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Klarner T, Zehr EP. Sherlock Holmes and the curious case of the human locomotor central pattern generator. J Neurophysiol 2018. [PMID: 29537920 DOI: 10.1152/jn.00554.2017] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Evidence first described in reduced animal models over 100 years ago led to deductions about the control of locomotion through spinal locomotor central pattern-generating (CPG) networks. These discoveries in nature were contemporaneous with another form of deductive reasoning found in popular culture, that of Arthur Conan Doyle's detective, Sherlock Holmes. Because the invasive methods used in reduced nonhuman animal preparations are not amenable to study in humans, we are left instead with deducing from other measures and observations. Using the deductive reasoning approach of Sherlock Holmes as a metaphor for framing research into human CPGs, we speculate and weigh the evidence that should be observable in humans based on knowledge from other species. This review summarizes indirect inference to assess "observable evidence" of pattern-generating activity that leads to the logical deduction of CPG contributions to arm and leg activity during locomotion in humans. The question of where a CPG may be housed in the human nervous system remains incompletely resolved at this time. Ongoing understanding, elaboration, and application of functioning locomotor CPGs in humans is important for gait rehabilitation strategies in those with neurological injuries.
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Affiliation(s)
- Taryn Klarner
- Rehabilitation Neuroscience Laboratory, University of Victoria , Victoria, British Columbia , Canada.,Human Discovery Science, International Collaboration on Repair Discoveries , Vancouver, British Columbia , Canada.,Centre for Biomedical Research, University of Victoria , Victoria, British Columbia , Canada
| | - E Paul Zehr
- Rehabilitation Neuroscience Laboratory, University of Victoria , Victoria, British Columbia , Canada.,Human Discovery Science, International Collaboration on Repair Discoveries , Vancouver, British Columbia , Canada.,Centre for Biomedical Research, University of Victoria , Victoria, British Columbia , Canada.,Division of Medical Sciences, University of Victoria, British Columbia, Canada
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52
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Hilderley AJ, Taylor MJ, Fehlings D, Chen JL, Wright FV. Optimization of fMRI methods to determine laterality of cortical activation during ankle movements of children with unilateral cerebral palsy. Int J Dev Neurosci 2018; 66:54-62. [PMID: 29413879 DOI: 10.1016/j.ijdevneu.2018.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/20/2018] [Accepted: 01/22/2018] [Indexed: 10/18/2022] Open
Abstract
Measurement of laterality of motor cortical activations may provide valuable information about lower limb control in children with unilateral cerebral palsy (UCP). Evidence from upper limb research suggests that increased contralateral activity may accompany functional gains. However, lower limb areas of activation and associated changes have been underexplored due to challenges with imaging motor cortical leg representations. In this study, methods for a task-based functional magnetic resonance imaging (fMRI) ankle dorsiflexion paradigm were refined with three pilot groups of participants: (i) adults (n = 5); (ii) typically developing (TD) children (n = 5) and; (iii) children with UCP (n = 4). Parameters of experimental design, task resistance, reproducibility, and pre-scan procedures were tested/refined using a staged development approach with additions or changes introduced if image quality did not meet pre-defined standards. When image quality was acceptable for two consecutive participants, the next participant group was recruited to test/refine the next parameter. The final paradigm involved an event-related design of a single dorsiflexion movement against individualized resistance, with two runs per leg. It included a pre-scan session to increase child comfort and determine task resistance. This paradigm produced valid data for laterality index (LI) calculations to determine the ratio of activity in each hemisphere. Ventricle and lesion masks were used in non-linear image registration, and individual thresholds were used for extent-based LI calculations. LI of dominant ankle movements were contralateral (LI ≥ +0.2) for TD children (mean LI = +0.89, std = 0.27) and children with UCP (mean LI = +0.86, std = 0.26). For the affected ankle of children with UCP, LI values indicated ipsilateral and/or contralateral activation (mean LI = +0.02, std = 0.71, range -0.92 to +1.00). This fMRI paradigm will support investigations of cortical activation and mechanisms of skill improvement following lower limb interventions.
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Affiliation(s)
- A J Hilderley
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, M4K 1E1, Canada; Rehabilitation Sciences Institute, University of Toronto, 500 University Ave, Toronto, M5G 1V7, Canada.
| | - M J Taylor
- Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, Toronto, M5G 1X8, Canada; Department of Medical Imaging, University of Toronto, 263 McCaul Street, Toronto, M5T 1W7, Canada; Department of Psychology, University of Toronto, 100 St. George Street, Toronto, M5S 3G3, Canada.
| | - D Fehlings
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, M4K 1E1, Canada; Rehabilitation Sciences Institute, University of Toronto, 500 University Ave, Toronto, M5G 1V7, Canada; Department of Developmental Paediatrics, University of Toronto, 1 King's College Circle, Toronto, M5S 1A8, Canada.
| | - J L Chen
- Rehabilitation Sciences Institute, University of Toronto, 500 University Ave, Toronto, M5G 1V7, Canada; Hurvitz Brain Sciences Program, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, M4N 3M5, Canada; Department of Physical Therapy, University of Toronto, 500 University Ave, Toronto, M5G 1V7, Canada.
| | - F V Wright
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, M4K 1E1, Canada; Rehabilitation Sciences Institute, University of Toronto, 500 University Ave, Toronto, M5G 1V7, Canada; Department of Physical Therapy, University of Toronto, 500 University Ave, Toronto, M5G 1V7, Canada.
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53
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Deng W, Papavasileiou I, Qiao Z, Zhang W, Lam KY, Han S. Advances in Automation Technologies for Lower Extremity Neurorehabilitation: A Review and Future Challenges. IEEE Rev Biomed Eng 2018; 11:289-305. [DOI: 10.1109/rbme.2018.2830805] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Okabe N, Himi N, Maruyama-Nakamura E, Hayashi N, Narita K, Miyamoto O. Rehabilitative skilled forelimb training enhances axonal remodeling in the corticospinal pathway but not the brainstem-spinal pathways after photothrombotic stroke in the primary motor cortex. PLoS One 2017; 12:e0187413. [PMID: 29095902 PMCID: PMC5667818 DOI: 10.1371/journal.pone.0187413] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 10/19/2017] [Indexed: 12/17/2022] Open
Abstract
Task-specific rehabilitative training is commonly used for chronic stroke patients. Axonal remodeling is believed to be one mechanism underlying rehabilitation-induced functional recovery, and significant roles of the corticospinal pathway have previously been demonstrated. Brainstem-spinal pathways, as well as the corticospinal tract, have been suggested to contribute to skilled motor function and functional recovery after brain injury. However, whether axonal remodeling in the brainstem-spinal pathways is a critical component for rehabilitation-induced functional recovery is not known. In this study, rats were subjected to photothrombotic stroke in the caudal forelimb area of the primary motor cortex and received rehabilitative training with a skilled forelimb reaching task for 4 weeks. After completion of the rehabilitative training, the retrograde tracer Fast blue was injected into the contralesional lower cervical spinal cord. Fast blue-positive cells were counted in 32 brain areas located in the cerebral cortex, hypothalamus, midbrain, pons, and medulla oblongata. Rehabilitative training improved motor performance in the skilled forelimb reaching task but not in the cylinder test, ladder walk test, or staircase test, indicating that rehabilitative skilled forelimb training induced task-specific recovery. In the histological analysis, rehabilitative training significantly increased the number of Fast blue-positive neurons in the ipsilesional rostral forelimb area and secondary sensory cortex. However, rehabilitative training did not alter the number of Fast blue-positive neurons in any areas of the brainstem. These results indicate that rehabilitative skilled forelimb training enhances axonal remodeling selectively in the corticospinal pathway, which suggests a critical role of cortical plasticity, rather than brainstem plasticity, in task-specific recovery after subtotal motor cortex destruction.
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Affiliation(s)
- Naohiko Okabe
- Second Department of Physiology, Kawasaki Medical School, Matsushima, Kurashiki City, Okayama, Japan
- * E-mail:
| | - Naoyuki Himi
- Second Department of Physiology, Kawasaki Medical School, Matsushima, Kurashiki City, Okayama, Japan
| | - Emi Maruyama-Nakamura
- Second Department of Physiology, Kawasaki Medical School, Matsushima, Kurashiki City, Okayama, Japan
| | - Norito Hayashi
- Second Department of Physiology, Kawasaki Medical School, Matsushima, Kurashiki City, Okayama, Japan
| | - Kazuhiko Narita
- Second Department of Physiology, Kawasaki Medical School, Matsushima, Kurashiki City, Okayama, Japan
| | - Osamu Miyamoto
- Second Department of Physiology, Kawasaki Medical School, Matsushima, Kurashiki City, Okayama, Japan
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55
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Geiger M, Supiot A, Zory R, Aegerter P, Pradon D, Roche N. The effect of transcranial direct current stimulation (tDCS) on locomotion and balance in patients with chronic stroke: study protocol for a randomised controlled trial. Trials 2017; 18:492. [PMID: 29061169 PMCID: PMC5654046 DOI: 10.1186/s13063-017-2219-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 09/29/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Following stroke, patients are often left with hemiparesis that reduces balance and gait capacity. A recent, non-invasive technique, transcranial direct current stimulation, can be used to modify cortical excitability when used in an anodal configuration. It also increases the excitability of spinal neuronal circuits involved in movement in healthy subjects. Many studies in patients with stroke have shown that this technique can improve motor, sensory and cognitive function. For example, anodal tDCS has been shown to improve motor performance of the lower limbs in patients with stroke, such as voluntary quadriceps strength, toe-pinch force and reaction time. Nevertheless, studies of motor function have been limited to simple tasks. Surprisingly, the effects of tDCS on the locomotion and balance of patients with chronic stroke have never been evaluated. In this study, we hypothesise that anodal tDCS will improve balance and gait parameters in patients with chronic stroke-related hemiparesis through its effects at cortical and spinal level. METHODS/DESIGN This is a prospective, randomised, placebo-controlled, double-blinded, single-centre, cross-over study over 36 months. Forty patients with chronic stroke will be included. Each patient will participate in three visits: an inclusion visit, and two visits during which they will all undergo either one 30-min session of transcranial direct current stimulation or one 30-min session of placebo stimulation in a randomised order. Evaluations will be carried out before, during and twice after stimulation. The primary outcome is the variability of the displacement of the centre of mass during gait and a static-balance task. Secondary outcomes include clinical and functional measures before and after stimulation. A three-dimensional gait analysis, and evaluation of static balance on a force platform will be also conducted before, during and after stimulation. DISCUSSION These results should constitute a useful database to determine the aspects of complex motor function that are the most improved by transcranial direct current stimulation in patients with hemiparesis. It is the first essential step towards validating this technique as a treatment, coupled with task-oriented training. TRIAL REGISTRATION ClinicalTrials.gov, ID: NCT02134158 . First received on 18 December 2013; last updated on 14 September 2016. Other study ID numbers: P120135 / AOM12126, 2013-A00952-43.
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Affiliation(s)
- M Geiger
- Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular diseases, UVSQ, CIC 805, Physiology-Functional Testing Ward, AP-HP, Raymond Poincaré Teaching Hospital, Garches, France. .,CIAMS, Université Paris-Sud, Université Paris-Saclay, 91405, Orsay Cedex, France. .,CIAMS, Université d'Orléans, 45067, Orléans, France.
| | - A Supiot
- Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular diseases, UVSQ, CIC 805, Physiology-Functional Testing Ward, AP-HP, Raymond Poincaré Teaching Hospital, Garches, France.,CIAMS, Université Paris-Sud, Université Paris-Saclay, 91405, Orsay Cedex, France.,CIAMS, Université d'Orléans, 45067, Orléans, France
| | - R Zory
- Laboratory of Human Motricity, Sport, Education and Health (EA 6312), University of Nice Sophia Antipolis, Nice, France
| | - P Aegerter
- Assistance Publique-Hôpitaux de Paris, Hôpital Ambroise Paré, Unité de Recherche Clinique (URC), Boulogne, France
| | - D Pradon
- Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular diseases, UVSQ, CIC 805, Physiology-Functional Testing Ward, AP-HP, Raymond Poincaré Teaching Hospital, Garches, France
| | - N Roche
- Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular diseases, UVSQ, CIC 805, Physiology-Functional Testing Ward, AP-HP, Raymond Poincaré Teaching Hospital, Garches, France
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56
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Tan AQ, Dhaher YY. Contralesional Hemisphere Regulation of Transcranial Magnetic Stimulation-Induced Kinetic Coupling in the Poststroke Lower Limb. Front Neurol 2017; 8:373. [PMID: 28824530 PMCID: PMC5545591 DOI: 10.3389/fneur.2017.00373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 07/17/2017] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The neural constraints underlying hemiparetic gait dysfunction are associated with abnormal kinetic outflow and altered muscle synergy structure. Recent evidence from our lab implicates the lesioned hemisphere in mediating the expression of abnormally coupled hip adduction and knee extension synergy, suggesting a role of cortical networks in the regulation of lower limb motor outflow poststroke. The potential contribution of contralesional hemisphere (CON-H) in regulating paretic leg kinetics is unknown. The purpose of this study is to characterize the effect of CON-H activation on aberrant across-joint kinetic coupling of the ipsilateral lower-extremity muscles poststroke. METHODS Amplitude-matched adductor longus motor-evoked potentials were elicited using single pulse transcranial magnetic stimulation (TMS) of the lesioned (L-H) and CON-Hs during an isometric adductor torque matching task from 11 stroke participants. For 10 control participants, TMS of the contralateral and ipsilateral hemisphere were given during the same task. TMS-induced torques were characterized at the hip and knee joints to determine the differential regulation of abnormal kinetic synergies by each motor cortices. The TMS-induced ratio of knee extension/hip adduction torques was quantified during 40 and 20% of maximum adduction torque. FINDINGS For both the 40 and 20% target adduction tasks, we find that contralesional stimulation significantly reduced but did not eliminate the TMS-induced ratio of knee extension/hip adduction torques for the stroke group (p = 0.0468, p = 0.0396). In contrast, the controls did not present a significantly different TMS-evoked torque following stimulation (p = 0.923) of the hemisphere ipsilateral to the test leg. INTERPRETATION The reduced expression of abnormal across-joint kinetic coupling suggests that the CON-H may contribute an adaptive role in lower limb control poststroke. Future study of neuromodulation paradigms that leverage adaptive CON-H activation may yield clinically relevant gains in lower limb motor function poststroke.
