Frontal lobe motor syndromes.

The motor phenomena accompanying frontal lobe disease are diverse, reflecting the various roles the frontal lobes play in the organization of motor control. The principal frontal motor areas, the primary motor cortex, the premotor cortex, and the supplementary motor area, have different but interrelated functions in motor control. The principal efferent pathway of the primary motor cortex is the corticospinal tract which conducts fine motor control.

Response to Comment on Trophic strategy and bleaching resistance in reef-building corals.

Recently, we published a novel method used to assess the trophic niches of different coral species and demonstrated that their nutrition varied considerably, with some species highly dependent on their photosynthetic algal symbionts and others able to feed on plankton to meet energetic requirements. Adjustments to the use of this tool are necessary when it is applied to other scientific questions and symbiotic organisms. We respond to a comment highlighting a risk of bias in the methods, discuss suggested adjustments, and propose further refinements to improve method robustness.

The effect of temperature on physiology, toxicity and toxin content of the benthic dinoflagellate Coolia malayensis from a seasonal tropical region.

Coolia malayensis is one of the commonly found benthic dinoflagellates in Hong Kong which can produce biotoxins and threaten the early life stages of marine invertebrates. Seawater temperature has been recognized as one of the primary environmental factors that affect the formation of harmful algal blooms. The present study evaluated the responses of C.

Subtropical thermal variation supports persistence of corals but limits productivity of coral reefs.

Concomitant to the decline of tropical corals caused by increasing global sea temperatures is the potential removal of barriers to species range expansions into subtropical and temperate habitats. In these habitats, species must tolerate lower annual mean temperature, wider annual temperature ranges and lower minimum temperatures. To understand ecophysiological traits that will impact geographical range boundaries, we monitored populations of five coral species within a marginal habitat and used a year of in situ measures to model thermal performance of vital host, symbiont and holobiont physiology.

Dancing Dorsal Quadrilaterals: A Novel Peripherally Induced Movement Disorder.

Importance: Recognized peripherally induced movement disorders include the painful legs moving toes syndrome, postamputation dyskinesias, and belly dancer dyskinesias.

Objective: To introduce and characterize the dancing dorsal quadrilaterals, a novel peripherally induced movement disorder that predominantly affects dorsal quadrilateral muscles (trapezius and rhomboids) after upper spine instrumentation.

Design, Setting, And Participants: Between 1990 and 2015, a total of 4 patients who developed abnormal movements of the dorsal quadrilateral muscles after upper spine instrumentation were referred to movement disorders clinics at 3 academic medical centers in the United States, Canada, and Argentina.

Brainstem lesions and gait.

The brainstem contains virtually all of the important structures involved in experimental models of locomotion, encompassing control of upright posture, balance, and stepping. The physiologic basis for these functions is intricately related. Studies of the effects of lesions and disease on these functions in humans are limited to clinical observation and hampered by the anatomic complexity of closely spaced structures and lack of selectivity of lesions.

Life and death of a sewage treatment plant recorded in a coral skeleton δN record.

We investigated the potential of coral skeleton δN (CS-δN) records for tracking anthropogenic-N sources in coral reef ecosystems. We produced a 56yr-long CS-δN record (1958-2014) from a reef flat in Guam that has been exposed to varying 1) levels of sewage treatment 2) population density, and 3) land use. Increasing population density (from <30 to 300ind·km) and land use changes in the watershed resulted in a ~1‰ enrichment of the CS-δN record until a sewage treatment plant (STP) started operation in 1975.

Long-term adherence to apomorphine infusion in patients with Parkinson disease: a 10-year observational study.

Background: Patients with Parkinson disease (PD) commonly experience motor fluctuations and dyskinesias in response to oral dopaminergic medications. Affected patients may benefit from device-assisted therapy, such as medication infusion or deep brain stimulation surgery. This is the first Australian study of the long-term adherence to apomorphine infusion (AI) in patients with PD.

Facial bradykinesia.

The aim of this paper is to summarise the main clinical and pathophysiological features of facial bradykinesia in Parkinson's disease (PD) and in atypical parkinsonism. Clinical observation suggests that reduced spontaneous and emotional facial expressions are features of facial bradykinesia in PD and atypical parkinsonism. In atypical parkinsonism, facial bradykinesia is complicated by additional dystonic features.

Upper limb tremor.

Tremor is a common clinical problem in middle-aged and older patients, and Parkinson disease (PD) is one of the commonest causes. Careful history-taking and physical examination is usually sufficient for diagnosis of PD; extensive investigation is generally not required. Treatment of PD should be individualised, taking into account the patient's age, lifestyle, severity of motor symptoms, level of disability, comorbidities, expectations of treatment and PD subtype (eg, akinetic rigid or tremor dominant).

Frontal lobe ataxia.

The precise anatomy and physiology of human walking remains poorly understood. The frontal lobes appear crucial, and, on the basis of clinical observation, contribute to the control of truncal motion, postural responses, and the maintenance of equilibrium and locomotion. The rich repertoire of frontal gait disorders gives some indication of this complexity.

Milestones in myoclonus.

This review examines some of the advances in understanding myoclonus over the last 25 years. The classification of myoclonus into cortical, brainstem, and spinal forms has been consolidated, each with distinctive clinical characteristics and physiological mechanisms. New genetic causes of myoclonus have been identified, and the molecular basis of several of these conditions has been discovered.

Unusual focal dyskinesias.

This chapter reviews focal dyskinesias that affect a restricted region of the body in isolation. Focal dyskinesias often affect body parts not commonly involved in isolation by movement disorders and are not readily classified into one of the major categories of movement disorders or peripheral nerve excitability syndromes. The clinical features and phenomenology of these "unusual focal dyskinesias" are discussed according to the region affected (ear, lip, chin, jaw, tongue, abdomen, and diaphragm (belly dancer's dyskinesias), back, scapula, and limbs).

Limb amputations in fixed dystonia: a form of body integrity identity disorder?

Fixed dystonia is a disabling disorder mainly affecting young women who develop fixed abnormal limb postures and pain after apparently minor peripheral injury. There is continued debate regarding its pathophysiology and management. We report 5 cases of fixed dystonia in patients who sought amputation of the affected limb.

Elevated serum concentrations of troponin T in acute stroke: what do they mean?

Elevations in serum troponin T in acute stroke have been suggested as an early marker of a poor outcome. A prospective, case-control study was undertaken to define characteristics associated with elevations in troponin T concentrations. Consecutive admissions to the Royal Adelaide stroke unit were assessed.

Stroke prevention and stroke thrombolysis: quantifying the potential benefits of best practice therapies.

Objective: To identify and quantify current deficiencies in primary and secondary stroke prevention, as well as potential gains from optimal employment of thrombolysis.

Design, Participants And Setting: Observational study of 259 consecutive patients admitted to a tertiary hospital stroke unit from 24 January 2006 to 10 January 2007, with retrospective assessment of prestroke risk factors and therapies to determine stroke preventability, based on relative risk reductions from published meta-analyses of preventive therapies.

Main Outcome Measures: Numbers of strokes preventable by optimal risk factor modification and numbers of strokes with preventable disability through optimal thrombolysis; characteristics of patients with preventable strokes; contributions of each risk factor to stroke preventability.

Cranial movement disorders: clinical features, pathophysiology, differential diagnosis and treatment.

Cranial movement disorders are a common neurological problem. These disorders can be limited to the cranial muscles alone or manifest as part of a more generalized movement disorder. Cranial movement disorders can originate from the highest (motor cortex) to the lowest (cranial nerve and muscle) levels of the motor system.