Cerebellar language and cognitive functions in childhood: A comparative review of the clinical research

Background: Recent research addressing evidence from functional neuroimaging studies, neurophysiological research, and new advances in neuropsychology together with traditional cerebellar lesion studies have recently implicated the cerebellum in adult language and cognitive functions. However, more limited information is currently available in describing the functional connectivity present in the paediatric population. Aims: It is the purpose of this paper to review recent clinical research pertaining to paediatric populations, outlining the impact of site of lesion and specific associated clinical changes in children with cerebellar disturbances. Main contribution: The specific contribution of the right cerebellar hemisphere to language function is identified to also exist in the paediatric population, highlighting the existence of functional connections between this region of the brain and left frontal cortical areas early in development. Conclusions: Implications for future research in paediatric populations are extensive, as a greater awareness and an understanding of the recently acknowledged involvement of the cerebellum in cognition and nonmotor linguistic function is anticipated to also add new dimension and direction to the analysis of childhood language outcomes associated with the cerebellum.

MR morphometry of posterior tibialis muscle in adult acquired flat foot

We conducted magnetic resonance imaging of the posterior tibial (PT) and flexor digitorum longus (FDL) muscle bellies in 12 patients undergoing surgical treatment for unilateral posterior tibial tendon (PTT) dysfunction. All patients had atrophy of the PT muscle compared to the normal leg (mean 10.7%, p=0.008). In those patients with a complete rupture of PTT there was replacement of the PT muscle by fatty infiltration. Conversely, the FDL muscle showed a compensatory hypertrophy (mean 17.2%, p

Articulatory imprecision in dysarthria following childhood cerebellar tumor: A perceptual and acoustic investigation of three male participants

Articulatory imprecision has been documented as a key perceptual feature of the dysarthria associated with childhood cerebellar tumor (CCT). As yet the underlying acoustic and physiological characteristics of motor speech production that contribute to this perceptual feature have not been identified. The aim of the current study was to describe perceptual and acoustic characteristics of consonant production in three children with dysarthria associated with CCT The results indicated that in all three cases the timing of articulatory movements during stop consonant production differed from that measured in a control group of same-age peers. The impact of cerebellar lesions in adulthood on articulatory gestures is used as a reference for discussing the findings of the current study with similarities evident. Also discussed are future research directions for examining the underlying acoustic or physiological basis for articulatory imprecision in children with dysarthria associated with CCT.

Language outcomes subsequent to treatment of brainstem tumour in childhood

While the occurrence and management of brainstem tumours in children would not traditionally indicate potential direct structural impact on classical language centres, recent theories have implicated some involvement of the brainstem in a functional language and cognitive neural loop between the cerebellum and the cerebral hemispheres. Thus, the present paper explored the impact of treatment for brainstem tumour on the general and high-level language abilities of six children treated for brainstem tumour, in addition to phonological awareness skills. Group analysis revealed that children treated for brainstem tumour demonstrated intact language and phonological awareness abilities in comparison to an age- and gender-matched control group. Individual analysis revealed only one of six children treated for brainstem tumour revealed evidence of language disturbances, with an additional child demonstrating an isolated mildly reduced score on one phonological awareness task. Language deficits identified in a child treated with a combination of both radiotherapy and chemotherapy were noted in the high-level language area of lexical generation. Findings highlighted that no overt language disturbances were evident in children treated for brainstem tumour. However, further analysis into higher-level language skills in the present study indicated that both general and high-level language abilities require long-term monitoring in this population.

