Translating experimental evidence to finding novel ways to promote motor recovery in stroke patients - a review.

Recent advances in basic research have revealed the complex structural plasticity associated with the spontaneous motor recovery after stroke. Various rehabilitative interventions seem to act through the same repair mechanisms to further enhance recovery processes. In this review, we first summarize the current understanding on brain plasticity and repair after stroke.

Early psychosocial intervention does not delay institutionalization in persons with mild Alzheimer disease and has impact on neither disease progression nor caregivers' well-being: ALSOVA 3-year follow-up.

Objectives: Early diagnosis, initiation of Alzheimer's disease (AD) therapy and programs that support care of persons with AD at home are recommended. The objective of this study was to assess the effect of early psychosocial intervention on delaying the institutionalization of persons with AD. We also assessed the influence of intervention on AD progression, behavioral symptoms, and health-related quality of life (HRQoL) in persons with AD and caregivers.

Hemispatial neglect reflected on visual memory.

Purpose: Recent studies of hemispatial neglect have revealed both lateralized and nonlateralized attention mechanisms contributing to the syndrome. In addition, neglect patients show impaired spatial working memory and diminished working memory capacity. The aim of this study was to investigate, how neglect would be reflected in their performances in commonly used clinical visual memory tests.

Comparison of the Behavioural Inattention Test and the Catherine Bergego Scale in assessment of hemispatial neglect.

The objective of the study was to correlate visual and behavioural assessments of hemispatial neglect caused by cerebrovascular accident. We assessed 17 consecutive right-hemisphere stroke patients with hemispatial neglect: the Catherine Bergego Scale (CBS) was used to evaluate neglect in spontaneous behaviour and the conventional subtests of the Behavioural Inattention Test (BIT C) were used to assess visual neglect. The proportional severity of both visual and behavioural neglect was calculated in each individual patient.

Rehabilitation of hemispatial neglect: A randomized study using either arm activation or visual scanning training.

Purpose: Hemispatial neglect, a failure to orient to the contralateral side of the lesion, is a disabling disorder after stroke. Previously arm activation combined with visual training or visual scanning training were found effective in rehabilitation of hemispatial neglect. The aim of this study was to determine whether left arm activation alone could be sufficient to produce a long lasting amelioration of neglect comparable to the effect obtained with traditional visual scanning training.

Modelling the burden of stroke in Finland until 2030.

Background: It is well known that increasing age is the strongest risk factor of stroke. Therefore, it has been a common belief in many countries including Finland that the numbers of stroke patients will increase considerably during the next two decades because the population is rapidly ageing.

Methods: The FINMONICA and FINSTROKE registers operated in Finland in the Kuopio area and city of Turku from 1983 to 1997.

Methods to improve constraint-induced movement therapy.

In global terms, cerebrovascular stroke is the leading cause of long-term disability. Despite improved acute phase management of stroke, the majority of survivors are disabled and many require effective rehabilitation. Constraint-induced movement therapy (CIMT) is one of the recently emerging therapies for subjects with stroke.

Alterations in cortical excitability in chronic stroke after constraint-induced movement therapy.

Objective: Cerebral stroke is a major cause for long-term disability in the elderly and it is often manifested in hemiparesis of the upper extremity. Constraint-induced movement therapy (CIMT), an intensive 2 week rehabilitation program, improves affected upper limb motor abilities in subjects with stroke. Intensive training has also been suggested to modify neural function.

Postural instability in patients with chronic stroke.

Purpose: It is known that visuospatial orientation and the extent of spontaneous recovery vary between right or left hemisphere affected stroke patients. We hypothesized that the right hemisphere affected chronic patients would show more impaired static balance than left hemisphere affected patients. The purpose of the study was to assess displacement of the center of pressure (COP) of ambulatory patients with either left or right hemiparesis.

The effectiveness of body weight-supported gait training and floor walking in patients with chronic stroke.

Objective: To compare body weight-supported exercise on a gait trainer with walking exercise overground.

Design: Randomized controlled trial.

Setting: Rehabilitation hospital.

Gait characteristics after gait-oriented rehabilitation in chronic stroke.

Purpose: To assess the effects of rehabilitation in thirty-seven ambulatory patients with chronic stroke during three weeks in-patient rehabilitation period.

Methods: In the intervention group, each patient received 75 min physiotherapy daily every workday including 20 minutes in the electromechanical gait trainer with body-weight support (BWS). In the control group, each patient participated in 45 min conventional physiotherapy daily.

Paretic hand rehabilitation with constraint-induced movement therapy after stroke.

Objective: Hemiparesis of the upper limb after stroke can be severely disabling. We studied the effectiveness of constraint-induced movement therapy in improving motor abilities in very chronic stroke subjects. We assessed whether the obtained changes, if any, would endure after the intervention program.

Familiar-face recognition and comparison: source analysis of scalp-recorded event-related potentials.

Objective: We studied the event-related potentials elicited by categorical matching of faces. The purpose was to find cortical sources responsible for face recognition and comparison.

