scholarly journals Influence of Vibrotactile Random Noise on the Smoothness of the Grasp Movement in Patients in Chemotherapy-Induced Peripheral Neuropathy

Author(s):  
Michihiro Osumi ◽  
Masahiko Sumitani ◽  
Yuko Otake ◽  
Yuki Nishi ◽  
Satoshi Nobusako ◽  
...  

Abstract Background Patients with chemotherapy-induced peripheral neuropathy (CIPN) often suffer from sensorimotor dysfunction of the distal portion of the extremities (e.g., loss of somatosensory sensation, numbness/tingling, difficulty typing on a keyboard, or difficulty undoing or doing up a button). The present study aimed to reveal the effects of subthreshold vibrotactile random noise stimulation on sensorimotor dysfunction in CIPN patients without exacerbating symptoms. Methods Twenty-five patients with CIPN and 28 age-matched healthy adults participated in this study. To reveal the effects of subthreshold vibrotactile random noise stimulation on sensorimotor function, participants were asked to perform grasp movement tasks during random noise stimulation delivered to the volar and dorsal wrist. We set three intensity conditions of the vibrotactile random noise: 0%, 60%, and 120% of the sensory threshold (Noise 0%, Noise 60%, and Noise 120% conditions). In the grasp movement task, the distance between the thumb and index finger was recorded while the participant attempted to grasp a target object, and the smoothness of the grasp movement was quantified by calculating normalized jerk in each experimental condition. The experimental data were compared using two-way repeated-measures analyses of variance with two binary factors: experimental condition (Noise 0%, 60%, 120%) × group (Healthy controls, CIPN patients).Results The smoothness of the grasp movement was only improved in the Noise 60% condition without exacerbating numbness/tingling in CIPN patients and healthy controls. Conclusions The current study suggested that the development of treatment devices using stochastic resonance can improve sensorimotor function for CIPN patients.Trial registration UMIN Clinical Trials Registry(UMIN-CTR)No. UMIN000024776https://rctportal.niph.go.jp/s/detail/um?trial_id=UMIN000024776#

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23088-e23088
Author(s):  
Sabrina Ramnarine ◽  
Roman Rolke ◽  
Patrick M. Dougherty ◽  
Linda J Williams ◽  
Christi Alessi Fox ◽  
...  

e23088 Background: The lack of standardized diagnostic or assessment tools in CIPN pose an unmet need for objective and reliable measures. Advances in non-invasive, in vivo reflectance confocal microscopy (RCM) offer a painless method to identify markers of peripheral neuropathy such as loss of Meissner’s corpuscles (MC). This study aims to investigate the feasibility of RCM in CIPN by assessing MC density in healthy controls compared to cancer patients. Methods: RCM imaging (Vivascope 1500) was performed on the fingertip (digit V) to evaluate MC density in 45 healthy controls and 9 cancer patients prior to starting chemotherapy. Quantification was completed by two reviewers, one being blinded to achieve unbiased identification as the maximum MC count/6x6 mm image. Quantitative Sensory Testing (thermal and mechanical detection thresholds) along with the grooved pegboard test (sensorimotor function) were conducted for comparison with MC density. Spearman’s correlation coefficients were used to determine associations. Results: In healthy controls (25 females, 20 males; mean age 58.9, range 24-81 years), females exhibited a greater mean MC density compared with males (49.9 ± 7.1 MC vs 30.9 ± 4.2 MC; p = 0.03). Variances were observed across age range by decade (p < 0.0001). MC density was inversely correlated with mechanical detection (ρ = -0.51) and warm detection thresholds (ρ = -0.47) in contrast to cold pain threshold (ρ = 0.49). All correlations were significant (p < 0.01). Time to complete the grooved pegboard test correlated with MC density in the dominant hand (p = 0.02) and non-dominant hand (p < 0.01). Compared with age and gender matched controls, cancer patients had reduced MC density (22.0 ± 9.3 vs 35.4 ± 14.1; p = 0.03), mirroring deficits in cold detection threshold and the grooved pegboard test. Inter-rater reliability of MC density count showed an intraclass correlation of 0.96 (p < 0.0001). Conclusions: The findings from this study support the clinical utility of RCM in CIPN. Assessment of MC density using RCM may provide meaningful markers of sensory loss, sensorimotor function and an ability to detect possible subclinical deficits in patients at risk of CIPN prior to initiating chemotherapy.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Patrick Fuerst ◽  
Albert Gollhofer ◽  
Markus Wenning ◽  
Dominic Gehring

