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Robert E. Kingsley is the author of Interactive Atlas of the Human Brain ( avg rating, 1 rating, 0 reviews) and Concise Text of Neuroscience ( av. Get Instant Access to Concise Text Of Neuroscience (Periodicals) By Robert Kingsley #3a1b2c. EBOOK EPUB site PDF. Read Download. PDF [DOWNLOAD] Neuroanatomy: An Atlas of Structures, Sections, and Systems DOWNLOAD Concise Text of Neuroscience (Periodicals) Robert E. Kingsley.
With intact corticospinal tracts from the motor cortex, the lost response to cortical stimulation along with hyporeflexia appears consistent with more distal interruption, perhaps at the level of the spinal cord, caused by the loss of the SMA contribution to the corticospinal tract.
This observation has been difficult to reconcile with conceptions of the anatomico-functional relationship between the SMA, primary motor cortex, and the spinal cord.
In this article, we review historic explanation for the acute hyporeflexia of UMN injuries and propose a theory implicating corticospinal tracts originating outside of the primary motor cortex. We hypothesize that the SMA contributions to the motor system provide a net inhibitory influence on the spinal cord and acute compromise is a dominant effector of acute hypotonia and hyporeflexia. Clinical Insights Spinal shock offers the classically described paradigm of acute hypotonic plegia after CNS injury.
Over the last two centuries, the teaching that has persisted is that this hyporeflexia is caused by loss of excitatory background descending input to the spinal motor neurons and interneurons leading to a hyperpolarization Ashby et al.
However, lost descending tonic influence is also used to explain the increased excitability that is associated with delayed spinal cord injury Nielsen et al. Further, it is accepted that alpha motor neuron depression is not the sole source for reflex depression Hiersemenzel et al. Other contributory metabolic, humoral, and structural mechanisms have been proposed to explain the temporal evolution of spinal shock to eventual hypertonicity and hyperreflexia, but they fail to clearly explain the initial reflex response and have clouded our interpretation of UMN function Hiersemenzel et al.
Even focal and incomplete injuries to the spinal cord, in anterior spinal artery infarct, for example, are similarly associated with an initial flaccid weakness Suzuki et al. In a complementary manner, the reflex recovery after supplementary motor cortex resection occurs over days to weeks as is expected after acute spinal cord injury Dittuno and Ditunno, ; Krainik et al.
Spinal Reflex Arc A reflex conveys an afferent stimulus to an effector via an integration center, and a simple physiologic version is the monosynaptic arc that underlies the deep tendon reflex Figure 1. The responsiveness of the two neuron backbone is the result of an interplay between the local segmental inputs and descending influences. The context of reflex responsiveness is often key to interpreting their significance, and the physiology at play is not always evident.
UMN lesions are said to result in a net loss of inhibition that enhances tonic and phasic stretch reflex responses Brashear and Elovic, , however, this is not always clinically observed.
This figure illustrates the classically described spinal reflex arc and the historically described contradictory changes in output resulting from corticospinal tract injury. Arrows indicate the increased alpha motor neuron output as a result of injury to the corticospinal tract, despite the direct connection and stimulatory output from the motor cortex.
The extensive synaptic contributions to the monosynaptic tendon reflex complex are illustrated by exploring the afferent and efferent connectivity of the alpha motor neuron Figure 2. Supraspinal input includes the corticospinal tract, the rubrospinal tract, the vestibulospinal tract; and segmental and intersegmental input includes the interneuron pool and extensive sensory afferents Carpenter, ; Kingsley et al. There is a non-linearity to the input-output relationship of the motor neuronal pool, and the influence of some neuronal inputs may not be sufficient to independently achieve an excitation threshold but other neurons can facilitate Emmanuel Pierrot-Deseilligny, Conversely, the postsynaptic output following simultaneous stimulation by two input neurons can be less than that following stimulation by only one of the neurons, a phenomenon called occlusion.
As the interneurons play a large role in the ultimate response of the alpha motor neurons, afferent, and efferent contributions to this neuron pool may be consequential in the response to injury.