Methods: Nineteen healthy volunteers participated in the study.

Continuous 15-year decrease in incidence and mortality of stroke in Finland: the FINSTROKE study.

Background And Purpose: The purpose of this study was to analyze the incidence and mortality trends in stroke events among persons 25 to 74 years of age in Finland during 1983 to 1997.

Methods: The population-based FINSTROKE register recorded 5650 new strokes among persons 25 to 74 years of age in 2 geographical areas of Finland: 2770 in the Kuopio area (east central Finland) and 2880 in Turku (southwestern Finland). Of these, 3065 were men and 2585 were women.

Functional specialization in the human frontal cortex observed during task anticipation.

The purpose was to evaluate whether a scalp-recorded slow potential will show specificity during the anticipation of different types of visual tasks. One of the tasks required the comparison of pairs of familiar faces, and the other was the comparison of abstract dotted patterns. Each trial began with one of the two cues (S1) followed by consecutive pictures (S2 and S3).

Matching of familiar faces and abstract patterns: behavioral and high-resolution ERP study.

Electrical scalp-recorded components peaking approximately 350-400 ms were reported to be sensitive to both repetition/priming effects and face familiarity. We studied the categorical matching of familiar faces and compared it to the matching of abstract patterns. Nineteen healthy volunteers participated in the study.

Task-specific expectation is revealed in scalp-recorded slow potentials.

The contingent negative variation (CNV) is known as an electrical manifestation of expectancy, readiness and attention. The purpose of this study was to evaluate whether slow potentials recorded from the human scalp during the expectation to perform different tasks or during the expectation of the second stimulus in the pair demonstrate specificity regarding the type of visual stimuli. Participants were nineteen healthy adults.

Postural balance in elderly people: changes over a five-year follow-up and its predictive value for survival.

Postural balance in three test conditions (normal standing with eyes open, normal standing with eyes closed, and tandem standing with eyes open) was measured in samples of 75-year-old men and women (N=757) living in three Nordic localities (Glostrup in Denmark, Göteborg in Sweden, and Jyväskylä in Finland). The subjects were re-tested five years later when they had reached the age of 80 years (N=434). The results showed a highly significant longitudinal decline in balancing abilities in all localities and in both sexes.

Cutaneous electrical stimulation may enhance sensorimotor recovery in chronic stroke.

Objective: To investigate whether cutaneous electrical stimulation has a role in the enhancement of sensorimotor function in chronic stroke.

Subjects And Setting: Fifty-nine patients with chronic stroke received cutaneous stimulation during their three-week-long inpatient rehabilitation. Thirty-two received active treatment in the paretic hand and eight received no-current placebo treatment in the paretic hand.

Auditory adaptation is differentially impaired in familial and sporadic Alzheimer's disease.

Neurophysiologic measures are particularly sensitive to alterations in attention and arousal. The purpose of this study was to evaluate the auditory adaptation of normal and mildly demented elderly people. We compared the automatic behavior of an auditory evoked potential (N100) in three age-matched groups of elderly subjects, one with familial Alzheimer's disease (AD), one with sporadic AD and one healthy group.

Electric source localization adds evidence for task-specific CNVs.

This study was an attempt to replicate recent magnetoencephalographic (MEG) findings on human task-specific CNV sources (Basile et al., Electroencephalography and Clinical Neurophysiology 90, 1994, 157-165) by means of a spatio-temporal electric source localization method (Scherg and von Cramon, Electroencephalography and Clinical Neurophysiology 62, 1985, 32-44; Scherg and von Cramon, Electroencephalography and Clinical Neurophysiology 65, 1986, 344-360; Scherg and Berg, Brain Electric Source Analysis Handbook, Version 2). The previous MEG results showed CNV sources in the prefrontal cortex of the two hemispheres for two tasks used, namely visual pattern recognition and visual spatial recognition tasks.

Altered frontal lobe function suggested by source analysis of event-related potentials in impulsive violent alcoholics.

Scalp-recorded event-related potentials (ERPs) are sensitive indicators of subtle alterations in cerebral processes. We assessed automatic auditory adaptation and detection of novel stimuli in violent and non-violent alcoholics and normal subjects. Source analysis of ERPs revealed active medial temporal and frontal regions in all subjects.

Cerebral sources of electrical potentials related to human vocalization and mouth movement.

Self-paced voluntary movements are reflected in scalp recordings of electrical potentials. Here the cerebral sources of the electrical wave forms related to human mouth movement and vocalization were identified non-invasively. Seven healthy volunteers performed vocalization and silent puckering movements.

Delirium episode as a sign of undetected dementia among community dwelling elderly subjects: a 2 year follow up study.

Cognitive decline is commonly stated as one of the main risk factors for delirium. The aim was to assess the importance of a delirium episode as a symptom of an underlying dementia among community dwelling healthy elderly people in a prospective 2 year follow up study. The study patients consisted of 51 people living at home and older than 65 years of age, without severe underlying disorders including diagnosed dementia, admitted consecutively as emergency cases to hospital because of an acute delirious state and followed up for 2 years.