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1.
Fisioter. Bras ; 22(5): 773-788, Nov 11, 2021.
Article in Portuguese | LILACS | ID: biblio-1353566

ABSTRACT

Estimulação Transcraniana por Corrente Contínua (ETCC) é um recurso terapêutico não invasivo ao paciente, de baixo custo, baseado na alteração da excitabilidade do córtex motor. Técnica capaz de influenciar no mecanismo autônomo do SNC, aumentando a eficiência sináptica e favorecendo o aprendizado motor. Objetivo: Sistematizar evidências científicas sobre a ETCC como recurso terapêutico no processo de reabilitação de crianças com paralisia cerebral. Métodos: Revisão sistematizada seguindo recomendações do PRISMA e a busca estratégica PICO diante da indicação da ETCC, como recurso terapêutico no processo de reabilitação de crianças com paralisia cerebral. Incluídos ensaios clínicos controlados e randomizados, publicados nos últimos 10 anos, disponíveis em cinco relevantes bases de dados em saúde nos idiomas inglês, espanhol e português. Resultados: Foram encontrados 604 estudos, dos quais, após aplicação dos critérios de elegibilidade, quatro deles foram selecionados. Os resultados de tais estudos se mostraram benéficos no tratamento de crianças com paralisia cerebral, incluindo aquelas com mais de 70% de presença de espasticidade. Conclusão: ETCC constitui recurso promissor no tratamento da criança com paralisia cerebral, aceito pelas crianças visto ser indolor e apresentar reações leves como vermelhidão e formigamento no local da aplicação. Os efeitos favoráveis destacados foram: melhora no desempenho funcional e da marcha. (AU)


Subject(s)
Therapeutics , Central Nervous System , Transcranial Direct Current Stimulation , Motor Cortex , Rehabilitation , Cerebral Palsy , Electric Stimulation
2.
Journal of Biomedical Engineering ; (6): 1154-1162, 2021.
Article in Chinese | WPRIM | ID: wpr-921857

ABSTRACT

The functional coupling between motor cortex and effector muscles during autonomic movement can be quantified by calculating the coupling between electroencephalogram (EEG) signal and surface electromyography (sEMG) signal. The maximal information coefficient (MIC) algorithm has been proved to be effective in quantifying the coupling relationship between neural signals, but it also has the problem of time-consuming calculations in actual use. To solve this problem, an improved MIC algorithm was proposed based on the efficient clustering characteristics of K-means ++ algorithm to accurately detect the coupling strength between nonlinear time series. Simulation results showed that the improved MIC algorithm proposed in this paper can capture the coupling relationship between nonlinear time series quickly and accurately under different noise levels. The results of right dorsiflexion experiments in stroke patients showed that the improved method could accurately capture the coupling strength of EEG signal and sEMG signal in the specific frequency band. Compared with the healthy controls, the functional corticomuscular coupling (FCMC) in beta (14~30 Hz) and gamma band (31~45 Hz) were significantly weaker in stroke patients, and the beta-band MIC values were positively correlated with the Fugl-Meyers assessment (FMA) scale scores. The method proposed in this study is hopeful to be a new method for quantitative assessment of motor function for stroke patients.


Subject(s)
Algorithms , Electroencephalography , Electromyography , Humans , Motor Cortex , Muscle, Skeletal , Stroke
3.
Chinese Acupuncture & Moxibustion ; (12): 1365-1369, 2021.
Article in Chinese | WPRIM | ID: wpr-921061

