A transcranial magnetic stimulation study for the investigation of corticospinal motor pathways in children with cerebral palsy

Background: Task-dependent neurophysiological adaptations in people with cerebral palsy have been examined using various techniques such as functional magnetic resonance imaging, peripheral nerve stimulation in order to assess H-reflexes, and transcranial magnetic stimulation. This activity-dependent plasticity is hypothesized to improve specific gross motor function in individuals with cerebral palsy. Although these adaptations have been examined extensively, most studies examined tasks utilizing the upper limbs. The aim of this review is to assess the neurophysiological adaptations of the central nervous system in individuals with cerebral palsy during lower limb functional tasks. Methods: A systematic review and meta-analysis will be conducted to evaluate the neurophysiological changes in the brain and spinal cord associated with lower extremity tasks in individuals with cerebral palsy. We will search within PubMed, MEDLINE, Embase, PsychINFO, and CINAHL using a predetermined search string to identify and evaluate relevant studies. Two independent reviewers will screen these studies against our inclusion criteria and risks of bias, and will extract the data from each study. A third reviewer will be used to resolve any disagreement regarding the inclusion of a study between reviewers. Randomized controlled trials as well as cross-sectional studies published in English 10 years before May 2021 that investigate the neurophysiological adaptations in the brain and spinal cord in people with cerebral palsy will be included if they meet the eligibility criteria. Primary outcomes will include scalar values of fractional anisotropy (FA), H-reflex gains or measures of amplitude, as well as motor cortex (M1) cortical excitability as measured by transcranial magnetic stimulation. Discussion: Since no identifiable data will be involved in this study, no ethical approval is required. Our results will provide insight into the neurophysiological adaptations in children with cerebral palsy, which will be useful in guiding directions for clinical decision making and future development of targeted interventions in pediatrics rehabilitation for children with cerebral palsy. Systematic review registration: The protocol for this systematic review is registered with the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42020215902).

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Transcranial magnetic stimulation in neurorehabilitation: experience and prospects

Fizioterapevt (Physiotherapist) ◽

10.33920/med-14-2110-01 ◽

2021 ◽

pp. 7-17

Author(s):

Vladislav Borisovich Voitenkov ◽

J. Málly ◽

I. V. Cherkashina ◽

N. V. Skripchenko . ◽

E. V. Ekusheva ◽

...

Keyword(s):

Transcranial Magnetic Stimulation ◽

Magnetic Stimulation ◽

Low Cost ◽

Motor Pathway ◽

Rehabilitation Process ◽

Motor Pathways ◽

Wide Range ◽

Central Inhibition ◽

Adults And Children ◽

Therapy And Diagnosis

Diagnostic transcranial magnetic stimulation (TMS) is a valuable neurophysiological technique. The use of TMS has fundamentally changed the therapy and diagnosis of nervous diseases, introducing the possibility of direct assessment of conduction along the motor pathway in the central region, neuroplasticity, the ratio of central inhibition and excitation, and the effect on neuroplasticity and neurogenesis. The technique is safe, has a low cost and there is no need to purchase expensive consumables, it is applicable for a wide range of diseases in both adult and pediatric practice. The issues of the TMS use in CVA, depression, cerebral palsy and neurodegenerative diseases (amyotrophic lateral sclerosis, parkinsonism) have been studied to the greatest extent. When carrying out TMS in children, it should be borne in mind that signs of incomplete myelination of the motor pathways, which are normally observed, may look like pathological changes (demyelination or axonal disorders). The basic principles of TMS in both adults and children have been established and known, and the age norms have been determined, which makes it possible to widely implement this technique in applied neurophysiological practice. In the rehabilitation process, TMS can be used as a tool for personalizing and monitoring the effectiveness of rehabilitation treatment.

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Gold Nanoparticle-Optimized Computed Tomography Imaging Combined with Transcranial Magnetic Stimulation on Rehabilitation Training of Children with Cerebral Palsy

Science of Advanced Materials ◽

10.1166/sam.2021.4052 ◽

2021 ◽

Vol 13 (9) ◽

pp. 1674-1684

Author(s):

Yangfan Zhang ◽

Yuanyuan Luo ◽

Xinglei Wu ◽

Liuqiong Yang ◽

Dandan Cui ◽

...

Keyword(s):

Computed Tomography ◽

Gold Nanoparticles ◽

Transcranial Magnetic Stimulation ◽

Contrast Agents ◽

Magnetic Stimulation ◽

Ct Imaging ◽

Nude Mouse Model ◽

Children With Cerebral Palsy ◽

Movement Function ◽

Ct Contrast

Traditional computed tomography (CT) contrast agents, such as iodine-containing small molecules (omnipaque), have limitations in some applications. The development of nanotechnology has made it possible to develop CT contrast agents based on this technology. In this study, a large number of surface functional groups of the fifth-generation polyamide-amine dendrimer (P5-NH2) were applied to functionally modify polyethylene glycol (PEG), targeting molecules, or drugs, which were used as the carrier of CT contrast agents. With the help of sodium borohydride (NaBH4), there was a rapid reduction. The fluorescein thiocyanate (FT) and PEG modified with lactobionic acid (PEG-LA) weres connected before gold coating to obtain gold nanoparticles coated with targeted dendrimer (Au(P5-LA)DENPs). In the experiment, the gold nanoparticles were characterized, and the liver cancer nude mouse model was established, so as to analyze the CT imaging performance of the material. Besides, the above was applied in the motor function of children with cerebral palsy, and the improvement effect of CT imaging combined with transcranial magnetic stimulation based on the preparation of nanomaterials on the movement function of children was analyzed and demonstrated with the help of graph theory. The results showed that the average particle size of gold nanoparticles was 1.88 nm. Within the range of 5 °C–50 °C and pH = 4–7, the physical properties of the aqueous solution of this material were stable. What’s more, the cell activity still exceeded 80% when the material concentration reached 2000 nm. The nude mouse model of liver cancer indicated that the CT imaging based on this material enhanced the image contrast effect of the tumor part, and the material had no obvious toxic and side effects. CT imaging based on the preparation of nanomaterials can promote transcranial magnetic stimulation to accelerate the efficiency of brain movement, accelerate the global and local information exchange and integration speed of brain network, thereby improving the movement function of children.

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