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Jain D, Porfido T, de Souza NL, Brown AM, Caccese JB, Czykier A, Dennis EL, Tosto-Mancuso J, Wilde EA, Esopenko C. Neural Mechanisms Associated With Postural Control in Collegiate Soccer and Non-Soccer Athletes. J Neurol Phys Ther 2024; 48:151-158. [PMID: 38709008 DOI: 10.1097/npt.0000000000000476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 01/15/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND AND PURPOSE Sport-specific training may improve postural control, while repetitive head acceleration events (RHAEs) may compromise it. Understanding the neural mechanisms underlying postural control may contextualize changes due to training and RHAE. The goal of this study was to determine whether postural sway during the Balance Error Scoring System (BESS) is related to white matter organization (WMO) in collegiate athletes. METHODS Collegiate soccer ( N = 33) and non-soccer athletes ( N = 44) completed BESS and diffusion tensor imaging. Postural sway during each BESS stance, fractional anisotropy (FA), and mean diffusivity (MD) were extracted for each participant. Partial least squares analyses determined group differences in postural sway and WMO and the relationship between postural sway and WMO in soccer and non-soccer athletes separately. RESULTS Soccer athletes displayed better performance during BESS 6, with lower FA and higher MD in the medial lemniscus (ML) and inferior cerebellar peduncle (ICP), compared to non-soccer athletes. In soccer athletes, lower sway during BESS 2, 5, and 6 was associated with higher FA and lower MD in the corticospinal tract, ML, and ICP. In non-soccer athletes, lower sway during BESS 2 and 4 was associated with higher FA and lower MD in the ML and ICP. BESS 1 was associated with higher FA, and BESS 3 was associated with lower MD in the same tracts in non-soccer athletes. DISCUSSION AND CONCLUSIONS Soccer and non-soccer athletes showed unique relationships between sway and WMO, suggesting that sport-specific exposures are partly responsible for changes in neurological structure and accompanying postural control performance and should be considered when evaluating postural control after injury.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content, available at: http://links.lww.com/JNPT/A472 ).
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Affiliation(s)
- Divya Jain
- Divya Jain and Tara Porfido are considering as co-first authors. Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York City, New York (D.J., N.L.D., A.C., C.E.); Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, New Jersey (T.P., A.M.B.); School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, Ohio (J.B.C.); Department of Neurology, University of Utah (E.L.D., E.A.W.); George E. Wahlen Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah (E.L.D., E.A.W.); and Abilities Research Center, Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York City, New York (J.T.-M.)
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Hadi Z, Mahmud M, Seemungal BM. Brain Mechanisms Explaining Postural Imbalance in Traumatic Brain Injury: A Systematic Review. Brain Connect 2024; 14:144-177. [PMID: 38343363 DOI: 10.1089/brain.2023.0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Abstract
Introduction: Persisting imbalance and falls in community-dwelling traumatic brain injury (TBI) survivors are linked to reduced long-term survival. However, a detailed understanding of the impact of TBI upon the brain mechanisms mediating imbalance is lacking. To understand the state of the art concerning the brain mechanisms mediating imbalance in TBI, we performed a systematic review of the literature. Methods: PubMed, Web of Science, and Scopus were searched and peer-reviewed research articles in humans, with any severity of TBI (mild, moderate, severe, or concussion), which linked a postural balance assessment (objective or subjective) with brain imaging (through computed tomography, T1-weighted imaging, functional magnetic resonance imaging [fMRI], resting-state fMRI, diffusion tensor imaging, magnetic resonance spectroscopy, single-photon emission computed tomography, electroencephalography, magnetoencephalography, near-infrared spectroscopy, and evoked potentials) were included. Out of 1940 articles, 60 were retrieved and screened, and 25 articles fulfilling inclusion criteria were included. Results: The most consistent finding was the link between imbalance and the cerebellum; however, the regions within the cerebellum were inconsistent. Discussion: The lack of consistent findings could reflect that imbalance in TBI is due to a widespread brain network dysfunction, as opposed to focal cortical damage. The inconsistency in the reported findings may also be attributed to heterogeneity of methodology, including data analytical techniques, small sample sizes, and choice of control groups. Future studies should include a detailed clinical phenotyping of vestibular function in TBI patients to account for the confounding effect of peripheral vestibular disorders on imbalance and brain imaging.
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Affiliation(s)
- Zaeem Hadi
- Centre for Vestibular Neurology, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Mohammad Mahmud
- Centre for Vestibular Neurology, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Barry M Seemungal
- Centre for Vestibular Neurology, Department of Brain Sciences, Imperial College London, London, United Kingdom
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Liu M, He J, Liu D, Hou M, Ma Y. Bibliometric and visualized analysis of dynamic balance and brain function using web of science and CiteSpace from 1995 to 2022. Heliyon 2024; 10:e24300. [PMID: 38293478 PMCID: PMC10824782 DOI: 10.1016/j.heliyon.2024.e24300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/05/2024] [Accepted: 01/05/2024] [Indexed: 02/01/2024] Open
Abstract
Purpose This study aims to explore the dynamic balance of human beings and investigate the relationship between functional structure as well as functional connectivity. Through a comprehensive bibliometric and visual analysis of the research literature from 1995 to 2022, we quantitatively display the development of the dynamic balance and brain structure as well as functional connection. Our objective is to present new trends and frontiers in the study of dynamic balance and brain function through bibliometrics software, providing valuable insights for future research in this domain. Methods The literature on dynamic balance, brain structure and functional connectivity between 1995 and 2022 was retrieved from the Web of Science database. We employed CiteSpace software to analyze various aspects, including the year of publication, journal, authors, keywords, institutions, countries, and references. Based on the analysis results, a co-reference map was generated to visually observe research hotspots and knowledge structures. Results A total of 1533 records were retrieved during the survey period (1995-2022), with a gradually increase in the number of annual publications. Notably, the data suggests a notable increase in publications between 2020 and 2021. The number of publications increased by 20 % from 2020 to 2021. The journal "Proceedings of the National Academy of Sciences (PNAS)" emerged as the most prolific journal. Among the cited authors, Deco and Gustavo ranked at the top. Key research terms in this field include "neural network", "functional connectivity", "dynamic", "model" and "brain". Particularly, the keyword "neural network" exhibited the strongest growth. The analysis of keywords cluster revealed the top 10 clusters of research themes. Oxford University stood out as the most productive institution, while the United States held the greatest influence with the highest number of publications and centrality. The reference cluster analysis further demonstrated the top 10 clusters in the literature. Conclusion Through the use of CiteSpace software, this study performed a comprehensive bibliometric and visual analysis of the Web of Science research literature on human dynamic balance and brain structural as well as functional connectivity over the past few decades. This may help researchers identify new perspectives on potential collaborators as well as collaborating institutions, hot topics, and research frontiers in the research field. The results provided an intuitive displayed overview of research trends, hotspots and frontiers in this field, facilitating a general understanding of its progression. Through unremitting efforts, it provides valuable guidance and reference for future research work.
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Affiliation(s)
- Mengjiao Liu
- Research Academy of Grand Health, Faculty of Sports Sciences, Ningbo University, Ningbo 315211, China
| | - Jian He
- Research Academy of Grand Health, Faculty of Sports Sciences, Ningbo University, Ningbo 315211, China
| | - Dongwei Liu
- School of Information Management and Artificial Intelligence, Zhejiang University of Finance and Economics, Hangzhou 310018, China
| | - Meijin Hou
- National Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou 350108, China
- Key Laboratory of Orthopaedics and Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Fujian, China
| | - Ye Ma
- Research Academy of Grand Health, Faculty of Sports Sciences, Ningbo University, Ningbo 315211, China
- National Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou 350108, China
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Xue X, Lu R, Li H, Chen Z, Sheng D, Jin Z, Liu S, Liu A, Yan X, Tang W, Chen S, Hua Y. In Vivo Characterization of Cerebellar Peduncles in Chronic Ankle Instability: A Single and Multishell Diffusion-Weighted Imaging Study. Sports Health 2024; 16:38-46. [PMID: 38112261 PMCID: PMC10732106 DOI: 10.1177/19417381231156544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Ankle sprain causes proprioceptor injuries and prolonged joint deafferentation, which might lead to maladaptive neuroplasticity in patients with chronic ankle instability (CAI), especially in the cerebellum. Previous studies have indicated the impairment of superior cerebellar peduncle (SCP), but the inferior cerebellar peduncle (ICP) and middle cerebellar peduncle (MCP) have not been fully analyzed. HYPOTHESIS The cerebellar peduncles of participants with CAI would have altered fractional anisotropy (FA) and orientation dispersion index (ODI) in comparison with healthy controls without ankle injury history. In addition, FA and ODI would be correlated with the duration or severity of the sensorimotor deficits in CAI. STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 3. METHODS A group of 27 participants with CAI and 26 healthy controls underwent diffusion-weighted imaging scanning, with the cerebellar peduncles as the regions of interest. The measures obtained by single-shell diffusion tensor imaging and the multishell neurite orientation dispersion and density imaging were used. Correlation analyses were performed to examine the potential relationship between the FA/ODI and both the normalized Y-balance scores and the durations of ankle instability. RESULTS The ipsilateral ICP of the injured ankle in participants with CAI showed significantly lower FA (Cohen d 95% CI, -1.33 to -0.21; P = 0.04) and marginally significant higher ODI (Cohen d 95% CI, 0.10 to 1.20, P = 0.08) when compared with the same measures in the control group, with the ODI being positively correlated with the duration of ankle instability (r = 0.42, P = 0.03). CONCLUSION The ICP in participants with CAI exhibited impaired integrity and a trend of abnormally organized neurites in comparison with a healthy control group. CLINICAL RELEVANCE The impairments of ICP might be an ongoing part of the pathological process of CAI, having the potential to become a target for the diagnostic evaluation of this clinical entity.
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Affiliation(s)
- Xiao’ao Xue
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Rong Lu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Hong Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Ziyi Chen
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Dandan Sheng
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhengbiao Jin
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Shiyin Liu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ailin Liu
- Department of Medical Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
| | - Xu Yan
- Scientific Marketing, Siemens Healthcare Ltd., Shanghai, China
| | - Weijun Tang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Shuang Chen
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yinghui Hua
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
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Surgent O, Guerrero-Gonzalez J, Dean DC, Kirk GR, Adluru N, Kecskemeti SR, Alexander AL, Travers BG. How we get a grip: Microstructural neural correlates of manual grip strength in children. Neuroimage 2023; 273:120117. [PMID: 37062373 PMCID: PMC10161685 DOI: 10.1016/j.neuroimage.2023.120117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/23/2023] [Accepted: 04/13/2023] [Indexed: 04/18/2023] Open
Abstract
Maximal grip strength is associated with a variety of health-related outcome measures and thus may be reflective of the efficiency of foundational brain-body communication. Non-human primate models of grip strength strongly implicate the cortical lateral grasping network, but little is known about the translatability of these models to human children. Further, it is unclear how supplementary networks that provide proprioceptive information and cerebellar-based motor command modification are associated with maximal grip strength. Therefore, this study employed high resolution, multi-shell diffusion and quantitative T1 imaging to examine how variations in lateral grasping, proprioception input, and cortico-cerebellar modification network white matter microstructure are associated with variations in grip strength across 70 children. Results indicated that stronger grip strength was associated with higher lateral grasping and proprioception input network fractional anisotropy and R1, indirect measures consistent with stronger microstructural coherence and increased myelination. No relationships were found in the cerebellar modification network. These results provide a neurobiological mechanism of grip behavior in children which suggests that increased myelination of cortical sensory and motor pathways is associated with stronger grip. This neurobiological mechanism may be a signature of pediatric neuro-motor behavior more broadly as evidenced by the previously demonstrated relationships between grip strength and behavioral outcome measures across a variety of clinical and non-clinical populations.