ABSTRACT

OBJECTIVE@#To compare the effect of electroacupuncture (EA), motor training (MT) and EA combined with MT on motor learning and motor cortex excitability in healthy subjects, and to explore the effect of EA combined with MT on synaptic metaplasticity.@*METHODS@#Using self-control design, 12 healthy subjects were assigned into an EA group, a motor training group (MT group) and an EA plus motor training group (EA+MT group) successively, wash-out period of at least 2 weeks was required between each group. EA was applied at left Hegu (LI 4) in the EA group for 30 min, with continuous wave, 2 Hz in frequency and 0.5-1 mA in density. Motor training of left hand was adopted in the MT group for 30 min. EA and motor training were adopted in the EA+MT group successively. The time of finishing grooved pegboard test (GPT) was observed, and the average amplitude of motor evoked potentials (MEPs), the rest motor threshold (rMT) and the latency were recorded by transcranial magnetic stimulation technique before intervention (T0), after intervention (T1) and 30 min after EA (T3) in the EA group and the EA+MT group, T0 and T1 in the MT group.@*RESULTS@#Compared with T0, the time of finishing GPT was shortened at T1 in the MT group and at T2 in the EA group and the EA+MT group (@*CONCLUSION@#In physiological state, electroacupuncture combined with motor training have a synergistic effect on motor learning, while have no such effect on excitability of cerebral motor cortex.


Subject(s)
Electroacupuncture , Evoked Potentials, Motor , Hand , Humans , Motor Cortex
4.
Acta neurol. colomb ; 35(1): 36-39, ene.-mar. 2019. graf
Article in Spanish | LILACS | ID: biblio-989196

ABSTRACT

RESUMEN La parálisis pseudoperiférica es una presentación infrecuente del ataque cerebrovascular (ACV) isquémico, que suele llevar a un diagnóstico erróneo de patología de nervio periférico. Se caracteriza por una presentación clínica consistente en paresia de la mano o de un grupo de dedos y alteración de la sensibilidad que puede simular el compromiso de un nervio periférico. Se reporta el caso clínico de un paciente que cursó con parálisis pseudoperiférica, con compromiso motor predominantemente cubital asociado a hipoestesia multimodal en la región hipotenar, lo cual ilustrando la dificultad de la localización topográfica para explicar el compromiso motor y sensitivo por un síndrome mononeuropático, troncular, radicular o medular. Se resalta la importancia de una adecuada evaluación semiológica, que permita hacer aproximaciones diagnósticas acertadas para dar un manejo adecuado de acuerdo con el estudio topográfico en las patologías neurológicas.


SUMMARY Pseudo-peripheral palsy is an infrequent presentation of ischemic stroke, which often leads to a misdiagnosis of peripheral nerve pathology. It is characterized by palsy of the hand or a group of fingers and altered sensitivity which can simulate peripheral nerve damage. We report a case of a patient who had pseudo-peripheral palsy with predominantly ulnar motor involvement, associated with multimodal hypoesthesia in the hypothenar region; illustrating the difficulty of topographic localization to explain motor and sensory involvement by a mononeuropathic, radicular or spinal syndrome. We highlight the importance of an adequate semiological evaluation to accurately diagnose and manage these pathologies.


Subject(s)
Paralysis , Stroke , Diagnosis, Differential , Motor Cortex
5.
Clinical Pain ; (2): 88-91, 2019.
Article in Korean | WPRIM | ID: wpr-811489

ABSTRACT

Unexplained pain and weakness, i.e., without obvious predisposing factors, are often encountered by physiatrists and efforts should be made to determine the cause. A 63-year-old male presented with radiating pain in his right arm and mild weakness of the right hand. An electrodiagnostic examination revealed distal symmetric sensory polyneuropathy in the upper and lower extremities, and denervation potentials in the forearm muscles, which were inconsistent with the cervical spine MRI images and symptoms. A predisposing undiscovered disease was revealed, i.e., squamous cell carcinoma in the lung; brain metastasis affecting the left primary motor cortex was also detected. Therefore, we concluded that the pain and weakness were related to paraneoplastic syndrome and brain metastases of the hand knob. The observed denervation potentials were characterized as trans-synaptic changes in the brain metastasis. This case highlights the importance of unexplainable focal pain and weakness in the increasing prevalence of cancer.


