scholarly journals Priming the Ipsilesional Motor Cortex with Excitatory rTMS to Augment Functional Task Practice Post-Stroke

2016 ◽  
Vol 97 (10) ◽  
pp. e93
Author(s):  
Dorian Rose ◽  
Carolynn Patten ◽  
Alexandra Taylor ◽  
William Triggs
Keyword(s):  
Motor Cortex ◽  
Post Stroke ◽  
Task Practice ◽  
Functional Task

scholarly journals Effect of opposing needling on motor cortex excitability in healthy participants and in patients with post-stroke hemiplegia: study protocol for a single-blind, randomised controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mindong Xu ◽  
Yinyu Zi ◽  
Jianlu Wu ◽  
Nenggui Xu ◽  
Liming Lu ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Primary Motor Cortex ◽  
Motor Evoked Potentials ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Post Stroke ◽  
Motor Cortex Excitability ◽  
Opposing Needling ◽  
Single Blind ◽  
Healthy Participants

Abstract Background Opposing needling has an obvious curative effect in the treatment of post-stroke hemiplegia; however, the mechanism of the opposing needling in the treatment of post-stroke hemiplegia is still not clear. The purpose of this study is to investigate the effect of opposing needling on the excitability of primary motor cortex (M1) of healthy participants and patients with post-stroke hemiplegia, which may provide insight into the mechanisms of opposing needling in treating post-stroke hemiplegia. Methods This will be a single-blind, randomised, sham-controlled trial in which 80 healthy participants and 40 patients with post-stroke hemiplegia will be recruited. Healthy participants will be randomised 1:1:1:1 to the 2-Hz, 50-Hz, 100-Hz, and sham electroacupuncture groups. Patients with post-stroke hemiplegia will be randomised 1:1 to the opposing needling or conventional treatment groups. The M1 will be located in all groups by using neuroimaging-based navigation. The stimulator coil of transcranial magnetic stimulation (TMS) will be moved over the left and right M1 in order to identify the TMS hotspot, followed by a recording of resting motor thresholds (RMTs) and motor-evoked potentials (MEPs) of the thenar muscles induced by TMS before and after the intervention. The primary outcome measure will be the percent change in the RMTs of the thenar muscles at baseline and after the intervention. The secondary outcome measures will be the amplitude (μV) and latency (ms) of the MEPs of the thenar muscles at baseline and after the intervention. Discussion The aim of this trial is to explore the effect of opposing needling on the excitability of M1 of healthy participants and patients with post-stroke hemiplegia. Trial registration Chinese Clinical Trial Registry ChiCTR1900028138. Registered on 13 December 2019.

scholarly journals Brain stimulation for arm recovery after stroke (B-STARS): protocol for a randomised controlled trial in subacute stroke patients

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016566
Author(s):  
Eline C C van Lieshout ◽  
Johanna M A Visser-Meily ◽  
Sebastiaan F W Neggers ◽  
H Bart van der Worp ◽  
Rick M Dijkhuizen
Keyword(s):  
Motor Cortex ◽  
Upper Limb ◽  
Brain Stimulation ◽  
Primary Outcome ◽  
Primary Motor Cortex ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Stroke Patients ◽  
Post Stroke ◽  
Subacute Stroke

IntroductionMany patients with stroke have moderate to severe long-term sensorimotor impairments, often including inability to execute movements of the affected arm or hand. Limited recovery from stroke may be partly caused by imbalanced interaction between the cerebral hemispheres, with reduced excitability of the ipsilesional motor cortex while excitability of the contralesional motor cortex is increased. Non-invasive brain stimulation with inhibitory repetitive transcranial magnetic stimulation (rTMS) of the contralesional hemisphere may aid in relieving a post-stroke interhemispheric excitability imbalance, which could improve functional recovery. There are encouraging effects of theta burst stimulation (TBS), a form of TMS, in patients with chronic stroke, but evidence on efficacy and long-term effects on arm function of contralesional TBS in patients with subacute hemiparetic stroke is lacking.Methods and analysisIn a randomised clinical trial, we will assign 60 patients with a first-ever ischaemic stroke in the previous 7–14 days and a persistent paresis of one arm to 10 sessions of real stimulation with TBS of the contralesional primary motor cortex or to sham stimulation over a period of 2 weeks. Both types of stimulation will be followed by upper limb training. A subset of patients will undergo five MRI sessions to assess post-stroke brain reorganisation. The primary outcome measure will be the upper limb function score, assessed from grasp, grip, pinch and gross movements in the action research arm test, measured at 3 months after stroke. Patients will be blinded to treatment allocation. The primary outcome at 3 months will also be assessed in a blinded fashion.Ethics and disseminationThe study has been approved by the Medical Research Ethics Committee of the University Medical Center Utrecht, The Netherlands. The results will be disseminated through (open access) peer-reviewed publications, networks of scientists, professionals and the public, and presented at conferences.Trial registration numberNTR6133

scholarly journals Motor Cortex Neurostimulation Technologies for Chronic Post-stroke Pain: Implications of Tissue Damage on Stimulation Currents