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Affiliation(s)
- Olivia Surgent
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States; Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, United States
| | - Jose Guerrero-Gonzalez
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States; Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States
| | - Douglas C Dean
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States; Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States; Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, United States
| | - Gregory R Kirk
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
| | - Nagesh Adluru
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States; Department of Radiology, University of Wisconsin-Madison, Madison, WI, United States
| | | | - Andrew L Alexander
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States; Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States; Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, United States
| | - Brittany G Travers
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States; Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, United States.
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Wang D, Zhou J, Huang Y, Yu H. Identifying the changes in the cortical activity of various brain regions for different balance tasks: A review. NeuroRehabilitation 2023:NRE220285. [PMID: 37125575 DOI: 10.3233/nre-220285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Balance support is critical to a person's overall function and health. Previous neuroimaging studies have shown that cortical structures play an essential role in postural control. OBJECTIVE This review aims to identify differences in the pattern of neural activity induced by balance tasks with different balance control requirements. METHODS Seventy-four articles were selected from the field of balance training and were examined based on four brain function detection technologies. RESULTS In general, most studies focused on the activity changes of various cortical areas during training at different difficulty levels, but more and more attention has also begun to focus on the functional changes of other cortical and deep subcortical structures. Our analysis also revealed the neglect of certain task types. CONCLUSION Based on these results, we identify and discuss future research directions that may contribute to a clear understanding of neural functional plasticity under different tasks.
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Affiliation(s)
- Duojin Wang
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
| | - Jiankang Zhou
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
| | - Yanping Huang
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
| | - Hongliu Yu
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
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Andersen MS, Güler DB, Larsen J, Rich KK, Svenningsen ÅF, Zhang M. The Development of Hindlimb Postural Asymmetry Induced by Focal Traumatic Brain Injury Is Not Related to Serotonin 2A/C Receptor Expression in the Spinal Cord. Int J Mol Sci 2022; 23:ijms23105358. [PMID: 35628167 PMCID: PMC9140651 DOI: 10.3390/ijms23105358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/05/2022] [Accepted: 05/07/2022] [Indexed: 11/16/2022] Open
Abstract
Brain injury and stroke are leading causes of adult disability. Motor deficits are common problems, and their underlying pathological mechanisms remain poorly understood. The serotoninergic system is implicated in both functional recovery from and the occurrence of spasticity after injuries to the central nervous system. This study, which was conducted on rats, investigated the development of limb postural changes and their relationship to the expression of serotonin (5-HT) 2A and 2C receptors in the spinal cord in the 4 weeks after focal traumatic brain injury (TBI) to the right hindlimb sensorimotor cortex. The limb motor deficits were assessed by measuring gait pattern changes during walking and hindlimb postural asymmetry at different time intervals (3−28 days) after surgery. The expressions of the 5-HT2A and 2C receptors in the lumbar spinal cord were investigated using immunohistochemistry. The results showed that all the rats with TBI, independently of the duration of the interval, displayed postural asymmetry with flexion on the contralateral (left) side (>2 mm), while the sham-operated rats showed no apparent postural asymmetry. The TBI rats also had longer stride lengths during walking in both their hindlimbs and their forelimbs compared with the sham rats. For both the TBI and the sham rats, the hind-paw placement angles were larger on the contralateral side in some of the groups. Compared to the sham-operated rats, the 5-HT2A and 2C receptor expression did not significantly change on either side of the lumbar spinal cords of the TBI rats in any of the groups. These results suggest that focal TBI can induce motor deficits lasting a relatively long time, and that these deficits are not related to the expression of the 5-HT2A and 2C receptors in the spinal cord.
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Affiliation(s)
- Marlene Storm Andersen
- Department of Molecular Medicine, University of Southern Denmark, DK-5000 Odense, Denmark; (M.S.A.); (D.B.G.); (J.L.); (K.K.R.); (Å.F.S.)
| | - Dilârâ Bedriye Güler
- Department of Molecular Medicine, University of Southern Denmark, DK-5000 Odense, Denmark; (M.S.A.); (D.B.G.); (J.L.); (K.K.R.); (Å.F.S.)
| | - Jonas Larsen
- Department of Molecular Medicine, University of Southern Denmark, DK-5000 Odense, Denmark; (M.S.A.); (D.B.G.); (J.L.); (K.K.R.); (Å.F.S.)
| | - Karen Kalhøj Rich
- Department of Molecular Medicine, University of Southern Denmark, DK-5000 Odense, Denmark; (M.S.A.); (D.B.G.); (J.L.); (K.K.R.); (Å.F.S.)
| | - Åsa Fex Svenningsen
- Department of Molecular Medicine, University of Southern Denmark, DK-5000 Odense, Denmark; (M.S.A.); (D.B.G.); (J.L.); (K.K.R.); (Å.F.S.)
- BRIDGE, University of Southern Denmark, DK-5000 Odense, Denmark
| | - Mengliang Zhang
- Department of Molecular Medicine, University of Southern Denmark, DK-5000 Odense, Denmark; (M.S.A.); (D.B.G.); (J.L.); (K.K.R.); (Å.F.S.)
- BRIDGE, University of Southern Denmark, DK-5000 Odense, Denmark
- Correspondence:
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Callow DD, Purcell JJ, Won J, Smith JC. Neurite dispersion and density mediates the relationship between cardiorespiratory fitness and cognition in healthy younger adults. Neuropsychologia 2022; 169:108207. [PMID: 35259402 PMCID: PMC8985444 DOI: 10.1016/j.neuropsychologia.2022.108207] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 11/23/2022]
Abstract
Growing evidence suggests physical activity and cardiorespiratory fitness are associated with better cognition across the lifespan. However, the neurobiological underpinnings relating fitness and cognition remain unclear, particularly in healthy younger adults. Using a well-established and popular multi-compartment diffusion modeling approach, called Neurite Orientation and Dispersion and Density Imaging (NODDI), we investigated the relationship between physical fitness (measured via a 2-min walk test), cognition (fluid and crystallized), and gray and white matter microstructure, in a large sample (n = 816) of healthy younger adults (ages 22-35 years) from the human connectome project (HCP). Concurrent with previous literature, we found that fitness was positively associated with both fluid and crystallized cognition. Furthermore, we found that physical fitness was negatively associated with white matter orientation dispersion index (ODIWM) around the cerebellar peduncle and was negatively associated with widespread cortical and subcortical gray matter neurite density index (NDIGM). Lower ODIWM of the cerebral peduncle was associated with better fluid cognitive performance, while lower NDIGM was associated with better crystallized cognition. Finally, we found that while ODIWM partially mediated the relationship between fitness and fluid cognition, NDIGM partially mediated the relationship between fitness and crystallized cognition. This study is the first to explore the relationship between physical fitness and white and gray matter microstructure measures using NODDI. Our findings suggest that in addition to improved cognitive performance, higher physical fitness may be associated with lower white matter tract dispersion and lower neurite density in the cortical and subcortical gray matter of healthy younger adults.
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Affiliation(s)
- Daniel D. Callow
- Department of Kinesiology, University of Maryland, College Park, MD, USA
- Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, USA
| | | | - Junyeon Won
- Department of Kinesiology, University of Maryland, College Park, MD, USA
| | - J. Carson Smith
- Department of Kinesiology, University of Maryland, College Park, MD, USA
- Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, USA
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Neef NE, Korzeczek A, Primaßin A, Wolff von Gudenberg A, Dechent P, Riedel CH, Paulus W, Sommer M. White matter tract strength correlates with therapy outcome in persistent developmental stuttering. Hum Brain Mapp 2022; 43:3357-3374. [PMID: 35415866 PMCID: PMC9248304 DOI: 10.1002/hbm.25853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/22/2022] [Accepted: 03/22/2022] [Indexed: 11/11/2022] Open
Abstract
Persistent stuttering is a prevalent neurodevelopmental speech disorder, which presents with involuntary speech blocks, sound and syllable repetitions, and sound prolongations. Affected individuals often struggle with negative feelings, elevated anxiety, and low self-esteem. Neuroimaging studies frequently link persistent stuttering with cortical alterations and dysfunctional cortico-basal ganglia-thalamocortical loops; dMRI data also point toward connectivity changes of the superior longitudinal fasciculus (SLF) and the frontal aslant tract (FAT). Both tracts are involved in speech and language functions, and the FAT also supports inhibitory control and conflict monitoring. Whether the two tracts are involved in therapy-associated improvements and how they relate to therapeutic outcomes is currently unknown. Here, we analyzed dMRI data of 22 patients who participated in a fluency-shaping program, 18 patients not participating in therapy, and 27 fluent control participants, measured 1 year apart. We used diffusion tractography to segment the SLF and FAT bilaterally and to quantify their microstructural properties before and after a fluency-shaping program. Participants learned to speak with soft articulation, pitch, and voicing during a 2-week on-site boot camp and computer-assisted biofeedback-based daily training for 1 year. Therapy had no impact on the microstructural properties of the two tracts. Yet, after therapy, stuttering severity correlated positively with left SLF fractional anisotropy, whereas relief from the social-emotional burden to stutter correlated negatively with right FAT fractional anisotropy. Thus, posttreatment, speech motor performance relates to the left dorsal stream, while the experience of the adverse impact of stuttering relates to the structure recently associated with conflict monitoring and action inhibition.
