Motor neurorehabilitation in patients with epileptic seizures: limitations of methods with proven efficacy in stroke

Patients with epilepsy may require a neurorehabilitation aid particularly due to developing motor alterations related to stroke, sequelae of traumatic brain injury, multiple sclerosis and other brain damage. Modern neurorehabilitation approaches directly or indirectly affect neuroplastic processes altering cerebral cortex excitability, stimulate the afferentation systems, and result in fatigue and may act as factors provoking seizures or aggravated epilepsy. In addition, developing seizures may temporarily coincide but unrelated to the neurorehabilitation activities: e.g., while omitting antiepileptic drug administration, sleep deprivation or long-term stress occurring to patient etc. Here we present a review on recent studies aimed at investigating epilepsy triggers by aligning them with the factors of interventions used in motor rehabilitation. We also emphasize the safety data for routine use of the main neurorehabilitation methods as well as propose actions to reduce the risk of developing epileptic seizure.

Global Motor, Oral and Deglutition Characteristics in Children with Cerebral Palsy

Cerebral palsy (CP) is a disorder in postural and movement tone resulting from involvement in the motor centers of the immature brain. Thus, this work sought to expose the global motor, oral, and deglutition characteristics in children with CP. To this end, it performed a cross-sectional study of 100 children with CP. The data collection consisted in the detection of the main global motor and oral alterations, their repercussions on the deglutition process, and the main manifestations of dysphagia according to different consistencies of food and types of cerebral palsy. All children exhibited global motor and oral alterations. There were significant differences between age and global motor alterations. Alterations in the tongue mobility were more present in spastics (p=<0.031). The main manifestations of dysphagia, in decreasing order of occurrence were: premature liquids spillage (70%), cough (60%), decreased bolus formation in solids (57,9%), presence of food residues in the oral cavity (47,4%), increased pasty oral transit (47,1%) and presence of wet voice after the liquids swallowing (30%). Therefore, the influence of pelvic instability and compensatory patterns was observed in the presence of clinical signs of tracheal aspiration. Regardless the type of CP, the global and oral motor alterations lead to deglutition disorders. Keywords: Cerebral Palsy. Child. Deglutition Disorders. Posture ResumoA paralisia cerebral (PC) é uma desordem no tônus postural e de movimento decorrentes de um acometimento nos centros motores do cérebro imaturo. Com isso buscou apresentar as características motoras globais, orais e de deglutição em crianças com PC. Assim, realizou um estudo transversal com amostra de 100 crianças com PC. A coleta de dados consistiu na detecção das principais alterações motoras globais e orais, a repercussão na dinâmica da deglutição e as principais manifestações disfágicas em diferentes consistências alimentares. Todas as crianças apresentaram comprometimentos motores globais e orais. Houve diferença significante entre a idade e as alterações globais. Alteração na mobilidade da língua esteve mais presente em espásticos (p=<0,031). As principais manifestações disfágicas, em ordem decrescente de ocorrência, foram: escape anterior de líquidos (70%), tosse (60%), diminuição da formação do bolo alimentar no sólido (57,9%), presença de resíduos alimentares na cavidade oral após a deglutição de sólidos (47,4%), aumento do trânsito oral de pastoso (47,1%) e presença da voz molhada após a deglutição de líquidos (30%). Então, observou-se a influência das alterações tônicas e posturais na presença de sinais clínicos de aspiração traqueal. Alterações tônicas e posturais com comprometimentos motores orais acarretam transtornos da deglutição em crianças com PC. Palavras-chave: Paralisia Cerebral. Criança. Transtornos da Deglutição. Postura

An Adapted Chronic Constriction Injury of the Sciatic Nerve Produces Sensory, Affective, and Cognitive Impairments: A Peripheral Mononeuropathy Model for the Study of Comorbid Neuropsychiatric Disorders Associated with Neuropathic Pain in Rats

