Neurorehabilitation and neural repair
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Neurorehabil Neural Repair · Sep 2009
ReviewInterhemispheric competition after stroke: brain stimulation to enhance recovery of function of the affected hand.
Within the concept of interhemispheric competition, technical modulation of the excitability of motor areas in the contralesional and ipsilesional hemisphere has been applied in an attempt to enhance recovery of hand function following stroke. This review critically summarizes the data supporting the use of novel electrophysiological concepts in the rehabilitation of hand function after stroke. ⋯ Brain stimulation is a safe and promising tool to induce plastic changes in the cortical sensorimotor network to improve motor behavior after stroke. However, several methodological issues remain to be answered to further improve the effectiveness of these new approaches.
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Neurorehabil Neural Repair · Jul 2009
Sympathetic skin responses evoked by different stimuli modalities in spinal cord injury patients.
By using a combination of physiological and electrical peripheral nerve stimuli, the authors aimed to characterize the expected dysfunction of the circuits responsible for sympathetic skin response (SSR) in persons with spinal cord injury (SCI). ⋯ SSR to various stimuli confirms the importance of supraspinal centers and the integrity of sympathetic descending pathways. Simultaneous recording of the SSR in the hands and feet provides information about the degree of sympathetic impairment possibly in the efferent pathway. To monitor spontaneous recovery or the efficacy of a drug or biological therapeutic intervention, changes in the latency delay between the hand and foot may be valuable.
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Neurorehabil Neural Repair · Jul 2009
Comparative StudyCost-effectiveness modeling of intrathecal baclofen therapy versus other interventions for disabling spasticity.
To assess by simulation the cost-effectiveness of intrathecal baclofen (ITB) therapy compared with conventional medical treatments for patients with disabling spasticity and functional dependence caused by any neurological disease. ⋯ Within the assumptions of our modeling, ITB therapy evaluated by a combination of treatment success criteria at 6-month intervals over a 2-year period may be a cost-effective strategy compared to conventional medical management alone.
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Neurorehabil Neural Repair · Jul 2009
Transcutaneously coupled, high-frequency electrical stimulation of the pudendal nerve blocks external urethral sphincter contractions.
Detrusor-sphincter dyssynergia is a condition in which reflexive contractions of the external urethral sphincter occur during bladder contractions, preventing the expulsion of urine. High-frequency stimulation (kHz range) has been shown to elicit a fast-acting and reversible block of action potential propagation in peripheral nerves, which may be a useful technique in the management of this condition. ⋯ The transcutaneous passive implanted conductor stimulus delivery system is an effective way to stimulate the pudendal nerve at high frequency, leading to sphincter relaxation. This system may provide a simple means to implement this stimulation paradigm in people with detrusor-sphincter dyssynergia.
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Neurorehabil Neural Repair · Jul 2009
Training with virtual visual feedback to alleviate phantom limb pain.
Performing phantom movements with visual virtual feedback, or mirror therapy, is a promising treatment avenue to alleviate phantom limb pain. However the effectiveness of this approach appears to vary from one patient to another. ⋯ These results support the use of training with virtual feedback to alleviate phantom limb pain. Our observations suggest that between-participant differences in the effectiveness of the treatment might be related more to a difference in the susceptibility to the virtual visual feedback, than to factors related to the lesion, such as the duration of the deafferentation.