The Equine Movement Disorder "Shivers" Is Associated With Selective Cerebellar Purkinje Cell Axonal Degeneration.

"Shivers" is a progressive equine movement disorder of unknown etiology. Clinically, horses with shivers show difficulty walking backward, assume hyperflexed limb postures, and have hind limb tremors during backward movement that resembles shivering. At least initially, forward movements are normal. Given that neither the neurophysiologic nor the pathologic mechanisms of the disease is known, nor has a neuroanatomic locus been identified, we undertook a detailed neuroanatomic and neuropathologic analysis of the complete sensorimotor system in horses with shivers and clinically normal control horses. No abnormalities were identified in the examined hind limb and forelimb skeletal muscles nor the associated peripheral nerves. Eosinophilic segmented axonal spheroids were a common lesion. Calretinin-positive axonal spheroids were present in many regions of the central nervous system, particularly the nucleus cuneatus lateralis; however, their numbers did not differ significantly from those of control horses. When compared to controls, calretinin-negative, calbindin-positive, and glutamic acid decarboxylase-positive spheroids were increased 80-fold in Purkinje cell axons within the deep cerebellar nuclei of horses with shivers. Unusual lamellar or membranous structures resembling marked myelin decompaction were present between myelin sheaths of presumed Purkinje cell axons in the deep cerebellar nuclei of shivers but not control horses. The immunohistochemical and ultrastructural characteristics of the lesions combined with their functional neuroanatomic distribution indicate, for the first time, that shivers is characterized by end-terminal neuroaxonal degeneration in the deep cerebellar nuclei, which results in context-specific hypermetria and myoclonus.

Location and restoration of function after cerebellar tumor removal-a longitudinal study of children and adolescents.

Sequelae in children following cerebellar tumor removal surgery are well defined, and predictors for poor recovery include lesions of the cerebellar nuclei and the inferior vermis. Dynamic reorganization is thought to promote functional recovery in particular within the first year after surgery. Yet, the time course and mechanisms of recovery within this critical time frame are elusive and longitudinal studies are missing. Thus, a group of children and adolescents (n = 12, range 6-17 years) were followed longitudinally after cerebellar surgery and compared to age- and gender-matched controls (n = 11). Patients were examined (1) within the first days, (2) 3 months, and (3) 1 year after surgery. Each time behavioral tests of balance and upper limb motor function, ataxia rating, and a MRI scan were performed. Data were used for subsequent lesion-symptom mapping of cerebellar function. Behavioral improvements continued beyond 3 months, but were not complete in all patients after 1 year. At that time, remaining deficits were mild. Within the first 3 months, cerebellar lesion volumes were notably reduced by vanishing edema. Reduction in edema affecting the deep cerebellar nuclei but not reduction of total cerebellar lesion volume was a major predictor of early functional recovery. Persistent impairment in balance and upper limb function was linked to permanent lesions of the inferior vermis and the deep cerebellar nuclei.

Lesion-symptom mapping of the human cerebellum.

