Pub Date : 2025-01-15DOI: 10.1177/09226028241292033
Lívia Shirahige, Fernanda Nogueira, Lorena Melo, Ruxandra Ungureanu, Sérgio Rocha, Rodrigo Brito, Thyciane Mendonça, Abelardo de Farias, Maria das Graças Rodrigues de Araújo, Daniele Piscitelli, Kátia Monte-Silva
Background: A better understanding of migraine pathophysiology through standardized methods could facilitate the development of more effective therapeutic approaches for migraine sufferers. However, neurophysiological studies with migraine sufferers present larger variability, as most contain only a single measurement.
Objective: This observational study aimed to compare the cortical and visual excitability of migraine sufferers, individuals with other types of headaches, and healthy participants in response to pattern-reversal visual stimulation.
Methods: Fifty-nine individuals were classified by a neurologist into the following groups: (i) migraineurs (n = 25); (ii) other types of headaches (n = 23); (iii) healthy (n = 11). Habituation during pattern-reversal visual stimulation was assessed by visual evoked potentials. Visual and motor cortex excitability were evaluated before and after pattern-reversal visual stimulation.
Results: We found no intergroup differences in motor and visual excitability measures after pattern-reversal visual stimulation. Compared to the healthy group, migraineurs and individuals with other types of headaches displayed a reduction in phosphene threshold after pattern-reversal visual stimulation. Additionally, an increase in visual cortical excitability in these groups was also observed. Lastly, the habituation in individuals with migraines and other types of headaches was lower compared to healthy individuals. Therefore, the lack of habituation may not be exclusively associated with the pathophysiological mechanisms of migraine.
Conclusion: Individuals who experience headaches, including migraineurs, have an increased visual cortical excitability in response to visual stimuli. This finding is promising for guiding future neurophysiological research to identify cortical biomarkers in migraineurs and in other types of headaches.
{"title":"Effects of Pattern-Reversal Visual Stimulation on Brain Activity in Migraineurs and General Population.","authors":"Lívia Shirahige, Fernanda Nogueira, Lorena Melo, Ruxandra Ungureanu, Sérgio Rocha, Rodrigo Brito, Thyciane Mendonça, Abelardo de Farias, Maria das Graças Rodrigues de Araújo, Daniele Piscitelli, Kátia Monte-Silva","doi":"10.1177/09226028241292033","DOIUrl":"https://doi.org/10.1177/09226028241292033","url":null,"abstract":"<p><strong>Background: </strong>A better understanding of migraine pathophysiology through standardized methods could facilitate the development of more effective therapeutic approaches for migraine sufferers. However, neurophysiological studies with migraine sufferers present larger variability, as most contain only a single measurement.</p><p><strong>Objective: </strong>This observational study aimed to compare the cortical and visual excitability of migraine sufferers, individuals with other types of headaches, and healthy participants in response to pattern-reversal visual stimulation.</p><p><strong>Methods: </strong>Fifty-nine individuals were classified by a neurologist into the following groups: (i) migraineurs (n = 25); (ii) other types of headaches (n = 23); (iii) healthy (n = 11). Habituation during pattern-reversal visual stimulation was assessed by visual evoked potentials. Visual and motor cortex excitability were evaluated before and after pattern-reversal visual stimulation.</p><p><strong>Results: </strong>We found no intergroup differences in motor and visual excitability measures after pattern-reversal visual stimulation. Compared to the healthy group, migraineurs and individuals with other types of headaches displayed a reduction in phosphene threshold after pattern-reversal visual stimulation. Additionally, an increase in visual cortical excitability in these groups was also observed. Lastly, the habituation in individuals with migraines and other types of headaches was lower compared to healthy individuals. Therefore, the lack of habituation may not be exclusively associated with the pathophysiological mechanisms of migraine.</p><p><strong>Conclusion: </strong>Individuals who experience headaches, including migraineurs, have an increased visual cortical excitability in response to visual stimuli. This finding is promising for guiding future neurophysiological research to identify cortical biomarkers in migraineurs and in other types of headaches.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"9226028241292033"},"PeriodicalIF":1.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-04DOI: 10.1177/09226028241290400
Jessica Mai-Phuong Phan, Jiwon Yi, Julia Hope Amor Foote, Asia Rei Katsura Ayabe, Kevin Guan, Theodore Garland, Karen Diane Parfitt
Background: High-Runner (HR) mice, selectively bred for increased voluntary wheel running behavior, exhibit heightened motivation to run. Exercise has been shown to influence hippocampal long-term potentiation (LTP) and memory, and is neuroprotective in several neurodegenerative diseases.