While the nature of these interactions is not entirely understood for all contributors, it is clear that alpha motor neuron stimulation and suppression is achieved via a complex and poorly quantified afferent pool that influences the central state of the cells. The suprasegmental descending fiber systems normally maintain the spinal motor neurons in a state of readiness Ropper et al.
Contemporary summary of the afferent pool of the alpha motor neuron. Significant contributions include those from the spinal interneuron pool whose inputs include the same projections received from the corticospinal tract.
Cortical Functions An opportunity to study the corticospinal tracts is offered by the study of discrete surgical lesions, focal stroke, cortical electrical stimulation, EEG, and functional imaging. The differences in function and response to insult between areas supplying corticospinal neurons support the concept of alternate functions and mechanisms of action beyond pure motor activation.
For example, the discrete functions of the precentral and postcentral gyri are relatively easily discernible with well-established principle roles of mediating primary motor and sensory functions, respectively Penfield and Rasmussen, ; Uematsu et al. Clinically illustrative is that pure sensory stroke is described after focal infarct to the postcentral gyrus Derouesne et al. Similarly, dedicated function of the primary motor cortex is supported by the dense and often irreversible focal motor deficit seen following even small focal insults Pikula, In short, except for the primary motor cortex, cortical areas contributing corticospinal tracts need not contribute essentially to motor neuron activation and are of ill-defined purpose in their capacity as efferents to the spinal cord.
Recognition of cortical inhibitory effects on motor function offers potential insights into connectivity that might participate in distal effects following injury. Evidence strongly supports an inhibitory function to the SMA with reciprocal activation of this area and the primary motor area. Ball et al. This concept of negative motor areas and inhibitory effects is well described Luders et al.
The SMA, pre-SMA, inferior frontal gyrus, and the medial frontal gyrus have been heavily implicated in the planning of actions and in the ability to stop an action in progress Sharp et al.
Functional imaging has further elucidated the relationship between regions recruited to achieve inhibitory control with premotor areas being integral Swann et al.
Brain death and some focal seizure syndromes may hint at further clinical insight into hypotonia and diminished reflexes when the primary physiology involves the CNS. While brain death can often be attributed to an isolated brain injury, the associated plegia is confidently attributed to supraspinal compromise but not to a more focal insult.
Brooks-Gunn Eds. New York: Garland.
Self-regulation of motivation through anticipatory and self-regulatory mechanisms. Dienstbier Ed. Lincoln: University of Nebraska Press. Social cognitive theory of moral thought and action. Gewirtz Eds. Hillsdale, NJ: Lawrence Erlbaum..
Social cognitive theory of self-regulation. Organizational Behavior and Human Decision Processes, 50, The changing icons in personality psychology. Cantor Ed. A social cognitive approach to the exercise of control over AIDS infection.
DiClemente Ed. Beverly Hills: Sage. Exercise of personal agency through the self-efficacy mechanism. Schwarzer Ed. Washington, D. Squire Ed. New York: Macmillan. On rectifying the comparative anatomy of perceived control.
Psychological aspects of prognostic judgments. Evans, D. Yatsu Eds. Self-efficacy mechanism in psychobiologic functioning. Social cognitive theory and social referencing. Feinman Ed.
New York: Plenum Press. London: Jessica Kingsley Publishers.
Perceived self-efficacy in cognitive development and functioning. Educational Psychologist, 28, Regulative function of perceived self-efficacy. Rumsey, C. Harris Eds.
Corsini Ed. New York: Wiley.
Ramachaudran Ed. New York: Academic Press. Reprinted in H. Friedman [Ed. San Diego: Academic Press, Social cognitive theory and exercise of control over HIV infection. Peterson Eds. New York: Plenum. Zillman Eds. Comments on the crusade against the causal efficacy of human thought , Journal of Behavior Therapy and Experimental Psychiatry, 26, Exercise of personal and collective efficacy in changing societies.
