Restorative neurology and neuroscience
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Restor. Neurol. Neurosci. · Jan 2011
Assessment and treatment of pain with non-invasive cortical stimulation.
There remains an unmet clinical need for the development of new therapeutic approaches for the treatment of pain. Recent findings have confirmed significant changes in the pain-related neural networks among patients with chronic pain, opening novel possibilities for investigation. Two non-invasive techniques (transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS)) have emerged as interesting, effective, and promising modalities for pain relief. ⋯ Besides its use as a therapeutic tool, non-invasive brain stimulation can also be used to measure cortical reactivity and plasticity in chronic pain. Such measurements could potentially be used as biomarkers for the dysfunctional chronic pain-related neural network and might be helpful in measuring the efficacy of interventions designed for chronic pain.
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Restor. Neurol. Neurosci. · Jan 2011
Randomized Controlled Trial Clinical TrialImproved picture naming in aphasia patients treated with cathodal tDCS to inhibit the right Broca's homologue area.
Previous reports have suggested that noninvasive cortical stimulation could influence speech production in patients with chronic stroke. Here, we evaluated the hypothesis that cathodal transcranial DC stimulation (ctDCS), a technique that decreases excitability of stimulated cortical sites, applied over a healthy right Broca's homologue area could improve picture naming in patients with post-stroke aphasia. ⋯ These results demonstrate that cathodal tDCS over the right healthy Broca's homologue area with a left supraorbital anodal location can improve picture naming task performance in post-stroke aphasia.
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Restor. Neurol. Neurosci. · Jan 2011
ReviewUnderstanding and enhancing motor recovery after stroke using transcranial magnetic stimulation.
Stroke is the leading cause of long-term disability. Understanding how people recover from stroke and other brain lesions remain one of the biggest conundrums in neuroscience. As a result, concerted efforts in recent years have focused on investigating the neurophysiological changes that occur in the brain after stroke, and in developing novel strategies to enhance motor recovery. ⋯ We also consider recent studies using repetitive TMS (rTMS) in stroke patients to enhance upper extremity function. Although further studies are needed, these investigations provide an important starting point to understand the stimulation parameters and patient characteristics that may influence the optimal response to non-invasive brain stimulation. Future directions of rTMS are discussed in the context of post-stroke motor recovery.
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Restor. Neurol. Neurosci. · Jan 2011
ReviewNoninvasive brain stimulation in the treatment of aphasia: exploring interhemispheric relationships and their implications for neurorehabilitation.
Aphasia is a common consequence of unilateral stroke, typically involving perisylvian regions of the left hemisphere. The course of recovery from aphasia after stroke is variable, and relies on the emergence of neuroplastic changes in language networks. Recent evidence suggests that rehabilitation interventions may facilitate these changes. ⋯ Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are two safe and noninvasive procedures that can be applied clinically to modulate cortical excitability during poststroke language recovery. Intervention with these noninvasive brain stimulation techniques also allows for inferences to be made regarding mechanisms of recovery, including the role of intrahemispheric and interhemispheric interactions. Here we review recent evidence that suggests that TMS and tDCS are promising tools for facilitating language recovery in aphasic patients, and examine evidence that indicates that both right and left hemisphere mechanisms of plasticity are instrumental in aphasia recovery.
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Restor. Neurol. Neurosci. · Jan 2011
Comparative StudyImproved behavioral outcomes after progesterone administration in aged male rats with traumatic brain injury.
Twenty-month-old male Fischer 344 rats with bilateral contusions of the frontal cortex (n=8/group) or sham operations received 16 mg/kg of progesterone or vehicle at 1 and 6 h post-injury, then once every 24 h for the next seven days, with tapering of the dose over the final two treatments. The rats' behavioral recovery was then evaluated on tests of locomotor activity and Morris water maze learning. ⋯ The progesterone-treated rats had better functional outcomes than vehicle-treated rats with similar cortical injuries. The neurosteroid treatment did not affect the size of the necrotic cavity.