High-resolution structural magnetic resonance imaging (MRI) has become a powerful tool in human cerebellar lesion studies. Structural MRI is helpful to analyse the localisation and extent of cerebellar lesions and to determine possible extracerebellar involvement. Functionally meaningful correlations between a cerebellar lesion site and behavioural data can be obtained both in subjects with degenerative as well as focal cerebellar disorders. In this review, examples are presented which demonstrate that MRI-based lesion-symptom mapping is helpful to study the function of cerebellar cortex and cerebellar nuclei. Behavioural measures were used which represent two main areas of cerebellar function, that is, motor coordination and motor learning. One example are correlations with clinical data which are in good accordance with the known functional compartmentalisation of the cerebellum in three sagittal zones: In patients with cerebellar cortical degeneration ataxia of stance and gait was correlated with atrophy of the medial (and intermediate) cerebellum, oculomotor disorders with the medial, dysarthria with the intermediate and limb ataxia with atrophy of the intermediate and lateral cerebellum. Similar findings were obtained in patients with focal lesions. In addition, in patients with acute focal lesions, a somatotopy in the superior cerebellar cortex was found which is in close relationship to animal data and functional MRI data in healthy control subjects. Finally, comparison of data in patients with acute and chronic focal lesions revealed that lesion site appears to be critical for motor recovery. Recovery after lesions to the nuclei of the cerebellum was less complete. Another example which extended knowledge about functional localisation within the cerebellum is classical conditioning of the eyeblink response, a simple form of motor learning. In healthy subjects, learning rate was related to the volume of the cortex of the posterior cerebellar lobe. In patients with focal cerebellar lesions, acquisition of eyeblink conditioning was significantly reduced in lesions including the cortex of the superior posterior lobe, but not the inferior posterior lobe. Disordered timing of conditioned eyeblink responses correlated with lesions of the anterior lobe. Findings are in good agreement with the animal literature. Different parts of the cerebellar cortex may be involved in acquisition and timing of conditioned eyeblink responses in humans. These examples demonstrate that MRI-based lesion-symptom mapping is helpful to study the contribution of functionally relevant cerebellar compartments in motor control and recovery in patients with cerebellar disease. In addition, information about the function of cerebellar cortex and nuclei can be gained.

Increased basal-ganglia activation performing a non-dystonia-related task in focal dystonia.

BACKGROUND AND PURPOSE: We tried to determine whether altered sensorimotor cortex and basal-ganglia activation in blepharospasm (BSP) and cervical dystonia (CD) are restricted to areas directly responsible for the innervation of dystonic muscles, or whether impairment in focal dystonia reaches beyond these direct associations supporting a more global disturbance of sensory and motor control in focal dystonia. METHODS: Twenty patients with focal dystonia (11 BSP, 9 CD) and 14 healthy controls were investigated with functional magnetic resonance imaging (fMRI) performing a simple grip force forearm contraction task. RESULTS: BSP and CD patients and healthy controls showed similar activation in the pre-motor, primary motor and primary sensory cortex, whilst basal-ganglia activation was increased in BSP and CD with related activation patterns compared with controls. BSP patients had increased activation in the thalamus, caudate nucleus, putamen and lateral globus pallidus, whilst CD patients showed increased activation in the caudate nucleus, putamen and thalamus. No differences in applied grip force were detected between groups. CONCLUSIONS: In both, BSP and CD, increased basal-ganglia activation could be demonstrated in a task not primarily involving the dystonic musculature affected by these disorders. Comparable activation changes may also indicate a common pathway in the pathophysiology in BSP and CD.

Abnormal locomotor muscle recruitment activity is present in horses with shivering and Purkinje cell distal axonopathy.

BACKGROUND: Cerebellar Purkinje cell axonal degeneration has been identified in horses with shivering but its relationship with abnormal hindlimb movement has not been elucidated. OBJECTIVES: To characterise surface electromyographic (sEMG) hindlimb muscle activity in horses with shivering, correlate with clinical scores and examine horses for Purkinje axonal degeneration. STUDY DESIGN: Descriptive controlled clinical study. METHODS: The hindlimb of seven shivering and six control draught horses were clinically scored. Biceps femoris (BF), vastus lateralis (VL), tensor fasciae latae and extensor digitorum longus were recorded via sEMG during forward/backward walking and trotting. Integrated (iEMG) and peak EMG activity were compared between groups and correlated with clinical locomotor exam scores. Sections of the deep cerebellar nuclei (DCN) of six of the seven shivering horses were examined with calbindin immunohistochemistry. RESULTS: In control horses, backward walking resembled forward walking (right hindlimb peak EMG: backward: 47.5 ± 21.9%, forward: 36.9 ± 15.7%) but displayed significantly higher amplitudes during trotting (76.1 ± 3.4%). However, in shivering horses, backward walking was significantly different from forward (backward: 88.5 ± 21.5%, forward: 49.2 ± 8.9%), and resembled activity during trotting (81.4 ± 4.8%). Specific to backward walking, mean sEMG amplitude fell outside two standard deviations of mean control sEMG for ≥25% of the stride in the BF for all seven and the VL for six of the seven shivering horses. Locomotor exam scores were correlated with peak EMG (r = 0.87) and iEMG (r = 0.87). Calbindin-positive spheroids were present in Purkinje axons in DCN of all shivering horses examined. MAIN LIMITATIONS: The neuropathological examination focused specifically on the DCN and, therefore, we cannot fully exclude additional lesions that may have influenced abnormal sEMG findings in shivering horses. CONCLUSION: Shivering is characterised by abnormally elevated muscle recruitment particularly in BF and VL muscles during backward walking and associated with selective Purkinje cell distal axonal degeneration.