Abstract Background The application of ankle braces is an effective method for the prevention of recurrent ankle sprains. It has been proposed that the reduction of injury rates is based on the mechanical stiffness of the brace and on beneficial effects on proprioception and neuromuscular activation. Yet, how the neuromuscular system responds to the application of various types of ankle braces during highly dynamic injury-relevant movements is not well understood. Enhanced stability of the ankle joint seems especially important for people with chronic ankle instability. We therefore aimed to analyse the effects of a soft and a semi-rigid ankle brace on the execution of highly dynamic 180° turning movements in participants with and without chronic ankle instability. Methods Fifteen participants with functional ankle instability, 15 participants with functional and mechanical ankle instability and 15 healthy controls performed 180° turning movements in reaction to light signals in a cross-sectional descriptive laboratory study. Ankle joint kinematics and kinetics as well as neuromuscular activation of muscles surrounding the ankle joint were determined. Two-way repeated measures analyses of variance and post-hoc t-tests were calculated. Results Maximum ankle inversion angles and velocities were significantly reduced with the semi-rigid brace in comparison to the conditions without a brace and with the soft brace (p ≤ 0.006, d ≥ 0.303). Effect sizes of these reductions were larger in participants with chronic ankle instability than in healthy controls. Furthermore, peroneal activation levels decreased significantly with the semi-rigid brace in the 100 ms before and after ground contact. No statistically significant brace by group effects were found. Conclusions Based on these findings, we argue that people with ankle instability in particular seem to benefit from a semi-rigid ankle brace, which allows them to keep ankle inversion angles in a range that is comparable to values of healthy people. Lower ankle inversion angles and velocities with a semi-rigid brace may explain reduced injury incidences with brace application. The lack of effect of the soft brace indicates that the primary mechanism behind the reduction of inversion angles and velocities is the mechanical resistance of the brace in the frontal plane.


2015 ◽  
Vol 24 (1) ◽  
pp. 6-12 ◽  
Author(s):  
Tiffany Switlick ◽  
Thomas W. Kernozek ◽  
Stacey Meardon

Context:A relationship between altered postural control and injury has been reported in sports. Sensorimotor function serves a fundamental role in postural control and is not often studied in runners. Persons who sustain running injury may have altered sensorimotor function contributing to risk of injury or reinjury.Objectives:To determine if differences in knee and ankle proprioception or plantar sensation exist between injured and noninjured runners.Design:Retrospective case-control study.Setting:University campus.Participants:Twenty runners with a history of lower-extremity overuse injury and 20 noninjured runners were examined. Injured runners were subcategorized into 2 groups based on site of injury: foot/ankle and knee/hip.Main Outcome Measures:Active absolute joint-repositioning error of the ankle at 20° inversion and 10° eversion and the knee at 15° and 40° flexion was assessed using an isokinetic dynamometer. Vibratory threshold at the calcaneus, arch, and great toe was determined for each subject using a handheld electric sensory threshold instrument.Results:Runners in the injured-foot/ankle group had increased absolute error during ankle-eversion repositioning (6.55° ± 3.58°) compared with those in the noninjured (4.04° ± 1.78°, P = .01) and the hip/knee (3.63° ± 2.2°, P = .01) groups. Runners in the injured group, as a whole, had greater sensitivity in the arch of the plantar surface (2.94 ± 0.52 V) than noninjured runners (2.38 ± 0.53 V, P = .02).Conclusions:Differences in ankle-eversion proprioception between runners with a history of ankle and foot injuries and noninjured runners were observed. Runners with a history of injury also displayed an increased vibratory threshold in the arch region compared with noninjured runners. Poor ankle-joint-position sense and increased plantar sensitivity suggest altered sensorimotor function after injury. These factors may influence underlying postural control and contribute to altered loading responses commonly observed in injured runners.


BJPsych Open ◽  
2021 ◽  
Vol 7 (4) ◽  
Author(s):  
Timea Sparding ◽  
Erik Joas ◽  
Caitlin Clements ◽  
Carl M. Sellgren ◽  
Erik Pålsson ◽  
...  