Objective: This study aimed to determine the impact of intense running in HR mice with wheel access on hippocampal LTP, compared to HR mice without wheels and non-selected control (C) mice with/without wheels. Additionally, we investigated the involvement of D1/D5 receptors and the dopamine transporter (DAT) in LTP modulation and examined levels of these proteins in HR and C mice.
Methods: Adult female HR and C mice were individually housed with/without running wheels for at least two weeks. Hippocampal LTP of extracellular field excitatory postsynaptic potentials (fEPSPs) was measured in area CA1, and SKF-38393 (D1/D5 receptor agonist) and GBR 12909 (DAT inhibitor) were used to probe the role of D1/D5 receptors and DAT in LTP differences. Western blot analyses assessed D1/D5 receptor and DAT expression in the hippocampus, prefrontal cortex, and cerebellum.
Results: HR mice with wheel access showed significantly increased hippocampal LTP compared to those without wheels and to C mice with/without wheels. Treatment with SKF-38393 or GBR 12909 prevented the heightened LTP in HR mice with wheels, aligning it with levels in C mice. Hippocampal D1/D5 receptor levels were lower, and DAT levels were higher in HR mice compared to C mice. No significant changes were observed in other brain regions.
Conclusions: The increased hippocampal LTP seen in HR mice with wheel access may be related to alterations in dopaminergic synaptic transmission that underlie the neurophysiological basis of hyperactivity, motor disorders, and/or motivation.
{"title":"Hippocampal long-term potentiation is modulated by exercise-induced alterations in dopaminergic synaptic transmission in mice selectively bred for high voluntary wheel running.","authors":"Jessica Mai-Phuong Phan, Jiwon Yi, Julia Hope Amor Foote, Asia Rei Katsura Ayabe, Kevin Guan, Theodore Garland, Karen Diane Parfitt","doi":"10.1177/09226028241290400","DOIUrl":"https://doi.org/10.1177/09226028241290400","url":null,"abstract":"<p><strong>Background: </strong>High-Runner (HR) mice, selectively bred for increased voluntary wheel running behavior, exhibit heightened motivation to run. Exercise has been shown to influence hippocampal long-term potentiation (LTP) and memory, and is neuroprotective in several neurodegenerative diseases.</p><p><strong>Objective: </strong>This study aimed to determine the impact of intense running in HR mice with wheel access on hippocampal LTP, compared to HR mice without wheels and non-selected control (C) mice with/without wheels. Additionally, we investigated the involvement of D1/D5 receptors and the dopamine transporter (DAT) in LTP modulation and examined levels of these proteins in HR and C mice.</p><p><strong>Methods: </strong>Adult female HR and C mice were individually housed with/without running wheels for at least two weeks. Hippocampal LTP of extracellular field excitatory postsynaptic potentials (fEPSPs) was measured in area CA1, and SKF-38393 (D1/D5 receptor agonist) and GBR 12909 (DAT inhibitor) were used to probe the role of D1/D5 receptors and DAT in LTP differences. Western blot analyses assessed D1/D5 receptor and DAT expression in the hippocampus, prefrontal cortex, and cerebellum.</p><p><strong>Results: </strong>HR mice with wheel access showed significantly increased hippocampal LTP compared to those without wheels and to C mice with/without wheels. Treatment with SKF-38393 or GBR 12909 prevented the heightened LTP in HR mice with wheels, aligning it with levels in C mice. Hippocampal D1/D5 receptor levels were lower, and DAT levels were higher in HR mice compared to C mice. No significant changes were observed in other brain regions.</p><p><strong>Conclusions: </strong>The increased hippocampal LTP seen in HR mice with wheel access may be related to alterations in dopaminergic synaptic transmission that underlie the neurophysiological basis of hyperactivity, motor disorders, and/or motivation.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"9226028241290400"},"PeriodicalIF":1.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aqeela Afzal, Nagheme Thomas, Zuha Warraich, Scott Barbay, J. Mocco
Hematopoietic stem cells (HSC) are recruited to ischemic areas in the brain and contribute to improved functional outcome in animals. However, little is known regarding the mechanisms of improvement following HSC administration post cerebral ischemia. To better understand how HSC effect post-strokeimprovement, we examined the effect of HSC in ameliorating motor impairment and cortical dysfunction following cerebral ischemia. Methods:Baseline motor performance of male adult rats was established on validated motor tests. Animals were assigned to one of three experimental cohorts: control, stroke, stroke + HSC. One, three and five weeks following a unilateral stroke all animals were tested on motor skills after which intracortical microstimulation was used to derive maps of forelimb movement representations within the motor cortex ipsilateral to the ischemic injury. Results:Stroke + HSC animals significantly outperformed stroke animals on single pellet reaching at weeks 3 and 5 (28±3% and 33±3% versus 11±4% and 17±3%, respectively, p < 0.05 at both time points). Control animals scored 44±1% and 47±1%, respectively. Sunflower seed opening task was significantly improved in the stroke + HSC cohort versus the stroke cohort at week five-post stroke (79±4 and 48±5, respectively, p < 0.05). Furthermore, Stroke + HSC animals had significantly larger forelimb motor maps than animals in the stroke cohort. Overall infarct size did not significantly differ between the two stroked cohorts. Conclusion:These data suggest that post stroke treatment of HSC enhances the functional integrity of residual cortical tissue, which in turn supports improved behavioral outcome, despite no observed reduction in infarct size.