Subject(s)
Arm , Brain , Carcinoma, Non-Small-Cell Lung , Carcinoma, Squamous Cell , Causality , Denervation , Forearm , Hand , Humans , Lower Extremity , Lung , Lung Neoplasms , Magnetic Resonance Imaging , Male , Middle Aged , Motor Cortex , Muscles , Neoplasm Metastasis , Paraneoplastic Syndromes , Polyneuropathies , Prevalence , Spine
6.
Article in English | WPRIM | ID: wpr-762632

ABSTRACT

OBJECTIVE: To investigate association between lesion location on magnetic resonance imaging (MRI) performed after an infarction and the duration of dysphagia in middle cerebral artery (MCA) infarction. METHODS: A videofluoroscopic swallowing study was performed for 59 patients with dysphagia who were diagnosed as cerebral infarction of the MCA territory confirmed by brain MRI. Lesions were divided into 11 regions of interest: primary somatosensory cortex, primary motor cortex, supplementary motor cortex, anterior cingulate cortex, orbitofrontal cortex, parieto-occipital cortex, insular cortex, posterior limb of the internal capsule (PLIC), thalamus, basal ganglia (caudate nucleus), and basal ganglia (putamen). Recovery time was defined as the period from the first day of L-tube feeding to the day that rice porridge with thickening agent was prescribed. Recovery time and brain lesion patterns were compared and analyzed. RESULTS: The mean recovery time of all patients was 26.71±16.39 days. The mean recovery time was 36.65±15.83 days in patients with PLIC lesions and 32.6±17.27 days in patients with caudate nucleus lesions. Only these two groups showed longer recovery time than the average recovery time for all patients. One-way analysis of variance for recovery time showed significant differences between patients with and without lesions in PLIC and caudate (p<0.001). CONCLUSION: Injury to both PLIC and caudate nucleus is associated with longer recovery time from dysphagia.


Subject(s)
Basal Ganglia , Brain , Caudate Nucleus , Cerebral Cortex , Cerebral Infarction , Deglutition , Deglutition Disorders , Extremities , Gyrus Cinguli , Humans , Infarction , Infarction, Middle Cerebral Artery , Internal Capsule , Magnetic Resonance Imaging , Middle Cerebral Artery , Motor Cortex , Prefrontal Cortex , Somatosensory Cortex , Thalamus
7.
Article in Korean | WPRIM | ID: wpr-766826

ABSTRACT

Brain death is a clinical diagnosis that implies irreversible loss of function of the entire brain, including the brainstem and both hemispheres. It is not uncommon for reflex and spontaneous movements to occur in patients with impending brain death during the process of determining brain death. When physicians charged with judging brain death witness such movements during this period, unless they know how common these movements are and what they mean, it will be difficult for them to make an appropriate determination of brain death. Movements following brain death have been reported in previous studies of various types, including cohort studies and case series or reports. However, only a few studies have employed verified diagnostic tools and neurological examinations as a standard protocol when diagnosing brain death. According to previous reports, the frequency of these movements ranges from 19.2% to 75.0% of all brain death cases. These reports have also described which movements are commonly seen. However, it is difficult to determine conclusively where these movements originate, i.e., in the spinal cord or in the cerebral motor cortex, and how such information should be considered in determining brain death. Although limited information is available on the characteristics and pathophysiological mechanism of these movements, it will help physicians to diagnose brain death correctly if they obtain sufficient knowledge about them.


Subject(s)
Brain Death , Brain Stem , Brain , Cohort Studies , Diagnosis , Humans , Motor Cortex , Neurologic Examination , Reflex , Spinal Cord
8.
Article in English | WPRIM | ID: wpr-739826

