ABSTRACT
ObjectiveTo investigate the effects of dopamine receptor agonist pramipexole and levodopa on emotion and cognition, and mitochondrial membrane potential of rats after global cerebral ischemia-reperfusion injury. MethodsA total of 80 male Sprague-Dawley rats were divided into sham group (n = 20), model group (n = 20), pramipexole group (n = 20) and combined group (n = 20). The latter three groups were used to prepare the model of global cerebral ischemia-reperfusion injury with Pulsinelli's four-vessel occlusion. The pramipexole group was intraperitoneally injected pramipexole 0.5 mg/kg once a day, while the combined group was injected levodopa 50 mg/kg and pramipexole 0.5 mg/kg, for 14 days. Five rats in each group were tested with open field test three, seven and 14 days after modeling; five were tested with Y-maze test seven and 14 days after modeling; five were detected mitochondrial membrane potential three, seven and 14 days after modeling; and five were observed under Nissl's staining14 days after modeling. ResultsCompared with the model group, the number of entries into the central zone (P < 0.05), total distance travelled (P < 0.05) and average velocity (P < 0.05) in the open field test increased in the pramipexole and combined groups seven and 14 days after modeling, duration spent in the central zone increased in the pramipexole and combined groups seven days after modeling (P < 0.05); the rate of spontaneous alternation of Y-maze test increased in the pramipexole and combined groups 14 days after modeling (P < 0.05); mitochondrial membrane potential in hippocampus increased in the pramipexole and combined groups seven and 14 days after modeling (P < 0.05), and it was less in the pramipexole group than in the combined group 14 days after modeling (P < 0.05); and the number of surviving neurons in the hippocampal CA1 increased in the pramipexole and combined groups 14 days after modeling (P < 0.05). ConclusionPramipexole may improve emotion and cognition of rats after global cerebral ischemia-reperfusion injury, and it may be helpful for restoring mitochondrial membrane potential as combining with levodopa.
ABSTRACT
ObjectiveTo investigate the clinical characteristics of dysphagia after brainstem stroke, and rehabilitation effect and influencial factors for it. MethodsA retrospectively analysis was conducted in patients who were diagnosed as dysphagia after brainstem stroke in the Beijing Bo'ai Hospital from April, 2018 to December, 2021. The following data were collected: the general information (gender, age, course of disease, and time of treatment), the result of videofluoroscopic swallowing study (VFSS), the Dysphagia Severity Scale (DSS) score before and after treatment, the scores of Fugl-Meyer Assessment (FMA), FMA-Balance (FMA-B), National Institutes of Health Stroke Scale (NIHSS) and Barthel index (BI), Mini-Mental State Examination (MMSE), and whether oral feeding. Based on the result of VFSS, all patients were divided into non-cricopharyngeal achalasia group (control group) and cricopharyngeal achalasia group (observation group). ResultsA total of 60 patients were collected, with 29 in the control group and 31 in the observation group. The scores of FMA, FMA-B, BI and MMSE were higher (|t| > 3.281, P < 0.01), and the NIHSS score was lower (t = 4.390, P < 0.001) in the observation group than in the control group. Before treatment, the score of DSS was significantly lower in the observation group than in the control group (t = 5.785, P < 0.001); after treatment, the scores improved in both groups (|t| > 5.387, P < 0.001), and no significant difference was found between two groups (t = 1.675, P = 0.099); however, the d-value was more in the observation group than in the control group (t = -2.729, P = 0.008). There was no significant difference in the rate of oral feeding (χ² = 2.742, P = 0.098). In the control group, there were differences in the scores of NIHSS, FMA-B, BI and DSS between patients with oral feeding and those with nasal feeding (|t| > 2.429, P < 0.05); however, no significant difference was found in all factors in the observation group (P > 0.05). The DSS score was the influence factor of oral feeding in the control group (OR = 3.947, 95%CI 1.361 to 11.450, P = 0.012), and no influencing factor was found in the observation group. ConclusionAmong the patients with dysphagia after brainstem stroke, less accompanying disorders and more severe dysphagia were found in those with cricopharyngeal achalasia. All patients improved in dysphagia after treatment, and the rehabilitation effect of cricopharyngeal achalasia was better. The score of DSS relates with oral feeding in non-cricopharyngeal achalasia patients, and there was no specific influencing factor in cricopharyngeal achalasia patients.