{"title":"Hematopoietic Endothelial Progenitor cells enhance motor function and cortical motor map integrity following cerebral ischemia","authors":"Aqeela Afzal, Nagheme Thomas, Zuha Warraich, Scott Barbay, J. Mocco","doi":"10.3233/rnn-231378","DOIUrl":"https://doi.org/10.3233/rnn-231378","url":null,"abstract":"Hematopoietic stem cells (HSC) are recruited to ischemic areas in the brain and contribute to improved functional outcome in animals. However, little is known regarding the mechanisms of improvement following HSC administration post cerebral ischemia. To better understand how HSC effect post-strokeimprovement, we examined the effect of HSC in ameliorating motor impairment and cortical dysfunction following cerebral ischemia. Methods:Baseline motor performance of male adult rats was established on validated motor tests. Animals were assigned to one of three experimental cohorts: control, stroke, stroke + HSC. One, three and five weeks following a unilateral stroke all animals were tested on motor skills after which intracortical microstimulation was used to derive maps of forelimb movement representations within the motor cortex ipsilateral to the ischemic injury. Results:Stroke + HSC animals significantly outperformed stroke animals on single pellet reaching at weeks 3 and 5 (28±3% and 33±3% versus 11±4% and 17±3%, respectively, p < 0.05 at both time points). Control animals scored 44±1% and 47±1%, respectively. Sunflower seed opening task was significantly improved in the stroke + HSC cohort versus the stroke cohort at week five-post stroke (79±4 and 48±5, respectively, p < 0.05). Furthermore, Stroke + HSC animals had significantly larger forelimb motor maps than animals in the stroke cohort. Overall infarct size did not significantly differ between the two stroked cohorts. Conclusion:These data suggest that post stroke treatment of HSC enhances the functional integrity of residual cortical tissue, which in turn supports improved behavioral outcome, despite no observed reduction in infarct size.","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":"48 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141166386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thomas E. Augenstein, Seonga Oh, Trevor A. Norris, Joshua Mekler, Amit Sethi, Chandramouli Krishnan
Background: Previous research has shown that noninvasive brain stimulation can be used to study how the central nervous system (CNS) prepares the execution of a motor task. However, these previous studies have been limited to a single muscle or single degree of freedom movements (e.g., wrist flexion). It is currently unclear if the findings of these studies generalize to multi-joint movements involving multiple muscles, which may be influenced by kinematic redundancy and muscle synergies. Objective: The objective of this study was to characterize corticospinal excitability during motor preparation in the cortex prior to functional upper extremity reaches. Methods: 20 participants without neurological impairments volunteered for this study. During the experiment, the participants reached for a cup in response to a visual “Go Cue”. Prior to movement onset, we used transcranial magnetic stimulation (TMS) to stimulate the motor cortex and measured the changes in motor evoked potentials (MEPs) in several upper extremity muscles. We varied each participant’s initial arm posture and used a novel synergy-based MEP analysis to examine the effect of muscle coordination on MEPs. Additionally, we varied the timing of the stimulation between the Go Cue and movement onset to examine the time course of motor preparation. Results: We found that synergies with strong proximal muscle (shoulder and elbow) components emerged as the stimulation was delivered closer to movement onset, regardless of arm posture, but MEPs in the distal (wrist and finger) muscles were not facilitated. We also found that synergies varied with arm posture in a manner that reflected the muscle coordination of the reach. Conclusions: We believe that these findings provide useful insight into the way the CNS plans motor skills.
