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Criss CR, Lepley AS, Onate JA, Simon JE, France CR, Clark BC, Grooms DR. Neural Correlates of Self-Reported Knee Function in Individuals After Anterior Cruciate Ligament Reconstruction. Sports Health 2023; 15:52-60. [PMID: 35321615 PMCID: PMC9808834 DOI: 10.1177/19417381221079339] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Anterior cruciate ligament (ACL) rupture is a common knee injury among athletes and physically active adults. Despite surgical reconstruction and extensive rehabilitation, reinjuries are common and disability levels are high, even years after therapy and return to activity. Prolonged knee dysfunction may result in part from unresolved neuromuscular deficits of the surrounding joint musculature in response to injury. Indeed, "upstream" neurological adaptations occurring after injury may explain these persistent functional deficits. Despite evidence for injury consequences extending beyond the joint to the nervous system, the link between neurophysiological impairments and patient-reported measures of knee function remains unclear. HYPOTHESIS Patterns of brain activation for knee control are related to measures of patient-reported knee function in individuals after ACL reconstruction (ACL-R). STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 3. METHODS In this multicenter, cross-sectional study, participants with unilateral ACL-R (n = 25; 10 men, 15 women) underwent task-based functional magnetic resonance imaging testing. Participants performed repeated cycles of open-chain knee flexion/extension. Neural activation patterns during the movement task were quantified using blood oxygen level-dependent (BOLD) signals. Regions of interest were generated using the Juelich Histological Brain Atlas. Pearson product-moment correlations were used to determine the relationship between mean BOLD signal within each brain region and self-reported knee function level, as measured by the International Knee Documentation Committee index. Partial correlations were also calculated after controlling for time from surgery and sex. RESULTS Patient-reported knee function was positively and moderately correlated with the ipsilateral secondary somatosensory cortex (r = 0.57, P = 0.005) and the ipsilateral supplementary motor area (r = 0.51, P = 0.01). CONCLUSION Increased ipsilateral secondary sensorimotor cortical activity is related to higher perceived knee function. CLINICAL RELEVANCE Central nervous system mechanisms for knee control are related to subjective levels of knee function after ACL-R. Increased neural activity may reflect central neuroplastic strategies to preserve knee functionality after traumatic injury.
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Affiliation(s)
- Cody R. Criss
- Translational Biomedical Sciences,
Graduate College, Ohio University, Athens, Ohio
- Ohio Musculoskeletal & Neurological
Institute (OMNI), Ohio University, Athens, Ohio
- Cody R Criss, W283 Grover
Center, 1 Ohio University, Athens, OH 45701 (
) (Twitter: @criss_cody)
| | - Adam S. Lepley
- Exercise and Sport Science Initiative,
School of Kinesiology, University of Michigan, Ann Arbor, Michigan
| | - James A. Onate
- School of Health and Rehabilitation
Sciences, The Ohio State University, Columbus, Ohio
| | - Janet E. Simon
- Ohio Musculoskeletal & Neurological
Institute (OMNI), Ohio University, Athens, Ohio
- Division of Athletic Training, School
of Applied Health Sciences and Wellness, College of Health Sciences and Professions,
Ohio University, Athens, Ohio
| | - Christopher R. France
- Ohio Musculoskeletal & Neurological
Institute (OMNI), Ohio University, Athens, Ohio
- Department of Psychology, College of
Arts and Sciences, Ohio University, Athens, Ohio
| | - Brian C. Clark
- Ohio Musculoskeletal & Neurological
Institute (OMNI), Ohio University, Athens, Ohio
- Department of Biomedical Sciences,
Ohio University, Athens, Ohio
- Department of Geriatric Medicine, Ohio
University, Athens, Ohio
| | - Dustin R. Grooms
- Ohio Musculoskeletal & Neurological
Institute (OMNI), Ohio University, Athens, Ohio
- Division of Athletic Training, School
of Applied Health Sciences and Wellness, College of Health Sciences and Professions,
Ohio University, Athens, Ohio
- Division of Physical Therapy, School
of Rehabilitation and Communication Sciences, College of Health Sciences and
Professions, Ohio University, Athens, Ohio
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Asthana P, Kumar G, Milanowski LM, Au NPB, Chan SC, Huang J, Feng H, Kwan KM, He J, Chan KWY, Wszolek ZK, Ma CHE. Cerebellar glutamatergic system impacts spontaneous motor recovery by regulating Gria1 expression. NPJ Regen Med 2022; 7:45. [PMID: 36064798 PMCID: PMC9445039 DOI: 10.1038/s41536-022-00243-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/12/2022] [Indexed: 11/09/2022] Open
Abstract
Peripheral nerve injury (PNI) often results in spontaneous motor recovery; however, how disrupted cerebellar circuitry affects PNI-associated motor recovery is unknown. Here, we demonstrated disrupted cerebellar circuitry and poor motor recovery in ataxia mice after PNI. This effect was mimicked by deep cerebellar nuclei (DCN) lesion, but not by damaging non-motor area hippocampus. By restoring cerebellar circuitry through DCN stimulation, and reversal of neurotransmitter imbalance using baclofen, ataxia mice achieve full motor recovery after PNI. Mechanistically, elevated glutamate-glutamine level was detected in DCN of ataxia mice by magnetic resonance spectroscopy. Transcriptomic study revealed that Gria1, an ionotropic glutamate receptor, was upregulated in DCN of control mice but failed to be upregulated in ataxia mice after sciatic nerve crush. AAV-mediated overexpression of Gria1 in DCN rescued motor deficits of ataxia mice after PNI. Finally, we found a correlative decrease in human GRIA1 mRNA expression in the cerebellum of patients with ataxia-telangiectasia and spinocerebellar ataxia type 6 patient iPSC-derived Purkinje cells, pointing to the clinical relevance of glutamatergic system. By conducting a large-scale analysis of 9,655,320 patients with ataxia, they failed to recover from carpal tunnel decompression surgery and tibial neuropathy, while aged-match non-ataxia patients fully recovered. Our results provide insight into cerebellar disorders and motor deficits after PNI.