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Affiliation(s)
- Nicole E Neef
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Göttingen, Göttingen, Germany.,Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany
| | - Alexandra Korzeczek
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany
| | - Annika Primaßin
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany.,Fachbereich Gesundheit, FH Münster University of Applied Sciences, Münster, Germany
| | | | - Peter Dechent
- Department of Cognitive Neurology, MR Research in Neurosciences, University Medical Center Göttingen, Göttingen, Germany
| | - Christian Heiner Riedel
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Göttingen, Göttingen, Germany
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany
| | - Martin Sommer
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany.,Department of Neurology, University Medical Center Göttingen, Göttingen, Germany.,Department of Geriatrics, University Medical Center Göttingen, Göttingen, Germany
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10
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Cabaraux P, Agrawal SK, Cai H, Calabro RS, Casali C, Damm L, Doss S, Habas C, Horn AKE, Ilg W, Louis ED, Mitoma H, Monaco V, Petracca M, Ranavolo A, Rao AK, Ruggieri S, Schirinzi T, Serrao M, Summa S, Strupp M, Surgent O, Synofzik M, Tao S, Terasi H, Torres-Russotto D, Travers B, Roper JA, Manto M. Consensus Paper: Ataxic Gait. CEREBELLUM (LONDON, ENGLAND) 2022; 22:394-430. [PMID: 35414041 DOI: 10.1007/s12311-022-01373-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/20/2022] [Indexed: 12/19/2022]
Abstract
The aim of this consensus paper is to discuss the roles of the cerebellum in human gait, as well as its assessment and therapy. Cerebellar vermis is critical for postural control. The cerebellum ensures the mapping of sensory information into temporally relevant motor commands. Mental imagery of gait involves intrinsically connected fronto-parietal networks comprising the cerebellum. Muscular activities in cerebellar patients show impaired timing of discharges, affecting the patterning of the synergies subserving locomotion. Ataxia of stance/gait is amongst the first cerebellar deficits in cerebellar disorders such as degenerative ataxias and is a disabling symptom with a high risk of falls. Prolonged discharges and increased muscle coactivation may be related to compensatory mechanisms and enhanced body sway, respectively. Essential tremor is frequently associated with mild gait ataxia. There is growing evidence for an important role of the cerebellar cortex in the pathogenesis of essential tremor. In multiple sclerosis, balance and gait are affected due to cerebellar and spinal cord involvement, as a result of disseminated demyelination and neurodegeneration impairing proprioception. In orthostatic tremor, patients often show mild-to-moderate limb and gait ataxia. The tremor generator is likely located in the posterior fossa. Tandem gait is impaired in the early stages of cerebellar disorders and may be particularly useful in the evaluation of pre-ataxic stages of progressive ataxias. Impaired inter-joint coordination and enhanced variability of gait temporal and kinetic parameters can be grasped by wearable devices such as accelerometers. Kinect is a promising low cost technology to obtain reliable measurements and remote assessments of gait. Deep learning methods are being developed in order to help clinicians in the diagnosis and decision-making process. Locomotor adaptation is impaired in cerebellar patients. Coordinative training aims to improve the coordinative strategy and foot placements across strides, cerebellar patients benefiting from intense rehabilitation therapies. Robotic training is a promising approach to complement conventional rehabilitation and neuromodulation of the cerebellum. Wearable dynamic orthoses represent a potential aid to assist gait. The panel of experts agree that the understanding of the cerebellar contribution to gait control will lead to a better management of cerebellar ataxias in general and will likely contribute to use gait parameters as robust biomarkers of future clinical trials.
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Affiliation(s)
- Pierre Cabaraux
- Unité Des Ataxies Cérébelleuses, Department of Neurology, CHU de Charleroi, Charleroi, Belgium.
| | | | - Huaying Cai
- Department of Neurology, Neuroscience Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, China
| | | | - Carlo Casali
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy
| | - Loic Damm
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France
| | - Sarah Doss
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, USA
| | - Christophe Habas
- Université Versailles Saint-Quentin, Versailles, France.,Service de NeuroImagerie, Centre Hospitalier National des 15-20, Paris, France
| | - Anja K E Horn
- Institute of Anatomy and Cell Biology I, Ludwig Maximilians-University Munich, Munich, Germany
| | - Winfried Ilg
- Section Computational Sensomotorics, Hertie Institute for Clinical Brain Research, University Tübingen, Tübingen, Germany
| | - Elan D Louis
- Department of Neurology, University of Texas Southwestern, Dallas, TX, USA
| | - Hiroshi Mitoma
- Department of Medical Education, Tokyo Medical University, Tokyo, Japan
| | - Vito Monaco
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Maria Petracca
- Department of Human Neurosciences, University of Rome Sapienza, Rome, Italy
| | - Alberto Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, Rome, Italy
| | - Ashwini K Rao
- Department of Rehabilitation & Regenerative Medicine (Programs in Physical Therapy), Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Serena Ruggieri
- Department of Human Neurosciences, University of Rome Sapienza, Rome, Italy.,Neuroimmunology Unit, IRCSS Fondazione Santa Lucia, Rome, Italy
| | - Tommaso Schirinzi
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Mariano Serrao
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy.,Movement Analysis LAB, Policlinico Italia, Rome, Italy
| | - Susanna Summa
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy
| | - Michael Strupp
- Department of Neurology and German Center for Vertigo and Balance Disorders, Hospital of the Ludwig Maximilians-University Munich, Munich, Germany
| | - Olivia Surgent
- Neuroscience Training Program and Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Matthis Synofzik
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research and Centre of Neurology, Tübingen, Germany
| | - Shuai Tao
- Dalian Key Laboratory of Smart Medical and Health, Dalian University, Dalian, 116622, China
| | - Hiroo Terasi
- Department of Neurology, Tokyo Medical University, Tokyo, Japan
| | - Diego Torres-Russotto
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, USA
| | - Brittany Travers
- Department of Kinesiology and Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Jaimie A Roper
- School of Kinesiology, Auburn University, Auburn, AL, USA
| | - Mario Manto
- Unité Des Ataxies Cérébelleuses, Department of Neurology, CHU de Charleroi, Charleroi, Belgium.,Service Des Neurosciences, University of Mons, UMons, Mons, Belgium
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11
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Shenoy Handiru V, Alivar A, Hoxha A, Saleh S, Suviseshamuthu ES, Yue GH, Allexandre D. Graph-theoretical analysis of EEG functional connectivity during balance perturbation in traumatic brain injury: A pilot study. Hum Brain Mapp 2021; 42:4427-4447. [PMID: 34312933 PMCID: PMC8410544 DOI: 10.1002/hbm.25554] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 05/08/2021] [Accepted: 05/27/2021] [Indexed: 12/13/2022] Open
Abstract
Traumatic brain injury (TBI) often results in balance impairment, increasing the risk of falls, and the chances of further injuries. However, the underlying neural mechanisms of postural control after TBI are not well understood. To this end, we conducted a pilot study to explore the neural mechanisms of unpredictable balance perturbations in 17 chronic TBI participants and 15 matched healthy controls (HC) using the EEG, MRI, and diffusion tensor imaging (DTI) data. As quantitative measures of the functional integration and segregation of the brain networks during the postural task, we computed the global graph-theoretic network measures (global efficiency and modularity) of brain functional connectivity derived from source-space EEG in different frequency bands. We observed that the TBI group showed a lower balance performance as measured by the center of pressure displacement during the task, and the Berg Balance Scale (BBS). They also showed reduced brain activation and connectivity during the balance task. Furthermore, the decrease in brain network segregation in alpha-band from baseline to task was smaller in TBI than HC. The DTI findings revealed widespread structural damage. In terms of the neural correlates, we observed a distinct role played by different frequency bands: theta-band modularity during the task was negatively correlated with the BBS in the TBI group; lower beta-band network connectivity was associated with the reduction in white matter structural integrity. Our future studies will focus on how postural training will modulate the functional brain networks in TBI.
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Affiliation(s)
- Vikram Shenoy Handiru
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, New Jersey, USA.,Department of Physical Medicine and Rehabilitation, Rutgers University New Jersey Medical School, Newark, New Jersey, USA
| | - Alaleh Alivar
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, New Jersey, USA.,Department of Physical Medicine and Rehabilitation, Rutgers University New Jersey Medical School, Newark, New Jersey, USA
| | - Armand Hoxha
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, New Jersey, USA
| | - Soha Saleh
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, New Jersey, USA.,Department of Physical Medicine and Rehabilitation, Rutgers University New Jersey Medical School, Newark, New Jersey, USA
| | - Easter S Suviseshamuthu
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, New Jersey, USA.,Department of Physical Medicine and Rehabilitation, Rutgers University New Jersey Medical School, Newark, New Jersey, USA
| | - Guang H Yue
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, New Jersey, USA.,Department of Physical Medicine and Rehabilitation, Rutgers University New Jersey Medical School, Newark, New Jersey, USA
| | - Didier Allexandre
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, New Jersey, USA.,Department of Physical Medicine and Rehabilitation, Rutgers University New Jersey Medical School, Newark, New Jersey, USA
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12
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Surgent O, Dean DC, Alexander AL, Dadalko OI, Guerrero-Gonzalez J, Taylor D, Skaletski E, Travers BG. Neurobiological and behavioural outcomes of biofeedback-based training in autism: a randomized controlled trial. Brain Commun 2021; 3:fcab112. [PMID: 34250479 PMCID: PMC8254423 DOI: 10.1093/braincomms/fcab112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/26/2021] [Accepted: 04/28/2021] [Indexed: 11/13/2022] Open
Abstract
The human brain has demonstrated the power to structurally change as a result of movement-based interventions. However, it is unclear whether these structural brain changes differ in autistic individuals compared to non-autistic individuals. The purpose of the present study was to pilot a randomized controlled trial to investigate brain, balance, autism symptom severity and daily living skill changes that result from a biofeedback-based balance intervention in autistic adolescents (13-17 years old). Thirty-four autistic participants and 28 age-matched non-autistic participants underwent diagnostic testing and pre-training assessment (neuroimaging, cognitive, autism symptom severity and motor assessments) and were then randomly assigned to 6 weeks of a balance-training intervention or a sedentary-control condition. After the 6 weeks, neuroimaging, symptom severity and motor assessments were repeated. Results found that both the autistic and non-autistic participants demonstrated similar and significant increases in balance times with training. Furthermore, individuals in the balance-training condition showed significantly greater improvements in postural sway and reductions in autism symptom severity compared to individuals in the control condition. Daily living scores did not change with training, nor did we observe hypothesized changes to the microstructural properties of the corticospinal tract. However, follow-up voxel-based analyses found a wide range of balance-related structures that showed changes across the brain. Many of these brain changes were specific to the autistic participants compared to the non-autistic participants, suggesting distinct structural neuroplasticity in response to balance training in autistic participants. Altogether, these findings suggest that biofeedback-based balance training may target postural stability challenges, reduce core autism symptoms and influence neurobiological change. Future research is encouraged to examine the superior cerebellar peduncle in response to balance training and symptom severity changes in autistic individuals, as the current study produced overlapping findings in this brain region.
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Affiliation(s)
- Olivia Surgent
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Douglas C Dean
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
- Pediatrics, University of Wisconsin-Madison, Madison, WI 53792, USA
- Medical Physics, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Andrew L Alexander
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
- Medical Physics, University of Wisconsin-Madison, Madison, WI 53705, USA
- Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, USA
| | - Olga I Dadalko
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Jose Guerrero-Gonzalez
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
- Medical Physics, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Desiree Taylor
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
- Occupational Therapy Program in Kinesiology, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Emily Skaletski
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
- Occupational Therapy Program in Kinesiology, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Brittany G Travers
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
- Occupational Therapy Program in Kinesiology, University of Wisconsin-Madison, Madison, WI 53706, USA
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13
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Jolly AE, Bălăeţ M, Azor A, Friedland D, Sandrone S, Graham NSN, Zimmerman K, Sharp DJ. Detecting axonal injury in individual patients after traumatic brain injury. Brain 2021; 144:92-113. [PMID: 33257929 PMCID: PMC7880666 DOI: 10.1093/brain/awaa372] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/11/2020] [Accepted: 08/17/2020] [Indexed: 12/04/2022] Open
Abstract
Poor outcomes after traumatic brain injury (TBI) are common yet remain difficult to predict. Diffuse axonal injury is important for outcomes, but its assessment remains limited in the clinical setting. Currently, axonal injury is diagnosed based on clinical presentation, visible damage to the white matter or via surrogate markers of axonal injury such as microbleeds. These do not accurately quantify axonal injury leading to misdiagnosis in a proportion of patients. Diffusion tensor imaging provides a quantitative measure of axonal injury in vivo, with fractional anisotropy often used as a proxy for white matter damage. Diffusion imaging has been widely used in TBI but is not routinely applied clinically. This is in part because robust analysis methods to diagnose axonal injury at the individual level have not yet been developed. Here, we present a pipeline for diffusion imaging analysis designed to accurately assess the presence of axonal injury in large white matter tracts in individuals. Average fractional anisotropy is calculated from tracts selected on the basis of high test-retest reliability, good anatomical coverage and their association to cognitive and clinical impairments after TBI. We test our pipeline for common methodological issues such as the impact of varying control sample sizes, focal lesions and age-related changes to demonstrate high specificity, sensitivity and test-retest reliability. We assess 92 patients with moderate-severe TBI in the chronic phase (≥6 months post-injury), 25 patients in the subacute phase (10 days to 6 weeks post-injury) with 6-month follow-up and a large control cohort (n = 103). Evidence of axonal injury is identified in 52% of chronic and 28% of subacute patients. Those classified with axonal injury had significantly poorer cognitive and functional outcomes than those without, a difference not seen for focal lesions or microbleeds. Almost a third of patients with unremarkable standard MRIs had evidence of axonal injury, whilst 40% of patients with visible microbleeds had no diffusion evidence of axonal injury. More diffusion abnormality was seen with greater time since injury, across individuals at various chronic injury times and within individuals between subacute and 6-month scans. We provide evidence that this pipeline can be used to diagnose axonal injury in individual patients at subacute and chronic time points, and that diffusion MRI provides a sensitive and complementary measure when compared to susceptibility weighted imaging, which measures diffuse vascular injury. Guidelines for the implementation of this pipeline in a clinical setting are discussed.
