Download or read book Non invasive Brain Stimulation to Characterize and Alter Motor Function After Spinal Cord Injury written by Aaron Z. Bailey and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Advances in transcranial magnetic stimulation (TMS) now permit the precise assessment of circuitry in human motor cortices that contribute to movement. Further, TMS approaches are used to promote neural plasticity within cortical and spinal circuitry in an attempt to create short-term changes in motor control. This review is focused on the application of TMS techniques in the study of characterizing and promoting neural plasticity within individuals presenting with chronic spinal cord injury. We review TMS research performed in individuals with SCI and consider new opportunities for the use of TMS approaches to promote neural plasticity for improving motor recovery.
Download or read book Recovery of Motor Function Following Spinal Cord Injury written by Heidi Fuller and published by BoD – Books on Demand. This book was released on 2016-08-17 with total page 332 pages. Available in PDF, EPUB and Kindle. Book excerpt: Restoration of motor function following spinal cord injury is a complex and challenging task. By reviewing emerging cellular, pharmacological, rehabilitative, as well as surgical approaches, this book seeks to highlight promising therapeutic strategies for the repair and regeneration of motor circuitry. The multidisciplinary nature of these approaches illustrates various routes to bridging the gap between the bench and the bedside and to identify the challenges that must be overcome in order to bring about a viable therapeutic strategy for spinal cord injury patients.
Download or read book Utilizing Neuromodulation of the Spinal Cord to Assess and Modulate Aberrant Spinal Physiology Below the Lesion Following Severe Upper Motor Neuron Injury written by Lisa Moore and published by . This book was released on 2018 with total page 169 pages. Available in PDF, EPUB and Kindle. Book excerpt: Upper motor neuron injury damages the descending circuits connecting the brain to sensory and motor neurons responsible for sensing and interacting with the world. While spinal cord stimulation is showing extraordinary promise as a novel therapeutic to restore lost motor function following spinal cord injury, we have yet to fully characterize the mechanisms of its action or identify the limits of its therapeutic potential. Towards these ends I conducted a series of three studies which utilized spinal stimulation in novel subject populations to map the cervical spinal cord, identify and modulate aberrant spinal physiology, and enhance upper limb function. In the first study a group of SCI subjects with motor complete lesions, half of which had no measurable hand strength, received transcutaneous stimulation to the cervical spinal cord alone and in combination with the partial serotonergic agonist buspirone. Stimulation but not buspirone significantly improved hand function in subjects with measurable strength prior to the study and maintained hand strength for up to five months following treatment in more functional subjects. In the second study, two subjects who demonstrated improvement with transcutaneous stimulation but failed to maintain it 5 months after treatment, received epidural stimulators. The different properties and performance outcomes of the two forms of stimulation were compared in these severely impaired subjects. Finally in a cohort of rats, epidural stimulation was used to map the cervical spinal cord, track physiological changes in the spinal cord following a severe stroke injury to the motor cortex, and treat observed deficits in reaching success and muscle activity. While 20 Hz stimulation enhanced afferent derived spinal activity, only 1 Hz stimulation resulted in improved reaching success and muscle activity. Together these studies further our understanding, by identifying patient pools most receptive to spinal cord stimulation, characterizing the different properties and functional outcomes of transcutaneous versus epidural stimulation, and illustrating the potential to utilize spinal cord stimulation for other forms of upper motor neuron injury.
Download or read book Subcortical Stroke written by Geoffrey Donnan and published by OUP Oxford. This book was released on 2002-04-11 with total page 468 pages. Available in PDF, EPUB and Kindle. Book excerpt: Subcortical Stroke is a new and fully revised edition of Lacunar and Other Subcortical Infarctions (OUP, 1995). Stroke is one of the most common causes of death and subcortical stroke accounts for 20-30% of all cerebrovascular infarctions. Our understanding of stroke processes in general, and subcortical stroke in particular, has advanced considerably in recent years. Research findings from the fields of neurochemistry, imaging and genetics have provided insight and input to our understanding of this condition, and this new edition provides an opportunity to describe these advances, and to relate the findings to the clinical expression, neural mechanism, prognosis and treatment of subcortical stroke. In addition, new subcortical syndromes such as CADASIL are covered, as is subcortical haemorrhage. This book presents a comprehensive and authoritative review of the field with contributions from the leading international experts. Subcortical Stroke is for stroke physicians, neurologists and those researching cerebrovascular diseases.
