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Neurorehabilitation and Neural Repair

Marzieh M Ardestani, Catherine R Kinnaird, Christopher E Henderson, T George Hornby
BACKGROUND: High-intensity, variable stepping training can improve walking speed in individuals poststroke, although neuromuscular strategies used to achieve faster speeds are unclear. We evaluated changes in joint kinetics and neuromuscular coordination following such training; movement strategies consistent with intact individuals were considered evidence of recovery and abnormal strategies indicative of compensation. METHODS: A total of 15 individuals with stroke (duration: 23 ± 30 months) received ≤40 sessions of high-intensity stepping in variable contexts (tasks and environments)...
December 29, 2018: Neurorehabilitation and Neural Repair
Elizabeth G Condliffe, Dean T Jeffery, Derek J Emery, Sarah Treit, Christian Beaulieu, Monica A Gorassini
BACKGROUND: Dysfunction of corticospinal pathways has been implicated in motor impairments in people with bilateral spastic cerebral palsy (CP). While structural damage to corticospinal pathways in people with CP is known, its impact on the activation of these pathways is not. OBJECTIVE: To provide the first, complete activation profile of corticospinal pathways in adults with CP using a full range of transcranial magnetic stimulation (TMS) intensities and voluntary contractions...
December 29, 2018: Neurorehabilitation and Neural Repair
Shahabeddin Vahdat, Mohammed Darainy, Alexander Thiel, David J Ostry
BACKGROUND: Passive robot-generated arm movements in conjunction with proprioceptive decision making and feedback modulate functional connectivity (FC) in sensory motor networks and improve sensorimotor adaptation in normal individuals. This proof-of-principle study investigates whether these effects can be observed in stroke patients. METHODS: A total of 10 chronic stroke patients with a range of stable motor and sensory deficits (Fugl-Meyer Arm score [FMA] 0-65, Nottingham Sensory Assessment [NSA] 10-40) underwent resting-state functional magnetic resonance imaging before and after a single session of robot-controlled proprioceptive training with feedback...
December 29, 2018: Neurorehabilitation and Neural Repair
Jessica F Baird, Robert W Motl
Multiple sclerosis (MS) is a heterogeneous disease, both in its pathology and symptomology. This poses a challenge for the medical management and rehabilitation of MS; however, physical activity and exercise training are rehabilitation approaches that have demonstrated beneficial effects on many of the burdensome consequences of MS such as mobility impairment and fatigue. Given the heterogeneous course of MS, it is possible that outcomes of physical activity and exercise training interventions demonstrate heterogeneity both in the magnitude and pattern of change, but there has been little focus on response heterogeneity with these interventions among persons with MS...
December 26, 2018: Neurorehabilitation and Neural Repair
Yu-Sun Min, Jang Woo Park, Kyung Eun Jang, Hui Joong Lee, Jongmin Lee, Yang-Soo Lee, Tae-Du Jung, Yongmin Chang
BACKGROUND: Prognostic measures of long-term motor recovery are important in patients with stroke presenting with severe hemiplegia. OBJECTIVE: We aimed to investigate whether initial power spectral density (PSD) analysis of resting-state functional magnetic resonance (fMRI) data can provide a sensitive prognostic predictor in patients with subacute stroke with severe hand disability. METHODS: Twelve patients with good recovery, 14 patients with poor recovery, and 12 healthy subjects were included...
December 19, 2018: Neurorehabilitation and Neural Repair
Sudhir Karthikeyan, Matthew Strider Jeffers, Anthony Carter, Dale Corbett
BACKGROUND: Stroke is a leading cause of neurological disability, often resulting in long-term motor impairments due to damage to cortical or subcortical motor areas. Despite the high prevalence of subcortical strokes in the clinical population, preclinical research has primarily focused on investigating and treating cortical strokes. Moreover, while both humans and animals show spontaneous recovery following stroke, little is known about how injury location affects this process. OBJECTIVE: To capture the heterogeneity of human stroke and examine how stroke location affects spontaneous motor recovery following damage to cortical, subcortical, or a combination of both areas...
December 10, 2018: Neurorehabilitation and Neural Repair
Yanlu Zhang, Michael Chopp, Zheng Gang Zhang, Yi Zhang, Li Zhang, Mei Lu, Talan Zhang, Stefan Winter, Edith Doppler, Hemma Brandstäetter, Asim Mahmood, Ye Xiong
BACKGROUND: Cerebrolysin is a neuropeptide preparation with neuroprotective and neurotrophic properties. Our previous study demonstrates that cerebrolysin significantly improves functional recovery in rats after mild traumatic brain injury (mTBI). OBJECTIVE: To determine histological outcomes associated with therapeutic effects of cerebrolysin on functional recovery after TBI. METHODS: In this prospective, randomized, blinded, and placebo-controlled study, adult Wistar rats with mild TBI induced by a closed head impact were randomly assigned to one of the cerebrolysin dose groups (0...
