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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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Sensory-based motor disorder shows motor output that is disorganized as a result of incorrect processing of sensory information affecting postural control challenges, resulting in postural disorder, or developmental coordination disorder.
The SBMD subtypes are:
1. Dyspraxia
2. Postural disorder
Symptoms may vary according to the disorder's type and subtype present. SPD can affect one sense or multiple senses. While many people can present one or two symptoms, sensory processing disorder has to have a clear functional impact on the person's life.
Sensory dysfunction disorder is a reported neurological disorder of information processing, characterized by difficulty in understanding and responding appropriately to sensory inputs. Sensory dysfunction disorder is not recognized by the American Medical Association. "Sensory processing (SP) difficulties have been reported in as many as 95% of children with autism, however, empirical research examining the existence of specific patterns of SP difficulties within this population is scarce."
The brain receives messages from the body's sensory systems, which informs the brain of what is going on around and to a person's body. If one or more of these systems become overstimulated, it may result in what is known as Sensory Dysfunction Disorder. An example of a response to overstimulation is expressed by A. Jean Ayres, in "Sensory Integration and the Child: Understanding Hidden Sensory Challenges". She writes, "When the flow of sensations is disorganized, life can be like a rush-hour traffic jam” (p. 289). The following sensory systems are broken down into individual categories to better understand the impact a sensitivity can have on an individual.
Auditory processing disorder (APD), also known as central auditory processing disorder (CAPD), is an umbrella term for a variety of disorders that affect the way the brain processes auditory information. Individuals with APD usually have normal structure and function of the outer, middle and inner ear (peripheral hearing). However, they cannot process the information they hear in the same way as others do, which leads to difficulties in recognizing and interpreting sounds, especially the sounds composing speech. It is thought that these difficulties arise from dysfunction in the central nervous system.
The American Academy of Audiology notes that APD is diagnosed by difficulties in one or more auditory processes known to reflect the function of the central auditory nervous system.
APD can affect both children and adults, although the actual prevalence is currently unknown. It has been suggested that males are twice as likely to be affected by the disorder as females, but there are no good epidemiological studies.
Whole body movement and motor coordination issues mean that major developmental targets including walking, running, climbing and jumping can be affected. The difficulties vary from person to person and can include the following:
- Poor timing
- Poor balance (sometimes even falling over in mid-step). Tripping over one's own feet is also common.
- Difficulty combining movements into a controlled sequence.
- Difficulty remembering the next movement in a sequence.
- Problems with spatial awareness, or proprioception.
- Trouble picking up and holding onto simple objects such as pencils, owing to poor muscle tone or proprioception.
- Clumsiness to the point of knocking things over and bumping into people accidentally.
- Difficulty in determining left from right.
- Cross-laterality, ambidexterity, and a shift in the preferred hand are also common in people with developmental coordination disorder.
- Problems with chewing foods.
Fine-motor problems can cause difficulty with a wide variety of other tasks such as using a knife and fork, fastening buttons and shoelaces, cooking, brushing one's teeth, styling one's hair, shaving, applying cosmetics, opening jars and packets, locking and unlocking doors, and doing housework.
Difficulties with fine motor co-ordination lead to problems with handwriting, which may be due to either ideational or ideo-motor difficulties.
Problems associated with this area may include:
- Learning basic movement patterns.
- Developing a desired writing speed.
- Establishing the correct pencil grip
- The acquisition of graphemes – e.g. the letters of the Latin alphabet, as well as numbers.
The tactile system is the sense of touch. Someone with Sensory Dysfunction Disorder may have symptoms of not being able to process any form of physical connection. Conversely, a person may need to have some sort of physical connection to soothe an anxiety he or she is experiencing.
CAPD can continue into adulthood. Cooper and Gates (1991) estimated the prevalence of adult APD to be 10 to 20%. Many people experience problems with learning and day-to-day tasks with difficulties over time. Adults with this disorder
- talk louder than necessary
- have trouble remembering a list or sequence
- often need words or sentences repeated
- have poor ability to memorize information learned by listening
- interpret words too literally
- need assistance hearing clearly in noisy environments
- rely on accommodation and modification strategies
- find or request a quiet work space away from others
- request written material when attending oral presentations
- ask for directions to be given one step at a time
There are two types of Apraxia. Developmental (or Childhood Apraxia of speech) or acquired Apraxia. Childhood apraxia of speech (CAS) is a neurological childhood speech sound disorder that involves impaired precision and consistency of movements required for speech production without any neuromuscular deficits (ASHA, 2007a, Definitions of CAS section, para. 1). Both are the inability to plan volitional motor movements for speech production in the absence of muscular weakness. Apraxia is not a result of sensory problems, or physical issues with the articulatory structures themselves, simply the way the brain plans to move them.