Download or read book Brain Stimulation written by Marco Sandrini and published by Elsevier Inc. Chapters. This book was released on 2013-11-11 with total page 41 pages. Available in PDF, EPUB and Kindle. Book excerpt: Stroke is the major cause of long-term disability worldwide, with impaired manual dexterity being a common feature. In the past few years, noninvasive brain stimulation (NIBS) techniques, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), have been investigated as adjuvant strategies to neurorehabilitative interventions. These NIBS techniques can be used to modulate cortical excitability during and for several minutes after the end of the stimulation period. Depending on the stimulation parameters, cortical excitability can be reduced (inhibition) or enhanced (facilitation). Differential modulation of cortical excitability in the affected and unaffected hemisphere of patients with stroke may induce plastic changes within neural networks active during functional recovery. The aims of this chapter are to describe results from these proof-of-principle trials and discuss possible putative mechanisms underlying such effects. Neurophysiological and neuroimaging changes induced by application of NIBS are reviewed briefly.
Download or read book The Effect of Intermittent Theta Burst Stimulation on Biceps Corticomotor Excitability in Non impaired Individuals and Individuals with Tetraplegia written by Blaize Majdic and published by . This book was released on 2020 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Neuromodulation of the primary motor cortex (M1) in pair with physical therapy may be a promising method for improving motor outcomes after spinal cord injury (SCI). Increased excitability of the corticospinal motor pathways (i.e. corticomotor excitability) has shown to be associated with improved motor learning and skill acquisition. Intermittent theta burst stimulation (iTBS) is a form of non-invasive brain stimulation which can increase corticomotor excitability, as measured by an increase in the amplitude of motor evoked potentials (MEPs). However, the ability for iTBS to increase the corticomotor excitability of proximal muscles such as the biceps, and muscles affected by spinal cord injury is currently unclear. Therefore, the purpose of the present studies was to determine the effect of iTBS on the corticomotor excitability of the biceps, as measured by MEP amplitudes, in non-impaired individuals and individuals with tetraplegia. Participants completed three sessions of the protocol, each including sham and active iTBS. Sessions were separated by a minimum of three days to prevent the potential for carry over effects. Results showed no change in nMEP amplitude after either sham or active iTBS in the non-impaired group. However, the SCI group showed an increase in nMEP amplitude after active iTBS relative to sham, suggesting an increase in corticomotor excitability. While further research is needed before combinatorial therapies can be achieved, this study suggests that iTBS may be a promising method for improving motor function in those with tetraplegia.
Download or read book Sensorimotor Rehabilitation written by and published by Elsevier. This book was released on 2015-04-14 with total page 470 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume of Progress in Brain Research focuses on Sensorimotor Rehabilitation. - This well-established international series examines major areas of basic and clinical research within neuroscience, as well as emerging subfields
Download or read book Brain Computer Interfaces written by Cesar Marquez-Chin and published by Springer Nature. This book was released on 2022-05-31 with total page 133 pages. Available in PDF, EPUB and Kindle. Book excerpt: Stroke and spinal cord injury often result in paralysis with serious negative consequences to the independence and quality of life of those who sustain them. For these individuals, rehabilitation provides the means to regain lost function. Rehabilitation following neurological injuries has undergone revolutionary changes, enriched by neuroplasticity. Neuroplastic-based interventions enhance the efficacy and continue to guide the development of new rehabilitation strategies. This book presents three important technology-based rehabilitation interventions that follow the concepts of neuroplasticity. The book also discusses clinical results related to their efficacy. These interventions are: functional electrical stimulation therapy, which produces coordinated muscle contractions allowing people with paralysis to perform functional movements with rich sensory feedback; robot-assisted therapy, which uses robots to assist, resist, and guide movements with increased intensity while also reducing the physical burden on therapists; and brain–computer interfaces, which make it possible to verify the presence of motor-related brain activity during rehabilitation. Further, the book presents the combined use of these three technologies to illustrate some of the emerging approaches to the neurorehabilitation of voluntary movement. The authors share their practical experiences obtained during the development and clinical testing of functional electrical stimulation therapy controlled by a brain–computer interface as an intervention to restore reaching and grasping.
