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Neuromodulation Rehabilitation

Won-Seok Kim, Kiwon Lee, Seonghoon Kim, Sungmin Cho, Nam-Jong Paik
After traumatic brain injury (TBI), motor impairment is less common than neurocognitive or behavioral problems. However, about 30% of TBI survivors have reported motor deficits limiting the activities of daily living or participation. After acute primary and secondary injuries, there are subsequent changes including increased GABA-mediated inhibition during the subacute stage and neuroplastic alterations that are adaptive or maladaptive during the chronic stage. Therefore, timely and appropriate neuromodulation by transcranial direct current stimulation (tDCS) may be beneficial to patients with TBI for neuroprotection or restoration of maladaptive changes...
January 25, 2019: Journal of Neuroengineering and Rehabilitation
Elisa Biou, Hélène Cassoudesalle, Mélanie Cogne, Igor Sibon, Isabelle De Gabory, Patrick Dehail, Jerome Aupy, Bertrand Glize
BACKGROUND: Transcranial direct current stimulation (tDCS) is a non-invasive tool that induces neuromodulation in the brain. Several studies have shown the effectiveness of tDCS in improving language recovery in post-stroke aphasia. However, this innovative technique is not currently used in routine speech and language therapy (SLT) practice. OBJECTIVE: This systematic review aimed to summarise the role of tDCS in aphasia rehabilitation. METHODS: We searched MEDLINE via PubMed and Scopus on October 5, 2018 for English articles published from 1996 to 2018...
January 17, 2019: Annals of Physical and Rehabilitation Medicine
Richard Garfinkle, Nathalie Wong-Chong, Andrea Petrucci, Patricia Sylla, Steven D Wexner, Sahir Bhatnagar, Nancy Morin, Marylise Boutros
BACKGROUND: Management of Low Anterior Resection Syndrome (LARS) requires a high degree of patient engagement. This process may be facilitated by online health-related information and education. The objective of this study was to systematically review current online health information on LARS. METHODS: An online search of Google, Yahoo and Bing using the search terms "low anterior/anterior resection syndrome" and "bowel function/movements after rectal cancer surgery" was performed...
January 4, 2019: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Shi-Chun Bao, Wan-Wa Wong, Thomas Wai Hong Leung, Kai-Yu Tong
High-definition transcranial direct current stimulation (HD-tDCS) is a potential neuromodulation apparatus for stroke rehabilitation. However, its modulatory effects in stroke subjects are still not well understood. Here, the offline modulatory effects of HD-tDCS on the ipsilesional primary motor cortex were investigated by performing wrist isometric contraction tasks before and after HD-tDCS in eleven unilateral chronic stroke subjects using a synchronized HD-tDCS and EEG/EMG measurement system. This study is a randomized, single blinded, sham controlled crossover study...
December 27, 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Renata Markiewicz, Małgorzata Kozioł, Marcin Olajossy, Jolanta Masiak
The increasing body of evidence implies that brain-derived neurotrophic factor (BDNF) is the most common neurotrophin in the nervous system, playing an important role as an effectiveness indicator for rehabilitation interventions in schizophrenia patients. Currently, with the modern laboratory and instrumental diagnostic methods it is possible to diagnose deficits influencing the level of patient's functioning and use them as a basis for establishing individual re-adaptation programs for schizophrenia patients considering various forms of the therapy in different environments...
October 27, 2018: Psychiatria Polska
Maíra C Lixandrão, James W Stinear, Tonya Rich, Chao-Ying Chen, Tim Feyma, Gregg D Meekins, Bernadette T Gillick
BACKGROUND: The cortical silent period is a transient suppression of electromyographic activity after a transcranial magnetic stimulation pulse, attributed to spinal and supraspinal inhibitory mechanisms. Electromyographic breakthrough activity has been observed in healthy adults as a result of a spinal reflex response within the cortical silent period. OBJECTIVES: The objective of this case series is to report the ipsilesional and contralesional cortical silent period and the electromyographic breakthrough activity of 7 children with congenital hemiparesis...
November 21, 2018: Brazilian Journal of Physical Therapy
M Alsharidah, F Al-Hussain, M Iqbal, A Hamza, W-K Yoo, S Bashir
The field of neuromodulation encompasses a wide spectrum of interventional technologies that modify pathological activity within the nervous system to achieve a therapeutic effect. Therapy including transcranial direct current stimulation (tDCS) has all shown promising results across a range of neurological and neuropsychiatric disorders. This article reviews the state-of-the-art of neuromodulation for stroke and discusses the opportunities and challenges available for clinicians and researchers interested in advancing neuromodulation therapy...
