Neurorehabilitation and neural repair
-
Neurorehabil Neural Repair · May 2012
Promotion of recovery from thoracic spinal cord contusion in rats by stimulation of medullary raphe or its midbrain input.
. Brainstem regions with descending axons could influence recovery after spinal cord injury, thus presenting potential targets for treatment. Neurons in the hindbrain raphe magnus respond to sensory and chemical concomitants of trauma (eg, pain, circulating cytokines) and release trophic substances (serotonin, neuropeptides) in widespread spinal regions. ⋯ . Raphe magnus neurons mediate restorative feedback in acute spinal cord injury. Their interim activation, direct or indirect (via periaqueductal gray), offers a basis for possible treatments in patients.
-
Neurorehabil Neural Repair · Mar 2012
Randomized Controlled TrialContralaterally controlled functional electrical stimulation for upper extremity hemiplegia: an early-phase randomized clinical trial in subacute stroke patients.
Contralaterally controlled functional electrical stimulation (CCFES) is an experimental treatment intended to improve hand function after stroke. ⋯ The results favor CCFES over cyclic NMES though the small sample size limits the statistical power of the study. The effect size estimates from this study will be used to power a larger trial.
-
Neurorehabil Neural Repair · Feb 2012
Randomized Controlled TrialExposure to acute intermittent hypoxia augments somatic motor function in humans with incomplete spinal cord injury.
Neural plasticity may contribute to motor recovery following spinal cord injury (SCI). In rat models of SCI with respiratory impairment, acute intermittent hypoxia (AIH) strengthens synaptic inputs to phrenic motor neurons, thereby improving respiratory function by a mechanism known as respiratory long-term facilitation. Similar intermittent hypoxia-induced facilitation may be feasible in somatic motor pathways in humans. ⋯ AIH elicits sustained increases in volitional somatic motor output in persons with chronic SCI. Thus, AIH has promise as a therapeutic tool to induce plasticity and enhance motor function in SCI patients.
-
Neurorehabil Neural Repair · Nov 2011
Clinical TrialA novel command signal for motor neuroprosthetic control.
Neuroprostheses can restore functions such as hand grasp or standing to individuals with spinal cord injury (SCI) using electrical stimulation to elicit movements in paralyzed muscles. Implanted neuroprostheses currently use electromyographic (EMG) activity from muscles above the lesion that remain under volitional control as a command input. Systems in development use a networked approach and will allow for restoration of multiple functions but will require additional command signals to control the system, especially in individuals with high-level tetraplegia. ⋯ Results suggest that voluntary activity is present and recordable in below lesion muscles even after clinically complete SCI.
-
Neurorehabil Neural Repair · Oct 2011
Accelerometer-triggered electrical stimulation for reach and grasp in chronic stroke patients: a pilot study.
Electrical stimulation of the upper extremity may reduce impairment in patients following stroke. Stimulation triggered on demand combined with task practice may be an effective means of promoting recovery of function. ⋯ Accelerometer-triggered electrical stimulation to augment task training for the hemiplegic arm is feasible and may improve functional ability and quality of life which may be maintained 12 weeks after treatment. A randomized trial design is required to evaluate efficacy and cost benefit.