Dysarthria is the reduced ability to motor plan volitional movements needed for speech production as the result of weakness/paresis and/or paralysis of the musculature of the oral mechanism needed for respiration, phonation, resonance, articulation, and/or prosody.
Patients with autotopagnosia exhibit an inability to locate parts of their own body, the body of an examiner’s, or the parts of a representation of a human body. Deficiencies can be in localizing parts of a certain area of the body, or the entire body.
Some patients demonstrating the symptoms of autotopagnosia have a decreased ability to locate parts of other multipart object. Patients are considered to suffer from “pure” autotopagnosia, however, if their deficiency is specific to body part localization. Patients suffering from “pure” autotopagnosia often have no problems carrying out tasks involved in everyday life that require body part awareness. Patients have difficulty locating body parts when directly asked, but can carry out activities such as putting on pants without difficulty. Patients can describe the function and appearance of body parts, yet they are still unable to locate them.
Damage to the left parietal lobe can result in what is called Gerstmann syndrome. It can include right-left confusion, a difficulty with writing Agraphia and a difficulty with mathematics Acalculia. In addition, it can also produce language deficiencies Aphasia and an inability to recognize objects normally Agnosia.
Other related disorders include:
- Apraxia: an inability to perform skilled movements despite understanding of the movements and intact sensory and motor systems.
- Finger agnosia: An inability to name the fingers, move a specific finger upon being asked, and/or recognize which finger has been touched when an examiner touches one.
Autotopagnosia from the Greek "a" and "gnosis," meaning "without knowledge", "topos" meaning "place", and "auto" meaning "oneself", autotopagnosia virtually translates to the "lack of knowledge about one's own space," and is clinically described as such.
Autotopagnosia is a form of agnosia, characterized by an inability to localize and orient different parts of the body. The psychoneurological disorder has also been referred to as "body-image agnosia" or "somatotopagnosia." "Somatotopagnosia" has been argued to be a better suited term to describe the condition. While autotopagnosia emphasizes the deficiencies in localizing only one's own body parts and orientation, "somatotopagnosia" also considers the inability to orient and recognize the body parts of others or representations of the body (e.g., manikins, diagrams).
Typically, the cause of autotopagnosia is a lesion found in the parietal lobe of the left hemisphere of the brain. However, it as also been noted that patients with generalized brain damage present with similar symptoms of autotopagnosia.
As a concept, autotopagnosia has been criticized as nonspecific; some claim that this is a manifestation of a greater symptomatic complex of anomia, marked by an inability to name things in general—not just parts of the human body.
Deficits in any area of information processing can manifest in a variety of specific learning disabilities. It is possible for an individual to have more than one of these difficulties. This is referred to as comorbidity or co-occurrence of learning disabilities. In the UK, the term "dual diagnosis" is often used to refer to co-occurrence of learning difficulties.
Witzelsucht (from the German "witzeln", meaning to joke or wisecrack, and "sucht", meaning addiction or yearning) is a set of rare neurological symptoms characterized by a tendency to make puns, or tell inappropriate jokes or pointless stories in socially inappropriate situations. A less common symptom is hypersexuality, the tendency to make sexual comments at inappropriate times or situations. Patients do not understand that their behavior is abnormal, therefore are nonresponsive to others' reactions. This disorder is most commonly seen in patients with frontal lobe damage, particularly right frontal lobe tumors or trauma. The disorder remains named in accordance with its reviewed definition by German neurologist Hermann Oppenheim; its first description as the less focused "Moria" ("stupidity"), by German neurologist Moritz Jastrowitz, was in 1888.
Due to similarity of symptoms of the disorder to the mannerisms of Batman's arch-rival Joker, it is sometimes known as 'The Joker Syndrome'
Dysmetria () refers to a lack of coordination of movement typified by the undershoot or overshoot of intended position with the hand, arm, leg, or eye. It is a type of ataxia. It is sometimes described as an inability to judge distance or scale.
Hypermetria and hypometria refer, respectively, to overshooting and undershooting the intended position.
Learning disabilities can be categorized by either the type of information processing affected by the disability or by the specific difficulties caused by a processing deficit.
In both case studies, patients showed an altered sense of humor, mostly in regard to producing and appreciating humor. The right hemisphere is involved with processing speed and problem solving, which plays a role in humor processing. These patients have difficulty fully interpreting a joke's content, but can recognize the importance of the form of a joke. Patients with witzelsucht often find non sequiturs, slapstick humor, and puns funniest since these forms of humor do not require integration of content across sentences. In other words, the end of the joke is not dependent on the first part; one does not need to make a logical connection to understand humor. Patients show no change in understanding simple logic, and understand the importance of surprise in humor (hence why they choose slapstick humor instead of the “correct” punch line); however, once they have registered this surprise, they cannot connect the punch line to the body of the joke to fully appreciate the true humor behind the joke. Successful jokes require a juxtaposition of the sound and the meaning of words used to understand the punch line. However, patients with witzelsucht have difficulty connecting the two, resulting in an inability to appreciate humor.
