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Singaram S, Ramakrishnan K, Selvam J, Senthil M, Narayanamurthy V. Sweat gland morphology and physiology in diabetes, neuropathy, and nephropathy: a review. Arch Physiol Biochem 2024; 130:437-451. [PMID: 36063413 DOI: 10.1080/13813455.2022.2114499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 08/02/2022] [Indexed: 11/02/2022]
Abstract
Context: Sweat glands (SGs) play a vital role in thermal regulation. The function and structure are altered during the different pathological conditions.Objective: These alterations are studied through three techniques: biopsy, sweat analytes and electrical activity of SG.Methods: The morphological study of SG through biopsy and various techniques involved in quantifying sweat analytes is focussed on here. Electrical activities of SG in diabetes, neuropathy and nephropathy cases are also discussed, highlighting their limitations and future scope.Results and Conclusion: The result of this review identified three areas of the knowledge gap. The first is wearable sensors to correlate pathological conditions. Secondly, there is no device to look for its structure and quantify its associated function. Finally, therapeutic applications of SG are explored, especially for renal failure. With these aspects, this paper provides information collection and correlates SG with pathologies related to diabetes. Hence this could help researchers develop suitable technologies for the gaps identified.
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Affiliation(s)
- Sudha Singaram
- Department of Biomedical Engineering, Rajalakshmi Engineering College, Chennai, Tamil Nadu, India
| | - Kalpana Ramakrishnan
- Department of Biomedical Engineering, Rajalakshmi Engineering College, Chennai, Tamil Nadu, India
| | - Jayashree Selvam
- Department of Biomedical Engineering, Rajalakshmi Engineering College, Chennai, Tamil Nadu, India
| | - Mallika Senthil
- Department of Biomedical Engineering, Rajalakshmi Engineering College, Chennai, Tamil Nadu, India
| | - Vigneswaran Narayanamurthy
- Faculty of Electrical and Electronic Engineering Technology, Universiti Teknikal Malaysia Melaka, Melaka, Malaysia
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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: 13] [Impact Index Per Article: 4.3] [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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Dash A, Yadav A, Chauhan A, Lahiri U. Kinect-Assisted Performance-Sensitive Upper Limb Exercise Platform for Post-stroke Survivors. Front Neurosci 2019; 13:228. [PMID: 30967755 PMCID: PMC6438898 DOI: 10.3389/fnins.2019.00228] [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: 12/24/2018] [Accepted: 02/26/2019] [Indexed: 11/23/2022] Open
Abstract
One's ability to use upper limbs is critical for performing activities of daily living necessary for enjoying quality community life. However, after stroke, such abilities becomes adversely affected and it often deprives one of their capability to perform tasks that need coordinated movement in the upper limbs. To address issues with upper limb dysfunction, patients typically undergo rehabilitative exercises. Given the high patient to doctor ratio particularly in developing countries like India, conventional rehabilitation with patients undergoing exercises under one-on-one therapist's supervision often becomes a challenge. Thus, investigators are exploring technology such as computer-based platforms coupled with cameras that can alleviate the need for the continuous presence of a therapist and can offer a powerful complementary tool in the hands of the clinicians. Such marker-based imaging systems used for rehabilitation can offer real-time processing and high accuracy of data. However, these systems often require dedicated lab space and high set-up time. Often this is very expensive and suffers from portability issues. Investigators have been exploring marker-less imaging techniques e.g., Kinect integrated computer-based graphical user interfaces in stroke-rehabilitation such as tracking one's limb movement during rehabilitation. In our present study, we have developed a Kinect-assisted computer-based system that offered Human Computer Interaction (HCI) tasks of varying challenge levels. Execution of the tasks required one to use reaching and coordination skills of the upper limbs. Also, the system was Performance-sensitive i.e., adaptive to the individualized residual movement ability of one's upper limb quantified in terms of task performance score. We tested for the usability of our system by exposing 15 healthy participants to our system. Subsequently, seven post-stroke patients interacted with our system over a few sessions spread over 2 weeks. Also, we studied patient's mean tonic activity corresponding to the HCI tasks as a possible indicator of one's post-stroke functional recovery suggesting its potential of our system to serve as a rehabilitation platform. Our results indicate the potential of such systems toward the improvement of task performance capability of post-stroke patients with possibilities of upper limb movement rehabilitation.
