Neural plasticity is a major factor driving cortical reorganization after stroke. We here tested whether repetitively enhancing motor cortex plasticity by means of intermittent theta-burst stimulation (iTBS) prior to physiotherapy might promote recovery of function early after stroke. Functional magnetic resonance imaging (fMRI) was used to elucidate underlying neural mechanisms. Twenty-six hospitalized, first-ever stroke patients (time since stroke: 1-16 days) with hand motor deficits were enrolled in a sham-controlled design and pseudo-randomized into 2 groups. iTBS was administered prior to physiotherapy on 5 consecutive days either over ipsilesional primary motor cortex (M1-stimulation group) or parieto-occipital vertex (control-stimulation group). Hand motor function, cortical excitability, and resting-state fMRI were assessed 1 day prior to the first stimulation and 1 day after the last stimulation. Recovery of grip strength was significantly stronger in the M1-stimulation compared to the control-stimulation group. Higher levels of motor network connectivity were associated with better motor outcome. Consistently, control-stimulated patients featured a decrease in intra- and interhemispheric connectivity of the motor network, which was absent in the M1-stimulation group. Hence, adding iTBS to prime physiotherapy in recovering stroke patients seems to interfere with motor network degradation, possibly reflecting alleviation of post-stroke diaschisis.
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http://dx.doi.org/10.1093/cercor/bhw034 | DOI Listing |
Hum Brain Mapp
January 2025
Department of Psychology, Concordia University, Montreal, Quebec, Canada.
The cortex and cerebellum are densely connected through reciprocal input/output projections that form segregated circuits. These circuits are shown to differentially connect anterior lobules of the cerebellum to sensorimotor regions, and lobules Crus I and II to prefrontal regions. This differential connectivity pattern leads to the hypothesis that individual differences in structure should be related, especially for connected regions.
View Article and Find Full Text PDFMater Today Bio
February 2025
Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing, 100044, China.
Recent advancements in tissue engineering have promoted the development of nerve guidance conduits (NGCs) that significantly enhance peripheral nerve injury treatment, improving outcomes and recovery rates. However, utilising tailored biomimetic three-dimensional (3D) topological porous structures combined with multiple bio-effect neurotrophic factors to create environments similar to neural tissues, regulate local immune responses, and develop a supportive microenvironment to promote peripheral nerve regeneration and repair poses significant challenges. Herein, a biomimetic extracellular matrix (ECM) NGC featuring an interconnected 3D porous network and sustained delivery of insulin-like growth factor-1 (IGF-1) is designed using multi-functional gelatine microcapsules (GMs).
View Article and Find Full Text PDFEur J Neurol
January 2025
Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Background: Catechol-O-methyl transferase (COMT) inhibitors are routinely used to manage motor fluctuations in Parkinson's disease (PD). We assessed the effect of opicapone on motor symptom severity in levodopa-treated patients without motor complications.
Methods: This was a randomized, double-blind, 24-week, placebo-controlled study of opicapone 50 mg as adjunct to levodopa (NCT04978597).
Sci Rep
January 2025
Dept. of Neurology, University of Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany.
Primary lateral sclerosis (PLS) is a motor neuron disease (MND) which mainly affects upper motor neurons. Within the MND spectrum, PLS is much more slowly progressive than amyotrophic laterals sclerosis (ALS). `Classical` ALS is characterized by catabolism and abnormal energy metabolism preceding onset of motor symptoms, and previous studies indicated that the disease progression of ALS involves hypothalamic atrophy.
View Article and Find Full Text PDFBrain Topogr
January 2025
Department of Radiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, No 152, Ai Guo Road, Dong Hu District, Nanchang, Jiangxi, 330006, China.
Stroke is a condition characterized by damage to the cerebral vasculature from various causes, resulting in focal or widespread brain tissue damage. Prior neuroimaging research has demonstrated that individuals with stroke present structural and functional brain abnormalities, evident through disruptions in motor, cognitive, and other vital functions. Nevertheless, there is a lack of studies on alterations in static and dynamic functional network connectivity in the brains of stroke patients.
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