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Considering abnormal outgrowth of neurons also as a possible substrate underlying mirror movements, we studied 3 patients and 2 asymptomatic female gene carriers from a kindred with proven linkage to Xp22.3, using focal transcranial magnetic stimulation of motor cortex hand areas with a figure\u2010eight coil. In all 3 affected brothers, bilateral responses could be evoked almost simultaneously in their thenar muscles (slight latency differences were statistically insignificant). In contrast, the mother and the maternal aunt showed only unilateral, normal thenar responses, even with maximum tolerable stimulator output and high signal amplification. Correspondingly, mirror movements were present in the patients, but not in the gene carriers. Bilaterality of cortically evoked hand muscle responses and mirror movements, therefore, behaved as X\u2010chromosomal recessive traits. A likely cause might be a disorder of neuronal outgrowth in the motor system, particularly of inhibitory callosal fibers. For normal anatomical development of the motor system, one intact Xp22.3 gene seems necessary.<\/jats:p>","DOI":"10.1002\/ana.410310312","type":"journal-article","created":{"date-parts":[[2005,1,1]],"date-time":"2005-01-01T12:11:00Z","timestamp":1104581460000},"page":"299-304","source":"Crossref","is-referenced-by-count":62,"title":["Cortically evoked motor responses in patients with Xp22.3\u2010linked Kallmann's syndrome and in female gene 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