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@#Objective To investigate the relationship between disrupted corticospinal tract (CST) and motor recovery after stroke by using diffusion tensor tracking (DTT). Methods From March, 2012 to June, 2013, 15 chronic stroke patients with left subcortical lesions and 15 age- and sex- matched healthy subjects were performed diffusion tensor imaging (DTI) examination. The CST was tracked by DTT technique, and the damaged values of the CST caused by the stroke lesions were quantified using a CST template generated from healthy controls. Furthermore, the correlations of the damaged values of the CST with Fugl-Meyer Assessment (FMA) were performed. Results The range of the damaged values of CST in stroke patients was 0.00% to 29.6%. There were very strong negative correlation between the damaged values of the CST and FMA scores (the wrist, r = -0.660; hand, r = -0.813; wrist plus hand, r = -0.795, respectively, P < 0.01). It also showed strong negative correlation between the damaged values of the CST and FMA scores (upper limb, r = -0.614; upper limb plus lower limb, r = -0.563, respectively, P < 0.05). Whereas, there was no correlation between the damaged values of the CST and FMA scores of lower limb (r = -0.270, P = 0.331). In addition, the lesion volumes of stroke and FMA scores were not significantly correlated (P > 0.05). Conclusion The severity of motor deficit after stroke was closely related to the overlap of lesions with CST. The damaged values of the CST based on DTT may be used as a potential biomarker to assess motor impairments of upper limbs, especially hand and wrist in stroke patients.
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Objective To investigate the effects of hyperbaric oxygen (HBO) on homing of exogenous bone marrow mesenchymal stem cells (BMSCs) after traumatic brain injury (TBI) in rats. Methods BMSCs were isolated and cultured with Ficoll density gradient centrifuga-tion, and the surface markers (CD29, CD90, CD45, CD11b) of the third generation were identified with flow cytometry. The authenticated BM-SCs were processed by the cell membrane fluorescent probe CM-DiI before transplantation. Thirty-six Sprague-Dawley rats were divided in-to Sham group (n=6), TBI group (n=6), BMSCs group (n=12), HBO+BMSCs group (n=12). The number and locations of homing of tracing BMSCs were observed under fluorescent microscope after frozen sections, and the expression of stromal cell-derived factor 1 (SDF-1) and CXC chemokine receptor type 4 (CXCR4) proteins were detected with Western blotting one and three days after BMSCs transplantation. Re-sults The fluorescence-labeled BMSCs focused on the injured hemisphere, especially around the damaged brain tissue. The number of hom-ing was more in HBO+BMSCs group than in BMSCs group at the same time (P<0.01), and increased in both groups three days after trans-plantation compared with those of one day after transplantation (P<0.01). The expression of SDF-1 and CXCR4 protein were more in HBO+BMSCs group than in BMSCs group (P<0.05). Conclusion HBO can promote the exogenous BMSCs homing to damaged brain tissue in rats after traumatic brain injury, which is related to the enhancement of SDF-1/CXCR4 axis.
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Objective To explore the effect of a multimodal electroencephalogram ( EEG) data visualiza-tion system on the motor imagery ability of stroke survivors. Methods Twenty stroke patients were randomly di-vided into an experimental group and a control group, each of 10. Both groups were provided with brain-computer interface-based motor imagery ( MI) training. At the same time, the experimental group was monitored and guided using an online, multimodal EEG data visualization system developed in our department. The classification accuracy ( CA) and event-related desynchronization ( ERD) of the 2 groups′ motor imagery were compared before and after the treatment. Results Before the treatment, no significant differences in the average CA of MI were found be-tween the experiment group (50.92±2.08) and the control group (49.35±4.20)(P>0.05). After the treatment, however, the experimental group′s average CA had increased to (64.52±5.27), significantly higher than that of the control group (51.18±5.02). When the stroke patients imaged affected upper extremity movements, obvious ERD was observed in the α frequency around the bilateral central motor regions of both groups, especially in the experi-mental group, but without significant differences between the two groups. However, no significant changes were found in the ERD of theβwaves of the two groups( P>0.05) . Conclusion The proposed online multimodal elec-troencephalogram data visualization system can help stroke patients imagine movements actively. It is worth sprea-ding in clinical practice.