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Affiliation(s)
- Adyasha Dash
- Department of Electrical Engineering, Indian Institute of Technology Gandhinagar, Gandhinagar, India
| | - Anand Yadav
- Department of Electrical Engineering, Indian Institute of Technology Gandhinagar, Gandhinagar, India
| | - Anand Chauhan
- Department of Electrical Engineering, Indian Institute of Technology Gandhinagar, Gandhinagar, India
| | - Uttama Lahiri
- Department of Electrical Engineering, Indian Institute of Technology Gandhinagar, Gandhinagar, India
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Promjunyakul NO, Schmit BD, Schindler-Ivens SM. A novel fMRI paradigm suggests that pedaling-related brain activation is altered after stroke. Front Hum Neurosci 2015; 9:324. [PMID: 26089789 PMCID: PMC4454878 DOI: 10.3389/fnhum.2015.00324] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 05/20/2015] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to examine the feasibility of using functional magnetic resonance imaging (fMRI) to measure pedaling-related brain activation in individuals with stroke and age-matched controls. We also sought to identify stroke-related changes in brain activation associated with pedaling. Fourteen stroke and 12 control subjects were asked to pedal a custom, MRI-compatible device during fMRI. Subjects also performed lower limb tapping to localize brain regions involved in lower limb movement. All stroke and control subjects were able to pedal while positioned for fMRI. Two control subjects were withdrawn due to claustrophobia, and one control data set was excluded from analysis due to an incidental finding. In the stroke group, one subject was unable to enter the gantry due to excess adiposity, and one stroke data set was excluded from analysis due to excessive head motion. Consequently, 81% of subjects (12/14 stroke, 9/12 control) completed all procedures and provided valid pedaling-related fMRI data. In these subjects, head motion was ≤3 mm. In both groups, brain activation localized to the medial aspect of M1, S1, and Brodmann's area 6 (BA6) and to the cerebellum (vermis, lobules IV, V, VIII). The location of brain activation was consistent with leg areas. Pedaling-related brain activation was apparent on both sides of the brain, with values for laterality index (LI) of -0.06 (0.20) in the stroke cortex, 0.05 (±0.06) in the control cortex, 0.29 (0.33) in the stroke cerebellum, and 0.04 (0.15) in the control cerebellum. In the stroke group, activation in the cerebellum - but not cortex - was significantly lateralized toward the damaged side of the brain (p = 0.01). The volume of pedaling-related brain activation was smaller in stroke as compared to control subjects. Differences reached statistical significance when all active regions were examined together [p = 0.03; 27,694 (9,608) μL stroke; 37,819 (9,169) μL control]. When individual regions were examined separately, reduced brain activation volume reached statistical significance in BA6 [p = 0.04; 4,350 (2,347) μL stroke; 6,938 (3,134) μL control] and cerebellum [p = 0.001; 4,591 (1,757) μL stroke; 8,381 (2,835) μL control]. Regardless of whether activated regions were examined together or separately, there were no significant between-group differences in brain activation intensity [p = 0.17; 1.30 (0.25)% stroke; 1.16 (0.20)% control]. Reduced volume in the stroke group was not observed during lower limb tapping and could not be fully attributed to differences in head motion or movement rate. There was a tendency for pedaling-related brain activation volume to increase with increasing work performed by the paretic limb during pedaling (p = 0.08, r = 0.525). Hence, the results of this study provide two original and important contributions. First, we demonstrated that pedaling can be used with fMRI to examine brain activation associated with lower limb movement in people with stroke. Unlike previous lower limb movements examined with fMRI, pedaling involves continuous, reciprocal, multijoint movement of both limbs. In this respect, pedaling has many characteristics of functional lower limb movements, such as walking. Thus, the importance of our contribution lies in the establishment of a novel paradigm that can be used to understand how the brain adapts to stroke to produce functional lower limb movements. Second, preliminary observations suggest that brain activation volume is reduced during pedaling post-stroke. Reduced brain activation volume may be due to anatomic, physiology, and/or behavioral differences between groups, but methodological issues cannot be excluded. Importantly, brain action volume post-stroke was both task-dependent and mutable, which suggests that it could be modified through rehabilitation. Future work will explore these possibilities.
