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The handle http://hdl.handle.net/1887/63240 holds various files of this Leiden University dissertation.

Author: Anguelova, G.V.

Title: Unravelling cossed wires : dysfunction in obstetric brachial plexus lesions in the light of intertwined effects of the peripheral and central nervous system

Issue Date: 2018-06-26

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Unravelling Crossed Wires

Dysfunction in obstetric brachial plexus lesions in the light of intertwined effects of the peripheral and central nervous system

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Unravelling Crossed Wires

Dysfunction in obstetric brachial plexus lesions in the light of intertwined effects of the peripheral and

central nervous system

Proefschrift

ter verkrijging van

de graad van Doctor aan de Universiteit Leiden, op gezag van Rector Magnificus prof.mr. C.J.J.M. Stolker,

volgens besluit van het College voor Promoties te verdedigen op dinsdag 26 juni 2018

klokke 16.15 uur door

Galia Valentinova Anguelova geboren te Sofia, Bulgarije

in 1986

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Promotoren:

Prof. dr. J.G. van Dijk Prof. dr. M.J.A. Malessy Leden promotiecommissie:

Prof. dr. P.C.W. Hogendoorn Prof. dr. T.P.M. Vliet Vlieland

Dr. ir. A.C. Schouten (Technische Universiteit Delft)

Prof. dr. ir. M.J.A.M. van Putten (Universiteit Twente en Medisch Spectrum Twente)

ISBN: 978-94-90858-59-9

Layout and printed by: drukkerij Mostert, Leiden Cover: G.V. Anguelova

© G.V. Anguelova

All rights reserved. No part of this book may be produced, stored in retrieval system, or transmitted in any form or by means, electronic, mechanical, photocopying or otherwise, without the prior permission of the author, or, when appropriate, of the publishers of the publication.

The research in this thesis was financially supported by the MD/PhD-track of the Leiden University Medical Centre.

Contents

Chapter 1 Introduction 7

Chapter 2 A cross-sectional study of hand sensation in adults with conservatively treated obstetric brachial plexus lesion

17 Chapter 3 Sensory deficit in conservatively treated neonatal

brachial Plexus Palsy Patients

35 Chapter 4 Extensive motor axonal misrouting after conservative

treatment of obstetric brachial plexus lesions 39 Chapter 5 Cocontraction in adults with obstetric brachial plexus

lesion

57 Chapter 6 Cocontraction measured with short-range stiffness

was higher in obstetric brachial plexus lesions patients compared to healthy subjects

73

Chapter 7 Impaired automatic arm movements in obstetric brachial plexus palsy suggest a central disorder

93 Chapter 8 Increased brain activation during motor imagery suggests

central abnormality in neonatal brachial plexus palsy

107

Chapter 9 Discussion and summary 129

Summary in Dutch (Nederlandse samenvatting) 141

List of publications 142

Curriculum vitae 143

Referenties

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Bij volwassenen leidde OPBL tot een hogere corticale activiteit tijdens imaginaire flexie van de aangedane elleboog, maar niet tijdens daadwerkelijke flexie, wat wijst op