ABSTRACT
Objective To investigate the effects of reciprocal inhibition on motor function connectivity in the brains of stroke patients.Methods Thirty patients with stroke were randomly divided into a treatment group (n =15) and a control group (n =15).The control group underwent normal limb positioning,medium frequency electrotherapy,circulated compression of the limbs,etc.The treatment group received conventional rehabilitation treatment plus reciprocal inhibition treatment for 30 min daily,6 times a week for 4 weeks.All of the patients were assessed before and after treatment using the Canadian neurological scale (CNS),the Frenchay activities index (FAI),the motricity index (MI) and functional magnetic resonance imaging of the motor cortex in a resting state (rs-fMRI).Results In both groups the average CNS,FAI and MI scores improved significantly.Compared with the control group,the changes in FAI and MI scores in the treatment group improved significantly more.The coefficient of functional connectivity of the bilateral motor cortex decreased significantly after treatment in both groups.In the treatment group the motor cortex functional connectivity correlated significantly with the improvements in MI scores.Conclusions Reciprocal inhibition can accelerate the improvement of extremity motor function and ability in the activities of daily living significantly after stroke.It reduces functional connectivity in the bilateral motor cortex in ways significantly correlated with improvements in motor function.
ABSTRACT
O objetivo do presente estudo foi comparar os níveis de inibição pré-sináptica (IPS) e inibição recíproca (IR) entre indivíduos com Doença de Parkinson e saudáveis e, a correlação entre essas inibições e a rigidez muscular e a severidade clínica de indivíduos com Doença de Parkinson (avaliadas através da Escala Unificada de Avaliação da Doença de Parkinson). Foram avaliados 11 indivíduos nos estágios 2 e 3 da doença e 13 indivíduos saudáveis pareados pela idade. A IPS foi menor em indivíduos com Doença de Parkinson (31,6%) do que em saudáveis (67,1%) (p = 0,02). A IR não diferiu entre indivíduos com Doença de Parkinson (26,9%) e saudáveis (27,6%) (p = 0,91). Adicionalmente, não foram detectadas correlações entre os níveis de IPS com a rigidez e a severidade clínica (p > 0,05). Portanto, mecanismos inibitórios não explicam totalmente a rigidez muscular e a severidade clinica da doença. Alterações entre ativação de músculos agonistas e antagonistas parecem estar relacionadas a influências supraespinhais anormais nos mecanismos espinhais decorrentes da doença...
The purposes of the present study were to compare presynaptic inhibition (PI) and disynaptic reciprocal inhibition (DRI) levels between parkinsonians and healthy individuals and to verify the correlation of such inhibitions with muscle rigidity and clinical severity (assessed by the Unified Parkinson Disease Rating Scale). We evaluated 11 parkinsonians in stages 2 and 3 of the disease and 13 healthy individuals matched for age. The PI was significant lower in parkinsonians (31.6%) than in healthy individuals (67.1%) (p = 0.02). The DRI did not differ between parkinsonians (26.9%) and healthy individuals (27.6%) (p = 0.91). Furthermore, no significant correlation was observed between PI with muscle rigidity and clinical severity (p > 0.05). Therefore, inhibitory mechanisms do not fully explain the cause of muscle rigidity and clinical severity of parkinsonians. Changes between the activation of agonist and antagonist muscles seem to be caused by abnormal supraspinal influence on spinal mechanisms...
Subject(s)
Humans , Male , Female , Middle Aged , Muscle Rigidity , Neural Inhibition , Parkinson Disease , Spinal CordABSTRACT
@#Spasticity can influence the outcome of the patients with cerebral injury. Most traditional physical therapies often focused on the spastic muscle. The recent development has showed that stimulating the antagonistic muscle can relieve the spasticity, which based on the reciprocal inhibition theory. This paper reviewed these approaches on its theory and application.
ABSTRACT
Patients with focal hand dystonia demonstrate abnormally increased corticospinal excitability, which has been reported to be ameliorated, at least for a short term, with low frequency repetitive transcranial magnetic stimulation (rTMS). Transcranial direct current stimulation (tDCS), which is less costly and easier to apply than rTMS, is also known to modulate cortical excitability. Especially with cathodal tDCS, cortical excitability can be reduced. On the other hand, upper extremity splinting is also known to reduce dystonic symptoms by inhibiting abnormal movement. We therefore combined cathodal tDCS with finger splinting to treat focal hand dystonia in a 34-year-old man with traumatic brain injury who showed involuntary movement of his right fingers during writing and chopsticks use. After 5 days of cathodal tDCS sessions (1mA, 10min), he was encouraged to use interphalangeal joint splints for his thumb and index finger during these activities. We assessed computer-rated handwriting, reciprocal inhibition and intracortical inhibition before, 24 hours and 3 months after the 5-day tDCS sessions. Before the treatment, his flexor pollicis longus (FPL) and first dorsal interosseous (FDI) muscles showed 4Hz rhythmic hyperactivity during writing, and reciprocal inhibition at interstimulus intervals (ISI) of 20 and 100 ms were lost. Paired pulse TMS also revealed disinhibited short interval intracortical inhibition (SICI) at an ISI of 2 and 3 ms. The 5-day tDCS sessions reduced FPL and FDI EMG activities, and SICI and RI at 20 and 100 ms were also restored. Wearing the finger splints, these improvements were maintained at the 3-month follow-up. This case report is the first to demonstrate the possible long-term effects of tDCS combined with splinting for focal hand dystonia. It is supposed that splinting after tDCS plays an important role in making the tDCS aftereffects last longer.
ABSTRACT
OBJECTIVE: To evaluate the effect of a transcranial magnetic stimulation on reciprocal inhibition of the human leg. METHOD: Twenty healthy human subjects who showed significant inhibition of soleus H reflex after conditioning electrical stimulation of tibialis anterior at a conditioning-test interval of 2 ms were included in this study. Changes in the amount of reciprocal inhibition by conditioning electrical stimulus were compared after transcranial magnetic stimulation of tibialis anterior. RESULTS: Approximately 12% inhibition of H reflex was produced by motor threshold stimulation, and 14% inhibition by maximum stimulation of common peroneal nerve. When a submotor threshold cortical shock was given with test-conditioning interval 0 ms, this inhibition was not significantly changed. There was no significant change of H reflex amplitude ratio by conditioning electrical stimulation after delivering supramotor threshold cortical shock. Amplitude of H reflex was enhanced by transcranial magnetic stimulation at each same conditioning electrical stimulation. CONCLUSION: We conclude that TMS can produce excitatory effects on spinal motor neurons rather than Ia inhibitory interneuron and there is no evidence for convergence onto Ia inhibitory interneurons from the fiber systems excited by magnetic stimulation over the cortex.