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Affiliation(s)
- Nutta-On Promjunyakul
- Department of Physical Therapy, Marquette University Milwaukee, WI, USA ; Department of Biomedical Engineering, Marquette University Milwaukee, WI, USA
| | - Brian D Schmit
- Department of Biomedical Engineering, Marquette University Milwaukee, WI, USA ; Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin Milwaukee, WI, USA
| | - Sheila M Schindler-Ivens
- Department of Physical Therapy, Marquette University Milwaukee, WI, USA ; Department of Biomedical Engineering, Marquette University Milwaukee, WI, USA ; Clinical and Translational Science Institute of Southeastern Wisconsin, Medical College of Wisconsin Milwaukee, WI, USA
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Meier ML, Hotz-Boendermaker S, Boendermaker B, Luechinger R, Humphreys BK. Neural responses of posterior to anterior movement on lumbar vertebrae: a functional magnetic resonance imaging study. J Manipulative Physiol Ther 2013; 37:32-41. [PMID: 24229849 DOI: 10.1016/j.jmpt.2013.09.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Revised: 09/05/2013] [Accepted: 09/22/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The purpose of this study was to develop and test a clinically relevant method to mechanically stimulate lumbar functional spinal units while recording brain activity by means of functional magnetic resonance imaging (MRI). METHODS Subjects were investigated in the prone position with their face lying on a modified stabilization pillow. To minimize head motion, the pillow was fixed to the MRI headrest, and supporting straps were attached around the shoulders. An experienced manual therapist applied controlled, nonpainful pressure stimuli to 10 healthy subjects at 3 different lumbar vertebrae (L1, L3, and L5). Pressure applied to the thumb was used as a control. The stimulation consisted of posterior to anterior (PA) pressure movement. The therapist followed a randomized stimulation protocol projected onto a screen in the MRI room. Blood oxygenation level-dependent responses were analyzed in relation to the lumbar and the thumb stimulations. The study was conducted by the Chiropractic Department, Faculty of Medicine, University of Zürich, Switzerland. RESULTS No participant reported any discomfort due to the prone-lying position or use of the pillow. Importantly, PA-induced pressure produced only minimal head movements. Stimulation of the lumbar spinous processes revealed bilateral neural responses in medial parts of the postcentral gyrus (S1). Additional activity was observed in the secondary somatosensory cortex (S2), posterior parts of the insular cortex, different parts of the cingulate cortex, and the cerebellum. Thumb stimulations revealed activation only in lateral parts of the contralateral S1. CONCLUSION The current study demonstrates the feasibility of the application of PA pressure on lumbar spinous processes in an MRI environment. This approach may serve as a promising tool for further investigations regarding neuroplastic changes in chronic low back pain subjects.
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Affiliation(s)
- Michael L Meier
- Research Associate, Chiropractic Department, Faculty of Medicine, University of Zürich, Zürich, Switzerland.
| | - Sabina Hotz-Boendermaker
- Research Associate, Chiropractic Department, Faculty of Medicine, University of Zürich, Zürich, Switzerland
| | - Bart Boendermaker
- Manual Therapist, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussel, Belgium
| | - Roger Luechinger
- Physicist, Institute of Biomedical Engineering, Swiss Federal Institute of Technology and the University of Zurich, Zürich, Switzerland
| | - Barry Kim Humphreys
- Professor, Chiropractic Department, Faculty of Medicine, University of Zürich, Zürich, Switzerland
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Macintosh BJ, Graham SJ. Magnetic resonance imaging to visualize stroke and characterize stroke recovery: a review. Front Neurol 2013; 4:60. [PMID: 23750149 PMCID: PMC3664317 DOI: 10.3389/fneur.2013.00060] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 05/09/2013] [Indexed: 11/21/2022] Open
Abstract
The global burden of stroke continues to grow. Although stroke prevention strategies (e.g., medications, diet, and exercise) can contribute to risk reduction, options for acute interventions (e.g., thrombolytic therapy for ischemic stroke) are limited to the minority of patients. The remaining patients are often left with profound neurological disabilities that substantially impact quality of life, economic productivity, and increase caregiver burden. In the last decade, however, the future outlook for such patients has been tempered by movement toward the view that the brain is capable of reorganizing after injury. Many now view brain recovery after stroke as an area of scientific research with large potential for therapeutic advances, far into the future (Broderick and William, 2004). As a probe of brain anatomy, function and physiology, magnetic resonance imaging (MRI) is a non-invasive and highly versatile modality that promises to play a particularly important role in such research. Here we provide a basic review of MRI physical principles and applications for assessing stroke, looking toward the future role MRI may play in improving stroke rehabilitation methods and stroke recovery.
