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Cureus May 2023Neuro-developmental delay (NDD) is when a child's reflexes and nervous system are underdeveloped or immature at a given stage of child development. Neurodevelopmental... (Review)
Review
Neuro-developmental delay (NDD) is when a child's reflexes and nervous system are underdeveloped or immature at a given stage of child development. Neurodevelopmental delays account for delayed skill development surrounding speech, social, emotional, behavioral, motor, and cognitive delays. NDD might affect the child's psychological and physical well-being, resulting in chronic disease and disabilities throughout adulthood. This review sought to investigate the implication of early diagnosis and intervention of NDD in children. In this regard, this research opted for a systematic meta-analysis that used keywords and Boolean operators to search through main databases, including the Web of Science, JStor, PsychINFO, Science Direct, Cochrane, Scopus, and ASSIA. The result identified that telehealth interventions improved the management of NDD in children. Also, the Early Start Denver Model (ESDM) model was determined to improve the quality of life for NDD children. Another model was LEAP (Learning Experience and Alternative Program for Preschoolers and Their Parents) and Leap (Learning, engaging, and Playing), which improved behavioral, education, and social interventions in NDD children. The study identified that technology could revolutionize NDD interventions in children, possibly improving the quality of life. The parent-children relationship was shown to enhance the management of this condition; thus, it is recommended as one of the best ways to intervene in the management of NDD. Most importantly, the integration of machine learning algorithms and technology can create models; while this may not be significant in the treatment of childhood NDD but instead might be ideal in improving the quality of life for NDD children. Moreover, their social and communication skills along with academic achievements will improve. The study proposes further research in order to understand the different types of NDDs and their intervention strategies to help the researchers identify the most accurate models to improve the conditions and support the parents and guardians in the management.
PubMed: 37303321
DOI: 10.7759/cureus.38745 -
Diagnostics (Basel, Switzerland) Nov 2023Preterm infants are more likely to demonstrate developmental delays than fullterm infants. Postural measurement tools may be effective in measuring the center of... (Review)
Review
Preterm infants are more likely to demonstrate developmental delays than fullterm infants. Postural measurement tools may be effective in measuring the center of pressure (COP) and asymmetry, as well as predicting future motor impairment. The objective of this systematic review was to evaluate existing evidence regarding use of pressure mats or force plates for measuring COP and asymmetry in preterm infants, to determine how measures differ between preterm and fullterm infants and if these tools appropriately predict future motor impairment. The consulted databases included PubMed, Embase, Scopus, and CINAHL. The quality of the literature and the risk of bias were assessed utilizing the ROB2: revised Cochrane risk-of bias tool. Nine manuscripts met the criteria for review. The postural control tools included were FSA UltraThin seat mat, Conformat Pressure-Sensitive mat, Play and Neuro-Developmental Assessment, and standard force plates. Studies demonstrated that all tools were capable of COP assessment in preterm infants and support the association between the observation of reduced postural complexity prior to the observation of midline head control as an indicator of future motor delay. Postural measurement tools provide quick and objective measures of postural control and asymmetry. Based on the degree of impairment, these tools may provide an alternative to standardized assessments that may be taxing to the preterm infant, inaccessible to therapists, or not sensitive enough to capture motor delays.
PubMed: 37998609
DOI: 10.3390/diagnostics13223473 -
Tremor and Other Hyperkinetic Movements... 2021The mechanisms contributing to the pathogenesis of tremor and/or dysmetria in multiple sclerosis (MS) are poorly understood. Abnormal oscillations within the...
OBJECTIVE
The mechanisms contributing to the pathogenesis of tremor and/or dysmetria in multiple sclerosis (MS) are poorly understood. Abnormal oscillations within the olivo-cerebello-thalamo-cortical networks are believed to play an important part in tremor aetiology, but could also contribute to intention dysmetria due to disruptions in motor timing. Conversely, delayed central motor conduction times are a common feature of ataxias, but could also contribute to the expression of dysmetria in MS. This study examined the roles of central conduction delays in the manifestation of tremor and/or dysmetria in MS.
METHODS
Twenty-three individuals with MS participated: 8 with no movement disorder, 6 with tremor, 4 with pure dysmetria and 5 with both tremor and dysmetria. Median nerve somatosensory evoked potentials (SEPs), transcranial magnetic stimulation (TMS) over the motor cortex and cervical spine, stretch reflexes were used assess sensory and motor conduction times.
