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Ma T, Liu C, Li H, Xu X, Wang Y, Tao W, Xue X, Li Q, Zhao R, Hua Y. Rehabilitation increases cortical activation during single-leg stance in patients with chronic ankle instability. Asia Pac J Sports Med Arthrosc Rehabil Technol 2024; 35:65-70. [PMID: 38235498 PMCID: PMC10792568 DOI: 10.1016/j.asmart.2023.11.008] [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: 09/03/2023] [Accepted: 11/30/2023] [Indexed: 01/19/2024] Open
Abstract
Background Chronic ankle instability (CAI) has been considered a neurophysiological disease, having as symptoms dysfunction in somatosensory and motor system excitability. Rehabilitation has been considered an effective treatment for CAI. However, few studies have explored the effects of rehabilitation on neuroplasticity in the CAI population. Objective The purpose of this study was to investigate the effects of rehabilitation on cortical activities for postural control in CAI patients and to find the correlation between the change in cortical activities and patient-reported outcomes (PROs). Methods Thirteen participants with CAI (6 female, 7 male, age = 33.8 ± 7.7 years, BMI = 24.7 ± 4.9 kg/m2) received a home exercise program for about 40 min per day, four days per week and six weeks, including ankle range-of-motion exercise, muscle strengthening, and balance activities. Cortical activation, PROs and Y-balance test outcomes were assessed and compared before and after rehabilitation. Cortical activation was detected via Functional near-infrared spectroscopy (fNIRS) while the participants performed single-leg stance tasks. Results The participants had better PROs and Y balance test outcomes after rehabilitation. Greater cortical activation was observed in the primary somatosensory cortex (S1, d = 0.66, p = 0.035), the superior temporal gyrus (STG, d = 1.06, p = 0.002) and the middle temporal gyrus (MTG, d = 0.66, p = 0.035) in CAI patients after rehabilitation. Moreover, significant positive correlations were observed between the recovery of ankle symptoms and the change of cortical activation in S1 (r = 0.74, p = 0.005) and STG (r = 0.72, p = 0.007) respectively. Conclusion The current study reveals that six weeks of rehabilitation can cause greater cortical activation in S1, STG and MTG. This increase in cortical activation suggested a better ability to perceive somatosensory stimuli and may have a compensatory role in function improvement.
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Affiliation(s)
- Tengjia Ma
- Orthopedic and Sports Medicine Department, The Second Affiliated Hospital of Dalian Medical University, Dalian, 116023, Liaoning, China
| | - Chang Liu
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Haozheng Li
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Xiaoyun Xu
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
| | - Yiran Wang
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Weichu Tao
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
| | - Xiao'ao Xue
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Qianru Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Rongshan Zhao
- Shanghai Lixin University of Accounting and Finance, Shanghai, 201209, China
| | - Yinghui Hua
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
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Sánchez-González JL, Díez-Villoria E, Pérez-Robledo F, Sanz-Esteban I, Llamas-Ramos I, Llamas-Ramos R, de la Fuente A, Bermejo-Gil BM, Canal-Bedia R, Martín-Nogueras AM. Synergy of Muscle and Cortical Activation through Vojta Reflex Locomotion Therapy in Young Healthy Adults: A Pilot Randomized Controlled Trial. Biomedicines 2023; 11:3203. [PMID: 38137425 PMCID: PMC10740470 DOI: 10.3390/biomedicines11123203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/20/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Vojta Therapy is a neurorehabilitation therapy that allows to activate reflex movement patterns. The scientific literature has shown its ability to generate muscle contractions. The activation of brain neural networks has also been proven. However, the relationship between these processes has not yet been demonstrated. For this reason, the aim of this study is to verify brain activation produced by recording with near-infrared spectroscopy and its relationship with muscle activation produced in the abdominal muscles recorded with surface electromyography. METHODS A total sample of 27 healthy subjects over 18 years of age was recruited. An experimental study on a cohort was conducted. Two experimental conditions were considered: stimuli according to the Vojta protocol, and a control non-stimuli condition. Abdominal muscle activation was measured using surface electromyography, and the activation of the motor cortex was assessed with near-infrared spectroscopy. RESULTS In relation to the oxygenated hemoglobin concentration (HbO), an interaction between the stimulation phase and group was observed. Specifically, the Vojta stimulation group exhibited an increase in concentration from the baseline phase to the first resting period in the right hemisphere, contralateral to the stimulation area. This rise coincided with an enhanced wavelet coherence between the HbO concentration and the electromyography (EMG) signal within a gamma frequency band (very low frequency) during the first resting period. CONCLUSIONS The results underscore the neurophysiological effects on the brain following tactile stimulation via Vojta Therapy, highlighting increased activity in pivotal areas essential for sensory processing, motor planning, and control. This activation, particularly evident in the Vojta stimulation group, aligns with previous findings, suggesting that tactile stimuli can not only evoke the intention to move but can also initiate actual muscle contractions, emphasizing the therapy's potential in enhancing innate locomotion and rolling movements in patients with neurological disorders.
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Affiliation(s)
- Juan Luis Sánchez-González
- Department of Nursing and Physiotherapy, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, 37008 Salamanca, Spain; (J.L.S.-G.); (I.L.-R.); (R.L.-R.); (B.M.B.-G.); (A.M.M.-N.)
| | - Emiliano Díez-Villoria
- Centro de Atención Integral al Autismo-InFoAutismo, INICO-Instituto Universitario de Integración en la Comunidad and Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, 37008 Salamanca, Spain; (E.D.-V.); (R.C.-B.)
| | - Fátima Pérez-Robledo
- Department of Nursing and Physiotherapy, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, 37008 Salamanca, Spain; (J.L.S.-G.); (I.L.-R.); (R.L.-R.); (B.M.B.-G.); (A.M.M.-N.)
| | - Ismael Sanz-Esteban
- Physical Therapy and Health Research Group, Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain;
| | - Inés Llamas-Ramos
- Department of Nursing and Physiotherapy, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, 37008 Salamanca, Spain; (J.L.S.-G.); (I.L.-R.); (R.L.-R.); (B.M.B.-G.); (A.M.M.-N.)
- University Hospital of Salamanca, 37007 Salamanca, Spain
| | - Rocío Llamas-Ramos
- Department of Nursing and Physiotherapy, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, 37008 Salamanca, Spain; (J.L.S.-G.); (I.L.-R.); (R.L.-R.); (B.M.B.-G.); (A.M.M.-N.)
| | - Antonio de la Fuente
- Department of Physiology and Pharmacology, Institute of Neurosciences of Castilla and León (INCyL), University of Salamanca, Avenida Alfonso X El Sabio s/n, 37007 Salamanca, Spain;
| | - Beatriz María Bermejo-Gil
- Department of Nursing and Physiotherapy, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, 37008 Salamanca, Spain; (J.L.S.-G.); (I.L.-R.); (R.L.-R.); (B.M.B.-G.); (A.M.M.-N.)
| | - Ricardo Canal-Bedia
- Centro de Atención Integral al Autismo-InFoAutismo, INICO-Instituto Universitario de Integración en la Comunidad and Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, 37008 Salamanca, Spain; (E.D.-V.); (R.C.-B.)
| | - Ana María Martín-Nogueras
- Department of Nursing and Physiotherapy, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, 37008 Salamanca, Spain; (J.L.S.-G.); (I.L.-R.); (R.L.-R.); (B.M.B.-G.); (A.M.M.-N.)
- Department of Nursing and Physiotherapy, Institute of Neurosciences of Castilla and León (INCyL), University of Salamanca, 37008 Salamanca, Spain
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Nishimoto R, Fujiwara S, Kutoku Y, Ogata T, Mihara M. Effect of dual-task interaction combining postural and visual perturbations on cortical activity and postural control ability. Neuroimage 2023; 280:120352. [PMID: 37648121 DOI: 10.1016/j.neuroimage.2023.120352] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/27/2023] [Accepted: 08/27/2023] [Indexed: 09/01/2023] Open
Abstract
Previous studies have suggested cortical involvement in postural control in humans by measuring cortical activities and conducting dual-task paradigms. In dual-task paradigms, task performance deteriorates and can be facilitated in specific dual-task settings. Theoretical frameworks explaining these dual-task interactions have been proposed and debated for decades. Therefore, we investigated postural control performance under different visual conditions using a virtual reality system, simultaneously measuring cortical activities with a functional near-infrared spectroscopy system. Twenty-four healthy participants were included in this study. Postural stability and cortical activities after perturbations were measured under several conditions consisting of postural and visual perturbations. The results showed that concurrent visual and postural perturbations could facilitate cortical activities in the supplementary motor area and superior parietal lobe. Additionally, visual distractors deteriorated postural control ability and cortical activation of the supplementary motor area. These findings supported the theoretical framework of the "Cross talk model", in which concurrent tasks using similar neural domains can facilitate these task performances. Furthermore, it indicated that the cortical resource capacity and domains activated for information processing should be considered in experiments involving dual-task paradigms and training.
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Affiliation(s)
- Ryoki Nishimoto
- Department of Neurology, Kawasaki Medical School, Okayama 701-0192, Japan; Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - Yumiko Kutoku
- Department of Neurology, Kawasaki Medical School, Okayama 701-0192, Japan
| | - Toru Ogata
- Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan; Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - Masahito Mihara
- Department of Neurology, Kawasaki Medical School, Okayama 701-0192, Japan.
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Yoo M, Chun MH, Hong GR, Lee C, Lee JK, Lee A. Effects of Training with a Powered Exoskeleton on Cortical Activity Modulation in Hemiparetic Chronic Stroke Patients: A Randomized Controlled Pilot Trial. Arch Phys Med Rehabil 2023; 104:1620-1629. [PMID: 37295705 DOI: 10.1016/j.apmr.2023.05.012] [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] [Received: 05/02/2022] [Revised: 04/26/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To investigate the effects of exoskeleton-assisted gait training in stroke patients. DESIGN Prospective randomized controlled trial. SETTING Rehabilitation department in a single tertiary hospital. PARTICIPANTS Thirty (N=30) chronic stroke patients with Functional Ambulatory Category scale (FAC) between 2 and 4. INTERVENTION Patients were randomly assigned to 1 of 2 groups: training with Healbot G, a wearable powered exoskeleton (Healbot G group; n=15), or treadmill training (control group; n=15). All participants received 30 minutes of training, 10 times per week, for 4 weeks. OUTCOME MEASUREMENTS The primary outcome was oxyhemoglobin level changes, representing cortical activity in both motor cortices using functional near-infrared spectroscopy. The secondary outcomes included FAC, Berg Balance Scale, Motricity Index for the lower extremities (MI-Lower), 10-meter walk test, and gait symmetry ratio (spatial step and temporal symmetry ratio). RESULTS Compared to the control group, during the entire training session, the pre-training and post-training mean cortical activity, and the amount of increment between pre- and post-training were significantly higher in the Healbot G group (∆mean ± SD; pre-training, 0.245±0.119, post-training, 0.697±0.429, between pre- and post-training, 0.471±0.401μmol, P<.001). There was no significant difference in cortical activity between affected- and unaffected hemispheres after Healbot G training. FAC (∆mean ± SD; 0.35 ± 0.50, P=.012), MI-Lower (∆mean ± SD; 7.01 ± 0.14, P=.001), and spatial step gait symmetry ratio (∆mean ± SD; -0.32 ± 0.25, P=.049) were improved significantly in the Healbot G group. CONCLUSION Exoskeleton-assisted gait training induces cortical modulation effect in both motor cortices, a balanced cortical activation pattern with improvements in spatial step symmetry ratio, walking ability, and voluntary strength.
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Affiliation(s)
- Miran Yoo
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min Ho Chun
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Ga Ram Hong
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Changmin Lee
- School of Electrical and Electronic Engineering, Yonsei University, Seoul, Republic of Korea
| | - June Kyoung Lee
- Department of Rehabilitation Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Gyeonggi-do, Republic of Korea
| | - Anna Lee
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Wang D, Wang J, Zhao H, Liang Y, Zhang W, Li M, Liu H, Hu D, Zhang S, Xing E, Su Y, Yu W, Sun J, Yang A. The relationship between the prefrontal cortex and limb motor function in stroke: A study based on resting-state functional near-infrared spectroscopy. Brain Res 2023; 1805:148269. [PMID: 36736871 DOI: 10.1016/j.brainres.2023.148269] [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] [Received: 08/18/2022] [Revised: 01/13/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND With the ageing of the world population, the incidence of stroke has been increasing annually, becoming a public health problem affecting adult health. Limb motor dysfunction is one of the common complications of stroke and an important factor in disability. Therefore, restoring limb function is an important task in current rehabilitation. Accurate assessment of motor function in stroke patients is the basis for formulating effective rehabilitation strategies. With the development of neuroimaging technology, scholars have begun to study objective evaluation methods for limb motor dysfunction in stroke to determine reliable neural biomarkers to accurately identify brain functional activity and its relationship with limb motor function. The prefrontal cortex (PFC) plays an important role in motor control and in response to motor state changes. Our previous study found that the PFC network characteristics of stroke patients are related to their motor function status and the topological properties of the PFC network under resting state can predict the motor function of stroke patients to some extent. Therefore, this study used functional near-infrared spectroscopy (fNIRS) to evaluate prefrontal neuroplasticity markers and the relationships between such neural markers and limb motor function in stroke patients with limb motor dysfunction, which could be helpful to further clarify the relationship between brain neuroplasticity and cerebral haemodynamics. At the same time, through accurate and objective means of evaluation, it could be helpful for clinicians to formulate and optimize individualized rehabilitation treatment plans and accurately determine the rehabilitation efficacy and prognosis. METHODS This study recruited 17 S patients with limb motor dysfunction and 9 healthy subjects. fNIRS was used to collect 22 channels of cerebral blood oxygen signals in the PFC in the resting state. The differences in prefrontal oxygenated haemoglobin (HbO) and deoxygenated haemoglobin (HbR) concentrations were analysed between stroke patients and healthy subjects, and the lateralization index (LI) of HbO in stroke patients was also calculated. Pearson's correlation analysis was performed between the LI and the scores of the Fugl-Meyer Assessment Scale (FMA) of motor function in stroke patients. RESULTS The results found that the prefrontal HbO concentration was significantly decreased in stroke patients with limb motor dysfunction compared with healthy subjects, and there was a significant, positive correlation between the LI of the PFC and FMA scores in stroke patients. CONCLUSION These study results showed that stroke can cause cerebral haemodynamic changes in the PFC, and the functional imbalance of the left and right PFC in the resting state is correlated with the severity of limb motor dysfunction. Furthermore, we emphasize that the cerebral haemodynamic activity reflected by fNIRS could be used as a reliable neural biomarker for assessing limb motor dysfunction in stroke.
