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Restorative Neurology and Neuroscience

Danny Eizicovits, Yael Edan, Iris Tabak, Shelly Levy-Tzedek
BACKGROUND: Effective human-robot interactions in rehabilitation necessitates an understanding of how these should be tailored to the needs of the human. We report on a robotic system developed as a partner on a 3-D everyday task, using a gamified approach. OBJECTIVES: To: (1) design and test a prototype system, to be ultimately used for upper-limb rehabilitation; (2) evaluate how age affects the response to such a robotic system; and (3) identify whether the robot's physical embodiment is an important aspect in motivating users to complete a set of repetitive tasks...
2018: Restorative Neurology and Neuroscience
Giovanni Morone, Stefano Masiero, Paola Coiro, Domenico De Angelis, Vincenzo Venturiero, Stefano Paolucci, Marco Iosa
BACKGROUND: Robotic walking training improves probability to reach an autonomous walking in non-ambulant patients affected by subacute stroke. However, little information is available regarding the prognostic factors for identifying best responder patients. The purpose of the present study is therefore to investigate the clinical features of patients with subacute stroke that might benefit more from robotic walking therapy. METHODS: One hundred subacute inpatients randomized in robotic or conventional gait training were assessed at baseline and after 4 weeks of training performed 5 times per week...
2018: Restorative Neurology and Neuroscience
Gitendra Uswatte, Edward Taub, Mary H Bowman, Adriana Delgado, Camille Bryson, David M Morris, Staci Mckay, Joydip Barman, Victor W Mark
PURPOSE: To evaluate the efficacy of an expanded form of Constraint-Induced Movement Therapy (eCIMT) that renders CIMT, originally designed for treating mild-to-moderate upper-extremity hemiparesis, suitable for treating severe hemiparesis. METHODS: Twenty-one adults ≥1 year after stroke with severe upper-extremity hemiparesis (with little or no capacity to make movements with the more-affected hand) were randomly assigned to eCIMT (n = 10), a placebo-control procedure (n = 4), or usual care (n = 7)...
2018: Restorative Neurology and Neuroscience
Katlyn E Brown, Jason L Neva, Samantha J Feldman, W Richard Staines, Lara A Boyd
BACKGROUND: The integration of somatosensory information from the environment into the motor cortex to inform movement is essential for motor function. As motor deficits commonly persist into the chronic phase of stroke recovery, it is important to understand potential contributing factors to these deficits, as well as their relationship with motor function. To date the impact of chronic stroke on sensorimotor integration has not been thoroughly investigated. OBJECTIVES: The current study aimed to comprehensively examine the influence of chronic stroke on sensorimotor integration, and determine whether sensorimotor integration can be modified with an intervention...
2018: Restorative Neurology and Neuroscience
Jacqueline A Palmer, Steven L Wolf, Michael R Borich
BACKGROUND: Paired associative stimulation (PAS) combining repeated pairing of electrical stimulation of a peripheral nerve with transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) can induce neuroplastic adaptations in the human brain and enhance motor learning in neurologically-intact individuals. However, the extent to which PAS is an effective technique for inducing associative plasticity and improving motor function in individuals post-stroke is unclear. OBJECTIVE: The objective of this pilot study was to investigate the effects of a single session of PAS to modulate corticomotor excitability and motor skill performance in individuals post-stroke...
2018: Restorative Neurology and Neuroscience
Alessandro Picelli, Elena Chemello, Paola Castellazzi, Mirko Filippetti, Annalisa Brugnera, Marialuisa Gandolfi, Andreas Waldner, Leopold Saltuari, Nicola Smania
BACKGROUND: Preliminary evidence showed additional effects of anodal transcranial direct current stimulation over the damaged cerebral hemisphere combined with cathodal transcutaneous spinal direct current stimulation during robot-assisted gait training in chronic stroke patients. This is consistent with the neural organization of locomotion involving cortical and spinal control. The cerebellum is crucial for locomotor control, in particular for avoidance of obstacles, and adaptation to novel conditions during walking...
2018: Restorative Neurology and Neuroscience
Edward P Washabaugh, Chandramouli Krishnan
BACKGROUND: Robotic-resisted treadmill walking is a form of task-specific training that has been used to improve gait function in individuals with neurological injury, such as stroke, spinal cord injury, or cerebral palsy. Traditionally, these devices use active elements (e.g., motors or actuators) to provide resistance during walking, making them bulky, expensive, and less suitable for overground or in-home rehabilitation. We recently developed a low-cost, wearable robotic brace that generates resistive torques across the knee joint using a simple magnetic brake...
