Neurorehabilitation and neural repair
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Neurorehabil Neural Repair · May 2008
ReviewInforming dose-finding studies of repetitive transcranial magnetic stimulation to enhance motor function: a qualitative systematic review.
Repetitive transcranial magnetic stimulation (rTMS) of the lesioned hemisphere might enhance motor recovery after stroke, but the appropriate dose (parameters of rTMS) remains uncertain. The present review collates evidence of the effect of rTMS on corticospinal pathway excitability and motor function in healthy adults and in people after stroke. ⋯ There is as yet insufficient published evidence to guide the dose of rTMS to the lesioned hemisphere after stroke to improve recovery of a paretic limb. Moreover, it is apparent that there is variability in response to rTMS in healthy adults. Dose-finding studies in groups of well-characterized stroke patients are needed.
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Neurorehabil Neural Repair · May 2008
Multicenter StudyChanges in activity after a complete spinal cord injury as measured by the Spinal Cord Independence Measure II (SCIM II).
The assessment of rehabilitation efficacy in spinal cord injury (SCI) should be based on a combination of neurological and functional outcome measures. The Spinal Cord Independence Measure II (SCIM II) is an independence scale that was specifically developed for subjects with SCI. However, little is know about the changes in SCIM II scores during and after rehabilitation. ⋯ The SCIM II is responsive to functional changes in patients with a persistent motor complete SCI. It is clinically useful for monitoring functional improvement during rehabilitation and after discharge. The SCIM II and the clinical examination based on the ASIA protocol are of complementary value and separately describe changes in independence and sensorimotor deficits in SCI patients.
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Neurorehabil Neural Repair · May 2008
Nogo-66 receptor antagonist peptide (NEP1-40) administration promotes functional recovery and axonal growth after lateral funiculus injury in the adult rat.
The myelin protein Nogo inhibits axon regeneration by binding to its receptor (NgR) on axons. Intrathecal delivery of an NgR antagonist (NEP1-40) promotes growth of injured corticospinal axons and recovery of motor function following a dorsal hemisection. The authors used a similar design to examine recovery and repair after a lesion that interrupts the rubrospinal tract (RST). ⋯ NgR blockade after RST injury is associated with axonal growth and/or diminished dieback of severed RST axons up to but not into or beyond the lesion/matrix site, and growth of serotonergic and dorsal root axons adjacent to and into the lesion/matrix site. NgR blockade also supported partial recovery of function. The authors' results indicate that severed rubrospinal axons respond to NEP1-40 treatment but less robustly than corticospinal, raphe-spinal, or dorsal root axons.
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Neurorehabil Neural Repair · Mar 2008
Multicenter StudyChanges in activity after a complete spinal cord injury as measured by the Spinal Cord Independence Measure II (SCIM II).
The assessment of rehabilitation efficacy in spinal cord injury (SCI) should be based on a combination of neurological and functional outcome measures. The Spinal Cord Independence Measure II (SCIM II) is an independence scale that was specifically developed for subjects with SCI. However, little is known about the changes in SCIM II scores during and after rehabilitation. ⋯ The SCIM II is responsive to functional changes in patients with a persistent motor complete SCI. It is clinically useful for monitoring functional improvement during rehabilitation and after discharge. The SCIM II and the clinical examination based on the ASIA protocol are of complementary value and separately describe changes in independence and sensorimotor deficits in SCI patients.
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Neurorehabil Neural Repair · Mar 2008
Neural correlates of proprioceptive integration in the contralesional hemisphere of very impaired patients shortly after a subcortical stroke: an FMRI study.
The effects of physiotherapy are difficult to assess in very impaired early stroke patients. ⋯ We have demonstrated that purely passive proprioceptive training applied for 4 weeks is able to modify brain sensorimotor activity after a stroke. This training revealed fMRI change in the ventral premotor and parietal cortices of the contralesional hemisphere, which are secondary sensorimotor areas. Recent studies have demonstrated the crucial role of these areas in severely impaired patients. We propose that increased contralesional activity in secondary sensorimotor areas likely facilitates control of recovered motor function by simple proprioceptive integration in those patients with poor recovery.