ABSTRACT
ObjectiveTo explore the effect of low frequency or high frequency repetitive transcranial magnetic stimulation (rTMS) on right Broca's homologue in stroke patients with nonfluent aphasia. MethodsFrom January, 2019 to August, 2022, 80 inpatients in Beijing Bo'ai Hospital were randomly divided into control group (n = 20), sham stimulation group (n = 20), low-frequency (1 Hz) rTMS (LF-rTMS) group (n = 20) and high-frequency (10 Hz) rTMS (HF-rTMS) group (n = 20). All the patients received routine language therapy. LF-rTMS group and HF-rTMS group received ten days of rTMS (1 Hz or 10 Hz), and the sham group received ten days of sham rTMS. The Western Aphasia Battery (WAB) was used to evaluate the language function before, after treatment, and two months after treatment. ResultsBefore treatment, there was no significant difference in the scores of WAB among four groups (P > 0.05). All the scores improved in the four groups immediately after treatment and two months after treatment (P < 0.05). Compared with immediately after treatment, all the scores of WAB improved in LF-rTMS group (P < 0.05), and the scores of recall, name and aphasia quotient (AQ) improved in HF-rTMS group (P < 0.05) two months after treatment. Immediately after treatment, the scores of content and fluency, auditory comprehension and AQ were higher in LF-rTMS group than in HF-rTMS group (P < 0.05). Two months after treatment, the scores of content and fluency were higher in LF-rTMS group than in HF-rTMS group (P < 0.05). ConclusionBoth 1 Hz and 10 Hz rTMS could improve the language function of stroke patients with nonfluent aphasia, especially 1 Hz.
ABSTRACT
@#Objective To investigate the incidence of Holmes tremor (HT) after stroke and its outcome after medication and rehabilitation. Methods Patients diagnosed as HT after stroke in the ward of neurorehabilitation department from October, 2019 to September, 2021 were reviewed the clinical features, imaging manifestations, drug treatment plan, rehabilitation evaluation scales scores, rehabilitation plan and outcome. Results There were five inpatients with HT (0.7%, 5/715), and all were hemorrhagic stroke, accounting for 1.7% of hemorrhagic stroke. The lesions were located in the midbrain and pons in three cases, cerebellum in one case and thalamus in one case. The tremor appeared 1.5 to seven months after stroke, limited on head and limbs, with other neurological dysfunction. After the comprehensive treatment of drugs and rehabilitation, tremor improved in four cases, and ineffective in one case. The motor and balance function improved less, and the activities of daily living improved somehow. Conclusion The incidence of Holmes tremor is low in stroke patients. The tremor might respond to the treatment, but motor function would not.
ABSTRACT
@#Objective To explore the risk of venous thromboembolism (VTE), especially lower-extremity deep vein thrombosis (DVT) and pulmonary embolism (PE), for stroke patients in rehabilitating, and the functional outcome. Methods A total of 3 557 stroke patients in the neurological rehabilitation center of Beijing Bo'ai Hospital for stroke rehabilitation from January, 2015 to October, 2020 were reviewed through the electronic medical record system. Demographic characteristics, stroke characteristics (type and location), laboratory data (D-dimer polymer and arterial partial pressure of oxygen), motor function (Brunnstrom stage, Fugl-Meyer Assessment of motor and balance, modified Ashworth Scale score of triceps crus, and Holden Walking Ability Classification), activities of daily living (Barthel Index), and anticoagulant/antiplatelet treatment data were collected and analyzed. Results The incidence of DVT and PE was 28.5% and 1.29%, respectively. Most were found 30 days later after onset. The incidence of PE was higher after ischemic stroke (χ2 = 12.49, P < 0.001) rather than hemorrhagic stroke. The patients with hemispheric stroke, severe lower-extremity paralysis, and poor activities of daily living were more prone to complications associated with VTE. After rehabilitation, the function of stroke patients with PE could be improved (|t| > 4.302, P < 0.001). Conclusion The risk of DVT and PE in patients during stroke convalescence may not be negligible, and those with older age, previous history of thrombosis, severe stroke, and severe limb paralysis may be stratified in high-risk. Following anticoagulation treatment, early individualized comprehensive rehabilitation can be done for patients with PE to improve their function and activities of daily living.