Download or read book Neuroplasticity and Neurorehabilitation written by Edward Taub and published by Frontiers E-books. This book was released on 2015-01-22 with total page 141 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nothing provided
Download or read book Non Invasive Brain Stimulation New Prospects in Cognitive Neurorehabilitation written by Carlo Professor Miniussi and published by Psychology Press. This book was released on 2012-12-06 with total page 218 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cognitive deficits are a common consequence of neurological disease, and there is evidence that specific cognitive training may be effective in rehabilitation. Behavioural dysfunction following neurological disease constitutes one of the major causes of disability worldwide, exerts a major impact on the daily life of affected individuals, and their families, also with a financial burden both for patients, and the society in general. Therefore, the adequate treatment of cognitive dysfunction is a much relevant issue, with social and economical implications, over and above the neuropsychological problem per se. Several investigations emphasise the fact that interacting with neural activity, by means of cortical stimulation, can affect cognitive performance. A number of studies have reported enhanced performance in specific cognitive tasks in patients with several types of neurological disease, after receiving Non Invasive Brain Stimulation (NIBS) to specific cortical areas, namely: Transcranial Magnetic Stimulation, and transcranial Electrical Stimulation. In general, the evidence highlights the possibility of inducing changes in cortical excitability, which, in turn, may lead to a plastic reorganization of dysfunctional networks, responsible for the impaired cognitive functions. Despite these advances, a number of important questions remain open, regarding the use of stimulation techniques in cognitive rehabilitation. This special issue puts together international leading experts in the field, to review and discuss recent advances as to whether NIBS techniques alone, or combined with behavioural cognitive rehabilitation, can lead to performance enhancements, and why. The issue is timely and promises to have a huge impact across many domains of clinical and basic neuroscience.
Download or read book Using Stimulation and Repetitive Task Practice to Promote Neuroplasticity Targeted at Improving Hand Function in Individuals with Chronic Tetraplegia written by Joyce R Gomes-Osman and published by . This book was released on 2013 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Injury to the cervical segments of the spinal cord causes significant functional deficits to the upper extremities, affecting the performance of daily life activities and quality of life. Functional impairments following a cervical spinal cord injury (SCI) are primarily attributed to the damage to ascending and descending tracts that hinders the flow of information to and from supraspinal centers and the hand muscles, but there is also evidence that post-injury patterns of cortical reorganization can also play an important role. This thesis explored the influence of different approaches used to activate the motor cortex combined with repetitive task practice, and assessed their effects on hand function and corticomotor excitability. In chapter 1, we explored the literature regarding the primary processes (the lesion itself) and secondary processes (cortical reorganization and anatomical changes) that may further contribute to deficits in hand function after tetraplegia. In addition, we explored the evidence regarding the use of stimulation approaches that either target the motor cortex directly (repetitive transcranial magnetic stimulation [rTMS] and transcranial direct current stimulation [tDCS]), or indirectly (transcutaneous electrical nerve stimulation [TENS] and peripherally applied vibration [VIB]) for their effects on hand function and corticomotor excitability and thus, their potential as adjunct tools in neurorehabilitation. In the study described in chapter 2, we assessed the safety and late effects of a multi-day intervention consisting of a novel electrode montage using tDCS aimed at increasing bi-hemispheric cortical excitability (and thus, targeting the bimanual motor deficits observed after SCI and the cortical activation that exists in bimanual movements) interleaved with bimanual typing task performance in neurologically healthy participants. We found that a multi-day intervention consisting of 5 days of BAC-tDCS was associated with significantly greater gains in bimanual typing performance when compared with sham-tDCS, which was not retained after one week. In chapter 3, we describe a study where we assessed the late effects of a 3-day intervention of 10 Hz rTMS (a frequency that is associated with increased corticomotor excitability) interleaved with performance of a fine motor task on hand function and cortical excitability in individuals with tetraplegia and neurologically healthy controls. We found that participants who received rTMS made greater improvements in skilled hand function and assessed by the Jebsen-Taylor Hand Function Test and grasp force than participants who received sham-rTMS. The improvement in skilled hand function was not accompanied by changes in pinch grip force or corticomotor excitability. In Chapter 4, we undertook a study to assess whether there are differences in outcomes of repetitive task practice when combined with each of the clinically accessible approaches to increase corticomotor excitability either directly (tDCS) or indirectly (TENS, VIB) . Individuals with tetraplegia participated in this crossover study consisting of one session of each stimulation approach, simultaneously delivered with repetitive task practice. We found transient increases in pinch force in the VIB condition, and increases in skilled hand function measured by the Nine-hole Peg Test with the TENS and tDCS conditions. In addition, TENS and tDCS seemed to have shared similarities in terms of early increases in corticomotor excitability, whereas VIB seemed to follow a different pattern characterized by late increases in corticomotor excitability. Finally, in chapter 5 we explore discuss the results of these studies and their applicability to upper extremity rehabilitation of individuals with tetraplegia.