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Affiliation(s)
- Pallavi Asthana
- Department of Neuroscience, City University of Hong Kong, Tat Chee Avenue, Kowloon Tong, Hong Kong SAR
| | - Gajendra Kumar
- Department of Neuroscience, City University of Hong Kong, Tat Chee Avenue, Kowloon Tong, Hong Kong SAR
| | - Lukasz M Milanowski
- Department of Neurology, Mayo Clinic, Jacksonville, USA.,Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
| | - Ngan Pan Bennett Au
- Department of Neuroscience, City University of Hong Kong, Tat Chee Avenue, Kowloon Tong, Hong Kong SAR
| | - Siu Chung Chan
- Department of Neuroscience, City University of Hong Kong, Tat Chee Avenue, Kowloon Tong, Hong Kong SAR
| | - Jianpan Huang
- Department of Biomedical Engineering, City University of Hong Kong, Tat Chee Avenue, Kowloon Tong, Hong Kong SAR
| | - Hemin Feng
- Department of Neuroscience, City University of Hong Kong, Tat Chee Avenue, Kowloon Tong, Hong Kong SAR
| | - Kin Ming Kwan
- School of Life Sciences, Center for Cell and Developmental Biology and State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Jufang He
- Department of Neuroscience, City University of Hong Kong, Tat Chee Avenue, Kowloon Tong, Hong Kong SAR
| | - Kannie Wai Yan Chan
- Department of Biomedical Engineering, City University of Hong Kong, Tat Chee Avenue, Kowloon Tong, Hong Kong SAR.,Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, USA
| | | | - Chi Him Eddie Ma
- Department of Neuroscience, City University of Hong Kong, Tat Chee Avenue, Kowloon Tong, Hong Kong SAR.
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3
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Doshi RM, Reid MY, Dixit NN, Fawcett EB, Cole JH, Saul KR. Location of brachial plexus birth injury affects functional outcomes in a rat model. J Orthop Res 2022; 40:1281-1292. [PMID: 34432311 PMCID: PMC8873217 DOI: 10.1002/jor.25173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/08/2021] [Accepted: 08/16/2021] [Indexed: 02/04/2023]
Abstract
Brachial plexus birth injury (BPBI) results in shoulder and elbow paralysis with shoulder internal rotation and elbow flexion contracture as frequent sequelae. The purpose of this study was to develop a technique for measuring functional movement and examine the effect of brachial plexus injury location (preganglionic and postganglionic) on functional movement outcomes in a rat model of BPBI, which we achieved through integration of gait analysis with musculoskeletal modeling and simulation. Eight weeks following unilateral brachial plexus injury, sagittal plane shoulder and elbow angles were extracted from gait recordings of young rats (n = 18), after which rats were sacrificed for bilateral muscle architecture measurements. Musculoskeletal models reflecting animal-specific muscle architecture parameters were used to simulate gait and extract muscle fiber lengths. The preganglionic neurectomy group spent significantly less (p = 0.00116) time in stance and walked with significantly less (p < 0.05) elbow flexion and shoulder protraction in the affected limb than postganglionic neurectomy or control groups. Linear regression revealed no significant linear relationship between passive shoulder external rotation and functional shoulder protraction range of motion. Despite significant restriction in longitudinal muscle growth, normalized functional fiber excursions did not differ significantly between groups. In fact, when superimposed on a normalized force-length curve, neurectomy-impaired muscle fibers (except subscapularis) accessed regions of the curve that overlapped with the control group. Our results suggest the presence of compensatory motor control strategies during locomotion following BPBI. The clinical implications of our findings support emphasis on functional movement analysis in treatment of BPBI, as functional and passive outcomes may differ substantially.