{"title":"Corticospinal excitability during motor preparation of upper extremity reaches reflects flexor muscle synergies: A novel principal component-based motor evoked potential analyses","authors":"Thomas E. Augenstein, Seonga Oh, Trevor A. Norris, Joshua Mekler, Amit Sethi, Chandramouli Krishnan","doi":"10.3233/rnn-231367","DOIUrl":"https://doi.org/10.3233/rnn-231367","url":null,"abstract":"Background:\u0000Previous research has shown that noninvasive brain stimulation can be used to study how the central nervous system (CNS) prepares the execution of a motor task. However, these previous studies have been limited to a single muscle or single degree of freedom movements (e.g., wrist flexion). It is currently unclear if the findings of these studies generalize to multi-joint movements involving multiple muscles, which may be influenced by kinematic redundancy and muscle synergies. Objective:\u0000The objective of this study was to characterize corticospinal excitability during motor preparation in the cortex prior to functional upper extremity reaches. Methods:\u000020 participants without neurological impairments volunteered for this study. During the experiment, the participants reached for a cup in response to a visual “Go Cue”. Prior to movement onset, we used transcranial magnetic stimulation (TMS) to stimulate the motor cortex and measured the changes in motor evoked potentials (MEPs) in several upper extremity muscles. We varied each participant’s initial arm posture and used a novel synergy-based MEP analysis to examine the effect of muscle coordination on MEPs. Additionally, we varied the timing of the stimulation between the Go Cue and movement onset to examine the time course of motor preparation. Results:\u0000We found that synergies with strong proximal muscle (shoulder and elbow) components emerged as the stimulation was delivered closer to movement onset, regardless of arm posture, but MEPs in the distal (wrist and finger) muscles were not facilitated. We also found that synergies varied with arm posture in a manner that reflected the muscle coordination of the reach. Conclusions:\u0000We believe that these findings provide useful insight into the way the CNS plans motor skills.","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":"43 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140583782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amit Sethi, Alvaro Pascual-Leone, Emiliano Santarnecchi, Ghaleb Almalki, Chandramouli Krishnan
Background:Interventions to recover upper extremity (UE) function after moderate-to-severe stroke are limited. Transcranial random noise stimulation (tRNS) is an emerging non-invasive technique to improve neuronal plasticity and may potentially augment functional outcomes when combined with existing interventions, such as functional electrical stimulation (FES). Objective:The objective of this study was to investigate the feasibility and preliminary efficacy of combined tRNS and FES-facilitated task practice to improve UE impairment and function after moderate-to-severe stroke. Methods:Fourteen individuals with UE weakness were randomized into one of two groups: 1) tRNS with FES-facilitated task practice, or 2) sham-tRNS with FES-facilitated task practice. Both groups involved 18 intervention sessions (3 per week for 6 weeks). tRNS was delivered at 2 mA current between 100–500 Hz for the first 30 minutes of FES-facilitated task practice. We evaluated the number of sessions completed, adverse effects, participant satisfaction, and intervention fidelity between the two therapists. UE impairment (Fugl-Meyer Upper Extremity, FMUE), function (Wolf Motor Function Test, WMFT), participation (Stroke Impact Scale hand score, SIS-H), and grip strength were assessed at baseline, within 1 week and 3 months after completing the intervention. Results:All participants completed the 18 intervention sessions. Participants reported minimal adverse effects (mild tingling in head). The two trained therapists demonstrated 93% adherence and 96% competency with the intervention protocol. FMUE and SIS-H improved significantly more in the tRNS group than in the sham-tRNS group at both timepoints (p≤0.05), and the differences observed exceeded the clinically meaningful differences for these scores. The WMFT and paretic hand grip strength improved in both groups after the intervention (p≤0.05), with no significant between group differences. Conclusion:Our findings show for the first time that combining tRNS and FES-facilitated task practice is a feasible and promising approach to improve UE impairment and function after moderate-to-severe stroke.