Background Cross-sectional studies have found impaired cognitive functioning in patients with bipolar disorder, but long-term longitudinal studies are scarce. Aims The aims of this study were to examine the 6-year longitudinal course of cognitive functioning in patients with bipolar disorder and healthy controls. Subsets of patients were examined to investigate possible differences in cognitive trajectories. Method Patients with bipolar I disorder (n = 44) or bipolar II disorder (n = 28) and healthy controls (n = 59) were tested with a comprehensive cognitive test battery at baseline and retested after 6 years. We conducted repeated measures ANCOVAs with group as a between-subject factor and tested the significance of group and time interaction. Results By and large, the change in cognitive functioning between baseline and follow-up did not differ significantly between participants with bipolar disorder and healthy controls. Comparing subsets of patients, for example those with bipolar I and II disorder and those with and without manic episodes during follow-up, did not reveal subgroups more vulnerable to cognitive decline. Conclusions Cognitive performance remained stable in patients with bipolar disorder over a 6-year period and evolved similarly to healthy controls. These findings argue against the notion of a general progressive decline in cognitive functioning in bipolar disorder.


2020 ◽  
Vol 17 (3) ◽  
pp. 147916412092830
Author(s):  
Sara Tehrani ◽  
Karin Bergen ◽  
Louisa Azizi ◽  
Gun Jörneskog

Aim: The aim of this study was to investigate the correlation between skin microvascular reactivity and clinical microangiopathy in patients with type 1 diabetes. Methods: We included 61 patients with type 1 diabetes, that is, 31 patients with and 30 without clinical microangiopathy, and 31 healthy controls. A microangiopathy scoring system was introduced for comparison of data between patients with microangiopathy. Responses to iontophoresis of acetylcholine and sodium nitroprusside were assessed by laser Doppler imaging. Results: Patients with microangiopathy had reduced acetylcholine- and sodium nitroprusside-mediated flux in forearm skin microcirculation compared to healthy controls ( p = 0.03 and p < 0.001, respectively, repeated measures analysis of variance), whereas no significant differences were found between patients without microangiopathy and controls. Skin reactivity was reduced in patients with microangiopathy compared to patients without microangiopathy: 1.43 ± 0.38 versus 1.59 ± 0.39 arbitrary units for acetylcholine-mediated peak flux and 1.44 ± 0.46 versus 1.74 ± 0.34 arbitrary units for sodium nitroprusside-mediated peak flux ( p < 0.05 for both). A tendency of gradual decrease in acetylcholine and sodium nitroprusside responses was found in patients with increasing microangiopathy scores. Conclusion: We conclude that skin microvascular reactivity is associated with clinical microangiopathy in patients with type 1 diabetes. Impaired skin microvascular function in type 1 diabetes seems to be multifactorial and involves both endothelial-dependent and endothelial-independent pathways. We introduce a novel microangiopathy score that could easily be used in a clinical setting for comparison of patients with various degrees of microangiopathy.


Cephalalgia ◽  
1995 ◽  
Vol 15 (3) ◽  
pp. 224-229 ◽  
Author(s):  
M Leone ◽  
V Lucini ◽  
D D'Amico ◽  
F Moschiano ◽  
C Maltempo ◽  
...  

The cyclic recurrence of cluster periods and the regular timing of headache occurrence in cluster headache (CH) induced us to study the circadian secretion of melatonin and cortisol in 12 patients with episodic CH, during a cluster period, and compare them with 7 age- and sex-matched healthy controls. Blood was sampled every 2, h for 24 h. All subjects were confined to a dark room from 22.00 to 08.00. Plasma melatonin levels were significantly reduced in CH patients (repeated measures ANOVA p < 0.03; mesor p < 0.02), and the cortisol mesor was significantly increased ( p < 0.03). Amplitudes and acrophases did not differ between the groups. Individual cosinor analysis showed that 4/12 (33.3%) CH patients had no significant melatonin rhythm, and that 5/11 (45.5%) had no cortisol rhythm. Group analysis of cosinor revealed significant rhythmicity of melatonin and cortisol secretion in both groups. In controls, the timing of melatonin and cortisol acrophase significantly correlated with each other, indicating that the biorhythm controllers for the secretion of these hormones were synchronized. Such correlation was not found in the CH patients; mesor, amplitude and acrophase of melatonin and cortisol did not correlate with duration of illness, duration of headache in course, or time since last headache attack.


