scholarly journals Daily repetitive sensory stimulation of the paretic hand for the treatment of sensorimotor deficits in patients with subacute stroke: RESET, a randomized, sham-controlled trial

BMC Neurology ◽  
2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Jan C. Kattenstroth ◽  
Tobias Kalisch ◽  
Matthias Sczesny-Kaiser ◽  
Wolfgang Greulich ◽  
Martin Tegenthoff ◽  
...  
Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 461
Author(s):  
Weslania Nascimento ◽  
Noemí Tomsen ◽  
Saray Acedo ◽  
Cristina Campos-Alcantara ◽  
Christopher Cabib ◽  
...  

Spontaneous swallowing contributes to airway protection and depends on the activation of brainstem reflex circuits in the central pattern generator (CPG). We studied the effect of age and gender on spontaneous swallowing frequency (SSF) in healthy volunteers and assessed basal SSF and TRPV1 stimulation effect on SSF in patients with post-stroke oropharyngeal dysphagia (OD). The effect of age and gender on SSF was examined on 141 healthy adult volunteers (HV) divided into three groups: GI—18–39 yr, GII—40–59 yr, and GIII—>60 yr. OD was assessed by the Volume–Viscosity Swallowing Test (VVST). The effect of sensory stimulation with capsaicin 10−5 M (TRPV1 agonist) was evaluated in 17 patients with post-stroke OD, using the SSF. SSF was recorded in all participants during 10 min using surface electromyography (sEMG) of the suprahyoid muscles and an omnidirectional accelerometer placed over the cricothyroid cartilage. SSF was significantly reduced in GII (0.73 ± 0.50 swallows/min; p = 0.0385) and GIII (0.50 ± 0.31 swallows/min; p < 0.0001) compared to GI (1.03 ± 0.62 swallows/min), and there was a moderate significant correlation between age and SFF (r = −0.3810; p < 0.0001). No effect of gender on SSF was observed. Capsaicin caused a strong and significant increase in SSF after the TRPV1 stimulation when comparing to basal condition (pre-capsaicin: 0.41 ± 0.32 swallows/min vs post-capsaicin: 0.81 ± 0.51 swallow/min; p = 0.0003). OD in patients with post-stroke OD and acute stimulation with TRPV1 agonists caused a significant increase in SSF, further suggesting the potential role of pharmacological stimulation of sensory pathways as a therapeutic strategy for CPG activation in patients with OD.


2009 ◽  
Vol 23 (7) ◽  
pp. 699-705 ◽  
Author(s):  
Hannes Devos ◽  
Abiodun Emmanuel Akinwuntan ◽  
Alice Nieuwboer ◽  
Mark Tant ◽  
Steven Truijen ◽  
...  

Background. Several driving retraining programs have been developed to improve driving skills after stroke. Those programs rely on different rehabilitation concepts. Objectives. The current study sought to examine the specific carryover effect of driving skills of a comprehensive training program in a driving simulator when compared with a cognitive training program. Methods. Further analysis from a previous randomized controlled trial that investigated the effect of simulator training on driving after stroke. Forty-two participants received simulator-based driving training, whereas 41 participants received cognitive training for 15 hours. Overall performance in the on-road test and each of its 13 items were compared between groups immediately posttraining and at 6 months poststroke. Results. Generalized estimating equation analysis showed that the total score on the on-road test and each item score improved significantly over time for both groups. Those who received driving simulator training achieved better results when compared with the cognitive training group in the overall on-road score and the items of anticipation and perception of signs, visual behavior and communication, quality of traffic participation, and turning left. Most of the differences in improvement between the 2 interventions were observed at 6 months poststroke. Conclusions . Contextual training in a driving simulator appeared to be superior to cognitive training to treat impaired on-road driving skills after stroke. The effects were primarily seen in visuointegrative driving skills. Our results favor the implementation of driving simulator therapy in the conventional rehabilitation program of subacute stroke patients with mild deficits.