2016 ◽  
Vol 10 ◽  
Author(s):  
Anthony T. O’Brien ◽  
Rivadavio Amorim ◽  
R. Jarrett Rushmore ◽  
Uri Eden ◽  
Linda Afifi ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Tissue Damage ◽  
Post Stroke

Pharmacological classification of central post-stroke pain: comparison with the results of chronic motor cortex stimulation therapy

Pain ◽  
1997 ◽  
Vol 72 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Takamitsu Yamamoto ◽  
Yoichi Katayama ◽  
Teruyasu Hirayama ◽  
Takashi Tsubokawa
Keyword(s):  
Motor Cortex ◽  
Motor Cortex Stimulation ◽  
Post Stroke

scholarly journals Socially Assistive Robotics for Guiding Motor Task Practice

2011 ◽  
Vol 2 (4) ◽  
Author(s):  
Eric Wade ◽  
Avinash Parnandi ◽  
Ross Mead ◽  
Maja Matarić
Keyword(s):  
User Behavior ◽  
Motor Task ◽  
Evaluation Study ◽  
Human Robot Interaction ◽  
Assistive Robotics ◽  
User Preference ◽  
Socially Assistive Robotics ◽  
Post Stroke ◽  
Coaching Styles ◽  
Task Practice

AbstractDue to their quantitative nature, robotic systems are useful tools for systematically augmenting human behavior and performance in dynamic environments, such as therapeutic rehabilitation settings. The efficacy of human-robot interaction (HRI) in these settings will depend on the robot’s coaching style. Our goal was to investigate the influence of robot coaching styles designed to enhance motivation and encouragement on post-stroke individuals during motor task practice. We hypothesized that coaching styles incorporating user performance and preference would be preferred in a therapeutic HRI setting. We designed an evaluation study with seven individuals post stroke. A socially assistive robotics (SAR) system using three different coaching styles guided participants during performance of an upper extremity practice task. User preference was not significantly affected by the different robot coaching styles in our participant sample (H(2) = 2.638, p = 0.267). However, trends indicated differences in preference for the coaching styles. Our results provide insights into the design and use of SAR systems in therapeutic interactions aiming to influence user behavior.

Cortical vs. afferent stimulation as an adjunct to functional task practice training: a randomized, comparative pilot study in people with cervical spinal cord injury

2014 ◽  
Vol 29 (8) ◽  
pp. 771-782 ◽  
Author(s):  
Joyce Gomes-Osman ◽  
Edelle C Field-Fote
Keyword(s):  
Direct Current ◽  
Nerve Stimulation ◽  
Transcranial Direct Current Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Short Term ◽  
Electrical Nerve Stimulation ◽  
Direct Current Stimulation ◽  
Cohen’S D ◽  
Task Practice ◽  
Functional Task

Objective: To assess single-session effects of three different types of stimuli known to increase cortical excitability when combined with functional task practice. Design: Randomized cross-over trial. Participants: A total of 24 participants with chronic cervical spinal cord injury. Interventions: One 30-minute session of each, applied concurrently with functional task practice: transcranial direct current stimulation, vibration, and transcutaneous electrical nerve stimulation. Measurements: Nine-hole Peg Test, pinch force, visuomotor tracking, and cortical excitability were collected at pretest, posttest and late posttest (30 minutes after). Early effects (posttest minus pretest) and short-term persistence (late posttest minus pretest) were assessed using a general linear mixed model. Magnitude of effect size was assessed using the Cohen’s d. Results: Transcutaneous electrical nerve stimulation was associated with moderate, significant early effects and short-term persistence on Nine-hole Peg Test performance (1.8 ±1.8, p = 0.003, d = 0.59; 2.0 ±2.5, p < 0.001, Cohen’s d = 0.65, respectively). Transcranial direct current stimulation (1.8 ±2.5, p = 0.003, Cohen’s d = 0.52) was also associated with significant short-term persistence of moderate size on Nine-hole Peg Test performance (1.8 ±2.5, p = 0.003, Cohen’s d = 0.52) and visuomotor tracking performance ( p = 0.05, d = 0.51). Early effects on corticomotor excitability were significant for transcutaneous electrical nerve stimulation ( p = 0.003), approached significance for transcranial direct current stimulation ( p = 0.07), and only vibration was associated with significant short-term persistence ( p = 0.006). Conclusions: Meaningful improvements in aspects of hand-related function that persisted at least 30 minutes after intervention were observed with transcutaneous electrical nerve stimulation and transcranial direct current stimulation, when combined with functional task practice.

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