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The responsibility and mission of Neurorestoratology‒New year’s greetings for 2025 神经修复学的责任与使命——向2025年拜年
IF 3.1 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.jnrt.2024.100174
Hongyun Huang, Paul R. Sanberg, Hari Shanker Sharma, Sang Ryong Jeon
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引用次数: 0
Primed low frequency repetitive transcranial magnetic stimulation rebalances cortical excitatory-inhibitory circuitry and improves functional outcomes in infantile cerebral palsy patients: A randomized controlled trial 启动低频重复经颅磁刺激重新平衡皮层兴奋-抑制回路并改善婴儿脑瘫患者的功能结局:一项随机对照试验
IF 3.1 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.jnrt.2024.100169
Aliya Mufti , Suman Jain , Kanwal Preet Kochhar , Sheffali Gulati , Sanjay Wadhwa , Kapil Sikka , Rohit Saxena , Md Iqbal Alam

Background

Multiple prenatal and postnatal etiologies in cerebral palsy (CP) patients cause neural tissue damage and alterations in cortical neuronal activity and plasticity, leading to motor and cognitive deficits early in life. Repetitive transcranial magnetic stimulation (rTMS) to the lesioned or contralesional hemisphere has been shown to alleviate these functional deficits. However, the underlying mechanisms of the beneficial effects of rTMS via realigning intracortical and interhemispheric circuitry and excitability remain unclear. The present study explored the ability of primed low-frequency rTMS to modulate intracortical excitatory-inhibitory circuitry, interhemispheric and corticospinal integrity, and plasticity in infantile hemiplegic CP.

Methods

The current study was a randomized, placebo-controlled trial with infantile hemiplegic CP patients. The active group received 6 Hz primed low-frequency 1Hz rTMS delivered to the contralesional primary motor cortex for 4 weeks, in 10 sessions. The placebo group received sham stimulation. Both groups also underwent 10 sessions of modified-constraint induced movement therapy (mCIMT). Pre- and post-intervention assessments were conducted using the Quality of Upper Extremity Skills Test to evaluate sensory and motor function, and the Modified Ashworth Scale (MAS) to assess spasticity. Additionally, cortical excitability and plasticity were measured using single- and paired-pulse TMS.

Results

We found a significant increase in Quality of Upper Extremity Skills Test scores, CP Quality of Life Child (CP QOL-Child) scores, and grip strength, and a decrease in MAS scores in the active rTMS group compared with the sham group. Single- and paired-pulse paradigms revealed a significant decrease in resting and active motor threshold, a reduction in the cortical silent period, and short- and long-interval intracortical inhibition in the intervention group compared with the sham group.

Conclusion

Primed low-frequency rTMS in the contralesional hemisphere combined with mCIMT shows potential for modulating motor neuronal excitability, rebalancing intracortical excitatory-inhibitory circuitry, and enhancing functional outcomes in children with infantile hemiparetic CP.
背景脑瘫(CP)患者的多种产前和产后病因导致神经组织损伤和皮质神经元活动和可塑性的改变,导致生命早期的运动和认知缺陷。反复经颅磁刺激(rTMS)损伤或对侧半球已被证明可以减轻这些功能缺陷。然而,rTMS通过重新调整皮层内和半球间回路以及兴奋性而产生有益作用的潜在机制尚不清楚。本研究探讨了启动低频rTMS对婴儿偏瘫CP的皮质内兴奋-抑制回路、半球间和皮质脊髓完整性以及可塑性的调节能力。方法:本研究是一项随机、安慰剂对照的婴儿偏瘫CP患者试验。积极组接受6赫兹启动低频1赫兹rTMS,传递给对侧初级运动皮层,为期4周,共10次。安慰剂组接受假刺激。两组均进行了10次改良约束诱导运动疗法(mCIMT)。采用上肢技能质量测试评估感觉和运动功能,采用改良Ashworth量表(MAS)评估痉挛。此外,采用单脉冲和双脉冲经颅磁刺激测量皮质兴奋性和可塑性。结果我们发现,与假手术组相比,活动rTMS组上肢技能质量测试分数、CP儿童生活质量(CP QOL-Child)分数和握力显著增加,MAS分数下降。与假手术组相比,单脉冲和成对脉冲模式显示干预组的静息和活动运动阈值显著降低,皮质沉默期减少,短间隔和长间隔皮质内抑制显著减少。结论对侧半球启动低频rTMS联合mCIMT可能调节运动神经元的兴奋性,重新平衡皮质内兴奋-抑制回路,并改善婴儿偏瘫CP的功能结局。
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引用次数: 0
Top cited articles of 2023 in Journal of Neurorestoratology 《Journal of Neurorestoratology》2023年度被引文章排名
IF 3.1 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.jnrt.2024.100172
Yong Hu
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引用次数: 0
Timing of single-event multilevel surgical interventions on long-term motor outcomes in children and adolescents with cerebral palsy: A systematic review and meta-analysis 单事件多水平手术干预时机对脑瘫儿童和青少年长期运动预后的影响:一项系统回顾和荟萃分析
IF 3.1 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.jnrt.2024.100170
Weihong Wang , Qiang Tang , Hua Liu , Rong Xu , Lijun Zhang

