Jeff Bagust

Midlumbar lateral flexion stability measured in healthy volunteers by in vivo fluoroscopy.

Study Design. Prospective fluoroscopic and electromyographic study of coronal plane lumbar spine motion in healthy male volunteers. Objectives. Assess the intervertebral motion profiles in healthy volunteers for symmetry, regularity, and neutral zone laxity during passive recumbent lateral bending motion. Summary of Background Data. Previous continuous in vivo motion studies of the lumbar spine have mainly been limited to active, weight-bearing, flexion-extension (sagittal plane) motion. No data are available for passive lateral bending or to indicate the motion profiles when muscle activity is minimized. Methods. Thirty asymptomatic male volunteers underwent video-fluoroscopy of their lumbar spines during passive, recumbent lumbar lateral bending through 80° using a motor-driven motion table. Approximately 120 consecutive images of segments L2–L5 were captured, and the position of each vertebra was tracked throughout the sequence using automated frame-to-frame registration. Reference intervals for intervertebral motion parameters were calculated. Surface electromyography recordings of erector spinae were obtained in a similar group of volunteers using the same protocol without fluoroscopy to determine to what extent the motion was completely passive. Results. Correlations between intervertebral and lumbar motion were always positive in controls and asymmetry was less than 55% of intervertebral range. The upper reference interval for the slope of intervertebral rotation in the first 10° of trunk motion did not exceed 0.46 for any level. Muscle electrical activity during the motion was very low. Examples from patient studies showed markedly different results. Conclusion. These results suggest that reference limits from asymptomatic data for coronal plane passive recumbent intervertebral motion may be a useful resource for investigating the relationship between symptoms of chronic (nonspecific) low back pain and biomechanics and in the clinical assessment of patients and interventions that target the passive holding elements of the spine. Data pooling from multiple studies would be necessary to establish a complete database.

Changes in Rod and Frame Test Scores Recorded in Schoolchildren during Development – A Longitudinal Study

The Rod and Frame Test has been used to assess the degree to which subjects rely on the visual frame of reference to perceive vertical (visual field dependence- independence perceptual style). Early investigations found children exhibited a wide range of alignment errors, which reduced as they matured. These studies used a mechanical Rod and Frame system, and presented only mean values of grouped data. The current study also considered changes in individual performance. Changes in rod alignment accuracy in 419 school children were measured using a computer-based Rod and Frame test. Each child was tested at school Grade 2 and retested in Grades 4 and 6. The results confirmed that children displayed a wide range of alignment errors, which decreased with age but did not reach the expected adult values. Although most children showed a decrease in frame dependency over the 4 years of the study, almost 20% had increased alignment errors suggesting that they were becoming more frame-dependent. Plots of individual variation (SD) against mean error allowed the sample to be divided into 4 groups; the majority with small errors and SDs; a group with small SDs, but alignments clustering around the frame angle of 18°; a group showing large errors in the opposite direction to the frame tilt; and a small number with large SDs whose alignment appeared to be random. The errors in the last 3 groups could largely be explained by alignment of the rod to different aspects of the frame. At corresponding ages females exhibited larger alignment errors than males although this did not reach statistical significance. This study confirms that children rely more heavily on the visual frame of reference for processing spatial orientation cues. Most become less frame-dependent as they mature, but there are considerable individual differences.

Perception of subjective visual vertical and horizontal in patients with chronic neck pain: A cross-sectional observational study

Previous studies have shown that chronic neck pain (CNP) patients have a larger spread of perceptual errors for subjective visual vertical (SVV) than those exhibited by asymptomatic controls. The current study investigated whether this was also the case for perception of subjective visual horizontal (SVH) and whether there was a correlation between the two measurements. Fifty patients with CNP were compared with a group of 50 age- and gender-matched controls. All subjects were required to complete a test to measure SVH as well as SVV using the computerised rod and frame (CRAF) test. These tests were conducted under various frame conditions. No difference was found between the errors of the CNP and control groups in the absence of a surrounding frame. When a tilted frame was added to the CRAF test, the range of errors observed in the CNP group increased for both SVV and SVH. In particular, significantly more CNP patients fell outside the reference range of errors and a subgroup of patients, characterised by higher neck pain disability indices, was identified who demonstrated higher than expected errors for both SVV and SVH. However no conclusion could be drawn with regards to the direction of error asymmetry and laterality of pain as those patients with unilateral pain exhibited errors both towards and away from the affected area.

Subjective visual vertical perception and sense of smell in Parkinson disease

This article describes an open cross-sectional observational study involving 47 participants with Parkinson disease (PD) and 47 (age- and sex-matched) nondisabled controls without PD. The aim was to determine the profiles of subjective visual vertical (SVV) perception and sense of smell perception in both groups. There was a statistically significant difference (p < 0.001) between patients and controls on their smell test performance. Controls were more likely to correctly identify odors, with a median score of 10 out of 12 compared with 6.5 out of 12 for patients with PD. The median SVV error for the PD group when the frame was untilted was 0.75 degrees compared with 0.50 degrees for controls. This difference was statistically significant (p = 0.02). When the frame was tilted, the median SVV error for the PD group was 2.31 degrees compared with 2.00 degrees for controls (not statistically significant), with both groups showing similar distribution pattern of errors. There was no statistical correlation between number of correctly identified odors and an individuals SVV error. However, a statistically significant negative correlation (r = -0.45, p = 0.01) was found between Mini-Mental State Examination score and mean time taken to complete each rod and frame test in patients with PD, suggesting that SVV errors might be more correlated with cognitive function than with loss of sense of smell.

