scholarly journals The combined effect of non-invasive cortical stimulation and motor training on hand motor deficit in chronic stroke

2018 ◽  
Vol 61 ◽  
pp. e195
Author(s):  
N. Ilic ◽  
E. Dubljanin Raspopovic ◽  
U. Nedeljkovic ◽  
S. Tomanovic Vujadinovic
Keyword(s):  
Chronic Stroke ◽  
Cortical Stimulation ◽  
Combined Effect ◽  
Motor Deficit ◽  
Motor Training ◽  
Non Invasive

P14.1 Non-invasive cortical stimulation enhances lower limb function in chronic stroke patients

2011 ◽  
Vol 122 ◽  
pp. S121
Author(s):  
S. Tanaka ◽  
K. Takeda ◽  
Y. Otaka ◽  
K. Kita ◽  
R. Osu ◽  
...  
Keyword(s):  
Lower Limb ◽  
Chronic Stroke ◽  
Cortical Stimulation ◽  
Stroke Patients ◽  
Limb Function ◽  
Non Invasive ◽  
Lower Limb Function

Movement-Related EEG Oscillations of Contralesional Hemisphere Discloses Compensation Mechanisms of Severely Affected Motor Chronic Stroke Patients

2021 ◽  
Author(s):  
Juan A. Barios ◽  
Santiago Ezquerro ◽  
Arturo Bertomeu-Motos ◽  
Jose M. Catalan ◽  
Jose M. Sanchez-Aparicio ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Time Course ◽  
Chronic Stroke ◽  
Cortical Activation ◽  
Motor Deficit ◽  
Control Group ◽  
Detailed Knowledge ◽  
Stroke Patients ◽  
Stroke Treatment ◽  
Compensation Mechanisms

Conventional rehabilitation strategies for stroke survivors become difficult when voluntary movements are severely disturbed. Combining passive limb mobilization, robotic devices and EEG-based brain-computer interfaces (BCI) systems might improve treatment and clinical follow-up of these patients, but detailed knowledge of neurophysiological mechanisms involved in functional recovery, which might help for tailoring stroke treatment strategies, is lacking. Movement-related EEG changes (EEG event-related desynchronization (ERD) in [Formula: see text] and [Formula: see text] bands, an indicator of motor cortex activation traditionally used for BCI systems), were evaluated in a group of 23 paralyzed chronic stroke patients in two unilateral motor tasks alternating paretic and healthy hands ((i) passive movement, using a hand exoskeleton, and (ii) voluntary movement), and compared to nine healthy subjects. In tasks using unaffected hand, we observed an increase of contralesional hemisphere activation for stroke patients group. Unexpectedly, when using paralyzed hand, motor cortex activation was reduced or absent in severely affected group of patients, while patients with moderate motor deficit showed an activation greater than control group. Cortical activation was reduced or absent in damaged hemisphere of all the patients in both tasks. Significant differences related to severity of motor deficit were found in the time course of [Formula: see text] bands power ratio in EEG of contralesional hemisphere while moving affected hand. These findings suggest the presence of different compensation mechanisms in contralesional hemisphere of stroke patients related to the grade of motor disability, that might turn quantitative EEG during a movement task, obtained from a BCI system controlling a robotic device included in a rehabilitation task, into a valuable tool for monitoring clinical progression, evaluating recovery, and tailoring treatment of stroke patients.

scholarly journals Strategies for resection of lesions in the motor area: preliminary results in 42 surgical patients

2006 ◽  
Vol 64 (4) ◽  
pp. 963-970 ◽  
Author(s):  
Stênio Abrantes Sarmento ◽  
Emerson Magno F. de Andrade ◽  
Helder Tedeschi
Keyword(s):  
Preoperative Planning ◽  
Anatomical Study ◽  
Cortical Stimulation ◽  
Motor Area ◽  
Surgical Patients ◽  
Motor Deficit ◽  
Surgical Results ◽  
Preoperative Period ◽  
Technological Advances ◽  
Anatomical Knowledge

In recent years considerable technological advances have been made with the purpose of improving the surgical results in the treatment of eloquent lesions. The overall aim of this study is to evaluate the postoperative surgical outcome in 42 patients who underwent surgery to remove lesions around the motor cortex, in which preoperative planning by using neuroimaging exams, anatomical study, appropriate microsurgery technique and auxiliary methods such as cortical stimulation were performed. Twenty-two patients (52.3%) presented a normal motor function in the preoperative period. Of these, six developed transitory deficit. Twenty patients (47.6%) had a motor deficit preoperatively, nevertheless 90% of these improved postoperatively. Surgery in the motor area becomes safer and more effective with preoperative localization exams, anatomical knowledge and appropriate microsurgery technique. Cortical stimulation is important because it made possible to maximize the resection reducing the risk of a motor deficit. Stereotaxy method was useful in the location of subcortical lesions.

scholarly journals Surgical management of Rolandic area meningioma in the era of intraoperative neurophysiological monitoring