November 2018: European Review for Medical and Pharmacological Sciences
Natalie Mrachacz-Kersting, Andrew J T Stevenson, Helle R M Jørgensen, Kåre Eg Severinsen, Susan Aliakbaryhosseinabadi, Ning Jiang, Dario Farina
OBJECTIVE: Adjuvant protocols devised to enhance motor recovery in subacute stroke patients have failed to show benefits with respect to classic therapeutic interventions. Here we evaluate the efficacy of a novel brain-state dependent intervention based on known mechanisms of memory and learning, that is integrated as part of the weekly rehabilitation program in subacute stroke patients. METHODS: Twenty-four hospitalized subacute stroke patients were randomly assigned to two intervention groups; 1...
November 8, 2018: Annals of Neurology
Vincent Chi-Kwan Cheung, Chuanxin Minos Niu, Si Li, Qing Xie, Ning Lan
The past decades have witnessed remarkable progresses in neural technologies such as functional electrical stimulation (FES) and their applications in neuro-rehabilitation and neuromodulation. These advances are powered by new neuroscientific understandings of the organization and compositionality of neuromuscular control illuminating how muscle groups may be activated together as discrete units known as muscle synergies. These parallel developments have promoted novel approaches to clinical rehabilitation for neurological disorders that are insurmountable to current treatments...
October 11, 2018: IEEE Reviews in Biomedical Engineering
Danielle Silveira Pires, Danielle De Sá Boasquevisque, Danielli Souza Speciali, Gisele Sampaio Silva, Adriana Bastos Conforto
OBJECTIVE: To prospectively evaluate the success of promotion strategies for a protocol of motor rehabilitation strategies for patients with stroke at Albert Einstein Hospital. METHODS: In a clinical trial of neuromodulation and rehabilitation for patients with stroke, conventional methods of dissemination and publications about the research protocol in social networks or on the hospital's website were performed. Frequencies of types of advertisements that reached potentially eligible subjects were calculated...
May 2018: Revista da Associação Médica Brasileira
Argyrios Stampas, Radha Korupolu, Liang Zhu, Christopher P Smith, Kenneth Gustafson
OBJECTIVES: We investigated whether transcutaneous tibial nerve stimulation (TTNS) in acute spinal cord injury was safe and feasible, and could achieve neuromodulation and improve cystometrogram parameters during acute inpatient rehabilitation. MATERIALS AND METHODS: Participants were consecutive acute traumatic spinal cord injury patients admitted for acute inpatient rehabilitation, randomized to a 2-week trial of TTNS v sham stimulation. Primary outcomes were safety and feasibility of TTNS and secondary outcomes were bladder measures based on pre- and post-TTNS cystometrogram by group and within groups, including bladder capacity, detrusor hyperreflexia, pressures, and detrusor-sphincter dyssynergia, as well as filling sensations and desire to void...
October 3, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Megan L Gill, Peter J Grahn, Jonathan S Calvert, Margaux B Linde, Igor A Lavrov, Jeffrey A Strommen, Lisa A Beck, Dimitry G Sayenko, Meegan G Van Straaten, Dina I Drubach, Daniel D Veith, Andrew R Thoreson, Cesar Lopez, Yury P Gerasimenko, V Reggie Edgerton, Kendall H Lee, Kristin D Zhao
Spinal sensorimotor networks that are functionally disconnected from the brain because of spinal cord injury (SCI) can be facilitated via epidural electrical stimulation (EES) to restore robust, coordinated motor activity in humans with paralysis1-3 . Previously, we reported a clinical case of complete sensorimotor paralysis of the lower extremities in which EES restored the ability to stand and the ability to control step-like activity while side-lying or suspended vertically in a body-weight support system (BWS)4 ...
November 2018: Nature Medicine
Ann Van de Winckel, James R Carey, Teresa A Bisson, Elsa C Hauschildt, Christopher D Streib, William K Durfee
BACKGROUND: Transcranial direct current stimulation (tDCS) is an effective neuromodulation adjunct to repetitive motor training in promoting motor recovery post-stroke. Finger tracking training is motor training whereby people with stroke use the impaired index finger to trace waveform-shaped lines on a monitor. Our aims were to assess the feasibility and safety of a telerehabilitation program consisting of tDCS and finger tracking training through questionnaires on ease of use, adverse symptoms, and quantitative assessments of motor function and cognition...