Robot-assisted training to improve proprioception does benefit from added vibro-tactile feedback.

Proprioception is central for motor control and its role must also be taken into account when designing motor rehabilitation training protocols. This is particularly important when dealing with motor deficits due to proprioceptive impairment such as peripheral sensory neuropathy. In these cases substituting or augmenting diminished proprioceptive sensory information might be beneficial for improving motor function. However it still remains to be understood how proprioceptive senses can be improved by training, how this would translate into motor improvement and whether additional sensory modalities during motor training contribute to the sensorimotor training process. This preliminary study investigated how proprioceptive/haptic training can be augmented by providing additional sensory information in the form of vibro-tactile feedback. We tested the acuity of the wrist proprioceptive position sense before and after robotic training in two groups of healthy subjects, one trained only with haptic feedback and one with haptic and vibro-tactile feedback. We found that only the group receiving the multimodal feedback significantly improved proprioceptive acuity. This study demonstrates that non-proprioceptive position feedback derived from another somatosensory modality is easily interpretable for humans and can contribute to an increased precision of joint position. The clinical implications of this finding will be outlined.

Kinematics of goal-directed arm movements in neglect: control of hand in space.

The present study investigated unrestrained, three-dimensional arm movements during goal-directed pointing in five patients with clinically manifest neglect to targets positioned either in the center or the left and right hemispace. Five patients with unilateral right hemispheric lesions without neglect and six healthy subjects served as controls. All subjects were able to point to these targets. Terminal accuracy of pointing did not differ between the three groups along the horizontal, vertical and anterior-posterior axis. Subjects' hand trajectories did not reveal direction-specific deviations from a straightline hand path. Our data show that deviations in the trajectories toward the ipsilesional side are not characteristic for patients with spatial neglect. We argue that exploratory and goal-directed motor behavior might not share the same egocentric, body-centered reference frame. A spatial reference frame for exploratory behavior is disturbed in patients with neglect resulting in a failure to explore the contralesional part of space by eye or limb movements. Its failure does not induce a spatial bias in hand trajectory formation during goal-directed arm movements in peripersonal space. Such deviations of reaching or pointing rather seem to be characteristic for patients with optic ataxia.

Interaction of finger representation in the human first somatosensory cortex: a neuromagnetic study.

Neuromagnetic responses to separate tactile stimulation of digits I, II and V and simultaneous stimulation of digit pairs II and I, and II and V, were recorded in six healthy adult subjects using a 122-channel whole-head neuromagnetometer in order to investigate functional overlap of finger representations in primary somatosensory cortex (SI). Evoked responses to single digit stimulation were explained by time-varying equivalent current dipoles (ECDs) located in SI. These ECDs were then used to explain responses to stimulation of digit pairs. A cortical interaction ratio (IR) was defined as the vector sum of peak source amplitudes to separate stimulations of two fingers divided by the vector sum of source amplitudes to simultaneous stimulation of the two digits. Mean IR was significantly higher (P<0.05; Wilcoxon test) for digit pair II + I (1.69+/- 0.15) compared to digit pair II + V (1.14+/- 0.12). These results indicate that there is an overlap of finger representations in human SI which differs between anatomically adjacent and non-adjacent digit pairs.