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Affiliation(s)
- Andrew Q. Tan
- Northwestern University Interdepartmental Neuroscience, Northwestern University, Chicago, IL, United States
- Searle Center for the Science of Walking, Shirley Ryan AbilityLab, Chicago, IL, United States
| | - Yasin Y. Dhaher
- Northwestern University Interdepartmental Neuroscience, Northwestern University, Chicago, IL, United States
- Searle Center for the Science of Walking, Shirley Ryan AbilityLab, Chicago, IL, United States
- Department of Biomedical Engineering, Northwestern University, Chicago, IL, United States
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57
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Bürki CN, Bridenbaugh SA, Reinhardt J, Stippich C, Kressig RW, Blatow M. Imaging gait analysis: An fMRI dual task study. Brain Behav 2017; 7:e00724. [PMID: 28828204 PMCID: PMC5561304 DOI: 10.1002/brb3.724] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 03/24/2017] [Accepted: 03/28/2017] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION In geriatric clinical diagnostics, gait analysis with cognitive-motor dual tasking is used to predict fall risk and cognitive decline. To date, the neural correlates of cognitive-motor dual tasking processes are not fully understood. To investigate these underlying neural mechanisms, we designed an fMRI paradigm to reproduce the gait analysis. METHODS We tested the fMRI paradigm's feasibility in a substudy with fifteen young adults and assessed 31 healthy older adults in the main study. First, gait speed and variability were quantified using the GAITRite© electronic walkway. Then, participants lying in the MRI-scanner were stepping on pedals of an MRI-compatible stepping device used to imitate gait during functional imaging. In each session, participants performed cognitive and motor single tasks as well as cognitive-motor dual tasks. RESULTS Behavioral results showed that the parameters of both gait analyses, GAITRite© and fMRI, were significantly positively correlated. FMRI results revealed significantly reduced brain activation during dual task compared to single task conditions. Functional ROI analysis showed that activation in the superior parietal lobe (SPL) decreased less from single to dual task condition than activation in primary motor cortex and in supplementary motor areas. Moreover, SPL activation was increased during dual tasks in subjects exhibiting lower stepping speed and lower executive control. CONCLUSION We were able to simulate walking during functional imaging with valid results that reproduce those from the GAITRite© gait analysis. On the neural level, SPL seems to play a crucial role in cognitive-motor dual tasking and to be linked to divided attention processes, particularly when motor activity is involved.
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Affiliation(s)
- Céline N Bürki
- Division of Diagnostic and Interventional Neuroradiology Department of Radiology University of Basel Hospital and University of Basel Basel Switzerland.,Felix Platter-Hospital University Center for Medicine of Aging and University of Basel Basel Switzerland
| | - Stephanie A Bridenbaugh
- Felix Platter-Hospital University Center for Medicine of Aging and University of Basel Basel Switzerland
| | - Julia Reinhardt
- Division of Diagnostic and Interventional Neuroradiology Department of Radiology University of Basel Hospital and University of Basel Basel Switzerland
| | - Christoph Stippich
- Division of Diagnostic and Interventional Neuroradiology Department of Radiology University of Basel Hospital and University of Basel Basel Switzerland
| | - Reto W Kressig
- Felix Platter-Hospital University Center for Medicine of Aging and University of Basel Basel Switzerland
| | - Maria Blatow
- Division of Diagnostic and Interventional Neuroradiology Department of Radiology University of Basel Hospital and University of Basel Basel Switzerland
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Sacheli LM, Zapparoli L, De Santis C, Preti M, Pelosi C, Ursino N, Zerbi A, Banfi G, Paulesu E. Mental steps: Differential activation of internal pacemakers in motor imagery and in mental imitation of gait. Hum Brain Mapp 2017; 38:5195-5216. [PMID: 28731517 DOI: 10.1002/hbm.23725] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/30/2017] [Accepted: 07/03/2017] [Indexed: 12/30/2022] Open
Abstract
Gait imagery and gait observation can boost the recovery of locomotion dysfunctions; yet, a neurologically justified rationale for their clinical application is lacking as much as a direct comparison of their neural correlates. Using functional magnetic resonance imaging, we measured the neural correlates of explicit motor imagery of gait during observation of in-motion videos shot in a park with a steady cam (Virtual Walking task). In a 2 × 2 factorial design, we assessed the modulatory effect of gait observation and of foot movement execution on the neural correlates of the Virtual Walking task: in half of the trials, the participants were asked to mentally imitate a human model shown while walking along the same route (mental imitation condition); moreover, for half of all the trials, the participants also performed rhythmic ankle dorsiflexion as a proxy for stepping movements. We found that, beyond the areas associated with the execution of lower limb movements (the paracentral lobule, the supplementary motor area, and the cerebellum), gait imagery also recruited dorsal premotor and posterior parietal areas known to contribute to the adaptation of walking patterns to environmental cues. When compared with mental imitation, motor imagery recruited a more extensive network, including a brainstem area compatible with the human mesencephalic locomotor region (MLR). Reduced activation of the MLR in mental imitation indicates that this more visually guided task poses less demand on subcortical structures crucial for internally generated gait patterns. This finding may explain why patients with subcortical degeneration benefit from rehabilitation protocols based on gait observation. Hum Brain Mapp 38:5195-5216, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Lucia Maria Sacheli
- Department of Psychology and Milan Center for Neuroscience (NeuroMI), University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy.,IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, Milan, 20161, Italy
| | - Laura Zapparoli
- IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, Milan, 20161, Italy
| | - Carlo De Santis
- Department of Psychology and Milan Center for Neuroscience (NeuroMI), University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy
| | - Matteo Preti
- Department of Psychology and Milan Center for Neuroscience (NeuroMI), University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy
| | - Catia Pelosi
- IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, Milan, 20161, Italy
| | - Nicola Ursino
- IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, Milan, 20161, Italy
| | - Alberto Zerbi
- IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, Milan, 20161, Italy
| | - Giuseppe Banfi
- IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, Milan, 20161, Italy.,University Vita e Salute San Raffaele, Milan, Italy
| | - Eraldo Paulesu
- Department of Psychology and Milan Center for Neuroscience (NeuroMI), University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy.,IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, Milan, 20161, Italy
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Beaulieu LD, Massé-Alarie H, Ribot-Ciscar E, Schneider C. Reliability of lower limb transcranial magnetic stimulation outcomes in the ipsi- and contralesional hemispheres of adults with chronic stroke. Clin Neurophysiol 2017; 128:1290-1298. [DOI: 10.1016/j.clinph.2017.04.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 04/19/2017] [Accepted: 04/26/2017] [Indexed: 12/30/2022]
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Cerebral Reorganization in Subacute Stroke Survivors after Virtual Reality-Based Training: A Preliminary Study. Behav Neurol 2017; 2017:6261479. [PMID: 28720981 PMCID: PMC5506482 DOI: 10.1155/2017/6261479] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 04/12/2017] [Accepted: 05/31/2017] [Indexed: 11/17/2022] Open
Abstract
Background Functional magnetic resonance imaging (fMRI) is a promising method for quantifying brain recovery and investigating the intervention-induced changes in corticomotor excitability after stroke. This study aimed to evaluate cortical reorganization subsequent to virtual reality-enhanced treadmill (VRET) training in subacute stroke survivors. Methods Eight participants with ischemic stroke underwent VRET for 5 sections per week and for 3 weeks. fMRI was conducted to quantify the activity of selected brain regions when the subject performed ankle dorsiflexion. Gait speed and clinical scales were also measured before and after intervention. Results Increased activation in the primary sensorimotor cortex of the lesioned hemisphere and supplementary motor areas of both sides for the paretic foot (p < 0.01) was observed postintervention. Statistically significant improvements were observed in gait velocity (p < 0.05). The change in voxel counts in the primary sensorimotor cortex of the lesioned hemisphere is significantly correlated with improvement of 10 m walk time after VRET (r = −0.719). Conclusions We observed improved walking and increased activation in cortical regions of stroke survivors after VRET training. Moreover, the cortical recruitment was associated with better walking function. Our study suggests that cortical networks could be a site of plasticity, and their recruitment may be one mechanism of training-induced recovery of gait function in stroke. This trial is registered with ChiCTR-IOC-15006064.
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61
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Mankodi A, Azzabou N, Bulea T, Reyngoudt H, Shimellis H, Ren Y, Kim E, Fischbeck KH, Carlier PG. Skeletal muscle water T 2 as a biomarker of disease status and exercise effects in patients with Duchenne muscular dystrophy. Neuromuscul Disord 2017; 27:705-714. [PMID: 28601553 DOI: 10.1016/j.nmd.2017.04.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 04/19/2017] [Accepted: 04/19/2017] [Indexed: 12/16/2022]
Abstract
The purpose of this study was to examine exercise effects on muscle water T2 in patients with Duchenne muscular dystrophy (DMD). In 12 DMD subjects and 19 controls, lower leg muscle fat (%) was measured by Dixon and muscle water T2 and R2 (1/T2) by the tri-exponential model. Muscle water R2 was measured again at 3 hours after an ankle dorsiflexion exercise. The muscle fat fraction was higher in DMD participants than in controls (p < .001) except in the tibialis posterior muscle. Muscle water T2 was measured independent of the degree of fatty degeneration in DMD muscle. At baseline, muscle water T2 was higher in all but the extensor digitorum longus muscles of DMD participants than controls (p < .001). DMD participants had a lower muscle torque (p < .001) and exerted less power (p < .01) during exercise than controls. Nevertheless, muscle water R2 decreased (T2 increased) after exercise from baseline in DMD subjects and controls with greater changes in the target muscles of the exercise than in ankle plantarflexor muscles. Skeletal muscle water T2 is a sensitive biomarker of the disease status in DMD and of the exercise response in DMD patients and controls.
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Affiliation(s)
- Ami Mankodi
- Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
| | - Noura Azzabou
- NMR Laboratory, DRF, I2BM, MIRCen, Institute of Myology, Pitie-Salpetriere University Hospital and CEA, Paris, France
| | - Thomas Bulea
- Functional & Applied Biomechanics Section, Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Harmen Reyngoudt
- NMR Laboratory, DRF, I2BM, MIRCen, Institute of Myology, Pitie-Salpetriere University Hospital and CEA, Paris, France
| | - Hirity Shimellis
- Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | | | - Eunhee Kim
- Office of Biostatistics, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Kenneth H Fischbeck
- Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Pierre G Carlier
- NMR Laboratory, DRF, I2BM, MIRCen, Institute of Myology, Pitie-Salpetriere University Hospital and CEA, Paris, France
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62
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Wittenberg E, Thompson J, Nam CS, Franz JR. Neuroimaging of Human Balance Control: A Systematic Review. Front Hum Neurosci 2017; 11:170. [PMID: 28443007 PMCID: PMC5385364 DOI: 10.3389/fnhum.2017.00170] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 03/22/2017] [Indexed: 12/13/2022] Open
Abstract
This review examined 83 articles using neuroimaging modalities to investigate the neural correlates underlying static and dynamic human balance control, with aims to support future mobile neuroimaging research in the balance control domain. Furthermore, this review analyzed the mobility of the neuroimaging hardware and research paradigms as well as the analytical methodology to identify and remove movement artifact in the acquired brain signal. We found that the majority of static balance control tasks utilized mechanical perturbations to invoke feet-in-place responses (27 out of 38 studies), while cognitive dual-task conditions were commonly used to challenge balance in dynamic balance control tasks (20 out of 32 studies). While frequency analysis and event related potential characteristics supported enhanced brain activation during static balance control, that in dynamic balance control studies was supported by spatial and frequency analysis. Twenty-three of the 50 studies utilizing EEG utilized independent component analysis to remove movement artifacts from the acquired brain signals. Lastly, only eight studies used truly mobile neuroimaging hardware systems. This review provides evidence to support an increase in brain activation in balance control tasks, regardless of mechanical, cognitive, or sensory challenges. Furthermore, the current body of literature demonstrates the use of advanced signal processing methodologies to analyze brain activity during movement. However, the static nature of neuroimaging hardware and conventional balance control paradigms prevent full mobility and limit our knowledge of neural mechanisms underlying balance control.
