[Psychosomatic Rehabilitation: An Overview].

Psychosomatic Rehabilitation: An Overview Psychosomatic Medicine is based on the shared understanding that physical illnesses can have a multi-factorial aetiology, whereby biological, psychological and social factors interact to cause and maintain physical and mental symptoms and complaints. Commonly implicated aetiological factors in psychosomatic disorders are physical and / or psychological stress, inflammation and degeneration, and the resulting symptoms can manifest themselves in different organ systems, such as: the nervous system, the musculoskeletal system, the cardiovascular system, the respiratory system, the gastrointestinal system and the skin. In order to create a model of psychosomatic symptoms that would allow for a systematic classification of psychosomatic disorders, the Diagnostic Criteria for Psychosomatic Research (DCPR) were developed in 1995.

Ipsilesional anodal tDCS enhances the functional benefits of rehabilitation in patients after stroke.

Anodal transcranial direct current stimulation (tDCS) can boost the effects of motor training and facilitate plasticity in the healthy human brain. Motor rehabilitation depends on learning and plasticity, and motor learning can occur after stroke. We tested whether brain stimulation using anodal tDCS added to motor training could improve rehabilitation outcomes in patients after stroke.

Prefrontal Cortex Activation While Walking Under Dual-Task Conditions in Stroke: A Multimodal Imaging Study.

Background Walking while performing another task (eg, talking) is challenging for many stroke survivors, yet its neural basis are not fully understood. Objective To investigate prefrontal cortex activation and its relationship to gait measures while walking under single-task (ST) and dual-task (DT) conditions (ie, walking while simultaneously performing a cognitive task) in stroke survivors. Methods We acquired near-infrared spectroscopy (NIRS) data from the prefrontal cortex during treadmill walking in ST and DT conditions in chronic stroke survivors and healthy controls.

Predicting behavioural response to TDCS in chronic motor stroke.

Transcranial direct current stimulation (TDCS) of primary motor cortex (M1) can transiently improve paretic hand function in chronic stroke. However, responses are variable so there is incentive to try to improve efficacy and or to predict response in individual patients. Both excitatory (Anodal) stimulation of ipsilesional M1 and inhibitory (Cathodal) stimulation of contralesional M1 can speed simple reaction time.

Pointing and the interference effect in obsessive-compulsive disorder (OCD).

The interference effect in obsessive-compulsive disorder (OCD) was investigated in order to analyze cognitive aspects of motor stereotypy in OCD-related compulsions. So far, the domain of cognitive control in compulsive behavior has been under-investigated. Twelve participants (OCD patients and healthy controls) completed a newly created computer-based pointing task as well as standard clinical and psychological background measures.

Relationships between functional and structural corticospinal tract integrity and walking post stroke.

Objective: Studies on upper limb recovery following stroke have highlighted the importance of the structural and functional integrity of the corticospinal tract (CST) in determining clinical outcomes. However, such relationships have not been fully explored for the lower limb. We aimed to test whether variation in walking impairment was associated with variation in the structural or functional integrity of the CST.

Comparison of embedded and added motor imagery training in patients after stroke: results of a randomised controlled pilot trial.

Background: Motor imagery (MI) when combined with physiotherapy can offer functional benefits after stroke. Two MI integration strategies exist: added and embedded MI. Both approaches were compared when learning a complex motor task (MT): 'Going down, laying on the floor, and getting up again'.

Cortical activation changes underlying stimulation-induced behavioural gains in chronic stroke.

Transcranial direct current stimulation, a form of non-invasive brain stimulation, is showing increasing promise as an adjunct therapy in rehabilitation following stroke. However, although significant behavioural improvements have been reported in proof-of-principle studies, the underlying mechanisms are poorly understood. The rationale for transcranial direct current stimulation as therapy for stroke is that therapeutic stimulation paradigms increase activity in ipsilesional motor cortical areas, but this has not previously been directly tested for conventional electrode placements.

Dexamphetamine improves upper extremity outcome during rehabilitation after stroke: a pilot randomized controlled trial.

Background: For early inpatient stroke rehabilitation, the effectiveness of amphetamine combined with physiotherapy varies across studies.

Objective: To investigate whether the recovery of activities of daily living (ADL, primary outcome) and motor function (secondary outcome) can be improved by dexamphetamine added to physiotherapy.

Methods: In a double-blind, placebo-controlled trial, 16 patients, from 918 who were screened, were randomized to the experimental group (EG, dexamphetamine + physiotherapy) or control group (CG, placebo + physiotherapy).

Best practice for motor imagery: a systematic literature review on motor imagery training elements in five different disciplines.