2014 ◽  
Vol 116 (12) ◽  
pp. 1623-1631 ◽  
Author(s):  
Steffen Vangsgaard ◽  
Janet L. Taylor ◽  
Ernst A. Hansen ◽  
Pascal Madeleine

Trapezius muscle Hoffman (H) reflexes were obtained to investigate the neural adaptations induced by a 5-wk strength training regimen, based solely on eccentric contractions of the shoulder muscles. Twenty-nine healthy subjects were randomized into an eccentric training group ( n = 15) and a reference group ( n = 14). The eccentric training program consisted of nine training sessions of eccentric exercise performed over a 5-wk period. H-reflex recruitment curves, the maximal M wave (Mmax), maximal voluntary contraction (MVC) force, rate of force development (RFD), and electromyographic (EMG) voluntary activity were recorded before and after training. H reflexes were recorded from the middle part of the trapezius muscle by electrical stimulation of the C3/4 cervical nerves; Mmax was measured by electrical stimulation of the accessory nerve. Eccentric strength training resulted in significant increases in the maximal trapezius muscle H reflex (Hmax) (21.4% [5.5–37.3]; P = 0.01), MVC force (26.4% [15.0–37.7]; P < 0.01), and RFD (24.6% [3.2–46.0]; P = 0.025), while no significant changes were observed in the reference group. Mmax remained unchanged in both groups. A significant positive correlation was found between the change in MVC force and the change in EMG voluntary activity in the training group ( r = 0.57; P = 0.03). These results indicate that the net excitability of the trapezius muscle H-reflex pathway increased after 5 wk of eccentric training. This is the first study to investigate and document changes in the trapezius muscle H reflex following eccentric strength training.


PM&R ◽  
2009 ◽  
Vol 1 ◽  
pp. S99-S99 ◽  
Author(s):  
Zeev Meiner ◽  
Iris Fisher ◽  
Michal Katz-Leurer ◽  
Martin Neeb ◽  
Anna Sajin ◽  
...  

2005 ◽  
Vol 94 (4) ◽  
pp. 2644-2652 ◽  
Author(s):  
Makoto Araki ◽  
Toshiki Nagayama ◽  
Jordanna Sprayberry

The lateral giant (LG)-mediated escape behavior of the crayfish habituates readily on repetitive sensory stimulation. Recent studies suggested that the biogenic amines serotonin and octopamine modulate the time course of recovery and/or re-depression of the LG response after habituation. However, little is known of how serotonin and octopamine effect LG habituation and what second-messenger cascades they may activate. To investigate the effect of biogenic amines on LG habituation, serotonin and octopamine were superfused before presenting repetitive sensory stimulation. Serotonin and octopamine increased the number of stimuli needed to habituate the LG response. Their effects were mimicked by mixed application of a cAMP analogue [8-(4-chlorophenylthio)-cAMP (CPT-cAMP)] and a phosphodiesterase inhibitor [3-isobutyl-1-methylxanthine (IBMX)] but not by a cGMP analogue (8-bromoguanosine 3′,5′-cyclic monophosphate). Perfusion of the adenylate cyclase inhibitor (SQ22536) abolished the effect of serotonin but not that of octopamine. To investigate the site of action of each biogenic amines in the neural circuit meditating LG escape, the effect of drugs on directly and indirectly elicited postsynaptic potentials in LG was investigated. Serotonin, octopamine, and a mixture of CPT-cAMP and IBMX increased both the direct and indirect synaptic inputs. Simultaneous application of SQ22536 abolished the effect of serotonin on both inputs but did not block the effect of octopamine. Direct injection of the cAMP analogue (Sp-isomer of adenosine-3′,5′-cyclic monophosphorothioate) into LG increased both the direct and indirect inputs to LG. These results indicate that serotonin mediates an increase in cAMP levels in LG, but octopamine acts independently of cAMP and cGMP.


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