ABSTRACT
Objective:To investigate any change in the effective connectivity between the bilateral anterior central gyruses after transcranial magnetic stimulation (TMS).Methods:Twenty-one healthy subjects were examined using resting state functional magnetic resonance imaging (rs-fMRI) before and after receiving continuous theta burst stimulation (cTBS). The brain atlas of the Institute of Automation of the Chinese Academy of Sciences was used for fine partitioning of the bilateral anterior central gyruses. Granger causality analysis was used to compare any changes in the effective connectivity between them.Results:After the cTBS inhibited the right M1 area, significant changes in effective connectivity among the sub-regions of the bilateral M1 area were observed. The effective connectivity of the right upper limb to the left upper limb and the left head to face were weakened, while that of the left upper limb to the right head, as well as of the face to the right upper limb was enhanced.Conclusion:For people whose right M1 area has been inhibited by cTBS, the effective connectivity changes in both upper limb functional areas of the M1 region reflect inter-hemispheric inhibition. Opposite changes were found in the trunk and upper limbs.
ABSTRACT
Objective:To explore the effectiveness of evaluating voice disorders in dysarthria patients after brain injury using speech production measurements and analyze their phonics characteristics.Methods:Twenty-nine patients were divided into a severe dysarthria group ( n=19) and a mild dysarthria group ( n=10) through the subjective evaluation of their speech, and then evaluated using a computer speech monitor. The maximum phonation time (MPT), maximum counting ability (MCA), basic frequency (F0), standard deviation of F0 (F0SD), F0 range, intensity, formant, and the distance of jaw and tongue movements were recorded. Results:All of the patients displayed abnormal MPTs and MCAs, with the average MPT and MCA of the severe dysarthria group significantly lower than the mild group′s averages. In the severe dysarthria group, the abnormal F0s, F0SDs, F2(i)s and tongue movement distances were significantly greater than in the mild group.Conclusions:Speech production measurements can be applied to evaluate the speech dysarthria patients after brain injury. It is very common for such patients to have impaired speech and respiratory function, so this is worthy of attention.
ABSTRACT
Objective To determine the effect of treadmill exercise on expression of matrix metalloproteinase-2 (MMP-2) in rats follow-ing traumatic brain injury (TBI). Methods Fifty-five male adult Sprague-Dawley rats were randomly assigned to sham (n=15), control (n=20) and exercise (n=20) groups, the later two groups subjected to unilateral cortical contusion injury (CCI). All the rats were assessed with foot-fault test 6, 12, 18 and 24 days after CCI. Evans blue perfusion was used to evaluate the integrity of the blood-brain-barrier (BBB) 48 hours after CCI. Protein expression of MMP-2 was determined with Western blotting one week after CCI. Results The score of foot-fault test improved more in the exercise group than in the control group 12, 18 and 24 days after CCI (F>4.793, P<0.05). Evans blue extravasa-tion was less in the exercise group than in the control group (t=-8.091, P<0.001), as well as the expression of MMP-2 (t=-13.12, P<0.001). Conclusion Early treadmill exercise can improve the motor function in rats with TBI, which may associate with inhibition of MMP-2 ex-pression to protect BBB integrity.
ABSTRACT
Objective To evaluate the effectiveness of standardized three-stage rehabilitation program on spasticity and motor function in the upper extremities after cerebral hemorrhage.Methods A total of 364 patients were included and randomly assigned to a control group (n =181) and a rehabilitation group (n =183).The standardized three-stage rehabilitation program,which included early-stage bedside rehabilitation,specialized treatment in rehabilitation ward during recovery and rehabilitation follow-up at regular intervals was applied in the rehabilitation group,but only rehabilitation guidance and follow-up after discharge were provided for the control group.The modified Ashworth scale (MAS) and Fugl-Meyer assessment (FMA) were performed at the time of recruitment,1 month (M1),3 months(M3) and 6 months(M6) later.Results There was no statistical difference between the groups at recruitment.The occurrence rate of spasticity was 22.7％ in the control and 23.5％ in the rehabilitation group.At M6 the occurrence rate of spasticity was about 59.7％ and 43.2％ in control group and rehabilitation group respectively,and the number of patients grade 1 + and grade 2 on the MAS was 50/181 in the control group,significantly more than in the rehabilitation group (25/183).At all time points,MAS grade 0 accounted for a large proportion of both groups.At M6,both MAS distributions and scores of the two groups were different statistically (P ＜ 0.01).FMA scores in both groups increased significantly (P ＜ 0.01) with time,with the score being (17.13 ± 16.46),(24.87±18.36),(30.68±19.41) at M1,M3 and M6 in the control group and (24.71 ±19.80),(39.83 ± 19.50),(48.87 ± 18.25) in the rehabilitation group,but the average scores of the latter were consistently significantly higher than the former (P ＜ 0.01).Conclusions Standardized three-stage rehabilitation can alleviate spasticity and improve motor function of the upper extremities in cerebral hemorrhage patients.