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Affiliation(s)
- Raveena M. Doshi
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC
| | - Monique Y. Reid
- Joint Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC and North Carolina State University, Raleigh, NC
| | - Nikhil N. Dixit
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC
| | - Emily B. Fawcett
- Joint Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC and North Carolina State University, Raleigh, NC
| | - Jacqueline H. Cole
- Joint Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC and North Carolina State University, Raleigh, NC
| | - Katherine R. Saul
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC
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Ghai S, Maso FD, Ogourtsova T, Porxas AX, Villeneuve M, Penhune V, Boudrias MH, Baillet S, Lamontagne A. Neurophysiological Changes Induced by Music-Supported Therapy for Recovering Upper Extremity Function after Stroke: A Case Series. Brain Sci 2021; 11:brainsci11050666. [PMID: 34065395 PMCID: PMC8161385 DOI: 10.3390/brainsci11050666] [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: 03/29/2021] [Revised: 05/12/2021] [Accepted: 05/17/2021] [Indexed: 12/30/2022] Open
Abstract
Music-supported therapy (MST) follows the best practice principles of stroke rehabilitation and has been proven to instigate meaningful enhancements in motor recovery post-stroke. The existing literature has established that the efficacy and specificity of MST relies on the reinforcement of auditory-motor functional connectivity in related brain networks. However, to date, no study has attempted to evaluate the underlying cortical network nodes that are key to the efficacy of MST post-stroke. In this case series, we evaluated changes in connectivity within the auditory-motor network and changes in upper extremity function following a 3-week intensive piano training in two stroke survivors presenting different levels of motor impairment. Connectivity was assessed pre- and post-training in the α- and the β-bands within the auditory-motor network using magnetoencephalography while participants were passively listening to a standardized melody. Changes in manual dexterity, grip strength, movement coordination, and use of the upper extremity were also documented in both stroke survivors. After training, an increase in the clinical measures was accompanied by enhancements in connectivity between the auditory and motor network nodes for both the α- and the β-bands, especially in the affected hemisphere. These neurophysiological changes associated with the positive effects of post-stroke MST on motor outcomes delineate a path for a larger scale clinical trial.
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Affiliation(s)
- Shashank Ghai
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada; (T.O.); (M.-H.B.); (A.L.)
- Feil & Oberfeld Research Centre of the Jewish Rehabilitation Hospital–CISSS Laval, A Research Site of the Centre for Interdisciplinary Research of Greater Montreal (CRIR), Laval, QC H7V 1R2, Canada;
- Correspondence:
| | - Fabien Dal Maso
- Laboratory of Simulation and Movement Modelling, School of Kinesiology and Physical Activity, Université de Montréal, Montreal, QC H3T 1J4, Canada;
- Centre Interdisciplinaire de Recherche sur le Cerveau et l’Apprentissage, Montréal, QC H7N 0A5, Canada
| | - Tatiana Ogourtsova
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada; (T.O.); (M.-H.B.); (A.L.)
- Feil & Oberfeld Research Centre of the Jewish Rehabilitation Hospital–CISSS Laval, A Research Site of the Centre for Interdisciplinary Research of Greater Montreal (CRIR), Laval, QC H7V 1R2, Canada;
| | - Alba-Xifra Porxas
- Graduate Program in Biological and Biomedical Engineering, McGill University, Montreal, QC H3A 0C3, Canada;
| | - Myriam Villeneuve
- Feil & Oberfeld Research Centre of the Jewish Rehabilitation Hospital–CISSS Laval, A Research Site of the Centre for Interdisciplinary Research of Greater Montreal (CRIR), Laval, QC H7V 1R2, Canada;
| | - Virginia Penhune
- Department of Psychology, Concordia University, Montreal, QC H3G 1M8, Canada;
- Laboratory for Brain Music and Sound (BRAMS), Centre for Research in Brain, Language and Music, Montreal, QC H2V 2S9, Canada
| | - Marie-Hélène Boudrias
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada; (T.O.); (M.-H.B.); (A.L.)
- Feil & Oberfeld Research Centre of the Jewish Rehabilitation Hospital–CISSS Laval, A Research Site of the Centre for Interdisciplinary Research of Greater Montreal (CRIR), Laval, QC H7V 1R2, Canada;
| | - Sylvain Baillet
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada;
| | - Anouk Lamontagne
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada; (T.O.); (M.-H.B.); (A.L.)