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Affiliation(s)
- Bradley J Macintosh
- Physical Sciences Platform, Sunnybrook Research Institute Toronto, ON, Canada ; Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Research Institute Toronto, ON, Canada ; Department of Medical Biophysics, University of Toronto Toronto, ON, Canada
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Christodoulou AG, Bauer TE, Kiehl KA, Feldstein Ewing SW, Bryan AD, Calhoun VD. A quality control method for detecting and suppressing uncorrected residual motion in fMRI studies. Magn Reson Imaging 2013; 31:707-17. [PMID: 23290482 DOI: 10.1016/j.mri.2012.11.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Revised: 08/03/2012] [Accepted: 11/09/2012] [Indexed: 11/26/2022]
Abstract
Motion correction is an important step in the functional magnetic resonance imaging (fMRI) analysis pipeline. While many studies simply exclude subjects who are estimated to have moved beyond an arbitrary threshold, there exists no objective method for determining an appropriate threshold. Furthermore, any criterion based only upon motion estimation ignores the potential for proper realignment. The method proposed here uses unsupervised learning (specifically k-means clustering) on features derived from the mean square derivative (MSD) of the signal before and after realignment to identify problem data. These classifications are refined through analysis of correlation between subject activation maps and the mean activation map, as well as the relationship between tasking and motion as measured through regression of the canonical hemodynamic response functions to fit both estimated motion parameters and MSD. The MSD is further used to identify specific scans containing residual motion, data which is suppressed by adding nuisance regressors to the general linear model; this statistical suppression is performed for identified problem subjects, but has potential for use over all subjects. For problem subjects, our results show increased hemodynamic activity more consistent with group results; that is, the addition of nuisance regressors resulted in a doubling of the correlation between the activation map for the problem subjects and the activation map for all subjects. The proposed method should be useful in helping fMRI researchers make more efficient use of their data by reducing the need to exclude entire subjects from studies and thus collect new data to replace excluded subjects.
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Page SJ, Schmid A, Harris JE. Optimizing terminology for stroke motor rehabilitation: recommendations from the American Congress of Rehabilitation Medicine Stroke Movement Interventions Subcommittee. Arch Phys Med Rehabil 2012; 93:1395-9. [PMID: 22446292 DOI: 10.1016/j.apmr.2012.03.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Revised: 03/02/2012] [Accepted: 03/09/2012] [Indexed: 11/16/2022]
Abstract
As knowledge and interest in stroke motor rehabilitation continue to increase, consistent terminologies that are specific to this discipline must be established. Such language is critical to effective rehabilitative team communication, and is important to facilitating communication among the diverse groups interested in the science and practice of stroke motor rehabilitation. The purpose of this article is to provide operational definitions for 3 concepts that are common-and commonly mislabeled-attributes of stroke motor rehabilitation interventions: intensity, duration, and frequency. In developing these guidelines, conceptual frameworks used in the pharmaceutical, exercise, and rehabilitative therapy realms were used. Implications of these definitions for research and clinical practice are also discussed.
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Affiliation(s)
- Stephen J Page
- School of Allied Medical Professions, and the Neuromotor Recovery and Rehabilitation Laboratory (the RehabLab) at the School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University Medical Center, Columbus, OH 43210, USA.
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Mochizuki G, Hoque T, Mraz R, Macintosh BJ, Graham SJ, Black SE, Staines WR, McIlroy WE. Challenging the brain: Exploring the link between effort and cortical activation. Brain Res 2009; 1301:9-19. [PMID: 19747900 PMCID: PMC4896806 DOI: 10.1016/j.brainres.2009.09.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2009] [Revised: 09/02/2009] [Accepted: 09/03/2009] [Indexed: 11/18/2022]
Abstract
To better understand the contributions of effort on cortical activation associated with motor tasks, healthy participants with varying capacities for isolating the control of individual finger movements performed tasks consisting of a single concurrent abduction of all digits (Easy) and paired finger abduction with digits 2 and 3 abducted together concurrently with digits 4 and 5 (Hard). Brain activity was inferred from measurement using functional magnetic resonance imaging. Effort was measured physiologically using electrodermal responses (EDR) and subjectively using the Borg scale. On average, the Borg score for the Hard task was significantly higher (p=0.007) than for the Easy task (2.9+/-1.1 vs. 1.4+/-0.7, respectively). Similarly, the average normalized peak-to-peak amplitude of the EDR was significantly higher (p=0.002) for the Hard task than for the Easy task (20.4+/-6.5% vs. 12.1+/-4.9%, respectively). The Hard task produced increases in sensorimotor network activation, including supplementary motor area, premotor, sensorimotor and parietal cortices, cerebellum and thalamus. When the imaging data were subdivided based on Borg score, there was an increase in activation and involvement of additional areas, including extrastriate and prefrontal cortices. Subdividing the data based on EDR amplitude produced greater effects including activation of the premotor and parietal cortices. These results show that the effort required for task performance influences the interpretation of fMRI data. This work establishes understanding and methodology for advancing future studies of the link between effort and motor control, and may be clinically relevant to sensorimotor recovery from neurologic injury.
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Affiliation(s)
- G Mochizuki
- Heart and Stroke Foundation Centre for Stroke Recovery, University of Toronto, Canada.
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