The “Rod and Fran Test”: Relationship Priming Influences Cognitive-Perceptual Performance

We theorized that interpersonal relationships can provide structures for experience. In particular, we tested whether primes of same-sex versus mixed-sex relationships could foster cognitive-perceptual processing styles known to be associated with independence versus interdependence respectively. Seventy-two participants visualized either a same-sex or other-sex relationship partner and then performed two measures of cognitive-perceptual style. On a computerized Rod and Frame Test, individuals were more field-dependent after visualizing a mixed-sex versus same-sex relationship partner. On a measure involving perceptions of group behavior, participants demonstrated more holistic/contextually based perception after being primed with a female versus male relationship partner. These findings support the hypothesis that activated cognitive structures representing interpersonal relationships can shape individuals’ cognitive-perceptual performance.

Effects of nociceptin and analogues of nociceptin upon spontaneous dorsal root activity recorded from an in vitro preparation of rat spinal cord.

The 17 amino acid peptide nociceptin has been implicated in pain modulation in the central nervous system. The effects of bath applied nociceptin, and some analogues of nociceptin, upon spontaneous lumbar dorsal root activity have been investigated in an isolated preparation of rat spinal cord. Nociceptin was found to reversibly depress spontaneous dorsal root activity at concentrations of 1.0 microM and 10.0 microM (IC50 2.0 microM), whereas acetyl-nociceptin at concentrations up to 10 microM had no detectable effect. Omission of the last four amino acids (nociceptin 1-13), increased the potency of the effect upon dorsal root activity by approximately 100-fold (IC50 30 nM), but activity was lost when only the first seven amino acids of the nociceptin molecule (nociceptin 1-7) were tested.

Differential effects of muscimol upon the firing frequency of large and small amplitude antidromic dorsal root action potentials in rat spinal cord in vitro

The effects of bath applied muscimol upon spontaneous and evoked antidromic activity recorded from lumbar dorsal roots was investigated in hemisected, isolated preparations of rat spinal cord. In magnesium free medium containing 0.1 microM 4-aminopyridine, bursts of high amplitude (up to 1 mV), dorsal root reflexes were recorded. These were blocked by low concentrations of muscimol (2-5 microM). Higher concentrations (5-20 microM) of muscimol caused a concentration-dependent increase in the frequency of small amplitude (<200 microV) spontaneous dorsal root action potentials. The possibility that the large and small amplitude extracellular action potentials reflect activity in large and small diameter dorsal root axons, and that these respond in different ways to the GABA(A) agonist muscimol, is discussed.

High-normal blood glucose levels may be associated with decreased spatial perception in young healthy adults

The negative effects of high normal glucose on cognitive function were previously reported in euglycemic individuals of middle age and the elderly population. This study aimed at examining the effect of baseline blood glucose levels on spatial ability, specifically verticality perception on the computerized rod and frame test (CRFT) in young healthy adults. 63 healthy male medical students (age range from 18–23 years), of whom 30 were non-fasting outside the month of Ramadan and 33 fasting during Ramadan of the year 2016, were recruited in order to create varying degrees of glycemia during which verticality perception was carried out. Baseline blood glucose reading was obtained prior to commencing the CRFT test. Blood glucose levels at the time of testing decreased as the duration between the last meal and testing increased. A blood glucose range of 62–117 mg/dl was achieved among participants for this study. Linear regression analysis showed that blood glucose level at testing correlated positively with all alignment spatial error parameters, indicating a probable reduction of spatial perception ability with higher blood glucose levels. These results are consistent with other cognitive studies in older healthy humans and emphasize the critical impact of early glucose dys-homeostasis on cognitive function. They also indicate that elevated blood glucose may affect cognitive functioning outside of the usual complications of diabetes.

Inspiratory conductance: an alternative index of the relationship between inspiratory effort and airflow with potential for clinical use.

Introduction and Objectives:  There is a need for a measure of airway status that is easier for patients to use. If airflow is briefly occluded at the onset of inspiration, the maximum rate of pressure fall, dP/dtmax can be measured. After the occlusion is released, the maximum rate of change of inspiratory airflow (dF/dtmax) can be measured and expressed as a ratio of dP/dtmax to generate an index of inspiratory conductance (IC). We explored the characteristics of IC as a preliminary step towards developing it as an easy‐to‐use alternative.

Effects of amino acid antagonists on spontaneous dorsal root activity and evoked dorsal horn field potentials in an isolated preparation of rat spinal cord.

Fast and slow dorsal horn field potentials and spontaneous dorsal root activity were recorded from 19–23-day-old rat isolated spinal cord preparations. The effects of GABA, glycine, and glutamate antagonists were tested on these recordings. CNQX, an AMPA/kainate antagonist, reduced all 3 components of the dorsal horn field potential whereas MK801, an NMDA ion channel antagonist, reduced the fast S2 component and the slow wave. Both reduced spontaneous dorsal root activity. NMDA antagonists, D-AP5, 7-chlorokynurenic acid and arcaine, and the metabotropic glutamate antagonists L-AP3 and ethylglutamic acid, while having little effect on the fast components of the field potential, all reduced the slow component. The GABA antagonist, bicuculline, and the glycine antagonist, strychnine, while having no effect on the fast S1 and slow components of the field potential, reduced both the fast S2 component of the field potential and spontaneous dorsal root activity. These results suggest that non-NMDA glutamate receptors are involved in low and high threshold transmission to dorsal horn neurones while NMDA and metabotropic glutamate receptors are primarily involved in high threshold transmission and both GABA and glycine have roles in the transmission or modulation of sensory information within the dorsal horn of the cord.