ABSTRACT
@#Objective To investigate the effect of comprehensive rehabilitation on ischemic-hypoxic encephalopathy at recovery stage. Methods From January, 2014 to December, 2016, the general data, rehabilitation evaluation, main problems, rehabilitation methods and the functional scores from 28 patients with ischemic-hypoxic encephalopathy were retrospectively analyzed.Results The patients improved in the scores of Mini-Mental State Examination, motor function and balance of Fugl-Meyer Assessment, Holden Gait Classification and modified Barthel Index after rehabilitation (Z>2.588, P<0.05).Conclusion The patients with ischemic-hypoxic encephalopathy may be benefited from comprehensive rehabilitation in cognition, motor function, walking and activities of daily living, etc.
ABSTRACT
Objective To observe the effect of rhythmic auditory stimulation (RAS) on gait of stroke hemiplegic patients. Methods From April, 2014 to April, 2015, eleven stroke hemiplegic patients were divided into RAS group (n=6) and control group (n=5) randomly. Both groups accepted routine rehabilitation, and the RAS group accepted RAS walking exercise, while the control group accepted verbal in-structed walking exercise. They were tested with Brunnstrom's Stage and gait analysis before and three weeks after training. Results There was no significant increase in Brunnstrom's Stage (Z0.05) in both groups after training. The RAS group increased in stride length, velocity and cadence (t>4.829, P0.05). Conclusion Walking exercise under RAS facilitates to improve gait in stroke hemiplegic patients.
ABSTRACT
This article showed the work pattern of rehabilitation assessment, and made assessment of a patient who suffered from bilat-eral hemiplegia and pseudobulbar paralysis caused by multiple cerebral apoplexy. Finally, the special characteristics of rehabilitation treat-ment for a patient with bilateral paralysis were summarized.
ABSTRACT
@# Objective To explore the characteristics and rehabilitation treatment methods of young ischemic stroke combined with congenital myopathy. Methods The clinical data of one young patient with ischemic stroke combined with congenital myopathy was retrospective analyzed, and its pathological feature and rehabilitation treatment methods were also analyzed. Results The etiology may be artery dissection mural thrombus fell off. Conclusion The etiology of young ischemic stroke should be clear diagnosed, and the intensity of rehabilitation training need attention.
ABSTRACT
@#Respiratory dysfunction is a significant part of disorders associated with stroke. Stroke could impair respiratory center or motor pathway, leading to alter breath pattern or reduced respiratory muscle strength. Pneumonia secondary to stroke and stroke-associated sleep apnea are common respiratory disorder, which are adverse to the prognosis of stroke. Clinical routine physical examination is basic evaluation of respiratory function. Attention should be paid especially in breath pattern, respiratory muscle volume and muscle tone. Multiple quantitative assessments include arterial blood gas analysis, sleep apnea monitoring, dynamical, imaging and electrophysiological tests. Rehabilitation can be used to improve the inspiratory muscle strength, endurance and cough effectiveness, reduce sleep apnea hypoventilation, enhance the cardiorespiratory fitness, finally improve the quality of life in stroke patients.
ABSTRACT
@#Objective To explore the effect of intensity of 1 Hz repetitive transcranial magnetic stimulation (rTMS) to right Broca's ho-mologue on nonfluent aphasia after stroke. Methods 40 inpatients were equally divided into low-intensity group and high-intensity group, who received rTMS (1 Hz for 10 minutes) once a day and twice a day respectively for 10 days. They were assessed with Western Aphasia Battery (WAB) before and after intervention, and 2 months after intervention. Results The scores of content and fluency, auditory compre-hension, naming, repetition and AQ improved more in the high-intensity group than in the low-intensity group (P<0.01). It maintained more for 2 months in the scores of content and fluency, repetition and AQ (P<0.05). Conclusion High-intensity rTMS can promote the improve-ment of speech in patients with nonfluent aphasia after stroke that remains for a long term.