Additionally, patients show no emotional reaction to humor, whether produced by themselves or others. This lack of responsiveness is due to dissociation between their cognitive and affective responses to humorous stimuli. That is, even when a patient understands that a joke is funny (based on quantitative brain activity), they do not respond with laughter, or even a smile. While they have grasped the cognitive basis of humor, they do not affectively respond. This also considered a cognitive component of empathy, affecting ability to take the perspective of others; hence why patients often do not respond to humor produced by other people.
Associative visual agnosia is a form of visual agnosia. It is an impairment in recognition or assigning meaning to a stimulus that is accurately perceived and not associated with a generalized deficit in intelligence, memory, language or attention. The disorder appears to be very uncommon in a "pure" or uncomplicated form and is usually accompanied by other complex neuropsychological problems due to the nature of the etiology. Afflicted individuals can accurately distinguish the object, as demonstrated by the ability to draw a picture of it or categorize accurately, yet they are unable to identify the object, its features or its functions.
Agnosias are sensory modality specific, usually classified as visual, auditory, or tactile. Associative visual agnosia refers to a subtype of visual agnosia, which was labeled by Lissauer (1890), as an inability to connect the visual percept (mental representation of something being perceived through the senses) with its related semantic information stored in memory, such as, its name, use, and description. This is distinguished from the visual apperceptive form of visual agnosia, "apperceptive visual agnosia", which is an inability to produce a complete percept, and is associated with a failure in higher order perceptual processing where feature integration is impaired, though individual features can be distinguished. In reality, patients often fall between both distinctions, with some degree of perceptual disturbances exhibited in most cases, and in some cases, patients may be labeled as integrative agnostics when they fit the criteria for both forms. Associative visual agnosias are often category-specific, where recognition of particular categories of items are differentially impaired, which can affect selective classes of stimuli, larger generalized groups or multiple intersecting categories. For example, deficits in recognizing stimuli can be as specific as familiar human faces or as diffuse as living things or non-living things.
An agnosia that affects hearing, "auditory sound agnosia", is broken into subdivisions based on level of processing impaired, and a "semantic-associative" form is investigated within the auditory agnosias.
The actual cause of dysmetria is thought to be caused by lesions in the cerebellum or by lesions in the proprioceptive nerves that lead to the cerebellum that coordinate visual, spatial and other sensory information with motor control. Damage to the proprioceptive nerves does not allow the cerebellum to accurately judge where the hand, arm, leg, or eye should move. These lesions are often caused by strokes, multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), or tumors.
According to the research article cited above, motor control is a learning process that utilizes APPGs. Disruption of APPGs is possibly the cause of ataxia and dysmetria and upon identification of the motor primitives, clinicians may be able to isolate the specific areas responsible for the cerebellar problems.
There are two types of cerebellar disorders that produce dysmetria, specifically midline cerebellar syndromes and hemispheric cerebellar syndromes. Midline cerebellar syndromes can cause ocular dysmetria, which is a condition in which the pupils of the eye overshoot. Ocular dysmetria makes it difficult to focus vision onto one object. Hemispheric cerebellar syndromes cause dysmetria in the typical motor sense that many think of when hearing the term dysmetria.
A common motor syndrome that causes dysmetria is cerebellar motor syndrome, which also marked by impairments in gait (also known as ataxia), disordered eye movements, tremor, difficulty swallowing and poor articulation. As stated above, cerebellar cognitive affective syndrome (CCAS) also causes dysmetria.
Developmental disorders comprise a group of psychiatric conditions originating in childhood that involve serious impairment in different areas. There are several ways of using this term. The most narrow concept is used in the category "Specific Disorders of Psychological Development" in the ICD-10. These disorders comprise language disorders, learning disorders, motor disorders and autism spectrum disorders. In broader definitions ADHD is included, and the term used is neurodevelopmental disorders. Yet others include antisocial behavior and schizophrenia that begins in childhood and continues through life. However, these two latter conditions are not as stable as the other developmental disorders, and there is not the same evidence of a shared genetic liability.
Developmental disorders are present from early life. They usually improve as the child grows older, but they also entail impairments that continue through adult life. There is a strong genetic component, and more males are afflicted than females.
