RESUMO
INTRODUCTION: Somatosensory stimulation of the paretic upper limb enhances motor performance and excitability in the affected hemisphere, and increases activity in the unaffected hemisphere, in chronic stroke patients. We tested the hypothesis that somatosensory stimulation of the paretic hand would lead to changes in excitability of the unaffected hemisphere in these patients, and we investigated the relation between motor function of the paretic hand and excitability of the unaffected hemisphere. METHODS: Transcranial magnetic stimulation was administered to the unaffected hemisphere of nine chronic stroke patients. Patients were submitted to 2-h somatosensory stimulation in the form of median nerve stimulation and control stimulation using a cross-over design. Baseline Jebsen-Taylor test scores were evaluated. Resting motor threshold, intracortical facilitation, short-interval intracortical inhibition, and visual analog scores for attention, fatigue and drowsiness were measured across conditions. RESULTS: Better pre-stimulation baseline motor function was correlated with deeper SICI in the unaffected hemisphere. We found no overt changes in any physiological marker after somatosensory stimulation. There was increased drowsiness in the control session, which may have led to changes in intracortical facilitation. CONCLUSIONS: Our results do not support an overt effect of a single session of somatosensory stimulation of the paretic hand on motor cortical excitability of the unaffected hemisphere as measured by motor threshold, short-interval intracortical inhibition or intracortical facilitation. It remains to be determined if other markers of cortical excitability are modulated by somatosensory stimulation, and whether repeated sessions or lesion location may lead to different effects.
Assuntos
Adulto , Feminino , Humanos , Masculino , Mãos/fisiopatologia , Córtex Motor/fisiopatologia , Córtex Somatossensorial/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Estimulação Magnética Transcraniana , Doença Crônica , Lateralidade Funcional , Mãos/inervação , Atividade Motora/fisiologia , Acidente Vascular Cerebral/reabilitaçãoRESUMO
PURPOSE: The purpose of this study was to determine the effect of a 3-week somatosensory stimulation program on the integrity of the somatosensory pathway of patients with brain damage. METHOD: The sample consisted of two groups of patients with brain damage matched by Glasgow Coma Scale (GCS) scores and age:8 patients with a mean age of 56.75 years who were treated with somatosensory stimulation, and 8 patients with a mean age of 58.88 years, who were not treated with sensory intervention program. A repeated measures matched-control group design was used to assess functional recovery of the brain. The instrument used in this study was SSEP (somatosensory evoked potentials), a neurophysiological parameter, for the integrity of the somatosensory pathway. RESULTS: The hypothesis that patients with brain damage who were treated with the somatosensory stimulation program will show higher SSEP wave form scores than the non-treatment group was supported (3rd week.: U=13.000, p=.014). Additional repeated measures analysis showed that there were no significant differences in recovery trends between the groups (F=1.945, p=.159). CONCLUSION: This study demonstrates that a somatosensory stimulation program is effective in promoting recovery of the integrity of the somatosensory pathway of patients with brain damage.
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vias Aferentes , Lesões Encefálicas/fisiopatologia , Potenciais Somatossensoriais Evocados , Córtex Somatossensorial/fisiopatologiaRESUMO
En el presente trabajo se describen algunos aspectos morfológicos de la evolución de la corteza cerebral, determinada por la expresión de la proteína asociada a microtúbulos 2 (MAP-2) en diferentes etapas del desarrollo postnatal (3,5,7 y 10 días). Se describe la organización de los procesos dendríticos y se discuten los resultados a la luz de las implicaciones anatomofuncionales
Assuntos
Camundongos , Córtex Somatossensorial/anatomia & histologia , Córtex Somatossensorial/fisiopatologia , Córtex Somatossensorial/ultraestrutura , Proteínas Associadas aos Microtúbulos/história , Proteínas Associadas aos Microtúbulos/normas , Proteínas Associadas aos Microtúbulos/ultraestruturaRESUMO
Potencial evocado somato-sensorial (PES) por estimulacao eletrica do nervo mediano e a resposta eletrica produzida pela ativacao do plexo braquial, raizes C6-7, medula cervical, sistema lemniscal do tronco cerebral, talamo e cortex sensorial. Este teste clinico, nao invasivo, permite a avaliacao da integridade funcional da via somato-sensorial possibilitando a localizacao de lesoes nos niveis acima apontados. O PES tem sido util no estudo de comas, esclerose multipla, doencas vasculares e outras patologias do sistema nervoso.PES por estimulacao do nervo peroneiro parece ser muito sensivel na deteccao precoce do comprometimento da medula espinal