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Pathophysiology and Management Strategies for Post-Stroke Spasticity: An Update Review.
Int J Mol Sci
January 2025
School of Pharmacy, Hunan University of Chinese Medicine, Changsha 410208, China.
Post-stroke spasticity (PSS), characterized by a velocity-dependent increase in muscle tone and exaggerated reflexes, affects a significant portion of stroke patients and presents a substantial obstacle to post-stroke rehabilitation. Effective management and treatment for PSS remains a significant clinical challenge in the interdisciplinary aspect depending on the understanding of its etiologies and pathophysiology. We systematically review the relevant literature and provide the main pathogenic hypotheses: alterations in the balance of excitatory and inhibitory inputs to the descending pathway or the spinal circuit, which are secondary to cortical and subcortical ischemic or hemorrhagic injury, lead to disinhibition of the stretch reflex and increased muscle tone.
View Article and Find Full Text PDFLimited Evidence of Functional Benefit After Upper Limb Botulinum Toxin Treatment in Children With Cerebral Palsy: Systematic Review and Meta-analysis.
Am J Phys Med Rehabil
February 2025
From the Centre for Translational Medicine, Semmelweis University, Budapest, Hungary (OZG, MV, MAE, LS, ZM, PH, TT); Department of Orthopaedics, Semmelweis University, Budapest, Hungary (OZG, MV, TT); Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary (ZM); Department of Anesthesiology and Intensive Therapy, Poznan University for Medical Sciences, Poznan, Poland (ZM); and Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary (PH).
Objectives: This systematic review and meta-analysis of randomized controlled trials aimed to summarize the reported functional effects of upper limb botulinum toxin treatment in children with spastic cerebral palsy.
Design: Six databases were searched in October 2022. Two independent authors screened and extracted data on upper limb function, body function, life quality, muscle tone, spasticity, goals, pain, adverse events, and client satisfaction.
Efficacy and Renal Safety of Protocol-based 11.7% Hypertonic Saline Infusion Compared with 20% Mannitol in Patients with Elevated Intracranial Pressure: A Study Protocol for a Randomized Clinical Trial.
Electrolyte Blood Press
December 2024
Department of Internal Medicine, College of Medicine, Dankook University, Republic of Korea.
Background: Elevated intracranial pressure (ICP) is a potentially life-threatening condition requiring prompt intervention. While both mannitol and hypertonic saline (HTS) are commonly used hyperosmotic agents for treating elevated ICP, there is insufficient evidence comparing their renal safety profiles and overall effectiveness. This study protocol outlines a pragmatic randomized trial to compare protocol-based 11.
View Article and Find Full Text PDFHigh-frequency epidural electrical stimulation reduces spasticity and facilitates walking recovery in patients with spinal cord injury.
Sci Transl Med
January 2025
Modular Implantable Neuroprostheses (MINE) Laboratory, Università Vita-Salute San Raffaele & Scuola Superiore Sant'Anna, 20132 Milan, Italy.
Spinal cord injury (SCI) causes severe motor and sensory deficits, and there are currently no approved treatments for recovery. Nearly 70% of patients with SCI experience pathological muscle cocontraction and spasticity, accompanied by clinical signs such as patellar hyperreflexia and ankle clonus. The integration of epidural electrical stimulation (EES) of the spinal cord with rehabilitation has substantial potential to improve recovery of motor functions; however, abnormal muscle cocontraction and spasticity may limit the benefit of these interventions and hinder the effectiveness of EES in promoting functional movements.
View Article and Find Full Text PDFProline Improves Pullulan Biosynthesis Under High Sugar Stress Condition.
Microorganisms
December 2024
School of Bioengineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China.
Pullulan is an extracellular polysaccharide produced via the fermentation of . However, high sugar concentrations and hyperosmotic stress limit pullulan biosynthesis during the fermentation process. Therefore, we investigated the effects of proline supplementation on .
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