration of hand movements and sucking behavior in healthy term newborns who were placed skin-to-skin on their mothers' chests, and to study maternal oxytocin release in relation to these behaviors.Methods:Ten vaginally delivered infants whose mothers had not been exposed to maternal analgesia were video-recorded from birth until the first breastfeeding. Video protocols were developed based on observations of the videotapes. Each infant's hand, finger, mouth, and tongue movements, positions of the hand and body, and sucking behavior were assessed every 30 seconds. Maternal blood samples were collected every 15 minutes, and oxytocin levels were analyzed by radioimmunoassay. A statistical test for establishing the relationship between maternal oxytocin levels and infants' hand movements or sucking behavior was developed.Results:Infants used their hands to explore and stimulate their mother's breast in preparation for the first breastfeeding. A coordinated pattern of infant hand and sucking movements was also identified. When the infants were sucking, the massagelike hand movements stopped and started again when the infants made a sucking pause. Periods of increased massagelike hand movements or sucking of the mother's breast were followed by an increase in maternal oxytocin levels (p < 0.005). Conclusions:The findings indicate that the newborns use their hands as well as their mouths to stimulate maternal oxytocin release after birth, which may have significance for uterine contraction, milk ejection, and mother-infant interaction. [source] Longterm follow-up of diode laser transscleral cyclophotocoagulation in the treatment of refractory glaucomaACTA OPHTHALMOLOGICA, Issue 1 2010Paolo Frezzotti Abstract. Purpose:, This prospective study was conducted to evaluate the efficacy and safety of transscleral diode laser cyclophotocoagulation (TDLCP) in advanced refractory glaucoma. Methods:, A total of 124 eyes in 121 patients with advanced glaucoma refractory to medical treatment were treated consecutively with TDLCP. Success was defined as final intraocular pressure (IOP) of 5,21 mmHg in eyes with visual acuity (VA) of more than hand movements (HM) and relief of pain in eyes with VA of HM or less, including blind eyes. Results:, Mean patient age was 65.6 ± 17.1 years (range 14,91 years). Mean follow-up was 17 ± 14.6 months (range 3,42 months). Mean pretreatment IOP was 29.9 ± 8.4 mmHg (range 17,58 mmHg) and IOP at last follow-up was 20.8 ± 8 mmHg (range 6,45 mmHg) (p < 0.001). The number of laser applications (mean 9.2 ± 2.8, range 4,15) and maximal laser power (mean 2.01 ± 0.22 mW, range 1.3,3.0 mW) were not associated with lower postoperative IOP. Intraocular pressure of , 21 mmHg was recorded in 63.0% of eyes at the last follow-up visit. Overall, 28 (21.7%) eyes required at least one retreatment. No phthisis bulbi or persistent hypotonia developed. Conclusions:, TDLCP is an effective and safe method for the treatment of advanced refractory glaucoma, although repeated treatments are often necessary. [source] | ||||||||||||||||