- Feil & Oberfeld Research Centre of the Jewish Rehabilitation Hospital–CISSS Laval, A Research Site of the Centre for Interdisciplinary Research of Greater Montreal (CRIR), Laval, QC H7V 1R2, Canada;
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Socolovsky M, Malessy M. Brain changes after peripheral nerve repair: limitations of neuroplasticity. J Neurosurg Sci 2021; 65:421-430. [PMID: 33709667 DOI: 10.23736/s0390-5616.21.05298-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Neuroplasticity is the capacity of the central nervous system to adapt to external or internal stimuli. It is being increasingly recognized as an important factor which contributes to the successful outcome of nerve transfers. Other much more well-known factors are the number of axons that cross the coaptation site, the interval between trauma and repair, and age. Neuroplasticity is mediated by synaptic and neurotransmitter changes which underlie activation of previously existing but low-active connections in the brain. Dendritic sprouting and axonal elongation might also take place, but is likely less prominent. We review different factors that play a role in neuroplasticity and functional regeneration after specific nerve transfers. These factors include, amongst others, the distance between cortical areas of the donor and receptor neurons; the presence versus absence of pre-existing low-active inter-neuronal connections; gross versus fine movement restoration; rehabilitation; brain trauma and also very important: the age. The potential for plastic adaptation should be taken into consideration if the surgical strategy and post-operative rehabilitation are planned, as its influence on results cannot be denied.
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Affiliation(s)
- Mariano Socolovsky
- Peripheral Nerve & Plexus Surgery Unit, University of Buenos Aires School of Medicine, Buenos Aires, Argentina -
| | - Martijn Malessy
- Department of Neurosurgery, University of Leiden Medical Center, Leiden, the Netherlands
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6
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Li C, Liu SY, Pi W, Zhang PX. Cortical plasticity and nerve regeneration after peripheral nerve injury. Neural Regen Res 2021; 16:1518-1523. [PMID: 33433465 PMCID: PMC8323687 DOI: 10.4103/1673-5374.303008] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
With the development of neuroscience, substantial advances have been achieved in peripheral nerve regeneration over the past decades. However, peripheral nerve injury remains a critical public health problem because of the subsequent impairment or absence of sensorimotor function. Uncomfortable complications of peripheral nerve injury, such as chronic pain, can also cause problems for families and society. A number of studies have demonstrated that the proper functioning of the nervous system depends not only on a complete connection from the central nervous system to the surrounding targets at an anatomical level, but also on the continuous bilateral communication between the two. After peripheral nerve injury, the interruption of afferent and efferent signals can cause complex pathophysiological changes, including neurochemical alterations, modifications in the adaptability of excitatory and inhibitory neurons, and the reorganization of somatosensory and motor regions. This review discusses the close relationship between the cerebral cortex and peripheral nerves. We also focus on common therapies for peripheral nerve injury and summarize their potential mechanisms in relation to cortical plasticity. It has been suggested that cortical plasticity may be important for improving functional recovery after peripheral nerve damage. Further understanding of the potential common mechanisms between cortical reorganization and nerve injury will help to elucidate the pathophysiological processes of nerve injury, and may allow for the reduction of adverse consequences during peripheral nerve injury recovery. We also review the role that regulating reorganization mechanisms plays in functional recovery, and conclude with a suggestion to target cortical plasticity along with therapeutic interventions to promote peripheral nerve injury recovery.
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Affiliation(s)
- Ci Li
- Department of Orthopedics and Trauma, Peking University People's Hospital; Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing, China
| | - Song-Yang Liu
- Department of Orthopedics and Trauma, Peking University People's Hospital; Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing, China
| | - Wei Pi
- Department of Orthopedics and Trauma, Peking University People's Hospital; Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing, China
| | - Pei-Xun Zhang
- Department of Orthopedics and Trauma, Peking University People's Hospital; Key Laboratory of Trauma and Neural Regeneration, Peking University; National Center for Trauma Medicine, Beijing, China
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7
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Courson M, Tremblay P. Neural correlates of manual action language: Comparative review, ALE meta-analysis and ROI meta-analysis. Neurosci Biobehav Rev 2020; 116:221-238. [DOI: 10.1016/j.neubiorev.2020.06.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 03/30/2020] [Accepted: 06/18/2020] [Indexed: 10/24/2022]
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Xing XX, Hua XY, Zheng MX, Ma ZZ, Huo BB, Wu JJ, Ma SJ, Ma J, Xu JG. Intra and inter: Alterations in functional brain resting-state networks after peripheral nerve injury. Brain Behav 2020; 10:e01747. [PMID: 32657022 PMCID: PMC7507705 DOI: 10.1002/brb3.1747] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 05/18/2020] [Accepted: 06/04/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Numerous treatments suggest that brain plasticity changes after peripheral nerve injury (PNI), and most studies examining functional magnetic resonance imaging focused on abnormal changes in specific brain regions. However, it is the large-scale interaction of neuronal networks instead of isolated brain regions contributed to the functional recovery after PNI. In the present study, we examined the intra- and internetworks alterations between the related functional resting-state networks (RSNs) in a sciatic nerve injury rat model. METHODS Ninety-six female rats were divided into a control and model group. Unilateral sciatic nerve transection and direct anastomosis were performed in the latter group. We used an independent component analysis (ICA) algorithm to observe the changes in RSNs and assessed functional connectivity between different networks using the functional networks connectivity (FNC) toolbox. RESULTS Six RSNs related to PNI were identified, including the basal ganglia network (BGN), sensorimotor network (SMN), salience network (SN), interoceptive network (IN), cerebellar network (CN), and default mode network (DMN). The model group showed significant changes in whole-brain FC changes within these resting-state networks (RSNs), but four of these RSNs exhibited a conspicuous decrease. The interalterations performed that significantly decreased FNC existed between the BGN and SMN, BGN and IN, and BGN and DMN (p < .05, corrected). A significant increase in FNC existed between DMN and CN and between CN and SN (p < .05, corrected). CONCLUSION The results showed the large-scale functional reorganization at the network level after PNI. This evidence reveals new implications to the pathophysiological mechanisms in brain plasticity of PNI.
