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Sensorimotor function and axonal integrity in adrenomyeloneuropathy.
[adrenomyeloneuropathy]
Gait
abnormalities
and
sensorimotor
disturbances
are
principal
defects
in
adrenomyeloneuropathy
(
AMN
)
.
However
,
to
our
knowledge
,
their
association
with
overall
impairment
and
neuroanatomical
changes
has
not
been
defined
.
To
understand
how
sensorimotor
impairments
create
mobility
deficits
and
to
analyze
how
these
impairments
are
related
to
specific
metrics
of
axonal
integrity
.
Cross-sectional
study
assessing
impairments
,
including
vibration
sensation
,
strength
,
spasticity
,
and
global
measures
of
walking
and
balance
.
Fractional
anisotropy
was
measured
to
evaluate
the
integrity
of
the
corresponding
brainstem
tracts
.
Men
with
AMN
and
healthy
control
subjects
.
Individuals
with
sensory
loss
only
showed
minimal
walking
deficits
.
Concomitant
strength
and
sensory
loss
resulted
in
slower
walking
,
with
abnormal
knee
control
;
increased
spasticity
led
to
an
exaggerated
trunk
motion
and
a
knee
-flexed
(
crouched
)
posture
.
Hip
strength
was
an
independent
predictor
of
walking
velocity
in
subjects
with
AMN
.
Subjects
with
sensory
loss
only
had
greater
sway
amplitudes
during
standing
balance
testing
,
which
did
not
worsen
with
additional
impairments
.
There
were
significant
associations
among
sway
amplitude
,
great
toe
vibration
sense
,
and
dorsal
column
fractional
anisotropy
.
Brainstem
fractional
anisotropy
in
AMN
was
significantly
negatively
correlated
with
impairment
,
indicating
that
overall
tract
integrity
is
associated
with
sensorimotor
abnormalities
in
AMN
.
Impairment
measures
capture
specific
abnormalities
in
walking
and
balance
that
can
be
used
to
direct
rehabilitation
therapy
in
AMN
.
Tract-
specific
magnetic
resonance
imaging
metrics
,
such
as
fractional
anisotropy
(
used
herein
to
evaluate
structure-function
relationships
)
,
significantly
reflect
disease
severity
in
AMN
.
Diseases
Validation
Diseases presenting
"a knee-flexed"
symptom
adrenomyeloneuropathy
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