RESUMEN

Camptocormia or Bent Spine Syndrome (BSS) is a symptom, often unknown, affecting elderly patients. Camptocormia is a dynamic anteflexion of the trunk occurring during physical exercises or in standing position and reducible in decubitus. It is caused by an impairment of the extensor muscles of the spinal column, either idiopathic or secondary to a muscular or a neurological disease. Its diagnosis is primarily anamnestic and clinical. The use of imaging could highlight a paraver tebral muscular fatty infi l tration with preserved volume in the case of idiopathic disorder and allows exclusion of osteoarticular pathologies. The treatment must be proposed as early as possible, before advanced adipose muscle evolution and significant anteflexion of the trunck. Symptomatic measures apply to primary and secondary forms and include physiotherapy, technical assistances to the walk and equipment by lordosis supporting corsets.

La camptocormie ou Bent Spine Syndrome (BSS) est un symptôme, souvent méconnu, touchant le patient âgé. La camptocormie est une antéflexion dynamique du tronc survenant à l'effort ou en position debout et est réductible en décubitus. Elle est causée par une atteinte des muscles extenseurs du rachis soit d'origine musculaire idiopathique ou secondai re, soit d'origine neurologique. Son diagnostic est essentiellement anamnestique et clinique. Le bilan par imagerie permet d'étudier la musculature paravertébrale et permet d'exclure les pathologies ostéoarticulaires. Le traitement étiologique ou symptomatique doit se faire précocement, avant que l'évolution adipeuse des muscles extenseurs et l'antéflexion soient trop importantes. Dans le traitement de la camptocormie, les mesures symptomatiques s'appl iquant aux formes primaires et secondaires associent de la kinésithérapie, des aides techniques à la marche et l'appareillage par des corsets lordosants.

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This review presents neuroimaging studies that have explored the cerebral substrates of executive functioning. These studies have demonstrated that different executive functions not only recruit various frontal areas but also depend upon posterior (mainly parietal) regions. These results are in accordance with the hypothesis that executive functioning relies on a distributed cerebral network that is not restricted to anterior cerebral areas. However, there exists an important heterogeneity in the cerebral areas associated with these different processes, and also between different tasks assessing the same process. Since these discrepant results could be due to the paradigms used (subtraction designs), recent results obtained with conjunction and interaction analyses are presented, which confirm the role of parietal areas in executive functioning and also demonstrate the existence of some specificity in the neural substrates of the executive processes of updating, shifting and inhibition. Finally, functional magnetic resonance imaging studies show that the activity in cerebral areas involved in executive tasks can be transient or sustained. Consequently, to better characterize the functional role of areas associated with executive functioning, it is important to take into account not only the localization of cerebral activity but also the temporal pattern of this activity.

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Height, weight, and skinfold thickness were measured on 82 patients prior to muscle biopsy which was performed to determine their susceptibility to malignant hyperpyrexia. Percentage body fat was calculated from the skinfold measurements. Using AP photographs six coronal diameters of the left thigh, equally spaced between the lower border of the patella and the perineum, were measured on another group of 90 patients referred for biopsy. The subjects were then divided into those who were susceptible to malignant hyperpyrexia (MHS) and those who were normal and acted as controls. Each group was separated into males and females. There was no significant difference in age between the MHS and the control groups. There was no difference between MHS and controls in height or weight but the percentage body fat in the MHS males was significantly lower than in the controls (P less than 0.02). The upper three thigh diameters in the MHS females were significantly greater than in the control group (P less than 0.05). There appears to be a difference in the leanness/fatness relationship and in the development of the thigh in MHS subjects compared with controls, but these differences are subtle and appear to vary with sex.

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