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Affiliation(s)
- Xiang-Xin Xing
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xu-Yun Hua
- Department of Traumatology and Orthopedics, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Yangzhi Rehabilitation Hospital, Tongji University, Shanghai, China
| | - Mou-Xiong Zheng
- Department of Traumatology and Orthopedics, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhen-Zhen Ma
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bei-Bei Huo
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jia-Jia Wu
- Center of Rehabilitation Medicine, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shu-Jie Ma
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jie Ma
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jian-Guang Xu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Center of Rehabilitation Medicine, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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9
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Longo E, Nishiyori R, Cruz T, Alter K, Damiano DL. Obstetric Brachial Plexus Palsy: Can a Unilateral Birth Onset Peripheral Injury Significantly Affect Brain Development? Dev Neurorehabil 2020; 23:375-382. [PMID: 31906763 PMCID: PMC7550966 DOI: 10.1080/17518423.2019.1689437] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 11/02/2019] [Indexed: 01/15/2023]
Abstract
Purpose: Examine brain structure and function in OBPP and relate to clinical outcomes to better understand the effects of decreased motor activity on early brain development. Methods: 9 OBPP, 7 controls underwent structural MRI scans. OBPP group completed evaluations of upper-limb function and functional near-infrared spectroscopy (fNIRS) during motor tasks. Results: Mean primary motor area volume was lower in both OBPP hemispheres. No volume differences across sides seen within groups; however, Asymmetry Ratio in supplementary motor area differed between groups. Greater asymmetry in primary somatosensory area correlated with lower ABILHAND-Kids scores. fNIRS revealed more cortical activity in both hemispheres during affected arm reach. Conclusion: Cortical volume differences or asymmetry were found in motor and sensory regions in OBPP that related to clinical outcomes. Widespread cortical activity in fNIRS during affected arm reach suggests reorganization in both hemispheres and is relevant to rehabilitation of those with developmental peripheral and brain injuries.
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Affiliation(s)
- Egmar Longo
- Federal University of Rio Grande do Norte/Faculty of Health Sciences of Trairi - UFRN/FACISA, Health of Children, Santa Cruz, Brazil
| | - Ryota Nishiyori
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, US
| | - Theresa Cruz
- National Center for Medical Rehabilitation Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, US
| | - Katharine Alter
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, US
| | - Diane L. Damiano
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, US
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10
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Ma J, Hua XY, Zheng MX, Wu JJ, Huo BB, Xing XX, Ding W, Xu JG. Spatial patterns of intrinsic brain activity and functional connectivity in facial synkinesis patients. Br J Neurosurg 2020; 35:730-735. [PMID: 32500814 DOI: 10.1080/02688697.2020.1773396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Objectives: As one of the most objectionable sequelae of facial paralysis, patients with facial synkinesis are more likely to be depressed and have lower quality of life than other facial paralysis patients. However, there is no research on the spatial patterns of intrinsic brain activity and functional connectivity in these patients. The objective of this study was to investigate the spatial patterns and cerebral plasticity of facial synkinesis patients.Methods: A total of 20 facial synkinesis patients (18 men and 2 women; mean age: 33.35 ± 6.97 years old) and 19 healthy controls (17 men and 2 women; mean age: 33.21 ± 6.75 years old) were enrolled in this study. resting-state functional magnetic resonance imaging (rs-fMRI) data were collected, and the amplitude of low frequency fluctuation (ALFF), regional homogeneity (ReHo), and degree centrality (DC) were calculated for each participant. Two-sample t-tests were performed to compare the ALFF, ReHo, and DC maps between the two groups.Results: Compared with the healthy controls, facial synkinesis patients exhibited decreased ALFF in the fusiform gyrus, lingual gyrus, parahippocampal gyrus, triangular inferior frontal gyrus, precentral gyrus, postcentral gyrus, cingulate gyrus, superior frontal gyrus, precuneus, caudate nucleus and thalamus; decreased ReHo in the cingulate gyrus, superior frontal gyrus, insula, superior temporal gyrus, orbital middle frontal gyrus, caudate nucleus and thalamus; and decreased DC in the frontal lobe, insula, cingulate gyrus, superior temporal gyrus, lenticular putamen, hippocampus and parahippocampal gyrus. We found significant overlap in the superior frontal gyrus across the ALFF, ReHo and DC analyses.Conclusions: In facial synkinesis patients, the neurological activity in brain areas is reduced and the local synchronization in motion-related brain regions is decreased. The superior frontal gyrus could be a crucial region in the unique spatial patterns of intrinsic brain activity and functional connectivity in these patients.