{"title":"Transcranial random noise stimulation to augment hand function in individuals with moderate-to-severe stroke: A pilot randomized clinical trial","authors":"Amit Sethi, Alvaro Pascual-Leone, Emiliano Santarnecchi, Ghaleb Almalki, Chandramouli Krishnan","doi":"10.3233/rnn-231314","DOIUrl":"https://doi.org/10.3233/rnn-231314","url":null,"abstract":"Background:Interventions to recover upper extremity (UE) function after moderate-to-severe stroke are limited. Transcranial random noise stimulation (tRNS) is an emerging non-invasive technique to improve neuronal plasticity and may potentially augment functional outcomes when combined with existing interventions, such as functional electrical stimulation (FES). Objective:The objective of this study was to investigate the feasibility and preliminary efficacy of combined tRNS and FES-facilitated task practice to improve UE impairment and function after moderate-to-severe stroke. Methods:Fourteen individuals with UE weakness were randomized into one of two groups: 1) tRNS with FES-facilitated task practice, or 2) sham-tRNS with FES-facilitated task practice. Both groups involved 18 intervention sessions (3 per week for 6 weeks). tRNS was delivered at 2 mA current between 100–500 Hz for the first 30 minutes of FES-facilitated task practice. We evaluated the number of sessions completed, adverse effects, participant satisfaction, and intervention fidelity between the two therapists. UE impairment (Fugl-Meyer Upper Extremity, FMUE), function (Wolf Motor Function Test, WMFT), participation (Stroke Impact Scale hand score, SIS-H), and grip strength were assessed at baseline, within 1 week and 3 months after completing the intervention. Results:All participants completed the 18 intervention sessions. Participants reported minimal adverse effects (mild tingling in head). The two trained therapists demonstrated 93% adherence and 96% competency with the intervention protocol. FMUE and SIS-H improved significantly more in the tRNS group than in the sham-tRNS group at both timepoints (p≤0.05), and the differences observed exceeded the clinically meaningful differences for these scores. The WMFT and paretic hand grip strength improved in both groups after the intervention (p≤0.05), with no significant between group differences. Conclusion:Our findings show for the first time that combining tRNS and FES-facilitated task practice is a feasible and promising approach to improve UE impairment and function after moderate-to-severe stroke.","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":"85 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139584179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nourelhoda A. Haridy, Mohamed M. Shehab, Eman M. Khedr
Background: Most previous studies comparing the effectiveness of Plasma Exchange (PE) or intravenous immunoglobulin (IVIG) in treating Guillain-Barre syndrome (GBS) have focused on the short-term outcome at around 1 month. Objective: To compare the long-term efficacy of PE and IVIG at one year in adult patients with GBS. Methods: Eighty-one adult patients with acute GBS were randomized into two groups with a ratio of 2 : 1: PE (N = 54) and IVIG (N = 27). Patients were assessed with the Medical Research Council sum score (MRC sum score), GBS Disability Scale (GDS), and Functional assessment of acute inflammatory neuropathy (FAAIN) at baseline, ten days, one month, three months, and one year. Neurophysiological examinations were performed at baseline and three months following treatment. Results: There were no significant differences between groups in demographic, clinical, and laboratory data. Both treatments produced a significant improvement in all clinical rating scales in both groups that continued up to one year. There were significant differences in the time course of recovery in the MRC and FAAIN scales, with significantly more improvement in the IVIG group at 1 and 3 months, although there was no significant difference in outcome at one year. However the effect size showed measurable differences between the PE and IVIG groups across the different measures at one-year. Electrophysiological studies showed equal improvement in most measures in both groups at three months, with a slightly greater effect in the IVIG group. Conclusion: long term outcomes of IVIG and PE were equivalent. However the effect size showed measurable differences between the PE and IVIG groups across the different measures at one-year follow-up that indicate the superiorty of IVIG. There was also a tendency for improvement to be slightly faster in the IVIG group.