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Affiliation(s)
- Amy E Jolly
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK.,UK Dementia Research Institute Care Research and Technology Centre, Imperial College London and the University of Surrey, London, W12 0NN UK
| | - Maria Bălăeţ
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - Adriana Azor
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - Daniel Friedland
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - Stefano Sandrone
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - Neil S N Graham
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - Karl Zimmerman
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - David J Sharp
- Clinical, cognitive and computational neuroimaging laboratory (C3NL), Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK.,UK Dementia Research Institute Care Research and Technology Centre, Imperial College London and the University of Surrey, London, W12 0NN UK
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14
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Liang X, Yeh CH, Domínguez D JF, Poudel G, Swinnen SP, Caeyenberghs K. Longitudinal fixel-based analysis reveals restoration of white matter alterations following balance training in young brain-injured patients. Neuroimage Clin 2021; 30:102621. [PMID: 33780865 PMCID: PMC8022866 DOI: 10.1016/j.nicl.2021.102621] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 02/24/2021] [Accepted: 03/03/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES Traumatic brain injury (TBI) is one of the leading causes of death and disability in children and adolescents. Young TBI patients suffer from gross motor deficits, such as postural control deficits, which can severely compromise their daily life activities. However, little attention has been devoted to uncovering the underlying white matter changes in response to training in TBI. In this study, we used longitudinal fixel-based analysis (FBA), an advanced diffusion imaging analysis technique, to investigate the effect of a balance training program on white matter fibre density and morphology in a group of young TBI patients. METHODS Young patients with moderate-to-severe TBI (N = 17, 10 females, mean age = 13 ± 3 years) and age-matched controls (N = 17) underwent a home-based balance training program. Diffusion MRI scans together with gross motor assessments, including the gross motor items of the Bruininks-Oseretsky Test of Motor Proficiency, the Activities-Specific Balance Confidence (ABC) Scale, and the Sensory Organization Test (SOT) were administered before and at completion of 8-weeks of training. We used FBA to compare microstructural differences in fibre density (FD), macrostructural (morphological) changes in fibre cross-section (FC), and the combined FD and FC (FDC) metric across the whole brain. We then performed a longitudinal analysis to test whether training restores the white matter in the regions found to be damaged before treatment. RESULTS Whole-brain fixel-based analysis revealed lower FD and FC in TBI patients compared to the control group across several commissural tracts, association fibres and projection fibres, with FD reductions of up to 50%. Following training, TBI patients showed a significant interaction effect between Group and Time for the SOT test, as well as significant increases in macrostructural white matter (i.e., FC & FDC) in left sensorimotor tracts. The amount of change in FC and FDC over time was, however, not associated with behavioural changes. DISCUSSION Our fixel-based findings identified both microstructural and macrostructural abnormalities in young TBI patients. The longitudinal results provide a deeper understanding of the neurobiological mechanisms underlying balance training, which will allow clinicians to make more effective treatment decisions in everyday clinical practice with brain-injured patients.
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Affiliation(s)
- Xiaoyun Liang
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Chun-Hung Yeh
- Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Juan F Domínguez D
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Govinda Poudel
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Stephan P Swinnen
- Motor Control Laboratory, Movement Control and Neuroplasticity Research Group, KU Leuven, Belgium
| | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia.
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15
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Casella C, Bourbon-Teles J, Bells S, Coulthard E, Parker GD, Rosser A, Jones DK, Metzler-Baddeley C. Drumming Motor Sequence Training Induces Apparent Myelin Remodelling in Huntington's Disease: A Longitudinal Diffusion MRI and Quantitative Magnetization Transfer Study. J Huntingtons Dis 2020; 9:303-320. [PMID: 32894249 PMCID: PMC7836062 DOI: 10.3233/jhd-200424] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background: Impaired myelination may contribute to Huntington’s disease (HD) pathogenesis. Objective: This study assessed differences in white matter (WM) microstructure between HD patients and controls, and tested whether drumming training stimulates WM remodelling in HD. Furthermore, it examined whether training-induced microstructural changes are related to improvements in motor and cognitive function. Methods: Participants undertook two months of drumming exercises. Working memory and executive function were assessed before and post-training. Changes in WM microstructure were investigated with diffusion tensor magnetic resonance imaging (DT-MRI)-based metrics, the restricted diffusion signal fraction (Fr) from the composite hindered and restricted model of diffusion (CHARMED) and the macromolecular proton fraction (MPF) from quantitative magnetization transfer (qMT) imaging. WM pathways linking putamen and supplementary motor areas (SMA-Putamen), and three segments of the corpus callosum (CCI, CCII, CCIII) were studied using deterministic tractography. Baseline MPF differences between patients and controls were assessed with tract-based spatial statistics. Results: MPF was reduced in the mid-section of the CC in HD subjects at baseline, while a significantly greater change in MPF was detected in HD patients relative to controls in the CCII, CCIII, and the right SMA-putamen post-training. Further, although patients improved their drumming and executive function performance, such improvements did not correlate with microstructural changes. Increased MPF suggests training-induced myelin changes in HD. Conclusion: Though only preliminary and based on a small sample size, these results suggest that tailored behavioural stimulation may lead to neural benefits in early HD, that could be exploited for delaying disease progression.
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Affiliation(s)
- Chiara Casella
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff, UK
| | - Jose Bourbon-Teles
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff, UK
| | - Sonya Bells
- The Hospital for Sick Children, Neurosciences and Mental Health, Toronto, Canada
| | | | - Greg D Parker
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff, UK
| | - Anne Rosser
- School of Biosciences, Cardiff University, Museum Avenue, Cardiff, UK.,Department of Neurology and Psychological Medicine, Hayden Ellis Building, Cardiff, UK
| | - Derek K Jones
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff, UK.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Claudia Metzler-Baddeley
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff, UK
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16
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Drum training induces long-term plasticity in the cerebellum and connected cortical thickness. Sci Rep 2020; 10:10116. [PMID: 32572037 PMCID: PMC7308330 DOI: 10.1038/s41598-020-65877-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 04/06/2020] [Indexed: 11/24/2022] Open
Abstract
It is unclear to what extent cerebellar networks show long-term plasticity and accompanied changes in cortical structures. Using drumming as a demanding multimodal motor training, we compared cerebellar lobular volume and white matter microstructure, as well as cortical thickness of 15 healthy non-musicians before and after learning to drum, and 16 age matched novice control participants. After 8 weeks of group drumming instruction, 3 ×30 minutes per week, we observed the cerebellum significantly changing its grey (volume increase of left VIIIa, relative decrease of VIIIb and vermis Crus I volume) and white matter microstructure in the inferior cerebellar peduncle. These plastic cerebellar changes were complemented by changes in cortical thickness (increase in left paracentral, right precuneus and right but not left superior frontal thickness), suggesting an interplay of cerebellar learning with cortical structures enabled through cerebellar pathways.
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17
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Demšar J, Forsyth R. Synaptic Scaling Improves the Stability of Neural Mass Models Capable of Simulating Brain Plasticity. Neural Comput 2019; 32:424-446. [PMID: 31835005 DOI: 10.1162/neco_a_01257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Neural mass models offer a way of studying the development and behavior of large-scale brain networks through computer simulations. Such simulations are currently mainly research tools, but as they improve, they could soon play a role in understanding, predicting, and optimizing patient treatments, particularly in relation to effects and outcomes of brain injury. To bring us closer to this goal, we took an existing state-of-the-art neural mass model capable of simulating connection growth through simulated plasticity processes. We identified and addressed some of the model's limitations by implementing biologically plausible mechanisms. The main limitation of the original model was its instability, which we addressed by incorporating a representation of the mechanism of synaptic scaling and examining the effects of optimizing parameters in the model. We show that the updated model retains all the merits of the original model, while being more stable and capable of generating networks that are in several aspects similar to those found in real brains.
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Affiliation(s)
- Jure Demšar
- Faculty of Computer and Information Science, University of Ljubljana, 1000 Ljubljana, Slovenia, and MBLab, Department of Psychology, Faculty of Arts, University of Ljubljana, Slovenia
| | - Rob Forsyth
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE1 4LP, U.K.
