Impairments of upper limb function can negatively impact an individual???s ability to carry out everyday tasks. Children with cerebral palsy can have limitations of upper limb movement due to physiological and structural changes in their body. Current treatment regimes for children with upper limb involvement of cerebral palsy are assessed using a variety of qualitative assessment tools. These measures rely on subjective input from the assessor, and can be insensitive to significant functional improvements. Research methods in upper limb motion analysis are developing towards use as clinical tools. To date, there is a paucity of knowledge on the quantitative measures of range of motion (ROM) and function of upper limbs in healthy children. There is also lack of agreement on repeatable functional tasks of the upper limb for 3D measurement. The identification of a repeatable task in healthy children would facilitate the use of upper limb 3D motion analysis to guide clinical practice and improve patient outcomes. This thesis aims to describe upper limb joint range of movement in each degree of freedom and present normative three dimensional kinematic data of upper limb movement in healthy children during a repeatable upper limb functional task. This will provide a basis for comparison to children with movement disorders for future research and clinical practice. The UNSW kinematic upper limb model was found to successfully measure three dimensional upper limb anatomical and functional movements in healthy children. Normative kinematic data are reported for anatomical movements and two functional tasks. The results of the studies undertaken showed that differences in dominant and non-dominant limbs were present during anatomical and functional movements. Joint angles measured were found to be repeatable in healthy children. The results suggest that methods used were reliable for investigating upper limb kinematics. Functional movement time-series data were found to be repeatable for the group with the exception of wrist flexion/extension during the hand to mouth movement for both the dominant and non-dominant limbs. These findings improve current knowledge on upper limb kinematics in healthy children. This knowledge can assist the investigation of movement disorders in children to facilitate clinical decision making.

Impairments of upper limb function can negatively impact an individual???s ability to carry out everyday tasks. Children with cerebral palsy can have limitations of upper limb movement due to physiological and structural changes in their body. Current treatment regimes for children with upper limb involvement of cerebral palsy are assessed using a variety of qualitative assessment tools. These measures rely on subjective input from the assessor, and can be insensitive to significant functional improvements. Research methods in upper limb motion analysis are developing towards use as clinical tools. To date, there is a paucity of knowledge on the quantitative measures of range of motion (ROM) and function of upper limbs in healthy children. There is also lack of agreement on repeatable functional tasks of the upper limb for 3D measurement. The identification of a repeatable task in healthy children would facilitate the use of upper limb 3D motion analysis to guide clinical practice and improve patient outcomes. This thesis aims to describe upper limb joint range of movement in each degree of freedom and present normative three dimensional kinematic data of upper limb movement in healthy children during a repeatable upper limb functional task. This will provide a basis for comparison to children with movement disorders for future research and clinical practice. The UNSW kinematic upper limb model was found to successfully measure three dimensional upper limb anatomical and functional movements in healthy children. Normative kinematic data are reported for anatomical movements and two functional tasks. The results of the studies undertaken showed that differences in dominant and non-dominant limbs were present during anatomical and functional movements. Joint angles measured were found to be repeatable in healthy children. The results suggest that methods used were reliable for investigating upper limb kinematics. Functional movement time-series data were found to be repeatable for the group with the exception of wrist flexion/extension during the hand to mouth movement for both the dominant and non-dominant limbs. These findings improve current knowledge on upper limb kinematics in healthy children. This knowledge can assist the investigation of movement disorders in children to facilitate clinical decision making.