September 18, 2018: Journal of Neuroengineering and Rehabilitation
Shuo Hu, Tao Zheng, Yanchao Dong, Juan Du, Lanxiang Liu
Transcranial direct-current stimulation (DCS) offers a method for noninvasive neuromodulation usable in basic and clinical human neuroscience. Laser-speckle contrast imaging (LSCI), a powerful, low-cost method for obtaining images of dynamic systems, can detect regional blood-flow distributions with high spatial and temporal resolutions. Here, we used LSCI for measuring DCS-induced cerebral blood flow in real-time. Results showed that the change-rate of cerebral blood flow could reach approximately 10.1 ± 5...
2018: Frontiers in Neuroscience
Collene E Anderson, Jonviea D Chamberlain, Xavier Jordan, Thomas M Kessler, Eugenia Luca, Sandra Möhr, Jürgen Pannek, Martin Schubert, Martin W G Brinkhof
OBJECTIVE: To understand the occurrence of and risk factors for urinary tract infections (UTIs) in patients with spinal cord injury (SCI) undergoing specialized SCI rehabilitation in Switzerland. PATIENTS AND METHODS: This study used data collected from 369 patients, who participated in a nationwide rehabilitation cohort for SCI in Switzerland between 2013 and 2017. Information on UTIs as well as their potential determinants, including demographics, lesion characteristics, and time-updated data on functional independence and bladder management, was used...
August 16, 2018: BJU International
Yu-Qiu Jiang, Adrish Sarkar, Alzahraa Amer, John H Martin
Injury to the supraspinal motor systems, especially the corticospinal tract, leads to movement impairments. In addition to direct disruption of descending motor pathways, spinal motor circuits that are distant to and not directly damaged by the lesion undergo remodeling that contributes significantly to the impairments. Knowing which spinal circuits are remodeled and the underlying mechanisms are critical for understanding the functional changes in the motor pathway and for developing repair strategies. Here, we target spinal premotor cholinergic interneurons (IN) that directly modulate motoneuron excitability via their cholinergic C-bouton terminals...
September 26, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Tae Beom Kim, Chang Hee Kim, Kwang Taek Kim, Sang Jin Yoon, Kyung Jin Chung
As a urologist, we usually encounter with two representative functional behaviors, namely, voiding and sexual function. These are not only important but also complex and synchronized so if these functions are impaired, patients need active functional rehabilitation to recover. These functional impairments should be recognized and corrected early because they could not only cause direct damage to the affected functions but also have harmful consecutive consequences such as kidney damage due to voiding abnormality and self-esteem damage due to decreased sexual function...
June 2018: Journal of Exercise Rehabilitation
Derek R Verley, Daniel Torolira, Brittany A Hessell, Richard L Sutton, Neil G Harris
Traumatic brain injury (TBI) results in well-known, significant alterations in structural and functional connectivity. Although this is especially likely to occur in areas of pathology, deficits in function to and from remotely connected brain areas, or diaschisis, also occur as a consequence to local deficits. As a result, consideration of the network wiring of the brain may be required to design the most efficacious rehabilitation therapy to target specific functional networks to improve outcome. In this work, we model remote connections after controlled cortical impact injury (CCI) in the rat through the effect of callosal deafferentation to the opposite, contralesional cortex...
October 4, 2018: Journal of Neurotrauma
Cecília N Prudente, Lena Zetterberg, Annika Bring, Lynley Bradnam, Teresa J Kimberley
Background: Rehabilitation interventions are rarely utilized as an alternative or adjunct therapy for focal dystonias. Reasons for limited utilization are unknown, but lack of conclusive evidence of effectiveness is likely a crucial factor. Methods and Findings: The purpose of this systematic review was to determine the level of evidence for rehabilitation interventions in focal dystonias. Rehabilitation interventions were classified based upon the underlying theoretical basis of different approaches, and the strength of evidence for each category was evaluated to identify gaps in the field...
May 2018: Movement Disorders Clinical Practice
Marie-Pascale Côté, Lynda M Murray, Maria Knikou
Systematic research on the physiological and anatomical characteristics of spinal cord interneurons along with their functional output has evolved for more than one century. Despite significant progress in our understanding of these networks and their role in generating and modulating movement, it has remained a challenge to elucidate the properties of the locomotor rhythm across species. Neurophysiological experimental evidence indicates similarities in the function of interneurons mediating afferent information regarding muscle stretch and loading, being affected by motor axon collaterals and those mediating presynaptic inhibition in animals and humans when their function is assessed at rest...
2018: Frontiers in Physiology
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