Restorative Neurology and Neuroscience - Volume 32, issue 6

Authors: Szaflarski, J.P. | Allendorfer, J.B. | Byars, A.W. | Vannest, J. | Dietz, A. | Hernando, K.A. | Holland, S.K.

Article Type: Research Article

Abstract: Purpose: To determine how age at the time of left middle cerebral artery stroke affects language lateralization in a combined sample of subjects with perinatal, childhood, and adult stroke. Methods: 19 participants who had perinatal stroke (<1 month of age), 32 with later stroke, and 51 sex-/age-matched healthy controls (HCs) received fMRI of language using verb generation task (VGT). Results: Percent lesion volumes were not different between groups (perinatal vs. late stroke) when taking brain volume into account (p = 0.084). Perinatal stroke group showed bilateral signal increases compared to more left-lateralized signals in matched HCs; late stroke group and …HCs both showed left-hemispheric signal increases. LIs in the stroke groups were consistently more bilateral than in HCs (all p < 0.008) except for the late group's posterior LI (p = 0.080). There was greater proportion of leftward language lateralization in HCs compared to their respective stroke groups (78.9% vs. 31.6% in perinatal; 87.5% vs. 59.4% in late stroke; p = 0.004) and a larger proportion of leftward lateralization in late compared to perinatal stroke (p = 0.039). The age of stroke occurrence showed significant positive associations with global and frontal LI (both p ≤ 0.007). Conclusion: As expected, the age of stroke occurrence affects subsequent verb generation lateralization. Greater cortical plasticity is observed in earlier stroke while later stroke is associated with reliance on the repair of the previously damaged left-hemispheric networks. Show more

Keywords: fMRI, language, aphasia, stroke, child, adult, language lateralization

DOI: 10.3233/RNN-140402

Citation: Restorative Neurology and Neuroscience, vol. 32, no. 6, pp. 733-742, 2014

Authors: Lee, Seung Yeol | Kim, Min-Su | Chang, Won Hyuk | Cho, Jin-Whan | Youn, Jin-Young | Kim, Yun-Hee

Article Type: Research Article

Abstract: Purpose: The aim of this study was to investigate the site-specific effects of repetitive transcranial magnetic stimulation (rTMS) on freezing of gait (FOG) in patients with parkinsonism. Methods: Twenty patients with parkinsonism and FOG were included. A single session of 10 Hz rTMS was applied over three different cortical regions of the dominant hemisphere: the primary motor cortex of the lower leg (M1-LL), the supplementary motor area (SMA), and the dorsolateral prefrontal cortex (DLPFC). We also performed sham stimulation as a control. The Timed Up and Go (TUG) test, Turn Steps and Turn Time in 180° turning, Unified Parkinson's Disease …Rating Scale (UPDRS) part III, FOG Questionnaire (FOG-Q), and motor evoked potential (MEP) studies were performed before and after each intervention. Results: There were significant improvements in TUG test times after rTMS over the M1-LL and the DLPFC. Improvement was significantly greater after the M1-LL stimulation than sham condition. The M1-LL and DLPFC stimulation also resulted in significant improvements in both the number of Turn Steps and Turn Time. UPDRS-III scores were significantly decreased after the M1-LL and DLPFC stimulation. Conclusions: Use of 10 Hz rTMS on the M1-LL and DLPFC is therapeutically effective for FOG in patients with parkinsonism. Show more

Keywords: Freezing of gait, Parkinsonism, repetitive transcranial magnetic stimulation

DOI: 10.3233/RNN-140397

Citation: Restorative Neurology and Neuroscience, vol. 32, no. 6, pp. 743-753, 2014

Authors: Gauthier, Lynne V. | Mark, Victor W. | Taub, Edward | McCullars, Adrianne | Barghi, Ameen | Rickards, Tyler | Hicks, Jarrod | Uswatte, Gitendra

Article Type: Research Article

Abstract: Purpose: The purpose of this study was to delineate the relationship between several types of T1-weighted MRI pathology and motor rehabilitation potential following Constraint Induced Movement therapy (CI therapy) in chronic stroke. Methods: Stepwise regression was employed (n = 80) to identify predictors of motor recovery (prior to therapy) and of response to Constraint-Induced Movement therapy [measured via the Wolf Motor Function Test (WMFT) and Motor Activity Log (MAL)] from among the following: age, side of motor deficit, chronicity, gender, lesion volume, peri-infarct damage volume, white matter hypointensity volume, ventricular asymmetry, and lesion location. Results: Although extent of total stroke …damage weakly correlated with poorer performance on the WMFT prior to therapy, this relationship was mediated by the location of the damage. No metric of tissue damage examined here was associated with real-world arm use at baseline (MAL at pre-treatment) or with CI therapy-induced improvement in either best motor performance upon request (WMFT) or spontaneous arm use for daily activities (MAL). Conclusions: In sum, the extent of brain tissue damage of any type examined here poorly predicted motor function and response to rehabilitation in chronic stroke. Show more

Keywords: Stroke, rehabilitation, CI therapy, lesion volume, infarct volume, motor

DOI: 10.3233/RNN-130366

Citation: Restorative Neurology and Neuroscience, vol. 32, no. 6, pp. 755-765, 2014

Authors: Carboncini, Maria Chiara | Piarulli, Andrea | Virgillito, Alessandra | Arrighi, Pieranna | Andre, Paolo | Tomaiuolo, Francesco | Frisoli, Antonio | Bergamasco, Massimo | Rossi, Bruno | Bonfiglio, Luca