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Affiliation(s)
- Jie Ma
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xu-Yun Hua
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Department of Traumatology and Orthopedics, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Rehabilitation Section, Spine Surgery Division of Department of Orthopedics, Tongji Hospital, Affiliated to Tongji University School of Medicine, Shanghai, China.,Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education of the People's Republic of China, Tongji University, Shanghai, China
| | - Mou-Xiong Zheng
- Department of Traumatology and Orthopedics, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jia-Jia Wu
- Center of Rehabilitation Medicine, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bei-Bei Huo
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiang-Xin Xing
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei Ding
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jian-Guang Xu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Center of Rehabilitation Medicine, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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11
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Zink PJ, Philip BA. Cortical Plasticity in Rehabilitation for Upper Extremity Peripheral Nerve Injury: A Scoping Review. Am J Occup Ther 2020; 74:7401205030p1-7401205030p15. [PMID: 32078514 DOI: 10.5014/ajot.2020.036665] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
IMPORTANCE Poor outcomes after upper extremity peripheral nerve injury (PNI) may arise, in part, from the challenges and complexities of cortical plasticity. Occupational therapy practitioners need to understand how the brain changes after peripheral injury and how principles of cortical plasticity can be applied to improve rehabilitation for clients with PNI. OBJECTIVE To identify the mechanisms of cortical plasticity after PNI and describe how cortical plasticity can contribute to rehabilitation. DATA SOURCES PubMed and Embase (1900-2017) were searched for articles that addressed either (1) the relationship between PNI and cortical plasticity or (2) rehabilitative interventions based on cortical plastic changes after PNI. Study Selection and Data Collectio : PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Articles were selected if they addressed all of the following concepts: human PNI, cortical plasticity, and rehabilitation. Phantom limb pain and sensation were excluded. FINDINGS Sixty-three articles met the study criteria. The most common evidence level was Level V (46%). We identified four commonly studied mechanisms of cortical plasticity after PNI and the functional implications for each. We found seven rehabilitative interventions based on cortical plasticity: traditional sensory reeducation, activity-based sensory reeducation, selective deafferentation, cross-modal sensory substitution, mirror therapy, mental motor imagery, and action observation with simultaneous peripheral nerve stimulation. CONCLUSION AND RELEVANCE The seven interventions ranged from theoretically well justified (traditional and activity-based sensory reeducation) to unjustified (selective deafferentation). Overall, articles were heterogeneous and of low quality, and future research should prioritize randomized controlled trials for specific neuropathies, interventions, or cortical plasticity mechanisms. WHAT THIS ARTICLE ADDS This article reviews current knowledge about how the brain changes after PNI and how occupational therapy practitioners can take advantage of those changes for rehabilitation.
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Affiliation(s)
- Patrick J Zink
- Patrick J. Zink, MSOT, is Occupational Therapist, Select Physical Therapy, Kansas City, MO. At the time of the study, he was Student, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO
| | - Benjamin A Philip
- Benjamin A. Philip, PhD, is Assistant Professor, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO;
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Meyers EC, Kasliwal N, Solorzano BR, Lai E, Bendale G, Berry A, Ganzer PD, Romero-Ortega M, Rennaker RL, Kilgard MP, Hays SA. Enhancing plasticity in central networks improves motor and sensory recovery after nerve damage. Nat Commun 2019; 10:5782. [PMID: 31857587 PMCID: PMC6923364 DOI: 10.1038/s41467-019-13695-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 11/08/2019] [Indexed: 12/11/2022] Open
Abstract
Nerve damage can cause chronic, debilitating problems including loss of motor control and paresthesia, and generates maladaptive neuroplasticity as central networks attempt to compensate for the loss of peripheral connectivity. However, it remains unclear if this is a critical feature responsible for the expression of symptoms. Here, we use brief bursts of closed-loop vagus nerve stimulation (CL-VNS) delivered during rehabilitation to reverse the aberrant central plasticity resulting from forelimb nerve transection. CL-VNS therapy drives extensive synaptic reorganization in central networks paralleled by improved sensorimotor recovery without any observable changes in the nerve or muscle. Depleting cortical acetylcholine blocks the plasticity-enhancing effects of CL-VNS and consequently eliminates recovery, indicating a critical role for brain circuits in recovery. These findings demonstrate that manipulations to enhance central plasticity can improve sensorimotor recovery and define CL-VNS as a readily translatable therapy to restore function after nerve damage. Peripheral nerve damage generates maladaptive neuroplasticity as central networks attempt to compensate for the loss of peripheral connectivity. Here, the authors reverse the aberrant plasticity via vagus nerve stimulation to elicit synaptic reorganization and to improve sensorimotor recovery.