Changing affordances in stair climbing: the perception of maximum climbability in young and older adults.

This experiment extended Warren's leg-length model by investigating the relevance of leg strength and joint flexibility on perceptual judgments of climbability. From a set of 8 stairs (riser heights: 38-91 cm), 24 older and 24 young adults were asked to identify the highest stair they could climb without using their hands or knees. Ss then attempted to climb the selected stair. Tall and short young observers perceived similar action boundaries despite leg-length differences. Tall and short older adults had divergent action boundaries when a single-scale leg-length model was applied. A regression model that used flexibility and leg-strength measurements provided a better fit of the older adult data, indicating that models applying functional (kinematic and kinetic) criteria might be useful in describing lawful relationships between organisms and the environment.

The temporal control of repetitive articulatory movements in Parkinson's disease.

Recent clinical data indicate that internal cueing mechanisms required for the triggering of movement sequences are impaired in Parkinson's disease (PD). Nevertheless, most PD subjects produce maximal syllable repetition rates similar to those observed in healthy control individuals during oral diadochokinesis tasks. There is some evidence that tremor oscillations may pace repetitive movements in Parkinsonians giving rise to hastening phenomena. Conceivably, the performance of PD patients in syllable repetition tasks thus reflects a specific timing deficit, i.e., articulatory hastening. It is the aim of the present study to investigate the contribution of speech hastening to oral diadochokinesis in the presence of internal and external cues. By means of an optoelectric movement analysis system, the displacements of the lips during repetitions of the syllable /pa/ were recorded in two akinetic-rigid PD individuals. Subjects were asked to synchronize labial diadochokinesis to sequences of periodic acoustic stimuli (2.5-6 Hz). One of the PD patients showed speech hastening, i.e., he produced repetitions of 8 to 9 Hz whenever stimulus frequencies exceeded 4 Hz. The other Parkinsonian adequately matched the stimulus frequencies required. However, she achieved a higher diadochokinesis rate in the matching task than under the instruction to repeat "as fast as possible." Thus, the presence of an external cue improved performance. In conclusion, our data indicate two deficits of the temporal control of repetitive articulatory gestures in PD: speech hastening and impaired self-paced sequencing. These two pathomechanisms may allow to reconcile the controversial findings on oral diadochokinesis in PD reported so far.

Effects of optic flow on the kinematics of human gait: a comparison of young and older adults.

This experiment studied the effect of imposed optic flow on human locomotion. Six young and 6 older adults were exposed to various patterns of optic flow while walking in a moving hallway. Results showed few cases of impaired postural control (staggers, parachute reactions). No falls were recorded. Kinematic patterns of gait were altered when vision was absent or inconsistent optic flow was presented: Ninety two percent of the subjects' mean step velocity differed from their step velocities under normal vision. Compared with imposed central flow, peripheral optic flow was not dominant in inducing kinematic changes. Characteristic gait profiles were obtained, depending on flow direction. Global backward flow tended to slow down step velocity, whereas subjects' step velocity increased during conditions of forward flow. The results suggest that subjects attempted to match their own walking speed to the velocity of the moving visual scenes. It is concluded that in an uncluttered environment, imposed optic flow has a modulating rather than a destabilizing effect on human locomotion.

Functional training: muscle structure, function, and performance in older women.

Response to physical training at the cellular and whole muscle level has been established in older adults. However, the underlying molecular mechanism responsible for change has not been described nor have the relationships between change in muscle structure and functional performance been established. The purpose of this research study is to evaluate the changes of muscle ultrastructure, muscle strength, and whole body functional performance as a result of a functionally directed exercise program (stair climbing). Women (65-83 years old) selected either the control (no exercise; N = 6) or exercise (N = 7) group. The 1-year functionally based exercise program was both aerobic (75% heart rate reserve) and resistive (weighted stair climbing). Muscle ultrastructure, determined by quantitative morphometry of the vastus lateralis tissue, and maximal step-height achieved by each subject were related to isokinetic strength and muscle morphology. Changes in myofibrillar area accounted for 48% of the variance in muscle strength changes. Change in muscle contractile protein was the underlying basis for change in thigh strength which, in turn, was the basis for functional performance. These data provide evidence that, in older women, a mild functionally based training program results in improved muscle structure and performance of the lower body.

