Neurologic Signs in Senescence

Jenkyn, Lawrence R.; Reeves, Alexander G.; Warren, Thomas C.; Whiting, R. Keith; Clayton, R J; Moore, Walter W.; Rizzo, Alessandro; Tuzun, Illhan M.; Bonnett, John C.; Culpepper, B. W.

doi:10.1001/archneur.1985.04060110036012

Cited by 89 publications

(55 citation statements)

References 19 publications

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“…The pre s e n c e of four or more PR, particularly the combination of paratonia, snout, suck and palmomental re f l e xes, especially if marked, were associated to cognitive deficit and diffuse or multiple brain dysfunction. This finding concur with those of other authors who called attention for the abnormal nature of multiple (more than three) PR, which in combination may be most predictive of organic pathology 3,[23][24][25] . Analysis of associations of PR with each other revealed correlations only between snout and glabellar reflexes, as also re p o rted by some re s e a rc h e r s 2 6 , without clear explanation; and between snout and suck reflexes, probably because these reflexes share overlapped neural stru c t u res.…”

Section: Discussionsupporting

confidence: 92%

“…A plausible explanation for reappearance of these re f l e xes in the adult has been the loss of cortical inhibition, resulting from atrophy of normal aging or m ore severe lesions of degenerative dementias [1][2][3][4][5][6][7][8]25 . The term "frontal release signs" for PR seems to be inappropriate, since almost all patients pre s e n ting them had atrophy and hypoperfusion pre d o minantly in posterior regions, and other authors In this study of associations between PR and cognitive perf o rmance, CASI-S showed to be a practical test, easy and quick to administer, suitable for illiterate subjects (that constitute 15% of our population of patients).…”

Section: Discussionmentioning

confidence: 99%

“…Some authors 2,3 re g a rdthese reflexes as predictive of diffuse cerebral dysfunction, since these signs were significantly correlated to cognitive deficits determined by the Halstead-Reitan Neuropsychological Battery in a group of 76 individuals aged 20 to 80 years. On the other hand, other authors 1 2 found no correlation between snout, glabellar, and grasp re f l e xes and the presence of cerebral atrophy by CT scan or the results of psychometric tests (Wechsler Mem o ry Scale) in a sample of 52 patients with Alzheimer's disease and 48 normal controls.…”

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Primitive reflexes and cognitive function

Damasceno

Delicio

Mazo

et al. 2005

Arq. Neuro-Psiquiatr.

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-Background: Data on the prevalence of primitive reflexes (PR) in adulthood, their pathological significance and relationship to age and cognition are contro v e r s i a l . Objective: To study the re l a t i o nship between PR and cognition in 30 patients with probable Alzheimer's disease (AD) and 154 control subj e c t s . Method: Diagnosis of probable AD was based on DSM-IV, NINCDS-ADRDA, and CAMDEX criteria. Primitive reflexes were quantified from zero (absent) to 1 (mild) or 2 (markedly present). The Cognitive Abilities Screening Instrument -Short Form (CASI-S) was used to evaluate registration, temporal orientation, verbal fluency and recall. A drawing test was added. Results: Most frequent PR among demented and controls were suck (77% and 62%, respectively) and snout (60% and 27%), followed by glabellar (30% and 19%), paratonia (37% and 5%), and palmomental (23% and 5%). None of controls had more than t h ree PR. Frequency of PR tended to increase with age and cognitive deterioration. Grasp and Babinski responses were found only in dementia patients. Primitive reflexes were not correlated with each other, except snout with suck, and snout with glabellar re f l e x . Conclusion: The finding of grasp and Babinski sign, or the presence of more than three primitive signs, particularly the combination of paratonia, snout, suck, and palmomental reflexes strongly suggests brain dysfunction, especially when these signs are marked and accompanied by deficits in orientation, recall, verbal fluency, and constructional praxis.KEY WORDS: primitive reflexes, aging, dementia, Alzheimer's disease, cognitive tests.Reflexos primitivos e função cognitiva RESUMO -Contexto: A prevalência e significado patológico dos reflexos primitivos (RP) no adulto, bem como sua relação com a idade e a cognição, são questões contro v e r s a s . Objetivo: Estudar a relação entre RP e cognição em 30 pacientes com doença de Alzheimer (DA) e 154 sujeitos controles norm a i s . M é t o d o :O diagnóstico de DA baseou-se nos critérios DSM-IV, NINCDS-ADRDA e CAMDEX. Os RP foram quantificados de 0 (ausente) a 1 (leve) ou 2 (acentuado). CASI-S (Cognitive Abilities Screening Instrument -Short Form ) foi usado para avaliar o re g i s t ro, orientação temporal, fluência verbal e evocação. Um teste de cópia de pentágonos foi acrescentado . Resultados: Os RP mais frequentes nos pacientes e controles foram o de sucção (77% e 62%, respectivamente) e "snout" (60% e 27%), seguidos do glabelar (30% e 19%), paratonia (37% e 5%) e palmomentoniano (23% e 5%). Nenhum sujeito controle teve mais que três RP. A frequência dos RP tendeu a aumentar com a idade e a deterioração cognitiva. O reflexo de preensão e o sinal de Babinski foram encontrados apenas nos pacientes com DA. Os RP não se correlacionaram uns com os o u t ros, exceto o reflexo "snout" com o de sucção e com o glabelar. Conclusão: O achado de reflexo de preensão e sinal de Babinski, ou a presença de mais de três sinais primitivos, particularmente a combinação de paratonia e reflexos "snout", s...