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Affiliation(s)
- Dan Wang
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Jie Wang
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Hongbo Zhao
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Yahui Liang
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Wenyue Zhang
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Mingxi Li
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Hua Liu
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Di Hu
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Sibin Zhang
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Enlong Xing
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Ying Su
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Wanchen Yu
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Jinyan Sun
- School of Medicine, Foshan University, Foshan, China.
| | - Aoran Yang
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China.
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Li H, Fu X, Lu L, Guo H, Yang W, Guo K, Huang Z. Upper limb intelligent feedback robot training significantly activates the cerebral cortex and promotes the functional connectivity of the cerebral cortex in patients with stroke: A functional near-infrared spectroscopy study. Front Neurol 2023; 14:1042254. [PMID: 36814999 PMCID: PMC9939650 DOI: 10.3389/fneur.2023.1042254] [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: 09/12/2022] [Accepted: 01/11/2023] [Indexed: 02/09/2023] Open
Abstract
Background Upper limb intelligence robots are widely used to improve the upper limb function of patients with stroke, but the treatment mechanism is still not clear. In this study, functional near-infrared spectroscopy (fNIRS) was used to evaluate the concentration changes of oxygenated hemoglobin (oxy-Hb) and deoxyhemoglobin (deoxy-Hb) in different brain regions and functional connectivity (FC) of the cerebral cortex in patients with stroke. Method Twenty post-stroke patients with upper limb dysfunction were included in the study. They all received three different types of shoulder joint training, namely, active intelligent feedback robot training (ACT), upper limb suspension training (SUS), and passive intelligent feedback robot training (PAS). During the training, activation of the cerebral cortex was detected by fNIRS to obtain the concentration changes of hemoglobin and FC of the cerebral cortex. The fNIRS signals were recorded over eight ROIs: bilateral prefrontal cortices (PFC), bilateral primary motor cortices (M1), bilateral primary somatosensory cortices (S1), and bilateral premotor and supplementary motor cortices (PM). For easy comparison, we defined the right hemisphere as the ipsilesional hemisphere and flipped the lesional right hemisphere in the Nirspark. Result Compared with the other two groups, stronger cerebral cortex activation was observed during ACT. One-way repeated measures ANOVA revealed significant differences in mean oxy-Hb changes among conditions in the four ROIs: contralesional PFC [F(2, 48) = 6,798, p < 0.01], ipsilesional M1 [F(2, 48) = 6.733, p < 0.01], ipsilesional S1 [F(2, 48) = 4,392, p < 0.05], and ipsilesional PM [F(2, 48) = 3.658, p < 0.05]. Oxy-Hb responses in the contralesional PFC region were stronger during ACT than during SUS (p < 0.01) and PAS (p < 0.05). Cortical activation in the ipsilesional M1 was significantly greater during ACT than during SUS (p < 0.01) and PAS (p < 0.05). Oxy-Hb responses in the ipsilesional S1 (p < 0.05) and ipsilesional PM (p < 0.05) were significantly higher during ACT than during PAS, and there is no significant difference in mean deoxy-Hb changes among conditions. Compared with SUS, the FC increased during ACT, which was characterized by the enhanced function of the ipsilesional cortex (p < 0.05), and there was no significant difference in FC between the ACT and PAS. Conclusion The study found that cortical activation during ACT was higher in the contralesional PFC, and ipsilesional M1 than during SUS, and showed tighter cortical FC between the cortices. The activation of the cerebral cortex of ACT was significantly higher than that of PAS, but there was no significant difference in FC. Our research helps to understand the difference in cerebral cortex activation between upper limb intelligent feedback robot rehabilitation and other rehabilitation training and provides an objective basis for the further application of upper limb intelligent feedback robots in the field of stroke rehabilitation.
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Affiliation(s)
- Hao Li
- Guangzhou Panyu Central Hospital, Guangzhou, China,Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xuefeng Fu
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lijun Lu
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hua Guo
- Guangzhou Panyu Central Hospital, Guangzhou, China,Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wen Yang
- Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Kaifeng Guo
- Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Zhen Huang
- Guangzhou Panyu Central Hospital, Guangzhou, China,*Correspondence: Zhen Huang ✉
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Chen N, Qiu X, Hua Y, Hu J, Bai Y. Effects of sequential inhibitory and facilitatory repetitive transcranial magnetic stimulation on neurological and functional recovery of a patient with chronic stroke: A case report and literature review. Front Neurol 2023; 14:1064718. [PMID: 36779047 PMCID: PMC9911674 DOI: 10.3389/fneur.2023.1064718] [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: 10/08/2022] [Accepted: 01/05/2023] [Indexed: 01/28/2023] Open
Abstract
Background and purpose The effects of conventional protocols of repetitive transcranial magnetic stimulation (rTMS) in the chronic phase of stroke are limited. This study aimed to apply the sequential inhibitory and facilitatory rTMS for upper limb motor dysfunction post-stroke to observe the efficacy and explore the possible neurophysiological mechanism. We hypothesize that this protocol would both enhance the excitability of affected M1 and promote connections among motor areas. Case description We reported a 55-year-old female patient with a 1-year chronic stroke and right-sided hemiplegia, who underwent the 14-session rTMS with seven sessions of low frequency (LF) and with seven sessions of high frequency (HF). Clinical scales mainly including Fugl-Meyer Assessment of Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), neurophysiological measures, and functional near-infrared spectroscopy (fNIRS) were assessed before (T0), at the midpoint (T1), and after the intervention (T2). Outcomes The patient exhibited post-intervention improvement in upper extremity function. There was increased excitability in the ipsilesional hemisphere and the opposite in the contralesional hemisphere. The interhemispheric inhibition (IHI) ratio increased from 2.70 to 10.81 and finally decreased to 1.34. Oxy-Hb signal was significantly decreased in affected M1 and mildly decreased in unaffected M1, while that of PMC and SMA on the affected side increased significantly. Conclusion The sequential inhibitory and facilitatory rTMS significantly promoted motor recovery in the patient. Related mechanisms include upregulation of excitability in the ipsilesional hemisphere, return of interhemispheric balance, and neuroplasticity-induced cortical reorganization.
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He X, Lei L, Yu G, Lin X, Sun Q, Chen S. Asymmetric cortical activation in healthy and hemiplegic individuals during walking: A functional near-infrared spectroscopy neuroimaging study. Front Neurol 2023; 13:1044982. [PMID: 36761919 PMCID: PMC9905619 DOI: 10.3389/fneur.2022.1044982] [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: 09/15/2022] [Accepted: 12/22/2022] [Indexed: 01/26/2023] Open
Abstract
Background This study investigated the cortical activation mechanism underlying locomotor control during healthy and hemiplegic walking. Methods A total of eight healthy individuals with right leg dominance (male patients, 75%; mean age, 40.06 ± 4.53 years) and six post-stroke patients with right hemiplegia (male patients, 86%; mean age, 44.41 ± 7.23 years; disease course, 5.21 ± 2.63 months) completed a walking task at a treadmill speed of 2 km/h and a functional electrical stimulation (FES)-assisted walking task, respectively. Functional near-infrared spectroscopy (fNIRS) was used to detect hemodynamic changes in neuronal activity in the bilateral sensorimotor cortex (SMC), supplementary motor area (SMA), and premotor cortex (PMC). Results fNIRS cortical mapping showed more SMC-PMC-SMA locomotor network activation during hemiplegic walking than during healthy gait. Furthermore, more SMA and PMC activation in the affected hemisphere was observed during the FES-assisted hemiplegic walking task than during the non-FES-assisted task. The laterality index indicated asymmetric cortical activation during hemiplegic gait, with relatively greater activation in the unaffected (right) hemisphere during hemiplegic gait than during healthy walking. During hemiplegic walking, the SMC and SMA were predominantly activated in the unaffected hemisphere, whereas the PMC was predominantly activated in the affected hemisphere. No significant differences in the laterality index were noted between the other groups and regions (p > 0.05). Conclusion An important feature of asymmetric cortical activation was found in patients with post-stroke during the walking process, which was the recruitment of more SMC-SMA-PMC activation than in healthy individuals. Interestingly, there was no significant lateralized activation during hemiplegic walking with FES assistance, which would seem to indicate that FES may help hemiplegic walking recover the balance in cortical activation. These results, which are worth verifying through additional research, suggest that FES used as a potential therapeutic strategy may play an important role in motor recovery after stroke.
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Affiliation(s)
- Xiaokuo He
- Department of Rehabilitative Medicine, Fifth Hospital of Xiamen, Xiamen, China
| | - Lei Lei
- Department of Rehabilitative Medicine, Fifth Hospital of Xiamen, Xiamen, China
| | - Guo Yu
- Department of Rehabilitative Medicine, Fifth Hospital of Xiamen, Xiamen, China
| | - Xin Lin
- Department of Rehabilitative Medicine, Fifth Hospital of Xiamen, Xiamen, China
| | - Qianqian Sun
- Department of Rehabilitative Medicine, Xiangyang Central Hospital, Xiangyang, Hubei, China,Qianqian Sun ✉
| | - Shanjia Chen
- Department of Rehabilitative Medicine, Fifth Hospital of Xiamen, Xiamen, China,Department of Rehabilitative Medicine, The First Affiliated Hospital of Xiamen University, Xiamen, China,*Correspondence: Shanjia Chen ✉
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Wang D, Huang Y, Liang S, Meng Q, Yu H. The identification of interacting brain networks during robot-assisted training with multimodal stimulation. J Neural Eng 2023; 20. [PMID: 36548992 DOI: 10.1088/1741-2552/acae05] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/22/2022] [Indexed: 12/24/2022]
Abstract
Objective.Robot-assisted rehabilitation training is an effective way to assist rehabilitation therapy. So far, various robotic devices have been developed for automatic training of central nervous system following injury. Multimodal stimulation such as visual and auditory stimulus and even virtual reality technology were usually introduced in these robotic devices to improve the effect of rehabilitation training. This may need to be explained from a neurological perspective, but there are few relevant studies.Approach.In this study, ten participants performed right arm rehabilitation training tasks using an upper limb rehabilitation robotic device. The tasks were completed under four different feedback conditions including multiple combinations of visual and auditory components: auditory feedback; visual feedback; visual and auditory feedback (VAF); non-feedback. The functional near-infrared spectroscopy devices record blood oxygen signals in bilateral motor, visual and auditory areas. Using hemoglobin concentration as an indicator of cortical activation, the effective connectivity of these regions was then calculated through Granger causality.Main results.We found that overall stronger activation and effective connectivity between related brain regions were associated with VAF. When participants completed the training task without VAF, the trends in activation and connectivity were diminished.Significance.This study revealed cerebral cortex activation and interacting networks of brain regions in robot-assisted rehabilitation training with multimodal stimulation, which is expected to provide indicators for further evaluation of the effect of rehabilitation training, and promote further exploration of the interaction network in the brain during a variety of external stimuli, and to explore the best sensory combination.
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Affiliation(s)
- Duojin Wang
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, 516 Jungong Road, Shanghai 200093, People's Republic of China.,Shanghai Engineering Research Center of Assistive Devices, 516 Jungong Road, Shanghai 200093, People's Republic of China
| | - Yanping Huang
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, 516 Jungong Road, Shanghai 200093, People's Republic of China
| | - Sailan Liang
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, 516 Jungong Road, Shanghai 200093, People's Republic of China
| | - Qingyun Meng
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, 279 Zhouzhu Road, Shanghai 201318, People's Republic of China
| | - Hongliu Yu
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, 516 Jungong Road, Shanghai 200093, People's Republic of China.,Shanghai Engineering Research Center of Assistive Devices, 516 Jungong Road, Shanghai 200093, People's Republic of China
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10
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Wang Q, Dai W, Xu S, Zhu S, Sui Y, Kan C, Shen Y, Zhu Y, Guo C, Wang T. Brain activation of the PFC during dual-task walking in stroke patients: A systematic review and meta-analysis of functional near-infrared spectroscopy studies. Front Neurosci 2023; 17:1111274. [PMID: 36875661 PMCID: PMC9980909 DOI: 10.3389/fnins.2023.1111274] [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: 11/29/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Background Dual-task walking is a good paradigm to measure the walking ability of stroke patients in daily life. It allows for a better observation of brain activation under dual-task walking to assess the impact of the different tasks on the patient when combining with functional near-infrared spectroscopy (fNIRS). This review aims to summarize the cortical change of the prefrontal cortex (PFC) detected in single-task and dual-task walking in stroke patients. Methods Six databases (Medline, Embase, PubMed, Web of Science, CINAHL, and Cochrane Library) were systematically searched for relevant studies, from inception to August 2022. Studies that measured the brain activation of single-task and dual-task walking in stroke patients were included. The main outcome of the study was PFC activity measured using fNIRS. In addition, a subgroup analysis was also performed for study characteristics based on HbO to analyze the different effects of disease duration and the type of dual task. Results Ten articles were included in the final review, and nine articles were included in the quantitative meta-analysis. The primary analysis showed more significant PFC activation in stroke patients performing dual-task walking than single-task walking (SMD = 0.340, P = 0.02, I 2 = 7.853%, 95% CI = 0.054-0.626). The secondary analysis showed a significant difference in PFC activation when performing dual-task walking and single-task walking in chronic patients (SMD = 0.369, P = 0.038, I 2 = 13.692%, 95% CI = 0.020-0.717), but not in subacute patients (SMD = 0.203, P = 0.419, I 2 = 0%, 95% CI = -0.289-0.696). In addition, performing walking combining serial subtraction (SMD = 0.516, P < 0.001, I 2 = 0%, 95% CI = 0.239-0.794), obstacle crossing (SMD = 0.564, P = 0.002, I 2 = 0%, 95% CI = 0.205-0.903), or a verbal task (SMD = 0.654, P = 0.009, I 2 = 0%, 95% CI = 0.164-1.137) had more PFC activation than single-task walking, while performing the n-back task did not show significant differentiation (SMD = 0.203, P = 0.419, I 2 = 0%, 95% CI = -0.289-0.696). Conclusions Different dual-task paradigms produce different levels of dual-task interference in stroke patients with different disease durations, and it is important to choose the matching dual-task type in relation to the walking ability and cognitive ability of the patient, in order to better improve the assessment and training effects. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier: CRD42022356699.