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18
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O'Neil J, Egan M, Marshall S, Bilodeau M, Pelletier L, Sveistrup H. Remotely Supervised Home-Based Intensive Exercise Intervention to Improve Balance, Functional Mobility, and Physical Activity in Survivors of Moderate or Severe Traumatic Brain Injury: Protocol for a Mixed Methods Study. JMIR Res Protoc 2019; 8:e14867. [PMID: 31599733 PMCID: PMC6812480 DOI: 10.2196/14867] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/31/2019] [Accepted: 08/07/2019] [Indexed: 01/07/2023] Open
Abstract
Background Traumatic brain injury (TBI) may impact an individual physically, cognitively, socially, and emotionally. Poor balance, reduced mobility, and low daily physical activity often will require ongoing physical rehabilitation intervention. However, face-to-face specialized physiotherapy is not always accessible for individuals living in rural settings. Objective We will answer four questions: (1) What is the feasibility of a remotely supervised, home-based, intensive exercise intervention with survivors of moderate and severe TBI? (2) Does the frequency of remote supervision have an impact on the feasibility of completing a home-based intensive exercise program? (3) Does the frequency of remote supervision impact balance, functional mobility, and physical activity? (4) What is the lived experience of remote supervision for both survivors and caregivers? Methods Four participants will complete two intensive, 4-week (five days per week) home-based exercise interventions remotely supervised via synchronous videoconference. Each exercise intervention will have a goal of 160 to 300 repetitions or 60 minutes of tailored exercises to promote neuroplasticity and be defined as an intensive home-based exercise intervention. An alternating single-subject design will allow for the comparison between two frequencies of remote supervision, once weekly and five times weekly. Daily repeated outcome measures, pre- and postintervention outcome measures, and 1-month follow-up outcome measures will be collected to explore the effect on feasibility and physical variables. Daily outcome measures include step count and Five Times Sit-to-Stand test. Pre-post measures include assessment of quiet stance and the Community Balance and Mobility Scale. A semistructured interview will be completed at the end of each intervention segment to document the lived experience of both survivors and their study partners. Finally, five questionnaires will be used to understand the overall experience: the Mayo-Portland Adaptability Inventory-4 Participation Index, Satisfaction With Life Scale, Fall Efficacy Scale-International, Interpersonal Behavior Questionnaire, and System Usability Scale. Data will be analyzed following traditional single-subject methods of analysis. Results Ethics approval was received from both the Bruyère Research Institute and University of Ottawa review boards in March 2019. Recruitment is underway. Conclusions The proposed intervention is complex in nature due to the involvement of multiple technology sources and the inclusion of a complex dyad (survivors and caregivers) in a community setting. This type of research is timely given that alternative methods of physical intervention delivery are needed to facilitate gains in balance, mobility, physical activity among TBI survivors with limited access to clinical care, and the quality of the patients’ experience. International Registered Report Identifier (IRRID) PRR1-10.2196/14867
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Affiliation(s)
- Jennifer O'Neil
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | - Mary Egan
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | - Shawn Marshall
- Bruyère Research Institute, Ottawa, ON, Canada.,Physical Medicine and Rehabilitation, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Martin Bilodeau
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | - Luc Pelletier
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Heidi Sveistrup
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
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19
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Kim E, Seo HG, Lee HH, Lee SH, Choi SH, Cho WS, Wagner AK, Oh BM. Altered White Matter Integrity after Mild to Moderate Traumatic Brain Injury. J Clin Med 2019; 8:jcm8091318. [PMID: 31461987 PMCID: PMC6780936 DOI: 10.3390/jcm8091318] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 08/22/2019] [Accepted: 08/24/2019] [Indexed: 12/14/2022] Open
Abstract
(1) Background: White matter changes among individuals with mild-to-moderate traumatic brain injury (TBI) may be sensitive imaging markers reflecting functional impairment, particularly in the context of post-concussion syndrome. The objective of this study was to examine the altered white matter integrity in mild-to-moderate TBI patients compared with age-matched normal controls. (2) Methods: Diffusion tensor imaging data from 15 individuals with TBI and 15 control subjects were retrospectively obtained. We investigated and compared white matter integrity in both groups, with regard to fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) and examined the relationship with cognitive dysfunction and impaired balance in patients. (3) Results: In comparison with controls, the TBI patients had significantly decreased FA as well as increased RD, in the right corticospinal tract. Decreased RD was observed in the left cerebellar area near the middle cerebellar peduncle. Decreased AD was observed in the left inferior cerebellar peduncle, showing positive correlation with poor balance control. We observed decreased FA and increased AD in the left superior longitudinal fasciculus showing positive and negative correlation, respectively, with cognitive function in the TBI group. (4) Conclusions: Altered white matter integrity in mild-to-moderate TBI cases may be indicative of cognitive dysfunction and impaired balance.
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Affiliation(s)
- Eunkyung Kim
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Korea
| | - Han Gil Seo
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Korea
| | - Hyun Haeng Lee
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Korea
- Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul 03080, Korea
| | - Seung Hak Lee
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Korea
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 03080, Korea
| | - Seung Hong Choi
- Department of Radiology, Seoul National University College of Medicine, Seoul 03080, Korea
- Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea
- Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea
| | - Won-Sang Cho
- Department of Neurosurgery, Seoul National University Hospital, Seoul 03080, Korea
| | - Amy K Wagner
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburg, PA 15260, USA
| | - Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Korea.
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20
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Giboin LS, Loewe K, Hassa T, Kramer A, Dettmers C, Spiteri S, Gruber M, Schoenfeld MA. Cortical, subcortical and spinal neural correlates of slackline training-induced balance performance improvements. Neuroimage 2019; 202:116061. [PMID: 31374329 DOI: 10.1016/j.neuroimage.2019.116061] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 07/17/2019] [Accepted: 07/27/2019] [Indexed: 02/08/2023] Open
Abstract
Humans develop posture and balance control during childhood. Interestingly, adults can also learn to master new complex balance tasks, but the underlying neural mechanisms are not fully understood yet. Here, we combined broad scale brain connectivity fMRI at rest and spinal excitability measurements during movement. Six weeks of slackline training improved the capability to walk on a slackline which was paralleled by functional connectivity changes in brain regions associated with posture and balance control and by task-specific changes of spinal excitability. Importantly, the performance of trainees was not better than control participants in a different, untrained balance task. In conclusion, slackline training induced large-scale neuroplasticity which solely transferred into highly task specific performance improvements.
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Affiliation(s)
- Louis-Solal Giboin
- Sensorimotor Performance Lab, Human Research Performance Centre, University Konstanz, Germany.
| | - Kristian Loewe
- Dept of Experimental Neurology, Otto-von-Guericke-University Magdeburg, Germany; Dept of Computer Science, Otto-von-Guericke-University Magdeburg, Germany
| | - Thomas Hassa
- Lurija Institute, Kliniken Schmieder Allensbach, Germany
| | - Andreas Kramer
- Sensorimotor Performance Lab, Human Research Performance Centre, University Konstanz, Germany
| | - Christian Dettmers
- Lurija Institute, Kliniken Schmieder Allensbach, Germany; Kliniken Schmieder Konstanz, Germany
| | - Stefan Spiteri
- Lurija Institute, Kliniken Schmieder Allensbach, Germany
| | - Markus Gruber
- Sensorimotor Performance Lab, Human Research Performance Centre, University Konstanz, Germany
| | - Mircea Ariel Schoenfeld
- Dept of Experimental Neurology, Otto-von-Guericke-University Magdeburg, Germany; Lurija Institute, Kliniken Schmieder Allensbach, Germany; Dept of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany; Kliniken Schmieder Heidelberg, Germany
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21
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Surgent OJ, Dadalko OI, Pickett KA, Travers BG. Balance and the brain: A review of structural brain correlates of postural balance and balance training in humans. Gait Posture 2019; 71:245-252. [PMID: 31082657 PMCID: PMC6594858 DOI: 10.1016/j.gaitpost.2019.05.011] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 05/03/2019] [Accepted: 05/05/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Balance challenges are associated with not only the aging process but also a wide variety of psychiatric and neurological disorders. However, relatively little is known regarding the neural basis of balance and the effects of balance interventions on the brain. RESEARCH QUESTION This review synthesizes the existing literature to answer the question: What are the key brain structures associated with balance? METHODS This review examined 37 studies that assessed brain structures in relation to balance assessment or intervention. These studies provided 234 findings implicating 71 brain structures. The frequency of implication for each structure was examined based upon specific methodological parameters, including study design (assessment/intervention), type of balance measured (static/dynamic), population (clinical/non-clinical), and imaging analysis technique (region of interest [ROI]/voxel-based morphometry [VBM]). RESULTS Although a number of structures were associated with balance across the brain, the most frequently implicated structures included the cerebellum, basal ganglia, thalamus, hippocampus, inferior parietal cortex, and frontal lobe regions. Findings in the cerebellum and brainstem were most common in studies with clinical populations, studies that used an ROI approach, and studies that measured dynamic balance. Findings in the frontal, occipital, and parietal regions were also more common in studies that measured dynamic compared to static balance. SIGNIFICANCE While balance appears to be a whole-brain phenomenon, a subset of structures appear to play a key role in balance and are likely implicated in balance disorders. Some of these structures (i.e., the cerebellum, basal ganglia and thalamus) have a well-appreciated role in balance, whereas other regions (i.e., hippocampus and inferior parietal cortex) are not commonly thought to be associated with balance and therefore may provide alternative explanations for the neural basis of balance. Key avenues for future research include understanding the roles of all regions involved in balance across the lifespan and in different clinical populations.
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Affiliation(s)
- Olivia J. Surgent
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705, USA.,Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI 53705, USA.,Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Boulevard, Madison, Wisconsin, 53719, USA
| | - Olga I. Dadalko
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705, USA
| | - Kristen A. Pickett
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, 2185 Medical Sciences Center, 1300 University Avenue, Madison, WI 53706, USA.,Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Brittany G. Travers
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705, USA.,Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, 2185 Medical Sciences Center, 1300 University Avenue, Madison, WI 53706, USA
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22
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Augustijn MJCM, Deconinck FJA, D'Hondt E, Van Acker L, De Guchtenaere A, Lenoir M, Caeyenberghs K. Reduced motor competence in children with obesity is associated with structural differences in the cerebellar peduncles. Brain Imaging Behav 2019; 12:1000-1010. [PMID: 28831722 DOI: 10.1007/s11682-017-9760-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Previous studies have suggested that neurological factors partly explain the reduced motor competence found in many children with obesity. Accordingly, the aim of this study was to compare motor competence and white matter organization of important pathways for motor control (cerebellar peduncles) in children with and without obesity. Nineteen children with obesity and 25 children with a healthy weight, aged 7-11 years old, were included. Anthropometric measurements were taken and the level of motor competence was assessed using the Movement Assessment Battery for Children (2nd Edition). Children's brain was scanned using diffusion weighted imaging preceded by a standard anatomical scan. Fractional anisotropy and mean diffusivity were extracted from the cerebellar peduncles. Obese children's level of motor competence was significantly lower than that in healthy weight peers (p < 0.05). Additionally, significant group differences (p < 0.05) were found for values of fractional anisotropy, but not for mean diffusivity. Further analyses revealed that lower values of fractional anisotropy in the inferior (p = 0.040) and superior (p = 0.007) cerebellar peduncles were present in children with obesity compared to children with a healthy weight. After controlling for multiple comparisons (p < 0.0167), only significant differences in the superior cerebellar peduncle remained significant. Our results showed that childhood obesity is accompanied by reduced motor competence and alterations in white matter organization. This suggests that the motor difficulties of children with obesity are not solely due to carrying excess weight, which may have implications for prevention and intervention programs.
