The double contrast pharyngogram by use of computed radiography (CR) has been found to be useful detection of asymptomatic swallowing dysfunction. By this radiographic technique, we examined swallowing function in 72 patients with chronic cerebrovascular disease which was clinically diagnosed as normal. Abnormal barium adhesion to the pharyngeal wall was observed in 56% of the patients and was found frequently in patients with disturbances of intelligence, emotion, higher cerebral function and/or articulation due to brain stem lesion or cortical lesion or both. After one year, six patients were found to have frequent choking during meals and three of them revealed obvious aspiration in videofluorography. The double contrast pharyngogram in those dysphagic patients had shown marked barium adhesion of the pharyngeal wall. Most of them were aged patients with old multiple cerebral infarction. Therefore, we must pay attention to swallowing function of the stroke patients with abnormal double contrast pharyngogram.

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A quantitative analysis system for the functions of voluntary movements in the upper limbs was developed to identify parameters for distinguishing the movement functions of normal subjects and patients with Parkinson's disease. This system consisted of a personal computer and a digitizer tablet, to test a reaction movement task and a repetitive straight line motion task with visual tracking. Analysis of the reaction movement task showed that execution time was longer in patients with Parkinson's disease than that in normal subjects. The deviation component of the repetitive straight line motion task, which is the error in the vertical orientation from the trajectory of the target, was greater in the patients than in the normal subjects. Whereas, the delay component of the repetitive straight line motion task, which is the error in time from the trajectory of the target, was no difference between the two groups. Patients with Parkinson's disease were unable to modify their movement velocity to adapt to a visual tracking task with variable speeds, and also had difficulty in the tracking task in the horizontal orientation, but not in the vertical orientation.

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To investigate the relationship between morphological plasticity of the spinal cord and neurological outcome after surgery for compressive lesions, we correlated the transverse area of the cervical spinal cord measured by transaxial magnetic resonance imaging (MRI) obtained during the early postoperative period (6 months) with neurological function. Measurements on MRI in 56 patients (35 men and 21 women; 32 cervical spondylosis, 14 ossification of the posterior longitudinal ligament and 10 herniated interverterbral disc) included evaluation of the cross-sectional area of the cervical cord at the level of decompression. In the patients whom the transverse area of the cord was equal to or less than 40mm² on preoperative MR images, expansion of the cervical cord during the early postoperative period correlated significantly with postoperative neurological status (p=0.009). Our results suggest that an increase in the cross-sectional area of the cervical cord, representing spinal cord morphological plasticity, is a significant factor in determining the neurological improvement following decompressive surgery.

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