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Affiliation(s)
- Ellen Wittenberg
- Edward P. Fitts Department of Industrial and Systems Engineering, North Carolina State UniversityRaleigh, NC, USA
| | - Jessica Thompson
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State UniversityChapel Hill, NC, USA
| | - Chang S Nam
- Edward P. Fitts Department of Industrial and Systems Engineering, North Carolina State UniversityRaleigh, NC, USA
| | - Jason R Franz
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State UniversityChapel Hill, NC, USA
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63
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Koseoglu BF, Dogan A, Tatli HU, Sezgin Ozcan D, Polat CS. Can kinesio tape be used as an ankle training method in the rehabilitation of the stroke patients? Complement Ther Clin Pract 2017; 27:46-51. [PMID: 28438279 DOI: 10.1016/j.ctcp.2017.03.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 03/27/2017] [Accepted: 03/28/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the effects of the kinesio tape application to the tibialis anterior on rehabilitation outcomes of the stroke patients. DESIGN AND SETTING Twenty patients with stroke were allocated into two groups: the first group of ten patients was assigned to receive kinesio tape in addition to the conventional rehabilitation program while a second group of 10 patients was assigned to receive a conventional rehabilitation program only. MAIN OUTCOME MEASURES The clinical variables and health-related quality of life (HRQoL) were evaluated at baseline and at the end of the forth week. RESULTS The present study showed that kinesio tape application to the tibialis anterior has significant effects on motor recovery of the lower extremity, spasticity, ambulation capacity, HRQoL and gait compared to the control group and baseline. CONCLUSIONS The results of this study suggest that kinesio tape can be used as an ankle training method.
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Affiliation(s)
- Belma Fusun Koseoglu
- Ministry of Health, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey.
| | - Asuman Dogan
- Ministry of Health, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Hilmi Umut Tatli
- Ministry of Health, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Didem Sezgin Ozcan
- Ministry of Health, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Cemile Sevgi Polat
- Ministry of Health, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
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64
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Nieuwhof F, Bloem BR, Reelick MF, Aarts E, Maidan I, Mirelman A, Hausdorff JM, Toni I, Helmich RC. Impaired dual tasking in Parkinson’s disease is associated with reduced focusing of cortico-striatal activity. Brain 2017; 140:1384-1398. [DOI: 10.1093/brain/awx042] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 01/14/2017] [Indexed: 12/12/2022] Open
Affiliation(s)
- Freek Nieuwhof
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, The Netherlands
- Radboud university medical center, Departments of Geriatric Medicine, Neurology and Parkinson’s disease Center Nijmegen (ParC), Nijmegen, The Netherlands
| | - Bastiaan R Bloem
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, The Netherlands
- Radboud university medical center, Departments of Geriatric Medicine, Neurology and Parkinson’s disease Center Nijmegen (ParC), Nijmegen, The Netherlands
| | - Miriam F Reelick
- Radboud university medical center, Departments of Geriatric Medicine, Neurology and Parkinson’s disease Center Nijmegen (ParC), Nijmegen, The Netherlands
| | - Esther Aarts
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, The Netherlands
| | - Inbal Maidan
- Center for the study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Anat Mirelman
- Center for the study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jeffrey M Hausdorff
- Center for the study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Physical Therapy, Sackler Faculty of Medicine, and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Ivan Toni
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, The Netherlands
| | - Rick C Helmich
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, The Netherlands
- Radboud university medical center, Departments of Geriatric Medicine, Neurology and Parkinson’s disease Center Nijmegen (ParC), Nijmegen, The Netherlands
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65
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Labriffe M, Annweiler C, Amirova LE, Gauquelin-Koch G, Ter Minassian A, Leiber LM, Beauchet O, Custaud MA, Dinomais M. Brain Activity during Mental Imagery of Gait Versus Gait-Like Plantar Stimulation: A Novel Combined Functional MRI Paradigm to Better Understand Cerebral Gait Control. Front Hum Neurosci 2017; 11:106. [PMID: 28321186 PMCID: PMC5337483 DOI: 10.3389/fnhum.2017.00106] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 02/20/2017] [Indexed: 01/27/2023] Open
Abstract
Human locomotion is a complex sensorimotor behavior whose central control remains difficult to explore using neuroimaging method due to technical constraints, notably the impossibility to walk with a scanner on the head and/or to walk for real inside current scanners. The aim of this functional Magnetic Resonance Imaging (fMRI) study was to analyze interactions between two paradigms to investigate the brain gait control network: (1) mental imagery of gait, and (2) passive mechanical stimulation of the plantar surface of the foot with the Korvit boots. The Korvit stimulator was used through two different modes, namely an organized (“gait like”) sequence and a destructured (chaotic) pattern. Eighteen right-handed young healthy volunteers were recruited (mean age, 27 ± 4.7 years). Mental imagery activated a broad neuronal network including the supplementary motor area-proper (SMA-proper), pre-SMA, the dorsal premotor cortex, ventrolateral prefrontal cortex, anterior insula, and precuneus/superior parietal areas. The mechanical plantar stimulation activated the primary sensorimotor cortex and secondary somatosensory cortex bilaterally. The paradigms generated statistically common areas of activity, notably bilateral SMA-proper and right pre-SMA, highlighting the potential key role of SMA in gait control. There was no difference between the organized and chaotic Korvit sequences, highlighting the difficulty of developing a walking-specific plantar stimulation paradigm. In conclusion, this combined-fMRI paradigm combining mental imagery and gait-like plantar stimulation provides complementary information regarding gait-related brain activity and appears useful for the assessment of high-level gait control.
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Affiliation(s)
- Matthieu Labriffe
- Laboratoire Angevin de Recherche en Ingénierie des Systèmes, EA7315, University of Angers - Université Nantes Angers Le MansAngers, France; Department of Radiology, Angers University Hospital, University of Angers - Université Nantes Angers Le MansAngers, France
| | - Cédric Annweiler
- Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic - Angers University Hospital; UPRES EA 4638 - University of Angers, Université Nantes Angers Le MansAngers, France; Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, LondonON, Canada
| | - Liubov E Amirova
- Laboratoire de Biologie Neuro-Vasculaire et Mitochondriale Intégrée, UMR CNRS 6214 INSERM U1083, University of AngersAngers, France; Institute of Biomedical Problems, Russian Academy of SciencesMoscow, Russia
| | | | - Aram Ter Minassian
- Laboratoire Angevin de Recherche en Ingénierie des Systèmes, EA7315, University of Angers - Université Nantes Angers Le MansAngers, France; Department of Anesthesia and Critical Care, Angers University Hospital - University of Angers, Université Nantes Angers Le MansAngers, France
| | - Louis-Marie Leiber
- Laboratoire Angevin de Recherche en Ingénierie des Systèmes, EA7315, University of Angers - Université Nantes Angers Le MansAngers, France; Department of Radiology, Angers University Hospital, University of Angers - Université Nantes Angers Le MansAngers, France
| | - Olivier Beauchet
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, MontrealQC, Canada; Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, MontrealQC, Canada
| | - Marc-Antoine Custaud
- Laboratoire de Biologie Neuro-Vasculaire et Mitochondriale Intégrée, UMR CNRS 6214 INSERM U1083, University of AngersAngers, France; Clinical Research Center, Angers University Hospital, University of Angers - Université Nantes Angers Le MansAngers, France
| | - Mickaël Dinomais
- Laboratoire Angevin de Recherche en Ingénierie des Systèmes, EA7315, University of Angers - Université Nantes Angers Le MansAngers, France; Department of Physical and Rehabilitation Medicine, Angers University Hospital, University of Angers - Université Nantes Angers Le MansAngers, France
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66
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An fMRI-compatible force measurement system for the evaluation of the neural correlates of step initiation. Sci Rep 2017; 7:43088. [PMID: 28230070 PMCID: PMC5322382 DOI: 10.1038/srep43088] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 01/18/2017] [Indexed: 11/24/2022] Open
Abstract
Knowledge of brain correlates of postural control is limited by the technical difficulties in performing controlled experiments with currently available neuroimaging methods. Here we present a system that allows the measurement of anticipatory postural adjustment of human legs to be synchronized with the acquisition of functional magnetic resonance imaging data. The device is composed of Magnetic Resonance Imaging (MRI) compatible force sensors able to measure the level of force applied by both feet. We tested the device in a group of healthy young subjects and a group of elderly subjects with Parkinson’s disease using an event-related functional MRI (fMRI) experiment design. In both groups the postural behavior inside the magnetic resonance was correlated to the behavior during gait initiation outside the scanner. The system did not produce noticeable imaging artifacts in the data. Healthy young people showed brain activation patterns coherent with movement planning. Parkinson’s disease patients demonstrated an altered pattern of activation within the motor circuitry. We concluded that this force measurement system is able to index both normal and abnormal preparation for gait initiation within an fMRI experiment.
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67
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Gramigna V, Pellegrino G, Cerasa A, Cutini S, Vasta R, Olivadese G, Martino I, Quattrone A. Near-Infrared Spectroscopy in Gait Disorders: Is It Time to Begin? Neurorehabil Neural Repair 2017; 31:402-412. [PMID: 28196453 DOI: 10.1177/1545968317693304] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Walking is a complex motor behavior with a special relevance in clinical neurology. Many neurological diseases, such as Parkinson's disease and stroke, are characterized by gait disorders whose neurofunctional correlates are poorly investigated. Indeed, the analysis of real walking with the standard neuroimaging techniques poses strong challenges, and only a few studies on motor imagery or walking observation have been performed so far. Functional near-infrared spectroscopy (fNIRS) is becoming an important research tool to assess functional activity in neurological populations or for special tasks, such as walking, because it allows investigating brain hemodynamic activity in an ecological setting, without strong immobility constraints. A systematic review following PRISMA guidelines was conducted on the fNIRS-based examination of gait disorders. Twelve of the initial yield of 489 articles have been included in this review. The lesson learnt from these studies suggest that oxy-hemoglobin levels within the prefrontal and premotor cortices are more sensitive to compensation strategies reflecting postural control and restoration of gait disorders. Although this field of study is in its relative infancy, the evidence provided encourages the translation of fNIRS in clinical practice, as it offers a unique opportunity to explore in depth the activity of the cortical motor system during real walking in neurological patients. We also discuss to what extent fNIRS may be applied for assessing the effectiveness of rehabilitation programs.
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Affiliation(s)
| | | | - Antonio Cerasa
- 1 University Magna Graecia, Catanzaro, Italy.,3 Istituto di Bioimmagini e Fisiologia Molecolare, National Research Council, Catanzaro, Italy
| | - Simone Cutini
- 4 Department of Developmental Psychology, University of Padova, Padova, Italy
| | | | - Giuseppe Olivadese
- 3 Istituto di Bioimmagini e Fisiologia Molecolare, National Research Council, Catanzaro, Italy
| | | | - Aldo Quattrone
- 1 University Magna Graecia, Catanzaro, Italy.,3 Istituto di Bioimmagini e Fisiologia Molecolare, National Research Council, Catanzaro, Italy
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68
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Giesser B, Beres-Jones J, Budovitch A, Herlihy E, Harkema S. Locomotor training using body weight support on a treadmill improves mobility in persons with multiple sclerosis: a pilot study. Mult Scler 2017; 13:224-31. [PMID: 17450642 DOI: 10.1177/1352458506070663] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Rationale The purpose of this protocol was to investigate the potential benefits and tolerability of locomotor training using body weight support on a treadmill (LTBWST) in persons with multiple sclerosis (MS). Methods Four persons with primarily spinal cord MS and severely impaired ambulation (Expanded Disability Status Scale score 7.0–7.5) were enrolled in LTBWST. Subjects completed an average of 40 training sessions over several months. Results Subjects showed improvement in muscle strength, spasticity, endurance, balance, walking speed, and quality of life at the end of the training sessions, and could tolerate training without fatigue or other adverse effects. Conclusions LTBWST is well tolerated by persons with MS and may produce improvements in parameters related to functional mobility. Multiple Sclerosis 2007; 13: 224–231. http://msj.sagepub.com
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Affiliation(s)
- Barbara Giesser
- Department of Neurology, UCLA School of Medicine, Los Angeles, CA 90095, USA.
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69
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Mizuno T, Aramaki Y. Cathodal transcranial direct current stimulation over the Cz increases joint flexibility. Neurosci Res 2017; 114:55-61. [PMID: 27576117 DOI: 10.1016/j.neures.2016.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 08/15/2016] [Accepted: 08/18/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Takamasa Mizuno
- School of Health and Sport Sciences, Chukyo University, 101 Tokodachi kaizu-cho, Toyota 470-0393, Japan
| | - Yu Aramaki
- School of Health and Sport Sciences, Chukyo University, 101 Tokodachi kaizu-cho, Toyota 470-0393, Japan.
