Impaired anticipatory control of fingertip forces in patients with a pure motor or sensorimotor lacunar syndrome.

Impaired anticipatory control of fingertip forces in patients with a pure motor or sensorimotor lacunar syndrome. Research Abstract Details 

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Impaired anticipatory control of fingertip forces in patients with a pure motor or sensorimotor lacunar syndrome. Abstract Text:

Preeti Raghavan,John W Krakauer,Andrew M Gordon,

We examined planning and execution of precision grasp in eight right-handed patients with a right pure motor or sensorimotor lacunar syndrome after a subcortical stroke and eight age-matched controls as they grasped and lifted an instrumented object whose weight could be varied without altering its visual appearance. Grip (normal) and load (tangential) forces at the fingertip-object interface were measured and the grip force rate (GFR) and load force rate (LFR) were derived. Planning of precision grasp was assessed by measurement of anticipatory scaling of peak GFR and peak LFR to object weight. Execution of precision grasp was assessed by measurement of both the timing and efficiency of grip-load force coordination: the pre-load phase duration (PLD) and the load phase duration (LPD) measured timing, whereas the grip force at load force onset (GFO) and the grip force at lift-off (GFL) measured efficiency. Subjects lifted a light and heavy object five times first with the RIGHT hand, then with the LEFT hand, and then once more with the RIGHT AFTER LEFT hand. Patients with stroke did not scale the peak LFR or peak GFR to object weight with the RIGHT hand even with repeated attempts; however, they scaled the peak LFR to object weight on the first lift with the RIGHT AFTER LEFT hand (P = 0.01). Patients also prolonged the PLD and LPD and produced excessive GFO and GFL for RIGHT hand lifts, but decreased the GFL for the heavy object (P = 0.016) with the RIGHT AFTER LEFT hand. Correlation of precision grasp variables from lifts with the RIGHT hand with clinical measures showed that anticipatory scaling of peak LFR and peak GFR did not correlate with clinical measures of hand function, whereas the PLD did (r = 0.88, P = 0.004). The results suggest that patients with right hemiparesis from a subcortical lesion of the corticospinal tract have a higher-order motor planning deficit. This planning deficit is dissociable from deficits in motor execution, is not captured by routine clinical assessment, and is correctable by transfer of information from the unaffected hemisphere. A rehabilitation strategy that involves practice with the left hand prior to practice with the right hand may improve planning of grasping behaviour in patients with right hemiparesis.

Impaired anticipatory control of fingertip forces in patients with a pure motor or sensorimotor lacunar syndrome. Publishing Authors By Initials

P Raghavan,JW Krakauer,AM Gordon,

For similar biomechanics: weight-bearing research abstracts see: biomechanics: weight-bearing research

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Impaired anticipatory control of fingertip forces in patients with a pure motor or sensorimotor lacunar syndrome. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: Brain : a journal of neurology

VOLUME: 129

Page Numbers: 1415-25

Journal Abbreviation: Brain

ISSN: 1460-2156

DAY: 5

MONTH: 04

YEAR: 2006

Impaired anticipatory control of fingertip forces in patients with a pure motor or sensorimotor lacunar syndrome. Information

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LANGUAGE: eng

NlmUniqueID: 372537

Impaired anticipatory control of fingertip forces in patients with a pure motor or sensorimotor lacunar syndrome. Keywords Mesh Terms:

KEYWORDS: Weight-Bearing

MESH TERMS: physiopathology

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Grant and Affiliation Information for Impaired anticipatory control of fingertip forces in patients with a pure motor or sensorimotor lacunar syndrome.

AFFILIATION: Department of Rehabilitation Medicine, Mount Sinai Medical Center, Box 1674, 1425 Madison Avenue, New York, NY 10029, USA. Preeti.Raghavan@mountsinai.org

Country: England

AGENCY: United States NINDS

GRANT: NS02138

ACRONYM: NS

MEDLINETA: Brain

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