Impairments of upper limb function can negatively impact an individual???s ability to carry out everyday tasks. Children with cerebral palsy can have limitations of upper limb movement due to physiological and structural changes in their body. Current treatment regimes for children with upper limb involvement of cerebral palsy are assessed using a variety of qualitative assessment tools. These measures rely on subjective input from the assessor, and can be insensitive to significant functional improvements. Research methods in upper limb motion analysis are developing towards use as clinical tools. To date, there is a paucity of knowledge on the quantitative measures of range of motion (ROM) and function of upper limbs in healthy children. There is also lack of agreement on repeatable functional tasks of the upper limb for 3D measurement. The identification of a repeatable task in healthy children would facilitate the use of upper limb 3D motion analysis to guide clinical practice and improve patient outcomes. This thesis aims to describe upper limb joint range of movement in each degree of freedom and present normative three dimensional kinematic data of upper limb movement in healthy children during a repeatable upper limb functional task. This will provide a basis for comparison to children with movement disorders for future research and clinical practice. The UNSW kinematic upper limb model was found to successfully measure three dimensional upper limb anatomical and functional movements in healthy children. Normative kinematic data are reported for anatomical movements and two functional tasks. The results of the studies undertaken showed that differences in dominant and non-dominant limbs were present during anatomical and functional movements. Joint angles measured were found to be repeatable in healthy children. The results suggest that methods used were reliable for investigating upper limb kinematics. Functional movement time-series data were found to be repeatable for the group with the exception of wrist flexion/extension during the hand to mouth movement for both the dominant and non-dominant limbs. These findings improve current knowledge on upper limb kinematics in healthy children. This knowledge can assist the investigation of movement disorders in children to facilitate clinical decision making.

Gilles de la Tourette syndrome (GTS) is a chronic neuropsychiatric disorder characterized by multiple motor and vocal tics, affecting approximately 1% of the population. The precise neuropathology of GTS has not yet been delineated, but current models implicate subcortical and cortical areas - the cortico-striato-thalamo-cortical (CSTC) circuit. The majority of studies in the literature have either dealt with GTS with comorbid conditions and/or children with GTS. As these factors are known to affect brain structure and function, it unknown what the neurobiological underpinnings of pure adult GTS are. The objective of this body of work was to use functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) to characterize differences in brain function and structure in pure adult GTS patients versus age- and sex-matched controls. I employed a series of three distinct analyses for this purpose, based upon current models of CSTC circuit-related dysfunction in GTS. In the first, GTS patients and control participants executed three finger-tapping paradigms that varied in both complexity and memory requirements. These finger-tapping tasks were modeled after previous studies that showed CSTC circuit-related activity in healthy individuals. Using a multivariate statistical technique to assess task-related patterns of activation across the whole brain, I found that, while there was much overlap in brain activation patterns between groups, sensorimotor cortical regions were differentially recruited by GTS patients compared to controls. In the second fMRI analysis, I measured low-frequency spontaneous fluctuations of the blood oxygen level dependent signal during rest, and found that GTS patients exhibited greater resting state functional connectivity with the left putamen compared to controls. In the final analysis, DTI was used to provide a whole-brain assessment of regional diffusion anisotropy in GTS patients and healthy volunteers and to investigate the fractional anisotropy in predetermined ROIs. This analysis found no differences between GTS patients and controls. Overall, my findings indicated that several CSTC-related regions shown to be atypical in GTS patients previously, are also atypical in pure adult GTS, and that sensorimotor cortical regions and the putamen may be regions of functional disturbance in pure adult GTS.

Parkinson’s disease (PD) and dystonia are movement disorders related to dysfunctions of basal ganglia (BG). Deep brain stimulation (DBS) of the subthalamic nucleus (STN) and internal globus pallidus (GPi) are treatments for PD and dystonia. Previous research indicated that abnormally elevated oscillatory activities at the theta (3-10 Hz) beta frequency bands (11-30 Hz) may be related to parkinsonian and dystonic motor symptoms but their precise roles are not well understood. Recently, DBS of the pedunculopontine nucleus region (PPNR) has been used to treat PD patients with postural and gait dysfunctions, but movement-related PPNR activities had not been explored. We aimed to investigate movement-related local field potentials (LFP) recorded from the BG and PPNR in PD and dystonia patients. We recorded STN LFP from PD patients and subsequently applied the intrinsic STN theta, beta, and gamma (31-100 Hz) frequencies through DBS to study their effects on PD motor signs. We also recorded movement-related PPNR LFP in PD patients and movement-related GPi activities in patients with primary dystonia. Finally, we simultaneously recorded movement-related activities from the GPi and the motor thalamus in a patient with secondary dystonia. We found that DBS at the dopamine-dependent and movement-related intrinsic STN gamma frequencies, were as effective as traditionally used high frequencies (130-185 Hz) in reducing PD motor signs, but theta and beta frequencies did not worsen motor symptoms. Voluntary movements modulated two discrete movement-related frequencies in the theta and beta bands in the PPNR and these two frequencies interacted with the sensorimotor and frontal cortices during movements. We showed that voluntary movements modulated beta and gamma frequencies in the GPi. A resting ~5-18 Hz coherence between the GPi bilaterally was attenuated during movements in patients, which may be related to dystonia because this 5-18Hz coherence was also present between the GPi and motor thalamus in the patient with secondary dystonia. Our findings indicated that intrinsic STN gamma frequency oscillations were likely prokinetic rhythms but theta and beta frequencies may not contribute to PD motor symptoms. Voluntary movements modulated theta and beta frequencies in the PPNR, which may explain why PPNR DBS uses lower frequencies than those of the BG. The 5-18 Hz oscillatory activities in the BG-thalamic circuit may be a feature of dystonia.

