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Neuromodulation Rehabilitation

Maíra C Lixandrão, James W Stinear, Tonya Rich, Chao-Ying Chen, Tim Feyma, Gregg D Meekins, Bernadette T Gillick
BACKGROUND: The cortical silent period is a transient suppression of electromyographic activity after a transcranial magnetic stimulation pulse, attributed to spinal and supraspinal inhibitory mechanisms. Electromyographic breakthrough activity has been observed in healthy adults as a result of a spinal reflex response within the cortical silent period. OBJECTIVES: The objective of this case series is to report the ipsilesional and contralesional cortical silent period and the electromyographic breakthrough activity of 7 children with congenital hemiparesis...
November 21, 2018: Brazilian Journal of Physical Therapy
M Alsharidah, F Al-Hussain, M Iqbal, A Hamza, W-K Yoo, S Bashir
The field of neuromodulation encompasses a wide spectrum of interventional technologies that modify pathological activity within the nervous system to achieve a therapeutic effect. Therapy including transcranial direct current stimulation (tDCS) has all shown promising results across a range of neurological and neuropsychiatric disorders. This article reviews the state-of-the-art of neuromodulation for stroke and discusses the opportunities and challenges available for clinicians and researchers interested in advancing neuromodulation therapy...
November 2018: European Review for Medical and Pharmacological Sciences
Natalie Mrachacz-Kersting, Andrew J T Stevenson, Helle R M Jørgensen, Kåre Eg Severinsen, Susan Aliakbaryhosseinabadi, Ning Jiang, Dario Farina
OBJECTIVE: Adjuvant protocols devised to enhance motor recovery in subacute stroke patients have failed to show benefits with respect to classic therapeutic interventions. Here we evaluate the efficacy of a novel brain-state dependent intervention based on known mechanisms of memory and learning, that is integrated as part of the weekly rehabilitation program in subacute stroke patients. METHODS: Twenty-four hospitalized subacute stroke patients were randomly assigned to two intervention groups; 1...
November 8, 2018: Annals of Neurology
Vincent Chi-Kwan Cheung, Chuanxin Minos Niu, Si Li, Qing Xie, Ning Lan
The past decades have witnessed remarkable progresses in neural technologies such as functional electrical stimulation (FES) and their applications in neuro-rehabilitation and neuromodulation. These advances are powered by new neuroscientific understandings of the organization and compositionality of neuromuscular control illuminating how muscle groups may be activated together as discrete units known as muscle synergies. These parallel developments have promoted novel approaches to clinical rehabilitation for neurological disorders that are insurmountable to current treatments...
October 11, 2018: IEEE Reviews in Biomedical Engineering
Danielle Silveira Pires, Danielle De Sá Boasquevisque, Danielli Souza Speciali, Gisele Sampaio Silva, Adriana Bastos Conforto
OBJECTIVE: To prospectively evaluate the success of promotion strategies for a protocol of motor rehabilitation strategies for patients with stroke at Albert Einstein Hospital. METHODS: In a clinical trial of neuromodulation and rehabilitation for patients with stroke, conventional methods of dissemination and publications about the research protocol in social networks or on the hospital's website were performed. Frequencies of types of advertisements that reached potentially eligible subjects were calculated...
May 2018: Revista da Associação Médica Brasileira
Argyrios Stampas, Radha Korupolu, Liang Zhu, Christopher P Smith, Kenneth Gustafson
OBJECTIVES: We investigated whether transcutaneous tibial nerve stimulation (TTNS) in acute spinal cord injury was safe and feasible, and could achieve neuromodulation and improve cystometrogram parameters during acute inpatient rehabilitation. MATERIALS AND METHODS: Participants were consecutive acute traumatic spinal cord injury patients admitted for acute inpatient rehabilitation, randomized to a 2-week trial of TTNS v sham stimulation. Primary outcomes were safety and feasibility of TTNS and secondary outcomes were bladder measures based on pre- and post-TTNS cystometrogram by group and within groups, including bladder capacity, detrusor hyperreflexia, pressures, and detrusor-sphincter dyssynergia, as well as filling sensations and desire to void...