{"title":"Long-term outcomes of plasma exchange versus intravenous immunoglobulin for the treatment of Guillain-Barré Syndrome: A double-blind, randomized clinical trial","authors":"Nourelhoda A. Haridy, Mohamed M. Shehab, Eman M. Khedr","doi":"10.3233/rnn-231369","DOIUrl":"https://doi.org/10.3233/rnn-231369","url":null,"abstract":"Background:\u0000Most previous studies comparing the effectiveness of Plasma Exchange (PE) or intravenous immunoglobulin (IVIG) in treating Guillain-Barre syndrome (GBS) have focused on the short-term outcome at around 1 month. Objective:\u0000To compare the long-term efficacy of PE and IVIG at one year in adult patients with GBS. Methods:\u0000Eighty-one adult patients with acute GBS were randomized into two groups with a ratio of 2 : 1: PE (N = 54) and IVIG (N = 27). Patients were assessed with the Medical Research Council sum score (MRC sum score), GBS Disability Scale (GDS), and Functional assessment of acute inflammatory neuropathy (FAAIN) at baseline, ten days, one month, three months, and one year. Neurophysiological examinations were performed at baseline and three months following treatment. Results:\u0000There were no significant differences between groups in demographic, clinical, and laboratory data. Both treatments produced a significant improvement in all clinical rating scales in both groups that continued up to one year. There were significant differences in the time course of recovery in the MRC and FAAIN scales, with significantly more improvement in the IVIG group at 1 and 3 months, although there was no significant difference in outcome at one year. However the effect size showed measurable differences between the PE and IVIG groups across the different measures at one-year. Electrophysiological studies showed equal improvement in most measures in both groups at three months, with a slightly greater effect in the IVIG group. Conclusion:\u0000long term outcomes of IVIG and PE were equivalent. However the effect size showed measurable differences between the PE and IVIG groups across the different measures at one-year follow-up that indicate the superiorty of IVIG. There was also a tendency for improvement to be slightly faster in the IVIG group.","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":"8 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139460525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matteo Guidetti, Anisa Naci, Andrea Cerri, Rossella Pagani, Antonino Michele Previtera, Alberto Priori, Tommaso Bocci
Background:Focal extracorporeal shock wave therapy (fESWT) is a physical therapy vastly studied and used for various musculoskeletal disorders. However, the effect of fESWT on central nervous system is still to be determined. Objective:To elucidate spinal and supra-spinal mechanisms of fESWT in healthy subjects, in order to widen the spectrum of its clinical applications. Methods:In this quasi-experimental, unblinded, proof-of-concept clinical study, 10 voluntary healthy subjects underwent fESWT and were assessed immediately before (T0), immediately after (T1) and seven days after (T2) the intervention. As neurophysiological outcomes, motor evoked potentials (resting motor threshold, maximal motor evoked potential and maximal compound muscle action potential ratio, cortical silent period, total conduction motor time, direct and indirect central motor conduction time), F-waves (minimal and mean latency, persistence and temporal dispersion) and H-reflex (threshold, amplitude, maximal H reflex and maximal compound muscle action potential ratio, latency) were considered. Results:Resting motor threshold and F-waves temporal dispersion significantly decreased, respectively, from T1 and T2 and from T0 and T2 (for both, p < 0.05). H-reflex threshold increase between T0 and T1. Analysis disclosed a strong negative correlation between Δ3 cortical silent period (i.e., T2 –T1 recordings) and Δ1 Hr threshold (i.e., T1 –T0 recordings) (r = –0.66, p < 0.05), and a positive strong relationship between Δ3 cortical silent period and Δ3 Hr threshold (r = 0.63, p < 0.05). Conclusions:fESWT modulates corticospinal tract excitability in healthy volunteers, possibly inducing an early inhibition followed by a later facilitation after one week.
{"title":"Shock waves modulate corticospinal excitability: A proof of concept for further rehabilitation purposes?","authors":"Matteo Guidetti, Anisa Naci, Andrea Cerri, Rossella Pagani, Antonino Michele Previtera, Alberto Priori, Tommaso Bocci","doi":"10.3233/rnn-231371","DOIUrl":"https://doi.org/10.3233/rnn-231371","url":null,"abstract":"Background:Focal extracorporeal shock wave therapy (fESWT) is a physical therapy vastly studied and used for various musculoskeletal disorders. However, the effect of fESWT on central nervous system is still to be determined. Objective:To elucidate spinal and supra-spinal mechanisms of fESWT in healthy subjects, in order to widen the spectrum of its clinical applications. Methods:In this quasi-experimental, unblinded, proof-of-concept clinical study, 10 voluntary healthy subjects underwent fESWT and were assessed immediately before (T0), immediately after (T1) and seven days after (T2) the intervention. As neurophysiological outcomes, motor evoked potentials (resting motor threshold, maximal motor evoked potential and maximal compound muscle action potential ratio, cortical silent period, total conduction motor time, direct and indirect central motor conduction time), F-waves (minimal and mean latency, persistence and temporal dispersion) and H-reflex (threshold, amplitude, maximal H reflex and maximal compound muscle action potential ratio, latency) were considered. Results:Resting motor threshold and F-waves temporal dispersion significantly decreased, respectively, from T1 and T2 and from T0 and T2 (for both, p < 0.05). H-reflex threshold increase between T0 and T1. Analysis disclosed a strong negative correlation between Δ3 cortical silent period (i.e., T2 –T1 recordings) and Δ1 Hr threshold (i.e., T1 –T0 recordings) (r = –0.66, p < 0.05), and a positive strong relationship between Δ3 cortical silent period and Δ3 Hr threshold (r = 0.63, p < 0.05). Conclusions:fESWT modulates corticospinal tract excitability in healthy volunteers, possibly inducing an early inhibition followed by a later facilitation after one week.","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":"121 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139412823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabrielle N. Turski, Christopher A. Turski, Marcus Grobe-Einsler, Xenia Kobeleva, Jennifer S. Turski, Frank G. Holz, Robert P. Finger, Thomas Klockgether
Abstract
Background:
Hereditary spastic paraplegia (HSP) is characterized by progressive degeneration of distal axons in the long corticospinal tracts. Loss of retinal cells and microvascular networks has neither been suspected nor investigated. We concurrently examined the retinal microvasculature and retinal layer morphology in patients with HSP to assess whether retinal features may portray disease and its progression.