ABSTRACT

OBJECTIVE: To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on neurological and functional recovery in patients with central cord syndrome (CCS) involving the upper extremities between the treated and non-treated sides of the treated group and whether the outcomes are comparable to that of the untreated control group. METHODS: Nineteen CCS patients were treated with high-frequency (20 Hz) rTMS over the motor cortex for 5 days. The stimulation side was randomly selected, and all the subjects received conventional occupational therapy during the rTMS-treatment period. Twenty CCS patients who did not receive rTMS were considered as controls. Clinical assessments, including those by the International Standard for Neurological Classification of Spinal Cord Injury, the Jebsen-Taylor Hand Function Test, and the O'Connor Finger Dexterity Test were performed initially and followed up for 1 month after rTMS treatment or 5 weeks after initial assessments. RESULTS: The motor scores for upper extremities were increased and the number of improved cases was greater for the treated side in rTMS-treated patients than for the non-treated side in rTMS-treated patients or controls. The improved cases for writing time and score measured on the Jebsen-Taylor Hand Function Test were also significantly greater in number on the rTMS-treated side compared with the non-treated side and controls. There were no adverse effects during rTMS therapy or the follow-up period. CONCLUSION: The results of the application of high-frequency rTMS treatment to CCS patients suggest that rTMS can enhance the motor recovery and functional fine motor task performance of the upper extremities in such individuals.


Subject(s)
Central Cord Syndrome , Classification , Fingers , Follow-Up Studies , Hand , Humans , Motor Cortex , Occupational Therapy , Spinal Cord Injuries , Task Performance and Analysis , Transcranial Magnetic Stimulation , Upper Extremity , Writing
9.
Article in English | WPRIM | ID: wpr-739330

ABSTRACT

Despite the low incidence, seizures induced by repetitive transcranial magnetic stimulation (rTMS) have been studied as they may cause neurological and functional regression. Seizures may predict poor outcomes in stroke patients, with no reports of improved neurological status after seizures. This is the first Korean report of a seizure induced by rTMS, and the first report in the literature of prompt motor recovery following a seizure induced by high-frequency rTMS of the primary motor cortex in a stroke patient. A 43-year-old man with left hemiplegia due to infarction in the right basal ganglia was enrolled 10 sessions of rTMS (each session consisted of 15 trains, with each train consisting of 5 seconds of stimulation at 20 Hz and 90% of resting motor threshold for each session followed by 55 seconds of rest). The self-limited seizure occurred within 5 seconds after the 10th session. It lasted for 60 seconds, with generalized tonic features in all four extremities and the trunk and loss of consciousness followed by prompt improvement in left hand muscle strength and coordination. Though the seizure is known to usually cause neurologic regression, this case showed neurologic improvement after rTMS even after the rTMS-induced seizure.


Subject(s)
Adult , Basal Ganglia , Extremities , Hand , Hemiplegia , Humans , Incidence , Infarction , Motor Cortex , Muscle Strength , Seizures , Stroke , Transcranial Magnetic Stimulation , Unconsciousness
10.
Article in English | WPRIM | ID: wpr-739325

ABSTRACT

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that modulates cortical excitability and influences cognition. The role of the primary motor cortex (M1) in cognition is controversial. Here, we investigated the offline effects of anodal and sham tDCS over M1 on cognitive tasks that require comparable motor skills, but different levels of working memory and attention. Twenty healthy young female adults received anodal tDCS and sham tDCS to the M1 on two separate testing days in a counter balanced order. The cognitive functions outcome variables were the response time from the Attention Switching Task (AST) and Motor Screening Task (MST) tests using the Cambridge Neuropsychological Test Automated Battery before and after the anodal/sham tDCS. Anodal tDCS significantly improved AST response times from baseline in congruent and incongruent condition and MST mean correct latency (all p < 0.05). There was a significant difference for AST tasks variable include AST Switching cost (mean, correct), AST Mean correct latency, in congruent, incongruent, blocks 3, 5 (non-switching blocks), block 7 (switching block) (p < 0.01) and MST mean latency (p < 0.05) between anodal and sham conditions. These results indicate that tDCS is a promising tool to an improvement in response time in task related attention and motor speed. However, this study warrants further research to determine the long-term effect on other cognitive functions and in different age and gender groups.


