Funkční poruchy hybnosti jsou významným zdrojem disability. Diagnóza funkčních poruch hybnosti je založená na průkazu inkonzistence hybných projevů a na inkompatibilitě s jiným organickým onemocněním, a nikoliv na vyloučení jiného onemocnění či průkazu psychopatologie. Role neurologa spočívá v předání pozitivní diagnózy a vysvětlení, že funkční symptomy jsou skutečné, časté a potenciálně reverzibilní, a také v dlouhodobém sledování vývoje neurologických příznaků. Narůstající evidence svědčí pro účinnost fyzioterapie a psychoterapeutických intervencí buď samostatně, nebo v kombinaci. Úkolem psychiatrů je diagnostika a léčba psychiatrických komorbidit, zejména úzkosti a deprese. Farmakologické intervence cílené na motorické symptomy nejsou indikované.

Functional movement disorders are important source of disability. Diagnosis of functional movement disorders should be based on positive signs of inconsistency of motor symptoms and their incompatibility with an organic disorder and not on exclusion of other conditions. The role of neurologist involves the delivery of a positive diagnosis and an explanation that functional symptoms are genuine, common, and potentially reversible, and a long-term follow-up. Increasing evidence supports the efficacy of physiotherapy and psychotherapy alone or in combination. Psychiatrists should evaluate and treat psychiatric comorbidities such as anxiety and/or depression. Pharmacological treatments directed at motor symptoms are not appropriate.

• Klíčová slova
• funkční poruchy pohybu, Hooverovo znamení, funkční slabost,
• MeSH
• lidé MeSH
• motorické poruchy * diagnóza   patofyziologie   terapie   MeSH
• pohybové poruchy * diagnóza   patofyziologie   terapie   MeSH
• svalová slabost * diagnóza   patofyziologie   terapie   MeSH
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• lidé MeSH
• Publikační typ
• přehledy MeSH

• MeSH
• lidé MeSH
• muskuloskeletální manipulace klasifikace   metody   MeSH
• muskuloskeletální systém * diagnostické zobrazování   patofyziologie   MeSH
• neurologické vyšetření klasifikace   metody   MeSH
• palpace metody   MeSH
• pohybové poruchy diagnóza   klasifikace   patofyziologie   MeSH
• reflex fyziologie   MeSH
• reflexní terapie metody   MeSH
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• lidé MeSH
• Publikační typ
• přehledy MeSH

In motor functional neurological disorders (mFND), relationships between interoception (a construct of high theoretical relevance to its pathophysiology) and neuroanatomy have not been previously investigated. This study characterized white matter in mFND patients compared to healthy controls (HCs), and investigated associations between fiber bundle integrity and cardiac interoception. Voxel-based analysis and tractography quantified fractional anisotropy (FA) in 38 mFND patients compared to 38 HCs. Secondary analyses compared functional seizures (FND-seiz; n = 21) or functional movement disorders (n = 17) to HCs. Network lesion mapping identified gray matter origins of implicated fiber bundles. Within-group mFND analyses investigated relationships between FA, heartbeat tracking accuracy and interoceptive trait prediction error (discrepancies between interoceptive accuracy and self-reported bodily awareness). Results were corrected for multiple comparisons, and all findings were adjusted for depression and trait anxiety. mFND and HCs did not show any between-group interoceptive accuracy or FA differences. However, the FND-seiz subgroup compared to HCs showed decreased integrity in right-lateralized tracts: extreme capsule/inferior fronto-occipital fasciculus, arcuate fasciculus, inferior longitudinal fasciculus, and thalamic/striatum to occipital cortex projections. These alterations originated predominantly from the right temporoparietal junction and inferior temporal gyrus. In mFND patients, individual differences in interoceptive accuracy and interoceptive trait prediction error correlated with fiber bundle integrity originating from the insula, temporoparietal junction, putamen and thalamus among other regions. In this first study investigating brain-interoception relationships in mFND, individual differences in interoceptive accuracy and trait prediction error mapped onto multimodal integration-related fiber bundles. Right-lateralized limbic and associative tract disruptions distinguished FND-seiz from HCs.

