Impaired hand function is often the most disabling symptom in children with hemiplegic cerebral palsy (CP). Literature provides a wide number of studies dealing either with the kinematics or the cerebral correlates of the impairment. Nevertheless, few studies exist merging both aspects together. The aim of this study is the integrated analyses of time and spatial parameters of both the affected and less-affected sides and of the EEG signal, recorded during the movement execution, for the quantitative description of the pointing gesture in children with CP. The participants (pathological and control subjects) were asked to execute a pointing task simultaneously with the recording by an optoelectronic system and an electroencephalographer. Kinematic data were processed for the extraction of several synthetic indexes, to be correlated with parameters derived from frequency analysis of the electroencephalographic signal. Kinematic results showed statistical differences (1) between the affected and the less-affected arms in patients and (2) between the less-affected arm in patients and the normal arm in controls. Further differences were found in kinematics with respect to bilateral or ipsilateral motor control, extracted from EEG. Given the different behavior evidenced by either ipsilateral or contralateral reorganization, and considering the role of feedback and feed-forward contributions to motor programming, some hypotheses emerged about the motor control during pointing task in CP.
Ectopic implantation of the embryo in the tube opposite to the ovary containing the corpus luteum constitutes evidence of peritoneal or uterine transmigration of the egg. The frequency of this phenomenon was reinvestigated utilizing histopathologic confirmation of the side of the corpus luteum. A tubal pregnancy contralateral to the ovulating ovary was found in 28% of 67 cases, indicating that either the oocyte, the zygote or the embryo had entered the tube in which implantation took place from a medial site such as the peritoneal or the uterine cavity rather than directly from the ovulating ovary. Assuming that once in the medial site there is equal chance of entering either tube, it follows that in 56% of tubal pregnancies the egg has entered the tube from a midline location. Attempts to recover the oocyte from the tubes in normal women were successful in fewer than 5% of cases contralateral to the corpus luteum. It is concluded that tubal pregnancy is associated with a significant increase in the occurrence of transmigration of the egg.
These results provide evidences that small modifications in the end-effector performance often imply cerebral modifications and improvement in finalized motor strategy.
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