Perception ◽  
1988 ◽  
Vol 17 (5) ◽  
pp. 579-585 ◽  
Author(s):  
Eugene C Lechelt

Thresholds for tactile discrimination of stimulus orientation discrepancy from standard or referent vertical, horizontal, and diagonal orientations were determined for sighted, visually impaired, and blind subject groups. The stimuli were presented to the ventral distal portion of the tip of the subject's left index finger via an Optacon. Although the subject groups did not differ in overall discrimination accuracy, for each group the deviations from vertical and horizontal standard orientations were discriminated reliably more accurately than the deviations from standard diagonals, ie the oblique effect was obtained. The bases for this tactual spatial anisotropic effect appear to reflect both sensory—neurological and experiential factors.


2019 ◽  
Vol 37 (2) ◽  
pp. 123-128
Author(s):  
Marie L. Suarez ◽  
Judith M. Schlaeger ◽  
Veronica Angulo ◽  
David A. Shuey ◽  
Jesus Carrasco ◽  
...  

Objectives: Sickle cell disease (SCD) is a serious illness with disabling acute and chronic pain that needs better therapies, but insufficient patient participation in research is a major impediment to advancing SCD pain management. The purpose of this article is to discuss the challenges of conducting an SCD study and approaches to successfully overcoming those challenges. Design: In a repeated-measures, longitudinal study designed to characterize SCD pain phenotypes, we recruited 311 adults of African ancestry. Adults with SCD completed 4 study visits 6 months apart, and age- and gender-matched healthy controls completed 1 visit. Results: We recruited and completed measures on 186 patients with SCD and 125 healthy controls. We retained 151 patients with SCD with data at 4 time points over 18 months and 125 healthy controls (1 time point) but encountered many challenges in recruitment and study visit completion. Enrollment delays often arose from patients’ difficulty in taking time from their complicated lives and frequent pain episodes. Once scheduled, participants with SCD cancelled 49% of visits often because of pain; controls canceled 30% of their scheduled visits. To facilitate recruitment and retention, we implemented a number of strategies that were invaluable in our success. Conclusion: Patients’ struggles with illness, chronic pain, and their life situations resulted in many challenges to recruitment and completion of study visits. Important to overcoming challenges was gaining the trust of patients with SCD and a participant-centered approach. Early identification of potential problems allowed strategies to be instituted proactively, leading to success.


2017 ◽  
Vol 47 (9) ◽  
pp. 1637-1646 ◽  
Author(s):  
Y. Xu ◽  
W. Qin ◽  
C. Zhuo ◽  
L. Xu ◽  
J. Zhu ◽  
...  

BackgroundAs a disconnection syndrome, schizophrenia has shown impaired resting-state functional connectivity (rsFC) in the orbitofrontal cortex (OFC); however, the OFC is a rather heterogeneous region and the rsFC changes in the OFC subregions remain unknown.MethodA total of 98 schizophrenia patients and 102 healthy controls underwent resting-state functional MRI using a sensitivity-encoded spiral-in imaging sequence (SENSE-SPIRAL) to reduce susceptibility-induced signal loss and distortion. The OFC subregions were defined according to a previous parcellation study that divided the OFC into the anterior (OFCa), medial (OFCm), posterior (OFCp), intermediate (OFCi), and lateral (OFCl) subregions. The rsFC was compared using two-way repeated-measures ANOVA.ResultsWhether or not global signal regression, compared with healthy controls, schizophrenia patients consistently exhibited decreased rsFC between the left OFCi and the left middle temporal gyrus and the right middle frontal gyrus (MFG), between the right OFCi and the right MFG and the left inferior frontal gyrus, between the right OFCm and the middle cingulate cortex and the left Rolandic operculum. These rsFC changes still remained significant even after cortical atrophy correction.ConclusionsThese findings suggest a selective functional disconnection of the OFC subregions in schizophrenia, and provide more precise information about the functional disconnections of the OFC in this disorder.


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