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Huang YS, Wu HK, Chang HH, Lee TC, Huang SY, Chiang JY, Hsu PC, Lo LC. Exploring the pivotal variables of tongue diagnosis between patients with acute ischemic stroke and health participants. J Tradit Complement Med 2022; 12:505-510. [PMID: 36081819 PMCID: PMC9446173 DOI: 10.1016/j.jtcme.2022.04.001] [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: 01/13/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 11/30/2022] Open
Abstract
Background and aim Stroke is a major cause of disability worldwide, and ischemic stroke is the most common type of stroke. The prevention and treatment of ischemic stroke remain a challenge worldwide. Traditional Chinese medicine (TCM) is often sought to provide an alternative therapy for the prevention and rehabilitation intervention of ischemic stroke in Taiwan. Therefore, this study explored the pivotal variables of tongue diagnosis among acute ischemic stroke and healthy participants in middle and older age. Experimental procedure This was a cross-sectional and case-controlled study. Data were collected from 99 patients with acute ischemic stroke and 286 healthy participants who received tongue diagnoses at Changhua Christian Hospital (CCH) from September 1, 2014, to December 31, 2016. Tongue features were extracted using the automatic tongue diagnosis system. Nine tongue features, including tongue shape, tongue color, fur thickness, fur color, saliva, tongue fissures, ecchymoses, teeth marks, and red spots were analyzed. Results and conclusion Objective image analysis techniques were used to identify significant differences in the many tongue features between patients with acute ischemic stroke and individuals without stroke. According to the logistic regression analysis, pale tongue color (OR:5.501, p = 0.001), bluish tongue color (OR:4.249, p = 0.014), ecchymoses (OR:1.058, p < 0.001), and tongue deviation angle (OR:1.218, p < 0.001) were associated with significantly increased odds ratios for acute ischemic stroke. The research revealed that tongue feature abnormalities were significantly related to the occurrence of ischemic stroke. TCM provides a complementary therapy for stroke. ATDS serves as a non-invasive, objective, and reliable tool in TCM. A significantly higher prevalence of abnormal tongue features in acute ischemic stroke. Tongue diagnosis could serve as a feasible predictor of stroke.
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Affiliation(s)
- Yung-Sheng Huang
- School of Chinese Medicine, China Medical University, Taichung, 40402, Taiwan
- Department of Chinese Medicine, YuanRung Hospital, Yuanlin City, Changhua County, 510, Taiwan
| | - Han-Kuei Wu
- School of Post-Baccalaureate Chinese Medicine-Internal Medicine, China Medical University, Taichung, 40402, Taiwan
- Department of Traditional Chinese Medicine, Kuang Tien General Hospital, Taichung, Taiwan
| | - Hen-Hong Chang
- School of Post-Baccalaureate Chinese Medicine-Internal Medicine, China Medical University, Taichung, 40402, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Tsung-Chieh Lee
- Department of Chinese Medicine, Changhua Christian Hospital, Changhua, 500, Taiwan
| | - Sung-Yen Huang
- Department of Chinese Medicine, Changhua Christian Hospital, Changhua, 500, Taiwan
| | - John Y. Chiang
- Department of Computer Science and Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po-Chi Hsu
- School of Chinese Medicine, China Medical University, Taichung, 40402, Taiwan
- Department of Traditional Chinese Medicine, Kuang Tien General Hospital, Taichung, Taiwan
- Corresponding author. School of Chinese Medicine, China Medical University, Taichung, Taiwan.
| | - Lun-Chien Lo
- School of Chinese Medicine, China Medical University, Taichung, 40402, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
- Corresponding author. School of Chinese Medicine, China Medical University, Taichung, Taiwan.
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Ostadabbas S, Housley SN, Sebkhi N, Richards K, Wu D, Zhang Z, Rodriguez MG, Warthen L, Yarbrough C, Belagaje S, Butler AJ, Ghovanloo M. Tongue-controlled robotic rehabilitation: A feasibility study in people with stroke. ACTA ACUST UNITED AC 2017; 53:989-1006. [PMID: 28475207 DOI: 10.1682/jrrd.2015.06.0122] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 01/25/2016] [Indexed: 11/05/2022]
Abstract
Stroke survivors with severe upper limb (UL) impairment face years of therapy to recover function. Robot-assisted therapy (RT) is increasingly used in the field for goal-oriented rehabilitation as a means to improve function in ULs. To be used effectively for wrist and hand therapy, the current RT systems require the patient to have a minimal active range of movement in the UL, and those that do not have active voluntary movement cannot use these systems. We have overcome this limitation by harnessing tongue motion to allow patients to control a robot using synchronous tongue and hand movement. This novel RT device combines a commercially available UL exoskeleton, the Hand Mentor, and our custom-designed Tongue Drive System as its controller. We conducted a proof-of-concept study on six nondisabled participants to evaluate the system usability and a case series on three participants with movement limitations from poststroke hemiparesis. Data from two stroke survivors indicate that for patients with chronic, moderate UL impairment following stroke, a 15-session training regimen resulted in modest decreases in impairment, with functional improvement and improved quality of life. The improvement met the standard of minimal clinically important difference for activities of daily living, mobility, and strength assessments.