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Primitive reflexes and cognitive function

Damasceno

Delicio

Mazo

et al. 2005

Arq. Neuro-Psiquiatr.

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“…Again, such findings can be found in elderly normal subjects. 109 The presence of EPS occurs in a subset of (primarily possible) AD subjects. While a few investigators have claimed that the presence of EPS predicts more rapid decline, 76 others have failed to confirm this finding.…”

Section: Examinationmentioning

confidence: 99%

Assessment of Suspected Dementia

Chertkow

Bergman

Schipper

et al. 2001

Can. J. Neurol. Sci.

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At the Second Canadian Consensus Conference on Dementia (CCCD) (February, 1998), a group of neurologists, geriatricians, and psychiatrists met to consider guidelines for evaluation of dementia in Canada. This review paper formed a background paper for their discussion of dementia diagnosis. These experts from across the country concluded that diagnosis of suspected dementia cases continued to rest on skilled clinical assessment. Mental status exam, preferably in some quantifiable form, has become an essential part of the assessment. Selected laboratory tests are advisable in all cases (CBC, TSH, electrolytes, calcium, and glucose), but the CCCD continued to advise that CT scanning was mandatory only in selected cases where clinical findings pointed to another possibility besides Alzheimer’s disease. The growing list of other diagnostic measures with potential usefulness in diagnosis of Alzheimer’s disease or dementia in general was reviewed, but the evidence was judged as insufficient to support routine use of these tests by physicians. As new treatments for Alzheimer’s disease become available, neurologists face new diagnostic challenges - differentiating Mild Cognitive Impairment, Frontotemporal dementias and Mixed dementias, and Lewy Body Dementia. Guidelines to aid in differential diagnosis are presented.

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“…With the exception of satellite cells in the extraocular muscles, there seem to be few progenitor cells with the ability to replace dead or damaged cells (McLoon, 2009). Functional deficits, such as reduced conduction capacity, alterations in neuromuscular transmissions, and loss of contractile force, occur in a variety of somatic muscles once the age-related cellular atrophy has reached a critical level (Jenkyn et al, 1985;Kokmen, Bossemeyer, Barney, & Williams, 1977;Loeser & Delbono, 2009). Although extraocular muscles have a different embryologic origin than most of their somatic counterparts, they seem to undergo many of the same changes (Clark & Demer, 2002;Scelsi, Scelsi, & Poggi, 2002).…”

Section: Introductionmentioning

confidence: 99%

The Oculomotor Systems Ability to Adapt to Structural Changes Caused by the Process of Senescence: A Review

Bruenech

Haugen

Bak³

et al. 2012

Scand J Optom Vis Sci

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Age-related binocular vision anomalies are frequently encountered during clinical examination of mature patients. Observations of both concomitant and incomitant restrictions in eye motility indicate that all oculomotor system levels are implicated, from cortical neurons down to extraocular muscles. The system can make adaptations in response to changes induced by growth and ageing, which it does by monitoring and adjusting its own performance. This adaptive mechanism, which is important for maintaining motility, spatial orientation, and perceptual stability, seems to rely on extra-retinal information about eye position in relation to the head and trunk. Receptors in the extraocular muscles and the vestibular system, assumed to contribute to this type of information, also undergo age-related changes. This may compromise their ability to assist in the adaptive process and in potential calibrations of other neural systems. Furthermore, recent observations of a dual, common, final pathway and double insertions of distal extraocular muscles suggest that muscle and tendon receptors may facilitate other, still unresolved, functions in the visual system. Consequently, age-related changes in certain mechanoreceptors may have more severe implications for ocular motility and visual functions than previously assumed.This review aims to detail some of the most frequent neurogenic and myogenic age-related changes that take place in the human oculomotor system and relevant pre-motor structures. It will also address clinical implications of these changes and the potential adaptive mechanism they initiate.

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Neurologic Signs in Senescence

Cited by 89 publications

References 19 publications

Primitive reflexes and cognitive function

Primitive reflexes and cognitive function

Assessment of Suspected Dementia

The Oculomotor Systems Ability to Adapt to Structural Changes Caused by the Process of Senescence: A Review

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