Specialization in pyramidal cell structure in the cingulate cortex of the Chacma baboon (Papio ursinus): An intracellular injection study of the posterior and anterior cingulate gyrus with comparative notes on the macaque and vervet monkeys

This study forms part of an ongoing investigation of pyramidal cell structure in the cingulate cortex of primates. Recently we have demonstrated that layer III pyramidal cells in the anterior cingulate gyrus are considerably larger, more branched and more spinous than those in the posterior cingulate gyrus (areas 24 and 23, respectively) in the macaque and vervet monkeys. Moreover, the extent of the interareal difference in specialization in pyramidal cell structure differed between the two species. These data suggest that pyramidal cell circuitry may have evolved differently in these closely related species. Presently there are too few data to speculate on what is selecting for this specialization in structure. Here we extend the basis for comparison by studying pyramidal cell structure in cingulate gyrus of the Chacma baboon (Papio ursinus). Methodology used here is the same as that for our previous studies: intracellular injection of Lucifer Yellow in flat-mounted cortical slices. We found that pyramidal cells in anterior cingulate gyrus (area 24) were more branched and more spinous than those in posterior cingulate gyrus (area 23). Moreover, the complexity in pyramidal cell structure in both the anterior and posterior cingulate gyrus of the baboon differed to that in the corresponding regions in either the macaque or vervet monkeys. (C) 2005 Elsevier Ireland Ltd. All rights reserved.

Differential motor speech outcomes in children treated for mid-line cerebellar tumour

Primary objective: To investigate the nature of the motor speech impairments and dysarthria that can arise subsequent to treatment for childhood mid-line cerebellar tumours (CMCT). Research design: The motor speech ability of six cases of children with CMCT was analysed using perceptual and physiological measures and compared with that of a group of non-neurologically impaired children matched for age and sex. Main outcome and results: Three of the children with CMCT were perceived to exhibit dysarthric speech, while the remaining three were judged to have normal speech. The speech disorder in three of the children with CMCT was marked by deviances in prosody, articulation and phonation. The underlying pathophysiology was linked to cerebellar damage and expressed as difficulty in co-ordinating the motor speech musculature as required for speech production. These deficits were not identified in the three non-dysarthric children with CMCT. Conclusion: Differential motor speech outcomes occur for children treated for CMCT and these are discussed within the realm of possible mechanisms responsible for these differences. The need for further investigation of the risk factors for development of motor speech impairment in children treated for CMCT is also highlighted.

Regional specialization in pyramidal cell structure in the limbic cortex of the vervet monkey (Cercopithecus pygerythrus): an intracellular injection study of the anterior and posterior cingulate gyrus

The pyramidal cell phenotype varies quite dramatically in structure among different cortical areas in the primate brain. Comparative studies in visual cortex, in particular, but also in sensorimotor and prefrontal cortex, reveal systematic trends for pyramidal cell specialization in functionally related cortical areas. Moreover, there are systematic differences in the extent of these trends between different primate species. Recently we demonstrated differences in pyramidal cell structure in the cingulate cortex of the macaque monkey; however, in the absence of other comparative data it remains unknown as to whether the neuronal phenotype differs in cingulate cortex between species. Here we extend the basis for comparison by studying the structure of the basal dendritic trees of layer III pyramidal cells in the posterior and anterior cingulate gyrus of the vervet monkey (Brodmann's areas 23 and 24, respectively). Cells were injected with Lucifer Yellow in flat-mounted cortical slices, and processed for a light-stable DAB reaction product. Size, branching pattern, and spine density of basal dendritic arbors were determined, and somal areas measured. As in the macaque monkey, we found that pyramidal cells in anterior cingulate gyrus (area 24) were more branched and more spinous than those in posterior cingulate gyrus (area 23). In addition, the extent of the difference in pyramidal cell structure between these two cortical regions was less in the vervet monkey than in the macaque monkey.

Combined arteriovenous fistula and venous aneurysm following knee arthrodesis

We study a case of a 65-year-old woman who developed popliteal arteriovenous fistula (AVF) and venous aneurysm following left knee arthrodesis. Presenting features included left popliteal and calf pain, a tender pulsatile mass posterior to her left knee, popliteal bruit and a thrill at the popliteal fossa and ankle. Left femoral angiography showed an AVF arising from the right tibioperoneal trunk and an aneurysm at the level of the AVF. Findings at open investigation included AVF between the tibioperoneal trunk and the popliteal vein, and a venous aneurysm arising from the popliteal vein opposite the neck of the arteriovenous communication. The aneurysm and fistula were repaired using prolene suture.