Current advances in lesion-symptom mapping of the human cerebellum.

While high-resolution structural magnetic resonance imaging (MRI) combined with newer analysis methods has become a powerful tool in human cerebral lesion studies, comparatively few studies have used these advanced imaging techniques to study lesions of the human cerebellum and their associated symptoms. This review will summarize the methodology of MRI-based lesion-symptom mapping of the human cerebellum and discuss its potential for gaining insights into cerebellar function. The investigation of patients with defined focal lesions yields the greatest potential for obtaining meaningful correlations between lesion site and behavioral deficits. In smaller groups of patients overlay plots and subtraction analysis are good options. If larger groups of patients are available, different statistical techniques have been introduced to compare behavior and lesion site on a voxel-by-voxel basis. Although localization in degenerative cerebellar disorders is less accurate because of the diffuse nature of the disease, certain information about the supposed function of larger subdivisions of the cerebellum can be gained. Examples are given which show that lesion-symptom mapping allows to investigate the function of the intermediate zone and cerebellar nuclei. We conclude that meaningful correlations between lesion site and behavioral data can be obtained in patients with degenerative as well as focal cerebellar disorders.

Impact of surgery and adjuvant therapy on balance function in children and adolescents with cerebellar tumors.

OBJECTIVES: This study examined the effects of posterior fossa tumor surgery and concomitant irradiation and/or chemotherapy on the long-term recovery of balance function in children and adolescent patients. SUBJECTS AND METHODS: 22 patients, treated during childhood for a benign (n = 14) or malignant cerebellar tumor (n = 8), were examined in chronic state (mean latency between surgery and testing: 7.7 years, range 3 - 17 years). Postural impairments were assessed with static and dynamic posturography. All cerebellar lesions were documented by standardized and normalized MRI data. Healthy age- and gender-matched subjects served as a control group. RESULTS: Comparing the balance function of (i) children with or without affected cerebellar nuclei and (ii) children with and without adjuvant chemotherapy and/or radiotherapy revealed that damage to the cerebellar nuclei had more impact on neurological impairment than concomitant tumor therapy. Balance abnormalities were most pronounced when a lesion affected the fastigial nucleus. Chemotherapy with its neurological side effect was associated with enhanced postural sway in only two children with malignant tumors. CONCLUSIONS: The study results indicate that the sparing of the deep cerebellar nuclei had the greatest impact on the recovery of balance function in pediatric patients treated for both a benign or malignant cerebellar tumor.

The effect of subthalamic nucleus stimulation on kinaesthesia in Parkinson's disease.

BACKGROUND: Parkinson's disease is accompanied by deficits in passive motion and limb position sense. OBJECTIVE: To investigate whether deep brain stimulation of the subthalamic nucleus (STN-DBS) reverses these proprioceptive deficits. METHODS AND RESULTS: A passive movement task was applied to nine patients with Parkinson's disease and bilateral chronic STN-DBS and to seven controls. Thresholds for 75% correct responses were 0.9 degrees for controls, 2.5 degrees for Parkinson's disease patients when stimulation was OFF, and 2.0 degrees when stimulation was ON. CONCLUSIONS: STN-DBS improves kinaesthesic deficits in Parkinson's disease, but does not lead to a full recovery of proprioceptive function.

The development toward stereotypic arm kinematics during reaching in the first 3 years of life.

