Background: Deep brain stimulation (DBS) is a potential treatment for improving movement disorder. However, few large-sample studies can reveal its efficacy and safety. This study aims to initially explore the efficacy and safety of DBS in the mesencephalic locomotor region (MLR) on motor function in patients with post-stroke hemiplegia.
Methods/design: This multicenter, prospective, double-blind, randomized crossover clinical trial aims to assess the safety and effectiveness of Deep Brain Stimulation (DBS) in the mesencephalic locomotor region (MLR) for patients with moderate to severe post-stroke hemiplegia. Sixty-two patients with stable disease after a year of conservative treatment will be enrolled and implanted with deep brain electrodes. Post-surgery, patients will be randomly assigned to either the DBS group or the control group, with 31 patients in each. The DBS group will receive electrical stimulation 1 month later, while the control group will undergo sham stimulation. Stimulation will be discontinued after 3 and 6 months, followed by a 2-week washout period. Subsequently, the control group will receive electrical stimulation, while the DBS group will undergo sham stimulation. Both groups will resume electrical stimulation at the 9th and 12th-month follow-ups. Post-12-month follow-up, motor-related scores will be collected for analysis, with the Fugl-Meyer Assessment Upper Extremity Scale (FMA-UE) as the primary metric. Secondary outcomes include balance function, neuropsychiatric behavior, fall risk, daily living activities, and quality of life. This study aims to provide insights into the therapeutic benefits of DBS for post-stroke hemiplegia patients.
Result/conclusion: We proposed this study for the first time to comprehensively explore the effectiveness and safety of DBS in improving motor function for post-stroke hemiplegia, and provide evidence for DBS in the treatment of post-stroke hemiplegia. Study limitations are related to the small sample size and short study period.
Clinical Trial Registration: Clinicaltrials.gov, identifier NCT05968248.
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http://dx.doi.org/10.3389/fneur.2024.1355104 | DOI Listing |
Toxins (Basel)
January 2025
Doctor Negrín University Hospital of Gran Canaria, Pl. Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain.
The study aimed to identify expert opinions and obtain recommendations on the management of post-stroke hemiplegic shoulder pain (HSP) and treatment with botulinum toxin A (BoNT-A). A multicenter Delphi study was conducted using an online survey designed by a committee of experts with at least 10 years of experience in post-stroke HSP management with BoNT-A in Spain. Forty-seven panelists (specialists with at least 5 years of experience in post-stroke HSP management with BoNT-A) rated their level of agreement in two rounds based on acceptance by ≥66.
View Article and Find Full Text PDFBioengineering (Basel)
January 2025
Department of Intelligent Robotics, Sungkyunkwan University, Suwon 16419, Republic of Korea.
Rehabilitation of gait function in post-stroke hemiplegic patients is critical for improving mobility and quality of life, requiring a comprehensive understanding of individual gait patterns. Previous studies on gait analysis using unsupervised clustering often involve manual feature extraction, which introduces limitations such as low accuracy, low consistency, and potential bias due to human intervention. This cross-sectional study aimed to identify and cluster gait patterns using an end-to-end deep learning approach that autonomously extracts features from joint angle trajectories for a gait cycle, minimizing human intervention.
View Article and Find Full Text PDFFront Rehabil Sci
January 2025
Department of Rehabilitation, Shiragikuen Hospital, Kochi, Japan.
A 69-year-old right-handed man, who initially suffered a stroke 8 years ago and experienced two recurrences since then, presented with right hemiplegia and left hemispatial neglect as a post-stroke syndrome in the chronic phase. This report demonstrates the use of active musical instrument playing with Musical Neglect Training (MNT®) to improve severe left-side neglect and activities of daily living (ADLs). In addition to physical and occupational therapy, individual MNT® was incorporated into the patient's rehabilitation plan to improve his hemispatial neglect.
View Article and Find Full Text PDFFront Neural Circuits
January 2025
Department of Biosciences and Informatics, Faculty of Science and Technology, Keio University, Kanagawa, Japan.
Introduction: Motor-imagery-based Brain-Machine Interface (MI-BMI) has been established as an effective treatment for post-stroke hemiplegia. However, the need for long-term intervention can represent a significant burden on patients. Here, we demonstrate that motor imagery (MI) instructions for BMI training, when supplemented with somatosensory stimulation in addition to conventional verbal instructions, can help enhance MI capabilities of healthy participants.
View Article and Find Full Text PDFAnn Rehabil Med
December 2024
Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Objective: To identify the prevalence and factors associated with T-score discordance between the spine and hip, as well as between the paretic and non-paretic hips in hemiplegic stroke patients, this study investigated bone mineral density (BMD) patterns. Bone loss predominantly affects the paretic hip after a stroke, and typical clinical assessments using dual-energy X-ray absorptiometry (DXA) that scan the lumbar spine (LS) and a single hip may overlook an osteoporosis diagnosis. This oversight could potentially lead to suboptimal treatment for stroke patients.
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