Paratonia and gegenhalten in childhood and senescence

Pauc, Robin; Young, Antoinette

doi:10.1016/j.clch.2011.08.001

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…Five studies [14,22,27,35,48] The results demonstrated short-term improvement in PROM after both SC and HT interventions (p = 0.028 to p < 0.001) and decreased upper limb muscle tone after the SC intervention (p = 0.028). However, upper limb muscle tone increased after the HT intervention (p = 0.032).…”

Section: Pathogenesis Central Nervous System (Cns)mentioning

confidence: 99%

Paratonia in Dementia: A Systematic Review

Drenth¹,

Zuidema

Bautmans

et al. 2020

JAD

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Background: Paratonia is a dementia-induced motor abnormality. Although paratonia affects virtually all people with dementia, it is not well known among clinicians and researchers. Objective: The aim of this study was to perform a systematic review of the literature on the definition, pathogenesis, diagnosis, and intervention of paratonia as well as to propose a research agenda for paratonia. Methods: In this systematic review, the Embase, PubMed, CINAHL, and Cochrane CENTRAL databases were searched for articles published prior to December 2019. Two independent reviewers performed data extraction and assessed the risk of bias of the studies. The following data were extracted: first author, year of publication, study design, study population, diagnosis, assessment, pathogenesis, therapy and interventions. Results: Thirty-five studies met the inclusion criteria and were included. Most studies included in the review mention clinical criteria for paratonia. Additionally, pathogenesis, method of assessment, diagnosis, and paratonia severity as are interventions to address paratonia are also discussed. Conclusion: This systematic review outlines what is currently known about paratonia, as well as discusses the preliminary research on the underlying mechanisms of paratonia. Although paratonia has obvious devastating impacts on health and quality of life, the amount of research to date has been limited. In the last decade, there appears to have been increased research on paratonia, which hopefully will increase the momentum to further advance the field.

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Section: Pathogenesis Central Nervous System (Cns)mentioning

confidence: 99%

Paratonia in Dementia: A Systematic Review

Drenth¹,

Zuidema

Bautmans

et al. 2020

JAD

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“…Like other primitive reflexes, paratonia probably occurs naturally in the newborn and persists in developmental delay and attention deficit disorders instead of disappearing as a consequence of brain development (Pauc and Young 2012). The reappearance of primitive reflexes is probably related to neural loss which may occur with aging and could be eventually related to the development of dementia (Pauc and Young 2012). Paratonia may be an early sign of cognitive impairment and electromyographic assessment could be not only more precise but perhaps could also be more sensitive for its detection compared to a simple clinical approach.…”

Section: Discussionmentioning

confidence: 99%

Electromyographic assessment of paratonia

et al. 2016

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Many years after its initial description, paratonia remains a poorly understood concept. It is described as the inability to relax muscles during muscle tone assessment with the subject involuntary facilitating or opposing the examiner. Although related to cognitive impairment and frontal lobe function, the underlying mechanisms have not been clarified. Moreover, criteria to distinguish oppositional paratonia from parkinsonian rigidity or spasticity are not yet available.Paratonia is very frequently encountered in clinical practice and only semi-quantitative rating scales are available. The purpose of this study is to assess the feasibility of a quantitative measure of paratonia using surface electromyography. Paratonia was elicited by performing consecutive metronome-synchronized continuous and discontinuous elbow movements in a group of paratonic patients with cognitive impairment. Goniometric and electromyographic recordings were performed on biceps and triceps brachii muscles. Facilitatory (mitgehen) and oppositional (gegenhalten) paratonia could be recorded on both muscles. After normalization with voluntary maximal contraction, biceps showed higher paratonia than triceps. Facilitatory paratonia was higher than oppositional on the biceps. Movement repetition induced increased paratonic burst amplitude only when flexion and extension movements were performed continuously. Both facilitatory and oppositional paratonia increased with movement repetition. Only oppositional paratonia increased following faster movements. This is the first study providing a quantitative and objective characterization of paratonia using electromyography. Unlike parkinsonian rigidity, oppositional paratonia increases with velocity and with consecutive movement repetition. Like spasticity, oppositional paratonia is velocity-dependent, but different from spasticity, it increases during movement repetition instead of decreasing. A quantitative measure of paratonia could help better understanding its pathophysiology and could be used for research purposes on cognitive impairment.

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“…Furthermore, paratonia is suggested to be, to some extent, a return of an infantile stabilization reflex mechanism which may parallel the great decline in motor performance. Patients acquire a form of hypertonia, an inability to relax muscles during muscle tone assessment with an involuntary variable resistance during passive movement 3 . At the end stages, progressively, all become bedridden, curl up and lying in an increasingly fetal alike position.…”

Section: Résumé Position Foetale Dans La Maladie D'alzheimer Un Remomentioning

confidence: 99%