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Bruijn S.M.,Research Center for Movement Control and Neuroplasticity | Bruijn S.M.,Fujian Medical University | Meijer O.G.,VU University Amsterdam | Meijer O.G.,Fujian Medical University | And 2 more authors.
Journal of the Royal Society Interface | Year: 2013

Falling poses a major threat to the steadily growing population of the elderly in modern-day society. A major challenge in the prevention of falls is the identification of individuals who are at risk of falling owing to an unstable gait. At present, several methods are available for estimating gait stability, each with its own advantages and disadvantages. In this paper, we review the currently available measures: the maximum Lyapunov exponent (lS and lL), the maximum Floquet multiplier, variability measures, long-range correlations, extrapolated centre of mass, stabilizing and destabilizing forces, foot placement estimator, gait sensitivity norm and maximum allowable - perturbation. We explain what these measures represent and how they are calculated, andwe assess their validity, divided up into construct validity, predictive validity in simple models, convergent validity in experimental studies, and predictive validity in observational studies. We conclude that (i) the validity of variability measures and lS is best supported across all levels, (ii) the maximum Floquet multiplier and lL have good construct validity, but negative predictive validity in models, negative convergent validity and (for lL) negative predictive validity in observational studies, (iii) long-range correlations lack construct validity and predictive validity inmodels and have negative convergent validity, and (iv) measures derived from perturbation experiments have good construct validity, but data are lacking on convergent validity in experimental studies and predictive validity in observational studies. In closing, directions for future research on dynamic gait stability are discussed. © 2013 The Author(s) Published by the Royal Society. All rights reserved.


Duysens J.,Radboud University Nijmegen | Van Wezel B.M.H.,Radboud University Nijmegen | Smits-Engelsman B.,Radboud University Nijmegen | Smits-Engelsman B.,Research Center for Movement Control and Neuroplasticity
Journal of Neurophysiology | Year: 2010

Normal gait is characterized by a phase-dependent modulation of cutaneous reflexes. The role of the basal ganglia in regulating these reflexes is largely unknown. Therefore cutaneous reflex responses from the skin of the foot were studied during walking of patients with mild to moderate Parkinson's disease (PD). The reflex responses were elicited by stimulation of the sural nerve of the most affected leg. The responses were studied in the biceps femoris (BF) and tibialis anterior (TA) of both legs. The latencies, durations, and phase-dependent modulation patterns of the responses were mostly comparable with those observed in healthy subjects. However, on average the amplitude of the responses in the ipsilateral and contralateral BF was respectively 1.4- and 5-fold larger for the PD patients than that for the healthy subjects. This increase was mostly seen throughout the whole step cycle. However, in some PD patients the crossed BF responses were very large during the contralateral swing phase. In such cases the increase in crossed reflexes sometimes reflected premotoneuronal gating since it was not always due to increased background activation in that period. Fast activation of contralateral BF reflexes is known to occur in conjunction with ipsilateral perturbations when there is a threat to stability. It is concluded that cutanoeus reflexes are facilitated in PD but that some of the increase in reflexes in BF may be indirectly related to unsteady gait and to perceived instability. Copyright © 2010 The American Physiological Society.


Nackaerts E.,Research Center for Movement Control and Neuroplasticity | Wagemans J.,Catholic University of Leuven | Helsen W.,Research Center for Movement Control and Neuroplasticity | Swinnen S.P.,Research Center for Movement Control and Neuroplasticity | And 3 more authors.
PLoS ONE | Year: 2012