Subject(s)
Adult , Brain , Cognition , Female , Humans , Mass Screening , Memory, Short-Term , Motor Cortex , Motor Skills , Neuropsychological Tests , Reaction Time , Transcranial Direct Current Stimulation
11.
Article in English | WPRIM | ID: wpr-719586

ABSTRACT

OBJECTIVE: For localization of the motor cortex, seed-based resting-state functional MRI (rsfMRI) uses the contralateral motor cortex as a seed. However, research has shown that the location of the motor cortex could differ according to anatomical variations. The purpose of this study was to compare the results of rsfMRI using two seeds: a template seed (the anatomically expected location of the contralateral motor cortex) and a functional seed (the actual location of the contralateral motor cortex determined by task-based functional MRI [tbfMRI]). MATERIALS AND METHODS: Eight patients (4 with glioma, 3 with meningioma, and 1 with arteriovenous malformation) and 9 healthy volunteers participated. For the patients, tbfMRI was performed unilaterally to activate the healthy contralateral motor cortex. The affected ipsilateral motor cortices were mapped with rsfMRI using seed-based and independent component analysis (ICA). In the healthy volunteer group, both motor cortices were mapped with both-hands tbfMRI and rsfMRI. We compared the results between template and functional seeds, and between the seed-based analysis and ICA with visual and quantitative analysis. RESULTS: For the visual analysis, the functional seed showed significantly higher scores compared to the template seed in both the patients (p = 0.002) and healthy volunteers (p < 0.001). Although no significant difference was observed between the functional seed and ICA, the ICA results showed significantly higher scores than the template seed in both the patients (p = 0.01) and healthy volunteers (p = 0.005). In the quantitative analysis, the functional seed exhibited greater similarity to tbfMRI than the template seed and ICA. CONCLUSION: Using the contralateral motor cortex determined by tbfMRI as a seed could enhance visual delineation of the motor cortex in seed-based rsfMRI.


Subject(s)
Brain Mapping , Brain Neoplasms , Glioma , Healthy Volunteers , Humans , Magnetic Resonance Imaging , Meningioma , Motor Cortex
12.
Clinical Pain ; (2): 1-7, 2019.
Article in Korean | WPRIM | ID: wpr-785687

ABSTRACT

OBJECTIVE: To investigate the cortical disinhibition in diabetic patients with neuropathic pain and without pain. In addition, we assessed the cortical disinhibition and pain relief after repetitive transcranial magnetic stimulation (rTMS).METHOD: We recruited diabetic patients with neuropathic pain (n = 15) and without pain (n = 15). We compared the TMS parameters such as motor evoked potential (MEP) amplitude, cortical silent period (CSP), intracortical inhibition (ICI %) and intracortical facilitation (ICF %) between two groups. Moreover, we evaluated the changes of pain and TMS parameters after five consecutive high frequency (10 Hz) rTMS sessions in diabetic patients with neuropathic pain. The neuropathic pain intensity (visual analog scale) and TMS parameters were assessed on pre-rTMS, post-rTMS 1day, and post-rTMS 5 day.RESULTS: The comparison of the CSP, ICI % revealed significant differences between two groups (p<0.01). After rTMS sessions, the decrease in pain intensity across the three time points revealed a pattern of significant differences (p<0.01). The change of CSP and ICI % across the three test points revealed a pattern of significant differences (p<0.01). The ICI % revealed immediate increase after first rTMS application and significant increase after five rTMS application (p<0.01) in diabetic patients with neuropathic pain. The MEP amplitude and ICF % did not reveal any significant changes.CONCLUSION: Our findings demonstrate that cortical inhibition was decreased in diabetic patients with neuropathic pain compared with patients without pain. Furthermore, we also identified that five daily rTMS sessions restored the defective intracortical inhibition which related to improvement of neuropathic pain in diabetic patients.


