We present spatio-temporal characteristics of spreading depolarizations (SD) in two experimental systems: retracting SD wave segments observed with intrinsic optical signals in chicken retina, and spontaneously occurring re-entrant SD waves that repeatedly spread across gyrencephalic feline cortex observed by laser speckle flowmetry. A mathematical framework of reaction-diffusion systems with augmented transmission capabilities is developed to explain the emergence and transitions between these patterns. Our prediction is that the observed patterns are reaction-diffusion patterns controlled and modulated by weak nonlocal coupling. The described spatio-temporal characteristics of SD are of important clinical relevance under conditions of migraine and stroke. In stroke, the emergence of re-entrant SD waves is believed to worsen outcome. In migraine, retracting SD wave segments cause neurological symptoms and transitions to stationary SD wave patterns may cause persistent symptoms without evidence from noninvasive imaging of infarction.
A comprehensive language test battery (Aachen Aphasia Test) was administered to 45 patients in the early, middle or later stages of Huntington's disease (HD) and to 20 control subjects. In spontaneous speech, many HD patients exhibited a loss of conversational initiative. Dysarthria was a common finding. Reading skills were found to be impaired mainly as a consequence of dysarthria; some HD patients displayed visual dyslexia. In addition to the characteristic disturbances of writing skills due to the choreiform movement disorder, the writing of HD patients with advanced dementia indicated constructional dysgraphia, characterized by frequent omissions, perseverations and substitutions. HD patients exhibited no evidence of word-finding difficulty or other semantic deficits in spontaneous speech. There was, however, a marked impairment in visual confrontation naming, with a significant rise in naming error rate as the disease progressed in severity. In most instances, the inappropriate names referred to an object visually similar to the target object, suggesting that visual misperception is the major cause of the naming disorder in HD. Syntactical structure of spontaneous speech was typically reduced to short, simple sentence construction. Verbal stereotypes were only rarely encountered and occurred late in the course of the disease. Tests of language comprehension reflected the general degree of dementia. It is concluded that there are no primary language changes in HD. Instead, a variety of language impairments develop secondary to other neurological and neuropsychological changes.
Long-latency electromyographic (EMG) responses of the first dorsal interosseus muscle were evoked by short displacements of the index finger in healthy subjects and in patients with Huntington's disease (HD). In all 20 healthy subjects the early spinal response (mean latency 31.5 ms) was followed by a reproducible later reflex response with a mean latency of 56.5 ms. The activity pattern of single motor units of the stretched muscle was similar to that of the surface EMG. Thus all single motor units tested could be active during either the first or second response phase, but never in both in a given trial. Of the 50 patients with HD, the late EMG response was missing completely in all but 7, but the early spinal component was almost identical to that of the control group. Double stretches at an interval of 25 ms evoked two similar EMG responses in these patients, proving that the motoneuron pool is still excitable during the time at which the second response would have appeared in healthy subjects. The reflex responses of the thenar muscles evoked by electrical stimulation of the median nerve were examined during a voluntary opposing contraction of the thumb in both groups of subjects. In normal subjects, two EMG responses could be distinguished with latencies similar to those of the mechanically elicited responses. Patients with HD again lacked the second response, although the first spinal response was always present. The results are discussed with respect to different proposals concerning the origin of long-latency responses in human muscles. At least for distal hand muscles, the results suggest that the long-latency responses are long-loop reflexes.
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