Background

The aim of this meta-analysis was to evaluate the impact of the timing of single-event multilevel surgery (SEMLS) on long-term motor outcomes in children and adolescents with cerebral palsy (CP).

Methods

A systematic review and meta-analysis were conducted by searching PubMed, Cochrane Library, Embase, and Web of Science databases for studies up to April 2024. Twelve eligible studies were included, from which we examined patients’ gait, stride length, walking speed, and the gross motor function measure (GMFM66).

Results

Gait analysis showed significant improvements in CP patients after SEMLS, which included an increased gait deviation index (p < 0.001), reduced Gillette gait index (p < 0.001), and reduced gait profile score (p < 0.001). Subgroup analysis showed that age at surgery (<12 years old vs. 12−18 years old) was not a factor affecting patients’ gait. Spatial and temporal parameters such as stride length (p < 0.001) and walking velocity (p = 0.02) also improved significantly after surgery. However, there were only trends towards broader motor function gains measured by the GMFM66 (p = 0.39).

Conclusions

SEMLS effectively improved key gait and mobility parameters in children and adolescents with CP, and was not affected by younger or older surgical ages (<12 years old or 12−18 years old). However, these gait improvements do not uniformly translate into broader motor function gains.
本荟萃分析的目的是评估单事件多节段手术(SEMLS)时机对脑瘫(CP)儿童和青少年长期运动预后的影响。方法通过检索PubMed、Cochrane Library、Embase和Web of Science数据库,对截至2024年4月的研究进行系统评价和meta分析。纳入了12项符合条件的研究,从中我们检查了患者的步态、步幅、步行速度和大运动功能测量(GMFM66)。结果步态分析显示,SEMLS后CP患者的步态有显著改善,包括步态偏离指数增加(p <;0.001),吉列步态指数降低(p <;0.001),降低步态特征评分(p <;0.001)。亚组分析显示,手术年龄(12岁vs. 12 - 18岁)不是影响患者步态的因素。空间和时间参数,如步幅(p <;0.001),行走速度(p = 0.02)也显著改善。然而,只有GMFM66测量的更广泛的运动功能增益趋势(p = 0.39)。结论semls可有效改善儿童和青少年CP患者的关键步态和活动参数,且不受手术年龄(12岁或12 - 18岁)的影响。然而,这些步态的改善并不能统一转化为更广泛的运动功能的改善。
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引用次数: 0
Comparison of the efficacy of high-definition transcranial direct current stimulation and transcranial magnetic stimulation in the treatment of depression 高清晰度经颅直流电刺激与经颅磁刺激治疗抑郁症的疗效比较
IF 3.1 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-01-25 DOI: 10.1016/j.jnrt.2025.100190
Qi Lu , Juan Hui , Haiyue Dai , Ran Hao , Yuesen Hou , Di Wang , Yongfeng Yang , Juan Li , Jinggui Song , Zhaohui Zhang

Background

High-definition transcranial direct current stimulation (HD-tDCS) and repetitive transcranial magnetic stimulation (rTMS) demonstrate significant potential for improving depressive symptoms and cognitive function; however, their effectiveness varies greatly among individuals. Functional near-infrared spectroscopy enables real-time monitoring of brain function during cognitive tasks in patients with psychiatric disorders.

Methods

A 4-week longitudinal study was conducted involving 61 patients with depression and 26 healthy controls. Patients were randomly assigned to HD-tDCS, rTMS, and antidepressant (AD) groups. Changes in depressive symptoms, adverse event rates, and prefrontal cortical oxyhemoglobin concentrations were assessed.

