Objective: To examine the long-term effects of the low-frequency repetitive transcranial magnetic stimulation (LFrTMS) combined with task-specific training on paretic hand function following subacute stroke.
Methods: Sixteen participants were randomly selected and grouped into two: the experimental group (real LFrTMS) and the control group (sham LF-rTMS). All the 16 participants were then taken through a 1-hour taskspecific training of the paretic hand. The corticospinal excitability (motor evoke potential [MEP] amplitude) of the non-lesioned hemisphere, and the paretic hand performance (Wolf Motor Function Test total movement time [WMFT-TMT]) were evaluated at baseline, after the LF-rTMS, immediately after task-specific training, 1 and 2 weeks after the training.
Results: Groups comparisons showed a significant difference in the MEP after LF-rTMS and after the training. Compared to the baseline, the MEP of the experimental group significantly decreased after LF-rTMS and after the training and that effect was maintained for 2 weeks. Group comparisons showed significant difference in WMFT-TMT after the training. Only in the experimental group, the WMFT-TMT of the can lifting item significantly reduced compared to the baseline and the effect was sustained for 2 weeks.
Conclusion: The results of this study established that the improvement in paretic hand after task-specific training was enhanced by LF-rTMS and it persisted for at least 2 weeks.
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http://dx.doi.org/10.5535/arm.2018.42.6.777 | DOI Listing |
Biomed Phys Eng Express
January 2025
F. Joseph Halcomb III, MD, Department of Biomedical Engineering, University of Kentucky, 143 Graham Ave., Lexington, Kentucky, 40506, UNITED STATES.
Brain-computer interfaces (BCIs) offer disabled individuals the means to interact with devices by decoding the electroencephalogram (EEG). However, decoding intent in fine motor tasks can be challenging, especially in stroke survivors with cortical lesions. Here, we attempt to decode graded finger extension from the EEG in stroke patients with left-hand paresis and healthy controls.
View Article and Find Full Text PDFExp Brain Res
December 2024
Division of Basic Biomedical Sciences, Laboratory of Neurological Sciences, The University of South Dakota, Sanford School of Medicine, Vermillion, SD, USA.
Injury to one cerebral hemisphere can result in paresis of the contralesional hand and subsequent preference of the ipsilesional hand in daily activities. However, forced use therapy in humans can improve function of the contralesional paretic hand and increase its use in daily activities, although the ipsilesional hand may remain preferred for fine motor activities. Studies in monkeys have shown that minimal forced use of the contralesional hand, which was the preferred hand prior to brain injury, can produce remarkable recovery of function.
View Article and Find Full Text PDFBiomed Eng Online
December 2024
Department of Clinical Physiology, Motion Analysis Center, University Hospital of Toulouse, Hôpital de Purpan, Toulouse, France.
Background: Stroke is the leading cause of acquired motor deficiencies in adults. Restoring prehension abilities is challenging for individuals who have not recovered active hand opening capacities after their rehabilitation. Self-triggered functional electrical stimulation applied to finger extensor muscles to restore grasping abilities in daily life is called grasp neuroprosthesis (GNP) and remains poorly accessible to the post-stroke population.
View Article and Find Full Text PDFJ Neuroeng Rehabil
December 2024
Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA.
Background: This research aims to improve the control of assistive devices for individuals with hemiparesis after stroke by providing intuitive and proportional motor control. Stroke is the leading cause of disability in the United States, with 80% of stroke-related disability coming in the form of hemiparesis, presented as weakness or paresis on half of the body. Current assistive exoskeletonscontrolled via electromyography do not allow for fine force regulation.
View Article and Find Full Text PDFAnn 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).
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