2020 ◽  
pp. 488-494
Author(s):  
Mihaela Coșman ◽  
Ionuț Mihail Panțiru ◽  
Andrei Ionuț Cucu ◽  
Andreea Lenuța Atomei ◽  
Gabriela Florența Dumitrecu ◽  
...  
Keyword(s):  
Cortical Stimulation ◽  
Motor Area ◽  
Intraoperative Neurophysiological Monitoring ◽  
Motor Deficit ◽  
Cortical Mapping ◽  
Neurophysiological Monitoring ◽  
Direct Cortical Stimulation ◽  
One Year ◽  
The Impact

Introduction: The advantages and the necessity of intraoperative neurophysiological monitoring (IOM) in the surgery of motor area infiltrative tumours is well known. The use of this technique for Rolandic meningioma is still debatable. The absence or the loss of the cleavage plan and an infiltrative border make the dissection exceedingly difficult and increase the risk of new postoperative motor disfunction. Materials and methods: We evaluated the impact of IOM, especially direct cortical stimulation on the degree of resection, new postoperative deficits, symptom remission and clinical-imagistic aspects at one-year follow up of 19 cases of Rolandic meningioma admitted in Third Department of Neurosurgery,” Prof. Dr N. Oblu” Emergency Clinical Hospital, Yassi, Romania, between January 2014 and July 2018. Results: More than half of the cases (57,88%) had epileptic manifestations as the main clinical symptom with the Jacksonian seizures being on the first place (31,57%), followed by progressive paresis (26,31%) and other nonspecific symptoms. Intraparenchymal preoperative oedema was observed in 36,84% of patients. The intensity of direct cortical stimulation was between 6-13 mA (median = 9mA; mode = 12mA). Simpson degree of resection was dominated by S3– 47,36% and S4 was obtained in 15,78% of cases. Postoperative the outcome was favourable for 73,68% patients with 5,26% motor aggravation and 10,52% new deficits. At one-year follow up no imagistic recurrence was observed and the permanent motor deficit was maintained in one of the three cases (5,26%). Conclusion: Even though meningiomas are extranevraxial lesions and those located on the convexity have a low risk of complication, the absence of a clear dissection plan between the tumour and the adjacent motor cortex is associated with a high risk for new postoperative neurological deficits. Therefore, it is important to perform cortical mapping for Rolandic meningioma, to determine the location of the primary motor area and to protect it from mechanical and vascular trauma, during tumour resection.

scholarly journals Continuous Dynamic Mapping of the Corticospinal Tract in Motor Eloquent Tumor Surgery: Our Experience and Evaluation of the Method

2021 ◽  
Vol 49 (1, 2, 3) ◽  
pp. 63
Author(s):  
Andrej Porčnik ◽  
Jure Pešak ◽  
Tilen Žele ◽  
Blaž Koritnik ◽  
Zoran Rodi ◽  
...  
Keyword(s):  
Corticospinal Tract ◽  
Cortical Stimulation ◽  
Gross Total Resection ◽  
Motor Deficit ◽  
Total Resection ◽  
Direct Cortical Stimulation ◽  
Dynamic Mapping ◽  
Combined Use ◽  
Eloquent Tumor ◽  
Continuous Dynamic

<p><strong>Objective. </strong>The aim of this article is to present our experience with continuous dynamic mapping (CDM) of the corticospinal tract (CST) when removing tumors in motor eloquent regions.</p><p><strong>Methods. </strong>We studied 44 patients with a brain tumor adjacent to the CST where CDM was used. The mapping probe was integrated at the tip of the suction device. Thresholds for eliciting MEPs were recorded. In all patients, along with CDM, MEPs to direct cortical stimulation were also monitored throughout the operation. Motor function was assessed preoperatively, after the procedure and on discharge.</p><p><strong>Results. </strong>In the series, there were 37 patients with gliomas, six with brain metastasis, and one with cavernoma. The threshold to elicit MEPs in CDM was &gt;20 mA in 17 cases, 16–20 mA in six cases, 11–15 mA in six cases, 6–10 mA in nine cases and 2–5 mA in six cases. MEPs to direct cortical stimulation were preserved in all patients. In three cases a new temporary motor deficit was noted. No new permanent motor deficit occurred. Gross total resection was reached in 57% of cases.</p><p><strong>Conclusions. </strong>From our experience, the combined use of CDM and MEPs to direct cortical stimulation improves the safety of surgery in the proximity of the CST, and at the same time offers the possibility of higher rates of gross total resection.</p>

Assessment and treatment of pain with non-invasive cortical stimulation

2011 ◽  
Vol 29 (6) ◽  
pp. 439-451 ◽  
Author(s):  
Soroush Zaghi ◽  
Bruna Thiele ◽  
Daniel Pimentel ◽  
Thais Pimentel ◽  
Felipe Fregni
Keyword(s):  
Cortical Stimulation ◽  
Non Invasive ◽  
Assessment And Treatment
Sign in / Sign up

Export Citation Format

Share Document