One of the main characteristics of Autism Spectrum Disorder (ASD) are problems with social interaction and communication. Here, we explored ASD-related alterations in 'reading' body language of other humans. Accuracy and reaction times were assessed from two observational tasks involving the recognition of 'biological motion' and 'emotions' from point-light displays (PLDs). Eye movements were recorded during the completion of the tests. Results indicated that typically developed-participants were more accurate than ASD-subjects in recognizing biological motion or emotions from PLDs. No accuracy differences were revealed on two control-tasks (involving the indication of color-changes in the moving point-lights). Group differences in reaction times existed on all tasks, but effect sizes were higher for the biological and emotion recognition tasks. Biological motion recognition abilities were related to a person's ability to recognize emotions from PLDs. However, ASD-related atypicalities in emotion recognition could not entirely be attributed to more basic deficits in biological motion recognition, suggesting an additional ASD-specific deficit in recognizing the emotional dimension of the point light displays. Eye movements were assessed during the completion of tasks and results indicated that ASD-participants generally produced more saccades and shorter fixation-durations compared to the control-group. However, especially for emotion recognition, these altered eye movements were associated with reductions in task-performance. © 2012 Nackaerts et al.


Reijmer Y.D.,University Utrecht | Leemans A.,University Utrecht | Caeyenberghs K.,Research Center for Movement Control and Neuroplasticity | Heringa S.M.,University Utrecht | And 2 more authors.
Neurology | Year: 2013

Objective: To examine the relation between measures of whole-brain white matter connectivity and cognitive performance in patients with early Alzheimer disease (AD) using a network-based approach and to assess whether network parameters provide information that is complementary to conventional MRI markers of AD. Methods: Fifty patients (mean age 78.8 ± 7.1 years) with early AD were recruited via a memory clinic. In addition, 15 age-, sex-, and education-matched control participants were used as a reference group. All participants underwent a 3-T MRI scan and cognitive assessment. Diffusion tensor imaging-based tractography was used to reconstruct the brain network of each individual, followed by graph theoretical analyses. Overall network efficiency was assessed by measures of local (clustering coefficient, local efficiency) and global (path length, global efficiency) connectivity. Age-, sex-, and education-adjusted cognitive scores were related to network measures and to conventional MRI parameters (i.e., degree of cerebral atrophy and small-vessel disease). Results: The structural brain network of patients showed reduced local efficiency compared to controls. Within the patient group, worse performance in memory and executive functioning was related to decreased local efficiency (r = 0.434; p = 0.002), increased path length (r = 20.538; p < 0.001), and decreased global efficiency (r = 0.431; p = 0.005). Measures of network efficiency explained up to 27% of the variance in cognitive functioning on top of conventional MRI markers (p < 0.01). Conclusion: This study shows that network-based analysis of brain white matter connections provides a novel way to reveal the structural basis of cognitive dysfunction in AD. © 2013 American Academy of Neurology.


Meesen R.L.J.,Hasselt University | Meesen R.L.J.,Research Center for Movement Control and Neuroplasticity | Thijs H.,Hasselt University | Thijs H.,Catholic University of Leuven | And 3 more authors.
Restorative Neurology and Neuroscience | Year: 2014

Purpose: To assess the effects of atDCS on motor performance in patients with multiple sclerosis (MS). Previously, anodal transcranial direct current stimulation (atDCS) has been shown to improve motor performance in healthy subjects and neurodegenerative populations. However, the effect of atDCS on motor performance is not examined in MS. Methods: In the current study, a sham controlled double-blind crossover design was used to evaluate the effect of 20 minutes of 1 mA atDCS or sham tDCS (stDCS) on a unimanual motor sequence-training task, consisting of sequential finger presses on a computer keyboard with the most impaired hand. Patients received stimulation (atDCS or stDCS) during motor training. tDCS was applied over the primary motor cortex contralateral to the most impaired hand. Motor performance was assessed immediately before, during and 30 minutes after stimulation. Results: Although we need to be careful with the interpretation of the data due to lack of power, our results showed no significant effect of atDCS on motor performance. Conclusions: Our findings indicate that atDCS-supported motor training was not able to improve motor performance more than sham-supported motor training. Possibly, the effects of atDCS are mediated by specific MS-related characteristics. Furthermore, increasing atDCS intensity and offering multiple stimulation sessions might be necessary to optimize motor performance resulting from atDCS-supported motor training. © 2014 - IOS Press.

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