RESULTS
Central, but not peripheral, sensory conductions time were significantly delayed in participants with dysmetria, regardless of the presence of tremor. Similarly, the TMS evoked muscles responses and the long-latency component of stretch reflexes were significantly delayed in those with dysmetria, but not pure tremor.
CONCLUSION
Dysmetria in MS is associated with delays in central conduction of sensory or motor pathways, or both, likely leading to disruption of muscle activation timing and terminal oscillations that contribute to dysmetria.
SIGNIFICANCE
The presence of dysmetria in MS is associated with decreased conduction velocities in central sensory and/or motor pathways likely reflects greater demyelination of these axons compared to those with no movement disorder or pure tremor.
Topics: Cerebellar Ataxia; Evoked Potentials, Somatosensory; Humans; Multiple Sclerosis; Transcranial Magnetic Stimulation; Tremor
PubMed: 34395055
DOI: 10.5334/tohm.598 -
Journal of Neurophysiology Feb 2021To program a goal-directed response in the presence of acoustic reflections, the audio-motor system should suppress the detection of time-delayed sources. We examined...
To program a goal-directed response in the presence of acoustic reflections, the audio-motor system should suppress the detection of time-delayed sources. We examined the effects of spatial separation and interstimulus delay on the ability of human listeners to localize a pair of broadband sounds in the horizontal plane. Participants indicated how many sounds were heard and where these were perceived by making one or two head-orienting localization responses. Results suggest that perceptual fusion of the two sounds depends on delay and spatial separation. Leading and lagging stimuli in close spatial proximity required longer stimulus delays to be perceptually separated than those further apart. Whenever participants heard one sound, their localization responses for synchronous sounds were oriented to a weighted average of both source locations. For short delays, responses were directed toward the leading stimulus location. Increasing spatial separation enhanced this effect. For longer delays, responses were again directed toward a weighted average. When participants perceived two sounds, the first and the second response were directed to either of the leading and lagging source locations. Perceived locations were interchanged often in their temporal order (in ∼40% of trials). We show that the percept of two sounds occurring requires sufficient spatiotemporal separation, after which localization can be performed with high accuracy. We propose that the percept of temporal order of two concurrent sounds results from a different process than localization and discuss how dynamic lateral excitatory-inhibitory interactions within a spatial sensorimotor map could explain the findings. Sound localization requires spectral and temporal processing of implicit acoustic cues, and is seriously challenged when multiple sources coincide closely in space and time. We systematically varied spatial-temporal disparities for two sounds and instructed listeners to generate goal-directed head movements. We found that even when the auditory system has accurate representations of both sources, it still has trouble to decide whether the scene contained one or two sounds, and in which order they appeared.
Topics: Adult; Brain; Cues; Female; Head Movements; Humans; Male; Sound Localization; Spatial Behavior
PubMed: 33378250
DOI: 10.1152/jn.00184.2020 -
Pediatric Health, Medicine and... 2022Stimulating care during childhood is the foundation for optimal health, learning, productivity, and social well-being throughout the life course. In addition,...
BACKGROUND
Stimulating care during childhood is the foundation for optimal health, learning, productivity, and social well-being throughout the life course. In addition, malnutrition is a major public health concern affecting up to half of children under-five years in Ethiopia. However, evidence on the causal contribution of malnutrition to delay in child development is poorly understood in Ethiopia.
OBJECTIVE
To identify the relationship between different forms of malnutrition and delay in child development among children in Southwest Ethiopia.
METHODS
A community-based survey was conducted among 507 randomly selected mother-child pairs in the Guraghe Zone, Southwest Ethiopia. A pretested tool and validated anthropometric measurements were used. Anthropometric indices (WFH, WFA, and HFA) were calculated in Anthros software. The data were summarized in mean, median, standard deviation, tables and charts. Bivariable and multivariable binary logistic regression (stepwise backward regression) models were fitted with nutritional status (wasting, stunting and underweight) and other potential factors associated with delay in child developmental. Adjusted odds ratios with 95% confidence intervals and p-values were reported.