Result

At week 4, remission rates were 62.5% (15), 61.9% (13), and 62.5% (10) in the HD-tDCS, rTMS, and AD groups, respectively (x2 = 0.002, p = 1.000). Response rates were 66.7% (16), 71.4% (15), and 68.8% (11), respectively, with no significant difference between groups (x2 = 0.12, p = 0.941). All groups demonstrated significant improvement in depressive symptoms and cognitive function. The rTMS group exhibited a significantly greater decrease in Hamilton Depression Scale score compared with the HD-tDCS and AD groups. After 2 weeks of treatment, patients exhibited improved depressive symptoms and reduced activation during the verbal fluency task. However, these changes were not significantly correlated (r = −0.159 to 0.240, p = 0.121–0.988).

Limitations

All patients had concomitant use of ADs, which may impact near-infrared spectroscopy signaling and have an indeterminate effect on cognition.

Conclusion

HD-tDCS, rTMS, and ADs were equally effective, safe, and well-tolerated. HD-tDCS and rTMS were more effective for working memory, attention, executive functioning, and mood regulation.
高清晰度经颅直流电刺激(HD-tDCS)和重复性经颅磁刺激(rTMS)显示出改善抑郁症状和认知功能的显著潜力;然而,它们的效果因人而异。功能性近红外光谱能够实时监测精神疾病患者在认知任务期间的大脑功能。方法对61例抑郁症患者和26例健康对照者进行为期4周的纵向研究。患者被随机分配到HD-tDCS、rTMS和抗抑郁药(AD)组。评估抑郁症状、不良事件发生率和前额皮质氧合血红蛋白浓度的变化。结果第4周,HD-tDCS组、rTMS组和AD组的缓解率分别为62.5%(15例)、61.9%(13例)和62.5%(10例)(x2 = 0.002, p = 1.000)。有效率分别为66.7%(16例)、71.4%(15例)、68.8%(11例),组间差异无统计学意义(x2 = 0.12, p = 0.941)。所有组均表现出抑郁症状和认知功能的显著改善。与HD-tDCS和AD组相比,rTMS组汉密尔顿抑郁量表得分明显下降。治疗2周后,患者表现出抑郁症状的改善,在言语流畅性任务中的激活程度降低。然而,这些变化没有显著相关(r = - 0.159 ~ 0.240, p = 0.121 ~ 0.988)。局限性所有患者同时使用ADs,这可能影响近红外光谱信号,对认知有不确定的影响。结论hd - tdcs、rTMS和ADs的疗效、安全性和耐受性相同。HD-tDCS和rTMS在工作记忆、注意力、执行功能和情绪调节方面更有效。
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引用次数: 0
Brain-computer interface (BCI) in clinical neurorestorative practices 脑机接口(BCI)在临床神经修复实践中的应用
IF 3.1 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-01-21 DOI: 10.1016/j.jnrt.2025.100188
Yunfa Fu , Yuhang Xue , Xiaogang Chen , Yong Hu
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引用次数: 0
Developmental phases of Neurorestoratology and current key tasks 神经修复学的发展阶段和当前的关键任务
IF 3.1 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-01-21 DOI: 10.1016/j.jnrt.2025.100189
Hongyun Huang , Paul R. Sanberg , Hari Shanker Sharma , Sang Ryong Jeon
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引用次数: 0
X-ray-based ultra-high dose rate FLASH radiotherapy mitigates acute radiation-induced hippocampal injury and inflammation 基于x射线的超高剂量率FLASH放疗减轻急性辐射诱导的海马损伤和炎症
IF 3.1 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-01-17 DOI: 10.1016/j.jnrt.2025.100186
Renke He , Jiayu Liu , Bingxian Wang , Hanbo Zhang , Shengqiang Xie , Yiyuan Zhang , Xianhong Liu , Jianxin Wang , Dai Wu , Lehui Du , Baolin Qu , Gang Cheng , Jianning Zhang

Background

To compare neural damage induced by ultra-high dose rate FLASH radiotherapy (FLASH-RT) with that induced by conventional dose rate radiotherapy (CONV-RT) in healthy mice.