October 3, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Megan L Gill, Peter J Grahn, Jonathan S Calvert, Margaux B Linde, Igor A Lavrov, Jeffrey A Strommen, Lisa A Beck, Dimitry G Sayenko, Meegan G Van Straaten, Dina I Drubach, Daniel D Veith, Andrew R Thoreson, Cesar Lopez, Yury P Gerasimenko, V Reggie Edgerton, Kendall H Lee, Kristin D Zhao
Spinal sensorimotor networks that are functionally disconnected from the brain because of spinal cord injury (SCI) can be facilitated via epidural electrical stimulation (EES) to restore robust, coordinated motor activity in humans with paralysis1-3 . Previously, we reported a clinical case of complete sensorimotor paralysis of the lower extremities in which EES restored the ability to stand and the ability to control step-like activity while side-lying or suspended vertically in a body-weight support system (BWS)4 ...
September 24, 2018: Nature Medicine
Ann Van de Winckel, James R Carey, Teresa A Bisson, Elsa C Hauschildt, Christopher D Streib, William K Durfee
BACKGROUND: Transcranial direct current stimulation (tDCS) is an effective neuromodulation adjunct to repetitive motor training in promoting motor recovery post-stroke. Finger tracking training is motor training whereby people with stroke use the impaired index finger to trace waveform-shaped lines on a monitor. Our aims were to assess the feasibility and safety of a telerehabilitation program consisting of tDCS and finger tracking training through questionnaires on ease of use, adverse symptoms, and quantitative assessments of motor function and cognition...
September 18, 2018: Journal of Neuroengineering and Rehabilitation
Shuo Hu, Tao Zheng, Yanchao Dong, Juan Du, Lanxiang Liu
Transcranial direct-current stimulation (DCS) offers a method for noninvasive neuromodulation usable in basic and clinical human neuroscience. Laser-speckle contrast imaging (LSCI), a powerful, low-cost method for obtaining images of dynamic systems, can detect regional blood-flow distributions with high spatial and temporal resolutions. Here, we used LSCI for measuring DCS-induced cerebral blood flow in real-time. Results showed that the change-rate of cerebral blood flow could reach approximately 10.1 ± 5...
2018: Frontiers in Neuroscience
Collene E Anderson, Jonviea D Chamberlain, Xavier Jordan, Thomas M Kessler, Eugenia Luca, Sandra Möhr, Jürgen Pannek, Martin Schubert, Martin W G Brinkhof
OBJECTIVE: To understand the occurrence of and risk factors for urinary tract infections (UTIs) in patients with spinal cord injury (SCI) undergoing specialized SCI rehabilitation in Switzerland. PATIENTS AND METHODS: This study used data collected from 369 patients, who participated in a nationwide rehabilitation cohort for SCI in Switzerland between 2013 and 2017. Information on UTIs as well as their potential determinants, including demographics, lesion characteristics, and time-updated data on functional independence and bladder management, was used...
August 16, 2018: BJU International
Yu-Qiu Jiang, Adrish Sarkar, Alzahraa Amer, John H Martin
Injury to the supraspinal motor systems, especially the corticospinal tract, leads to movement impairments. In addition to direct disruption of descending motor pathways, spinal motor circuits that are distant to and not directly damaged by the lesion undergo remodeling that contributes significantly to the impairments. Knowing which spinal circuits are remodeled and the underlying mechanisms are critical for understanding the functional changes in the motor pathway and for developing repair strategies. Here, we target spinal premotor cholinergic interneurons (IN) that directly modulate motoneuron excitability via their cholinergic C-bouton terminals...
September 26, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Tae Beom Kim, Chang Hee Kim, Kwang Taek Kim, Sang Jin Yoon, Kyung Jin Chung
As a urologist, we usually encounter with two representative functional behaviors, namely, voiding and sexual function. These are not only important but also complex and synchronized so if these functions are impaired, patients need active functional rehabilitation to recover. These functional impairments should be recognized and corrected early because they could not only cause direct damage to the affected functions but also have harmful consecutive consequences such as kidney damage due to voiding abnormality and self-esteem damage due to decreased sexual function...
June 2018: Journal of Exercise Rehabilitation
Derek R Verley, Daniel Torolira, Brittany A Hessell, Richard L Sutton, Neil G Harris
Traumatic brain injury (TBI) results in well-known, significant alterations in structural and functional connectivity. Although this is especially likely to occur in areas of pathology, deficits in function to and from remotely connected brain areas, or diaschisis, also occur as a consequence to local deficits. As a result, consideration of the network wiring of the brain may be required to design the most efficacious rehabilitation therapy to target specific functional networks to improve outcome. In this work, we model remote connections after controlled cortical impact injury (CCI) in the rat through the effect of callosal deafferentation to the opposite, contralesional cortex...