RESULTS
A total of 507 mother-child (12-59 months) pairs were included in the survey (97% response rate). The mean ASQ-3 score was 150 (± 23.4), with a minimum and maximum score of 45 and 270, respectively. A total of 149 (29.4%; 95% CI: 25.4-33.4) children had developmental delays, where 17.2%, 16.8%, 13.4%, 10.8%, and 10.1% had delays in gross motor, communication, problem-solving, personal-social, and fine motor skills, respectively. Children of working mothers (AOR=2.9; 1.8, 4.8), preterm births (AOR=3.2; 1.4, 7.0), early initiation of complementary feeding (AOR=2.5; 1.37, 4.6), stunting (AOR=3.0; 1.9, 4.7), underweight (AOR= 2.3; 1.1, 4.7) and low dietary diversity score (AOR=3.1; 1.3, 7.5), were predictors of developmental delay.
CONCLUSION
Child development delay is a public health concern and it is strongly associated with stunting, underweight, undiversified dietary consumption, and suboptimal infant and young child feeding practices.
PubMed: 35046749
DOI: 10.2147/PHMT.S344715 -
Neurological Sciences : Official... Oct 2023Intracranial dural arterio-venous fistulas are pathological anastomoses between arteries and veins located within dural sheets and whose clinical manifestations depend... (Review)
Review
BACKGROUND
Intracranial dural arterio-venous fistulas are pathological anastomoses between arteries and veins located within dural sheets and whose clinical manifestations depend on location and hemodynamic features. They can sometimes display perimedullary venous drainage (Cognard type V fistulas-CVFs) and present as a progressive myelopathy. Our review aims at describing CVFs' variety of clinical presentation, investigating a possible association between diagnostic delay and outcome and assessing whether there is a correlation between clinical and/or radiological signs and clinical outcomes.
METHODS
We conducted a systematic search on Pubmed, looking for articles describing patients with CVFs complicated with myelopathy.
RESULTS
A total of 72 articles for an overall of 100 patients were selected. The mean age was 56.20 ± 14.07, 72% of patients were man, and 58% received an initial misdiagnosis. CVFs showed a progressive onset in 65% of cases, beginning with motor symptoms in 79% of cases. As for the MRI, 81% presented spinal flow voids. The median time from symptoms' onset to diagnosis was 5 months with longer delays for patients experiencing worse outcomes. Finally, 67.1% of patients showed poor outcomes while the remaining 32.9% obtained a partial-to-full recovery.
CONCLUSIONS
We confirmed CVFs' broad clinical spectrum of presentation and found that the outcome is not associated with the severity of the clinical picture at onset, but it has a negative correlation with the length of diagnostic delay. We furthermore underlined the importance of cervico-dorsal perimedullary T1/T2 flow voids as a reliable MRI parameter to orient the diagnosis and distinguish CVFs from most of their mimics.
Topics: Male; Humans; Adult; Middle Aged; Aged; Delayed Diagnosis; Spinal Cord Diseases; Magnetic Resonance Imaging; Arteries; Brain; Central Nervous System Vascular Malformations
PubMed: 37380820
DOI: 10.1007/s10072-023-06870-1 -
Frontiers in Microbiology 2022Bacterial type 4 pili (T4P) are extracellular polymers that serve both as adhesins and molecular motors. Functionally, they are involved in adhesion, colony formation,...
Bacterial type 4 pili (T4P) are extracellular polymers that serve both as adhesins and molecular motors. Functionally, they are involved in adhesion, colony formation, twitching motility, and horizontal gene transfer. T4P of the human pathogen have been shown to enhance survivability under treatment with antibiotics or hydrogen peroxide. However, little is known about the effect of external stresses on T4P production and motor properties. Here, we address this question by directly visualizing gonococcal T4P dynamics. We show that in the absence of stress gonococci produce T4P at a remarkably high rate of ∼200 T4P min. T4P retraction succeeds elongation without detectable time delay. Treatment with azithromycin or ceftriaxone reduces the T4P production rate. RNA sequencing results suggest that reduced piliation is caused by combined downregulation of the complexes required for T4P extrusion from the cell envelope and cellular energy depletion. Various other stresses including inhibitors of cell wall synthesis and DNA replication, as well as hydrogen peroxide and lactic acid, inhibit T4P production. Moreover, hydrogen peroxide and acidic pH strongly affect pilus length and motor function. In summary, we show that gonococcal T4P are highly dynamic and diverse external stresses reduce piliation despite the protective effect of T4P against some of these stresses.