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Affiliation(s)
- Mireille J C M Augustijn
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium. .,Research Foundation Flanders (FWO), Brussel, Belgium.
| | - Frederik J A Deconinck
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Eva D'Hondt
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium.,Faculty of Physical Education and Physiotherapy, Department of Movement and Sports Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussel, Belgium
| | - Lore Van Acker
- Zeepreventorium VZW, Koninklijke Baan 5, 8420, De Haan, Belgium
| | | | - Matthieu Lenoir
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Karen Caeyenberghs
- School of Psychology, Australian Catholic University, 115 Victoria Pde, Melbourne, VIC, 3065, Australia
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23
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Augustijn MJCM, D'Hondt E, Leemans A, Van Acker L, De Guchtenaere A, Lenoir M, Deconinck FJA, Caeyenberghs K. Weight loss, behavioral change, and structural neuroplasticity in children with obesity through a multidisciplinary treatment program. Hum Brain Mapp 2018; 40:137-150. [PMID: 30198627 DOI: 10.1002/hbm.24360] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 07/03/2018] [Accepted: 08/07/2018] [Indexed: 01/01/2023] Open
Abstract
This study evaluated the effect of a multidisciplinary treatment program for children with obesity (OB) on motor competence, executive functioning (EF), and brain structure. Nineteen children with OB (7-11 years), who attended a multidisciplinary treatment program consisting of diet restriction, cognitive behavioral therapy, and physical activity, were compared with an age-matched control group of 24 children with a healthy weight (HW), who did not follow any treatment. For both groups, anthropometric measurements and tests of motor competence and EF were administered twice, with 5 months between pretest and posttest. Additionally, children's brain structure was assessed by performing a magnetic resonance imaging (MRI) scan at the pretest and posttest, which included a T1 anatomical scan, diffusion MRI scan, and magnetization transfer imaging scan. Compared to HW controls, children with OB lost a considerable amount of their body mass (p ≤ .001) and significantly improved their balance skills (p ≤ .001), while no transfer effects of the program were observed for EF. Furthermore, the program resulted in a significant increase in total (p ≤ .001) and cerebellar (p ≤ .001) gray matter volume in children with OB, while no change was observed in the HW controls. Finally, only weak to moderate (nonsignificant) correlations could be observed between structural brain alterations, weight-related changes, and behavioral improvements. Altogether, this is the first longitudinal study showing behavioral and structural brain alterations in response to a multidisciplinary weight loss program for children with OB. Our findings support the need for multidimensional intervention (and prevention) measures for children with OB to deal with this multifactorial health problem.
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Affiliation(s)
- Mireille J C M Augustijn
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.,Research Foundation Flanders (FWO), Brussels, Belgium
| | - Eva D'Hondt
- Faculty of Physical Education and Physiotherapy, Department of Movement and Sports Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Alexander Leemans
- Image Sciences Institute, University Medical b Utrecht, Utrecht, The Netherlands
| | | | | | - Matthieu Lenoir
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | | | - Karen Caeyenberghs
- School of Psychology, Australian Catholic University, Melbourne, Victoria, Australia
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24
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Abstract
PURPOSES To present the history and aims of the STEP conferences; describe the interdependence of prevention, prediction, plasticity, and participation; reflect on where we stand today regarding those 4 Ps; and discuss how future neurorehabilitation should look for individuals with movement disorders. KEY POINTS Physical therapists have focused primarily on tertiary prevention, emphasizing primary/secondary prevention far less. Predicting optimal response to intervention is essential for primary prevention. Research examining neurorehabilitation effects mediated by brain plasticity is evolving from an emphasis on impairment outcomes toward examination of participation outcomes. CLINICAL PRACTICE RECOMMENDATIONS:: (1) Capitalize on primary and secondary prevention. (2) Administer simple, environmentally relevant predictive measures. (3) Partner with researchers to examine exercise-induced brain plasticity effects via neuroimaging. (4) Encourage physical activity to promote secondary prevention of lifestyle-related diseases and enhance participation. (5) Integrate psychological/social sciences with physiological sciences to move forward with advances in mindful health and patient-centered practices.
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25
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Diekfuss JA, Rhea CK, Schmitz RJ, Grooms DR, Wilkins RW, Slutsky AB, Raisbeck LD. The Influence of Attentional Focus on Balance Control over Seven Days of Training. J Mot Behav 2018; 51:281-292. [PMID: 29792580 DOI: 10.1080/00222895.2018.1468312] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
This study examined the training effect of attentional focus (external focus, internal focus, or no focus instructions) on a dynamic balance task. Participants completed baseline balance testing, seven consecutive days of dynamic balance board training, and retention testing 24 hours after the last session. The novel finding of this study was the presence of a training effect on balance control when adopting an external focus relative to an internal focus or no focus instructions. Further, we report the unique observation that more patterned behavior was adopted regardless of the focus instructions. These findings provide insight into how instructions can be altered to enhance human balance control and complement the constrained-action hypothesis.
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Affiliation(s)
- Jed A Diekfuss
- a The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA
| | - Christopher K Rhea
- b Department of Kinesiology , University of North Carolina at Greensboro , Greensboro , NC , USA
| | - Randy J Schmitz
- b Department of Kinesiology , University of North Carolina at Greensboro , Greensboro , NC , USA
| | - Dustin R Grooms
- c Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions & Ohio Musculoskeletal & Neurological Institute, Ohio University , Athens , Ohio , USA
| | - Robin W Wilkins
- d Joint School of Nanoscience and Nanoengineering, University of North Carolina at Greensboro , Greensboro , NC , USA
| | - Alexis B Slutsky
- b Department of Kinesiology , University of North Carolina at Greensboro , Greensboro , NC , USA
| | - Louisa D Raisbeck
- b Department of Kinesiology , University of North Carolina at Greensboro , Greensboro , NC , USA
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26
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Hybrid is not a dirty word: Commentary on Wade and Kazeck (2017). Hum Mov Sci 2018; 57:510-515. [DOI: 10.1016/j.humov.2017.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 02/08/2017] [Indexed: 11/23/2022]
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27
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Coppieters I, De Pauw R, Caeyenberghs K, Lenoir D, DeBlaere K, Genbrugge E, Meeus M, Cagnie B. Differences in white matter structure and cortical thickness between patients with traumatic and idiopathic chronic neck pain: Associations with cognition and pain modulation? Hum Brain Mapp 2018; 39:1721-1742. [PMID: 29327392 DOI: 10.1002/hbm.23947] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 12/05/2017] [Accepted: 01/01/2018] [Indexed: 12/18/2022] Open
Abstract
Brain alterations are hypothesized to be present in patients with chronic whiplash-associated disorders (CWAD). The aim of this case-control study was to examine alterations in cortical thickness and white matter (WM) structure, and the presence of brain microhemorrhages in a patient group encountering chronic neck pain of traumatic origin (i.e., CWAD) when compared with a patient group characterized by nontraumatic chronic neck pain [i.e., chronic idiopathic neck pain (CINP)], and healthy controls. Furthermore, we aimed to investigate associations between brain structure on one hand and cognitive performance and central sensitization (CS) on the other hand. T1-weighted, diffusion-weighted and T2*-weighted magnetic resonance images of the brain were acquired in 105 women (31 controls, 37 CINP, 37 CWAD) to investigate regional cortical thickness, WM structure, and microhemorrhages, respectively. Next, cognitive performance, and CS encompassing distant hyperalgesia and conditioned pain modulation (CPM) efficacy were examined. Cortical thinning in the left precuneus was revealed in CWAD compared with CINP patients. Also, decreased fractional anisotropy, together with increased values of mean diffusivity and radial diffusivity could be observed in the left cingulum hippocampus and tapetum in CWAD compared with CINP, and in the left tapetum in CWAD patients compared with controls. Moreover, the extent of WM structural deficits in the left tapetum coincided with decreased CPM efficacy in the CWAD group. This yields evidence for associations between decreased endogenous pain inhibition, and the degree of regional WM deficits in CWAD. Our results emphasize the role of structural brain alterations in women with CWAD compared with CINP.
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Affiliation(s)
- I Coppieters
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Pain in Motion International Research Group (www.paininmotion.be).,Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium
| | - R De Pauw
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - K Caeyenberghs
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Banyo, Australia
| | - D Lenoir
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - K DeBlaere
- Department of Radiology, Ghent University, Ghent, Belgium
| | - E Genbrugge
- Department of Radiology, Ghent University, Ghent, Belgium
| | - M Meeus
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Pain in Motion International Research Group (www.paininmotion.be).,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - B Cagnie
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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28
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Rasooli AH, Birgani PM, Azizi S, Shahrokhi A, Mirbagheri MM. Therapeutic effects of an anti-gravity locomotor training (AlterG) on postural balance and cerebellum structure in children with Cerebral Palsy. IEEE Int Conf Rehabil Robot 2017; 2017:101-105. [PMID: 28813801 DOI: 10.1109/icorr.2017.8009229] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We evaluated the therapeutic effects of anti-gravity locomotor treadmill (AlterG) training on postural stability in children with Cerebral Palsy (CP) and spasticity, particularly in the lower extremity. AlterG can facilitate walking by reducing the weight of CP children by up to 80%; it can also help subjects maintain an appropriate posture during the locomotor AlterG training. Thus, we hypothesized that AlterG training, for a sufficient period of time, has a potential to produce cerebellum neuroplasticity, and consequently result in an effective permanent postural stability. AlterG training was given for 45 minutes, three times a week for two months. Postural balance was evaluated using posturography. The parameters of the Romberg based posturography were extracted to quantify the Center of Balance (CoP). The neuroplasticity of Cerebellum was evaluated using a Diffusion Tensor Imaging (DTI). The evaluations were done pre- and post-training. The Fractional Anisotropy (FA) feature was used for quantifying structural changes in the cerebellum. The results showed that AlterG training resulted in an increase in average FA value of the cerebellum white matter following the training. The results of the posturography evaluations showed a consistent improvement in postural stability. These results were consistent in all subjects. Our findings indicated that the improvement in the posture was accompanied with the enhancement of the cerebellum white matter structure. The clinical implication is that AlterG training can be considered a therapeutic tool for an effective and permanent improvement of postural stability in CP children.
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29
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Harris SR, Winstein CJ. The Past, Present, and Future of Neurorehabilitation: From NUSTEP Through IV STEP and Beyond. Pediatr Phys Ther 2017; 29 Suppl 3:S2-S9. [PMID: 28654472 DOI: 10.1097/pep.0000000000000376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSES To present the history and aims of the STEP conferences; describe the interdependence of prevention, prediction, plasticity, and participation; reflect on where we stand today regarding those 4 Ps; and discuss how future neurorehabilitation should look for individuals with movement disorders. KEY POINTS Physical therapists have focused primarily on tertiary prevention, emphasizing primary/secondary prevention far less. Predicting optimal response to intervention is essential for primary prevention. Research examining neurorehabilitation effects mediated by brain plasticity is evolving from an emphasis on impairment outcomes toward examination of participation outcomes. CLINICAL PRACTICE RECOMMENDATIONS:: (1) Capitalize on primary and secondary prevention. (2) Administer simple, environmentally relevant predictive measures. (3) Partner with researchers to examine exercise-induced brain plasticity effects via neuroimaging. (4) Encourage physical activity to promote secondary prevention of lifestyle-related diseases and enhance participation. (5) Integrate psychological/social sciences with physiological sciences to move forward with advances in mindful health and patient-centered practices.
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Affiliation(s)
- Susan R Harris
- Department of Physical Therapy (Dr Harris), Faculty of Medicine, University of British Columbia, Vancouver, Canada; and Division of Biokinesiology & Physical Therapy, and Department of Neurology, Keck School of Medicine (Dr Winstein), and Motor Behavior & Neurorehabilitation Laboratory, Ostrow School of Dentistry, University of Southern California, Los Angeles
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30
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Diez I, Drijkoningen D, Stramaglia S, Bonifazi P, Marinazzo D, Gooijers J, Swinnen SP, Cortes JM. Enhanced prefrontal functional-structural networks to support postural control deficits after traumatic brain injury in a pediatric population. Netw Neurosci 2017; 1:116-142. [PMID: 29911675 PMCID: PMC5988395 DOI: 10.1162/netn_a_00007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 01/28/2017] [Indexed: 11/04/2022] Open
Abstract
Traumatic brain injury (TBI) affects structural connectivity, triggering the reorganization of structural-functional circuits in a manner that remains poorly understood. We focus here on brain network reorganization in relation to postural control deficits after TBI. We enrolled young participants who had suffered moderate to severe TBI, comparing them to young, typically developing control participants. TBI patients (but not controls) recruited prefrontal regions to interact with two separated networks: (1) a subcortical network, including parts of the motor network, basal ganglia, cerebellum, hippocampus, amygdala, posterior cingulate gyrus, and precuneus; and (2) a task-positive network, involving regions of the dorsal attention system, together with dorsolateral and ventrolateral prefrontal regions. We also found that the increased prefrontal connectivity in TBI patients was correlated with some postural control indices, such as the amount of body sway, whereby patients with worse balance increased their connectivity in frontal regions more strongly. The increased prefrontal connectivity found in TBI patients may provide the structural scaffolding for stronger cognitive control of certain behavioral functions, consistent with the observations that various motor tasks are performed less automatically following TBI and that more cognitive control is associated with such actions.