We recorded reaching movements from nine infants longitudinally from the onset of reaching (5th postnatal month) up to the age of 3 years. Here we analyze hand and proximal joint trajectories and examine the emerging temporal coordination between arm segments. The present investigation seeks (a) to determine when infants acquire consistent, adult-like patterns of multijoint coordination within that 3-year period, and (b) to relate their hand trajectory formation to underlying patterns of proximal joint motion (shoulder, elbow). Our results show: First, most kinematic parameters do not assume adult-like levels before the age of 2 years. At this time, 75% of the trials reveal a single peaked velocity profile of the hand. Between the 2nd and 3rd year of life, "improvements" of hand- or joint-related movement units are only marginal. Second, infant motor systems strive to obtain velocity patterns with as few force reversals as possible (uni- or bimodal) at all three limb segments. Third, the formation of a consistent interjoint synergy between shoulder and elbow motion is not achieved within the 1st year of life. Stable patterns of temporal coordination across arm segments begin to emerge at 12-15 months of age and continue to develop up to the 3rd year. In summary, the development toward adult forms of multijoint coordination in goal-directed reaching requires more time than previously assumed. Although infants reliably grasp for objects within their workspace 3-4 months after the onset of reaching, stereotypic kinematic motor patterns are not expressed before the 2nd year of life.

The development of goal-directed reaching in infants. II. Learning to produce task-adequate patterns of joint torque.

Nine young infants were followed longitudinally from 4 to 15 months of age. They performed multi-joint reaching movements to a stationary target presented at shoulder height. Time-position data of the hand, shoulder, and elbow were collected using an optoelectronic measurement system. In addition, we recorded electromyographic activity (EMG) from arm extensors and flexors. This paper documents how control problems of proximal torque generation may account for the segmented hand paths seen during early reaching. Our analysis revealed the following results: first, muscular impulse (integral of torque) increased significantly between the ages of 20 (reaching onset) and 64 weeks. That is, as infants got older they produced higher levels of mean muscular flexor torque during reaching. Data were normalized by body weight and movement time, so differences are not explained by anthropometric changes or systematic variations in movement time. Second, while adults produced solely flexor muscle torque to accomplish the task, infants generated flexor and extensor muscle torque at shoulder and elbow throughout a reach. At reaching onset more than half of the trials revealed this latter kinetic profile. Its frequency declined systematically as infants got older. Third, we examined the pattern of muscle coordination in those trials that exhibited elbow extensor muscle torque. We found that during elbow extension coactivation of flexor and extensor muscles was the predominant pattern in 67% of the trials. This pattern was notably absent in comparable adult reaching movements. Fourth, fluctuations in force generation, as measured by the rate of change of total torque (NET) and muscular torque (MUS), were more frequent in early reaching (20-28 weeks) than in the older cohort (52-64 weeks), indicating that muscular torque production became increasingly smoother and task-efficient. Our data demonstrate that young infants have problems in generating smooth profiles of proximal joint torques. One possible reason for this imprecision in infant force control is their inexperience in predicting the magnitude and direction of external forces. That infants learned to consider external forces is documented by their increasing reliance on these forces when performing voluntary elbow extensions. The patterns of muscle coordination underlying active elbow extensions were basically the same as during the prereaching phase, indicating that the formation of functional synergies is based on a basal repertoire of innervation patterns already observable in very early, spontaneous movements.

Coordination of multi-joint arm movements in cerebellar ataxia: analysis of hand and angular kinematics.