Methods:
Fifteen patients with HSP and 30 healthy controls were included in this cross-sectional case-control study. Disease severity was assessed with the Spastic Paraplegia Rating Scale (SPRS). Severity of ataxia was determined by the Scale for the Assessment and Rating of Ataxia (SARA). Retinal microvasculature was measured by means of optical coherence tomography angiography (OCT-A) and morphology of retinal layers using structural OCT. Mixed-effects models were applied for data analysis.
Results:
HSP patients showed significantly reduced vessel density of the superficial vascular plexus (SVP), reduced ganglion cell layer (GCL) volume, reduced inner plexiform layer (IPL) volume and reduced temporal-inferior peripapillary retinal nerve fiber layer (pRNFL) thickness versus healthy controls. GCL volume reduction correlated significantly with the worsening of visual acuity and higher SARA scores.
Conclusions:
These findings demonstrate that, in HSP both cells and vascular networks of the retina are compromised. Assessment of the retinal GCL, IPL and SVP may aid in diagnosis and monitoring of disease progression as well as provide novel structural outcome measures for clinical trials.
摘要背景：遗传性痉挛性截瘫（HSP）的特征是长皮质脊髓束远端轴突进行性变性。视网膜细胞和微血管网络的丧失既未被怀疑也未被研究。我们同时检查了HSP患者的视网膜微血管和视网膜层形态，以评估视网膜特征是否可以反映疾病及其进展。用痉挛性截瘫评定量表（SPRS）评估疾病的严重程度。共济失调的严重程度由共济失调评估和分级量表（SARA）确定。视网膜微血管通过光学相干断层血管成像（OCT-A）进行测量，视网膜层的形态则通过结构性 OCT 进行测量。结果显示：与健康对照组相比，HSP 患者的浅层血管丛（SVP）血管密度明显降低，神经节细胞层（GCL）体积缩小，内层丛状层（IPL）体积缩小，颞侧-下腹部视网膜神经纤维层（pRNFL）厚度缩小。结论：这些研究结果表明，HSP 患者视网膜的细胞和血管网络均受到损害。对视网膜 GCL、IPL 和 SVP 的评估可能有助于诊断和监测疾病的进展，并为临床试验提供新的结构性结果测量。
{"title":"Retinal ganglion cell and microvascular density loss in hereditary spastic paraplegia","authors":"Gabrielle N. Turski, Christopher A. Turski, Marcus Grobe-Einsler, Xenia Kobeleva, Jennifer S. Turski, Frank G. Holz, Robert P. Finger, Thomas Klockgether","doi":"10.3233/rnn-231380","DOIUrl":"https://doi.org/10.3233/rnn-231380","url":null,"abstract":"<h4><span>Abstract</span></h4><h3><span></span>Background:</h3><p>Hereditary spastic paraplegia (HSP) is characterized by progressive degeneration of distal axons in the long corticospinal tracts. Loss of retinal cells and microvascular networks has neither been suspected nor investigated. We concurrently examined the retinal microvasculature and retinal layer morphology in patients with HSP to assess whether retinal features may portray disease and its progression.</p><h3><span></span>Methods:</h3><p>Fifteen patients with HSP and 30 healthy controls were included in this cross-sectional case-control study. Disease severity was assessed with the Spastic Paraplegia Rating Scale (SPRS). Severity of ataxia was determined by the Scale for the Assessment and Rating of Ataxia (SARA). Retinal microvasculature was measured by means of optical coherence tomography angiography (OCT-A) and morphology of retinal layers using structural OCT. Mixed-effects models were applied for data analysis.</p><h3><span></span>Results:</h3><p>HSP patients showed significantly reduced vessel density of the superficial vascular plexus (SVP), reduced ganglion cell layer (GCL) volume, reduced inner plexiform layer (IPL) volume and reduced temporal-inferior peripapillary retinal nerve fiber layer (pRNFL) thickness versus healthy controls. GCL volume reduction correlated significantly with the worsening of visual acuity and higher SARA scores.</p><h3><span></span>Conclusions:</h3><p>These findings demonstrate that, in HSP both cells and vascular networks of the retina are compromised. Assessment of the retinal GCL, IPL and SVP may aid in diagnosis and monitoring of disease progression as well as provide novel structural outcome measures for clinical trials.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":"23 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139412707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chaeyoo Park, Youngkeun Woo, Jongim Won, Sujin Kim
Background: Asymmetric gait patterns are mostly observed in hemiplegic stroke patients. These abnormal gait patterns resulting in abnormal speed, and decreased ability in daily of activity living.