Download or read book Neurorehabilitation Technology written by David J. Reinkensmeyer and published by Springer Nature. This book was released on 2022-11-15 with total page 771 pages. Available in PDF, EPUB and Kindle. Book excerpt: This revised, updated, and substantially expanded third edition provides an accessible, practical overview of major areas of research, technical development and clinical application in the field of neurorehabilitation movement therapy. The initial section provides the basic framework and a rationale for technology application in movement therapy by summarizing recent findings in neuroplasticity and motor learning. The following section provides a detailed overview of the movement physiology of various neurologic conditions, illustrating how this knowledge has been used to design various neurorehabilitation technologies. The third section then explains the principles of human-machine interaction for movement rehabilitation. The fourth section provides an overview of assessment technology and predictive modeling in neurorehabilitation. The fifth section provides a survey of technological approaches to neurorehabilitation, including spinal cord stimulation, functional electrical stimulation, virtual reality, wearable sensing, brain computer interfaces, mobile technologies, and telerehabilitation. The final two sections examine in greater detail the ongoing revolution in robotic therapy for upper extremity movement and walking, respectively. The promises and limitations of these technologies in neurorehabilitation are discussed, including an Epilogue which debates the impact and utility of robotics for neurorehabilitation. Throughout the book the chapters provide detailed practical information on state-of-the-art clinical applications of these devices following stroke, spinal cord injury, and other neurologic disorders and future developments in the field. The text is illustrated throughout with photographs and schematic diagrams which serve to clarify the information for the reader. Neurorehabilitation Technology, Third Edition is a valuable resource for neurologists, biomedical engineers, roboticists, rehabilitation specialists, physiotherapists, occupational therapists and those training in these fields. Chapter “Spinal Cord Stimulation to Enable Leg Motor Control and Walking in People with Spinal Cord Injury is available open access under a Creative Commons Attribution 4.0 International License via link.springer.com.
Download or read book Spinal Interneurons written by Lyandysha Viktorovna Zholudeva and published by Elsevier. This book was released on 2022-10-15 with total page 474 pages. Available in PDF, EPUB and Kindle. Book excerpt: Spinal Interneurons: Plasticity after Spinal Cord Injury provides neuroscientists, clinicians and trainees a reference book exclusively concentrating on spinal interneurons and the techniques and experiments employed to identify and study these cells as part of normal, diseased and injured neural circuits. In addition, the book highlights the therapeutic potential of these cells by presenting relevant pre-clinical and clinical work that has been performed. The book's focus on the latest in therapeutic strategies for targeting spinal interneurons, considerations for the development and use of treatments, and how such treatments work make this a comprehensive source of information. Provides a comprehensive overview of the techniques used to identify, characterize and classify spinal interneurons and their role in neural circuits Presents an in-depth discussion of the therapeutic potential of spinal interneurons for SCI injury and/or disease Represents the first book to discuss spinal interneurons and translational research
Download or read book Oxford Handbook of Transcranial Stimulation written by Eric Wassermann and published by Oxford University Press. This book was released on 2008-01-24 with total page 773 pages. Available in PDF, EPUB and Kindle. Book excerpt: Transcranial stimulation comprises an important set of techniques for investigating brain function, some of which promise to treat diseases. This book provides a review of the scientific and technical background required to understand transcranial stimulation, for neuroscientists, neurologists, and psychiatrists.