2018: Restorative Neurology and Neuroscience
Nuria Mendoza Laiz, Sagrario Del Valle Díaz, Natalia Rioja Collado, Javier Gomez-Pilar, Roberto Hornero
BACKGROUND: Dementia is a disease that is constantly evolving in older people. Its diverse symptoms appear with varying degrees of severity affecting the daily life of those who suffer from it. The rate in which dementia progresses depends on different aspects of the treatment, chosen to try to control and slow down the development of the illness. OBJECTIVE: The aim of this study is to assess the effectiveness of cognitive training through a Brain Computer Interface (BCI) and the NeuronUp platform in two age groups whose MMSE is between 18-23 MCI (mild dementia)...
2018: Restorative Neurology and Neuroscience
Clara Casco, Michele Barollo, Giulio Contemori, Luca Battaglini
BACKGROUND: In recent years, the introduction of visual rehabilitation for patients with homonymous visual field defects has been met with both enthusiasm and caution. Despite the evidence that restitutive training results in expansion of the visual field, several concerns have been raised. OBJECTIVE: We tested the effectiveness of a new rehabilitative protocol called "Neuro Restoration Training" (NRT) in reducing visual field defects and in restituting visual functions in the restored hemianopic area...
2018: Restorative Neurology and Neuroscience
Gang Liu, Kangqiang Peng, Chao Dang, Shuangquan Tan, Hongbing Chen, Chuanmiao Xie, Shihui Xing, Jinsheng Zeng
BACKGROUND: Secondary degeneration of the fiber tract of the motor pathway below infarct foci and functional recovery after stroke have been well demonstrated, but the role of the fiber tract above stroke foci remains unclear. OBJECTIVE: This study aimed to investigate diffusion changes in motor fibers above the lesion and identify predictors of motor improvement within 12 weeks after subcortical infarction. METHODS: Diffusion tensor imaging and the Fugl-Meyer (FM) scale were conducted 1, 4, and 12 weeks (W) after a subcortical infarct...
2018: Restorative Neurology and Neuroscience
Aline Souza Pagnussat, Ana F R Kleiner, Carlos R M Rieder, Anapaula Frantz, Jaira Ehlers, Camila Pinto, Gilson Dorneles, Carlos Alexandre Netto, Alessandra Peres, Manuela Galli
BACKGROUND: The decrease of Brain-Derived Neurotrophic Factor (BDNF) serum levels has been related to the pathophysiology of several neurodegenerative diseases as well as to neural plasticity and rehabilitation. Automated Mechanical Peripheral Stimulation (AMPS) has been investigated as a complementary therapy for Parkinson Disease (PD). OBJECTIVES: (1) to investigate the effects of AMPS on BDNF and Cortisol serum levels of subjects with PD; (2) to evidence the interplay between BDNF and Cortisol serum levels and the functional mobility improvement after AMPS treatment...
2018: Restorative Neurology and Neuroscience
Charlotte Rosso, Céline Arbizu, Claire Dhennain, Jean-Charles Lamy, Yves Samson
OBJECTIVES: Small clinical trials reported that repetitive sessions of tDCS could improve naming abilities in post-stroke aphasia. However, systematic meta-analyses found no effect, but all of these analyses pooled data from both single and repetitive sessions at the group level. The aim of this paper was to perform a meta-analysis based on individual patient data to explore the effects of repetitive tDCS sessions on naming in post-stroke aphasia and in prespecified subgroups. METHODS: We searched for published sham-controlled trials using the keywords "aphasia OR language" AND "transcranial direct current stimulation OR tDCS" AND "stroke"...
2018: Restorative Neurology and Neuroscience
Corina O Bondi, Narayana K Yelleswarapu, Julian Day-Cooney, Kimiya Memarzadeh, Kaitlin A Folweiler, Carine E Bou-Abboud, Jacob B Leary, Jeffrey P Cheng, Roya Tehranian-DePasquale, Anthony E Kline
BACKGROUND: The acetylcholinesterase inhibitor (AChEI) donepezil (DON) is recommended as a potential treatment for cognition after clinical traumatic brain injury (TBI) and therefore may be prescribed as an adjunct therapy during rehabilitation. However, a dose-response study evaluating DON after a controlled cortical impact (CCI) injury in rats did not reveal cognitive benefits. OBJECTIVE: The aim of this study was to determine the effect of DON on behavioral and histological outcome when combined with environmental enrichment (EE), a preclinical model of neurorehabilitation...
2018: Restorative Neurology and Neuroscience
Sonja Mertsch, Katrin Schlicht, Harutyun Melkonyan, Stefan Schlatt, Solon Thanos
BACKGROUND: Retinal ganglion cells (RGCs) of mammals lose the ability to regenerate injured axons during postnatal maturation, but little is known about the underlying molecular mechanisms. OBJECTIVE: It remains of particular importance to understand the mechanisms of axonal regeneration to develop new therapeutic approaches for nerve injuries. METHODS: Retinas from newborn to adult monkeys (Callithrix jacchus)1 were obtained immediately after death and cultured in vitro...