ABSTRACT
Respiratory dysfunction is a significant part of disorders associated with stroke. Stroke could impair respiratory center or mo-tor pathway, leading to alter breath pattern or reduced respiratory muscle strength. Pneumonia secondary to stroke and stroke-associated sleep apnea are common respiratory disorder, which are adverse to the prognosis of stroke. Clinical routine physical examination is basic evaluation of respiratory function. Attention should be paid especially in breath pattern, respiratory muscle volume and muscle tone. Multi-ple quantitative assessments include arterial blood gas analysis, sleep apnea monitoring, dynamical, imaging and electrophysiological tests. Rehabilitation can be used to improve the inspiratory muscle strength, endurance and cough effectiveness, reduce sleep apnea hypoventila-tion, enhance the cardiorespiratory fitness, finally improve the quality of life in stroke patients.
ABSTRACT
Objective To explore the characteristics and rehabilitation treatment methods of young ischemic stroke combined with con-genital myopathy. Methods The clinical data of one young patient with ischemic stroke combined with congenital myopathy was retrospec-tive analyzed, and its pathological feature and rehabilitation treatment methods were also analyzed. Results The etiology may be artery dis-section mural thrombus fell off. Conclusion The etiology of young ischemic stroke should be clear diagnosed, and the intensity of rehabilita-tion training need attention.
ABSTRACT
@#The neuromechanism of language function recovery in patients with aphasia after stroke is still unclear. It is supported that the language function of aphasia after extensive damage of left hemisphere mainly recovered through activating the right hemisphere of ho-mologous regions to improve the function of speech. Melodic intonation therapy (MIT) can be achieved by melody tone and left hand clap to activate the right hemisphere of the frontal temporal lobe, which is particularly applicable to improve language function of non-fluent aphasia patients with large left hemisphere lesion. Non-invasive brain stimulation techniques (NBS) changes brain activity through stimulat-ing affected or contralateral side, which has been used to facilitate language functional recovery after stroke. Excitatory transcranial stimula-tion on the right hemisphere homology combined with melodic intonation therapy can promote language recovery of patients with extensive damage of left hemisphere after stroke. It is valuable to combine traditional speech training with MIT and NBS to activate related language functional areas to maximum improvement of language recovery after stroke.
ABSTRACT
@#Objective To compare the effect of virtual reality (VR) based balance training and routine balance training on static and dynamic balance function in stroke patients with hemiplegia. Methods 20 stroke patients with hemiplegia were randomly divided into experimental group (n=10) and control group (n=10). Both groups received routine neurology medication and rehabilitation training. The experimental group received balance training based on 3 VR games: City Ride, The Boat and Road Encounter, while the control group received routine balance training. They were assessed with Berg Balance Scale (BBS) and Timed Up and Go Test (TUGT), and their postural stability and limits of stability were measured with STABLE system before and 4 weeks after training. Results The scores of BBS and TUGT improved in both groups after training (P<0.001), and improved more in the experimental group than in the control group (P<0.001), as well as some of the parameters of postural stability and limits of stability (P<0.05). Conclusion Balance training based on VR is more effective than routine balance training on the static and dynamic balance function of stroke patients with hemiplegia.