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Affiliation(s)
- Qinglei Wang
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China
| | - Wenjun Dai
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Sheng Xu
- Department of Rehabilitation, Changzhou Dean Hospital, Changzhou, China
| | - Shizhe Zhu
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China
| | - Youxin Sui
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China
| | - Chaojie Kan
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China.,Department of Rehabilitation, Changzhou Dean Hospital, Changzhou, China
| | - Ying Shen
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yi Zhu
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chuan Guo
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Tong Wang
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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11
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Lin CC, Bair WN, Willson J. Age differences in brain activity in dorsolateral prefrontal cortex and supplementary motor areas during three different walking speed tasks. Hum Mov Sci 2022; 85:102982. [DOI: 10.1016/j.humov.2022.102982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022]
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12
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Li C, Wong Y, Langhammer B, Huang F, Du X, Wang Y, Zhang H, Zhang T. A study of dynamic hand orthosis combined with unilateral task-oriented training in subacute stroke: A functional near-infrared spectroscopy case series. Front Neurol 2022; 13:907186. [PMID: 36034313 PMCID: PMC9410701 DOI: 10.3389/fneur.2022.907186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/14/2022] [Indexed: 12/03/2022] Open
Abstract
Background Motor dysfunction in the upper extremities after stroke prohibits people with stroke from being independent in daily living. The application of fNIRS to explore brain activity under rehabilitation intervention is a research focus on neurorehabilitation. Objective The purpose of this study was to explore, using a grip-release ring motor task, the activated changes of regions of interest and changes in motor function utilizing fNIRS technology and test scales on persons with stroke who received unilateral task-oriented therapy with a hand orthosis in the early subacute stroke period before and after intervention. The study aimed to find a sensitive motor task and region of interest first, then to evaluate the feasibility and mechanism of this rehabilitation method by utilizing fNIRS technology in the next randomized controlled trial. Methods In this case series, eight right-handed, right hemiplegia subacute stroke persons (6 males,2 females from age 47 to 72) were enrolled. They received 30 min of unilateral task-oriented therapy without orthosis and 30 min of unilateral task-oriented therapy with orthosis (5 days/week) for 4 weeks. Activated channel numbers and beta values based on oxygenated hemoglobin concentration change using a grip-release ring motor task were estimated with fNIRS. Clinical outcome measures, including grip strength evaluation, action research arm test, and Fugl-Meyer assessment of the arm, were evaluated at the same time. Results Individual activation analysis showed that, after intervention, Subjects 1, 2, 6, 7, and 8 had the maximum mean beta value located in the left premotor cortex, while Subjects 4 and 5 had the maximum mean beta value located in the left sensorimotor cortex. The activation analysis of Subject 3 showed the maximum mean beta value located in the right premotor cortex. Deactivations of left sensorimotor cortex, left premotor cortex, and bilateral prefrontal cortex were observed after intervention which were different from other cases. Group activation analysis showed that bilateral cerebral hemispheres were activated in all eight participants, with right hemisphere and right supplementary motor cortex activated dominantly. After the intervention, the activation of bilateral hemispheres decreased but in different brain regions; there was a trend that the activation intensity of left sensorimotor cortex, right premotor cortex, and right prefrontal cortex decreased while activation intensity of left premotor cortex and left prefrontal cortex increased. Each participant demonstrated improvements in all the clinical test scales after intervention. Conclusions Left premotor cortex, left sensorimotor cortex, and right supplementary motor cortex may be the primary regions of interest. Grasp-release ring task was not appropriate to achieve our fNIRS research objective and a more sensitive motor task or more sensitive evaluating indicator should be used in further studies.
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Affiliation(s)
- ChaoJinZi Li
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Department of Neurological Rehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Yih Wong
- Department of Research, Sunnaas Rehabilitation Hospital, Bjornemyr, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Birgitta Langhammer
- Department of Research, Sunnaas Rehabilitation Hospital, Bjornemyr, Norway
- Department of Physiotherapy, Faculty of Health Science, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | - FuBiao Huang
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Department of Occupational Therapy, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - XiaoXia Du
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Department of Neurological Rehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - YunLei Wang
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Department of Neurological Rehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - HaoJie Zhang
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Tong Zhang
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Department of Neurological Rehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
- *Correspondence: Tong Zhang
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13
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Veldema J, Gharabaghi A. Non-invasive brain stimulation for improving gait, balance, and lower limbs motor function in stroke. J Neuroeng Rehabil 2022; 19:84. [PMID: 35922846 PMCID: PMC9351139 DOI: 10.1186/s12984-022-01062-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 07/21/2022] [Indexed: 11/27/2022] Open
Abstract
Objectives This systematic review and meta-analysis aim to summarize and analyze the available evidence of non-invasive brain stimulation/spinal cord stimulation on gait, balance and/or lower limb motor recovery in stroke patients. Methods The PubMed database was searched from its inception through to 31/03/2021 for randomized controlled trials investigating repetitive transcranial magnetic stimulation or transcranial/trans-spinal direct current/alternating current stimulation for improving gait, balance and/or lower limb motor function in stroke patients. Results Overall, 25 appropriate studies (including 657 stroke subjects) were found. The data indicates that non-invasive brain stimulation/spinal cord stimulation is effective in supporting recovery. However, the effects are inhomogeneous across studies: (1) transcranial/trans-spinal direct current/alternating current stimulation induce greater effects than repetitive transcranial magnetic stimulation, and (2) bilateral application of non-invasive brain stimulation is superior to unilateral stimulation. Conclusions The current evidence encourages further research and suggests that more individualized approaches are necessary for increasing effect sizes in stroke patients.
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Affiliation(s)
- Jitka Veldema
- Department of Sport Science, Bielefeld University, 33 501, Bielefeld, Germany. .,Institute for Neuromodulation and Neurotechnology, University Hospital and University of Tübingen, Tübingen, Germany.
| | - Alireza Gharabaghi
- Institute for Neuromodulation and Neurotechnology, University Hospital and University of Tübingen, Tübingen, Germany
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14
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Lim SB, Yang CL, Peters S, Liu-Ambrose T, Boyd LA, Eng JJ. Phase-dependent Brain Activation of the Frontal and Parietal Regions During Walking After Stroke - An fNIRS Study. Front Neurol 2022; 13:904722. [PMID: 35928123 PMCID: PMC9343616 DOI: 10.3389/fneur.2022.904722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/15/2022] [Indexed: 11/15/2022] Open
Abstract
Background Recovery of walking post-stroke is highly variable. Accurately measuring and documenting functional brain activation characteristics during walking can help guide rehabilitation. Previous work in this area has been limited to investigations of frontal brain regions and have not utilized recent technological and analytical advances for more accurate measurements. There were three aims for this study: to characterize the hemodynamic profile during walking post-stroke, to investigate regional changes in brain activation during different phases of walking, and to related brain changes to clinical measures. Methods Functional near-infrared spectroscopy (fNIRS) along the pre-frontal, premotor, sensorimotor, and posterior parietal cortices was used on twenty individuals greater than six months post-stroke. Individual fNIRS optodes were digitized and used to estimate channel locations on each participant and short separation channels were used to control for extracerebral hemodynamic changes. Participants walked at their comfortable pace several times along a hallway while brain activation was recorded. Exploratory cluster analysis was conducted to determine if there was a link between brain activation and clinical measures. Results Sustained activation was observed in the pre-frontal cortex with the ipsilesional hemisphere showing greater activation compared to the contralesional side. Sensorimotor cortex was active during the early, acceleration stage of walking only. Posterior parietal cortex showed changes in activation during the later, steady-state stage of walking. Faster gait speeds also related to increased activation in contralesional sensorimotor and posterior parietal cortices. Exploratory analysis clustered participants into two distinct groups based on their brain activation profiles and generally showed that individuals with greater activation tended to have better physical outcomes. Conclusions These findings can guide future research for obtaining adequate power and determining factors that can be used as effect modifiers to reduce inter-subject variability. Overall, this is the first study to report specific oxygenated and deoxygenated hemoglobin changes in frontal to parietal regions during walking in the stroke population. Our results shed light on the importance of measuring brain activation across the cortex and show the importance of pre-frontal, sensorimotor, and posterior parietal cortices in walking after a stroke.
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Affiliation(s)
- Shannon B. Lim
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, BC, Canada
| | - Chieh-ling Yang
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, BC, Canada
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Sue Peters
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, BC, Canada
- School of Physical Therapy, Western University, London, ON, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- The David Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Lara A. Boyd
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- The David Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Janice J. Eng
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, BC, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
- *Correspondence: Janice J. Eng
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15
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Yuan Z, Xu W, Bao J, Gao H, Li W, Peng Y, Wang L, Zhao Y, Song S, Qiao J, Wang G. Task-State Cortical Motor Network Characteristics by Functional Near-Infrared Spectroscopy in Subacute Stroke Show Hemispheric Dominance. Front Aging Neurosci 2022; 14:932318. [PMID: 35813955 PMCID: PMC9263394 DOI: 10.3389/fnagi.2022.932318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background There was a reorganization of the brain network after stroke. Some studies have compared the characteristics of activation or functional connectivity (FC) of cortical and subcortical regions between the dominant and non-dominant hemisphere stroke. Objectives To analyze hemispheric dominance differences in task-state motor network properties in subacute stroke by functional near-infrared spectroscopy (fNIRS). Materials and Methods Patients with first ischemic stroke in the basal ganglia within 1–3 months after onset and age- and sex-matched right-handed healthy subjects (HS) were enrolled. fNIRS with 29 channels was used to detect the oxyhemoglobin concentration changes when performing the hand grasping task. Activation patterns of motor cortex and two macroscale and two mesoscale brain network indicators based on graph theory were compared between dominant and non-dominant hemisphere stroke. Results We enrolled 17 subjects in each of left hemisphere stroke (LHS), right hemisphere stroke (RHS), and HS groups. Both patient groups showed bilateral activation. The average weighted clustering coefficient and global efficiency of patients were lower than those of healthy people, and the inter-density was higher than that of the HS group, but the significance was different between LHS and RHS groups. The intra-density changes in the RHS group were opposite to those in the LHS group. The correlation between mesoscale indicators and motor function differed between dominant and non-dominant hemisphere stroke. Conclusion The changes in macroscale cortical network indicators were similar between the two patient groups, while those of the mesoscale indicators were different. The mesoscale brain network characteristics were affected by the severity of dysfunction to varying degrees in the LHS and RHS patients.
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Affiliation(s)
- Ziwen Yuan
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Biomedical Engineering, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
- Department of Rehabilitation, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Weiwei Xu
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Biomedical Engineering, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
| | - Jiameng Bao
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Biomedical Engineering, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
| | - Hui Gao
- College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Wen Li
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Biomedical Engineering, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
| | - Yu Peng
- Department of Rehabilitation, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Lisha Wang
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Biomedical Engineering, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
- Department of Rehabilitation, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Ye Zhao
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Biomedical Engineering, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
- Department of Rehabilitation, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Siming Song
- Department of Rehabilitation, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jin Qiao
- Department of Rehabilitation, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- *Correspondence: Jin Qiao,
| | - Gang Wang
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Biomedical Engineering, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
- Gang Wang,
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16
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Nguyen VT, Lu YH, Wu CW, Sung PS, Lin CCK, Lin PY, Wang SMS, Chen FY, Chen JJJ. Evaluating Interhemispheric Synchronization and Cortical Activity in Acute Stroke Patients Using Optical Hemodynamic Oscillations. J Neural Eng 2022; 19. [PMID: 35617937 DOI: 10.1088/1741-2552/ac73b4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/26/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE An understanding of functional interhemispheric asymmetry in ischemic stroke patients is a crucial factor in the designs of efficient programs for post-stroke rehabilitation. This study evaluates interhemispheric synchronization and cortical activities in acute stroke patients with various degrees of severity and at different post-stroke stages. APPROACH Twenty-three patients were recruited to participate in the experiments, including resting-state and speed finger-tapping tasks at week-1 and week-3 post-stroke. Multichannel near-infrared spectroscopy (NIRS) was used to measure the changes in hemodynamics in the bilateral prefrontal cortex (PFC), the supplementary motor area (SMA), and the sensorimotor cortex (SMC). The interhemispheric correlation coefficient (IHCC) measuring the synchronized activities in time and the wavelet phase coherence (WPCO) measuring the phasic activity in time-frequency were used to reflect the symmetry between the two hemispheres within a region. The changes in oxyhemoglobin during the finger-tapping tasks were used to present cortical activation. MAIN RESULTS IHCC and WPCO values in the severe-stroke were significantly lower than those in the minor-stroke at low frequency intervals during week-3 post-stroke. Cortical activation in all regions in the affected hemisphere was significantly lower than that in the unaffected hemisphere in the moderate-severe stroke measured in week-1, however, the SMC activation on the affected hemisphere was significantly enhanced in week-3 post-stroke. SIGNIFICANCE In this study, non-invasive NIRS was used to observe dynamic synchronization in the resting-state based on the IHCC and WPCO results as well as hemodynamic changes in a motor task in acute stroke patients. The findings suggest that NIRS could be used as a tool for early stroke assessment and evaluation of the efficacy of post-stroke rehabilitation.