• MeSH
• bílá hmota * diagnostické zobrazování   patologie   patofyziologie   MeSH
• biologická variabilita populace fyziologie   MeSH
• dospělí MeSH
• interocepce fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mozková kůra MeSH
• pohybové poruchy * diagnostické zobrazování   patologie   patofyziologie   MeSH
• psychologická anticipace fyziologie   MeSH
• šedá hmota * diagnostické zobrazování   patologie   patofyziologie   MeSH
• srdeční frekvence fyziologie   MeSH
• zobrazování difuzních tenzorů * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH

• MeSH
• lidé MeSH
• pohybové poruchy * etiologie   patofyziologie   MeSH
• spoušťové body * patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

• MeSH
• lidé MeSH
• pohybové poruchy * etiologie   klasifikace   patofyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

• MeSH
• ataxie patofyziologie   terapie   MeSH
• lidé MeSH
• myoklonus patofyziologie   terapie   MeSH
• pohybové poruchy * patofyziologie   terapie   MeSH
• svalová slabost patofyziologie   terapie   MeSH
• svalová spasticita patofyziologie   terapie   MeSH
• tremor patofyziologie   terapie   MeSH
• záchvaty patofyziologie   terapie   MeSH
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• lidé MeSH
• Publikační typ
• přehledy MeSH

Evaluation of motions is the basis for the diagnosis of human locomotor system disorders. Analyses are usually focused on the performance components of this system, i.e. on the skeleton and muscles. However, where comprehensive diagnosis is to be obtained, the motor system must be evaluated as a whole, without omitting any of its parts. So, evaluation of the control function is very important to body motion evaluation. The method that is normally used to evaluate the activity of brain is electroencephalography, which is superior to other brain activity-evaluating methods in many respects. However, EEG has also a major drawback, namely, it cannot precisely locate the activated and deactivated brain regions. This drawback can be avoided by using the sLORETA neurophysiological program, a tool that can transform EEG data to 3D brain images and finding application across a wide range of clinical branches of medicine – neurology, neurophysiology, psychiatry, physiotherapy and also in sports.

• MeSH
• elektroencefalografie metody   MeSH
• kineziologie aplikovaná metody   MeSH
• lidé MeSH
• lokomoce * fyziologie   MeSH
• magnetická rezonanční tomografie metody   MeSH
• pohyb fyziologie   MeSH
• pohybové poruchy diagnostické zobrazování   etiologie   patofyziologie   MeSH
• rehabilitace metody   MeSH
• zobrazování trojrozměrné MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH

Study of motor activity is an important part of the experimental models of neural disorders of rats. It is used to study effects of the CNS impairment, however studies on the peripheral nervous system lesions are much less frequent. The aim of the study was to extend the spectrum of experimental models of anterior limb movement disorders in rats by blockade of the right anterior limb brachial plexus with the local anesthetic Marcaine (Ma), or with aqua for injection administered into the same location (Aq) (with control intact group C). Two other groups with anterior limb movement disorders underwent induction of cellular brain edema by water intoxication (MaWI and AqWI). Results showed a lower spontaneous motor activity of animals in all experimental groups versus controls, and lower spontaneous motor activity of animals in the MaWI group compared to other experimental groups in all categories. There was no difference in spontaneous activity between the groups Ma, Aq and AqWI. Our study indicates that alterations of spontaneous motor activity may result from the impaired forelimb motor activity induced by the anesthetic effect of Marcaine, by the volumetric effect of water, as a result of induced brain edema, or due to combination of these individual effects.

