Brain & NeuroRehabilitation最新文献

Repetitive transcranial magnetic stimulation (rTMS) is gaining popularity as a research tool in neuroscience; however, little is known about its molecular mechanisms of action. The present study aimed to investigate the rTMS-induced transcriptomic changes; we performed microarray messenger RNA, micro RNA, and integrated analyses to explore these molecular events. Eight adult male Sprague-Dawley rats were subjected to a single session of unilateral rTMS at 1 Hz (n = 4) or sham (n = 4). The left hemisphere was stimulated for 20 minutes. To evaluate the cumulative effect of rTMS, eight additional rats were assigned to the 1-Hz (n = 4) or sham (n = 4) rTMS groups. The left hemisphere was stimulated for 5 consecutive days using the same protocol. Microarray analysis revealed differentially expressed genes in the rat cortex after rTMS treatment. The overrepresented gene ontology categories included the positive regulation of axon extension, axonogenesis, intracellular transport, and synaptic plasticity after repeated sessions of rTMS. A single session of rTMS primarily induced changes in the early genes, and several miRNAs were significantly related to the mRNAs. Future studies are required to validate the functional significance of selected genes and refine the therapeutic use of rTMS.

[This corrects the article e16 in vol. 15.].

The present study examined cortical cerebral microinfarcts (CMIs) on a 3T magnetic resonance imaging and investigated the impact of CMIs on the comprehensive functional outcomes during the post-stroke rehabilitation period. Patients with acute phase of first-ever ischemic stroke were retrospectively recruited (n = 62) and divided into 2 groups with and without CMIs. Clinical parameters including age, sex, stroke lesion laterality, location, the National Institutes of Health Stroke Scale score, as well as history of hypertension, dyslipidemia, diabetes mellitus, and smoking were obtained. Functional outcomes were assessed twice at baseline and one month later with the Korean version of the Mini-Mental State Examination, the Berg balance scale (BBS), and the functional independence measure. Partial correlation and multiple linear regression analyses were used to examine the relationship between the presence of CMIs and the change in functional outcomes. At least one CMI was reported in 27 patients, who were older (p = 0.043). The presence of CMIs was significantly associated with functional impairment in all 3 functional outcomes, after controlling for confounding factors (p < 0.05). CMIs might contribute to poor functional outcomes during the post-stroke rehabilitation period. These results suggest that CMIs should be considered when establishing rehabilitation treatment strategies or making a prognosis.

Peduncular hallucinosis is a rare type of hallucination, wherein patients see colorful and vivid images. It usually appears after damage to the midbrain, pons, or thalamus. We report the case of a 56-year-old man with peduncular hallucinosis after conservative care for spontaneous pontine hemorrhage, 7 months prior to presentation. He was treated with atypical antipsychotics, which resolved the symptoms. We suggest that it is important to consider peduncular hallucinosis in patients after injuries in subcortical areas and the brainstem. Additionally, we found changes in the hypertrophic olivary degeneration using magnetic resonance imaging, and we suggest the possibility of their correlation with peduncular hallucinosis.

Gliomas are the most common type of primary brain tumor in adults. Glioma treatment requires a multidisciplinary approach involving surgery, radiotherapy, and chemotherapy. Multiple trials have been conducted to establish the appropriate choice of treatment to achieve long-term survival and better quality of life. This review provides up-to-date evidence regarding treatment strategies for gliomas.

This study aimed to investigate the visuoconstructive abilities and the relationship between visuoconstructive function and language performance in aphasic patients. Right-handed 24 aphasic patients (males 14, females 10) with at least 3 months post-stroke and 32 age-matched healthy controls participated in this study. Visuoconstructive function was assessed by 3 levels of task difficulty: simple (drawing objects), intermediate (clock drawing), and complex (copy subtest of Rey complex figure test and block construction). Aphasic patients were divided into 3 sub-groups (mild, moderate to severe, and very severe group) according to severity of aphasia and compared with the control group, respectively. We analyzed the relation all levels of visuoconstructive tasks to aphasia quotient (AQ) and sub-domain scores of K-WAB. Moderate to severe aphasia group demonstrated no significant differences in scores of simple drawing objects compared to controls, but clock drawing, Rey complex figure copy and block design showed significantly decreased scores. Very severe group showed significantly lower scores in all levels of visuoconstructive tasks than the control. Correlation between all levels of visuoconstructive tasks except drawing objects and AQ were found to be statistically significant. Among the tasks, the clock drawing test revealed the highest correlation with language performance. Visuoconstructive abilities varied according to the severity of aphasia and the level of visuoconstructive tasks. Therefore, a thorough individual assessment of visuoconstructive function is needed to plan and predict the treatment and prognosis of aphasia and the clock drawing test may be a useful screening tool to evaluate this function.

Brain tumors are receiving increasing attention in cancer rehabilitation due to their high rate of neurological deterioration. Motor dysfunction, cognitive deterioration, and emotional problems are commonly present in patients with brain tumors. Other medical complications, such as seizures, headache, and dysphagia are also common. An individualized multidisciplinary rehabilitation intervention is necessary to treat functional impairment due to the tumor itself and/or treatment-related dysfunction. Herein, we discuss rehabilitation treatment strategies in relation to the neurological and functional complications that commonly occur in patients with brain tumors.

A narrative review was conducted of machine learning applications and research in the field of stroke rehabilitation. The machine learning models commonly used in medical research include random forest, logistic regression, and deep neural networks. Convolutional neural networks (CNNs), a type of deep neural network, are typically used for image analysis. Machine learning has been used in stroke rehabilitation to predict recovery of motor function using a large amount of clinical data as input. Recent studies on predicting motor function have trained CNN models using magnetic resonance images as input data together with clinical data to increase the accuracy of motor function prediction models. Additionally, a model interpreting videofluoroscopic swallowing studies was developed and investigated. In the future, we anticipate that machine learning will be actively used to treat stroke patients, such as predicting the occurrence of depression and the recovery of language, cognitive, and sensory function, as well as prescribing appropriate rehabilitation treatments.

Hyper-immunoglobulin (Ig) M syndrome is a congenital immunodeficiency disorder characterized by increased serum IgM with low serum IgG, IgA, and IgE. We report the case of a 6-year-old boy with hyper-IgM syndrome as an underlying disease who showed progressive multifocal leukoencephalopathy findings on brain magnetic resonance imaging after visiting the hospital due to left upper extremity muscle weakness, gait disturbance, and speech impairment. At the time of hospitalization, he was treated with steroids and intravenous immunoglobulin, and his condition improved somewhat, but 6 months later, he visited the hospital with rapid deterioration.

Unilateral vocal cord palsy (UVCP) is frequently observed in patients with stroke. This study aimed to evaluate the association between objective dysphonia severity and the classification of UVCP in patients with stroke by objectively and quantitatively measuring their phonetic function. We recruited patients with UVCP diagnosed using laryngoscopy after stroke. Subgroups were divided according to UVCP type, and the dysphonia severity index (DSI) and maximum phonation time (MPT) were measured to objectively evaluate dysphonia. The DSI and MPT were compared between subgroups using analysis of variance with Tukey's honest significant difference post hoc test. In total, 103 patients with stroke and UVCP were recruited. We found that a higher UVCP severity possibly had to do with lower DSI and MPT values. We objectively confirmed that phonetic function was worse in patients with stroke with higher UVCP severity, and the DSI and MPT tests can be helpful in determining the severity and need for additional evaluation.