Subject(s)
Case-Control Studies , Diabetic Neuropathies , Evoked Potentials, Motor , Humans , Methods , Motor Cortex , Neuralgia , Transcranial Magnetic Stimulation
13.
Article in Chinese | WPRIM | ID: wpr-774202

ABSTRACT

The motor nervous system transmits motion control information through nervous oscillations, which causes the synchronous oscillatory activity of the corresponding muscle to reflect the motion response information and give the cerebral cortex feedback, so that it can sense the state of the limbs. This synchronous oscillatory activity can reflect connectivity information of electroencephalography-electromyography (EEG-EMG) functional coupling. The strength of the coupling is determined by various factors including the strength of muscle contraction, attention, motion intention etc. It is very significant to study motor functional evaluation and control methods to analyze the changes of EEG-EMG synchronous coupling caused by different factors. This article mainly introduces and compares coherence and Granger causality of linear methods, the mutual information and transfer entropy of nonlinear methods in EEG-EMG synchronous coupling, and summarizes the application of each method, so that researchers in related fields can understand the current research progress on analysis methods of EEG-EMG synchronous systematically.


Subject(s)
Electroencephalography , Electromyography , Humans , Motor Cortex , Physiology , Muscle, Skeletal , Physiology , Research
14.
Article in English | WPRIM | ID: wpr-765815

ABSTRACT

In recent years, several radiotracers that selectively bind to pathological tau proteins have been developed. Evidence is emerging that binding patterns of in vivo tau positron emission tomography (PET) studies in Alzheimer's disease (AD) patients closely resemble the distribution patterns of known neurofibrillary tangle pathology, with the extent of tracer binding reflecting the clinical and pathological progression of AD. In Lewy body diseases (LBD), tau PET imaging has clearly revealed cortical tau burden with a distribution pattern distinct from AD and increased cortical binding within the LBD spectrum. In progressive supranuclear palsy, the globus pallidus and midbrain have shown increased binding most prominently. Tau PET patterns in patients with corticobasal syndrome are characterized by asymmetrical uptake in the motor cortex and underlying white matter, as well as in the basal ganglia. Even in the patients with multiple system atrophy, which is basically a synucleinopathy, ¹⁸F-flortaucipir, a widely used tau PET tracer, also binds to the atrophic posterior putamen, possibly due to off-target binding. These distinct patterns of tau-selective radiotracer binding in the various degenerative parkinsonisms suggest its utility as a potential imaging biomarker for the differential diagnosis of parkinsonisms.


Subject(s)
Alzheimer Disease , Basal Ganglia , Diagnosis, Differential , Electrons , Globus Pallidus , Humans , Lewy Bodies , Mesencephalon , Motor Cortex , Multiple System Atrophy , Neurofibrillary Tangles , Parkinsonian Disorders , Pathology , Positron-Emission Tomography , Putamen , Supranuclear Palsy, Progressive , tau Proteins , White Matter
15.
Experimental Neurobiology ; : 103-111, 2018.
Article in English | WPRIM | ID: wpr-714116

ABSTRACT

A recent study reveals that missense mutations of EWSR1 are associated with neurodegenerative disorders such as amyotrophic lateral sclerosis, but the function of wild-type (WT) EWSR1 in the central nervous system (CNS) is not known yet. Herein, we investigated the neuroanatomical and motor function changes in Ewsr1 knock out (KO) mice. First, we quantified neuronal nucleus size in the motor cortex, dorsal striatum and hippocampus of three different groups: WT, heterozygous Ewsr1 KO (+/−), and homozygous Ewsr1 KO (−/−) mice. The neuronal nucleus size was significantly smaller in the motor cortex and striatum of homozygous Ewsr1 KO (−/−) mice than that of WT. In addition, in the hippocampus, the neuronal nucleus size was significantly smaller in both heterozygous Ewsr1 KO (+/−) and homozygous Ewsr1 KO (−/−) mice. We then assessed motor function of Ewsr1 KO (−/−) and WT mice by a tail suspension test. Both forelimb and hindlimb movements were significantly increased in Ewsr1 KO (−/−) mice. Lastly, we performed immunohistochemistry to examine the expression of TH, DARPP-32, and phosphorylated (p)-DARPP-32 (Thr75) in the striatum and substantia nigra, which are associated with dopaminergic signaling. The immunoreactivity of TH and DARPP-32 was decreased in Ewsr1 KO (−/−) mice. Together, our results suggest that EWSR1 plays a significant role in neuronal morphology, dopaminergic signaling pathways, and motor function in the CNS of mice.