• MeSH
• edém mozku komplikace   patofyziologie   MeSH
• intoxikace vodou komplikace   patofyziologie   MeSH
• krysa rodu rattus MeSH
• modely nemocí na zvířatech * MeSH
• pohybová aktivita fyziologie   MeSH
• pohybové poruchy etiologie   patofyziologie   MeSH
• potkani Wistar MeSH
• přední končetina patofyziologie   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Patients with functional movement disorders also typically have functional somatic symptoms, including pain, fatigue, and sensory disturbance. A potentially unifying mechanism for such symptoms is a failure in processing of sensory inputs. Prepulse inhibition is a neurophysiological method that allows for the study of preconscious somatosensory processing. OBJECTIVE: The objective of this study was to assess prepulse inhibition in patients with functional movement disorders and healthy control subjects. METHODS: We analyzed the effect of a weak electrical stimulus to the index finger (prepulse) on the magnitude of the R2 response of the blink reflex induced by electrical stimuli delivered to the supraorbital nerve in 22 patients with clinically established functional movement disorders and 22 matched controls. Pain, depression, anxiety, and obsessive-compulsive symptoms were assessed using self-rated questionnaires. In addition, in patients we assessed motor symptom severity. RESULTS: Prepulses suppressed the R2 response of the blink reflex in both groups, by 36.4% (standard deviation: 25.6) in patients and by 67.3% (standard deviation: 16.4) in controls. This difference was significant (P < 0.001). There was no significant correlation between motor and nonmotor symptom measures and prepulse inhibition size. CONCLUSIONS: Impaired prepulse inhibition of the blink reflex suggests an abnormal preconscious processing of somatosensory inputs, which can be interpreted within predictive coding accounts of both functional movement disorders and functional somatic syndromes. Our results, along with previous findings of a reduced prepulse inhibition in fibromyalgia syndrome, support a possible unified pathophysiology across functional neurological and somatic syndromes with noteworthy implications for diagnostic classification and development of novel biomarkers and treatments. © 2019 International Parkinson and Movement Disorder Society.

• MeSH
• dospělí MeSH
• elektrická stimulace metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mrkání fyziologie   MeSH
• nervový útlum fyziologie   MeSH
• pohybové poruchy patofyziologie   MeSH
• prepulsní inhibice fyziologie   MeSH
• prsty ruky patofyziologie   MeSH
• úleková reakce fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

OBJECTIVES: The prevalence of restless legs syndrome (RLS) in functional movement disorders (FMD) is not known. Patients with FMD often present with multiple motor and sensory symptoms. Some of these symptoms might be due to comorbid RLS. Therefore, our objective was to evaluate possible association between FMD and RLS. DESIGN: Case-control study. SETTING: Movement Disorders Center, 1st Faculty of Medicine and General University Hospital in Prague, Czech Republic. PARTICIPANTS: 96 consecutive patients with clinically established FMD (80 females, mean age (SD) 45.0 (13) years), and 76 matched controls. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was prevalence of RLS based on updated International RLS Study Group criteria. Secondary outcome measures included prevalence of periodic limb movements (PLM) using actigraphy; pain, motor and sensory symptoms in lower limbs; organic comorbidities and medication affecting RLS. RESULTS: RLS criteria were fulfilled in 43.8% of patients (95% CI 34 to 54) and in 7.9% of controls (95% CI 3 to 17, p<0.00001). Both RLS and PLM indices (PLMi) ≥22.5/hour were found in 21.2% of patients with FMD and 2.6% of controls. Patients with FMD with RLS had a higher mean PLMi (p<0.001) and a higher proportion of PLMi ≥22.5/hour (p<0.01) than RLS-negative patients. Patients with RLS had higher prevalence of pain and sensory symptoms in lower limbs, no difference was found in medication and prevalence of organic comorbidities in patients with FMD with and without RLS. CONCLUSIONS: We found an increased prevalence of RLS in patients with FMD. Clinical diagnosis of RLS was supported by actigraphic measurement of clinically relevant PLM in a significant proportion of patients with FMD. Although functional motor and sensory symptoms may mimic RLS, RLS may be unrecognised in patients with FMD. This finding may have clinical implications in management of FMD, and it raises the possibility of common pathophysiological mechanisms of FMD and RLS/PLM.

• MeSH
• dospělí MeSH
• dystonie patofyziologie   MeSH
• konverzní poruchy epidemiologie   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• myoklonus patofyziologie   MeSH
• neurologické poruchy chůze patofyziologie   MeSH
• pohybové poruchy epidemiologie   patofyziologie   MeSH
• poruchy hybnosti oka patofyziologie   MeSH
• poruchy řeči patofyziologie   MeSH
• prevalence MeSH
• studie případů a kontrol MeSH
• svalová slabost patofyziologie   MeSH
• syndrom neklidných nohou epidemiologie   MeSH
• tremor patofyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Intramural MeSH
• Geografické názvy
• Česká republika MeSH