Bringing order to higher order motor disorders

Journal of Neurology
Maja Kojović, Kailash P Bhatia

Abstract

Majority of movements in everyday situations are complex and involve volition, planning of the movement and selection of the motor programme, all occurring before movement execution. Higher order motor disorders may be defined as abnormal motor behaviours resulting from disruption of any of the cortical processes that precede execution of the motor act. They are common in patients with neurodegenerative disorders, psychiatric diseases and structural brain lesions. These abnormal behaviours may be overlooked in the clinic, unless specifically evoked by the examiner. We discuss clinical and pathophysiological aspects of higher order motor disorders including: (1) disorders of disinhibition, such as grasp reflex and grasping behaviour, utilisation and imitation behaviour, motor preservations and paratonia; (2) disorders of motor intention such as motor neglect and motor impersistence; (3) alien limb syndrome; and (4) motor overflow phenomena, such as mirror movements and synkinesias. A video illustration of each phenomenon is provided. We place the findings from recent neurophysiological studies within the framework of theories of motor control to provide better insight into pathophysiology of different disorders.

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Citations

Nov 30, 2019·Human Brain Mapping·Christoph SperberHans-Otto Karnath
Jul 18, 2020·Reviews in the Neurosciences·Tommaso SchirinziLuca Marsili
Apr 8, 2020·Movement Disorders Clinical Practice·Poornima Jayadev MenonShane Smyth
Dec 18, 2020·Movement Disorders : Official Journal of the Movement Disorder Society·Rok BerlotMaja Kojović
Apr 6, 2021·Movement Disorders Clinical Practice·Jacy Bezerra ParmeraRicardo Nitrini
May 1, 2021·Toxins·Jacky GangulyMandar Jog

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