November 30, 2018: Neurorehabilitation and Neural Repair
Alexander Baumann, Adelheid Nebel, Oliver Granert, Kathrin Giehl, Stephan Wolff, Wiebke Schmidt, Christin Baasch, Gerhard Schmidt, Karsten Witt, Günther Deuschl, Gesa Hartwigsen, Kirsten E Zeuner, Thilo van Eimeren
BACKGROUND: Hypokinetic dysarthria is highly prevalent in idiopathic Parkinson disease (PD), and effectiveness of high-intensity voice treatment is well established. However, the neural correlates remain largely unknown. OBJECTIVE: We aimed to specify cerebral pathophysiology of hypokinetic dysarthria and treatment-induced changes using functional magnetic resonance imaging (fMRI). METHODS: We used fMRI to investigate healthy controls (HCs) and patients with idiopathic PD-associated dysarthria before and after treatment according to the Lee Silverman Voice Treatment LOUD (LSVT)...
November 16, 2018: Neurorehabilitation and Neural Repair
Nina Lefeber, Emma De Keersmaecker, Stieven Henderix, Marc Michielsen, Eric Kerckhofs, Eva Swinnen
INTRODUCTION: Physiological responses are rarely considered during walking after stroke and if considered, only during a short period (3-6 minutes). The aims of this study were to examine physiological responses during 30-minute robot-assisted and body weight-supported treadmill and overground walking and compare intensities with exercise guidelines. METHODS: A total of 14 ambulatory stroke survivors (age: 61 ± 9 years; time after stroke: 2.8 ± 2.8 months) participated in 3 separate randomized walking trials...
November 12, 2018: Neurorehabilitation and Neural Repair
Serene S Paul, Sydney Y Schaefer, Genevieve N Olivier, Christopher S Walter, Keith R Lohse, Leland E Dibble
INTRODUCTION: Treatment of Parkinson's disease (PD) with exogenous dopamine (ie, levodopa) may positively affect motor symptoms, but may negatively affect other functions such as the learning of motor skills necessary for rehabilitation. This study aimed to determine whether levodopa medication affects general and sequence-specific learning of a stepping task and the transfer of movement skill to untrained balance tasks in people with PD. METHODS: Participants with PD were randomized to practice "on" (n = 14) or "off" (n = 13) levodopa medication...
November 9, 2018: Neurorehabilitation and Neural Repair
Carolina C Alcântara, Charalambos C Charalambous, Susanne M Morton, Thiago L Russo, Darcy S Reisman
BACKGROUND: Studies in neurologically intact subjects suggest that the gradual presentation of small perturbations (errors) during learning results in better transfer of a newly learned walking pattern to overground walking. Whether the same result would be true after stroke is not known. OBJECTIVE: To determine whether introducing gradual perturbations, during locomotor learning using a split-belt treadmill influences learning the novel walking pattern or transfer to overground walking poststroke...
November 9, 2018: Neurorehabilitation and Neural Repair
Peter R A Malik, Ryan T Muir, Sandra E Black, Fuqiang Gao, Richard H Swartz, Brian J Murray, Mark I Boulos
OBJECTIVE: Impaired attentional processes have been linked with poor outcomes after stroke, but their radiographical correlates have been infrequently studied. Our objective was to assess the relationship between stroke location and vigilant attention. METHODS: A total of 39 patients presenting within 2 weeks of a minor stroke were prospectively recruited. Vigilant attention was assessed using the psychomotor vigilance task (PVT), and neuroimaging was used to assess stroke location, white matter hyperintensity (WMH) burden, and ischemic stroke involvement within lateral cholinergic projections...
October 24, 2018: Neurorehabilitation and Neural Repair
Julia Boonzaier, Geralda A F van Tilborg, Sebastiaan F W Neggers, Rick M Dijkhuizen
BACKGROUND: Stroke is the leading cause of adult disability, but treatment options remain limited, leaving most patients with incomplete recovery. Patient and animal studies have shown potential of noninvasive brain stimulation (NIBS) strategies to improve function after stroke. However, mechanisms underlying therapeutic effects of NIBS are unclear and there is no consensus on which NIBS protocols are most effective. OBJECTIVE: Provide a review of articles that assessed effects and mechanisms of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) in animal stroke models...