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70
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Field-Fote EC, Yang JF, Basso DM, Gorassini MA. Supraspinal Control Predicts Locomotor Function and Forecasts Responsiveness to Training after Spinal Cord Injury. J Neurotrauma 2016; 34:1813-1825. [PMID: 27673569 DOI: 10.1089/neu.2016.4565] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Restoration of walking ability is an area of great interest in the rehabilitation of persons with spinal cord injury. Because many cortical, subcortical, and spinal neural centers contribute to locomotor function, it is important that intervention strategies be designed to target neural elements at all levels of the neuraxis that are important for walking ability. While to date most strategies have focused on activation of spinal circuits, more recent studies are investigating the value of engaging supraspinal circuits. Despite the apparent potential of pharmacological, biological, and genetic approaches, as yet none has proved more effective than physical therapeutic rehabilitation strategies. By making optimal use of the potential of the nervous system to respond to training, strategies can be developed that meet the unique needs of each person. To complement the development of optimal training interventions, it is valuable to have the ability to predict future walking function based on early clinical presentation, and to forecast responsiveness to training. A number of clinical prediction rules and association models based on common clinical measures have been developed with the intent, respectively, to predict future walking function based on early clinical presentation, and to delineate characteristics associated with responsiveness to training. Further, a number of variables that are correlated with walking function have been identified. Not surprisingly, most of these prediction rules, association models, and correlated variables incorporate measures of volitional lower extremity strength, illustrating the important influence of supraspinal centers in the production of walking behavior in humans.
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Affiliation(s)
- Edelle C Field-Fote
- 1 Shepherd Center, Crawford Research Institute and Division of Physical Therapy, Emory University , Atlanta, Georgia
| | - Jaynie F Yang
- 2 Department of Physical Therapy, Faculty of Rehabilitation Medicine and Neuroscience and Mental Health Institute, Faculty of Medicine & Dentistry, University of Alberta , Edmonton, Alberta, Canada
| | - D Michele Basso
- 3 School of Health and Rehabilitation Sciences, The Ohio State University , Columbus, Ohio
| | - Monica A Gorassini
- 4 Department of Biomedical Engineering, Neuroscience and Mental Health Institute, Faculty of Medicine and Dentistry, University of Alberta , Edmonton, Alberta, Canada
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71
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Formaggio E, Masiero S, Bosco A, Izzi F, Piccione F, Del Felice A. Quantitative EEG Evaluation During Robot-Assisted Foot Movement. IEEE Trans Neural Syst Rehabil Eng 2016; 25:1633-1640. [PMID: 27845668 DOI: 10.1109/tnsre.2016.2627058] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Passiveand imagined limbmovements induce changes in cerebral oscillatory activity. Central modulatory effects play a role in plastic changes, and are of uttermost importance in rehabilitation. This has extensively been studied for upper limb, but less is known for lower limb. The aim of this study is to investigate the topographical distribution of event-related desynchronization/synchronization(ERD/ERS) and task-relatedcoherence during a robot-assisted and a motor imagery task of lower limb in healthy subjects to inform rehabilitation paradigms. 32-channels electroencephalogram (EEG) was recorded in twenty-one healthy right footed and handed subjects during a robot-assisted single-joint cyclic right ankle movement performed by the BTS ANYMOV robotic hospital bed. Data were acquired with a block protocol for passive and imagined movement at a frequency of 0.2 Hz. ERD/ERS and task related coherence were calculated in alpha1 (8-10 Hz), alpha2 (10.5-12.5 Hz) and beta (13-30 Hz) frequency ranges. During passive movement, alpha2 rhythm desynchronized overC3 and ipsilateral frontal areas (F4, FC2, FC6); betaERD was detected over the bilateral motor areas (Cz, C3, C4). During motor imagery, a significant desynchronization was evident for alpha1 over contralateral sensorimotor cortex (C3), for alpha2 over bilateral motor areas (C3 and C4), and for beta over central scalp areas. Task-related coherence decreased during passive movement in alpha2 band between contralateral central area (C3, CP5, CP1, P3) and ipsilateral frontal area (F8, FC6, T8); beta band coherence decreased between C3-C4 electrodes, and increased between C3-Cz. These data contribute to the understanding of oscillatory activity and functional neuronal interactions during lower limb robot-assisted motor performance. The final output of this line of research is to inform the design and development of neurorehabilitation protocols.
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72
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Zehr EP, Barss TS, Dragert K, Frigon A, Vasudevan EV, Haridas C, Hundza S, Kaupp C, Klarner T, Klimstra M, Komiyama T, Loadman PM, Mezzarane RA, Nakajima T, Pearcey GEP, Sun Y. Neuromechanical interactions between the limbs during human locomotion: an evolutionary perspective with translation to rehabilitation. Exp Brain Res 2016; 234:3059-3081. [PMID: 27421291 PMCID: PMC5071371 DOI: 10.1007/s00221-016-4715-4] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 06/27/2016] [Indexed: 11/10/2022]
Abstract
During bipedal locomotor activities, humans use elements of quadrupedal neuronal limb control. Evolutionary constraints can help inform the historical ancestry for preservation of these core control elements support transfer of the huge body of quadrupedal non-human animal literature to human rehabilitation. In particular, this has translational applications for neurological rehabilitation after neurotrauma where interlimb coordination is lost or compromised. The present state of the field supports including arm activity in addition to leg activity as a component of gait retraining after neurotrauma.
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Affiliation(s)
- E P Zehr
- Rehabilitation Neuroscience Laboratory, University of Victoria, PO Box 3010 STN CSC, Victoria, BC, Canada, V8W 3P1.
- Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada.
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada.
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada.
| | - Trevor S Barss
- Rehabilitation Neuroscience Laboratory, University of Victoria, PO Box 3010 STN CSC, Victoria, BC, Canada, V8W 3P1
- Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
| | - Katie Dragert
- Rehabilitation Neuroscience Laboratory, University of Victoria, PO Box 3010 STN CSC, Victoria, BC, Canada, V8W 3P1
| | - Alain Frigon
- Department of Pharmacology-physiology, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Erin V Vasudevan
- Department of Physical Therapy, SUNY Stony Brook University, Stony Brook, NY, USA
| | - Carlos Haridas
- Rehabilitation Neuroscience Laboratory, University of Victoria, PO Box 3010 STN CSC, Victoria, BC, Canada, V8W 3P1
| | - Sandra Hundza
- Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
- Motion and Mobility Rehabilitation Laboratory, University of Victoria, Victoria, BC, Canada
| | - Chelsea Kaupp
- Rehabilitation Neuroscience Laboratory, University of Victoria, PO Box 3010 STN CSC, Victoria, BC, Canada, V8W 3P1
- Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
| | - Taryn Klarner
- Rehabilitation Neuroscience Laboratory, University of Victoria, PO Box 3010 STN CSC, Victoria, BC, Canada, V8W 3P1
- Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
| | - Marc Klimstra
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
- Motion and Mobility Rehabilitation Laboratory, University of Victoria, Victoria, BC, Canada
| | - Tomoyoshi Komiyama
- Division of Sports and Health Science, Chiba University, Chiba, Japan
- The United Graduate School of Education, Tokyo Gakugei University, Tokyo, Japan
| | - Pamela M Loadman
- Rehabilitation Neuroscience Laboratory, University of Victoria, PO Box 3010 STN CSC, Victoria, BC, Canada, V8W 3P1
- Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
| | - Rinaldo A Mezzarane
- Laboratory of Signal Processing and Motor Control, College of Physical Education, Universidade de Brasília-UnB, Brasília, Brazil
| | - Tsuyoshi Nakajima
- Department of Integrative Physiology, Kyorin University School of Medicine, Tokyo, Japan
| | - Gregory E P Pearcey
- Rehabilitation Neuroscience Laboratory, University of Victoria, PO Box 3010 STN CSC, Victoria, BC, Canada, V8W 3P1
- Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
| | - Yao Sun
- Rehabilitation Neuroscience Laboratory, University of Victoria, PO Box 3010 STN CSC, Victoria, BC, Canada, V8W 3P1
- Human Discovery Science, International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
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73
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Sharp KG, Gramer R, Page SJ, Cramer SC. Increased Brain Sensorimotor Network Activation after Incomplete Spinal Cord Injury. J Neurotrauma 2016; 34:623-631. [PMID: 27528274 DOI: 10.1089/neu.2016.4503] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
After complete spinal cord injury (SCI), activation during attempted movement of paralyzed limbs is sharply reduced, but after incomplete SCI-the more common form of human injury-it is unknown how attempts to move voluntarily are accompanied by activation of brain motor and sensory networks. Here, we assessed brain activation during ankle movement in subjects with incomplete SCI, among whom voluntary motor function is partially preserved. Adults with incomplete SCI (n = 20) and healthy controls (n = 15) underwent functional magnetic resonance imaging that alternated rest with 0.3-Hz right ankle dorsiflexion. In both subject groups, ankle movement was associated with bilateral activation of primary and secondary sensory and motor areas, with significantly (p < 0.001) greater activation in subjects with SCI within right hemisphere areas, including primary sensorimotor cortex and pre-motor cortex. This result was further evaluated using linear regression analysis with respect to core clinical variables. Poorer locomotor function correlated with larger activation within several right hemisphere areas, including pre- and post-central gyri, possibly reflecting increased movement complexity and effort, whereas longer time post-SCI was associated with larger activation in left post-central gyrus and bilateral supplementary motor area, which may reflect behaviorally useful adaptations. The results indicate that brain adaptations after incomplete SCI differ sharply from complete SCI, are related to functional behavioral status, and evolve with increasing time post-SCI. The results suggest measures that might be useful for understanding and treating incomplete SCI in human subjects.
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Affiliation(s)
- Kelli G Sharp
- 1 Reeve-Irvine Research Center, University of California , Irvine, Irvine, California.,2 Department of Dance, University of California , Irvine, Irvine, California
| | - Robert Gramer
- 3 Departments of Neurology, Anatomy & Neurobiology, and Physical Medicine & Rehabilitation, University of California , Irvine, Irvine, California
| | - Stephen J Page
- 4 Division of Occupational Therapy, The Ohio State University Medical Center , Columbus, Ohio
| | - Steven C Cramer
- 1 Reeve-Irvine Research Center, University of California , Irvine, Irvine, California.,3 Departments of Neurology, Anatomy & Neurobiology, and Physical Medicine & Rehabilitation, University of California , Irvine, Irvine, California.,5 The Sue and Bill Gross Stem Cell Research Center, University of California , Irvine, Irvine, California
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74
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Picelli A, Chemello E, Castellazzi P, Roncari L, Waldner A, Saltuari L, Smania N. Combined effects of transcranial direct current stimulation (tDCS) and transcutaneous spinal direct current stimulation (tsDCS) on robot-assisted gait training in patients with chronic stroke: A pilot, double blind, randomized controlled trial. Restor Neurol Neurosci 2016; 33:357-68. [PMID: 26410579 DOI: 10.3233/rnn-140474] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE Preliminary evidence has shown no additional effects of transcranial direct current stimulation (tDCS) on robotic gait training in chronic stroke, probably due to the neural organization of locomotion involving cortical and spinal control. Our aim was to compare the combined effects of tDCS and transcutaneous spinal direct current stimulation (tsDCS) on robotic gait training in chronic stroke. METHODS Thirty chronic stroke patients received ten 20-minute robot-assisted gait training sessions, five days a week, for 2 consecutive weeks combined with anodal tDCS + sham tsDCS (group 1; n = 10) or sham tDCS + cathodal tsDCS (group 2; n = 10) or tDCS + cathodal tsDCS (group 3; n = 10). The primary outcome was the 6-minute walk test (6MWT) performed before, after, 2 weeks and 4 weeks post-treatment. RESULTS Significant differences in the 6MWT distance were noted between group 3 and group 1 at the post-treatment and 2-week follow-up evaluations (post-treatment P = 0.015; 2-week follow-up P = 0.001) and between group 3 and group 2 (post-treatment P = 0.010; 2-week follow-up P = .015). No difference was found between group 2 and group 1. CONCLUSIONS Our preliminary findings support the hypothesis that anodal tDCS combined with cathodal tsDCS may be useful to improve the effects of robotic gait training in chronic stroke.
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Affiliation(s)
- Alessandro Picelli
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | - Elena Chemello
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | - Paola Castellazzi
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | - Laura Roncari
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | | | - Leopold Saltuari
- Department of Neurology, Hochzirl Hospital, Zirl, Austria.,Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy
| | - Nicola Smania
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurological and Movement Sciences, University of Verona, Verona, Italy.,Neurorehabilitation Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
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75
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Al-Yahya E, Johansen-Berg H, Kischka U, Zarei M, Cockburn J, Dawes H. Prefrontal Cortex Activation While Walking Under Dual-Task Conditions in Stroke: A Multimodal Imaging Study. Neurorehabil Neural Repair 2016; 30:591-9. [PMID: 26493732 PMCID: PMC5404717 DOI: 10.1177/1545968315613864] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Walking while performing another task (eg, talking) is challenging for many stroke survivors, yet its neural basis are not fully understood. Objective To investigate prefrontal cortex activation and its relationship to gait measures while walking under single-task (ST) and dual-task (DT) conditions (ie, walking while simultaneously performing a cognitive task) in stroke survivors. Methods We acquired near-infrared spectroscopy (NIRS) data from the prefrontal cortex during treadmill walking in ST and DT conditions in chronic stroke survivors and healthy controls. We also acquired functional magnetic resonance imaging (fMRI) and NIRS during simulated walking under these conditions. Results NIRS revealed increased oxygenated hemoglobin concentration in DT-walking compared with ST-walking for both groups. For simulated walking, NIRS showed a significant effect of group and group × task, being greater on both occasions, in stroke survivors. A greater increase in brain activation observed from ST to DT walking/ simulated walking was related to a greater change in motor performance in stroke survivors. fMRI revealed increased activity during DT relative to ST conditions in stroke patients in areas including the inferior temporal gyri, superior frontal gyri and cingulate gyri bilaterally, and the right precentral gyrus. The DT-related increase in fMRI activity correlated with DT-related change in behavior in stroke participants in the bilateral inferior temporal gyrus, left cingulate gyrus, and left frontal pole. Conclusion Our results provide novel evidence that enhanced brain activity changes relate to dual task motor decrements.