Parkinson’s disease (PD) and dystonia are movement disorders related to dysfunctions of basal ganglia (BG). Deep brain stimulation (DBS) of the subthalamic nucleus (STN) and internal globus pallidus (GPi) are treatments for PD and dystonia. Previous research indicated that abnormally elevated oscillatory activities at the theta (3-10 Hz) beta frequency bands (11-30 Hz) may be related to parkinsonian and dystonic motor symptoms but their precise roles are not well understood. Recently, DBS of the pedunculopontine nucleus region (PPNR) has been used to treat PD patients with postural and gait dysfunctions, but movement-related PPNR activities had not been explored. We aimed to investigate movement-related local field potentials (LFP) recorded from the BG and PPNR in PD and dystonia patients. We recorded STN LFP from PD patients and subsequently applied the intrinsic STN theta, beta, and gamma (31-100 Hz) frequencies through DBS to study their effects on PD motor signs. We also recorded movement-related PPNR LFP in PD patients and movement-related GPi activities in patients with primary dystonia. Finally, we simultaneously recorded movement-related activities from the GPi and the motor thalamus in a patient with secondary dystonia. We found that DBS at the dopamine-dependent and movement-related intrinsic STN gamma frequencies, were as effective as traditionally used high frequencies (130-185 Hz) in reducing PD motor signs, but theta and beta frequencies did not worsen motor symptoms. Voluntary movements modulated two discrete movement-related frequencies in the theta and beta bands in the PPNR and these two frequencies interacted with the sensorimotor and frontal cortices during movements. We showed that voluntary movements modulated beta and gamma frequencies in the GPi. A resting ~5-18 Hz coherence between the GPi bilaterally was attenuated during movements in patients, which may be related to dystonia because this 5-18Hz coherence was also present between the GPi and motor thalamus in the patient with secondary dystonia. Our findings indicated that intrinsic STN gamma frequency oscillations were likely prokinetic rhythms but theta and beta frequencies may not contribute to PD motor symptoms. Voluntary movements modulated theta and beta frequencies in the PPNR, which may explain why PPNR DBS uses lower frequencies than those of the BG. The 5-18 Hz oscillatory activities in the BG-thalamic circuit may be a feature of dystonia.

Gilles de la Tourette syndrome (GTS) is a chronic neuropsychiatric disorder characterized by multiple motor and vocal tics, affecting approximately 1% of the population. The precise neuropathology of GTS has not yet been delineated, but current models implicate subcortical and cortical areas - the cortico-striato-thalamo-cortical (CSTC) circuit. The majority of studies in the literature have either dealt with GTS with comorbid conditions and/or children with GTS. As these factors are known to affect brain structure and function, it unknown what the neurobiological underpinnings of pure adult GTS are. The objective of this body of work was to use functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) to characterize differences in brain function and structure in pure adult GTS patients versus age- and sex-matched controls. I employed a series of three distinct analyses for this purpose, based upon current models of CSTC circuit-related dysfunction in GTS. In the first, GTS patients and control participants executed three finger-tapping paradigms that varied in both complexity and memory requirements. These finger-tapping tasks were modeled after previous studies that showed CSTC circuit-related activity in healthy individuals. Using a multivariate statistical technique to assess task-related patterns of activation across the whole brain, I found that, while there was much overlap in brain activation patterns between groups, sensorimotor cortical regions were differentially recruited by GTS patients compared to controls. In the second fMRI analysis, I measured low-frequency spontaneous fluctuations of the blood oxygen level dependent signal during rest, and found that GTS patients exhibited greater resting state functional connectivity with the left putamen compared to controls. In the final analysis, DTI was used to provide a whole-brain assessment of regional diffusion anisotropy in GTS patients and healthy volunteers and to investigate the fractional anisotropy in predetermined ROIs. This analysis found no differences between GTS patients and controls. Overall, my findings indicated that several CSTC-related regions shown to be atypical in GTS patients previously, are also atypical in pure adult GTS, and that sensorimotor cortical regions and the putamen may be regions of functional disturbance in pure adult GTS.

