The neural mechanism of motor imagery training′s motor recovery effects after stroke / 中华物理医学与康复杂志

Objective:To explore the mechanism of motor imagery training (MIT) combined with conventional rehabilitation to promote the functional recovery of upper limbs in stroke survivors. To explore the brain network reorganization resulting when motor imagery training (MIT) is combined with conventional rehabilitation to promote the motor recovery of stroke survivors.Methods:Fourteen hemiplegic patients were recruited as the MIT group. They underwent 4 weeks of MIT (30 min/day, 5 days/week) along with conventional rehabilitation treatment. The upper limb section of the Fugl-Meyer assessment (FMA-UE) and the modified Barthel Index (MBI) were used to assess all of the patients, and resting-state fMRI was performed before and after the treatment. Twenty-eight age- and sex-matched healthy subjects also received one-time resting-state fMRI scanning. Granger causal analysis was performed in the MIT group to calculate the changes in effective connection between the ipsilesional primary motor cortex and the whole brain before and after the treatment, and the results were compared with the healthy control group.Results:After the treatment, the average FMA-UE and MBI of the MIT group had increased significantly. Before the intervention, the effective connection mode of the ipsilesional M1 area in the MIT group was significantly different from that of the healthy controls. The causal flow from the ipsilesional M1 area to the bilateral prefrontal cortex had increased abnormally and the causal flow from the contralesional primary motor cortex, the inferior parietal lobule and the cerebellum to the ipsilesional M1 area had decreased significantly. After the treatment, the effective connection pattern of the stroke survivors was nearly normal, and the causal influence from contralesional motor imagery-related brain areas (the superior parietal lobule, inferior parietal lobule, thalamus and the fusiform gyrus) to the ipsilesional M1 area was enhanced. Effective connection from the ipsilesional M1 area to the contralesional cerebellum before the intervention was positively correlated with the improvement in FMA-UE scores, and the effective connection from the contralesional middle frontal gyrus to the ipsilesional M1 area was correlated negatively.Conclusions:The neural mechanism of MIT's effectiveness when it is combined with conventional rehabilitation might be related to the reorganization of effective connections. That would include enhanced causal flow between motor imagery-related brain areas and the contralesional cerebellum and ipsilesional M1 area. Down-regulation of the effective connection from the contralesional middle frontal gyrus to the ipsilesional M1 area also occurs.

The therapeutic effect of melodic intonation therapy on Broca's aphasia after stroke / 中华物理医学与康复杂志

Objective To investigate the effect of melody intonation therapy on the language function of Chinese-speaking stroke survivors with Broca's aphasia. Methods Forty patients with Broca's aphasia after stroke were randomly divided into a treatment group and a control group, each of 20. The treatment group received melodic intonation training, while the control group received routine speech rehabilitation training including training of the vocal organs, oral expression, literal expression and listening comprehension 30 minutes a day, five days a week for 12 weeks. Before and after the treatment, the spontaneous speech, listening comprehension, retelling and naming of both groups were tested using the western aphasia battery. Results After the intervention, a significant increase was observed in the average aphasia quotient, speech, listening comprehension, retelling and naming scores of both groups. The average spontaneous speech, listening comprehension and naming scores and the aphasia quotient of the treatment group were then significantly better than those of the control group. Conclusion Melody intonation training and rhythm training can improve the speech and daily communication ability of stroke survivors effectively.