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Affiliation(s)
- Sarah Ostadabbas
- Electrical and Computer Engineering Department, Northeastern University, Boston, MA
| | - Stephen N Housley
- School of Nursing & Health Professions, Georgia State University, Atlanta, GA
| | - Nordine Sebkhi
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA
| | - Kimberly Richards
- School of Nursing & Health Professions, Georgia State University, Atlanta, GA
| | - David Wu
- School of Nursing & Health Professions, Georgia State University, Atlanta, GA
| | - Zhenxuan Zhang
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA
| | | | - Lindsey Warthen
- School of Nursing & Health Professions, Georgia State University, Atlanta, GA
| | - Crystal Yarbrough
- School of Nursing & Health Professions, Georgia State University, Atlanta, GA
| | | | - Andrew J Butler
- School of Nursing & Health Professions, Georgia State University, Atlanta, GA.,Department of Physical Therapy, Georgia State University, Atlanta, GA
| | - Maysam Ghovanloo
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA
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Morecraft RJ, Stilwell-Morecraft KS, Solon-Cline KM, Ge J, Darling WG. Cortical innervation of the hypoglossal nucleus in the non-human primate (Macaca mulatta). J Comp Neurol 2014; 522:3456-84. [PMID: 24752643 PMCID: PMC4139435 DOI: 10.1002/cne.23614] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 04/14/2014] [Accepted: 04/15/2014] [Indexed: 01/06/2023]
Abstract
The corticobulbar projection to the hypoglossal nucleus was studied from the frontal, parietal, cingulate, and insular cortices in the rhesus monkey by using high-resolution anterograde tracers and stereology. The hypoglossal nucleus received bilateral input from the face/head region of the primary (M1), ventrolateral pre- (LPMCv), supplementary (M2), rostral cingulate (M3), and caudal cingulate (M4) motor cortices. Additional bilateral corticohypoglossal projections were found from the dorsolateral premotor cortex (LPMCd), ventrolateral proisocortical motor area (ProM), ventrolateral primary somatosensory cortex (S1), rostral insula, and pregenual region of the anterior cingulate gyrus (areas 24/32). Dense terminal projections arose from the ventral region of M1, and moderate projections from LPMCv and rostral part of M2, with considerably fewer hypoglossal projections arising from the other cortical regions. These findings demonstrate that extensive regions of the non-human primate cerebral cortex innervate the hypoglossal nucleus. The widespread and bilateral nature of this corticobulbar connection suggests recovery of tongue movement after cortical injury that compromises a subset of these areas, may occur from spared corticohypoglossal projection areas located on the lateral, as well as medial surfaces of both hemispheres. Since functional imaging studies have shown that homologous cortical areas are activated in humans during tongue movement tasks, these corticobulbar projections may exist in the human brain.
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Affiliation(s)
- Robert J. Morecraft
- Division of Basic Biomedical Sciences, Laboratory of Neurological Sciences, The University of South Dakota, Sanford School of Medicine, Vermillion, South Dakota 57069
| | - Kimberly S. Stilwell-Morecraft
- Division of Basic Biomedical Sciences, Laboratory of Neurological Sciences, The University of South Dakota, Sanford School of Medicine, Vermillion, South Dakota 57069
| | - Kathryn M. Solon-Cline
- Division of Basic Biomedical Sciences, Laboratory of Neurological Sciences, The University of South Dakota, Sanford School of Medicine, Vermillion, South Dakota 57069
| | - Jizhi Ge
- Division of Basic Biomedical Sciences, Laboratory of Neurological Sciences, The University of South Dakota, Sanford School of Medicine, Vermillion, South Dakota 57069
| | - Warren G. Darling
- Department of Health and Human Physiology, Motor Control Laboratories, The University of Iowa, Iowa City, Iowa 52242
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