No description available.

Impairments of upper limb function can negatively impact an individual???s ability to carry out everyday tasks. Children with cerebral palsy can have limitations of upper limb movement due to physiological and structural changes in their body. Current treatment regimes for children with upper limb involvement of cerebral palsy are assessed using a variety of qualitative assessment tools. These measures rely on subjective input from the assessor, and can be insensitive to significant functional improvements. Research methods in upper limb motion analysis are developing towards use as clinical tools. To date, there is a paucity of knowledge on the quantitative measures of range of motion (ROM) and function of upper limbs in healthy children. There is also lack of agreement on repeatable functional tasks of the upper limb for 3D measurement. The identification of a repeatable task in healthy children would facilitate the use of upper limb 3D motion analysis to guide clinical practice and improve patient outcomes. This thesis aims to describe upper limb joint range of movement in each degree of freedom and present normative three dimensional kinematic data of upper limb movement in healthy children during a repeatable upper limb functional task. This will provide a basis for comparison to children with movement disorders for future research and clinical practice. The UNSW kinematic upper limb model was found to successfully measure three dimensional upper limb anatomical and functional movements in healthy children. Normative kinematic data are reported for anatomical movements and two functional tasks. The results of the studies undertaken showed that differences in dominant and non-dominant limbs were present during anatomical and functional movements. Joint angles measured were found to be repeatable in healthy children. The results suggest that methods used were reliable for investigating upper limb kinematics. Functional movement time-series data were found to be repeatable for the group with the exception of wrist flexion/extension during the hand to mouth movement for both the dominant and non-dominant limbs. These findings improve current knowledge on upper limb kinematics in healthy children. This knowledge can assist the investigation of movement disorders in children to facilitate clinical decision making.

Impairments of upper limb function can negatively impact an individual???s ability to carry out everyday tasks. Children with cerebral palsy can have limitations of upper limb movement due to physiological and structural changes in their body. Current treatment regimes for children with upper limb involvement of cerebral palsy are assessed using a variety of qualitative assessment tools. These measures rely on subjective input from the assessor, and can be insensitive to significant functional improvements. Research methods in upper limb motion analysis are developing towards use as clinical tools. To date, there is a paucity of knowledge on the quantitative measures of range of motion (ROM) and function of upper limbs in healthy children. There is also lack of agreement on repeatable functional tasks of the upper limb for 3D measurement. The identification of a repeatable task in healthy children would facilitate the use of upper limb 3D motion analysis to guide clinical practice and improve patient outcomes. This thesis aims to describe upper limb joint range of movement in each degree of freedom and present normative three dimensional kinematic data of upper limb movement in healthy children during a repeatable upper limb functional task. This will provide a basis for comparison to children with movement disorders for future research and clinical practice. The UNSW kinematic upper limb model was found to successfully measure three dimensional upper limb anatomical and functional movements in healthy children. Normative kinematic data are reported for anatomical movements and two functional tasks. The results of the studies undertaken showed that differences in dominant and non-dominant limbs were present during anatomical and functional movements. Joint angles measured were found to be repeatable in healthy children. The results suggest that methods used were reliable for investigating upper limb kinematics. Functional movement time-series data were found to be repeatable for the group with the exception of wrist flexion/extension during the hand to mouth movement for both the dominant and non-dominant limbs. These findings improve current knowledge on upper limb kinematics in healthy children. This knowledge can assist the investigation of movement disorders in children to facilitate clinical decision making.