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Affiliation(s)
- Eric C Meyers
- Texas Biomedical Device Center, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA.
| | - Nimit Kasliwal
- Texas Biomedical Device Center, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA
| | - Bleyda R Solorzano
- Texas Biomedical Device Center, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA
| | - Elaine Lai
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA
| | - Geetanjali Bendale
- Department of Bioengineering, Erik Jonsson School of Engineering and Computer Science, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA
| | - Abigail Berry
- Texas Biomedical Device Center, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA
| | - Patrick D Ganzer
- Texas Biomedical Device Center, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA
| | - Mario Romero-Ortega
- Texas Biomedical Device Center, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA.,School of Behavioral and Brain Sciences, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA.,Department of Bioengineering, Erik Jonsson School of Engineering and Computer Science, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA
| | - Robert L Rennaker
- Texas Biomedical Device Center, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA.,School of Behavioral and Brain Sciences, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA.,Department of Bioengineering, Erik Jonsson School of Engineering and Computer Science, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA
| | - Michael P Kilgard
- Texas Biomedical Device Center, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA.,School of Behavioral and Brain Sciences, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA.,Department of Bioengineering, Erik Jonsson School of Engineering and Computer Science, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA
| | - Seth A Hays
- Texas Biomedical Device Center, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA.,School of Behavioral and Brain Sciences, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA.,Department of Bioengineering, Erik Jonsson School of Engineering and Computer Science, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080-3021, USA
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13
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Long-term disuse of the hand affects motor imagery ability in patients with complete brachial plexus palsy. Neuroreport 2019; 30:452-456. [PMID: 30855560 DOI: 10.1097/wnr.0000000000001229] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to examine motor imagery ability in patients with peripheral nerve disorder using the hand mental rotation task. Five patients with left total avulsion brachial plexus palsy (BPP) and 16 healthy age-matched adults participated in this study. The mean±SD time from the injury was 103.6±49.7 months. Participants performed a hand mental rotation task as the motor imagery task; outcome measures included the reaction time from cognizing hand stimuli to the judgment of hand laterality (right or left) and the error rate. Patients also completed the Hand 20 questionnaire to assess the use of their affected limb. Log-transformed reaction times of the affected limb in patients with BPP were significantly higher than those of the unaffected limb and the left-sided limb of the healthy participants. Log-transformed reaction times of the unaffected limb in patients were significantly higher than those of the right-sided limb in healthy participants. Log-transformed error rate did not differ between patients and healthy participants. According to the results of the Hand 20 questionnaire, patients with BPP hardly used their affected limb because of severe sensory-motor dysfunction. Motor imagery ability of the affected and unaffected limbs in patients with complete BPP may be decreased owing to long-term disuse. These findings suggest that long-term disuse in those with severe peripheral nerve disorders could affect motor imagery ability of both the affected and unaffected limbs.
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Kou YH, Jiang BG, Yu F, Yu YL, Niu SP, Zhang PX, Yin XF, Han N, Zhang YJ, Zhang DY. Repair of long segmental ulnar nerve defects in rats by several different kinds of nerve transposition. Neural Regen Res 2019; 14:692-698. [PMID: 30632510 PMCID: PMC6352591 DOI: 10.4103/1673-5374.247473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Multiple regeneration of axonal buds has been shown to exist during the repair of peripheral nerve injury, which confirms a certain repair potential of the injured peripheral nerve. Therefore, a systematic nerve transposition repair technique has been proposed to treat severe peripheral nerve injury. During nerve transposition repair, the regenerated nerve fibers of motor neurons in the anterior horn of the spinal cord can effectively grow into the repaired distal nerve and target muscle tissues, which is conducive to the recovery of motor function. The aim of this study was to explore regeneration and nerve functional recovery after repairing a long-segment peripheral nerve defect by transposition of different donor nerves. A long-segment (2 mm) ulnar nerve defect in Sprague-Dawley rats was repaired by transposition of the musculocutaneous nerve, medial pectoral nerve, muscular branches of the radial nerve and anterior interosseous nerve (pronator quadratus muscle branch). In situ repair of the ulnar nerve was considered as a control. Three months later, wrist flexion function, nerve regeneration and innervation muscle recovery in rats were assessed using neuroelectrophysiological testing, osmic acid staining and hematoxylin-eosin staining, respectively. Our findings indicate that repair of a long-segment ulnar nerve defect with different donor nerve transpositions can reinnervate axonal function of motor neurons in the anterior horn of spinal cord and restore the function of affected limbs to a certain extent.