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Affiliation(s)
- Emad Al-Yahya
- The University of Jordan, Amman, Jordan Oxford Brookes University, Oxford, UK
| | | | | | - Mojtaba Zarei
- University of Oxford, Oxford, UK National Brain Mapping Centre, Shahid Beheshti University Medical and General Campus, Tehran, Iran
| | | | - Helen Dawes
- Oxford Brookes University, Oxford, UK University of Oxford, Oxford, UK
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76
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Rydwik E, Eliasson S, Akner G. The effect of exercise of the affected foot in stroke patients-a randomized controlled pilot trial. Clin Rehabil 2016; 20:645-55. [PMID: 16944822 DOI: 10.1191/0269215506cre986oa] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective: To evaluate the effect of treatment with a portable device called Stimulo on range of motion, muscle strength and spasticity in the ankle joint and its effect on walking ability, balance, activities of daily living (ADL) and health-related quality of life in stroke patients. Design: A randomized controlled pilot study. Setting: A research centre. Subjects: Ambulatory or partly ambulatory chronic stroke patients with remaining spasticity and/or decreased range of motion in the hemiparetic leg/ankle. Interventions: Standardized and individualized programme including active and passive range of motion of the ankle with a portable device (Stimulo), performed three times a week for 30 min, over a six-week period. Main measures: Range of motion, muscle strength, spasticity, gait variables, balance, ADL and health-related quality of life. Results: Eighteen subjects were included in the study with a mean age of 75 years. The compliance rate was 94-99%. There were no significant differences between the groups. Conclusion: The study showed no significant effect of an ankle-exercise intervention programme with Stimulo. Further studies with a larger sample size are of importance before any further conclusions can be drawn.
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Affiliation(s)
- Elisabeth Rydwik
- Nutrition and Pharmacotherapy Unit, Research and Development Unit for the Elderly North West, Karolinska Institute, Jakobsbergs Hospital, Birgittavägen 4, 177 31 Järfälla, Sweden.
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77
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Winchester P, McColl R, Querry R, Foreman N, Mosby J, Tansey K, Williamson J. Changes in Supraspinal Activation Patterns following Robotic Locomotor Therapy in Motor-Incomplete Spinal Cord Injury. Neurorehabil Neural Repair 2016; 19:313-24. [PMID: 16263963 DOI: 10.1177/1545968305281515] [Citation(s) in RCA: 152] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives. Body weight-supported treadmill training (BWSTT) is a task-specific rehabilitation strategy that enhances functional locomotion in patients following spinal cord injury (SCI). Supraspinal centers may play an important role in the recovery of over-ground locomotor function in patients with motor-incomplete SCI. The purpose of this study was to evaluate the potential for supraspinal reorganization associated with 12 weeks of robotic BWSTT using functional magnetic resonance imaging (fMRI). Methods. Four men with motor-incomplete SCI participated in this study. Time since onset ranged from 14 weeks to 48 months post-SCI injury. All subjects were trained with BWSTT 3 times weekly for 12 weeks. This training was preceded and followed by fMRI study of supraspinal activity during a movement task. Testing of locomotor disability included the Walking Index for Spinal Cord Injury (WISCI II) and over-ground gait speed. Results. All subjects demonstrated some degree of change in the blood-oxygen-level-dependent (BOLD) signal following BWSTT. fMRI results demonstrated greater activation in sensorimotor cortical regions (S1, S2) and cerebellar regions following BWSTT. Conclusions. Intensive task-specific rehabilitative training, such as robotic BWSTT, can promote supraspinal plasticity in the motor centers known to be involved in locomotion. Furthermore, improvement in over-ground locomotion is accompanied by an increased activation of the cerebellum.
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Affiliation(s)
- Patricia Winchester
- University of Texas Southwestern Medical Center, Department of Physical Therapy, Dallas, TX 75390-8876, USA.
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78
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Allen NE, Moloney N, van Vliet V, Canning CG. The Rationale for Exercise in the Management of Pain in Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2016; 5:229-39. [PMID: 25649828 PMCID: PMC4923748 DOI: 10.3233/jpd-140508] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Pain is a distressing non-motor symptom experienced by up to 85% of people with Parkinson’s disease (PD), yet it is often untreated. This pain is likely to be influenced by many factors, including the disease process, PD impairments as well as co-existing musculoskeletal and/or neuropathic pain conditions. Expert opinion recommends that exercise is included as one component of pain management programs; however, the effect of exercise on pain in this population is unclear. This review presents evidence describing the potential influence of exercise on the pain-related pathophysiological processes present in PD. Emerging evidence from both animal and human studies suggests that exercise might contribute to neuroplasticity and neuro-restoration by increasing brain neurotrophic factors, synaptic strength and angiogenesis, as well as stimulating neurogenesis and improving metabolism and the immune response. These changes may be beneficial in improving the central processing of pain. There is also evidence that exercise can activate both the dopaminergic and non-dopaminergic pain inhibitory pathways, suggesting that exercise may help to modulate the experience of pain in PD. Whilst clinical data on the effects of exercise for pain relief in people with PD are scarce, and are urgently needed, preliminary guidelines are presented for exercise prescription for the management of central neuropathic, peripheral neuropathic and musculoskeletal pain in PD.
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Affiliation(s)
- Natalie E Allen
- Clinical and Rehabilitation Sciences Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, Australia
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79
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Kurz MJ, Proskovec AL, Gehringer JE, Becker KM, Arpin DJ, Heinrichs-Graham E, Wilson TW. Developmental Trajectory of Beta Cortical Oscillatory Activity During a Knee Motor Task. Brain Topogr 2016; 29:824-833. [PMID: 27277428 DOI: 10.1007/s10548-016-0500-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 06/01/2016] [Indexed: 01/10/2023]
Abstract
There is currently a void in the scientific literature on the cortical beta oscillatory activity that is associated with the production of leg motor actions. In addition, we have limited data on how these cortical oscillations may progressively change as a function of development. This study began to fill this vast knowledge gap by using high-density magnetoencephalography to quantify the beta cortical oscillatory activity over a cross-section of typically developing children as they performed an isometric knee target matching task. Advanced beamforming methods were used to identify the spatiotemporal changes in beta oscillatory activity during the motor planning and motor action time frames. Our results showed that a widespread beta event-related desynchronization (ERD) was present across the pre/postcentral gyri, supplementary motor area, and the parietal cortices during the motor planning stage. The strength of this beta ERD sharply diminished across this fronto-parietal network as the children initiated the isometric force needed to match the target. Rank order correlations indicated that the older children were more likely to initiate their force production sooner, took less time to match the targets, and tended to have a weaker beta ERD during the motor planning stage. Lastly, we determined that there was a relationship between the child's age and the strength of the beta ERD within the parietal cortices during isometric force production. Altogether our results suggest that there are notable maturational changes during childhood and adolescence in beta cortical oscillatory activity that are associated with the planning and execution of leg motor actions.
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Affiliation(s)
- Max J Kurz
- Department of Physical Therapy, Munroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, 68198-5450, Omaha, NE, USA. .,Center for Magnetoencephalography, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Amy L Proskovec
- Center for Magnetoencephalography, University of Nebraska Medical Center, Omaha, NE, USA.,Department of Psychology, University of Nebraska - Omaha, Omaha, NE, USA
| | - James E Gehringer
- Department of Physical Therapy, Munroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, 68198-5450, Omaha, NE, USA.,Center for Magnetoencephalography, University of Nebraska Medical Center, Omaha, NE, USA
| | - Katherine M Becker
- Center for Magnetoencephalography, University of Nebraska Medical Center, Omaha, NE, USA
| | - David J Arpin
- Department of Physical Therapy, Munroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, 68198-5450, Omaha, NE, USA.,Center for Magnetoencephalography, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Tony W Wilson
- Center for Magnetoencephalography, University of Nebraska Medical Center, Omaha, NE, USA.,Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.,Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
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80
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Ikeda T, Matsushita A, Saotome K, Hasegawa Y, Matsumura A, Sankai Y. Muscle activity during gait-like motion provided by MRI compatible lower-extremity motion simulator. Adv Robot 2016. [DOI: 10.1080/01691864.2015.1122552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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81
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Wong YM. Commentary: Differential Cerebral Response to Somatosensory Stimulation of an Acupuncture Point vs. Two Non-Acupuncture Points Measured with EEG and fMRI. Front Hum Neurosci 2016; 10:63. [PMID: 26924978 PMCID: PMC4759246 DOI: 10.3389/fnhum.2016.00063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 02/08/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- Yiu Ming Wong
- Health Science Unit (PEC), Hong Kong Physically Handicapped and Able Bodied Association, Kowloon, Hong Kong
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82
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Chen X, Wan L, Qin W, Zheng W, Qi Z, Chen N, Li K. Functional Preservation and Reorganization of Brain during Motor Imagery in Patients with Incomplete Spinal Cord Injury: A Pilot fMRI Study. Front Hum Neurosci 2016; 10:46. [PMID: 26913000 PMCID: PMC4753296 DOI: 10.3389/fnhum.2016.00046] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 01/28/2016] [Indexed: 11/13/2022] Open
Abstract
Motor imagery (MI) is a cognitive process involved in mentally rehearsing movement representations, and it has great potential for the rehabilitation of motor function in patients with spinal cord injuries. The aim of this study was to explore changes in the brain activation patterns in incomplete spinal cord injury (ISCI) patients during motor execution (ME) and MI tasks, and to thereby explore whether MI shares similar motor-related networks with ME in ISCI patients. Seventeen right-handed ISCI patients with impaired motor function of their right ankles and 17 age- and gender-matched healthy controls were enrolled in this study. The activation patterns of the ISCI subjects and those of the healthy subjects were compared, both during mental dorsi-plantar flexion of the right ankle (the MI task) and the actual movement of the joint (the ME task). The patients and the healthy controls shared similar activation patterns during the MI or ME tasks. The activation patterns of the MI task between the patients and the healthy controls were more similar than those of the ME task. These findings indicate that the MI network is more functionally preserved than the ME network in ISCI patients. In addition, increased activation in the motor-related regions during ME task, and decreased activation in the parietal regions during both ME and MI tasks, were identified in the ISCI patients compared to the healthy controls, indicating a functional reorganization of these regions after ISCI. The functional preservation and reorganization of the MI network in the ISCI patients suggests a potential role for MI training in motor rehabilitation.
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Affiliation(s)
- Xin Chen
- Department of Radiology, Xuanwu Hospital, Capital Medical UniversityBeijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain InformaticsBeijing, China
| | - Lu Wan
- Department of Radiology, Xuanwu Hospital, Capital Medical UniversityBeijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain InformaticsBeijing, China
| | - Wen Qin
- Department of Radiology, Tianjin Medical University General Hospital Tianjin, China
| | - Weimin Zheng
- Department of Radiology, Xuanwu Hospital, Capital Medical UniversityBeijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain InformaticsBeijing, China
| | - Zhigang Qi
- Department of Radiology, Xuanwu Hospital, Capital Medical UniversityBeijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain InformaticsBeijing, China
| | - Nan Chen
- Department of Radiology, Xuanwu Hospital, Capital Medical UniversityBeijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain InformaticsBeijing, China
| | - Kuncheng Li
- Department of Radiology, Xuanwu Hospital, Capital Medical UniversityBeijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain InformaticsBeijing, China
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83
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Hackney ME, Lee HL, Battisto J, Crosson B, McGregor KM. Context-Dependent Neural Activation: Internally and Externally Guided Rhythmic Lower Limb Movement in Individuals With and Without Neurodegenerative Disease. Front Neurol 2015; 6:251. [PMID: 26696952 PMCID: PMC4667008 DOI: 10.3389/fneur.2015.00251] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 11/16/2015] [Indexed: 12/24/2022] Open
Abstract
Parkinson’s disease is a neurodegenerative disorder that has received considerable attention in allopathic medicine over the past decades. However, it is clear that, to date, pharmacological and surgical interventions do not fully address symptoms of PD and patients’ quality of life. As both an alternative therapy and as an adjuvant to conventional approaches, several types of rhythmic movement (e.g., movement strategies, dance, tandem biking, and Tai Chi) have shown improvements to motor symptoms, lower limb control, and postural stability in people with PD (1–6). However, while these programs are increasing in number, still little is known about the neural mechanisms underlying motor improvements attained with such interventions. Studying limb motor control under task-specific contexts can help determine the mechanisms of rehabilitation effectiveness. Both internally guided (IG) and externally guided (EG) movement strategies have evidence to support their use in rehabilitative programs. However, there appears to be a degree of differentiation in the neural substrates involved in IG vs. EG designs. Because of the potential task-specific benefits of rhythmic training within a rehabilitative context, this report will consider the use of IG and EG movement strategies, and observations produced by functional magnetic resonance imaging and other imaging techniques. This review will present findings from lower limb imaging studies, under IG and EG conditions for populations with and without movement disorders. We will discuss how these studies might inform movement disorders rehabilitation (in the form of rhythmic, music-based movement training) and highlight research gaps. We believe better understanding of lower limb neural activity with respect to PD impairment during rhythmic IG and EG movement will facilitate the development of novel and effective therapeutic approaches to mobility limitations and postural instability.