The effects of motor imagery training and conventional therapy on the functioning of stroke survivors: A resting-state fMRI study / 中华物理医学与康复杂志

Objective To measure the efficacy of combining motor imagery training ( MIT) with convention-al therapy in improving stroke patients′upper-extremity function. And to seek a cortical reorganization mechanism as-sociated with the improvement using resting-state functional magnetic resonance imaging ( rs-fMRI) . Methods Ten stroke survivors were selected as an experimental group. They were given motor imagery training for four weeks ( 30 minutes a day, 5 days a week) and conventional rehabilitation therapy ( 40 minutes a day, 5 days a week) . Another 10 healthy counterparts were the control group. Before and after the four weeks of treatment, both groups were as-sessed using the upper extremity Fugl-Meyer assessment ( FMA-UE) and the modified Barthel index ( MBI) . Moreo-ver, rs-fMRI was conducted to assess functional connectivity between cortical regions and the ipsilesional primary mo-tor cortex ( M1) before and after the intervention. The laterality index ( LI) of the primary motor or sensory cortex was also calculated. Results After the intervention, the average FMA-UE and MBI scores of the experimental group had increased significantly. After MIT and conventional therapy there was increased functional connectivity between the ip-silesional and contralesional M1 areas, and between the ipsilesional M1 and contralesional primary sensory cortex ( S1) and frontal lobe, the functional connection between the ipsilesional M1 and the ipsilesional paracentral lobule and the anterior cingutate was also increased. More specifically, the LI relating M1 and S1 decreased after the inter-vention, tending toward the normal level. LIMI decreased significantly. Conclusion The 4-week regimen of motor imagery training and conventional therapy resulted in functional improvement in the upper limbs and greater ability in the activities of daily living. The observed improvements may be due to cortical reorganization, including better func-tional connectivity between the bilateral M1 areas and increased connectivity between the ipsilesional M1 area and some non-motor areas. There is some recovery of symmetry in the bilateral primary motor cortex.

Understanding the genetic and epigenetic architecture in complex network of rice flowering pathways

Although the molecular basis of flowering time control is well dissected in the long day (LD) plant Arabidopsis, it is still largely unknown in the short day (SD) plant rice. Rice flowering time (heading date) is an important agronomic trait for season adaption and grain yield, which is affected by both genetic and environmental factors. During the last decade, as the nature of florigen was identified, notable progress has been made on exploration how florigen gene expression is genetically controlled. In Arabidopsis expression of certain key flowering integrators such as FLOWERING LOCUS C (FLC) and FLOWERING LOCUS T (FT) are also epigenetically regulated by various chromatin modifications, however, very little is known in rice on this aspect until very recently. This review summarized the advances of both genetic networks and chromatin modifications in rice flowering time control, attempting to give a complete view of the genetic and epigenetic architecture in complex network of rice flowering pathways.

Advance in Music Therapy for Speech Rehabilitation (review) / 中国康复理论与实践

Music and speech may share the same neural pathway, and the role of music therapy in speech rehabilitation gradually at-tracts the attention from the rehabilitation medical profession in recent years. This article reviewed the effect, mechanism, and strategy of music therapy in speech rehabilitation.

Modified radical mastectomy preserving intercostobrachial nerve in clinical application / 中国基层医药

Objective To explore the early(Ⅰ,Ⅱ)in modified radical mastectomy of breast cancer clinical value of preserving intercostobrachial nerve.Methods A retrospective analysis of 62 cases of early breast cancer patients with the clinical data,on intraoperative complete preservation of the intercostobrachial nerve in 46 cases as the observation group,intraoperative resected intercostobrachial nerve in 16 cases as control group,comparative analysis of the two groups after the upper medial arm and axilla skin paresthesia and breast cancer recurrence.Results All 62cases underwent modified radical mastectomy of breast cancer,all patients were cured.The observation group upper medial arm and axillary skin sensory abnormalities in 5 cases(10.9％),significantly lower than the control group of 16 cases(100％)(x2 =19.27,P ＜0.05).A mean follow-up of 1 year,the observation group in upper arm skin party abnormalities in patients with 5 cases,after 1 ～ 3 mongths recovery ;control group of sensory abnormalities were not returned to normal; the two groups were not found in local tumor recurrence or distant metastasis.Conclusion In modified radical mastectomy of breast cancer reserving intercostobrachial nerve was feasible,and could significantly reduce the postoperative lateral medial arm and axilla skin feeling abnormal rate,and improve the quality of life in patients.