Methods

Eighty adult male C57BL/6J mice were divided into five groups: Sham, CONV-RT10Gy, CONV-RT20Gy, FLASH-RT10Gy, and FLASH-RT20Gy. Three days post-irradiation, morphological changes in neurons within the dentate gyrus (DG), CA1, and CA3 were observed using hematoxylin and eosin and Nissl staining. The malondialdehyde (MDA), reduced glutathione (GSH), glutathione peroxidase (GSH-PX), superoxide dismutase (SOD), catalase (CAT), and hydroxyl radical (OH) levels were measured using assay kits. Quantitative reverse transcription PCR was used to assess interleukin (IL)-1β, IL-6, inducible nitric oxide synthase (iNOS), and tumor necrosis factor (TNF)-α mRNA expression levels in hippocampus. Immunofluorescence was employed to observe microglial activation in the DG.

Results

Compared with Sham, CONV-RT10Gy and CONV-RT20Gy exhibited disorganized neuronal arrangements and blurred nucleoli in the DG; the number of Nissl body was reduced, but FLASH-RT10Gy and FLASH-RT20Gy alleviated these abnormalities. Moreover, FLASH-RT20Gy mitigated the upregulation of MDA and downregulation of GSH, GSH-PX, SOD, CAT, and OH levels in the hippocampus of mice subjected to CONV-RT20Gy. Additionally, FLASH-RT20Gy attenuated the upregulation of IL-1β, IL-6, iNOS, and TNF-α mRNA levels in hippocampus of mice subjected to CONV-RT20Gy and diminished microglial activation in the DG.

Conclusion

FLASH-RT mitigate the structural and functional disruptions in hippocampal neurons induced by CONV-RT and alleviate oxidative stress and inflammation in hippocampal tissue by reducing microglial activation.
目的比较超高剂量率快闪放疗(FLASH- rt)与常规剂量率放疗(convt)对健康小鼠神经损伤的影响。方法将成年雄性C57BL/6J小鼠80只分为Sham组、con - rt10gy组、con - rt20gy组、FLASH-RT10Gy组和FLASH-RT20Gy组。照射3 d后,采用苏木精染色、伊红染色和尼氏染色观察大鼠齿状回(DG)内神经元及CA1、CA3的形态学变化。用检测试剂盒检测丙二醛(MDA)、还原性谷胱甘肽(GSH)、谷胱甘肽过氧化物酶(GSH- px)、超氧化物歧化酶(SOD)、过氧化氢酶(CAT)和羟基自由基(OH -)水平。采用定量反转录PCR法检测海马组织中白细胞介素(IL)-1β、IL-6、诱导型一氧化氮合酶(iNOS)和肿瘤坏死因子(TNF)-α mRNA的表达水平。采用免疫荧光法观察DG小胶质细胞的活化情况。结果与Sham相比,convr - rt10gy和convr - rt20gy在DG中表现出神经元排列紊乱和核仁模糊;Nissl小体数量减少,而FLASH-RT10Gy和FLASH-RT20Gy均可缓解这些异常。此外,FLASH-RT20Gy还能减轻rev - rt20gy小鼠海马组织中MDA的上调和GSH、GSH- px、SOD、CAT和OH -水平的下调。此外,FLASH-RT20Gy还能减弱rev - rt20gy小鼠海马中IL-1β、IL-6、iNOS和TNF-α mRNA水平的上调,并降低DG中小胶质细胞的激活。结论flash - rt可减轻convr - rt诱导的海马神经元结构和功能破坏,并通过降低小胶质细胞的激活来减轻海马组织的氧化应激和炎症。
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引用次数: 0
Compound B vitamins mitigate post-traumatic stress disorder-like behaviors induced by single prolonged stress in rats by inhibiting hippocampal mitochondrial DNA methylation 复合B族维生素通过抑制海马线粒体DNA甲基化,减轻大鼠单次长时间应激诱导的创伤后应激障碍样行为
IF 3.1 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-01-17 DOI: 10.1016/j.jnrt.2025.100187
Yanteng Li , Runzi Wang , Fang Xie , Lingjia Qian , Yong Zhang , Jianning Zhang

Background

Post-traumatic stress disorder (PTSD) is a serious mental disorder. Current treatments, typically using serotonin reuptake inhibitors, have limited effectiveness and often cause severe adverse effects. In the present study, we investigated whether Compound B vitamins (VBco) have protective effects in improving PTSD-like behaviors and the possible related molecular mechanisms in a rat model of single prolonged stress (SPS).