October 24, 2018: Neurorehabilitation and Neural Repair
Michael D Lewek, Cristina Raiti, Amanda Doty
BACKGROUND: The residual hemiparesis after stroke results in a unilateral reduction in propulsive force during gait. Prior work has suggested the presence of a propulsive reserve in the paretic limb. OBJECTIVE: The purpose of this study was to quantify the paretic propulsive reserve in individuals poststroke and to determine the biomechanical mechanism underlying the generation of additional paretic propulsive limb force. METHODS: Ten individuals with chronic hemiparesis poststroke walked on a treadmill against an impeding force (ascending 0% to 10% body weight [BW], in 2...
December 2018: Neurorehabilitation and Neural Repair
Jolanda M B Roelofs, Kirsten van Heugten, Digna de Kam, Vivian Weerdesteyn, Alexander C H Geurts
BACKGROUND: The relationships between motor impairment of the affected leg, postural control asymmetry, and impaired body sway control after stroke are not well understood. OBJECTIVE: To examine the relationship between motor impairment of the affected leg and reduced contribution of this leg to body sway control (ie, dynamic control asymmetry [DCA]) and to determine the relationships between impaired body sway control, DCA, and weight-bearing asymmetry (WBA). METHODS: We assessed quiet-standing balance with eyes open in 70 persons with a unilateral supratentorial chronic stroke using 2 force plates...
November 2018: Neurorehabilitation and Neural Repair
Rodrigo Vitorio, Samuel Stuart, Lilian T B Gobbi, Lynn Rochester, Lisa Alcock, Annette Pantall
BACKGROUND: Aging is associated with declining mobility, which negatively affects quality of life and incurs substantial economic costs. Techniques to maintain safe mobility in older adults are therefore essential. Rhythmic auditory cueing (RAC) can improve walking patterns in older adults. However, the neural correlates associated with RAC, how they are influenced by repeated exposure and their relationships with gait response, cognitive function, and depressive symptoms are unclear...
November 2018: Neurorehabilitation and Neural Repair
Jessica Battisto, Katharina V Echt, Steven L Wolf, Paul Weiss, Madeleine E Hackney
BACKGROUND: The Body Position Spatial Task (BPST) is a novel measure of whole-body spatial cognition involving multidirectional steps and turns. Individuals with Parkinson disease (PD) are affected by motor and cognitive impairments, particularly in spatial function, which is important for mental imagery and navigation. Performance on the BPST may inform understanding of motor-cognitive and spatial cognitive function of individuals with PD. OBJECTIVES: We conducted this study to determine feasibility and validity of the BPST with standard, validated, and reliable measures of spatial cognition and motor-cognitive integration and to compare BPST performance in adults with and without PD...
November 2018: Neurorehabilitation and Neural Repair
Nergiz Turgut, Lisa Möller, Kerstin Dengler, Katrin Steinberg, Andreas Sprenger, Paul Eling, Andreas Kastrup, Helmut Hildebrandt
BACKGROUND: Visuospatial neglect is a disabling syndrome with serious consequences for activities in daily life. This study investigated the effect of adaptive cueing during a reading task as a possible treatment for neglect by including (1) a task relevant for the patient's daily life, (2) a fading out procedure to stimulate independent orientation to the left by self-cueing, and (3) a clear definition of neglect severity for the adaptive treatment protocol. METHODS: A randomized controlled crossover design was used, including 26 patients from an early rehabilitation unit with left-sided visuospatial neglect after stroke or hemorrhage...
October 17, 2018: Neurorehabilitation and Neural Repair
Hsing-Ching Kuo, Ephrem Zewdie, Patrick Ciechanski, Omar Damji, Adam Kirton
BACKGROUND: Clinical trials are suggesting efficacy of intensive therapy combined with brain stimulation to improve hand function in hemiparetic children with perinatal stroke. However, individual variability exists and the underlying neuroplasticity mechanisms are unknown. Exploring primary motor cortex (M1) neurophysiology, and how it changes with such interventions, may provide valuable biomarkers for advancing personalized neurorehabilitation. METHODS: Forty-five children (age 6-19 years) with hemiparesis participated in PLASTIC CHAMPS, a blinded, sham-controlled, factorial clinical trial...
October 4, 2018: Neurorehabilitation and Neural Repair
Maria I Pestalozzi, Marie Di Pietro, Chrisovalandou Martins Gaytanidis, Lucas Spierer, Armin Schnider, Leila Chouiter, Françoise Colombo, Jean-Marie Annoni, Lea B Jost
BACKGROUND: A successful interplay between prefrontal and domain-specific language areas is critical for language processing. Previous studies involving people with aphasia have shown that executive control processes might act on lexical-semantic representations during retrieval. Modulating the prefrontal control network by means of noninvasive brain stimulation might, therefore, improve lexical access in people with aphasia. OBJECTIVE: The present study investigates the effects of prefrontal transcranial direct current stimulation (tDCS) on lexical access in chronic poststroke aphasia...
October 2018: Neurorehabilitation and Neural Repair
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