ABSTRACT
Objective To explore the effects and mechanism of repetitive transcranial magnetic stimulation (rTMS) applied to the right Broca's homologue of stroke patients with non-fluent aphasia.Methods One stroke patient with non-fluent aphasia received rTMS at 1 Hz and another received the same treatment at 10 Hz.The western aphasia battery (WAB) and functional magnetic resonance imaging (fMRI) were used to evaluate their language function before and after the intervention.Results After treatment,language function in both patients had improved significantly.The aphasia quotient (AQ) score of patient 1 had improved from 37.2 to 66.6,and the AQ score of patient 2 had improved from 36.2 to 60.8.Before treatment,patient 1's activated brain areas during a vocabulary reading task were the left anterior central gyrus and the left gyrus frontalis medius.After the 1 Hz rTMS treatment the activated brain areas were the left medial surface of the lobus frontalis,the left gyrus frontalis inferior,the left prefrontal area,the left preinsula,the left lobulus parietalis inferior,and the left middle/inferior temporal gyrus.Before the 10 Hz rTMS treatment,patient 2's activated brain areas with the same vocabulary reading task were the bilateral medial surface of the temporal lobe,and the bilateral anterior central gyrus.After treatment the bilateral medial surface gyrus,the frontalis medius and lobus frontalis,the right gyrus frontalis inferior,the left prefrontal area,the bilateral lobulus parietalis superior,and the right superior/middle temporal gyrus were activated.Conclusion rTMS can significantly improve language function in stroke patients with non-fluent aphasia.Patients with smaller lesions in the left hemisphere language area can achieve hemisphere function restructuring.Larger lesions in the left hemisphere language area will probably yield bilateral restructuring in both hemispheres.
ABSTRACT
@# A 33-year-old male patient with tick-borne encephalitis (TBE) was reviewed, who presented with severe neurological deficits following TBEV infection, and improved in his motor and quality of life after an individualized rehabilitation.
ABSTRACT
@# Objective To explore the effect of low frequency repetitive transranial magnetic stimulation (rTMS) on unilateral spatial neglect (USN). Methods 40 stroke patients with USN were divided into treatment group (n=20) and control group (n=20). Patients in the treatment group were treated with low frequency rTMS for 2 weeks. The USN degree of these groups were evaluated before and after the treatment. Results There was no significant difference of USN degree between these groups before the treatment (P>0.05); Compared with the control group, the treatment group improved significantly after the treatment (P<0.05). The USN degree of patients in the treatment group decreased significantly after the treatment (P<0.05), while patients in the controlled group had no difference (P>0.05). Conclusion USN induced by stroke could be improved obviously through low frequency rTMS.
ABSTRACT
<p><b>OBJECTIVE</b>To explore changes of neuronal calcium channel following brain damage induced by injection of pertussis bacilli in rats, and to investigate the relationship between cytosolic free calcium concentration ([Ca(2+)](i)) in the synaptosome and Ca(2+)-ATPase activities of mitochondria.</p><p><b>METHODS</b>The level of [Ca(2+)](i) in the synaptosome and Ca(2+)-ATPase activities of mitochondria in the acute brain damage induced by injection of pertussis bacilli (PB) in rat was determined and nimodipine was administrated to show its effects on [Ca(2+)](i) in the synaptosome and on alteration of Ca(2+)-ATPase activity in the mitochondria. Seventy-three rats were randomly divided into four groups, ie, normal control group (Group A), sham-operation control group (Group B), PB group (Group C) and nimodipine treatment group (Group D).</p><p><b>RESULTS</b>The level of [Ca(2+)](i) was significantly increased in the PB-injected cerebral hemisphere in the Group C as compared with that in the Group A and the Group B at 30 minutes after injection of PB. The level of [Ca(2+)](i) was kept higher in the 4 hours and 24 hours subgroups after the injection in the Group C (P<0.05). In contrast, the Ca(2+)-ATPase activities were decreased remarkably among all of the subgroups in the Group C. Nimodipine, which was administered after injection of PB, could significantly decrease the [Ca(2+)](i) and increase the activity of Ca(2+)-ATPase (P<0.05).</p><p><b>CONCLUSIONS</b>The neuronal calcium channel is opened after injection of PB. There is a negative correlation between activities of Ca(2+)-ATPase and [Ca(2+)](i). Nimodipine can reduce brain damage through stimulating the activities of Ca(2+)-ATPase in the mitochondria, and decrease the level of [Ca(2+)](i) in the synaptosome. Treatment with nimodipine dramatically reduces the effects of brain damage induced by injection of PB.</p>