ABSTRACT
Objective To study the effects of active and passive movement of the affected hand after ischemic stroke on brain activity patterns using blood oxygenation level-dependent functional magnetic resonance imaging (BOLD-fMRI) and to explore the central mechanism of movement treatment for hand disability.Methods Five pa-tients with subcortical cerebral infarction in Brunnstrom stages 1 to 3 (both upper limb and hand affected) were investigated using BOLD-fMRI during active and passive clenching and relaxing of the affected hand.Statistical parametric mapping software (SPM5) was used to integrate the activity data and display them in one standard brain map.The activated areas were then compared.Results The BOLD-fMRI signals aroused by both active and passive move-ment were enhanced in the contralateral sensorimotor cortex,the contralateral premotor cortex,bilaterally in the sup-plementary motor area and in the bilateral cerebellum.Both movements also activated the ipsilateral sensorimotor cor-tex and premotor cortex,which are not normally activated during such movements in healthy people.The areas were more extensive and the activation was stronger during passive movement.Moreover,the activated brain areas induced by active movement were mainly on the contralateral side,while passive movement induced activation distributed over both hemispheres almost evenly.Conclusions Both active and passive movement significantly activate the brain areas responsible for movement of the affected hand.Both are useful for boosting brain reorganization after stroke.
ABSTRACT
ObjectiveTo explore the efficacy of 131 Ⅰ treatment in Graves' disease,and to analyze the related factors.MethodIn 87 patients with Graves' disease,thyroid uptake ratio( TUR ) and its effective half-life(EHL) were compared before and after 131 Ⅰ treatment.The weight of thyroid gland was evaluated with radio-imaging and type B ultrasonography.ResultThe dose of 131 Ⅰ was ( 185.2 ± 148.0 ) MBq.The TUR of tracer dose and therapeutic 131 Ⅰ dose were 76.5 ％ ±8.2％ and 73.3 ％ ±9.0％ ( t =2.451,P =0.008 ).The EHL were ( 5.2±0.7 ) and ( 5.0 ±0.8 )days,respectively ( t =1.998,P =0.023 ).After followe-up of ( 57.0 ±26.3 ) months,49 patients ( 56.3 ％ ) became euthyroid,14 ( 16.1％ )manifested delayed hypothyroidism,and 24 (27.6％)remained in hyperthyroidism.Thyroid autoantibodies were found in 34.5％ patients,of whom,the incidence of hypothyroidism was higher in patients with positive autoantibodies than those with negative ones (30.0％ vs 8.8％,x2 =6.560,P =0.009 ).ConclusionBoth TUR and EHL of therapeutic doses of 131 Ⅰ are lower than the tracer doses.Positive thyroid autoantibodies may affect the outcome of the 131 Ⅰ treatment.
ABSTRACT
Objective To assess differences in brain activation between active and passive movement of the right hand using blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI). Methods Nine healthy adult right handed volunteers were studied. fMRI was performed with active and passive finger-to-finger movement. Results Right hand active and passive movement produced significant activation in the contralateral sensorimotor cortex ( SMC ), the contralateral premotor cortex ( PMC ), bilaterally in the supplementary motor area (SMA) and in the ipsilateral cerebellum. The activated brain areas were centered on the contralateral SMC and PMC and located more forward during active movement than during passive movement. The contralateral SMC was the most strongly and the most frequently activated brain area. The contralateral posterior parietal cortex (PPC) was less relevant to the hand movements. Unlike active movement, passivemovement activated more areas in the posterior central gyrus than in the anterior central gyrus. Conclusions Both active and passive movement significantly activate the brain areas which are responsible for hand movement, but there are some differences in the locations of the cortex areas activated and in the incidence activation except in the contralateral SMC.
ABSTRACT
Objective To evaluate the effects of community-based rehabilitation therapy on activitv of daily living performance of the Chinese stroke patients. Methods In a single blinded,randomized,controlled multicenter trial,737 consecutive stroke patients were stratified by two groups of cerebral infarction and hemorrhage. All the patients were randomly divided into a rehabilitation group and a control group.The patients in the rehabilitation group received atandardized community-based rehabilitation therapy,while those in the control group did not.All the patients were followed up for 5 months for evaluation of their performance with activity of daily living by using Modified Barthel Index before intervention,after follow-up 2 and 5 months,respectively. Results Patients in the rehabilitation group performed better in ADL as reflected by the Modified Barthel Index score than those in the control group after 5 months of intervention(P＜0.05).Although both the rehabilitation group and control group improved over time,the rehabilitation group showed a greater improvement with the Modified Barthel Index scores when compared with the control group(P＜0.01).After 5 months follow-up,the total gain of Modified Barthel Index scores was 26.28 and 32.89 for those with cerebral infarction and hemorrhage,respectively,in the rehabilitation group. In comparison,the gain of Modified Barthel Index scores was 7.65 and 2 1.70 for those with cerebral infarction and those with hemorrhage,respectively in the control group.This implies a difference in improvement of 1 8.63 in cerebral infarction group and 1 1.19 in hemorrhage group,in favor of the rehabilitation group. Conclusion Standardized community-based rehabilitation therapy may help stroke patients to improve their performance in activity of daily living significantly.
ABSTRACT
@#Peak Torque(PT),Total Work(TW),Average Power(AP),Torque Acceleration Energy(TAE),Set Total Work(STW),Endurance Ratio (ER)and DOrsal/plantar ratio of ankle dorsal and plantarflexion were tested in 101 patients with lumbar disc protrusion using a Cybex一6000 isokinetic muscle test-ing instrument.The results showed the most tested of the affected side was signficantly lower than that onthe opposite side. The PT,TW and STW of the affected side was lower 70一80%than that on the oppo-site side. The rest was lower 20一30%than another side. No significant difference of endurance ratios be-tween the affected and unaffected sides was noted.