Subject(s)
Amyotrophic Lateral Sclerosis , Animals , Central Nervous System , Dopamine , Forelimb , Hindlimb , Hindlimb Suspension , Hippocampus , Immunohistochemistry , Mice , Motor Cortex , Mutation, Missense , Neurodegenerative Diseases , Neurons , RNA , RNA-Binding Proteins , Substantia Nigra
16.
Article in Korean | WPRIM | ID: wpr-713746

ABSTRACT

PURPOSE: The prefrontal lobe, supplementary motor area, cerebellum, and basal ganglia are activated during gait. In addition, gait is controlled by nerves, such as the corticospinal tract (CST) and corticoreticular pathway (CRP). In this study, the presence of an injury to the CST and CRP was identified by diffusion tensor imaging and the characteristics of the gait pattern were investigated according to inferior cerebral artery infarction. METHODS: One patient and six control subjects of a similar age participated. A 69-year-old female patient had an injury to the left basal ganglia, insular gyrus, corona radiata, dorsolateral prefrontal cortex, and postcentral gyrus due to an inferior cerebral artery infarction. Diffusion tensor imaging (DTI) data was acquired 4 weeks after the stroke. The kinematic and spatio-temporal parameters of gait were collected using a three-dimensional gait analysis system. RESULTS: On 4 weeks DTI, the CST and CRP in the affected hemisphere did not show injury to the affected and unaffected hemisphere. Gait analysis showed that the cadence of spatio-temporal parameter was decreased significantly in the patient. The angle of the knee joint was decreased significantly in the affected and unaffected sides compared to the control group. CONCLUSION: The results of diffusion tensor imaging showed that although the patient was evaluated to be capable of an independent gait, the quality and quantity of gait might be reduced. This study could help better understand the gait ability analysis of stroke patients and the abnormal gait pattern of patients with a brain injury.


Subject(s)
Aged , Basal Ganglia , Brain Injuries , Cerebellum , Cerebral Arteries , Diffusion Tensor Imaging , Female , Gait , Humans , Infarction , Knee Joint , Motor Cortex , Prefrontal Cortex , Pyramidal Tracts , Somatosensory Cortex , Stroke
17.
Article in English | WPRIM | ID: wpr-717776

ABSTRACT

Transcranial electrical stimulation-motor evoked potential (TES-MEP) is a valuable intraoperative monitoring technique during brain tumor surgery. However, TES can stimulate deep subcortical areas located far from the motor cortex. There is a concern about false-negative results from the use of TES-MEP during resection of those tumors adjacent to the primary motor cortex. Our study reports three cases of TES-MEP monitoring with false-negative results due to deep axonal stimulation during brain tumor resection. Although no significant change in TES-MEP was observed during surgery, study subjects experienced muscle weakness after surgery. Deep axonal stimulation of TES could give false-negative results. Therefore, a combined method of TES-MEP and direct cortical stimulation-motor evoked potential (DCS-MEP) or direct subcortical stimulation should be considered to overcome the limitation of TES-MEP.


Subject(s)
Axons , Brain Neoplasms , Brain , Evoked Potentials , Methods , Monitoring, Intraoperative , Motor Cortex , Muscle Weakness , Transcranial Direct Current Stimulation
18.
Article in English | WPRIM | ID: wpr-716291

