A test of the effort equalization hypothesis in children with cerebral palsy who have an asymmetric gait.

Healthy people can walk nearly effortlessly thanks to their instinctively adaptive gait patterns that tend to minimize metabolic energy consumption. However, the economy of gait is severely impaired in many neurological disorders such as stroke or cerebral palsy (CP). Moreover, self-selected asymmetry of impaired gait does not seem to unequivocally coincide with the minimal energy cost, suggesting the presence of other adaptive origins. Here, we used hemiparetic CP gait as a model to test the hypothesis that pathological asymmetric gait patterns are chosen to equalize the relative muscle efforts between the affected and unaffected limbs. We determined the relative muscle efforts for the ankle and knee extensors by relating extensor joint moments during gait to maximum moments obtained from all-out hopping reference test. During asymmetric CP gait, the unaffected limb generated greater ankle (1.36±0.15 vs 1.17±0.16 Nm/kg, p = 0.002) and knee (0.74±0.33 vs 0.44±0.19 Nm/kg, p = 0.007) extensor moments compared with the affected limb. Similarly, the maximum moment generation capacity was greater in the unaffected limb versus the affected limb (ankle extensors: 1.81±0.39 Nm/kg vs 1.51±0.34 Nm/kg, p = 0.033; knee extensors: 1.83±0.37 Nm/kg vs 1.34±0.38 Nm/kg, p = 0.021) in our force reference test. As a consequence, no differences were found in the relative efforts between unaffected and affected limb ankle extensors (77±12% vs 80±16%, p = 0.69) and knee extensors (41±17% vs 38±23%, p = 0.54). In conclusion, asymmetric CP gait resulted in similar relative muscle efforts between affected and unaffected limbs. The tendency for effort equalization may thus be an important driver of self-selected gait asymmetry patterns, and consequently advantageous for preventing fatigue of the weaker affected side musculature.

Alcohol impairs auditory processing of frequency changes and novel sounds: a combined MEG and EEG study.

RATIONALE: Alcohol has been shown to impair involuntary attention studied by event-related potentials using mismatch negativity (MMN) and P3a. OBJECTIVES: However, no studies have investigated whether alcohol affects the magnetic counterparts of N1 (N1m), MMN (MMNm) and P3a (P3am). METHODS: Auditory evoked potentials and magnetic fields elicited by infrequent deviant tones differing in frequency (5% and 20% change) and novel sounds were recorded with whole-head magnetoencephalography (MEG) and electroencephalography (EEG). Stimuli were presented separately to the left and right ear. Eleven right-handed subjects were studied in a double-blind, placebo-controlled (0.8 g/kg ethanol or juice), cross-over design. N1m, MMNm, and P3am were calculated from the channel pair at the temporal cortex showing the strongest responses in the hemisphere contralateral to the stimulation. N1, MMN and P3a were analyzed from 12 electrodes at the midline frontocentral area. RESULTS: Alcohol reduced bilaterally N1, N1m, MMN and MMNm amplitudes. P3a amplitudes, but not P3am amplitudes were also significantly decreased. No effects of alcohol on the latencies of N1, MMN and P3a or their magnetic counterparts were observed. CONCLUSIONS: Alcohol impairs the processing of tones, frequency change and novel sounds at different phases of auditory processing similarly in both hemispheres. MEG provides us with additional information unobtainable with EEG about the effects of alcohol on the neural correlates of cognition.