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Affiliation(s)
- Van Truong Nguyen
- Department of Biomedical Engineering, National Cheng Kung University, No.1, University Road, Tainan City 701, Taiwan, Tainan, 70101, TAIWAN
| | - Yi-Hsuan Lu
- Department of Biomedical Engineering, National Cheng Kung University, No.1, University Road, Tainan City 701, Taiwan, Tainan, 70101, TAIWAN
| | - Chun-Wei Wu
- School of Biomedical Engineering, Taipei Medical University College of Biomedical Engineering, 250 Wu-Hsing Street, Taipei city, Taiwan 11031, Taipei, 11031, TAIWAN
| | - Pi-Shan Sung
- Department of Neurology, National Cheng Kung University Hospital, No.138,Sheng Li Road,Tainan, Taiwan 704, R.O.C, Tainan, 70403, TAIWAN
| | - Chou-Ching K Lin
- Department of Neurology, National Cheng Kung University, Medical Centre, National Cheng Kung University, Tainan, Taiwan 701, tainan, 70103, TAIWAN
| | - Pei-Yi Lin
- Pediatrics, Boston Children's Hospital, Harvard U, 300 Longwood Ave., Boston, Massachusetts, 02115, UNITED STATES
| | - Shun-Min Samuel Wang
- Department of Biomedical Engineering, National Cheng Kung University, No.1, University Road, Tainan City 701, Taiwan, Tainan, 70101, TAIWAN
| | - Fu-Yu Chen
- Department of Biomedical Engineering, Chung Yuan Christian University, No. 200, Zhongbei Rd., Zhongli Dist., Taoyuan City, Taoyuan City, 32023, TAIWAN
| | - Jia-Jin Jason Chen
- Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan 70101, ROC, Tainan, 70101, TAIWAN
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17
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Modulation of Interhemispheric Synchronization and Cortical Activity in Healthy Subjects by High-Definition Theta-Burst Electrical Stimulation. Neural Plast 2022; 2022:3593262. [PMID: 35529454 PMCID: PMC9076342 DOI: 10.1155/2022/3593262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/18/2022] [Indexed: 11/24/2022] Open
Abstract
Background Various forms of theta-burst stimulation (TBS) such as intermittent TBS (iTBS) and continuous TBS (cTBS) have been introduced as novel facilitation/suppression schemes during repetitive transcranial magnetic stimulation (rTMS), demonstrating a better efficacy than conventional paradigms. Herein, we extended the rTMS-TBS schemes to electrical stimulation of high-definition montage (HD-TBS) and investigated its neural effects on the human brain. Methods In a within-subject design, fifteen right-handed healthy adults randomly participated in 10 min and 2 mA HD-TBS sessions: unilateral (Uni)-iTBS, bilateral (Bi)-cTBS/iTBS, and sham stimulation over primary motor cortex regions. A 20-channel near-infrared spectroscopy (NIRS) system was covered on the bilateral prefrontal cortex (PFC), sensory motor cortex (SMC), and parietal lobe (PL) for observing cerebral hemodynamic responses in the resting-state and during fast finger-tapping tasks at pre-, during, and poststimulation. Interhemispheric correlation coefficient (IHCC) and wavelet phase coherence (WPCO) from resting-state NIRS and concentration of oxyhemoglobin during fast finger-tapping tasks were explored to reflect the symmetry between the two hemispheres and cortical activity, respectively. Results The IHCC and WPCO of NIRS data in the SMC region under Bi-cTBS/iTBS showed relatively small values at low-frequency bands III (0.06–0.15 Hz) and IV (0.02–0.06), indicating a significant desynchronization in both time and frequency domains. In addition, the SMC activation induced by fast finger-tapping exercise was significantly greater during Uni-iTBS as well as during and post Bi-cTBS/iTBS sessions. Conclusions It appears that a 10 min and 2 mA Bi-cTBS/iTBS applied over two hemispheres within the primary motor cortex region could effectively modulate the interhemispheric synchronization and cortical activation in the SMC of healthy subjects. Our study demonstrated that bilateral HD-TBS approaches is an effective noninvasive brain stimulation scheme which could be a novel therapeutic for inducing effects of neuromodulation on various neurological disorders caused by ischemic stroke or traumatic brain injuries.
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18
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Effects of Transcranial Direct Current Stimulation of Bilateral Supplementary Motor Area on the Lower Limb Motor Function in a Stroke Patient with Severe Motor Paralysis: A Case Study. Brain Sci 2022; 12:brainsci12040452. [PMID: 35447983 PMCID: PMC9029581 DOI: 10.3390/brainsci12040452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/23/2022] [Accepted: 03/26/2022] [Indexed: 02/04/2023] Open
Abstract
In patients with severe motor paralysis, increasing the excitability of the supplementary motor area (SMA) in the non-injured hemisphere contributes to the recovery of lower limb motor function. However, the contribution of transcranial direct current stimulation (tDCS) over the SMA of the non-injured hemisphere in the recovery of lower limb motor function is unclear. This study aimed to examine the effects of tDCS on bilateral hemispheric SMA combined with assisted gait training. A post-stroke patient with severe motor paralysis participated in a retrospective AB design. Assisted gait training was performed only in period A and tDCS to the SMA of the bilateral hemisphere combined with assisted gait training (bi-tDCS) was performed in period B. Additionally, three conditions were performed for 20 min each in the intervals between the two periods: (1) assisted gait training only, (2) assisted gait training combined with tDCS to the SMA of the injured hemisphere, and (3) bi-tDCS. Measurements were muscle activity and beta-band intermuscular coherence (reflecting corticospinal tract excitability) of the vastus medialis muscle. The bi-tDCS immediately and longitudinally increased muscle activity and intermuscular coherence. We consider that bi-tDCS may be effective in recovering lower limb motor function in a patient with severe motor paralysis.
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Yabluchanskiy A, Nyul-Toth A, Csiszar A, Gulej R, Saunders D, Towner R, Turner M, Zhao Y, Abdelkari D, Rypma B, Tarantini S. Age-related alterations in the cerebrovasculature affect neurovascular coupling and BOLD fMRI responses: Insights from animal models of aging. Psychophysiology 2021; 58:e13718. [PMID: 33141436 PMCID: PMC9166153 DOI: 10.1111/psyp.13718] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/10/2020] [Accepted: 09/28/2020] [Indexed: 12/11/2022]
Abstract
The present and future research efforts in cognitive neuroscience and psychophysiology rely on the measurement, understanding, and interpretation of blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging (fMRI) to effectively investigate brain function. Aging and age-associated pathophysiological processes change the structural and functional integrity of the cerebrovasculature which can significantly alter how the BOLD signal is recorded and interpreted. In order to gain an improved understanding of the benefits, drawbacks, and methodological implications for BOLD fMRI in the context of cognitive neuroscience, it is crucial to understand the cellular and molecular mechanism of age-related vascular pathologies. This review discusses the multifaceted effects of aging and the contributions of age-related pathologies on structural and functional integrity of the cerebral microcirculation as they has been investigated in animal models of aging, including age-related alterations in neurovascular coupling responses, cellular and molecular mechanisms involved in microvascular damage, vascular rarefaction, blood-brain barrier disruption, senescence, humoral deficiencies as they relate to, and potentially introduce confounding factors in the interpretation of BOLD fMRI.
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Affiliation(s)
- Andriy Yabluchanskiy
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Adam Nyul-Toth
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA,Institute of Biophysics, Biological Research Centre, Szeged, Hungary
| | - Anna Csiszar
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Rafal Gulej
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, Oklahoma, OK, USA
| | - Debra Saunders
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, Oklahoma, OK, USA
| | - Rheal Towner
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, Oklahoma, OK, USA
| | - Monroe Turner
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Yuguang Zhao
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Dema Abdelkari
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Bart Rypma
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA,Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Stefano Tarantini
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA,International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary,Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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20
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Lee HA, Kim DH. Brain Connectivity Affecting Gait Function After Unilateral Supratentorial Stroke. Brain Sci 2021; 11:brainsci11070870. [PMID: 34210030 PMCID: PMC8301903 DOI: 10.3390/brainsci11070870] [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: 06/09/2021] [Revised: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 11/16/2022] Open
Abstract
Gait dysfunction is a leading cause of long-term disability after stroke. The mechanisms underlying recovery of gait function are unknown. We retrospectively evaluated the association between structural connectivity and gait function in 127 patients with unilateral supratentorial stroke (>1 month after stroke). All patients underwent T1-weighted, diffusion tensor imaging and functional ambulation categorization. Voxel-wise linear regression analyses of the images were conducted using fractional anisotropy, mean diffusivity, and mode of anisotropy mapping as dependent variables, while the functional ambulation category was used as an independent variable with age and days after stroke as covariates. The functional ambulation category was positively associated with increased fractional anisotropy in the lesioned cortico-ponto-cerebellar system, corona radiata of the non-lesioned corticospinal tract pathway, bilateral medial lemniscus in the brainstem, and the corpus callosum. The functional ambulation category was also positively associated with increased mode of anisotropy in the lesioned posterior corpus callosum. In conclusion, structural connectivity associated with motor coordination and feedback affects gait function after stroke. Diffusion tensor imaging for evaluating structural connectivity can help to predict gait recovery and target rehabilitation goals after stroke.
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Affiliation(s)
- Hyun-Ah Lee
- Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul 05368, Korea;
| | - Dae-Hyun Kim
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea
- Correspondence: ; Tel.: +82-2-2228-3724
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21
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Motor Cortical Activation Assessment in Progressive Multiple Sclerosis Patients Enrolled in Gait Rehabilitation: A Secondary Analysis of the RAGTIME Trial Assisted by Functional Near-Infrared Spectroscopy. Diagnostics (Basel) 2021; 11:diagnostics11061068. [PMID: 34207923 PMCID: PMC8227480 DOI: 10.3390/diagnostics11061068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 01/16/2023] Open
Abstract
This study aimed to determine cortical activation responses to two different rehabilitative programs, as measured through functional near-infrared spectroscopy (fNIRS). As a secondary analysis of the RAGTIME trial, we studied 24 patients with progressive multiple sclerosis (MS) and severe disability who were randomized to a regimen of robot-assisted gait training (RAGT) or overground walking (OW). Cortical activation during a treadmill walking task, assessed through fNIRS recordings from the motor and premotor cortexes (M1/PM), was calculated as the area under the curve (AUC) of oxyhemoglobin for each hemisphere and the total area (Tot-OxyAUC). Gait speed, endurance, and balance were also measured, along with five healthy control subjects. At baseline, Tot-OxyAUC during walking was significantly increased in MS patients compared to healthy people and was significantly higher for those with more severe disabilities; it was also inversely correlated with physical performance. After rehabilitation, significant opposite variations in Tot-OxyAUC were observed, with activity levels being increased after OW and decreased after RAGT (+242,080 ± 361,902 and −157,031 ± 172,496 arbitrary units, respectively; p = 0.002), particularly in patients who were trained at a lower speed. Greater reductions in the cortical activation of the more affected hemisphere were significantly related to improvements in gait speed (r = −0.42) and endurance (r = −0.44). Cortical activation, assessed through fNIRS, highlighted the brain activity in response to the type and intensity of rehabilitation.
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22
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Cleland BT, Madhavan S. Ipsilateral motor pathways to the lower limb after stroke: Insights and opportunities. J Neurosci Res 2021; 99:1565-1578. [PMID: 33665910 DOI: 10.1002/jnr.24822] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/17/2021] [Indexed: 01/04/2023]
Abstract
Stroke-related damage to the crossed lateral corticospinal tract causes motor deficits in the contralateral (paretic) limb. To restore functional movement in the paretic limb, the nervous system may increase its reliance on ipsilaterally descending motor pathways, including the uncrossed lateral corticospinal tract, the reticulospinal tract, the rubrospinal tract, and the vestibulospinal tract. Our knowledge about the role of these pathways for upper limb motor recovery is incomplete, and even less is known about the role of these pathways for lower limb motor recovery. Understanding the role of ipsilateral motor pathways to paretic lower limb movement and recovery after stroke may help improve our rehabilitative efforts and provide alternate solutions to address stroke-related impairments. These advances are important because walking and mobility impairments are major contributors to long-term disability after stroke, and improving walking is a high priority for individuals with stroke. This perspective highlights evidence regarding the contributions of ipsilateral motor pathways from the contralesional hemisphere and spinal interneuronal pathways for paretic lower limb movement and recovery. This perspective also identifies opportunities for future research to expand our knowledge about ipsilateral motor pathways and provides insights into how this information may be used to guide rehabilitation.
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Affiliation(s)
- Brice T Cleland
- Brain Plasticity Lab, Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Sangeetha Madhavan
- Brain Plasticity Lab, Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
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23
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Lim SB, Louie DR, Peters S, Liu-Ambrose T, Boyd LA, Eng JJ. Brain activity during real-time walking and with walking interventions after stroke: a systematic review. J Neuroeng Rehabil 2021; 18:8. [PMID: 33451346 PMCID: PMC7811232 DOI: 10.1186/s12984-020-00797-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/09/2020] [Indexed: 12/27/2022] Open
Abstract
Investigations of real-time brain activations during walking have become increasingly important to aid in recovery of walking after a stroke. Individual brain activation patterns can be a valuable biomarker of neuroplasticity during the rehabilitation process and can result in improved personalized medicine for rehabilitation. The purpose of this systematic review is to explore the brain activation characteristics during walking post-stroke by determining: (1) if different components of gait (i.e., initiation/acceleration, steady-state, complex) result in different brain activations, (2) whether brain activations differ from healthy individuals. Six databases were searched resulting in 22 studies. Initiation/acceleration showed bilateral activation in frontal areas; steady-state and complex walking showed broad activations with the majority exploring and finding increases in frontal regions and some studies also showing increases in parietal activation. Asymmetrical activations were often related to performance asymmetry and were more common in studies with slower gait speed. Hyperactivations and asymmetrical activations commonly decreased with walking interventions and as walking performance improved. Hyperactivations often persisted in individuals who had experienced severe strokes. Only a third of the studies included comparisons to a healthy group: individuals post-stroke employed greater brain activation compared to young adults, while comparisons to older adults were less clear and limited. Current literature suggests some indicators of walking recovery however future studies investigating more brain regions and comparisons with healthy age-matched adults are needed to further understand the effect of stroke on walking-related brain activation.
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Affiliation(s)
- Shannon B Lim
- Graduate Studies in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.,Rehabiliation Research Program, GF Strong Rehabilitation Centre, 4255 Laurel St, Vancouver, BC, V5Z 2G9, Canada
| | - Dennis R Louie
- Graduate Studies in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.,Rehabiliation Research Program, GF Strong Rehabilitation Centre, 4255 Laurel St, Vancouver, BC, V5Z 2G9, Canada
| | - Sue Peters
- Rehabiliation Research Program, GF Strong Rehabilitation Centre, 4255 Laurel St, Vancouver, BC, V5Z 2G9, Canada.,Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.,The Djavad Mowafaghian Centre for Brain Health, 212-2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.,Centre for Hip Health and Mobility, Vancouver, Canada
| | - Lara A Boyd
- Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.,The Djavad Mowafaghian Centre for Brain Health, 212-2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Janice J Eng
- Rehabiliation Research Program, GF Strong Rehabilitation Centre, 4255 Laurel St, Vancouver, BC, V5Z 2G9, Canada. .,Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
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24
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Hashimoto K, Hotta K, Morishita S, Kanai R, Takahashi H, Tsubaki A. Cerebral Oxygenation Dynamics During Incremental Exercise: Comparison of Arm Cranking and Leg Cycling. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1269:125-130. [PMID: 33966206 DOI: 10.1007/978-3-030-48238-1_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This study aimed to compare cerebral oxyhemoglobin (O2Hb) levels during incremental exercise by cycling vs. arm cranking in 12 healthy adult men aged 20.8 ± 0.2 years old. O2Hb was measured by near-infrared spectroscopy. Regions of interest included the left and right prefrontal cortices (LtPFC and RtPFC, respectively), the left and right premotor cortices (LtPMC and RtPMC, respectively), and the supplementary motor area (SMA) bilaterally. After 4 min of rest, 4 min of warm-up was performed by using ergometer followed by incremental exercise (increasing work rate by 5 W/min for arm cranking and 20 W/min for cycling exercise). All values were averaged every tenth of the participant's exercise time period from beginning of incremental exercise to end point. At the middle exercise intensity (50% exercise time), the averaged O2Hb values obtained at all regions of interest seemed to be higher during arm cranking exercise as compared to cycling; however, there were no significant differences between two types of exercise. At the end point of incremental exercise (100% exercise time), the O2Hb obtained at all regions of interest was significantly higher during arm cranking exercise compared to cycling (LtPFC 0.081 ± 0.019 vs. -0.001 ± 0.013 mM·cm, RtPFC 0.076 ± 0.021 vs. 0.018 ± 0.015 mM·cm, SMA 0.012 ± 0.040 vs. 0.040 ± 0.016 mM·cm; arm cranking vs. cycling; p < 0.05, respectively). We conclude that exercise-induced cerebral oxygenation is greater with arm cranking than with leg cycling.