Download or read book Alternate Motor Pathways for Upper Limb Control written by Alana Bernice McCambridge and published by . This book was released on 2016 with total page 488 pages. Available in PDF, EPUB and Kindle. Book excerpt: Descending pathways other than the lateral corticospinal tract may play a role in the recovery of upper limb function after stroke. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that has shown the potential to improve motor function of the upper limb. This thesis investigated the neurophysiological and behavioural effects of motor cortex (M1) tDCS on control of the upper limb in healthy adults and chronic stroke patients. The effects of various tDCS electrode montages on corticomotor excitability were examined, with an emphasis on the proximal upper limb. Transcranial magnetic stimulation (TMS) was used to infer corticomotor excitability of crossed, uncrossed, and transcallosal motor pathways, cervical propriospinal neurons, and intracortical inhibition in M1. The first three experiments examined the effects of dual-hemisphere tDCS on the excitability of propriospinal neurons, separate motor pathways, and upper limb coordination. Dual-hemisphere tDCS modulated subcortical excitability to cervical propriospinal neurons, and transcallosal inhibition. The electrode montage anodal tDCS (a-tDCS) was examined in two experiments with healthy adults and in the final thesis experiment with chronic stroke patients. The effects of a-tDCS varied in healthy adults. The variability of tDCS after-effects on motor evoked potentials were correlated with an individual’s preferential recruitment of early vs late indirect (I)-waves. In another experiment, it was revealed that short-interval paired-pulse TMS can be used to examine intracortical inhibition on uncrossed motor projections to the proximal upper limb. This novel TMS paradigm provides new opportunities to investigate the role of the ipsilateral M1 during movement. In the final experiment, the interhemispheric imbalance model for chronic stroke was challenged. Anodal tDCS of the contralesional M1 was hypothesised to improve motor function of chronic stroke patients that may rely on alternate motor pathways for upper limb control. Motor function of the paretic arm was positively affected by contralesional a-tDCS for patients who had greater spasticity. By identifying novel biomarkers this may help individualise tDCS protocols for future clinical trials.
Download or read book Transcutaneous Spinal Cord Stimulation for Restoration of Upper Extremity Function After Spinal Cord Injury written by Fatma Inanici and published by . This book was released on 2019 with total page 98 pages. Available in PDF, EPUB and Kindle. Book excerpt: Spinal cord injury is currently incurable. Standard of care after spinal cord injury focuses on prevention of the secondary complications and maximizing residual function. The most common site of injury is the cervical level that results in tetraplegia. Incomplete cervical injury is the most frequent neurological category. Loss of motor control and sensory function in the upper extremity is a particularly devastating aspect of cervical injuries that impairs the ability to perform activities of daily living. Restoration of hand and arm function is consistently rated as the highest treatment priority among people with tetraplegia due to cervical spinal cord injury, 5-fold higher than any other function included in the surveys. Nevertheless, current approaches to improve hand and arm function are largely ineffective. Electrical spinal cord stimulation, however, is one of the emerging neuromodulation strategies to restore motor function. The aims of this dissertation are to (1) review the applications of therapeutic electrical spinal cord stimulation after spinal cord injury, (2) determine improvements in hand and arm function resulting from non-invasive electrical cervical spinal cord stimulation, and (3) quantify long-term benefits that may persist beyond the stimulation. Therapeutic potential of transcutaneous spinal cord stimulation is evaluated in a prospective, open-label, two arm cross-over study. Intervention arms consist of intensive upper limb functional task training alone and transcutaneous electrical cervical spinal cord stimulation combined with training. The Graded Redefined Assessment of Strength, Sensation and Prehension is used as the primary outcome measure. Improvements achieved by training alone are compared to those obtained when transcutaneous spinal cord stimulation is paired with training. The findings demonstrate that transcutaneous cervical spinal cord stimulation has augmentative effect on restoration of hand and arm function. Additionally, gains are maintained up to six months without stimulation or training, suggesting that electrical stimulation can promote neuroplasticity. This dissertation provides evidence that transcutaneous spinal cord stimulation is a highly promising intervention for recovery of upper extremity function after cervical spinal cord injury, with the significant advantage of not requiring surgery.
Download or read book An Assessment of Corticospinal Tract Function in Spinal Cord Injured Subjects Using Non invasive Magnetic Stimulation of the Motor Cortex written by Frank A. Proudlock and published by . This book was released on 1993 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