Background Chronic constriction injury (CCI) is a model of neuropathic pain induced by four loose ligatures around the sciatic nerve. This work aimed to investigate the sensory, affective, cognitive, and motor changes induced by an adaptation of the CCI model by applying a single ligature around the sciatic nerve. Methods Mechanical allodynia was measured from day 1 to day 28 postsurgery by the von Frey test. The beam walking test (BWT) was conducted weekly until 28 days after surgery. Anxiety- and depression-like behaviors, and cognitive performance were assessed through the open field (OF), forced swimming (FS), and novel object recognition (NOR) tests, respectively, 21 days after surgery. Results The two CCI models, both Bennett and Xie’s model (four ligatures of the sciatic nerve) and a modification of it (one ligature), induced mechanical allodynia, increased immobility in the FS, and reduced recognition index in the NOR. The exploratory behavior and time spent in the central part of the arena decreased, while the defensive behavior increased in the OF. The animals subjected to the two CCI models showed motor alterations in the BWT; however, autotomy was observed only in the group with four ligatures and not in the group with a single ligature. Conclusions Overall these results demonstrate that our adapted CCI model, using a single ligature around the sciatic nerve, induces sensory, affective, cognitive, and motor alterations comparable to the CCI model with four ligatures without generating autotomy. This adaptation to the CCI model may therefore represent an appropriate and more easily performed model for inducing neuropathic pain and study underlying mechanisms and effective treatments.

O6.2. A NETWORK FOR COGNITIVE, MOTOR, AND PSYCHOPATHOLOGICAL ALTERATIONS IN SCHIZOPHRENIA SPECTRUM DISORDERS

Background Schizophrenia spectrum disorders are complex syndromes involving multiple clinical manifestations. Besides psychopathological symptoms, cognitive and motor alterations are also highly relevant in the context of the comprehension, assessment, and treatment of these disorders. Moreover, these three domains of clinical manifestations display complex reciprocal interactions that require further characterization. This work aims to use network analysis to investigate the associations between cognitive, motor, and psychopathological alterations in schizophrenia spectrum disorders. This approach might prove to be advantageous in identifying key variables for the assessment and treatment of these disorders. Methods A sample of 732 patients with schizophrenia spectrum disorders from a multi-site cohort study was included in the analysis. We estimated a network using a regularized Gaussian Graphical Model and conducted network stability analyses. Twenty-six nodes were included, encompassing items from the Positive and Negative Syndrome Scale, multiple neuropsychological tests, and clinician-assessed extrapyramidal symptoms’ scores. The results were further explored with centrality analyses and network comparisons between subgroups defined according to illness duration and remission status. Results We found that the estimated network was densely interconnected. Furthermore, nodes representing symptoms of disorganization were very central and, therefore, pivotal in connecting other psychopathological symptoms to cognitive and motor alterations. The estimated network for the subgroup of patients in remission showed a more sparse density and a different structure from the network of non-remitted patients. Discussion In conclusion, in the context of a broader representation of schizophrenia spectrum disorders’ manifestations, our results of a network analysis confirm a close association between different symptom domains and unveil a highly influential role of disorganization symptoms. Moreover, structural differences in networks occur according to remission status. These results are relevant for research in nosology, clinical assessment, and treatment approaches.

Evaluation of Motor Changes and Toxicity of Insecticides Fipronil and Imidacloprid in Africanized Honey Bees (Hymenoptera: Apidae)

Honey bees are important pollinators and are essential in beekeeping. Honey bees get exposed to systemic pesticides while foraging in contaminated fields, and it is important to know the toxicity (LD50) and evaluate the impacts of bees’ exposure to these molecules. Fipronil and imidacloprid are systemic pesticides widely used in Brazil and other countries. The objective of this study was to determine the LD50 (24 hours) and evaluate motor changes in Africanized honey bee foragers exposed to lethal and sublethal doses of fipronil and imidacloprid. To determine the LD50, foraging honey bees were exposed by ingestion and contact to five doses of fipronil (Regent 800WG®) and imidacloprid (Appalus 200SC®) insecticides. After 24 hours of exposure, the number of dead bees was counted, and the results were subjected to probit analysis. The motor activity of bees exposed by ingestion or contact to LD50 and sublethal doses (1/500th of the LD50) of both pesticides was assessed 4 hours after exposure using a behavioral observation box. The ingestion and contact with LD50 of fipronil were 0.0528±0.0090 and 0.0054±0.0041 μg/bee, respectively; the ingestion and contact with LD50 of imidacloprid were 0.0809±0.0135 and 0.0626±0.0080 μg/bee, respectively. Bees exposed to lethal and sublethal doses of both insecticides experienced significant motor alterations compared to the control, except for exposure to sublethal doses of fipronil by contact. Fipronil and imidacloprid are highly toxic and promote motor changes in bees. Thus, it is important to establish management methods to reduce pollinators’ exposure to these pesticides.