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Affiliation(s)
- K Hashimoto
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - K Hotta
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.
| | - S Morishita
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - R Kanai
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - H Takahashi
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - A Tsubaki
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
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25
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Lee SH, Lee HJ, Shim Y, Chang WH, Choi BO, Ryu GH, Kim YH. Wearable hip-assist robot modulates cortical activation during gait in stroke patients: a functional near-infrared spectroscopy study. J Neuroeng Rehabil 2020; 17:145. [PMID: 33121535 PMCID: PMC7596937 DOI: 10.1186/s12984-020-00777-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 10/21/2020] [Indexed: 12/21/2022] Open
Abstract
Background Gait dysfunction is common in post-stroke patients as a result of impairment in cerebral gait mechanism. Powered robotic exoskeletons are promising tools to maximize neural recovery by delivering repetitive walking practice. Objectives The purpose of this study was to investigate the modulating effect of the Gait Enhancing and Motivating System-Hip (GEMS-H) on cortical activation during gait in patients with chronic stroke. Methods. Twenty chronic stroke patients performed treadmill walking at a self-selected speed either with assistance of GEMS-H (GEMS-H) or without assistance of GEMS-H (NoGEMS-H). Changes in oxygenated hemoglobin (oxyHb) concentration in the bilateral primary sensorimotor cortex (SMC), premotor cortices (PMC), supplemental motor areas (SMA), and prefrontal cortices (PFC) were recorded using functional near infrared spectroscopy. Results Walking with the GEMS-H promoted symmetrical SMC activation, with more activation in the affected hemisphere than in NoGEMS-H conditions. GEMS-H also decreased oxyHb concentration in the late phase over the ipsilesional SMC and bilateral SMA (P < 0.05). Conclusions The results of the present study reveal that the GEMS-H promoted more SMC activation and a balanced activation pattern that helped to restore gait function. Less activation in the late phase over SMC and SMA during gait with GEMS-H indicates that GEMS-H reduces the cortical participation of stroke gait by producing rhythmic hip flexion and extension movement and allows a more coordinate and efficient gait patterns. Trial registration NCT03048968. Registered 06 Feb 2017
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Affiliation(s)
- Su-Hyun Lee
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 115, Gangnam-gu, Seoul, 06355, Republic of Korea
| | - Hwang-Jae Lee
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 115, Gangnam-gu, Seoul, 06355, Republic of Korea.,Department of Health Sciences and Technology, Department of Medical Device Management and Research, Department of Digital Health, SAIHST, Sungkyunkwan University, Irwon-ro 81, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Youngbo Shim
- Samsung Research, Samsung Electronics, 56, Seongchon-gil, Seocho-gu, Seoul, 06756, Republic of Korea
| | - Won Hyuk Chang
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 115, Gangnam-gu, Seoul, 06355, Republic of Korea
| | - Byung-Ok Choi
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Gyu-Ha Ryu
- Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, Republic of Korea.,The Office of R&D Strategy & Planning, Samsung Medical Center, Irwon-ro 81, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Yun-Hee Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 115, Gangnam-gu, Seoul, 06355, Republic of Korea. .,Department of Health Sciences and Technology, Department of Medical Device Management and Research, Department of Digital Health, SAIHST, Sungkyunkwan University, Irwon-ro 81, Gangnam-gu, Seoul, 06351, Republic of Korea.
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26
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Takagi S, Sakuma S, Morita I, Sugimoto E, Yamaguchi Y, Higuchi N, Inamoto K, Ariji Y, Ariji E, Murakami H. Application of Deep Learning in the Identification of Cerebral Hemodynamics Data Obtained from Functional Near-Infrared Spectroscopy: A Preliminary Study of Pre- and Post-Tooth Clenching Assessment. J Clin Med 2020; 9:E3475. [PMID: 33126595 PMCID: PMC7693464 DOI: 10.3390/jcm9113475] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/14/2020] [Accepted: 10/27/2020] [Indexed: 12/05/2022] Open
Abstract
In fields using functional near-infrared spectroscopy (fNIRS), there is a need for an easy-to-understand method that allows visual presentation and rapid analysis of data and test results. This preliminary study examined whether deep learning (DL) could be applied to the analysis of fNIRS-derived brain activity data. To create a visual presentation of the data, an imaging program was developed for the analysis of hemoglobin (Hb) data from the prefrontal cortex in healthy volunteers, obtained by fNIRS before and after tooth clenching. Three types of imaging data were prepared: oxygenated hemoglobin (oxy-Hb) data, deoxygenated hemoglobin (deoxy-Hb) data, and mixed data (using both oxy-Hb and deoxy-Hb data). To differentiate between rest and tooth clenching, a cross-validation test using the image data for DL and a convolutional neural network was performed. The network identification rate using Hb imaging data was relatively high (80‒90%). These results demonstrated that a method using DL for the assessment of fNIRS imaging data may provide a useful analysis system.
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Affiliation(s)
- Shinya Takagi
- Department of Fixed Prosthodontics, School of Dentistry, Aichi Gakuin University, Nagoya 464-8651, Japan;
| | - Shigemitsu Sakuma
- Department of Fixed Prosthodontics, School of Dentistry, Aichi Gakuin University, Nagoya 464-8651, Japan;
| | - Ichizo Morita
- Japanese Red Cross Toyota College of Nursing, Toyota 471-8565, Japan;
| | - Eri Sugimoto
- Department of Pediatric Dentistry, School of Dentistry, Aichi Gakuin University, Nagoya 464-8651, Japan;
| | - Yoshihiro Yamaguchi
- Department of Fixed Prosthodontics, School of Dentistry, Aichi Gakuin University, Nagoya 464-8651, Japan;
| | - Naoya Higuchi
- Department of Endodontics, School of Dentistry, Aichi Gakuin University, Nagoya 464-8651, Japan; (N.H.); (K.I.)
| | - Kyoko Inamoto
- Department of Endodontics, School of Dentistry, Aichi Gakuin University, Nagoya 464-8651, Japan; (N.H.); (K.I.)
| | - Yoshiko Ariji
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Aichi Gakuin University, Nagoya 464-8651, Japan; (Y.A.); (E.A.)
| | - Eiichiro Ariji
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Aichi Gakuin University, Nagoya 464-8651, Japan; (Y.A.); (E.A.)
| | - Hiroshi Murakami
- Department of Gerodontology and Home Care Dentistry, School of Dentistry, Aichi Gakuin University, Nagoya 464-8651, Japan;
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27
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Karunakaran KK, Nisenson DM, Nolan KJ. Alterations in Cortical Activity due to Robotic Gait Training in Traumatic Brain Injury .. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:3224-3227. [PMID: 33018691 DOI: 10.1109/embc44109.2020.9175764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Traumatic brain injury (TBI), is one of the leading causes of motor deficits in children and adults, affecting motor control, coordination, and acuity. This results in reduced functional ambulation and quality of life. Robotic exoskeletons (REs) are quickly becoming an effective method for gait neurorehabilitation in individuals with TBI. Neurorehabilitation is based on the principle that the human brain is capable of reorganization due to high dose motor training. Understanding the underlying mechanisms of cortical reorganization will help improve current rehabilitation. The objective of the study is to understand the cortical activity differences due to RE training and recovery of functional ambulation for individuals with chronic TBI, using functional near-infrared spectroscopy. There was an increase in cortical activation in the prefrontal cortex (PFC), bilateral premotor cortex (PMC) and motor cortex (M1) while walking with RE versus without RE at follow-up. Furthermore, decreased activation was observed in PFC, bilateral PMC and M1 from baseline to follow-up while walking without RE with a corresponding improvement in functional ambulation. These preliminary results for one participant provide initial evidence to understand the cortical mechanisms during RE gait training and the recovery induced due to the training.
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28
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Rahman MA, Siddik AB, Ghosh TK, Khanam F, Ahmad M. A Narrative Review on Clinical Applications of fNIRS. J Digit Imaging 2020; 33:1167-1184. [PMID: 32989620 PMCID: PMC7573058 DOI: 10.1007/s10278-020-00387-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 08/06/2020] [Accepted: 09/14/2020] [Indexed: 01/08/2023] Open
Abstract
Functional near-infrared spectroscopy (fNIRS) is a relatively new imaging modality in the functional neuroimaging research arena. The fNIRS modality non-invasively investigates the change of blood oxygenation level in the human brain utilizing the transillumination technique. In the last two decades, the interest in this modality is gradually evolving for its real-time monitoring, relatively low-cost, radiation-less environment, portability, patient-friendliness, etc. Including brain-computer interface and functional neuroimaging research, this technique has some important application of clinical perspectives such as Alzheimer's disease, schizophrenia, dyslexia, Parkinson's disease, childhood disorders, post-neurosurgery dysfunction, attention, functional connectivity, and many more can be diagnosed as well as in some form of assistive modality in clinical approaches. Regarding the issue, this review article presents the current scopes of fNIRS in medical assistance, clinical decision making, and future perspectives. This article also covers a short history of fNIRS, fundamental theories, and significant outcomes reported by a number of scholarly articles. Since this review article is hopefully the first one that comprehensively explores the potential scopes of the fNIRS in a clinical perspective, we hope it will be helpful for the researchers, physicians, practitioners, current students of the functional neuroimaging field, and the related personnel for their further studies and applications.
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Affiliation(s)
- Md. Asadur Rahman
- Department of Biomedical Engineering, Military Institute of Science and Technology (MIST), Dhaka, 1216 Bangladesh
| | - Abu Bakar Siddik
- Department of Biomedical Engineering, Khulna University of Engineering & Technology (KUET), Khulna, 9203 Bangladesh
| | - Tarun Kanti Ghosh
- Department of Biomedical Engineering, Khulna University of Engineering & Technology (KUET), Khulna, 9203 Bangladesh
| | - Farzana Khanam
- Department of Biomedical Engineering, Jashore University of Science and Technology (JUST), Jashore, 7408 Bangladesh
| | - Mohiuddin Ahmad
- Department of Electrical and Electronic Engineering, Khulna University of Engineering & Technology (KUET), Khulna, 9203 Bangladesh
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29
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Kitatani R, Koganemaru S, Maeda A, Mikami Y, Matsuhashi M, Mima T, Yamada S. Gait-combined transcranial alternating current stimulation modulates cortical control of muscle activities during gait. Eur J Neurosci 2020; 52:4791-4802. [PMID: 32726506 DOI: 10.1111/ejn.14919] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 07/19/2020] [Accepted: 07/20/2020] [Indexed: 11/29/2022]
Abstract
Non-invasive brain stimulation has been of interest as a therapeutic tool to modulate cortical excitability. However, there is little evidence that oscillatory brain stimulation can modulate the cortical control of muscle activities during gait, which can be assessed using coherence analysis of paired surface electromyographic (EMG) recordings. This study aimed to investigate the effects of gait-combined transcranial alternating current stimulation (tACS) at the gait cycle frequency on the cortical control of muscle activities during gait using EMG-EMG coherence analysis. Fourteen healthy young adults participated in this study. All participants underwent 2 test conditions (real tACS and sham stimulation over the leg area of the primary motor cortex during 10-min treadmill walking). The average peak-to-peak amplitudes of the motor evoked potentials (MEPs) from the tibialis anterior (TA) and lateral gastrocnemius muscles in the sitting position and EMG-EMG coherences in the TA muscle, triceps surae muscles, quadriceps muscles, and hamstring muscles during gait were measured before and after stimulation. Entrainment effect was significantly higher during real tACS than during sham stimulation. After real tACS, the MEP amplitude and beta band (13-33 Hz) coherence area increased in the TA muscle. The change in MEP amplitude from the TA muscle was positively correlated with the change in beta band coherence area in the TA muscle. Gait-combined tACS can modulate the strength of descending neural drive to TA motoneurons during gait. This suggests that oscillatory brain stimulation is a useful therapeutic tool to modulate the cortical control of muscle activities during gait.
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Affiliation(s)
- Ryosuke Kitatani
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of Rehabilitation, Kansai Rehabilitation Hospital, Osaka, Japan
| | - Satoko Koganemaru
- Department of Physiology and Biological Information, Dokkyo Medical University, Tochigi, Japan
| | - Ayaka Maeda
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yusuke Mikami
- Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masao Matsuhashi
- Department of Epilepsy, Movement Disorders and Physiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tatsuya Mima
- Graduate School of Core Ethics and Frontier Sciences, Ritsumeikan University, Kyoto, Japan
| | - Shigehito Yamada
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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30
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Kim H, Park G, Shin JH, You JH. Neuroplastic effects of end-effector robotic gait training for hemiparetic stroke: a randomised controlled trial. Sci Rep 2020; 10:12461. [PMID: 32719420 PMCID: PMC7385173 DOI: 10.1038/s41598-020-69367-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 07/10/2020] [Indexed: 11/09/2022] Open
Abstract
Detecting neuroplastic changes during locomotor neurorehabilitation is crucial for independent primal motor behaviours. However, long-term locomotor training-related neuroplasticity remains unexplored. We compared the effects of end-effector robot-assisted gait training (E-RAGT) and bodyweight-supported treadmill training (BWST) on cortical activation in individuals with hemiparetic stroke. Twenty-three men and five women aged 53.2 ± 11.2 years were recruited and randomly assigned to participate in E-RAGT (n = 14) or BWST (n = 14) for 30 min/day, 5 days/week, for 4 weeks. Cortical activity, lower limb motor function, and gait speed were evaluated before and after training. Activation of the primary sensorimotor cortex, supplementary motor area, and premotor cortex in the affected hemisphere significantly increased only in the E-RAGT group, although there were no significant between-group differences. Clinical outcomes, including the Fugl-Meyer assessment (FMA), timed up and go test, and 10-m walk test scores, improved after training in both groups, with significantly better FMA scores in the E-RAGT group than in the BWST group. These findings suggest that E-RAGT effectively improves neuroplastic outcomes in hemiparetic stroke, although its superiority over conventional training remains unclear. This may have clinical implications and provides insight for clinicians interested in locomotor neurorehabilitation after hemiparetic stroke.Trial Registration: ClinicalTrials.gov Identifier NCT04054739 (12/08/2019).