Neurological disorders can be categorized according to the primary location affected, the primary type of dysfunction involved, or the primary type of cause. The broadest division is between central nervous system disorders and peripheral nervous system disorders. The Merck Manual lists brain, spinal cord and nerve disorders in the following overlapping categories:
- Brain:
- Brain damage according to cerebral lobe "(see also 'lower' brain areas such as basal ganglia, cerebellum, brainstem)":
- Frontal lobe damage
- Parietal lobe damage
- Temporal lobe damage
- Occipital lobe damage
- Brain dysfunction according to type:
- Aphasia (language)
- Dysgraphia (writing)
- Dysarthria (speech)
- Apraxia (patterns or sequences of movements)
- Agnosia (identifying things or people)
- Amnesia (memory)
- Spinal cord disorders (see spinal pathology, injury, inflammation)
- Peripheral neuropathy and other Peripheral nervous system disorders
- Cranial nerve disorder such as Trigeminal neuralgia
- Autonomic nervous system disorders such as dysautonomia, Multiple System Atrophy
- Seizure disorders such as epilepsy
- Movement disorders of the central and peripheral nervous system such as Parkinson's disease, Essential tremor, Amyotrophic lateral sclerosis, Tourette's Syndrome, Multiple Sclerosis and various types of Peripheral Neuropathy
- Sleep disorders such as Narcolepsy
- Migraines and other types of Headache such as Cluster Headache and Tension Headache
- Lower back and neck pain (see Back pain)
- Central neuropathy (see Neuropathic pain)
- Neuropsychiatric illnesses (diseases and/or disorders with psychiatric features associated with known nervous system injury, underdevelopment, biochemical, anatomical, or electrical malfunction, and/or disease pathology e.g. Attention deficit hyperactivity disorder, Autism, Tourette's syndrome and some cases of obsessive compulsive disorder as well as the neurobehavioral associated symptoms of degeneratives of the nervous system such as Parkinson's disease, essential tremor, Huntington's disease, Alzheimer's disease, multiple sclerosis and organic psychosis.)
Many of the diseases and disorders listed above have neurosurgical treatments available (e.g. Tourette's Syndrome, Parkinson's disease, Essential tremor and Obsessive compulsive disorder).
- Delirium and dementia such as Alzheimer's disease
- Dizziness and vertigo
- Stupor and coma
- Head injury
- Stroke (CVA, cerebrovascular attack)
- Tumors of the nervous system (e.g. cancer)
- Multiple sclerosis and other demyelinating diseases
- Infections of the brain or spinal cord (including meningitis)
- Prion diseases (a type of infectious agent)
- Complex regional pain syndrome (a chronic pain condition)
Neurological disorders in non-human animals are treated by veterinarians.
Learning disabilities are diagnosed when the children are young and just beginning school. Most learning disabilities are found under the age of 9.
Young children with communication disorders may not speak at all, or may have a limited vocabulary for their age. Some children with communication disorders have difficulty understanding simple directions or are unable to name objects. Most children with communication disorders are able to speak by the time they enter school, however, they continue to have problems with communication. School-aged children often have problems understanding and formulating words. Teens may have more difficulty with understanding or expressing abstract ideas.
Diagnosis consists of a variety of tests, including but not limited to:
- Measurement of orthostatic blood pressure
- Coordination
- rapid, alternating movements
- stroking of heel from along the opposite shin from knee to ankle
- finger-to-nose testing.
- Primary sensory modalities are examined with the following methods, searching for focal sensory loss, graded distal sensory loss, or levels of decreased sensation, hyperesthesia or dysesthesia.
- light touch
- pin-prick
- temperature
- position
- vibration
- Focused gait examination, which examines stationary position and walking abnormalities. Walking generally exposes any faults within the complex neurological communication between systems as weight is shifted from one foot to the other.
Unlike ataxias of cerebellar origin, Bruns apraxia exhibits many frontal lobe ataxia characteristics, with some or all present.
- Difficulty in initiating movement
- Poor truncal mobility
- Falls due to minor balance disturbances
- Greatly hindered postural responses
- Characteristic magnetic gait, the inability to raise one's foot off of the floor.
- Wide base, poor balance control when in stance
- Short stride
- En bloc turns
Often patients with frontal lobe ataxia may experience minute cognitive changes that accompany the gait disturbances, such as frontal dementia and presentation of frontal release signs (Plantar reflex). Urinary incontinence may also be present.
Bruns apraxia can be distinguished from Parkinsonian ataxia and cerebellar ataxia in a number of ways. Patients typically afflicted with Parkinsonian ataxia typically have irregular arm swing, a symptom not typically present in frontal ataxia. Walking stride in cerebellar ataxia varies dramatically, accompanied by erratic foot placement and sudden, uncontrolled lurching, not generally characteristic of Bruns apraxia.