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Affiliation(s)
- Madeleine E Hackney
- Atlanta VA Center for Visual and Neurocognitive Rehabilitation , Decatur, GA , USA ; Division of General Medicine and Geriatrics, Department of Medicine, Emory School of Medicine , Atlanta, GA , USA
| | - Ho Lim Lee
- Emory College of Arts and Sciences, Emory University , Atlanta, GA , USA
| | - Jessica Battisto
- Emory College of Arts and Sciences, Emory University , Atlanta, GA , USA
| | - Bruce Crosson
- Atlanta VA Center for Visual and Neurocognitive Rehabilitation , Decatur, GA , USA ; Department of Neurology, Emory School of Medicine , Atlanta, GA , USA
| | - Keith M McGregor
- Atlanta VA Center for Visual and Neurocognitive Rehabilitation , Decatur, GA , USA ; Department of Neurology, Emory School of Medicine , Atlanta, GA , USA
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84
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Jones PS, Pomeroy VM, Wang J, Schlaug G, Tulasi Marrapu S, Geva S, Rowe PJ, Chandler E, Kerr A, Baron JC. Does stroke location predict walk speed response to gait rehabilitation? Hum Brain Mapp 2015; 37:689-703. [PMID: 26621010 PMCID: PMC4738376 DOI: 10.1002/hbm.23059] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 10/16/2015] [Accepted: 11/07/2015] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Recovery of independent ambulation after stroke is a major goal. However, which rehabilitation regimen best benefits each individual is unknown and decisions are currently made on a subjective basis. Predictors of response to specific therapies would guide the type of therapy most appropriate for each patient. Although lesion topography is a strong predictor of upper limb response, walking involves more distributed functions. Earlier studies that assessed the cortico-spinal tract (CST) were negative, suggesting other structures may be important. EXPERIMENTAL DESIGN The relationship between lesion topography and response of walking speed to standard rehabilitation was assessed in 50 adult-onset patients using both volumetric measurement of CST lesion load and voxel-based lesion-symptom mapping (VLSM) to assess non-CST structures. Two functional mobility scales, the functional ambulation category (FAC) and the modified rivermead mobility index (MRMI) were also administered. Performance measures were obtained both at entry into the study (3-42 days post-stroke) and at the end of a 6-week course of therapy. Baseline score, age, time since stroke onset and white matter hyperintensities score were included as nuisance covariates in regression models. PRINCIPAL OBSERVATIONS CST damage independently predicted response to therapy for FAC and MRMI, but not for walk speed. However, using VLSM the latter was predicted by damage to the putamen, insula, external capsule and neighbouring white matter. CONCLUSIONS Walk speed response to rehabilitation was affected by damage involving the putamen and neighbouring structures but not the CST, while the latter had modest but significant impact on everyday functions of general mobility and gait. Hum Brain Mapp 37:689-703, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- P Simon Jones
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Valerie M Pomeroy
- Acquired Brain Injury Rehabilitation Alliance, School of Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Jasmine Wang
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Gottfried Schlaug
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - S Tulasi Marrapu
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Sharon Geva
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Philip J Rowe
- Bioengineering Unit, University of Strathclyde, Glasgow, United Kingdom
| | - Elizabeth Chandler
- Acquired Brain Injury Rehabilitation Alliance, School of Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Andrew Kerr
- Bioengineering Unit, University of Strathclyde, Glasgow, United Kingdom
| | - Jean-Claude Baron
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom.,Centre Hospitalier Sainte-Anne, Inserm U894, Sorbonne Paris Cité, Paris, France
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85
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Jaeger L, Marchal-Crespo L, Wolf P, Riener R, Kollias S, Michels L. Test-retest reliability of fMRI experiments during robot-assisted active and passive stepping. J Neuroeng Rehabil 2015. [PMID: 26577598 DOI: 10.1186/s12984‐015‐0097‐2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Brain activity has been shown to undergo cortical and sub-cortical functional reorganisation over the course of gait rehabilitation in patients suffering from a spinal cord injury or a stroke. These changes however, have not been completely elucidated by neuroimaging to date, mainly due to the scarcity of long-term, follow-up investigations. The magnetic resonance imaging (MRI) compatible stepper MARCOS was specifically developed to enable the investigation of the supraspinal adaptations in paretic patients undergoing gait-rehabilitation in a controlled and repeatable manner. In view of future clinical research, the present study aims at examining the test-retest reliability of functional MRI (fMRI) experiments using MARCOS. METHODS The effect of repeated active and passive stepping movements on brain activity was investigated in 16 healthy participants from fMRI data collected in two separate imaging sessions six weeks apart. Root mean square errors (RMSE) were calculated for the metrics of motor performance. Regional overlap of brain activation between sessions, as well as an intra-class correlation coefficient (ICC) was computed from the single-subject and group activation maps for five regions of interest (ROI). RESULTS Data from eight participants had to be excluded due to excessive head motion. Reliability of motor performance was higher during passive than active movements, as seen in 4.5- to 13-fold lower RMSE for passive movements. In contrast, ICC ranged from 0.48 to 0.72 during passive movements and from 0.77 to 0.85 during active movements. Regional overlap of activations was also higher during active than during passive movements. CONCLUSION These findings imply that an increased variability of motor performance during active movements of healthy participants may be associated with a stable neuronal activation pattern across repeated measurements. In contrast, a stable motor performance during passive movements may be accompanied by a confined reliability of brain activation across repeated measurements.
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Affiliation(s)
- Lukas Jaeger
- Department of Health Sciences and Technology, Sensory-Motor Systems (SMS) Lab, ETH Zurich, ML G 59, Sonneggstrasse 3, 8092, Zurich, Switzerland. .,Medical Faculty, University of Zurich, Zurich, Switzerland. .,Clinic of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland.
| | - Laura Marchal-Crespo
- Department of Health Sciences and Technology, Sensory-Motor Systems (SMS) Lab, ETH Zurich, ML G 59, Sonneggstrasse 3, 8092, Zurich, Switzerland. .,Medical Faculty, University of Zurich, Zurich, Switzerland.
| | - Peter Wolf
- Department of Health Sciences and Technology, Sensory-Motor Systems (SMS) Lab, ETH Zurich, ML G 59, Sonneggstrasse 3, 8092, Zurich, Switzerland. .,Medical Faculty, University of Zurich, Zurich, Switzerland.
| | - Robert Riener
- Department of Health Sciences and Technology, Sensory-Motor Systems (SMS) Lab, ETH Zurich, ML G 59, Sonneggstrasse 3, 8092, Zurich, Switzerland. .,Medical Faculty, University of Zurich, Zurich, Switzerland.
| | - Spyros Kollias
- Clinic of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland.
| | - Lars Michels
- Clinic of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland. .,Center of MR-Research, University Children's Hospital, Zurich, Switzerland.
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86
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Jaeger L, Marchal-Crespo L, Wolf P, Riener R, Kollias S, Michels L. Test-retest reliability of fMRI experiments during robot-assisted active and passive stepping. J Neuroeng Rehabil 2015; 12:102. [PMID: 26577598 PMCID: PMC4647500 DOI: 10.1186/s12984-015-0097-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 11/06/2015] [Indexed: 11/10/2022] Open
Abstract
Background Brain activity has been shown to undergo cortical and sub-cortical functional reorganisation over the course of gait rehabilitation in patients suffering from a spinal cord injury or a stroke. These changes however, have not been completely elucidated by neuroimaging to date, mainly due to the scarcity of long-term, follow-up investigations. The magnetic resonance imaging (MRI) compatible stepper MARCOS was specifically developed to enable the investigation of the supraspinal adaptations in paretic patients undergoing gait-rehabilitation in a controlled and repeatable manner. In view of future clinical research, the present study aims at examining the test-retest reliability of functional MRI (fMRI) experiments using MARCOS. Methods The effect of repeated active and passive stepping movements on brain activity was investigated in 16 healthy participants from fMRI data collected in two separate imaging sessions six weeks apart. Root mean square errors (RMSE) were calculated for the metrics of motor performance. Regional overlap of brain activation between sessions, as well as an intra-class correlation coefficient (ICC) was computed from the single-subject and group activation maps for five regions of interest (ROI). Results Data from eight participants had to be excluded due to excessive head motion. Reliability of motor performance was higher during passive than active movements, as seen in 4.5- to 13-fold lower RMSE for passive movements. In contrast, ICC ranged from 0.48 to 0.72 during passive movements and from 0.77 to 0.85 during active movements. Regional overlap of activations was also higher during active than during passive movements. Conclusion These findings imply that an increased variability of motor performance during active movements of healthy participants may be associated with a stable neuronal activation pattern across repeated measurements. In contrast, a stable motor performance during passive movements may be accompanied by a confined reliability of brain activation across repeated measurements.
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Affiliation(s)
- Lukas Jaeger
- Department of Health Sciences and Technology, Sensory-Motor Systems (SMS) Lab, ETH Zurich, ML G 59, Sonneggstrasse 3, 8092, Zurich, Switzerland. .,Medical Faculty, University of Zurich, Zurich, Switzerland. .,Clinic of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland.
| | - Laura Marchal-Crespo
- Department of Health Sciences and Technology, Sensory-Motor Systems (SMS) Lab, ETH Zurich, ML G 59, Sonneggstrasse 3, 8092, Zurich, Switzerland. .,Medical Faculty, University of Zurich, Zurich, Switzerland.
| | - Peter Wolf
- Department of Health Sciences and Technology, Sensory-Motor Systems (SMS) Lab, ETH Zurich, ML G 59, Sonneggstrasse 3, 8092, Zurich, Switzerland. .,Medical Faculty, University of Zurich, Zurich, Switzerland.
| | - Robert Riener
- Department of Health Sciences and Technology, Sensory-Motor Systems (SMS) Lab, ETH Zurich, ML G 59, Sonneggstrasse 3, 8092, Zurich, Switzerland. .,Medical Faculty, University of Zurich, Zurich, Switzerland.
| | - Spyros Kollias
- Clinic of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland.
| | - Lars Michels
- Clinic of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland. .,Center of MR-Research, University Children's Hospital, Zurich, Switzerland.
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87
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Bruijn SM, Van Dieën JH, Daffertshofer A. Beta activity in the premotor cortex is increased during stabilized as compared to normal walking. Front Hum Neurosci 2015; 9:593. [PMID: 26578937 PMCID: PMC4621867 DOI: 10.3389/fnhum.2015.00593] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 10/12/2015] [Indexed: 11/29/2022] Open
Abstract
Walking on two legs is inherently unstable. Still, we humans perform remarkable well at it, mostly without falling. To gain more understanding of the role of the brain in controlling gait stability we measured brain activity using electro-encephalography (EEG) during stabilized and normal walking. Subjects walked on a treadmill in two conditions, each lasting 10 min; normal, and while being laterally stabilized by elastic cords. Kinematics of trunk and feet, electro-myography (EMG) of neck muscles, as well as 64-channel EEG were recorded. To assess gait stability the local divergence exponent, step width, and trunk range of motion were calculated from the kinematic data. We used independent component (IC) analysis to remove movement, EMG, and eyeblink artifacts from the EEG, after which dynamic imaging of coherent sources beamformers were determined to identify cortical sources that showed a significant difference between conditions. Stabilized walking led to a significant increase in gait stability, i.e., lower local divergence exponents. Beamforming analysis of the beta band activity revealed significant sources in bilateral pre-motor cortices. Projection of sensor data on these sources showed a significant difference only in the left premotor area, with higher beta power during stabilized walking, specifically around push-off, although only significant around contralateral push-off. It appears that even during steady gait the cortex is involved in the control of stability.
