Restorative neurology and neuroscience
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Restor. Neurol. Neurosci. · Jan 2013
Combined bilateral anterior cingulotomy and ventral capsule/ventral striatum deep brain stimulation for refractory obsessive-compulsive disorder with major depression: do combined procedures have a long-term benefit?
The ventral capsule (VC), ventral striatum (VS), and the anterior cingulate gyrus are parts of the obsessive-compulsive disorder (OCD) and depression circuits. We assessed whether a combination of bilateral anterior cingulotomy and VC/VS deep brain stimulation (DBS) had an additive effect in patients with OCD and major depression. ⋯ The combination of the two therapies did not yield superior outcomes, as the clinical outcomes were comparable to those of previous reports for VC/VS DBS alone. Wide-area VC/VS DBS may be sufficient to control refractory OCD.
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Restor. Neurol. Neurosci. · Jan 2013
Randomized Controlled TrialAnodal transcranial direct current stimulation in early rehabilitation of patients with post-stroke non-fluent aphasia: a randomized, double-blind, sham-controlled pilot study.
Recent research in patients with chronic aphasia shows an association between excitatory anodal transcranial direct current stimulation (A-tDCS) of the stroke-affected left hemisphere coupled with speech and language therapy (SLT) and better language performance. The present study aimed to investigate this association during the early post-stroke rehabilitation period, when adaptive changes are most possible on neurophysiological and behavioral levels. ⋯ The findings provide only weak evidence for A-tDCS-related language gains during early neurorehabilitation of post-stroke aphasia. Further research is needed to explore the effectiveness of this kind of neuromodulation.
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Restor. Neurol. Neurosci. · Jan 2013
Modulatory effects of locomotor training on extensor spasticity in individuals with motor-incomplete spinal cord injury.
Sparse data exist about effects of locomotor training on spasticity in individuals with spinal cord injury (SCI). We investigated changes in spastic responses in individuals with motor-incomplete SCI (MISCI) associated with locomotor training and examined properties of a biomechanical measure of clonus severity, plantar flexor reflex threshold angle (PF RTA). ⋯ In persons with spastic paresis due to MISCI, locomotor training was associated with decreased spasticity as measured by decreased plantar flexor excitability, ankle clonus, and quadriceps spasm.
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Restor. Neurol. Neurosci. · Jan 2013
Towards physiological ankle movements with the ActiGait implantable drop foot stimulator in chronic stroke.
Functional electrical stimulation represents an alternative to conventional and passive ankle foot orthosis (AFO) for the treatment of stroke-related drop foot. We evaluated the implantable 4-channel stimulator ActiGait, which selectively and directly stimulates the peroneal nerve. In addition, it bypasses the need for surface electrodes and cables. ⋯ The ActiGait system increased gait speed, walking endurance and the physiology of important ankle joint kinematics. This is most likely a result of ankle dorsiflexion by active peroneal stimulation during the swing phase of gait and optimized prepositioning (IA) of the foot at the beginning of stance phase. The ActiGait system represents a therapeutic option for the treatment of patients suffering drop foot due to a cerebrovascular insult.
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Restor. Neurol. Neurosci. · Jan 2013
Perceptual effects of the mirror box training in normal subjects.
The mirror box (MB) was developed in the early 1990 s to relieve phantom limb sensations and chronic pain. Although its efficacy has been shown in several clinical populations, the mechanisms underpinning effects still have to be fully understood. ⋯ The present results suggest that the MB induce a somatotopically and contextually specific overriding of kinesthetic control by vision, compatible with a process of embodiment of the mirror-reflected hand image and provide novel clues to the understanding of the mechanisms underlying MB effects.