Most stroke lesions occur in the middle cerebral artery territory, presenting a high probability of damage of pathways with predominant ipsilesional disposition, mainly related to postural control. Despite the high probability of bilateral postural control dysfunction based on neuroanatomical fundaments, both research and clinical rehabilitation involving stroke subjects have been focused on contralesional side (also named affected side) impairments, while ipsilesional side (also named non-affected side) impairments have been attributed to an adaptive strategy. This paper aims to present a critical understanding about the state-of-the-art that sustains the hypothesis that stroke subjects with middle cerebral artery territory lesion at the subcortical level show an atypical behaviour in the ipsilateral side associated with the lesion itself and the possible implications.
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http://dx.doi.org/10.1080/08990220.2017.1384721 | DOI Listing |
Cortex
December 2024
Cognitive Neuroscience, Institute of Neuroscience & Medicine (INM-3), Forschungszentrum Jülich, Jülich, Germany; Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
The precise cognitive mechanisms underlying spatial neglect are not fully understood. Recent studies have provided the first evidence for aberrant behavioral and electrophysiological prediction and prediction error responses in patients with neglect, but also in right-hemispheric (RH) stroke patients without neglect. For prediction-dependent attention, as assessed with Posner-type cueing paradigms with volatile cue-target contingencies, studies in healthy volunteers point to a crucial role of the right temporo-parietal junction (rTPJ) - as part of a network commonly disrupted in neglect.
View Article and Find Full Text PDFAnn Neurol
December 2024
Department of Neurology, Jewish Hospital Berlin, Berlin, Germany.
Objective: Among patients with acute stroke, we aimed to identify those who will later develop central post-stroke pain (CPSP) versus those who will not (non-pain sensory stroke [NPSS]) by assessing potential differences in somatosensory profile patterns and evaluating their potential as predictors of CPSP.
Methods: In a prospective longitudinal study on 75 acute stroke patients with somatosensory symptoms, we performed quantitative somatosensory testing (QST) in the acute/subacute phase (within 10 days) and on follow-up visits for 12 months. Based on previous QST studies, we hypothesized that QST values of cold detection threshold (CDT) and dynamic mechanical allodynia (DMA) would differ between CPSP and NPSS patients before the onset of pain.
Ann Neurol
December 2024
Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Objective: Vagus nerve stimulation (VNS) paired with rehabilitation therapy improved motor status compared to rehabilitation alone in the phase III VNS-REHAB stroke trial, but treatment response was variable and not associated with any clinical measures acquired at baseline, such as age or side of paresis. We hypothesized that neuroimaging measures would be associated with treatment-related gains, examining performance of regional injury measures versus global brain health measures in parallel with clinical measures.
Methods: Baseline magnetic resonance imaging (MRI) scans in the VNS-REHAB trial were used to derive regional injury measures (extent of injury to corticospinal tract, the primary regional measure; plus extent of injury to precentral gyrus and postcentral gyrus; lesion volume; and lesion topography) and global brain health measures (degree of white matter hyperintensities, the primary global brain measure; plus volumes of cerebrospinal fluid, cortical gray matter, white matter, each thalamus, and total brain).
J Comp Neurol
December 2024
Department of Neuroscience, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
J Neuroeng Rehabil
December 2024
The Fifth Affiliated Hospital of Zhengzhou University, Henan, 450052, P.R. China.
Background: Impaired balance and gait in stroke survivors are associated with decreased functional independence. This study aimed to evaluate the effectiveness of unilateral lower-limb exoskeleton robot-assisted overground gait training compared with conventional treatment and to explore the relationship between neuroplastic changes and motor function recovery in subacute stroke patients.
Methods: In this randomized, single-blind clinical trial, 40 patients with subacute stroke were recruited and randomly assigned to either a robot-assisted training (RT) group or a conventional training (CT) group.
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