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Affiliation(s)
- Ibai Diez
- Biocruces Health Research Institute, Cruces University Hospital, Barakaldo, Spain
| | - David Drijkoningen
- KU Leuven, Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Leuve, Belgium
| | - Sebastiano Stramaglia
- Dipartimento di Fisica, Universita degli Studi di Bari and INFN, Bari, Italy.,Basque Center for Applied Mathematics (BCAM), Bilbao, Spain
| | - Paolo Bonifazi
- Biocruces Health Research Institute, Cruces University Hospital, Barakaldo, Spain.,Ikerbasque: The Basque Foundation for Science, Bilbao, Spain
| | - Daniele Marinazzo
- Department of Data Analysis, Faculty of Psychological and Pedagogical Sciences, University of Ghent, Ghent, Belgium
| | - Jolien Gooijers
- KU Leuven, Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Leuve, Belgium
| | - Stephan P Swinnen
- KU Leuven, Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Leuve, Belgium.,KU Leuven, Leuven Research Institute for Neuroscience & Disease (LIND), Leuven, Belgium
| | - Jesus M Cortes
- Biocruces Health Research Institute, Cruces University Hospital, Barakaldo, Spain.,Ikerbasque: The Basque Foundation for Science, Bilbao, Spain.,Department of Cell Biology and Histology, University of the Basque Country, Leioa, Spain
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31
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Hotta J, Zhou G, Harno H, Forss N, Hari R. Complex regional pain syndrome: The matter of white matter? Brain Behav 2017; 7:e00647. [PMID: 28523214 PMCID: PMC5434177 DOI: 10.1002/brb3.647] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 11/18/2016] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Many central pathophysiological aspects of complex regional pain syndrome (CRPS) are still unknown. Although brain-imaging studies are increasingly supporting the contribution of the central nervous system to the generation and maintenance of the CRPS pain, the brain's white-matter alterations are seldom investigated. METHODS In this study, we used diffusion tensor imaging to explore white-matter changes in twelve CRPS-type-1 female patients suffering from chronic right upper-limb pain compared with twelve healthy control subjects. RESULTS Tract-based spatial-statistics analysis revealed significantly higher mean diffusivity, axial diffusivity, and radial diffusivity in the CRPS patients, suggesting that the structural connectivity is altered in CRPS. All these measures were altered in the genu, body, and splenium of corpus callosum, as well as in the left anterior and posterior and the right superior parts of the corona radiata. Axial diffusivity was significantly correlated with clinical motor symptoms at whole-brain level, supporting the physiological significance of the observed white-matter abnormalities. CONCLUSIONS Altogether, our findings further corroborate the involvement of the central nervous system in CRPS.
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Affiliation(s)
- Jaakko Hotta
- Department of Neuroscience and Biomedical Engineering Aalto University Espoo Finland.,Aalto NeuroImaging Aalto University Espoo Finland.,Clinical Neurosciences, Neurology University of Helsinki and Department of Neurology, Helsinki University Hospital Helsinki Finland
| | - Guangyu Zhou
- Department of Neuroscience and Biomedical Engineering Aalto University Espoo Finland.,Department of Neurology Northwestern University Chicago IL USA
| | - Hanna Harno
- Clinical Neurosciences, Neurology University of Helsinki and Department of Neurology, Helsinki University Hospital Helsinki Finland.,Pain Clinic Department of Anesthesiology, Intensive Care and Pain Medicine University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Nina Forss
- Department of Neuroscience and Biomedical Engineering Aalto University Espoo Finland.,Clinical Neurosciences, Neurology University of Helsinki and Department of Neurology, Helsinki University Hospital Helsinki Finland
| | - Riitta Hari
- Department of Neuroscience and Biomedical Engineering Aalto University Espoo Finland.,Department of Art Aalto University Helsinki Finland
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Arshad Q, Roberts RE, Ahmad H, Lobo R, Patel M, Ham T, Sharp DJ, Seemungal BM. Patients with chronic dizziness following traumatic head injury typically have multiple diagnoses involving combined peripheral and central vestibular dysfunction. Clin Neurol Neurosurg 2017; 155:17-19. [PMID: 28212927 DOI: 10.1016/j.clineuro.2017.01.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 01/27/2017] [Accepted: 01/31/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We hypothesised that chronic vestibular symptoms (CVS) of imbalance and dizziness post-traumatic head injury (THI) may relate to: (i) the occurrence of multiple simultaneous vestibular diagnoses including both peripheral and central vestibular dysfunction in individual patients increasing the chance of missed diagnoses and suboptimal treatment; (ii) an impaired response to vestibular rehabilitation since the central mechanisms that mediate rehabilitation related brain plasticity may themselves be disrupted. METHODS We report the results of a retrospective analysis of both the comprehensive clinical and vestibular laboratory testing of 20 consecutive THI patients with prominent and persisting vestibular symptoms still present at least 6months post THI. RESULTS Individual THI patients typically had multiple vestibular diagnoses and unique to this group of vestibular patients, often displayed both peripheral and central vestibular dysfunction. Despite expert neuro-otological management, at two years 20% of patients still had persisting vestibular symptoms. CONCLUSION In summary, chronic vestibular dysfunction in THI could relate to: (i) the presence of multiple vestibular diagnoses, increasing the risk of 'missed' vestibular diagnoses leading to persisting symptoms; (ii) the impact of brain trauma which may impair brain plasticity mediated repair mechanisms. Apart from alerting physicians to the potential for multiple vestibular diagnoses in THI, future work to identify the specific deficits in brain function mediating poor recovery from post-THI vestibular dysfunction could provide the rationale for developing new therapy for head injury patients whose vestibular symptoms are resistant to treatment.
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Affiliation(s)
- Q Arshad
- Academic Department of Neuro-Otology, Division of Brain Sciences, Charing Cross Hospital Campus, Imperial College, Fulham Palace Road, London, W6 8RF, UK
| | - R E Roberts
- Academic Department of Neuro-Otology, Division of Brain Sciences, Charing Cross Hospital Campus, Imperial College, Fulham Palace Road, London, W6 8RF, UK
| | - H Ahmad
- Academic Department of Neuro-Otology, Division of Brain Sciences, Charing Cross Hospital Campus, Imperial College, Fulham Palace Road, London, W6 8RF, UK
| | - R Lobo
- Academic Department of Neuro-Otology, Division of Brain Sciences, Charing Cross Hospital Campus, Imperial College, Fulham Palace Road, London, W6 8RF, UK
| | - M Patel
- Academic Department of Neuro-Otology, Division of Brain Sciences, Charing Cross Hospital Campus, Imperial College, Fulham Palace Road, London, W6 8RF, UK
| | - T Ham
- The Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
| | - D J Sharp
- The Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
| | - B M Seemungal
- Academic Department of Neuro-Otology, Division of Brain Sciences, Charing Cross Hospital Campus, Imperial College, Fulham Palace Road, London, W6 8RF, UK.
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Drijkoningen D, Chalavi S, Sunaert S, Duysens J, Swinnen SP, Caeyenberghs K. Regional Gray Matter Volume Loss Is Associated with Gait Impairments in Young Brain-Injured Individuals. J Neurotrauma 2017; 34:1022-1034. [DOI: 10.1089/neu.2016.4500] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- David Drijkoningen
- University Medical Center Utrecht, Utrecht, the Netherlands
- Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Leuven, Belgium
| | - Sima Chalavi
- Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Leuven, Belgium
| | - Stefan Sunaert
- Department of Radiology, University Hospital, Leuven, Belgium
| | - Jacques Duysens
- Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Leuven, Belgium
| | - Stephan P. Swinnen
- Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Leuven, Belgium
- Leuven Research Institute for Neuroscience and Disease, Leuven, Belgium
| | - Karen Caeyenberghs
- Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Leuven, Belgium
- Australian Catholic University, Melbourne, Australia
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Re TJ, Levman J, Lim AR, Righini A, Grant PE, Takahashi E. High-angular resolution diffusion imaging tractography of cerebellar pathways from newborns to young adults. Brain Behav 2017; 7:e00589. [PMID: 28127511 PMCID: PMC5256176 DOI: 10.1002/brb3.589] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 08/22/2016] [Accepted: 08/23/2016] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Many neurologic and psychiatric disorders are thought to be due to, or result in, developmental errors in neuronal cerebellar connectivity. In this connectivity analysis, we studied the developmental time-course of cerebellar peduncle pathways in pediatric and young adult subjects. METHODS A cohort of 80 subjects, newborns to young adults, was studied on a 3T MR system with 30 diffusion-weighted measurements with high-angular resolution diffusion imaging (HARDI) tractography. RESULTS Qualitative and quantitative results were analyzed for age-based variation. In subjects of all ages, the superior cerebellar peduncle pathway (SCP) and two distinct subpathways of the middle cerebellar peduncle (MCP), as described in previous ex vivo studies, were identified in vivo with this technique: pathways between the rostral pons and inferior-lateral cerebellum (MCP cog), associated predominantly with higher cognitive function, and pathways between the caudal pons and superior-medial cerebellum (MCP mot), associated predominantly with motor function. DISCUSSION Our findings showed that the inferior cerebellar peduncle pathway (ICP), involved primarily in proprioception and balance appears to have a later onset followed by more rapid development than that exhibited in other tracts. We hope that this study may provide an initial point of reference for future studies of normal and pathologic development of cerebellar connectivity.