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Affiliation(s)
- Hayeon Kim
- Translational Research Center for Rehabilitation Robots, National Rehabilitation Center, Seoul, Republic of Korea
| | - Gyulee Park
- Translational Research Center for Rehabilitation Robots, National Rehabilitation Center, Seoul, Republic of Korea
| | - Joon-Ho Shin
- Translational Research Center for Rehabilitation Robots, National Rehabilitation Center, Seoul, Republic of Korea. .,Department of Rehabilitation Medicine, National Rehabilitation Center, 58, Samgaksan-ro, Gangbuk-gu, Seoul, 01022, Republic of Korea.
| | - Joshua H You
- Department of Physical Therapy, Dynamic Movement Institute and Technology, College of Health Science, Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute, "Yonsei GOODWELLNESS Center" for Sports, Wellness, and Fitness Across Life Span Disabilities, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, 26493, Republic of Korea.
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31
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Effects of injuries to descending motor pathways on restoration of gait in patients with pontine hemorrhage. J Stroke Cerebrovasc Dis 2020; 29:104857. [PMID: 32409256 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104857] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/27/2020] [Accepted: 03/28/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND PURPOSE Gait disturbance due to injuries of the descending motor pathway, including corticospinal tract (CST), corticoreticular pathway (CRP), and medial and lateral vestibulospinal tracts (VSTs), are commonly encountered disabling sequelae of pontine hemorrhage. We investigated relations between changes in the CST, CRP, and medial and lateral VST and corresponding changes in gait function in patients with pontine hemorrhage. METHOD Nine consecutive stroke patients with pontine hemorrhage, and 6 age-matched normal subjects were recruited. Four patients were allocated to group A (can't walk independently) and 5 to group B (can walk independently). Diffusion tensor imaging (DTI) data were acquired twice at acute to subacute stage and chronic stage after stroke onset. Diffusion tensor tractography (DTT) was used to reconstruct CST, CRP, medial and lateral VST. RESULT The CRP shows a significantly different between groups A and B in both initial and follow up DTT (p > 0.05). In contrast, CST, medial VST and lateral VST did not show a significant difference (p > 0.05). Regarding DTI parameters of CRPs in group A, percentages of patients with fractional anisotropy (FA) and mean diffusivity (MD) values more than two standard deviation from normal were higher by follow up DTI than by initial DTI, however, the CRPs in group B only showed increased abnormal range of MD. CONCLUSIONS The CST does not play an essential role in recovery of independent walking and vestibulospinal tracts may not crucially affect recovery of independent walking in patients with pontine hemorrhage. In contrast, and intact CRP or changes of the CRP integrity appear to be related to the recovery of gait function.
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Lee A, Kim H, Kim J, Choi DS, Jung JH, Lee J, Kim YH. Modulating Effects of Whole-body Vibration on Cortical Activity and Gait Function in Chronic Stroke Patients. BRAIN & NEUROREHABILITATION 2020; 13:e12. [PMID: 36744184 PMCID: PMC9879458 DOI: 10.12786/bn.2020.13.e12] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/28/2020] [Accepted: 03/05/2020] [Indexed: 11/08/2022] Open
Abstract
Whole-body vibration exercise (WBVe) can provide proper somatosensory stimulation and improve muscle strength in stroke patients. This study investigated the effects of WBVe on gait function and cortical activity in patients with chronic stroke. Thirty stroke patients were randomly assigned to either the WBVe or the control group. The WBVe group received the vibration in a half-squat position for 5 minutes at an intensity of 20 Hz. The control group kept the same posture but did not receive the vibration. Cortical activity was investigated using functional near-infrared spectroscopy (fNIRS). Gait function was assessed by a 10-m walk test (10MWT), a timed up and go (TUG) test, a Fugl-Meyer Assessment, and a Tinetti Performance-Oriented Mobility Assessment (TPOMA). In group analysis of the fNIRS data, oxygenated hemoglobin concentration was significantly increased in the ipsilesional supplementary motor area, bilateral sensorimotor cortex, and contralesional prefrontal cortex in the WBVe group compared to the control group (p < 0.05). Functional assessment demonstrated a significant interaction between time and group for the 10MWT and TUG test, suggesting that the WBVe group demonstrated meaningful improvement after intervention (p < 0.05). These results suggested that WBVe modulated the cerebral cortical activities and resulted in improvement of gait function in chronic stroke patients. Trial Registration ClinicalTrials.gov Identifier: NCT03375346.
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Affiliation(s)
- Ahee Lee
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.,Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Heegoo Kim
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.,Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jinuk Kim
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.,Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | - Jae Hwan Jung
- Department of Physical and Rehabilitation Medicine, Ilsan Central Hospital, Ilsan, Korea
| | - Jungsoo Lee
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yun-Hee Kim
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.,Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Medical Device Management and Research, Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Korea
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33
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Pinti P, Tachtsidis I, Hamilton A, Hirsch J, Aichelburg C, Gilbert S, Burgess PW. The present and future use of functional near-infrared spectroscopy (fNIRS) for cognitive neuroscience. Ann N Y Acad Sci 2020; 1464:5-29. [PMID: 30085354 PMCID: PMC6367070 DOI: 10.1111/nyas.13948] [Citation(s) in RCA: 407] [Impact Index Per Article: 101.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 07/10/2018] [Accepted: 07/13/2018] [Indexed: 01/11/2023]
Abstract
The past few decades have seen a rapid increase in the use of functional near-infrared spectroscopy (fNIRS) in cognitive neuroscience. This fast growth is due to the several advances that fNIRS offers over the other neuroimaging modalities such as functional magnetic resonance imaging and electroencephalography/magnetoencephalography. In particular, fNIRS is harmless, tolerant to bodily movements, and highly portable, being suitable for all possible participant populations, from newborns to the elderly and experimental settings, both inside and outside the laboratory. In this review we aim to provide a comprehensive and state-of-the-art review of fNIRS basics, technical developments, and applications. In particular, we discuss some of the open challenges and the potential of fNIRS for cognitive neuroscience research, with a particular focus on neuroimaging in naturalistic environments and social cognitive neuroscience.
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Affiliation(s)
- Paola Pinti
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
- Institute of Cognitive NeuroscienceUniversity College LondonLondonUK
| | - Ilias Tachtsidis
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Antonia Hamilton
- Institute of Cognitive NeuroscienceUniversity College LondonLondonUK
| | - Joy Hirsch
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
- Department of PsychiatryYale School of MedicineNew HavenConnecticut
- Department of NeuroscienceYale School of MedicineNew HavenConnecticut
- Comparative MedicineYale School of MedicineNew HavenConnecticut
| | | | - Sam Gilbert
- Institute of Cognitive NeuroscienceUniversity College LondonLondonUK
| | - Paul W. Burgess
- Institute of Cognitive NeuroscienceUniversity College LondonLondonUK
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Sacheli LM, Zapparoli L, Bonandrini R, Preti M, Pelosi C, Sconfienza LM, Banfi G, Paulesu E. How aging affects the premotor control of lower limb movements in simulated gait. Hum Brain Mapp 2020; 41:1889-1903. [PMID: 31922648 PMCID: PMC7267909 DOI: 10.1002/hbm.24919] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/19/2019] [Accepted: 12/23/2019] [Indexed: 12/19/2022] Open
Abstract
Gait control becomes more demanding in healthy older adults, yet what cognitive or motor process leads to this age-related change is unknown. The present study aimed to investigate whether it might depend on specific decay in the quality of gait motor representation and/or a more general reduction in the efficiency of lower limb motor control. Younger and older healthy participants performed in fMRI a virtual walking paradigm that combines motor imagery (MI) of walking and standing on the spot with the presence (Dynamic Motor Imagery condition, DMI) or absence (pure MI condition) of overtly executed ankle dorsiflexion. Gait imagery was aided by the concomitant observation of moving videos simulating a stroll in the park from a first-person perspective. Behaviorally, older participants showed no sign of evident depletion in the quality of gait motor representations, and absence of between-group differences in the neural correlates of MI. However, while younger participants showed increased frontoparietal activity during DMI, older participants displayed stronger activation of premotor areas when controlling the pure execution of ankle dorsiflexion, regardless of the imagery task. These data suggest that reduced automaticity of lower limb motor control in healthy older subjects leads to the recruitment of additional premotor resources even in the absence of basic gait functional disabilities.
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Affiliation(s)
- Lucia Maria Sacheli
- Psychology Department & Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Laura Zapparoli
- Psychology Department & Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Rolando Bonandrini
- Psychology Department & Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy
| | - Matteo Preti
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Catia Pelosi
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Giuseppe Banfi
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,University Vita e Salute San Raffaele, Milan, Italy
| | - Eraldo Paulesu
- Psychology Department & Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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35
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Kitatani R, Koganemaru S, Maeda A, Mikami Y, Matsuhashi M, Mima T, Yamada S. Gait-synchronized oscillatory brain stimulation modulates common neural drives to ankle muscles in patients after stroke: A pilot study. Neurosci Res 2019; 156:256-264. [PMID: 31726081 DOI: 10.1016/j.neures.2019.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/02/2019] [Accepted: 10/12/2019] [Indexed: 12/11/2022]
Abstract
The present study aimed to investigate the long-term effects of gait intervention with transcranial alternating current stimulation (tACS) synchronized with gait cycle frequency on the cortical control of muscle activity during gait, using coherence analyses, in patients after stroke. Eight chronic post-stroke patients participated in a single-blinded crossover study, and 7 patients completed the long-term intervention. Each patient received tACS over the primary motor cortex foot area on the affected side, which was synchronized with individual gait cycle frequency, and sham stimulation during treadmill gait in a random order. Electrical neuromuscular stimulation was used to assist the paretic ankle movement in both conditions. After gait intervention with tACS, beta band (15-35 Hz) coherence, which is considered to have a cortical origin, significantly increased in the paretic tibialis anterior (TA) muscle during 6-min of over-ground gait. The change in beta band coherence in the paretic TA muscle was positively correlated with the change in gait distance. These results indicate that gait intervention with tACS synchronized with gait cycle frequency may induce gait-specific plasticity that modulates the common neural drive to the TA motoneurons on the paretic side during gait and leads to changes in gait function in patients after stroke.
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Affiliation(s)
- Ryosuke Kitatani
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Rehabilitation, Kansai Rehabilitation Hospital, Osaka, Japan.
| | - Satoko Koganemaru
- Department of Physiology and Biological Information, Dokkyo Medical University, Tochigi, Japan
| | - Ayaka Maeda
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yusuke Mikami
- Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masao Matsuhashi
- Department of Epilepsy, Movement Disorders and Physiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tatsuya Mima
- Graduate School of Core Ethics and Frontier Sciences, Ritsumeikan University, Kyoto, Japan
| | - Shigehito Yamada
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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36
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Jang SH, Lee SJ. Corticoreticular Tract in the Human Brain: A Mini Review. Front Neurol 2019; 10:1188. [PMID: 31803130 PMCID: PMC6868423 DOI: 10.3389/fneur.2019.01188] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 10/25/2019] [Indexed: 01/25/2023] Open
Abstract
Previous studies have suggested that the corticoreticular tract (CRT) has an important role in motor function almost next to the corticospinal tract (CST) in the human brain. Herein, the CRT is reviewed with regard to its anatomy, function, and recovery mechanisms after injury, with particular focus on previous diffusion tensor tractography-based studies. The CRT originates from several cortical areas but mainly from the premotor cortex. It descends through the subcortical white matter anteromedially to the CST with a 6- to 12-mm separation in the anteroposterior direction, then passing through the mesencephalic tegmentum and the pontine and pontomedullary reticular formations. Regarding its motor functions, the CRT appears to be mainly involved in the motor function of proximal joint muscles accounting for ~30–40% of the motor function of these joint muscles. In addition, the CRT is involved in gait function and postural stability. However, further studies that clearly rule out the effects of other motor function-related neural tracts are necessary to clarify the precise portion of the total motor function for which the CRT is responsible. With regard to recovery mechanisms for an injured CRT, three recovery mechanisms were suggested in five previous studies: recovery through the original pathway, recovery through perilesional reorganization, and recovery through the transcallosal pathway. However, each of those studies was single-case reports; therefore, further original studies including a larger number of patients are warranted.
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Affiliation(s)
- Sung Ho Jang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, South Korea
| | - Sung Jun Lee
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, South Korea
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37
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Sun X, Long H, Zhao C, Duan Q, Zhu H, Chen C, Sun W, Ju F, Sun X, Zhao Y, Xue B, Tian F, Mou X, Yuan H. Analgesia-enhancing effects of repetitive transcranial magnetic stimulation on neuropathic pain after spinal cord injury:An fNIRS study. Restor Neurol Neurosci 2019; 37:497-507. [PMID: 31381538 DOI: 10.3233/rnn-190934] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Xiaolong Sun
- Department of Rehabilitation Medicine, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Hua Long
- Department of Orthopaedics, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
| | - Chenguang Zhao
- Department of Rehabilitation Medicine, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Qiang Duan
- Department of Rehabilitation Medicine, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
- Department of Rehabilitation Medicine, The People’s Hospital of China Three Gorges University, Yichang, China
| | - Huilin Zhu
- Children Developmental & Behavioral Center, Third Affiliated Hospital of Sun Yet-Sen University, Guangzhou, China
| | - Chunyan Chen
- Department of Rehabilitation Medicine, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Wei Sun
- Department of Rehabilitation Medicine, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Fen Ju
- Department of Rehabilitation Medicine, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Xinyan Sun
- Department of Rehabilitation Medicine, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Yilin Zhao
- Department of Medical Affair, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Baijie Xue
- Department of Rehabilitation Medicine, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Fei Tian
- Department of Rehabilitation Medicine, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Xiang Mou
- Department of Rehabilitation Medicine, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Hua Yuan
- Department of Rehabilitation Medicine, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
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38
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Lee KB, Hong BY, Kim JS, Son DB, Choi SI, Lim SH. The effect of white matter integrity on functional outcome in central pontine demyelination. J Phys Ther Sci 2019; 31:698-701. [PMID: 31528012 PMCID: PMC6698467 DOI: 10.1589/jpts.31.698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 05/15/2019] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Central pontine demyelination is a common osmotic demyelination syndrome.
Typically, central pontine demyelination shows high signal intensity with demyelination in
the mid-pons. Despite severe imaging findings, patients usually recover. This study
investigated the integrity of the corticospinal tract (CST) and corticoreticular pathway
(CRP) in patients at 12 months after the onset of central pontine demyelination.