October 4, 2018: Journal of Neurotrauma
Cecília N Prudente, Lena Zetterberg, Annika Bring, Lynley Bradnam, Teresa J Kimberley
Background: Rehabilitation interventions are rarely utilized as an alternative or adjunct therapy for focal dystonias. Reasons for limited utilization are unknown, but lack of conclusive evidence of effectiveness is likely a crucial factor. Methods and Findings: The purpose of this systematic review was to determine the level of evidence for rehabilitation interventions in focal dystonias. Rehabilitation interventions were classified based upon the underlying theoretical basis of different approaches, and the strength of evidence for each category was evaluated to identify gaps in the field...
May 2018: Movement Disorders Clinical Practice
Marie-Pascale Côté, Lynda M Murray, Maria Knikou
Systematic research on the physiological and anatomical characteristics of spinal cord interneurons along with their functional output has evolved for more than one century. Despite significant progress in our understanding of these networks and their role in generating and modulating movement, it has remained a challenge to elucidate the properties of the locomotor rhythm across species. Neurophysiological experimental evidence indicates similarities in the function of interneurons mediating afferent information regarding muscle stretch and loading, being affected by motor axon collaterals and those mediating presynaptic inhibition in animals and humans when their function is assessed at rest...
2018: Frontiers in Physiology
Kristen K Ellard, Aishwarya G Gosai, Emily E Bernstein, Navneet Kaur, Lousia G Sylvia, Joan A Camprodon, Darin D Dougherty, Andrew A Nierenberg, Thilo Deckersbach
BACKGROUND: Anxiety in bipolar disorder (BD) exacerbates emotion dysregulation and reduces treatment response. We recently conducted a pilot trial of transdiagnostic CBT to target anxiety and emotion dysregulation in BD adjunctive to pharmacotherapy. Reductions in depression and anxiety symptoms were significantly predicted by baseline levels of neuroticism and perceived affective control, as well as changes over time in emotion regulation skills. The present study investigates mechanism of treatment response by examining the relationship between baseline emotion regulation-related neural circuitry and trial outcomes...
October 1, 2018: Journal of Affective Disorders
John-Stuart Brittain, Hayriye Cagnan
Purpose of Review: This review aims to survey recent trends in electrical forms of neuromodulation, with a specific application to Parkinson's disease (PD). Emerging trends are identified, highlighting synergies in state-of-the-art neuromodulation strategies, with directions for future improvements in stimulation efficacy suggested. Recent Findings: Deep brain stimulation remains the most common and effective form of electrical stimulation for the treatment of PD...
2018: Current Behavioral Neuroscience Reports
L Eduardo Cofré Lizama, Andisheh Bastani, Maya G Panisset, Katharine Drummond, Fary Khan, Mary P Galea
Cranial-nerve non-invasive neuromodulation (CN-NINM) through the tongue has been proposed as an adjuvant intervention to improve efficacy of rehabilitation. However, CN-NINM effects have only been explored in multiple sclerosis and stroke populations. In this report we used CN-NINM during a 2-week (2 × 1.5 h sessions daily) physiotherapy program for the rehabilitation of a 57 y/o woman presenting with balance and gait impairments after a surgical resection of a fourth ventricular ependymoma. Clinical and instrumented balance and gait assessments showed improved performance in all tests and without adverse effects This study shows the beneficial effects and feasibility of combined physiotherapy and CN-NINM in this patient...
August 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Michael R Borich, Steven L Wolf, Andrew Q Tan, Jacqueline A Palmer
Background: Despite intensive rehabilitation efforts, most stroke survivors have persistent functional disability of the paretic arm and hand. These motor impairments may be due in part to maladaptive changes in structural and functional connections between brain regions. The following early stage clinical trial study protocol describes a noninvasive brain stimulation approach to target transcallosally mediated interhemispheric connections between the ipsi- and contralesional motor cortices (iM1 and cM1) using corticocortical paired associative stimulation (ihPAS)...
2018: Neural Plasticity
Marianna Semprini, Matteo Laffranchi, Vittorio Sanguineti, Laura Avanzino, Roberto De Icco, Lorenzo De Michieli, Michela Chiappalone
Neurological diseases causing motor/cognitive impairments are among the most common causes of adult-onset disability. More than one billion of people are affected worldwide, and this number is expected to increase in upcoming years, because of the rapidly aging population. The frequent lack of complete recovery makes it desirable to develop novel neurorehabilitative treatments, suited to the patients, and better targeting the specific disability. To date, rehabilitation therapy can be aided by the technological support of robotic-based therapy, non-invasive brain stimulation, and neural interfaces...
2018: Frontiers in Neurology
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