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Xi SD, Zhu YL, Chen C, Liu HQ, Wang WW, Li F. The plasticity of the corticospinal tract in children with obstetric brachial plexus palsy after Botulinum Toxin A treatment. J Neurol Sci 2018; 394:19-25. [PMID: 30196131 DOI: 10.1016/j.jns.2018.08.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 08/11/2018] [Accepted: 08/27/2018] [Indexed: 12/13/2022]
Abstract
Botulinum neurotoxin A (BTX-A) intervention has long-term benefits for children with obstetric brachial plexus palsy (OBPP). Although cortical plasticity has been widely studied, plasticity in white matter has not received as much attention. Here, six children with OBPP underwent functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) before and 6 months after BTX-A treatment. Surface electromyography (EMG) was recorded. The aim was to investigate changes in the corticospinal tract (CST) as an example longitudinal observation of white matter plasticity. Deterministic fiber tracking with a Fiber Assignment by Continuous Tracking algorithm was used to reconstruct the CST. Fiber tracts passing through a region of interest (ROI) in the posterior limb of the internal capsule and a target ROI in the upper-limb representation of M1 (defined by task-related fMRI) were selected as the CST. Motor performances were improved while EMG showed no significant difference 6 months after the treatment. We observed a significant increase in mean fractional anisotropy and a significant decrease in fiber number after treatment. We analyzed the correlations between DTI metrics and clinical motor assessments. Although the correlation results were not statistically significant, they support the notion that BTX-A treatment causes white matter plasticity and has a positive long-term outcome. Peripheral deafferentation may lead to altered information flow, resulting in the positive adaptation of white matter. This study provides novel insight into cerebral plasticity following peripheral nerve regeneration and indicates that a combination of relatively non-invasive therapies can accelerate plasticity of sensorimotor circuits and promote functional recovery in OBPP.
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Affiliation(s)
- Si-da Xi
- Shanghai Medical College, Fudan University, Shanghai, China
| | - Yu-Lan Zhu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Chan Chen
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Han-Qiu Liu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Wei-Wei Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Fang Li
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China; Department of Rehabilitation Medicine, Renhe Hospital, Baoshan District, Shanghai, China.
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A Longitudinal fMRI Research on Neural Plasticity and Sensory Outcome of Carpal Tunnel Syndrome. Neural Plast 2018; 2017:5101925. [PMID: 29348944 PMCID: PMC5733863 DOI: 10.1155/2017/5101925] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 08/07/2017] [Accepted: 09/10/2017] [Indexed: 11/29/2022] Open
Abstract
Peripheral nerve compression is reported to induce cortical plasticity, which was well pictured by former researches. However, the longitudinal changes brought by surgical treatment are not clear. In this research, 18 subjects who suffered from bilateral carpal tunnel syndrome were evaluated using task-dependent fMRI and electromyography assessment before and after surgery. The third digit was tactually simulated by von Frey filaments. The results demonstrated that the pattern of activation was similar but a decreased extent of activation in the postcentral gyrus, inferior frontal lobe, superior frontal lobe, and parahippocampal gyrus after surgery was found. The correlation analysis showed a significant correlation between the decreased number of activated voxels and the improvement of EMG performance. This result implied a potential connection between fMRI measurement and clinical improvement.
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Socolovsky M, Malessy M, Lopez D, Guedes F, Flores L. Current concepts in plasticity and nerve transfers: relationship between surgical techniques and outcomes. Neurosurg Focus 2017; 42:E13. [PMID: 28245665 DOI: 10.3171/2016.12.focus16431] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Neuroplasticity is analyzed in this article as the capacity of the CNS to adapt to external and internal stimuli. It is being increasingly recognized as an important factor for the successful outcome of nerve transfers. Better-known factors are the number of axons that cross the coaptation site, the time interval between trauma and repair, and age. Neuroplasticity is mediated initially by synaptic and neurotransmitter changes. Over time, the activation of previously existing but lowly active connections in the brain cortex contributes further. Dendritic sprouting and axonal elongation might also take place but are less likely to be prominent. METHODS The authors reviewed different factors that play roles in neuroplasticity and functional regeneration after specific nerve transfers. RESULTS The authors found that these different factors include, among others, the distance between cortical areas of the donor and receptor neurons, the presence versus absence of preexisting lowly active interneuronal connections, gross versus fine movement restoration, rehabilitation, brain trauma, and age. CONCLUSIONS The potential for plasticity should be taken into consideration by surgeons when planning surgical strategy and postoperative rehabilitation, because its influence on results cannot be denied.
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Affiliation(s)
- Mariano Socolovsky
- Peripheral Nerve and Plexus Surgery Unit, University of Buenos Aires School of Medicine, Buenos Aires, Argentina
| | - Martijn Malessy
- Department of Neurosurgery, University of Leiden Medical Center, Leiden, The Netherlands
| | - Dan Lopez
- Department of Neurosurgery, Hospital Juarez de México, México City, México
| | - Fernando Guedes
- Department of Neurosurgery, Hospital Universitário Gaffré e Guinle, Federal University of Rio de Janeiro, Rio de Janeiro; and
| | - Leandro Flores
- Department of Neurosurgery, Hospital das Forças Armadas, Brasília, Brazil
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