PubMed: 35283813
DOI: 10.3389/fmicb.2022.839711 -
Journal of the Neurological Sciences Oct 2020Amyotrophic lateral sclerosis (ALS) is a progressive, degenerative neuromuscular disease with limited treatment options. The diagnosis of ALS can be challenging for... (Review)
Review
Amyotrophic lateral sclerosis (ALS) is a progressive, degenerative neuromuscular disease with limited treatment options. The diagnosis of ALS can be challenging for numerous reasons, resulting in delays that may compromise optimal management and enrollment into clinical trials. Several studies have examined the process and challenges regarding the clinical diagnosis of ALS. Twenty-one studies that were almost exclusively from the English literature published between 1990 and 2020 were identified via PubMed using relevant search terms and included patient populations from the United States, Canada, Japan, Egypt, and several countries in South America and Europe. Probable or definitive ALS patients were identified using El Escorial or revised El Escorial/Airlie House Criteria. Time to diagnosis or diagnostic delay was defined as mean or median time from patient-reported first symptom onset to formal diagnosis by a physician, as recorded in medical records. The typical time to diagnosis was 10-16 months from symptom onset. Several points of delay in the diagnosis course were identified, including specialist referrals and misdiagnoses, often resulting in unnecessary procedures and surgeries. Bulbar onset was noted to significantly reduce time to ALS diagnosis. Future interventions and potential research opportunities were reviewed.
Topics: Amyotrophic Lateral Sclerosis; Canada; Delayed Diagnosis; Egypt; Europe; Humans; Japan
PubMed: 32763509
DOI: 10.1016/j.jns.2020.117054 -
Annals of Rehabilitation Medicine Feb 2017To investigate motor and cognitive developmental profiles and to evaluate the correlation between two developmental areas and assess the influencing factors of the...
OBJECTIVE
To investigate motor and cognitive developmental profiles and to evaluate the correlation between two developmental areas and assess the influencing factors of the developmental process in children with Down syndrome (DS).
METHODS
Seventy-eight children with DS participated in this study. The medical history was taken and motoric milestone achievements recorded. The Korean Wechsler Preschool and Primary Scale of Intelligence (K-WPPSI) and Bayley Scales of Infant Development-II (BSID-II) were administered. Subjects were divided into severe motor delay group (severe group) and typical motor delay group (typical group).
RESULTS
Children with DS follow the same sequence of motor development and generally displayed double times of acquisition of developmental milestones compared with healthy children. Furthermore, having surgery for associated complications showed negative influence to the motor development. Almost of all children with DS showed moderate degree of intellectual disability and motor and cognitive development do not seem to correlate one another.
CONCLUSION
Surgery of associated complications can be negatively related to motor development. However, early motor development did not have any significant effects on the achievement of later cognitive functioning.
PubMed: 28289641
DOI: 10.5535/arm.2017.41.1.97 -
Journal of Speech, Language, and... Sep 2020Purpose Gradual and sudden perturbations of vocal fundamental frequency ( ), also known as adaptive and reflexive perturbations, are techniques to study the influence...
Purpose Gradual and sudden perturbations of vocal fundamental frequency ( ), also known as adaptive and reflexive perturbations, are techniques to study the influence of auditory feedback on voice control mechanisms. Previous vocal perturbations have incorporated varied setup-specific feedback delays and amplifications. Here, we investigated the effects of feedback delays (10-100 ms) and amplifications on both adaptive and reflexive perturbation paradigms, encapsulating the variability in equipment-specific delays (3-45 ms) and amplifications utilized in previous experiments. Method Responses to adaptive and reflexive perturbations were recorded in 24 typical speakers for four delay conditions (10, 40, 70, and 100 ms) or three amplification conditions (-10, +5, and +10 dB relative to microphone) in a counterbalanced order. Repeated-measures analyses of variance were carried out on the magnitude of responses to determine the effect of feedback condition. Results There was a statistically significant effect of the level of auditory feedback amplification on the response magnitude during adaptive perturbations, driven by the difference between +10- and -10-dB amplification conditions (hold phase difference: = 38.3 cents, = 51.2 cents; after-effect phase: = 66.1 cents, = 84.6 cents). No other statistically significant effects of condition were found for either paradigm. Conclusions Experimental equipment delays below 100 ms in behavioral paradigms do not affect the results of perturbation paradigms. As there is no statistically significant difference between the response magnitudes elicited by +5- and +10-dB auditory amplification conditions, this study is a confirmation that an auditory feedback amplification of +5 dB relative to microphone is sufficient to elicit robust compensatory responses for perturbation paradigms.
Topics: Acoustic Stimulation; Feedback; Feedback, Sensory; Humans; Pitch Perception; Reaction Time; Voice
PubMed: 32755506
DOI: 10.1044/2020_JSLHR-19-00407