2018: Restorative Neurology and Neuroscience
Federica Bertolucci, Carmelo Chisari, Felipe Fregni
Up to now, the mechanism of motor impairment and recovery after stroke has been thought to be based on the interhemispheric competition model. According to this model, which assumes that suppressing the excitability of contralesional hemisphere will enhance recovery by reducing transcallosal inhibition (TCI) of the stroke hemisphere, many clinical trials used non-invasive brain stimulation to improve motor function. Despite some positive findings, meta-analysis shows an important source of variability in the results, questioning whether the interhemispheric competition model would be exhaustive enough to explain the positive results or whether other mechanisms could explain the motor effects of inhibitory stimulation in the contralesional hemisphere...
2018: Restorative Neurology and Neuroscience
Lina Bunketorp Käll, Robert J Cooper, Johanna Wangdell, Jan Fridén, Malin Björnsdotter
BACKGROUND: Tendon transfer is a surgical technique for restoring upper limb motor control in patients with cervical spinal cord injuries (SCI), and offers a rare window into cortical neuroplasticity following regained arm and hand function. OBJECTIVE: Here, we aimed to examine neuroplasticity mechanisms related to re-established voluntary motor control of thumb flexion following tendon transfer. METHODS: We used functional Magnetic Resonance Imaging (fMRI) to test the hypothesis that restored limb control following tendon transfer is mediated by activation of that limb's area of the primary motor cortex...
2018: Restorative Neurology and Neuroscience
Thomas Platz, Marija Adler-Wiebe, Sybille Roschka, Martin Lotze
BACKGROUND: Motor rehabilitation after brain damage relies on motor re-learning as induced by specific training. Non-invasive brain stimulation (NIBS) can alter cortical excitability and thereby has a potential to enhance subsequent training-induced learning. Knowledge about any priming effects of NIBS on motor learning in healthy subjects can help to design targeted therapeutic applications in brain-damaged subjects. OBJECTIVE: To examine whether complex motor learning in healthy subjects can be enhanced by intermittent theta burst stimulation (iTBS) to primary motor or sensory cortical areas...
2018: Restorative Neurology and Neuroscience
Trisha M Kesar, Steven Eicholtz, Bethany J Lin, Steven L Wolf, Michael R Borich
BACKGROUND: The use of transcranial magnetic stimulation (TMS) to evaluate corticomotor excitability of lower limb (LL) muscles can provide insights about neuroplasticity mechanisms underlying LL rehabilitation. However, to date, a majority of TMS studies have focused on upper limb muscles. Posture-related activation is an important under-investigated factor influencing corticomotor excitability of LL muscles. OBJECTIVE: The purpose of this study was to evaluate effects of posture and background activation on corticomotor excitability of ankle muscles...
2018: Restorative Neurology and Neuroscience
Yi Li, Jingjing Fan, Jingyi Yang, Chengqi He, Shasha Li
BACKGROUND: As a promising technique, transcranial direct current stimulation (tDCS) has gained so much attention in its potential effects on functional recovery of lower limb following stroke. However, individual studies have yielded inconsistent or conflicting results. OBJECTIVE: To investigate the efficacy and safety of tDCS for the functional recovery of lower limb following stroke reported in the randomized controlled trials by using a meta-analysis. METHODS: MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, CENTRAL, and Physiotherapy Evidence Database was comprehensively searched for randomized controlled trials published until April 2017 that investigated the effects of tDCS on lower limb function...
2018: Restorative Neurology and Neuroscience
Yoko Takahashi, Toshiyuki Fujiwara, Tomofumi Yamaguchi, Hikaru Matsunaga, Michiyuki Kawakami, Kaoru Honaga, Katsuhiro Mizuno, Meigen Liu
BACKGROUND: Reciprocal inhibition (RI) may be important for recovering locomotion after stroke. Patterned electrical stimulation (PES) can modulate RI in a manner that could be enhanced by voluntary muscle contraction (VC). OBJECTIVE: To investigate whether VC enhances the PES-induced spinal RI in patients with stroke. METHODS: Twelve patients with chronic stroke underwent three 20 min tasks, each on different days: (1) PES (10 pulses, 100 Hz every 2 s) applied to the common peroneal nerve; (2) VC consisting of isometric contraction of the affected-side tibialis anterior muscle; (3) PES combined with VC (PES + VC)...
2018: Restorative Neurology and Neuroscience
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