Kinematic abnormalities of fast multijoint movements in cerebellar ataxia include abnormally increased curvature of hand trajectories and an increased hand path and are thought to originate from an impairment in generating appropriate levels of muscle torques to support normal coordination between shoulder and elbow joints. Such a mechanism predicts that kinematic abnormalities are pronounced when fast movements are performed and large muscular torques are required. Experimental evidence that systematically explores the effects of increasing movement velocities on movement kinematics in cerebellar multijoint movements is limited and to some extent contradictory. We, therefore, investigated angular and hand kinematics of natural multijoint pointing movements in patients with cerebellar degenerative disorders and healthy controls. Subjects performed self-paced vertical pointing movements with their right arms at three different target velocities. Limb movements were recorded in three-dimensional space using a two-camera infrared tracking system. Differences between patients and healthy subjects were most prominent when the subjects performed fast movements. Peak hand acceleration and deceleration were similar to normals during slow and moderate velocity movements but were smaller for fast movements. While altering movement velocities had little or no effect on the length of the hand path and angular motion of elbow and shoulder joints in normal subjects, the patients exhibited overshooting motions (hypermetria) of the hand and at both joints as movement velocity increased. Hypermetria at one joint always accompanied hypermetria at the neighboring joint. Peak elbow angular deceleration was markedly delayed in patients compared with normals. Other temporal movement variables such as the relative timing of shoulder and elbow joint motion onsets were normal in patients. Kinematic abnormalities of multijoint arm movements in cerebellar ataxia include hypermetria at both the elbow and the shoulder joint and, as a consequence, irregular and enlarged paths of the hand, and they are marked with fast but not with slow movements. Our findings suggest that kinematic movement abnormalities that characterize cerebellar limb ataxia are related to an impairment in scaling movement variables such as joint acceleration and deceleration normally with movement speed. Most likely, increased hand paths and decomposition of movement during slow movements, as described earlier, result from compensatory mechanisms the patients may employ if maximum movement accuracy is required.

Kinematics of goal-directed arm movements in neglect: control of hand velocity.

Do patients with unilateral neglect exhibit direction-specific deficits in the control of movement velocity when performing goal-directed arm movements? Five patients with left-sided neglect performed unrestrained three-dimensional pointing movements to visual targets presented at body midline, the left and right hemispace. A group of healthy adults and a group of patients with right-hemispheric brain damage but no neglect served as controls. Pointing was performed under normal room light or in darkness. Time-position data of the hand were recorded with an opto-electronic camera system. We found that compared to healthy controls, movement times were longer in both patient groups due to prolonged acceleration and deceleration phases. Tangential peak hand velocity was lower in both patient groups, but not significantly different from controls. Single peak, bell-shaped velocity profiles of the hand were preserved in all right hemispheric patients and in three out of five neglect patients. Most important, the velocity profiles of neglect patients to leftward targets did not differ significantly from those to targets in the right hemispace. In summary, we found evidence for general bradykinesia in neglect patients, but not for a direction-specific deficit in the control of hand velocity. We conclude that visual neglect induces characteristic changes in exploratory behavior, but not in the kinematics of goal-directed movements to objects in peripersonal space.

The effect of the Ebbinghaus illusion on grasping behaviour of children.

Within the context of the Ebbinghaus illusion, adults regularly misjudge the physical size of a centre disc, yet scale their hand aperture according to its actual size. Separate visual pathways for perception and action are assumed to account for this finding. The dorsal visual stream is said to elaborate on egocentric (visuomotor), while the ventral stream is involved in allocentric transformations (object recognition). This study examines the ontogenetic development of this dissociation between perception and action in 35 children between the ages of 5 and 12 years. We report four major results. First, when children judged object size without grasping the disc, their judgements were deceived by the illusion to the same extent as adults. However, when asked to estimate size and then to grasp the disc, young children's (5-7 years) perceptual judgements became unreliable, while adults were still reliably deceived by the illusion in 80% of their trials. Second, the younger the children, the more their aperture was affected by the illusional surround. Discs of the same size were grasped with a smaller aperture when surrounded by a small annulus, although they were perceived as being larger. Third, young children used the largest safety margin during grasping. Fourth, the reliance on visual feedback decreased with increasing age, which was documented by shorter movement times and earlier maximum hand opening during grasping in the older children (feedforward control). Our results indicate that grasping behaviour in children is subject to an interaction between ventral and dorsal processes. Both pathways seem not to be functionally segregated in early and middle childhood. The data are inconclusive about whether young children predominantly use a specific visual stream for either a perceptual or motor task. However, our data demonstrate that children were relying on both visual processing streams during perceptual as well as visuomotor tasks. We found that children used egocentric cues to make perceptual judgements, while their grasping gestures were not exclusively shaped by viewer-centred but also by object-centred information.