Background: The literature suggests a beneficial effect of motor imagery (MI) if combined with physical practice, but detailed descriptions of MI training session (MITS) elements and temporal parameters are lacking. The aim of this review was to identify the characteristics of a successful MITS and compare these for different disciplines, MI session types, task focus, age, gender and MI modification during intervention.

Methods: An extended systematic literature search using 24 databases was performed for five disciplines: Education, Medicine, Music, Psychology and Sports.

Motor practice promotes increased activity in brain regions structurally disconnected after subcortical stroke.

Background: Motor practice is an important component of neurorehabilitation. Imaging studies in healthy individuals show that dynamic brain activation changes with practice. Defining patterns of functional brain plasticity associated with motor practice following stroke could guide rehabilitation.

Cognitive context determines dorsal premotor cortical activity during hand movement in patients after stroke.

Background And Purpose: Stroke patients often have difficulties in simultaneously performing a motor and cognitive task. Functional imaging studies have shown that movement of an affected hand after stroke is associated with increased activity in multiple cortical areas, particularly in the contralesional hemisphere. We hypothesized patients for whom executing simple movements demands greater selective attention will show greater brain activity during movement.

Errors of somatosensory localisation in a patient with right-hemisphere stroke.

Following a right-hemisphere stroke, Patient NG could detect somatosensory stimulation that she was unable to localise. With vision precluded, NG systematically mislocalized touch on the little and ring finger of her affected left hand, and reported feeling this touch on the neighbouring rightward finger. This pattern of mislocalization occurred not only when the Examiner administered touch but also when touch was self-administered.

Comparison of embedded and added motor imagery training in patients after stroke: study protocol of a randomised controlled pilot trial using a mixed methods approach.

Background: Two different approaches have been adopted when applying motor imagery (MI) to stroke patients. MI can be conducted either added to conventional physiotherapy or integrated within therapy sessions. The proposed study aims to compare the efficacy of embedded MI to an added MI intervention.

Touch and feel? Using the rubber hand paradigm to investigate self-touch enhancement in right-hemisphere stroke patients.

Following stroke, a patient may fail to report touch administered by another person but claim that she feels touch when it is self-administered. We investigated three explanations for self-touch enhancement: (1) proprioceptive information from the administering hand, (2) attentional modulation, and (3) temporal expectation. Tactile sensation was assessed with vision precluded, and with the affected hand positioned in the left and right hemispace.

Brain activity changes associated with treadmill training after stroke.

Background And Purpose: The mechanisms underlying motor recovery after stroke are not fully understood. Several studies used functional MRI longitudinally to relate brain activity changes with performance gains of the upper limb after therapy, but research into training-induced recovery of lower limb function has been relatively neglected thus far.

Methods: We investigated functional reorganization after 4 weeks of treadmill training with partial body weight support in 18 chronic patients (mean age, 59.

A distinct pattern of myofascial findings in patients after whiplash injury.

Objective: To identify objective clinical examinations for the diagnosis of whiplash syndrome, whereby we focused on trigger points.

Design: A cross-sectional study with 1 measurement point.

Setting: A quiet treatment room in a rehabilitation center.

Functional MRI correlates of lower limb function in stroke victims with gait impairment.

Background And Purpose: Although knowledge concerning cortical reorganization related to upper limb function after ischemic stroke is growing, similar data for lower limb movements are limited. Previous studies with hand movement suggested increasing recruitment of motor areas in the unlesioned hemisphere with increasing disability. We used ankle movement as a lower limb analog to test for similarities and differences in recovery patterns.

Depressive symptoms following herpes simplex encephalitis--an underestimated phenomenon?

Objective: In view of the herpes simplex virus' neurotropism for the limbic system and the temporal lobe, little is known about potential negative effects of this necrotizing encephalitis on affective functioning and health-related quality of life (HRQoL) after recovery. We therefore set out to explore an association between herpes simplex virus encephalitis (HSE) and both depressive symptoms and HRQoL.

Methods: A structured telephone interview was conducted in 26 subjects (F/M=10/16; age at follow-up, 49.

The role of ipsilateral premotor cortex in hand movement after stroke.

Movement of an affected hand after stroke is associated with increased activation of ipsilateral motor cortical areas, suggesting that these motor areas in the undamaged hemisphere may adaptively compensate for damaged or disconnected regions. However, this adaptive compensation has not yet been demonstrated directly. Here we used transcranial magnetic stimulation (TMS) to interfere transiently with processing in the ipsilateral primary motor or dorsal premotor cortex (PMd) during finger movements.