[Participants and Methods] This retrospective cross-sectional observational study assessed
two patients with central pontine demyelination, who were ultimately able to walk without
using an aid or orthosis and to use both hands but with mild residual symptoms. All
participants underwent diffusion tensor imaging (DTI) at 12 months after onset. [Results]
Both patients had mild ataxia at 12 months after onset. The integrity of the CST was
restored in both cases, while the integrity of the CRP recovered partially. [Conclusion]
The integrity of the CST and CRP at 12 months after the onset of central pontine
demyelination was similar in both cases as well as the recovery status of the hand
function and ambulation. These results may be useful in planning therapy for patients with
central pontine demyelination.
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Affiliation(s)
- Kyoung Bo Lee
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea: 222 Banpo-daero, Seocho-gu, Seoul, Republic of Korea
| | - Bo Young Hong
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea: 222 Banpo-daero, Seocho-gu, Seoul, Republic of Korea
| | - Joon Sung Kim
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea: 222 Banpo-daero, Seocho-gu, Seoul, Republic of Korea
| | - Dong Back Son
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea: 222 Banpo-daero, Seocho-gu, Seoul, Republic of Korea
| | - Sang Il Choi
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea: 222 Banpo-daero, Seocho-gu, Seoul, Republic of Korea
| | - Seong Hoon Lim
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea: 222 Banpo-daero, Seocho-gu, Seoul, Republic of Korea
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Picelli A, Brugnera A, Filippetti M, Mattiuz N, Chemello E, Modenese A, Gandolfi M, Waldner A, Saltuari L, Smania N. Effects of two different protocols of cerebellar transcranial direct current stimulation combined with transcutaneous spinal direct current stimulation on robot-assisted gait training in patients with chronic supratentorial stroke: A single blind, randomized controlled trial. Restor Neurol Neurosci 2019; 37:97-107. [PMID: 30958319 DOI: 10.3233/rnn-180895] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The neural organization of locomotion involves motor patterns generated by spinal interneuronal networks and supraspinal structures, which are approachable by noninvasive stimulation techniques. Recent evidences supported the hypothesis that transcranial direct current stimulation (combined with transcutaneous spinal direct current stimulation) may actually enhance the effects of robot-assisted gait training in chronic stroke patients. The cerebellum has many connections to interact with neocortical areas and may provide some peculiar plasticity mechanisms. So, it has been proposed as "non-lesioned entry" to the motor or cognitive system for the application of noninvasive stimulation techniques in patients with supratentorial stroke. OBJECTIVE To compare the effects of two different protocols of cerebellar transcranial direct current stimulation combined with transcutaneous spinal direct current stimulation on robotic gait training in patients with chronic supratentorial stroke. METHODS Forty patients with chronic supratentorial stroke were randomly assigned into two groups. All patients received ten, 20-minute robotic gait training sessions, five days a week, for two consecutive weeks. Group 1 underwent cathodal transcranial direct current stimulation over the contralesional cerebellar hemisphere + cathodal transcutaneous spinal direct current stimulation in combination with robotic training. Group 2 underwent cathodal transcranial direct current stimulation over the ipsilesional cerebellar hemisphere + cathodal transcutaneous spinal direct current stimulation in combination with robotic training. The primary outcome was the 6-minute walk test performed before, after, and at follow-up at 2 and 4 weeks post-treatment. RESULTS No significant difference in the 6-minute walk test between groups was found at the first post-treatment evaluation (P = 0.976), as well as at the 2-week (P = 0.178) and the 4-week (P = 0.069) follow-up evaluations. Both groups showed significant within-group improvements in the 6-minute walk test at all time points.∥Conclusions: Our findings support the hypothesis that cathodal transcranial direct current stimulation over the contralesional or ipsilesional cerebellar hemisphere in combination with cathodal transcutaneous spinal direct current stimulation may lead to similar effects on robotic gait training in chronic supratentorial stroke patients.
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Affiliation(s)
- Alessandro Picelli
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy.,Department of Neurosciences, Neurorehabilitation Unit, Hospital Trust of Verona, Verona, Italy
| | - Annalisa Brugnera
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Mirko Filippetti
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Nicola Mattiuz
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Elena Chemello
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Angela Modenese
- Department of Neurosciences, Neurorehabilitation Unit, Hospital Trust of Verona, Verona, Italy
| | - Marialuisa Gandolfi
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy.,Department of Neurosciences, Neurorehabilitation Unit, Hospital Trust of Verona, Verona, Italy
| | - Andreas Waldner
- Villa Melitta Rehabilitation Clinic, Bolzano, Italy.,Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy
| | - Leopold Saltuari
- Research Unit for Neurorehabilitation South Tyrol, Bolzano, Italy.,Department of Neurology, Hochzirl Hospital, Zirl, Austria
| | - Nicola Smania
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy.,Department of Neurosciences, Neurorehabilitation Unit, Hospital Trust of Verona, Verona, Italy
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40
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Yang M, Yang Z, Yuan T, Feng W, Wang P. A Systemic Review of Functional Near-Infrared Spectroscopy for Stroke: Current Application and Future Directions. Front Neurol 2019; 10:58. [PMID: 30804877 PMCID: PMC6371039 DOI: 10.3389/fneur.2019.00058] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/16/2019] [Indexed: 02/05/2023] Open
Abstract
Background: Survivors of stroke often experience significant disability and impaired quality of life. The recovery of motor or cognitive function requires long periods. Neuroimaging could measure changes in the brain and monitor recovery process in order to offer timely treatment and assess the effects of therapy. A non-invasive neuroimaging technique near-infrared spectroscopy (NIRS) with its ambulatory, portable, low-cost nature without fixation of subjects has attracted extensive attention. Methods: We conducted a comprehensive literature review in order to review the use of NIRS in stroke or post-stroke patients in July 2018. NCBI Pubmed database, EMBASE database, Cochrane Library and ScienceDirect database were searched. Results: Overall, we reviewed 66 papers. NIRS has a wide range of application, including in monitoring upper limb, lower limb recovery, motor learning, cortical function recovery, cerebral hemodynamic changes, cerebral oxygenation, as well as in therapeutic method, clinical researches, and evaluation of the risk for stroke. Conclusions: This study provides a preliminary evidence of the application of NIRS in stroke patients as a monitoring, therapeutic, and research tool. Further studies could give more emphasize on the combination of NIRS with other techniques and its utility in the prevention of stroke.
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Affiliation(s)
- Muyue Yang
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai, China.,School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhen Yang
- Core Facility of West China Hospital, Sichuan University, Chengdu, China
| | - Tifei Yuan
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wuwei Feng
- Department of Neurology, Medical University of South Carolina, Charleston, SC, United States
| | - Pu Wang
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai, China
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Groff BR, Antonellis P, Schmid KK, Knarr BA, Stergiou N. Stride-time variability is related to sensorimotor cortical activation during forward and backward walking. Neurosci Lett 2019; 692:150-158. [PMID: 30367957 PMCID: PMC6351206 DOI: 10.1016/j.neulet.2018.10.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 10/10/2018] [Indexed: 11/25/2022]
Abstract
Previous research has used functional near-infrared spectroscopy (fNIRS) to show that motor areas of the cortex are activated more while walking backward compared to walking forward. It is also known that head movement creates motion artifacts in fNIRS data. The aim of this study was to investigate cortical activation during forward and backward walking, while also measuring head movement. We hypothesized that greater activation in motor areas while walking backward would be concurrent with increased head movement. Participants performed forward and backward walking on a treadmill. Participants wore motion capture markers on their head to quantify head movement and pressure sensors on their feet to calculate stride-time. fNIRS was placed over motor areas of the cortex to measure cortical activation. Measurements were compared for forward and backward walking conditions. No significant differences in body movement or head movement were observed between forward and backward walking conditions, suggesting that conditional differences in movement did not influence fNIRS results. Stride-time was significantly shorter during backward walking than during forward walking, but not more variable. There were no differences in activation for motor areas of the cortex when outliers were removed. However, there was a positive correlation between stride-time variability and activation in the primary motor cortex. This positive correlation between motor cortex activation and stride-time variability suggests that forward walking variability may be represented in the primary motor cortex.
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Affiliation(s)
- Boman R Groff
- Department of Biomechanics and Center for Research in Human Movement Variability, College of Education, University of Nebraska at Omaha, 6160 University Drive South, Omaha, NE, 68182-0860, USA
| | - Prokopios Antonellis
- Department of Biomechanics and Center for Research in Human Movement Variability, College of Education, University of Nebraska at Omaha, 6160 University Drive South, Omaha, NE, 68182-0860, USA
| | - Kendra K Schmid
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, 984375 Nebraska Medical Center, Omaha, NE, 68198-4375, USA
| | - Brian A Knarr
- Department of Biomechanics and Center for Research in Human Movement Variability, College of Education, University of Nebraska at Omaha, 6160 University Drive South, Omaha, NE, 68182-0860, USA
| | - Nicholas Stergiou
- Department of Biomechanics and Center for Research in Human Movement Variability, College of Education, University of Nebraska at Omaha, 6160 University Drive South, Omaha, NE, 68182-0860, USA; Department of Environmental, Agricultural, and Occupational Health, College of Public Health, University of Nebraska Medical Center, 984388 Nebraska Medical Center, Omaha, NE, 68198-4388, USA.
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Brain Activation During Passive and Volitional Pedaling After Stroke. Motor Control 2019; 23:52-80. [PMID: 30012052 PMCID: PMC6685765 DOI: 10.1123/mc.2017-0059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 01/06/2018] [Accepted: 02/25/2018] [Indexed: 11/18/2022]
Abstract
Background: Prior work indicates that pedaling-related brain activation is lower in people with stroke than in controls. We asked whether this observation could be explained by between-group differences in volitional motor commands and pedaling performance. Methods: Individuals with and without stroke performed passive and volitional pedaling while brain activation was recorded with functional magnetic resonance imaging. The passive condition eliminated motor commands to pedal and minimized between-group differences in pedaling performance. Volume, intensity, and laterality of brain activation were compared across conditions and groups. Results: There were no significant effects of condition and no Group × Condition interactions for any measure of brain activation. Only 53% of subjects could minimize muscle activity for passive pedaling. Conclusions: Altered motor commands and pedaling performance are unlikely to account for reduced pedaling-related brain activation poststroke. Instead, this phenomenon may be due to functional or structural brain changes. Passive pedaling can be difficult to achieve and may require inhibition of excitatory descending drive.
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Allali G, Blumen HM, Devanne H, Pirondini E, Delval A, Van De Ville D. Brain imaging of locomotion in neurological conditions. Neurophysiol Clin 2018; 48:337-359. [PMID: 30487063 PMCID: PMC6563601 DOI: 10.1016/j.neucli.2018.10.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 10/05/2018] [Accepted: 10/09/2018] [Indexed: 01/20/2023] Open
Abstract
Impaired locomotion is a frequent and major source of disability in patients with neurological conditions. Different neuroimaging methods have been used to understand the brain substrates of locomotion in various neurological diseases (mainly in Parkinson's disease) during actual walking, and while resting (using mental imagery of gait, or brain-behavior correlation analyses). These studies, using structural (i.e., MRI) or functional (i.e., functional MRI or functional near infra-red spectroscopy) brain imaging, electrophysiology (i.e., EEG), non-invasive brain stimulation (i.e., transcranial magnetic stimulation, or transcranial direct current stimulation) or molecular imaging methods (i.e., PET, or SPECT) reveal extended brain networks involving both grey and white matters in key cortical (i.e., prefrontal cortex) and subcortical (basal ganglia and cerebellum) regions associated with locomotion. However, the specific roles of the various pathophysiological mechanisms encountered in each neurological condition on the phenotype of gait disorders still remains unclear. After reviewing the results of individual brain imaging techniques across the common neurological conditions, such as Parkinson's disease, dementia, stroke, or multiple sclerosis, we will discuss how the development of new imaging techniques and computational analyses that integrate multivariate correlations in "large enough datasets" might help to understand how individual pathophysiological mechanisms express clinically as an abnormal gait. Finally, we will explore how these new analytic methods could drive our rehabilitative strategies.
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Affiliation(s)
- Gilles Allali
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA.
| | - Helena M Blumen
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA; Department of Medicine, Division of Geriatrics, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA
| | - Hervé Devanne
- Department of Clinical Neurophysiology, Lille University Medical Center, Lille, France; EA 7369, URePSSS, Unité de Recherche Pluridisciplinaire Sport Santé Société, Université du Littoral Côte d'Opale, Calais, France
| | - Elvira Pirondini
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland; Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Arnaud Delval
- Department of Clinical Neurophysiology, Lille University Medical Center, Lille, France; Unité Inserm 1171, Faculté de Médecine, Université de Lille, Lille, France
| | - Dimitri Van De Ville
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland; Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
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Tamashiro H, Kinoshita S, Okamoto T, Urushidani N, Abo M. Effect of baseline brain activity on response to low-frequency rTMS/intensive occupational therapy in poststroke patients with upper limb hemiparesis: a near-infrared spectroscopy study. Int J Neurosci 2018; 129:337-343. [DOI: 10.1080/00207454.2018.1536053] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Hiroaki Tamashiro
- Department of Rehabilitation Medicine, Nishi-Hiroshima Rehabilitation Hospital, Hiroshima, Japan
| | - Shoji Kinoshita
- Department of Rehabilitation Medicine, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan
- Department of Rehabilitation Medicine, Aomori Shintoshi Hospital, Aomori, Aomori, Japan
| | - Takatsugu Okamoto
- Department of Rehabilitation Medicine, Nishi-Hiroshima Rehabilitation Hospital, Hiroshima, Japan
- Department of Rehabilitation Medicine, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan
| | - Naoki Urushidani
- Department of Rehabilitation Medicine, Nishi-Hiroshima Rehabilitation Hospital, Hiroshima, Japan
| | - Masahiro Abo
- Department of Rehabilitation Medicine, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan
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Toyomura A, Yokosawa K, Shimojo A, Fujii T, Kuriki S. Turning a cylindrical treadmill with feet: An MR-compatible device for assessment of the neural correlates of lower-limb movement. J Neurosci Methods 2018; 307:14-22. [PMID: 29924979 DOI: 10.1016/j.jneumeth.2018.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/24/2018] [Accepted: 06/12/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Locomotion, which is one of the most basic motor functions, is critical for performing various daily-life activities. Despite its essential function, assessment of brain activity during lower-limb movement is still limited because of the constraints of existing brain imaging methods. NEW METHOD Here, we describe an MR-compatible, cylindrical treadmill device that allows participants to perform stepping movements on an MRI scanner table. The device was constructed from wood and all of the parts were handmade by the authors. RESULTS We confirmed the MR-compatibility of the device by evaluating the temporal signal-to-noise ratio of 64 voxels of a phantom during scanning. Brain activity was measured while twenty participants turned the treadmill with feet in sync with metronome sounds. The rotary speed of the cylinder was encoded by optical fibers. The post/pre-central gyrus and cerebellum showed significant activity during the movements, which was comparable to the activity patterns reported in previous studies. Head movement on the y- and z-axes was influenced more by lower-limb movement than was head movement on the x-axis. Among the 60 runs (3 runs × 20 participants), head movement during two of the runs (3.3%) was excessive due to the lower-limb movement. COMPARISON WITH EXISTING METHODS Compared to MR-compatible devices proposed in the previous studies, the advantage of this device may be simple structure and replicability to realize stepping movement with a supine position. CONCLUSIONS Collectively, our results suggest that the treadmill device is useful for evaluating lower-limb-related neural activity.