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Affiliation(s)
- Sjoerd M Bruijn
- Department of Human Movement Sciences, MOVE Research Institute Amsterdam, VU University Amsterdam Amsterdam, Netherlands ; Department of Orthopaedic Surgery, First Affiliated Hospital, Fujian Medical University Fuzhou, China
| | - Jaap H Van Dieën
- Department of Human Movement Sciences, MOVE Research Institute Amsterdam, VU University Amsterdam Amsterdam, Netherlands
| | - Andreas Daffertshofer
- Department of Human Movement Sciences, MOVE Research Institute Amsterdam, VU University Amsterdam Amsterdam, Netherlands
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88
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Rigosa J, Panarese A, Dominici N, Friedli L, van den Brand R, Carpaneto J, DiGiovanna J, Courtine G, Micera S. Decoding bipedal locomotion from the rat sensorimotor cortex. J Neural Eng 2015; 12:056014. [PMID: 26331532 DOI: 10.1088/1741-2560/12/5/056014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Decoding forelimb movements from the firing activity of cortical neurons has been interfaced with robotic and prosthetic systems to replace lost upper limb functions in humans. Despite the potential of this approach to improve locomotion and facilitate gait rehabilitation, decoding lower limb movement from the motor cortex has received comparatively little attention. Here, we performed experiments to identify the type and amount of information that can be decoded from neuronal ensemble activity in the hindlimb area of the rat motor cortex during bipedal locomotor tasks. APPROACH Rats were trained to stand, step on a treadmill, walk overground and climb staircases in a bipedal posture. To impose this gait, the rats were secured in a robotic interface that provided support against the direction of gravity and in the mediolateral direction, but behaved transparently in the forward direction. After completion of training, rats were chronically implanted with a micro-wire array spanning the left hindlimb motor cortex to record single and multi-unit activity, and bipolar electrodes into 10 muscles of the right hindlimb to monitor electromyographic signals. Whole-body kinematics, muscle activity, and neural signals were simultaneously recorded during execution of the trained tasks over multiple days of testing. Hindlimb kinematics, muscle activity, gait phases, and locomotor tasks were decoded using offline classification algorithms. MAIN RESULTS We found that the stance and swing phases of gait and the locomotor tasks were detected with accuracies as robust as 90% in all rats. Decoded hindlimb kinematics and muscle activity exhibited a larger variability across rats and tasks. SIGNIFICANCE Our study shows that the rodent motor cortex contains useful information for lower limb neuroprosthetic development. However, brain-machine interfaces estimating gait phases or locomotor behaviors, instead of continuous variables such as limb joint positions or speeds, are likely to provide more robust control strategies for the design of such neuroprostheses.
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Affiliation(s)
- J Rigosa
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy. Bertarelli Foundation Chair in Translational Neuralengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
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89
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Promjunyakul NO, Schmit BD, Schindler-Ivens SM. A novel fMRI paradigm suggests that pedaling-related brain activation is altered after stroke. Front Hum Neurosci 2015; 9:324. [PMID: 26089789 PMCID: PMC4454878 DOI: 10.3389/fnhum.2015.00324] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 05/20/2015] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to examine the feasibility of using functional magnetic resonance imaging (fMRI) to measure pedaling-related brain activation in individuals with stroke and age-matched controls. We also sought to identify stroke-related changes in brain activation associated with pedaling. Fourteen stroke and 12 control subjects were asked to pedal a custom, MRI-compatible device during fMRI. Subjects also performed lower limb tapping to localize brain regions involved in lower limb movement. All stroke and control subjects were able to pedal while positioned for fMRI. Two control subjects were withdrawn due to claustrophobia, and one control data set was excluded from analysis due to an incidental finding. In the stroke group, one subject was unable to enter the gantry due to excess adiposity, and one stroke data set was excluded from analysis due to excessive head motion. Consequently, 81% of subjects (12/14 stroke, 9/12 control) completed all procedures and provided valid pedaling-related fMRI data. In these subjects, head motion was ≤3 mm. In both groups, brain activation localized to the medial aspect of M1, S1, and Brodmann's area 6 (BA6) and to the cerebellum (vermis, lobules IV, V, VIII). The location of brain activation was consistent with leg areas. Pedaling-related brain activation was apparent on both sides of the brain, with values for laterality index (LI) of -0.06 (0.20) in the stroke cortex, 0.05 (±0.06) in the control cortex, 0.29 (0.33) in the stroke cerebellum, and 0.04 (0.15) in the control cerebellum. In the stroke group, activation in the cerebellum - but not cortex - was significantly lateralized toward the damaged side of the brain (p = 0.01). The volume of pedaling-related brain activation was smaller in stroke as compared to control subjects. Differences reached statistical significance when all active regions were examined together [p = 0.03; 27,694 (9,608) μL stroke; 37,819 (9,169) μL control]. When individual regions were examined separately, reduced brain activation volume reached statistical significance in BA6 [p = 0.04; 4,350 (2,347) μL stroke; 6,938 (3,134) μL control] and cerebellum [p = 0.001; 4,591 (1,757) μL stroke; 8,381 (2,835) μL control]. Regardless of whether activated regions were examined together or separately, there were no significant between-group differences in brain activation intensity [p = 0.17; 1.30 (0.25)% stroke; 1.16 (0.20)% control]. Reduced volume in the stroke group was not observed during lower limb tapping and could not be fully attributed to differences in head motion or movement rate. There was a tendency for pedaling-related brain activation volume to increase with increasing work performed by the paretic limb during pedaling (p = 0.08, r = 0.525). Hence, the results of this study provide two original and important contributions. First, we demonstrated that pedaling can be used with fMRI to examine brain activation associated with lower limb movement in people with stroke. Unlike previous lower limb movements examined with fMRI, pedaling involves continuous, reciprocal, multijoint movement of both limbs. In this respect, pedaling has many characteristics of functional lower limb movements, such as walking. Thus, the importance of our contribution lies in the establishment of a novel paradigm that can be used to understand how the brain adapts to stroke to produce functional lower limb movements. Second, preliminary observations suggest that brain activation volume is reduced during pedaling post-stroke. Reduced brain activation volume may be due to anatomic, physiology, and/or behavioral differences between groups, but methodological issues cannot be excluded. Importantly, brain action volume post-stroke was both task-dependent and mutable, which suggests that it could be modified through rehabilitation. Future work will explore these possibilities.
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Affiliation(s)
- Nutta-On Promjunyakul
- Department of Physical Therapy, Marquette University Milwaukee, WI, USA ; Department of Biomedical Engineering, Marquette University Milwaukee, WI, USA
| | - Brian D Schmit
- Department of Biomedical Engineering, Marquette University Milwaukee, WI, USA ; Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin Milwaukee, WI, USA
| | - Sheila M Schindler-Ivens
- Department of Physical Therapy, Marquette University Milwaukee, WI, USA ; Department of Biomedical Engineering, Marquette University Milwaukee, WI, USA ; Clinical and Translational Science Institute of Southeastern Wisconsin, Medical College of Wisconsin Milwaukee, WI, USA
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90
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Verrel J, Almagor E, Schumann F, Lindenberger U, Kühn S. Changes in neural resting state activity in primary and higher-order motor areas induced by a short sensorimotor intervention based on the Feldenkrais method. Front Hum Neurosci 2015; 9:232. [PMID: 25972804 PMCID: PMC4411887 DOI: 10.3389/fnhum.2015.00232] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 04/11/2015] [Indexed: 01/14/2023] Open
Abstract
We use functional magnetic resonance imaging to investigate short-term neural effects of a brief sensorimotor intervention adapted from the Feldenkrais method, a movement-based learning method. Twenty-one participants (10 men, 19–30 years) took part in the study. Participants were in a supine position in the scanner with extended legs while an experienced Feldenkrais practitioner used a planar board to touch and apply minimal force to different parts of the sole and toes of their left foot under two experimental conditions. In the local condition, the practitioner explored movement within foot and ankle. In the global condition, the practitioner focused on the connection and support from the foot to the rest of the body. Before (baseline) and after each intervention (post-local, post-global), we measured brain activity during intermittent pushing/releasing with the left leg and during resting state. Independent localizer tasks were used to identify regions of interest (ROI). Brain activity during left-foot pushing did not significantly differ between conditions in sensorimotor areas. Resting state activity (regional homogeneity, ReHo) increased from baseline to post-local in medial right motor cortex, and from baseline to post-global in the left supplementary/cingulate motor area. Contrasting post-global to post-local showed higher ReHo in right lateral motor cortex. ROI analyses showed significant increases in ReHo in pushing-related areas from baseline to both post-local and post-global, and this increase tended to be more pronounced post-local. The results of this exploratory study show that a short, non-intrusive sensorimotor intervention can have short-term effects on spontaneous cortical activity in functionally related brain regions. Increased resting state activity in higher-order motor areas supports the hypothesis that the global intervention engages action-related neural processes.
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Affiliation(s)
- Julius Verrel
- Center for Lifespan Psychology, Max Planck Institute for Human Development Berlin, Germany
| | - Eilat Almagor
- The Jerusalem Academy of Music and Dance Jerusalem, Israel
| | - Frank Schumann
- Laboratoire Psychologie de la Perception, Université Paris Descartes Paris, France
| | - Ulman Lindenberger
- Center for Lifespan Psychology, Max Planck Institute for Human Development Berlin, Germany
| | - Simone Kühn
- Center for Lifespan Psychology, Max Planck Institute for Human Development Berlin, Germany
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91
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Bulea TC, Kim J, Damiano DL, Stanley CJ, Park HS. Prefrontal, posterior parietal and sensorimotor network activity underlying speed control during walking. Front Hum Neurosci 2015; 9:247. [PMID: 26029077 PMCID: PMC4429238 DOI: 10.3389/fnhum.2015.00247] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 04/17/2015] [Indexed: 11/13/2022] Open
Abstract
Accumulating evidence suggests cortical circuits may contribute to control of human locomotion. Here, noninvasive electroencephalography (EEG) recorded from able-bodied volunteers during a novel treadmill walking paradigm was used to assess neural correlates of walking. A systematic processing method, including a recently developed subspace reconstruction algorithm, reduced movement-related EEG artifact prior to independent component analysis and dipole source localization. We quantified cortical activity while participants tracked slow and fast target speeds across two treadmill conditions: an active mode that adjusted belt speed based on user movements and a passive mode reflecting a typical treadmill. Our results reveal frequency specific, multi-focal task related changes in cortical oscillations elicited by active walking. Low γ band power, localized to the prefrontal and posterior parietal cortices, was significantly increased during double support and early swing phases, critical points in the gait cycle since the active controller adjusted speed based on pelvis position and swing foot velocity. These phasic γ band synchronizations provide evidence that prefrontal and posterior parietal networks, previously implicated in visuo-spatial and somotosensory integration, are engaged to enhance lower limb control during gait. Sustained μ and β band desynchronization within sensorimotor cortex, a neural correlate for movement, was observed during walking thereby validating our methods for isolating cortical activity. Our results also demonstrate the utility of EEG recorded during locomotion for probing the multi-regional cortical networks which underpin its execution. For example, the cortical network engagement elicited by the active treadmill suggests that it may enhance neuroplasticity for more effective motor training.
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Affiliation(s)
- Thomas C Bulea
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, National Institutes of Health Bethesda, MD, USA
| | - Jonghyun Kim
- Robotics Engineering Department, Daegu Gyeongbuk Institute of Science and Technology Daegu, South Korea
| | - Diane L Damiano
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, National Institutes of Health Bethesda, MD, USA
| | - Christopher J Stanley
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, National Institutes of Health Bethesda, MD, USA
| | - Hyung-Soon Park
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology Daejeon, South Korea
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92
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Charalambous CC, Bowden MG, Adkins DL. Motor Cortex and Motor Cortical Interhemispheric Communication in Walking After Stroke: The Roles of Transcranial Magnetic Stimulation and Animal Models in Our Current and Future Understanding. Neurorehabil Neural Repair 2015; 30:94-102. [PMID: 25878201 DOI: 10.1177/1545968315581418] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Despite the plethora of human neurophysiological research, the bilateral involvement of the leg motor cortical areas and their interhemispheric interaction during both normal and impaired human walking is poorly understood. Using transcranial magnetic stimulation (TMS), we have expanded our understanding of the role upper-extremity motor cortical areas play in normal movements and how stroke alters this role, and probed the efficacy of interventions to improve post-stroke arm function. However, similar investigations of the legs have lagged behind, in part, due to the anatomical difficulty in using TMS to stimulate the leg motor cortical areas. Additionally, leg movements are predominately bilaterally controlled and require interlimb coordination that may involve both hemispheres. The sensitive, but invasive, tools used in animal models of locomotion hold great potential for increasing our understanding of the bihemispheric motor cortical control of walking. In this review, we discuss 3 themes associated with the bihemispheric motor cortical control of walking after stroke: (a) what is known about the role of the bihemispheric motor cortical control in healthy and poststroke leg movements, (b) how the neural remodeling of the contralesional hemisphere can affect walking recovery after a stroke, and (c) what is the effect of behavioral rehabilitation training of walking on the neural remodeling of the motor cortical areas bilaterally. For each theme, we discuss how rodent models can enhance the present knowledge on human walking by testing hypotheses that cannot be investigated in humans, and how these findings can then be back-translated into the neurorehabilitation of poststroke walking.