Bandura Ed. New York: Cambridge University Press. Hewstone Eds. Oxford: Blackwell. On rectifying conceptual ecumenism. Maddux Ed. Self-efficacy in changing societies. Social learning. Failures in self-regulation: Energy depletion or selective disengagement? Psychological Inquiry, 7, Ontological and epistemological terrains revisited , Journal of Behavior Therapy and Experimental Psychiatry, 27, A must read!!
Reflections on human agency.
Manthouli Eds. Belanger Eds. Novices and experienced practitioners alike will find it useful and easy to use—a clinical gem. He has studied Chinese healing arts for 30 years. David Twicken is a doctor of Oriental Medicine and has taught at Chinese medical schools for over twenty years.
He specializes in the Taoist Arts and has written a number of books on the subject. Twicken is internationally known for his work in the Taoist Arts.
He teaches year round at Acupuncture schools and in private classes. He is recognized internationally for his scholarly and clinical work and is a regular contributor to Acupuncture Today. In this unique book Dr. Twicken presents classic Chinese philosophical models that explain the relationships between philosophy, Chinese medical principles, acupuncture channels and the human body. Clear and systematic, the book is a potent resource for anyone involved in Chinese medicine.
In this book, Dr. David Twicken provides a comprehensive account of the Luo Mai, including detailed analyses of the classical and contemporary theories and clinical applications. The movements are graceful and easy to learn, and are based on the tenets of Chinese Medicine, working with the Zang Fu organs, the meridians, yin-yang, the Five Elements, and qi and blood.
The book provides step-by-step, fully-illustrated instruction for both standing and seated practice, learning tips and health benefits for each movement, and also a brief account on the origins and characteristics of the exercises.
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Ba Duan Jin: Eight-Section Qigong Exercises is an accessible, fully-illustrated guide to this particular qigong exercise, which has been shown to improve the respiratory, cardiovascular and immune systems. Based on the twelve traditional routines of Yi Jin Jing, the exercises covered in the book feature soft, extended, even movements that invigorate the limbs and internal organs.
In particular, practice of the Yi Jin Jing exercises improves flexibility, balance and muscular strength, and has a beneficial effect on the respiratory system. Discovered in the s alongside a wealth of classical texts, they are among the oldest and best preserved silk works in China, and provide a fascinating insight into the early history of qigong. Dating from the Han Dynasty, these easy-to-learn movements work with the flow of vital energy through the meridians and encourage connection between the external movements of the body and the internal activity of the mind.
He examines the psychology of meditation, showing what happens, both mentally and physically, when a person is in a meditation state.
Assessing Adverse Neural Tension in Athletes
Liu shows how the mastery of Rujing is a fundamental skill vital to the practice of Qigong, and presents a new type of Qigong exercise which takes the achievement of Rujing as its primary goal.
His scientific approach to meditation is a breakthrough in this area and will be of interest to practitioners of Qigong and related practices at any level, in addition to anyone with an academic interest in meditation. Explaining what Qi is, where it comes from, how we use it, and how we can cultivate it in order to achieve wholeness and balance, this much-needed book combines knowledge and practice to explore all aspects of Qi, including its modern, everyday implications.
Combining physical techniques with intellectual rigour to bring you to a place of grounded and relaxed creativity. The approach, rooted in the Michael Chekhov Technique, integrates ancient Qigong knowledge with somatic psychology and western actor training methods to identify the links between physical shape, emotion and feeling in performance.Atonic seizures have been localized to negative motor areas anterior to the supplementary motor area Luders et al.
In short, except for the primary motor cortex, cortical areas contributing corticospinal tracts need not contribute essentially to motor neuron activation and are of ill-defined purpose in their capacity as efferents to the spinal cord. Self-regulation of motivation and action through goal systems. Spinal Reflex Arc A reflex conveys an afferent stimulus to an effector via an integration center, and a simple physiologic version is the monosynaptic arc that underlies the deep tendon reflex Figure 1.
Significant contributions include those from the spinal interneuron pool whose inputs include the same projections received from the corticospinal tract.
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