ANÁLISE CEFALOMÉTRICA LATERAL DE RICKETTS: JOVENS DA REGIÃO NORTE DO BRASIL

Este trabalho teve como objetivo determinar as normas cefalométricas de medidas da análise lateral de RICKETTS 54 de 1981, numa amostra de indivíduos brasileiros, leucodermas, com oclusão normal, sem tratamento ortodôntico prévio, da Região Norte do Brasil e comparar estes valores com os preconizados por RICKETTS54 realizando a projeção destes valores para 18 anos de idade, a fim de tornar possível esta comparação. E determinar a freqüência dos diferentes tipos faciais obtidos pelo índice VERT (quantidade de crescimento vertical), obtido por meio da análise lateral de RICKETTS et al55 de 1982. O material constou de 28 telerradiografias em norma lateral de 15 indivíduos do sexo masculino e 13 do sexo feminino, com idades entre 20 e 26 anos, com média de idade de 22,42 anos. Estes indivíduos foram selecionados na Faculdade de odontologia do CESUPA (Centro Universitário do Pará). O método eleito para os traçados cefalométricos foi o computadorizado (programa Radiocef 2.0). Os resultados permitiram depreender que esta amostra da Região Norte do Brasil quando comparada aos valores normativos preconizados por RICKETTS54 apresentam: Biprotrusão dentária; maxila protruída; padrão braquifacial com tendência para mordida profunda; os molares superiores encontram-se numa posição mais posterior; incisivos inferiores protruídos e vestibularizados; incisivos superiores com inclinação adequada e bem posicionados na base óssea; lábio inferior equilibrado; profundidade facial aumentada; crescimento equilibrado do eixo facial; mandíbula rotacionada no sentido horário, plano palatal com inclinação no sentido horário. Quanto à freqüência dos tipos faciais obtidos pelo índice VERT, do total da amostra estudada 50% dos indivíduos eram braquifaciais, 39,28% dolicofaciais e 10,72% mesofaciais.(AU)

ESTUDO COMPARATIVO DA POSIÇÃO ÂNTERO POSTERIOR DOS PRIMEIROS MOLARES INFERIORES NO TRATAMENTO ORTODÔNTICO, UTILIZANDO AS TÉCNICAS STRAIGHT-WIRE E EDGEWISE, EM CASOS DE MÁ OCLUSÃO DE CLASSE I DE ANGLE, COM EXTRAÇÃO DE PRIMEIROS PRÉ-MOLARES

Este estudo avaliou o posicionamento ântero posterior dos primeiros molares inferiores, durante o tratamento ortodôntico, utilizando o arco lingual inferior como acessório de ancoragem na técnica Straight-Wire, em comparação aos casos tratados pela técnica Edgewise, sem a utilização do arco lingual. Dois grupos foram selecionados, ambos apresentando má oclusão de Classe I de Angle7, tratados com extração dos primeiros pré-molares superiores e inferiores. Foi utilizada uma amostra de 255 telerradiografias em norma lateral, obtidas de pacientes brasileiros, de ambos os sexos, com média de idade de 13 anos e 6 meses e com diferentes padrões de crescimento facial. Embasado na análise e discussão dos resultados, concluiu-se que: 1) do início do tratamento ao fim da fase de nivelamento, a perda de ancoragem coronária do primeiro molar inferior foi maior nos casos tratados com a técnica Straight-Wire; 2) do fim da fase de nivelamento ao fim do tratamento, a perda de ancoragem coronária e radicular do primeiro molar inferior foi maior na técnica Edgewise; 3) do início ao fim tratamento a perda de ancoragem radicular foi maior nos pacientes tratados com a técnica Edgewise; e 4) o deslocamento ântero-posterior dos incisivos inferiores não apresentou diferença estatisticamente significante para ambas as técnicas, em todas as etapas observadas.(AU)