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Affiliation(s)
- Charalambos C Charalambous
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
| | - Mark G Bowden
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - DeAnna L Adkins
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA Department of Neurosciences, Medical University of South Carolina, Charleston, SC
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93
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Excitability changes in intracortical neural circuits induced by differentially controlled walking patterns. PLoS One 2015; 10:e0117931. [PMID: 25688972 PMCID: PMC4331520 DOI: 10.1371/journal.pone.0117931] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 01/02/2015] [Indexed: 11/19/2022] Open
Abstract
Our previous single-pulse transcranial magnetic stimulation (TMS) study revealed that excitability in the motor cortex can be altered by conscious control of walking relative to less conscious normal walking. However, substantial elements and underlying mechanisms for inducing walking-related cortical plasticity are still unknown. Hence, in this study we aimed to examine the characteristics of electromyographic (EMG) recordings obtained during different walking conditions, namely, symmetrical walking (SW), asymmetrical walking 1 (AW1), and asymmetrical walking 2 (AW2), with left to right stance duration ratios of 1:1, 1:2, and 2:1, respectively. Furthermore, we investigated the influence of three types of walking control on subsequent changes in the intracortical neural circuits. Prior to each type of 7-min walking task, EMG analyses of the left tibialis anterior (TA) and soleus (SOL) muscles during walking were performed following approximately 3 min of preparative walking. Paired-pulse TMS was used to measure short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) in the left TA and SOL at baseline, immediately after the 7-min walking task, and 30 min post-task. EMG activity in the TA was significantly increased during AW1 and AW2 compared to during SW, whereas a significant difference in EMG activity of the SOL was observed only between AW1 and AW2. As for intracortical excitability, there was a significant alteration in SICI in the TA between SW and AW1, but not between SW and AW2. For the same amount of walking exercise, we found that the different methods used to control walking patterns induced different excitability changes in SICI. Our research shows that activation patterns associated with controlled leg muscles can alter post-exercise excitability in intracortical circuits. Therefore, how leg muscles are activated in a clinical setting could influence the outcome of walking in patients with stroke.
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94
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Conroy BE, Hatfield B, Nichols D. Opening the Black Box of Stroke Rehabilitation with Clinical Practice Improvement Methodology. Top Stroke Rehabil 2015; 12:36-48. [PMID: 15940583 DOI: 10.1310/l3x7-9y2r-aabf-nf5m] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Although stroke survivors are the largest consumer group for postacute rehabilitation services, there has been little quantification of the details of poststroke rehabilitation (PSR), with the major exception of the AHCPR Clinical Practice Guidelines #16 of 1995. The gold standard research methodology of a randomized controlled trial cannot practically encompass PSR. Using clinical practice improvement (CPI), a statistically based, validated research methodology, a mathematical representation of the inpatient stroke rehabilitation experience has been constructed. This article examines the principle aspects of CPI methodology and how it was adapted to a multicenter study of inpatient PSR.
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Affiliation(s)
- Brendan E Conroy
- Stroke Recovery Program, National Rehabilitation Hospital, Washington, DC, USA
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95
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Iseki K, Fukuyama H, Oishi N, Tomimoto H, Otsuka Y, Nankaku M, Benninger D, Hallett M, Hanakawa T. Freezing of gait and white matter changes: a tract-based spatial statistics study. JOURNAL OF CLINICAL MOVEMENT DISORDERS 2015; 2:1. [PMID: 26788337 PMCID: PMC4711070 DOI: 10.1186/s40734-014-0011-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 10/17/2014] [Indexed: 11/13/2022]
Abstract
Background We hypothesized that the integrity of white matter might be related to the severity of freezing of gait in age-related white matter changes. Methods Twenty subjects exhibiting excessive hyperintensities in the periventricular and deep white matter were recruited. The subjects underwent the Freezing of Gait Questionnaire, computerized gait analyses, and diffusion tensor magnetic resonance imaging. Images of axial, radial and mean diffusivity, and fractional anisotropy were calculated as indices of white matter integrity and analyzed with tract-based spatial statistics. Results The fractional anisotropy, mean, axial and radial diffusivity averaged across the whole white matter structure were all significantly correlated with Freezing of Gait Questionnaire scores. Regionally, a negative correlation between Freezing of Gait Questionnaire scores and fractional anisotropy was found in the left superior longitudinal fasciculus beneath the left premotor cortex, right corpus callosum, and left cerebral peduncle. The scores of the Freezing of Gait Questionnaire were positively correlated with mean diffusivity in the left corona radiata and right corpus callosum, and with both axial and radial diffusivity in the left corona radiata. The white matter integrity in these tracts (except the corpus callosum) showed no correlation with cognitive or other gait measures, supporting the specificity of those abnormalities to freezing of gait. Conclusion Divergent pathological lesions involved neural circuits composed of the cerebral cortex, basal ganglia and brainstem, suggesting that freezing of gait has a multifactorial nature.
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Affiliation(s)
- Kazumi Iseki
- Human Brain Research Center, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507 Japan ; Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD USA ; Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University, Graduate School of Medicine, Sendai, Miyagi Japan ; Department of Neurology, Sakakibara-Hakuho Hospital, Tsu, Mie Japan
| | - Hidenao Fukuyama
- Human Brain Research Center, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507 Japan
| | - Naoya Oishi
- Human Brain Research Center, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507 Japan
| | - Hidekazu Tomimoto
- Department of Neurology, Mie University, Graduate School of Medicine, Tsu, Mie Japan
| | - Yoshinobu Otsuka
- Human Brain Research Center, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507 Japan
| | - Manabu Nankaku
- Department of Physical Therapy, Kyoto University Hospital, Kyoto, Japan
| | - David Benninger
- Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD USA
| | - Mark Hallett
- Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD USA
| | - Takashi Hanakawa
- Human Brain Research Center, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507 Japan ; Department of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Japan ; PRESTO, JST, Kawaguchi, Saitama Japan
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Iandolo R, Marre I, Bellini A, Bommarito G, Oesingmann N, Fleysher L, Levrero F, Mancardi G, Casadio M, Inglese M. Neural correlates of ankle movements during different motor tasks: A feasibility study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2015:4679-4682. [PMID: 26737338 DOI: 10.1109/embc.2015.7319438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This ongoing study investigates the neural correlates of ankle dorsi-plantar flexion in active, passive, and proprioceptive tasks. Specifically, we investigated two proprioceptive matching tasks that required a simple combination of active and passive ankle movements: (1) a memory-based ipsilateral matching task and (2) a contralateral concurrent matching task. As expected, during the passive tasks, subjects recruited the same brain areas involved in the correspondent active movements (primary motor cortex (M1), premotor cortex (PM) supplementary motor cortex (SMA) and primary somatosensory cortex (S1)), but the activations were lower. Instead, in both the proprioceptive matching tasks, subjects recruited more motor and sensory-motor areas of the brain and the activations were greater.
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97
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Seo HG, Kim KD, Oh BM, Kim JS, Chung CK. Cortical Activity Measured with EEG during Stepping on a Recumbent Stepper. BRAIN & NEUROREHABILITATION 2015. [DOI: 10.12786/bn.2015.8.1.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Han Gil Seo
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Korea
| | - Kwang Dong Kim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Korea
| | - Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Korea
| | - June Sic Kim
- MEG Center, Seoul National University Hospital, Korea
- Department of Neurosurgery, Seoul National University Hospital, Korea
| | - Chun Kee Chung
- Department of Neurosurgery, Seoul National University Hospital, Korea
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98
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Effect of Task Specific Exercises, Gait Training, and Visual Biofeedback on Equinovarus Gait among Individuals with Stroke: Randomized Controlled Study. Neurol Res Int 2014; 2014:693048. [PMID: 25538853 PMCID: PMC4265373 DOI: 10.1155/2014/693048] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Revised: 10/14/2014] [Accepted: 10/15/2014] [Indexed: 11/17/2022] Open
Abstract
Background and Purpose. Equinovarus foot is a common sign after stroke. The aim of this study is to investigate the effect of task specific exercises, gait training, and visual biofeedback on correcting equinovarus gait among individuals with stroke. Subjects and Methods. Sixteen subjects with ischemic stroke were randomly assigned to two equal groups (G1 and G2). All the patients were at stage 4 of motor recovery of foot according to Chedoke-McMaster Stroke Assessment without any cognitive dysfunction. E-med pedography was used to measure contact time, as well as force underneath hind and forefoot during walking. Outcome measures were collected before randomization, one week after the last session, and four weeks later. Participants in G1 received task specific exercises, gait training, and visual biofeedback and a traditional physical therapy program was applied for participants in G2 for 8 weeks. Results. Significant improvement was observed among G1 patients (P ≤ 0.05) which lasts one month after therapy termination. On the other hand, there were no significant differences between measurements of the participants in G2. Between groups comparison also revealed a significant improvement in G1 with long lasting effect. Conclusion. The results of this study showed a positive long lasting effect of the task specific exercises, gait training, and visual biofeedback on equinovarus gait pattern among individuals with stroke.
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99
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Jaeger L, Marchal-Crespo L, Wolf P, Riener R, Michels L, Kollias S. Brain activation associated with active and passive lower limb stepping. Front Hum Neurosci 2014; 8:828. [PMID: 25389396 PMCID: PMC4211402 DOI: 10.3389/fnhum.2014.00828] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 09/29/2014] [Indexed: 11/14/2022] Open
Abstract
Reports about standardized and repeatable experimental procedures investigating supraspinal activation in patients with gait disorders are scarce in current neuro-imaging literature. Well-designed and executed tasks are important to gain insight into the effects of gait-rehabilitation on sensorimotor centers of the brain. The present study aims to demonstrate the feasibility of a novel imaging paradigm, combining the magnetic resonance (MR)-compatible stepping robot (MARCOS) with sparse sampling functional magnetic resonance imaging (fMRI) to measure task-related BOLD signal changes and to delineate the supraspinal contribution specific to active and passive stepping. Twenty-four healthy participants underwent fMRI during active and passive, periodic, bilateral, multi-joint, lower limb flexion and extension akin to human gait. Active and passive stepping engaged several cortical and subcortical areas of the sensorimotor network, with higher relative activation of those areas during active movement. Our results indicate that the combination of MARCOS and sparse sampling fMRI is feasible for the detection of lower limb motor related supraspinal activation. Activation of the anterior cingulate and medial frontal areas suggests motor response inhibition during passive movement in healthy participants. Our results are of relevance for understanding the neural mechanisms underlying gait in the healthy.
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Affiliation(s)
- Lukas Jaeger
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zürich Zürich, Switzerland ; Medical Faculty, University of Zurich Zurich, Switzerland ; Clinic of Neuroradiology, University Hospital of Zurich Zurich, Switzerland
| | - Laura Marchal-Crespo
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zürich Zürich, Switzerland ; Medical Faculty, University of Zurich Zurich, Switzerland
| | - Peter Wolf
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zürich Zürich, Switzerland ; Medical Faculty, University of Zurich Zurich, Switzerland
| | - Robert Riener
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zürich Zürich, Switzerland ; Medical Faculty, University of Zurich Zurich, Switzerland
| | - Lars Michels
- Clinic of Neuroradiology, University Hospital of Zurich Zurich, Switzerland ; Center of MR-Research, University Children's Hospital Zurich, Switzerland
| | - Spyros Kollias
- Clinic of Neuroradiology, University Hospital of Zurich Zurich, Switzerland
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100
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Yoon T, Vanden Noven ML, Nielson KA, Hunter SK. Brain areas associated with force steadiness and intensity during isometric ankle dorsiflexion in men and women. Exp Brain Res 2014; 232:3133-45. [PMID: 24903120 PMCID: PMC4172577 DOI: 10.1007/s00221-014-3976-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 04/23/2014] [Indexed: 10/25/2022]
Abstract
Although maintenance of steady contractions is required for many daily tasks, there is little understanding of brain areas that modulate lower limb force accuracy. Functional magnetic resonance imaging was used to determine brain areas associated with steadiness and force during static (isometric) lower limb target-matching contractions at low and high intensities. Fourteen young adults (6 men and 8 women; 27.1 ± 9.1 years) performed three sets of 16-s isometric contractions with the ankle dorsiflexor muscles at 10, 30, 50, and 70 % of maximal voluntary contraction (MVC). Percent signal changes (PSCs, %) of the blood oxygenation level-dependent response were extracted for each contraction using region of interest analysis. Mean PSC increased with contraction intensity in the contralateral primary motor area (M1), supplementary motor area, putamen, pallidum cingulate cortex, and ipsilateral cerebellum (p < 0.05). The amplitude of force fluctuations (standard deviation, SD) increased from 10 to 70 % MVC but relative to the mean force (coefficient of variation, CV %) was greatest at 10 % MVC. The CV of force was associated with PSC in the ipsilateral parietal lobule (r = -0.28), putamen (r = -0.29), insula (r = -0.33), and contralateral superior frontal gyrus (r = -0.33, p < 0.05). There were minimal sex differences in brain activation across the isometric motor tasks indicating men and women were similarly motivated and able to activate cortical motor centers during static tasks. Control of steady lower limb contractions involves cortical and subcortical motor areas in both men and women and provides insight into key areas for potential cortical plasticity with impaired or enhanced leg function.
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Affiliation(s)
- Tejin Yoon
- Exercise Science Program, Department of Physical Therapy, Marquette
University, P.O. Box 1881, Milwaukee, WI 53201, USA
- Kinesiology and Integrative Physiology, Michigan Technological University,
Houghton, MI, USA
| | - Marnie L. Vanden Noven
- Exercise Science Program, Department of Physical Therapy, Marquette
University, P.O. Box 1881, Milwaukee, WI 53201, USA
| | - Kristy A. Nielson
- Department of Psychology, Marquette University, Milwaukee, WI, USA
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI,
USA
| | - Sandra K. Hunter
- Exercise Science Program, Department of Physical Therapy, Marquette
University, P.O. Box 1881, Milwaukee, WI 53201, USA
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