Methods

Eighty adult male rats were randomly divided into four groups (n = 20): control (CTRL), SPS, VBco control (CTRL-VBco), and SPS and VBco (SPS-VBco). After modeling, behavioral tests (including open field test, forced swimming test, sucrose preference test, fear conditioning test) were conducted. Blood was collected to detect plasma homocysteine (Hcy) concentrations. Brain tissue was collected for mitochondrial function analysis, western blotting, and quantitative real-time Polymerase Chain Reaction (PCR).

Results

VBco reduced plasma Hcy levels significantly 1 week post-SPS. The SPS-VBco group showed decreased grooming times and increased movement speed in the open field test, less resting time in the forced swim test, increased sucrose preference ratios in the sucrose preference test, and less freezing time in the fear conditioning test. VBco increased the expression of mRNA for subunits of respiratory chain-related protein in hippocampal mitochondria and improved mitochondrial complex I and IV activity and membrane potential in hippocampus. VBco reversed SPS-induced mtND1 and mtND3 methylation in hippocampal mitochondria. VBco downregulated the levels of methyltransferases (DNMT1, DNMT3A, DNMT3B) in hippocampal mitochondria.

Conclusion

VBco can inhibit hippocampal mitochondrial DNA methylation effectively. This may be one of the mechanisms by which it attenuates PTSD-like behaviors.
创伤后应激障碍(PTSD)是一种严重的精神障碍。目前的治疗方法,通常使用血清素再摄取抑制剂,效果有限,经常引起严重的不良反应。本研究旨在探讨复合B族维生素(VBco)对单次延长应激(SPS)大鼠创伤后应激样行为的保护作用及其可能的分子机制。方法80只成年雄性大鼠随机分为4组(n = 20):对照组(CTRL)、SPS + VBco对照组(CTRL-VBco)和SPS + VBco组(SPS-VBco)。建模完成后,进行行为学测试(包括空地测试、强迫游泳测试、蔗糖偏好测试、恐惧条件反射测试)。采集血液检测血浆同型半胱氨酸(Hcy)浓度。采集脑组织进行线粒体功能分析、western blotting和实时定量聚合酶链反应(PCR)。结果vbco可显著降低sps后1周血浆Hcy水平。SPS-VBco组小鼠在开阔场地试验中梳洗次数减少,运动速度加快,在强迫游泳试验中休息时间减少,在蔗糖偏好试验中蔗糖偏好比增加,在恐惧条件反射试验中冻结时间减少。VBco增加了海马线粒体呼吸链相关蛋白亚基mRNA的表达,改善了海马线粒体复合体I和IV的活性和膜电位。VBco逆转了sps诱导的海马线粒体mtND1和mtND3甲基化。VBco下调海马线粒体甲基转移酶(DNMT1、DNMT3A、DNMT3B)水平。结论茯苓多糖可有效抑制海马线粒体DNA甲基化。这可能是它减轻类似创伤后应激障碍行为的机制之一。
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引用次数: 0
Making smiles and eye closure natural! Application of acupoint injection therapy in facial paralysis comorbidities: A case report 让微笑和闭上眼睛变得自然!穴位注射治疗面瘫合并症1例
IF 3.1 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-01-11 DOI: 10.1016/j.jnrt.2025.100185
Yuxin Liu , Xixi Han , Lin Chen , Bin Ma
Facial paralysis comorbidities is now understood to include two distinct forms: synkinesis and micro-entrapment syndrome of nerves innervating the face (MESNIF). These disorders manifest as oromandibular synkinesis, stiffness and atrophy of facial muscles on one side, which affect activities of daily living. Acupoint Injection is a treatment for facial paralysis, combining the meridian theory of traditional Chinese medicine, with the injection of specific drugs into acupuncture points of the face. In recent years, the use of acupoint injections has shown in remarkable clinical efficacy and few adverse effects. We report the case to introduce this integrative therapy and outline the key principles of rehabilitation therapy.
面瘫的合并症现在被理解为包括两种不同的形式:面部神经联动性和微压迫综合征(MESNIF)。这些疾病表现为单侧面部肌肉僵硬和萎缩,影响日常生活活动。穴位注射是结合中医经络理论,将特定药物注射到面部穴位,治疗面瘫的一种方法。近年来,穴位注射的临床疗效显著,不良反应少。我们报告的情况下,介绍这种综合疗法,并概述康复治疗的关键原则。
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引用次数: 0
期刊
Journal of Neurorestoratology
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