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Objective To explore the effects of transcutaneous electrical acupoint stimulation (TEAS) on paralytic hand and upper limb of stroke patients. Methods 32 patients were randomly divided into the treatment group (n=16) and the control group (n=16). All the pa-tients accepted routine rehabilitation, and the patients in the treatment group accepted TEAS in addition for 6 weeks. They were assessed with Fug1-Meyer Assessment of upper extremities (FMA-UE), motor status scale (MSS) and Modified Barthel Index (MBI) before and 2, 4, 6 weeks after treatment. Results All the measures improved in both groups after 2, 4, and 6 weeks of treatment (P<0.05), while the scores of MBI improved more in the treatment group than in the control group 4 weeks after treatment (P<0.05), and all the measures improved more in treatment group than in the control group 6 weeks after treatment (P<0.05). Conclusion TEAS may promote the recovery of flaccid hand and upper extremity function post stroke.
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@#Objective To explore the effects of transcutaneous electrical acupoint stimulation (TEAS) on paralytic hand and upper limb of stroke patients. Methods 32 patients were randomly divided into the treatment group (n=16) and the control group (n=16). All the patients accepted routine rehabilitation, and the patients in the treatment group accepted TEAS in addition for 6 weeks. They were assessed with Fug1-Meyer Assessment of upper extremities (FMA-UE), motor status scale (MSS) and Modified Barthel Index (MBI) before and 2, 4, 6 weeks after treatment. Results All the measures improved in both groups after 2, 4, and 6 weeks of treatment (P<0.05), while the scores of MBI improved more in the treatment group than in the control group 4 weeks after treatment (P<0.05), and all the measures improved more in treatment group than in the control group 6 weeks after treatment (P<0.05). Conclusion TEAS may promote the recovery of flaccid hand and upper extremity function post stroke.
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BACKGROUND:Mirror therapy was initial y used in the treatment of affected limb pain after amputation, and has been applied as a valid way for relieving complex regional pain syndrome due to other injuries, but the efficacy for patients with upper limb complex regional pain syndrome (type II) more than 3 years after high-level spinal cord injury has not been reported in any way. OBJECTIVE:To investigate the availability of mirror therapy for reducing pain in a patient with upper limb complex regional pain syndrome (type II) who suffered high-level spinal cord injury. METHODS:An experimental design of self cross-control was applied for al eviating the patient’s pain with the intervention of transcutaneous electrical nerve stimulation and mirror box therapy, which were conducted 2 or 3 weeks respectively. And the elution period between two kinds of treatments was 1 week, the fol ow-up time was 1 month. RESULTS AND CONCLUSION:The pain of the patient was not relieved, but even aggravated after 2 weeks of transcutaneous electrical nerve stimulation, while 3-week mirror box therapy significantly reduced the pain after elution period (the third week). The Hamilton anxiety scale, Hamilton depression scale, and WHO quality of life scale scores were significantly improved after treatment compared with before treatment. Experimental findings indicate that, mirror therapy may be an effective intervention for mitigating complex regional pain syndrome (type II) in addition to the comprehensive treatments, but further studies are warranted to confirm its effect.
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Upper extremities dysfunction seriously impacted quality of life and independent self-care ability in patients after stroke. Transcutaneous electrical nerve stimulation has been proved to be an effective method for upper extremities dysfunction rehabilitation. Clini-cians focused to select the proper therapeutic method according to the patient's specific condition to accelerate the upper limb rehabilitation. This article summarized the clinical application researches of transcutaneous electrical nerve stimulation in stroke patients with upper ex-tremities dysfunction.