Objective: This study aimed to determine the immediate changes in gait parameters and plantar pressure during elevation by wearing an insole on the sound side lower extremity of patients with hemiplegia.
Methods: Thirty-six participants were recruited, comprising those with a post-stroke follow-up of ≥3 months and a functional ambulation category score of ≥2. The participants were asked to walk with and without a 1 cm insole in the shoe of their sound side, and the order of wearing or not wearing the insole was randomized. Gait parameters, bilateral gait parameters, and dynamic plantar pressure were measured using the GAITRite Walkway System.
Results: Paired t-test was used to examine immediate changes in gait parameters and plantar pressure with and without insoles during walking in the same group. Overall, gait velocity and step length significantly decreased (p < 0.05), whereas step time significantly increased (p < 0.05). The swing phase of the affected sidelower extremities significantly increased (p < 0.05), and the stance phase significantly decreased (p < 0.05). Double-support unloading phase (pre-swing phase) significantly increased (p < 0.05). The changes in plantar pressure were significantly increased in some lateral zones and significantly decreased in the medial zone of the mid-hindfoot, both in terms of pressure per time and peak pressure (p < 0.05).
Conclusion: Although this study did not show immediate positive effects on gait parameters and gait cycle, it is expected that sensory input from the sole of the foot through changes in plantar pressure may help improve gait asymmetry and regulate postural symmetry.
{"title":"Immediate effects of insoles applied to the sound side lower extremity of patients with chronic hemiplegia during walking.","authors":"Chaeyoo Park, Youngkeun Woo, Jongim Won, Sujin Kim","doi":"10.3233/RNN-241389","DOIUrl":"10.3233/RNN-241389","url":null,"abstract":"<p><strong>Background: </strong>Asymmetric gait patterns are mostly observed in hemiplegic stroke patients. These abnormal gait patterns resulting in abnormal speed, and decreased ability in daily of activity living.</p><p><strong>Objective: </strong>This study aimed to determine the immediate changes in gait parameters and plantar pressure during elevation by wearing an insole on the sound side lower extremity of patients with hemiplegia.</p><p><strong>Methods: </strong>Thirty-six participants were recruited, comprising those with a post-stroke follow-up of ≥3 months and a functional ambulation category score of ≥2. The participants were asked to walk with and without a 1 cm insole in the shoe of their sound side, and the order of wearing or not wearing the insole was randomized. Gait parameters, bilateral gait parameters, and dynamic plantar pressure were measured using the GAITRite Walkway System.</p><p><strong>Results: </strong>Paired t-test was used to examine immediate changes in gait parameters and plantar pressure with and without insoles during walking in the same group. Overall, gait velocity and step length significantly decreased (p < 0.05), whereas step time significantly increased (p < 0.05). The swing phase of the affected sidelower extremities significantly increased (p < 0.05), and the stance phase significantly decreased (p < 0.05). Double-support unloading phase (pre-swing phase) significantly increased (p < 0.05). The changes in plantar pressure were significantly increased in some lateral zones and significantly decreased in the medial zone of the mid-hindfoot, both in terms of pressure per time and peak pressure (p < 0.05).</p><p><strong>Conclusion: </strong>Although this study did not show immediate positive effects on gait parameters and gait cycle, it is expected that sensory input from the sole of the foot through changes in plantar pressure may help improve gait asymmetry and regulate postural symmetry.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"167-177"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142111462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Announcement: Appointment of New Editor-in-Chief Lechoslaw (Les) Turski, MD, PhD.","authors":"","doi":"10.3233/RNN-249001","DOIUrl":"10.3233/RNN-249001","url":null,"abstract":"","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"91-92"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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