Lecture 28 - Biology of motor function/mobility

Question 1

what are the 2 causes of reduced mobility in older adults? give examples of each

Answer 1

specific disease/event due to stroke or fracture, multifactorial causes due to changes in cardio/pulmonary function, musculoskeletal system (sarcopenia, osteoarthritis) and CNS

Question 1

gait is the normal human movement walking pattern which is a complex integration of which two body systems?

Answer 1

musculoskeletal and nervous

Question 2

name the 5 types of feedback that the CNS makes to gait control

Answer 2

visual, vestibular, auditory, cutaneous, proprioceptive

Question 3

the planning of gait is related to which area in the brain?

Answer 3

frontal cortex

Question 4

the initiation/habitual aspect of gait is related to which group of neurons in the brain?

Answer 4

basal ganglia

Question 5

the coordination and adaptation of gait is related to which area in the brain?

Answer 5

cerebellum

Question 6

the spinal pattern and generation of gait is related to which part of the CNS?

Answer 6

spinal cord

Question 7

goal directed locomotor control is regulated in which area of the brain?

Answer 7

frontal cortex

Question 8

habitual locomotor control is regulated in which cortex of the brain?

Answer 8

sensorimotor cortex

Question 9

which 3 imaging techniques are used to measure brain activity during walking?

Answer 9

fNIRS, EEG, fMRI

Question 10

what does fNIRS measure in the brain during walking?

Answer 10

oxygenated and deoxygenated haemoglobin

Question 11

name the 7 CNS abnormalities in older adults which can contribute to mobility and cognitive decline

Answer 11

white matter hyperintensities, brain atrophy, small vessel disease, cerebral infarcts, lewy bodies, neuritic plaques, NFTs

Question 12

name 4 vascular/endocrine risk factors for gait impairment

Answer 12

atrial fibrillation, diabetes, hypertension, cerebral small vessel disease (microbleeds, lacunar infarcts, white matter lesions)

Question 13

which two parts of the brain provides cholinergic input to the thalamus, cerebellum, brainstem and spinal cord, affecting gait function?

Answer 13

pedunculopontine nucleus and nucleus basalis of meynert (NbM)

Question 14

the inhibition of which enzyme improves gait and can reduce falls in those with parkinson’s (cholinergic function)?

Answer 14

cholinesterase

Question 15

which drug that has effect on cholinergic and dopaminergic activity is a receptor antagonist which can improve gait? what is the receptor it is an antagonist for?

Answer 15

memantine, NMDA antagonist

Question 16

homocysteine is an amino acid intermediate formed during the metabolism of which amino acid?

Answer 16

methionine

Question 17

high homocysteine levels are linked to the risk of which 4 diseases?

Answer 17

peripheral vascular disease, cardiovascular disease, stroke and dementia

Question 18

what is the relationship between higher homocysteine levels and gait/mobility?

Answer 18

higher homocysteine = reduced gait speed and greater risk of mobility decline

Question 19

which gene, associated with alzheimer’s disease has an increased risk of gait speed decline and disability?

Answer 19

APOE E4

Question 20

which muscle fibre type is affected more in sarcopenia?

Answer 20

type 2