ABSTRACT

OBJECTIVE: To evaluate the effects of electric cortical stimulation (ECS) and transcranial direct current stimulation (tDCS) on motor and cognitive function recovery and brain plasticity in focal traumatic brain injury (TBI) of rats model. METHODS: Forty rats were pre-trained to perform a single pellet reaching task (SPRT), rotarod test (RRT), and Y-maze test for 14 days, then a focal TBI was induced by a weight drop model on the motor cortex. All rats were randomly assigned to one of the three groups: anodal ECS (50 Hz and 194 μs) (ECS group), tDCS (0.1 mA, 50 Hz and 200 μs) (tDCS group), and no stimulation as a control group. Four-week stimulation, including rehabilitation, was started 3 days after the operation. SPRT, RRT, and Y-maze were measured from day 1 to day 28 after the TBI was induced. Histopathological and immunohistochemistry staining evaluations were performed at 4 weeks. RESULTS: SPRT was improved from day 7 to day 26 in ECS, and from day 8 to day 26 in tDCS compared to the control group (p < 0.05). SPRT of ECS group was significantly improved on days 3, 8, 9, and 17 compared to the tDCS group. Y-maze was improved from day 8 to day 16 in ECS, and on days 6, 12, and 16 in the tDCS group compared to the control group (p < 0.05). Y-maze of the ECS group was significantly improved on day 9 to day 15 compared to the tDCS group. The c-Fos protein expression was better in the ECS group and the tDCS group compared to the control group. CONCLUSION: Electric stimulation in rats modified with a focal TBI is effective for motor recovery and brain plasticity. ECS induced faster behavioral and cognitive improvements compared to tDCS during the recovery period of rats with a focal TBI.


Subject(s)
Animals , Brain , Brain Injuries , Cognition , Electric Stimulation , Immunohistochemistry , Motor Cortex , Plastics , Rats , Recovery of Function , Rehabilitation , Rotarod Performance Test , Transcranial Direct Current Stimulation
19.
Article in English | WPRIM | ID: wpr-715693

ABSTRACT

BACKGROUND AND PURPOSE: Freezing of gait (FOG) is a frustrating problem in Parkinson's disease (PD) for which there is no effective treatment. Our aim was to find brain stimulation areas showing greater responses for reducing FOG. METHODS: Twelve PD patients with FOG were selected for inclusion. We explored the therapeutic effect of repetitive transcranial magnetic stimulation (rTMS) in the supplementary motor area (SMA) and the motor cortex (MC). We measured the number of steps, completion time, and freezing episodes during the stand-walk-sit test before and after rTMS treatment. We also tested freezing episodes in two FOG-provoking tasks. RESULTS: There was a trend for a greater reduction in freezing episodes with SMA stimulation than MC stimulation (p=0.071). FOG was significantly improved after SMA stimulation (p < 0.05) but not after MC stimulation. CONCLUSIONS: Our study suggests that the SMA is a more-appropriate target for brain stimulation when treating PD patients with FOG. This study provides evidence that stimulating the SMA using rTMS is beneficial to FOG, which might be useful for future developments of therapeutic strategies.


Subject(s)
Brain , Freezing , Gait , Humans , Motor Cortex , Parkinson Disease , Transcranial Magnetic Stimulation , Weather
20.
Article in English | WPRIM | ID: wpr-716956

ABSTRACT

BACKGROUND AND PURPOSE: To explore anatomic substrate of specific wandering patterns in patients with Alzheimer's disease (AD) by performing positron emission tomography with 18F fluorodeoxyglucose positron emission tomography (FDG PET). METHODS: Drug-naïve AD patients with wandering (n=80) and without wandering (n=262) were recruited. First, the specific pattern of wandering type was operationally classified according to specific wandering score and clinical assessment. Second, brain FDG PET was performed and fluorodeoxyglucose (FDG) uptake differences of specific brain regions according to wandering patterns were compared to those of non-wanderers. RESULTS: In patients with pacing pattern, FDG PET showed significant lower FDG uptake in both middle cingulum and left putamen cluster compared to non-wanderers. The right precuneus and supplementary motor area in patients with random pattern and left calcarine sulcus, right calcarine sulcus, right middle cingulum, and right post central gyrus in patients with lapping pattern had significantly lower FDG uptake compared to non-wanderers. CONCLUSIONS: This study showed that wandering in patients with AD had three distinct patterns. These specific patterns showed significant lower FDG uptake in specific brain areas compared to non-wanderers.


Subject(s)
Alzheimer Disease , Brain , Fluorodeoxyglucose F18 , Humans , Motor Cortex , Occipital Lobe , Parietal Lobe , Positron-Emission Tomography , Putamen , Somatosensory Cortex
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