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Affiliation(s)
- Akira Toyomura
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma 371-8514, Japan; Research and Education Center for Brain Science, Hokkaido University, Kita 15, Nishi 7 Kita-ku, Sapporo 060-8638, Japan.
| | - Koichi Yokosawa
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5 Kita-ku, Sapporo 060-0812, Japan
| | - Atsushi Shimojo
- Department of Pediatrics, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7 Kita-ku, Sapporo 060-8638, Japan
| | - Tetsunoshin Fujii
- Department of Psychology, Graduate School of Letters, Hokkaido University, Kita 10, Nishi 7 Kita-ku, Sapporo 060-0810, Japan
| | - Shinya Kuriki
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5 Kita-ku, Sapporo 060-0812, Japan
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Relationship between sensorimotor cortical activation as assessed by functional near infrared spectroscopy and lower extremity motor coordination in bilateral cerebral palsy. NEUROIMAGE-CLINICAL 2018; 20:275-285. [PMID: 30101059 PMCID: PMC6083901 DOI: 10.1016/j.nicl.2018.07.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 06/28/2018] [Accepted: 07/25/2018] [Indexed: 12/31/2022]
Abstract
Background Evaluation of task-evoked cortical responses during movement has been limited in individuals with bilateral cerebral palsy (CP), despite documented alterations in brain structure/function and deficits in motor control. Objective To systematically evaluate cortical activity associated with lower extremity tasks, and relate activation parameters to clinical measures in CP. Methods 28 ambulatory participants (14 with bilateral CP and 14 with typical development) completed five motor tasks (non-dominant ankle dorsiflexion, hip flexion and leg cycling as well as bilateral dorsiflexion and cycling) in a block design while their sensorimotor cortex was monitored using functional near infrared spectroscopy (fNIRS), in addition to laboratory and clinical measures of performance. Results Main effects for group and task were found for extent of fNIRS activation (number of active channels; p < 0.001 and p = 0.010, respectively), magnitude of activation (sum of beta values; p < 0.001 for both), and number of active muscles (p = 0.001 and p < 0.001, respectively), but no group by task interactions. Collectively, subgroups with CP and especially those with greater impairments, showed higher extent and magnitude of cortical sensorimotor activation as well as higher amounts of concurrent activity in muscles not required for task performance. Magnitude of fNIRS activation during non-dominant dorsiflexion correlated with validated measures of selective control (r = −0.60, p = 0.03), as well as mobility and daily activity (r = −0.55, p = 0.04 and r = −0.52, p = 0.05, respectively) and self-reported gait function (r = −0.68, p = 0.01) in those with CP. Conclusions The association between higher activity in the sensorimotor cortex and decreased selectivity in cortical organization suggests a potential neural mechanism of motor deficits and target for intervention. First fNIRS comparison of a range of lower extremity tasks in children with and without bilateral CP. FNIRS showed a greater amount and extent of activation of sensorimotor cortices in CP. Greater activation correlated with a greater number of muscles involved in the task. fNIRS results correlated to clinical measures of motor control and function.
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Thumm PC, Maidan I, Brozgol M, Shustak S, Gazit E, Shema Shiratzki S, Bernad-Elazari H, Beck Y, Giladi N, Hausdorff JM, Mirelman A. Treadmill walking reduces pre-frontal activation in patients with Parkinson's disease. Gait Posture 2018; 62:384-387. [PMID: 29626840 DOI: 10.1016/j.gaitpost.2018.03.041] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 03/22/2018] [Accepted: 03/24/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Among patients with Parkinson's disease (PD), gait is typically disturbed and less automatic. These gait changes are associated with impaired rhythmicity and increased prefrontal activation, presumably in an attempt to compensate for reduced automaticity. RESEARCH QUESTION We investigated whether during treadmill walking, when the pace is determined and fixed, prefrontal activation in patients with PD is lower, as compared to over-ground walking. METHODS Twenty patients with PD (age: 69.8 ± 6.5 yrs.; MoCA: 26.9 ± 2.4; disease duration: 7.9 ± 4.2 yrs) walked at a self-selected walking speed over-ground and on a treadmill. A wireless functional near infrared spectroscopy (fNIRS) system measured prefrontal lobe activation, i.e., oxygenated hemoglobin (Hb02) in the pre-frontal area. Gait was evaluated using 3D-accelerometers attached to the lower back and ankles (Opal™, APDM). Dynamic gait stability was assessed using the maximum Lyapunov exponent to investigate automaticity of the walking pattern. RESULTS Hb02 was lower during treadmill walking than during over-ground walking (p = 0.001). Gait stability was greater on the treadmill, compared to over-ground walking, in both the anteroposterior and medio-lateral axes (p < 0.001). SIGNIFICANCE These findings support the notion that when gait is externally paced, prefrontal lobe activation is reduced in patients with PD, perhaps reflecting a reduced need for compensatory cognitive mechanisms.
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Affiliation(s)
- Pablo Cornejo Thumm
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel
| | - Inbal Maidan
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel; Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Marina Brozgol
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel
| | - Shiran Shustak
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel
| | - Eran Gazit
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel
| | - Shirley Shema Shiratzki
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel
| | - Hagar Bernad-Elazari
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel
| | - Yoav Beck
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel
| | - Nir Giladi
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel; Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Israel
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel; Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Israel; Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, United States
| | - Anat Mirelman
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel; Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Israel; Laboratory for Early Markers Of Neurodegeneration (LEMON), Tel Aviv Medical Center, Tel Aviv, Israel.
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Herold F, Wiegel P, Scholkmann F, Thiers A, Hamacher D, Schega L. Functional near-infrared spectroscopy in movement science: a systematic review on cortical activity in postural and walking tasks. NEUROPHOTONICS 2017; 4:041403. [PMID: 28924563 PMCID: PMC5538329 DOI: 10.1117/1.nph.4.4.041403] [Citation(s) in RCA: 178] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 06/23/2017] [Indexed: 05/07/2023]
Abstract
Safe locomotion is a crucial aspect of human daily living that requires well-functioning motor control processes. The human neuromotor control of daily activities such as walking relies on the complex interaction of subcortical and cortical areas. Technical developments in neuroimaging systems allow the quantification of cortical activation during the execution of motor tasks. Functional near-infrared spectroscopy (fNIRS) seems to be a promising tool to monitor motor control processes in cortical areas in freely moving subjects. However, so far, there is no established standardized protocol regarding the application and data processing of fNIRS signals that limits the comparability among studies. Hence, this systematic review aimed to summarize the current knowledge about application and data processing in fNIRS studies dealing with walking or postural tasks. Fifty-six articles of an initial yield of 1420 publications were reviewed and information about methodology, data processing, and findings were extracted. Based on our results, we outline the recommendations with respect to the design and data processing of fNIRS studies. Future perspectives of measuring fNIRS signals in movement science are discussed.
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Affiliation(s)
- Fabian Herold
- Otto von Guericke University Magdeburg, Institute III, Department of Sport Science, Magdeburg, Germany
- Address all correspondence to: Fabian Herold, E-mail:
| | - Patrick Wiegel
- University of Freiburg, Department of Sport Science, Freiburg, Germany
| | - Felix Scholkmann
- University of Zurich, University Hospital Zurich, Department of Neonatology, Biomedical Optics Research Laboratory, Zurich, Switzerland
| | - Angelina Thiers
- Otto von Guericke University Magdeburg, Institute III, Department of Sport Science, Magdeburg, Germany
| | - Dennis Hamacher
- Otto von Guericke University Magdeburg, Institute III, Department of Sport Science, Magdeburg, Germany
| | - Lutz Schega
- Otto von Guericke University Magdeburg, Institute III, Department of Sport Science, Magdeburg, Germany
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Fujimoto H, Mihara M, Hattori N, Hatakenaka M, Yagura H, Kawano T, Miyai I, Mochizuki H. Neurofeedback-induced facilitation of the supplementary motor area affects postural stability. NEUROPHOTONICS 2017; 4:045003. [PMID: 29152530 PMCID: PMC5680482 DOI: 10.1117/1.nph.4.4.045003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 10/16/2017] [Indexed: 05/29/2023]
Abstract
Near-infrared spectroscopy-mediated neurofeedback (NIRS-NFB) is a promising therapeutic intervention for patients with neurological diseases. Studies have shown that NIRS-NFB can facilitate task-related cortical activation and induce task-specific behavioral changes. These findings indicate that the effect of neuromodulation depends on local cortical function. However, when the target cortical region has multiple functions, our understanding of the effects is less clear. This is true in the supplementary motor area (SMA), which is involved both in postural control and upper-limb movement. To address this issue, we investigated the facilitatory effect of NIRS SMA neurofeedback on cortical activity and behavior, without any specific task. Twenty healthy individuals participated in real and sham neurofeedback. Balance and hand dexterity were assessed before and after each NIRS-NFB session. We found a significant interaction between assessment periods (pre/post) and condition (real/sham) with respect to balance as assessed by the center of the pressure path length but not for hand dexterity as assessed by the 9-hole peg test. SMA activity only increased during real neurofeedback. Our findings indicate that NIRS-NFB itself has the potential to modulate focal cortical activation, and we suggest that it be considered a therapy to facilitate the SMA for patients with postural impairment.
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Affiliation(s)
- Hiroaki Fujimoto
- Morinomiya Hospital, Neurorehabilitation Research Institute, Osaka, Osaka, Japan
- Osaka University Graduate School of Medicine, Department of Neurology, Suita, Osaka, Japan
| | - Masahito Mihara
- Morinomiya Hospital, Neurorehabilitation Research Institute, Osaka, Osaka, Japan
- Osaka University Graduate School of Medicine, Department of Neurology, Suita, Osaka, Japan
- Kawasaki Medical School, Department of Neurology, Kurashiki, Okayama, Japan
| | - Noriaki Hattori
- Morinomiya Hospital, Neurorehabilitation Research Institute, Osaka, Osaka, Japan
- Osaka University Graduate School of Medicine, Department of Neurology, Suita, Osaka, Japan
| | - Megumi Hatakenaka
- Morinomiya Hospital, Neurorehabilitation Research Institute, Osaka, Osaka, Japan
| | - Hajime Yagura
- Morinomiya Hospital, Neurorehabilitation Research Institute, Osaka, Osaka, Japan
| | - Teiji Kawano
- Morinomiya Hospital, Neurorehabilitation Research Institute, Osaka, Osaka, Japan
| | - Ichiro Miyai
- Morinomiya Hospital, Neurorehabilitation Research Institute, Osaka, Osaka, Japan
| | - Hideki Mochizuki
- Osaka University Graduate School of Medicine, Department of Neurology, Suita, Osaka, Japan
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Marchal-Crespo L, Michels L, Jaeger L, López-Olóriz J, Riener R. Effect of Error Augmentation on Brain Activation and Motor Learning of a Complex Locomotor Task. Front Neurosci 2017; 11:526. [PMID: 29021739 PMCID: PMC5623679 DOI: 10.3389/fnins.2017.00526] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 09/08/2017] [Indexed: 01/14/2023] Open
Abstract
Up to date, the functional gains obtained after robot-aided gait rehabilitation training are limited. Error augmenting strategies have a great potential to enhance motor learning of simple motor tasks. However, little is known about the effect of these error modulating strategies on complex tasks, such as relearning to walk after a neurologic accident. Additionally, neuroimaging evaluation of brain regions involved in learning processes could provide valuable information on behavioral outcomes. We investigated the effect of robotic training strategies that augment errors—error amplification and random force disturbance—and training without perturbations on brain activation and motor learning of a complex locomotor task. Thirty-four healthy subjects performed the experiment with a robotic stepper (MARCOS) in a 1.5 T MR scanner. The task consisted in tracking a Lissajous figure presented on a display by coordinating the legs in a gait-like movement pattern. Behavioral results showed that training without perturbations enhanced motor learning in initially less skilled subjects, while error amplification benefited better-skilled subjects. Training with error amplification, however, hampered transfer of learning. Randomly disturbing forces induced learning and promoted transfer in all subjects, probably because the unexpected forces increased subjects' attention. Functional MRI revealed main effects of training strategy and skill level during training. A main effect of training strategy was seen in brain regions typically associated with motor control and learning, such as, the basal ganglia, cerebellum, intraparietal sulcus, and angular gyrus. Especially, random disturbance and no perturbation lead to stronger brain activation in similar brain regions than error amplification. Skill-level related effects were observed in the IPS, in parts of the superior parietal lobe (SPL), i.e., precuneus, and temporal cortex. These neuroimaging findings indicate that gait-like motor learning depends on interplay between subcortical, cerebellar, and fronto-parietal brain regions. An interesting observation was the low activation observed in the brain's reward system after training with error amplification compared to training without perturbations. Our results suggest that to enhance learning of a locomotor task, errors should be augmented based on subjects' skill level. The impacts of these strategies on motor learning, brain activation, and motivation in neurological patients need further investigation.
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Affiliation(s)
- Laura Marchal-Crespo
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Institute of Robotics and Intelligent Systems, ETH Zurich, Zurich, Switzerland.,Reharobotics Group, Spinal Cord Injury Center, Balgrist University Hospital, Medical Faculty, University of Zurich, Zurich, Switzerland
| | - Lars Michels
- Clinic of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.,MR-Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Lukas Jaeger
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Institute of Robotics and Intelligent Systems, ETH Zurich, Zurich, Switzerland.,Clinic of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Jorge López-Olóriz
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Institute of Robotics and Intelligent Systems, ETH Zurich, Zurich, Switzerland
| | - Robert Riener
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Institute of Robotics and Intelligent Systems, ETH Zurich, Zurich, Switzerland.,Reharobotics Group, Spinal Cord Injury Center, Balgrist University Hospital, Medical Faculty, University of Zurich, Zurich, Switzerland
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