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Affiliation(s)
- Thomas J. Re
- Department of RadiologyBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
- Fetal‐Neonatal Brain Imaging and Developmental Science CenterBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
- Department of RadiologyUniversity of MilanMilanItaly
| | - Jacob Levman
- Fetal‐Neonatal Brain Imaging and Developmental Science CenterBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
- Division of Newborn MedicineDepartment of MedicineBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
| | - Ashley R. Lim
- Division of Newborn MedicineDepartment of MedicineBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
- Department of Behavioral NeuroscienceNortheastern UniversityBostonMAUSA
| | - Andrea Righini
- Department of Pediatric Radiology and NeuroradiologyChildren's Hospital V. BuzziMilanItaly
| | - Patricia Ellen Grant
- Department of RadiologyBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
- Fetal‐Neonatal Brain Imaging and Developmental Science CenterBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
- Division of Newborn MedicineDepartment of MedicineBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
| | - Emi Takahashi
- Fetal‐Neonatal Brain Imaging and Developmental Science CenterBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
- Division of Newborn MedicineDepartment of MedicineBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
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Paillard T. Plasticity of the postural function to sport and/or motor experience. Neurosci Biobehav Rev 2017; 72:129-152. [DOI: 10.1016/j.neubiorev.2016.11.015] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 10/27/2016] [Accepted: 11/15/2016] [Indexed: 11/27/2022]
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Jang SH, Chang CH, Jung YJ, Kwon HG. Severe ataxia due to injuries of neural tract detected by diffusion tensor tractography in a patient with pontine hemorrhage: A case report. Medicine (Baltimore) 2016; 95:e5590. [PMID: 27977594 PMCID: PMC5268040 DOI: 10.1097/md.0000000000005590] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
RATIONALE We examined injuries of the dentato-rubro-thalamic tract (DRTT), cortico-ponto-cerebellar tract (CPCT), dorsal spinocerebellar tract (SCT), and inferior cerebellar peduncle (ICP) in a patient with severe ataxia following bilateral tegmental pontine hemorrhage (PH), using diffusion tensor tractography (DTT). PATIENT CONCERNS A 75-year-old female patient underwent conservative management for bilateral tegmental PH. She presented with moderate motor weakness, severe resting and intentional tremor on both hands, and severe truncal ataxia (Scale for Assessment and Rating of Ataxia [25 points/0-40 points: a higher score indicates a worse state]), and she was not able to sit independently. DIAGNOSES AND OUTCOMES On DTT taken at 2 weeks after initial presentation, both DRTTs and the left dorsal SCT were not reconstructed, whereas the CPCTs showed thinning of the entire pathways between the primary sensorimotor cortex and cerebellum in both hemispheres. The right ICP was discontinued at the transverse cerebellar branch of the ICP and thinning of the left ICP was observed in the vertical and transverse cerebellar branch of the ICP. LESSONS Using DTT, concurrent injuries of the DRTT, CPCT, dorsal SCT, and ICP were demonstrated in a patient with severe ataxia following PH. Our result suggests the necessity of evaluation of these neural tracts in patients who develop ataxia after brain injury.
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Affiliation(s)
- Sung Ho Jang
- Department of Physical Medicine and Rehabilitation
| | - Chul Hoon Chang
- Department of Neurosurgery, College of Medicine, Yeungnam University, Daemyung dong, Namku, Daegu, Republic of Korea
| | - Young Jin Jung
- Department of Neurosurgery, College of Medicine, Yeungnam University, Daemyung dong, Namku, Daegu, Republic of Korea
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An C, Jiang X, Pu H, Hong D, Zhang W, Hu X, Gao Y. Severity-Dependent Long-Term Spatial Learning-Memory Impairment in a Mouse Model of Traumatic Brain Injury. Transl Stroke Res 2016; 7:512-520. [DOI: 10.1007/s12975-016-0483-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 06/28/2016] [Accepted: 07/11/2016] [Indexed: 01/04/2023]
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Damiano D, Zampieri C, Ge J, Acevedo A, Dsurney J. Effects of a rapid-resisted elliptical training program on motor, cognitive and neurobehavioral functioning in adults with chronic traumatic brain injury. Exp Brain Res 2016; 234:2245-52. [PMID: 27025506 PMCID: PMC4925297 DOI: 10.1007/s00221-016-4630-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 03/15/2016] [Indexed: 11/27/2022]
Abstract
This small clinical trial utilized a novel rehabilitation strategy, rapid-resisted elliptical training, in an effort to increase motor, and thereby cognitive, processing speed in ambulatory individuals with traumatic brain injury (TBI). As an initial step, multimodal functional abilities were quantified and compared in 12 ambulatory adults with and 12 without TBI. After the baseline assessment, the group with TBI participated in an intensive 8-week daily exercise program using an elliptical trainer and was reassessed after completion and at an 8-week follow-up. The focus of training was on achieving a fast movement speed, and once the target was reached, resistance to motion was increased in small increments to increase intensity of muscle activation. Primary outcomes were: High-Level Mobility Assessment Tool (HiMAT), instrumented balance tests, dual-task (DT) performance and neurobehavioral questionnaires. The group with TBI had poorer movement excursion during balance tests and poorer dual-task (DT) performance. After training, balance reaction times improved and were correlated with gains in the HiMAT and DT. Sleep quality also improved and was correlated with improved depression and learning. This study illustrates how brain injury can affect multiple linked aspects of functioning and provides preliminary evidence that intensive rapid-resisted training has specific positive effects on dynamic balance and more generalized effects on sleep quality in TBI.
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Affiliation(s)
- Diane Damiano
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, 10 Center Drive, Room 1-1469 MSC 1604, Bethesda MD 20892-1604 USA
| | - Cris Zampieri
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, 10 Center Drive, Room 1-1469 MSC 1604, Bethesda MD 20892-1604 USA
| | - Jie Ge
- University of Maryland School of Dentistry, 650 West Baltimore Street, Baltimore MD 21201 USA
| | - Ana Acevedo
- Rehabilitation Medicine Department National Institutes of Health Clinical Center 10 Center Drive, Room 1-1469 MSC 1604. Bethesda MD USA
| | - John Dsurney
- Rehabilitation Medicine Department, Center for Neuroscience and Regenerative Medicine (CNRM)National Institutes of Health Clinical Center10 Center Drive, Room 1-1469 MSC 1604, Bethesda MD 20892-1604 USA
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Jang SH, Yi JH, Kwon HG. Injury of the inferior cerebellar peduncle in patients with mild traumatic brain injury: A diffusion tensor tractography study. Brain Inj 2016; 30:1271-5. [PMID: 27294795 DOI: 10.1080/02699052.2016.1178805] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES No study on injury of the inferior cerebellar peduncle (ICP) in patients with mild traumatic brain injury (mTBI) has been reported. This study, using diffusion tensor tractography (DTT), attempted to demonstrate injury of the ICP in patients with mTBI. METHODS Three patients with mTBI resulting from a car accident and 18 normal healthy control subjects were enrolled in this study. Diffusion tensor imaging data were acquired at 2 months (patient 1) and 3 months (patients 2 and 3) after onset and the ICP was reconstructed. The Balance Error Scoring System was used for evaluation of balance at the same time diffusion tensor imaging scanning was performed. RESULTS The ICPs were discontinued at the upper portion of the vertical cerebellar branch and the transverse cerebellar branch (patient 1) and the proximal portion of the transverse cerebellar branch (patients 2 and 3) compared to the normal control subjects. Regarding DTT parameters, in the three patients, the fibre number of the ICPs was decreased by more than 2 SD compared with those of subjects in the control group. CONCLUSION Evaluation of the ICP using DTT would be useful in patients with a balance problem after mTBI.
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Affiliation(s)
- Sung Ho Jang
- a Department of Physical Medicine and Rehabilitation
| | - Ji Hyun Yi
- b Department of Diagnostic Radiology , College of Medicine, Yeungnam University , Daegu , Republic of Korea
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Guernsey DT, Leder A, Yao S. Resolution of Concussion Symptoms After Osteopathic Manipulative Treatment: A Case Report. J Osteopath Med 2016; 116:e13-7. [DOI: 10.7556/jaoa.2016.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Abstract
A concussion is the result of a biomechanical force directed toward the head, causing neurologic dysfunction. The inflammatory response and the production of reactive oxygen species are proposed mechanisms for the symptoms and long-term sequelae of concussion. Osteopathic manipulative treatment (OMT) may help reduce inflammation by improving glymphatic flow. The authors describe the effect of OMT on a patient with mild concussion symptoms, including nausea, dizziness, tinnitus, and imbalance. The patient was evaluated with the Sensory Organization Test before and after undergoing a 25-minute session of OMT. After the session, the patient reported resolution of symptoms, and his sensory organization test score improved by 6 points. The role of OMT must be further investigated as an essential and cost-effective tool in the management of concussions.
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Structural brain alterations in hemifacial spasm: A voxel-based morphometry and diffusion tensor imaging study. Clin Neurophysiol 2016; 127:1470-1474. [DOI: 10.1016/j.clinph.2015.07.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 07/14/2015] [Accepted: 07/15/2015] [Indexed: 12/31/2022]
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Drijkoningen D, Leunissen I, Caeyenberghs K, Hoogkamer W, Sunaert S, Duysens J, Swinnen SP. Regional volumes in brain stem and cerebellum are associated with postural impairments in young brain-injured patients. Hum Brain Mapp 2015; 36:4897-909. [PMID: 26441014 DOI: 10.1002/hbm.22958] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 08/19/2015] [Accepted: 08/20/2015] [Indexed: 01/08/2023] Open
Abstract
Many patients with traumatic brain injury (TBI) suffer from postural control impairments that can profoundly affect daily life. The cerebellum and brain stem are crucial for the neural control of posture and have been shown to be vulnerable to primary and secondary structural consequences of TBI. The aim of this study was to investigate whether morphometric differences in the brain stem and cerebellum can account for impairments in static and dynamic postural control in TBI. TBI patients (n = 18) and healthy controls (n = 30) completed three challenging postural control tasks on the EquiTest® system (Neurocom). Infratentorial grey matter (GM) and white matter (WM) volumes were analyzed with cerebellum-optimized voxel-based morphometry using the spatially unbiased infratentorial toolbox. Volume loss in TBI patients was revealed in global cerebellar GM, global infratentorial WM, middle cerebellar peduncles, pons and midbrain. In the TBI group and across both groups, lower postural control performance was associated with reduced GM volume in the vermal/paravermal regions of lobules I-IV, V and VI. Moreover, across all participants, worse postural control performance was associated with lower WM volume in the pons, medulla, midbrain, superior and middle cerebellar peduncles and cerebellum. This is the first study in TBI patients to demonstrate an association between postural impairments and reduced volume in specific infratentorial brain areas. Volumetric measures of the brain stem and cerebellum may be valuable prognostic markers of the chronic neural pathology, which complicates rehabilitation of postural control in TBI.
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Affiliation(s)
- David Drijkoningen
- KU Leuven, Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Leuven, Belgium
| | - Inge Leunissen
- KU Leuven, Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Leuven, Belgium
| | - Karen Caeyenberghs
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Wouter Hoogkamer
- KU Leuven, Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Leuven, Belgium
| | - Stefan Sunaert
- KU Leuven, Department of Radiology, University Hospital, Leuven, Belgium
| | - Jacques Duysens
- KU Leuven, Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Leuven, Belgium
| | - Stephan P Swinnen
- KU Leuven, Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Leuven, Belgium.,KU Leuven, Leuven Research Institute for Neuroscience & Disease (LIND), Belgium
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Drijkoningen D, Caeyenberghs K, Vander Linden C, Van Herpe K, Duysens J, Swinnen SP. Associations between Muscle Strength Asymmetry and Impairments in Gait and Posture in Young Brain-Injured Patients. J Neurotrauma 2015; 32:1324-32. [DOI: 10.1089/neu.2014.3787] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- David Drijkoningen
- Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, KU Leuven, Belgium
| | - Karen Caeyenberghs
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
- Child Rehabilitation Center, Department of Physical Medicine and Rehabilitation, Ghent University Hospital, Ghent, Belgium
| | | | - Katrin Van Herpe
- Leuven Research Institute for Neuroscience & Disease (LIND), Leuven, Belgium
| | - Jacques Duysens
- Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, KU Leuven, Belgium
| | - Stephan P. Swinnen
- Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, KU Leuven, Belgium
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