Article Type: Research Article

Abstract: Purpose: We describe the case of a subject in a post-traumatic Minimally Conscious State (MCS) who retrieved full interaction with the environment after midazolam infusion. We studied EEG correlates of the “awakening reaction” in the different domains of frequency, time and cortical topography, along with the intrinsic connectivity within both the task-positive and the linguistic network. Methods: EEG recorded before and after midazolam administration has been submitted to spectral power analysis, sLORETA analysis and intrinsic connectivity analysis within both functional networks. Results: A critical change in the power spectrum profile was observed after midazolam: a) the power between 1 and …12 Hz decreased, reaching its maximum difference with respect to pre-infusion at about 7 Hz and b) the power between 12 and 30 Hz increased, with a maximum difference at about 15 Hz. At the same time, midazolam induced significant connectivity changes, especially for these two frequency bands, within both functional networks. Conclusions: We advance some hypotheses about certain aspects of the recovery from the MCS both in terms of anatomo-functional correlations and functional brain systems and we make inferences about the role that some kind of ‘catatonic’ symptoms might play in determining and/or maintaining this peculiar clinical state. Show more

Keywords: Connectivity, catatonia, disorders of consciousness, EEG, GABAergic drugs, minimally conscious state, non-convulsive status epilepticus, theta rhythm

DOI: 10.3233/RNN-140426

Citation: Restorative Neurology and Neuroscience, vol. 32, no. 6, pp. 767-787, 2014

Authors: Khedr, Eman M. | Elfetoh, Noha Abo | Ali, Anwer M. | Noamany, Mostafa

Article Type: Research Article

Abstract: Background: Existing treatments for adults with anorexia nervosa (AN) have limited proven efficacy. New treatments that have been suggested involve targeted, brain-directed interventions such as transcranial direct current stimulation (tDCS). We describe findings from seven individuals with treatment-resistant AN who received 10 sessions of anodal tDCS, over the left dorsolateral prefrontal cortex (DLPFC). Material and method: In this open-label, single-arm study, seven patients received anodal tDCS (2mA) for 25 minutes over the left dorsolateral prefrontal cortex daily for ten days. Assessments pre-tDCS, post-tDCS and one month later included the Eating Attitude Test (EAT), Eating Disorder Inventory (EDI) and Beck Depression …Inventory (BDI). Results: Three patients improved in all three rating scales immediately after the treatment sessions and one month later. Two patients showed improvement at the end of treatment but returned to the baseline after one month. One subject improved only on the BDI scale but not eating scales. The scores in the three rating scales were unaffected by treatment in the remaining patient. There was a significant effect of time (pre, post and 1 month later) on the three rating scores; BDI (P = 0.016), EDI (P = 0.018) and EAT (P = 0.016) and a significant correlation between the percent improvement of BDI and EAT (p = 0.01), and between BDI and EDI (P = 0.006). Conclusions: These findings suggest that tDCS has potential as an adjuvant treatment for AN and deserves further study. Show more

Keywords: Anorexia nervosa, transcranial direct current stimulation, beck depression inventory, eating attitude test, eating disorder inventory

DOI: 10.3233/RNN-140392

Citation: Restorative Neurology and Neuroscience, vol. 32, no. 6, pp. 789-797, 2014

Authors: Kamke, Marc R. | Van Luyn, Jeanette | Constantinescu, Gabriella | Harris, Jill

Article Type: Research Article

Abstract: Purpose: Evidence suggests that deafness-induced changes in visual perception, cognition and attention may compensate for a hearing loss. Such alterations, however, may also negatively influence adaptation to a cochlear implant. This study investigated whether involuntary attentional capture by salient visual stimuli is altered in children who use a cochlear implant. Methods: Thirteen experienced implant users (aged 8–16 years) and age-matched normally hearing children were presented with a rapid sequence of simultaneous visual and auditory events. Participants were tasked with detecting numbers presented in a specified color and identifying a change in the tonal frequency whilst ignoring irrelevant visual distractors. Results: …Compared to visual distractors that did not possess the target-defining characteristic, target-colored distractors were associated with a decrement in visual performance (response time and accuracy), demonstrating a contingent capture of involuntary attention. Visual distractors did not, however, impair auditory task performance. Importantly, detection performance for the visual and auditory targets did not differ between the groups. Conclusion: These results suggest that proficient cochlear implant users demonstrate normal capture of visuospatial attention by stimuli that match top-down control settings. Show more

Keywords: Cochlear implant, selective attention, spatial attention, contingent capture, children

DOI: 10.3233/RNN-140399

Citation: Restorative Neurology and Neuroscience, vol. 32, no. 6, pp. 799-811, 2014

Authors: Maidenbaum, Shachar | Hanassy, Shlomi | Abboud, Sami | Buchs, Galit | Chebat, Daniel-Robert | Levy-Tzedek, Shelly | Amedi, Amir

Article Type: Research Article

Abstract: Purpose: Independent mobility is one of the most pressing problems facing people who are blind. We present the EyeCane, a new mobility aid aimed at increasing perception of environment beyond what is provided by the traditional White Cane for tasks such as distance estimation, navigation and obstacle detection. Methods: The “EyeCane” enhances the traditional White Cane by using tactile and auditory output to increase detectable distance and angles. It circumvents the technical pitfalls of other devices, such as weight, short battery life, complex interface schemes, and slow learning curve. It implements multiple beams to enables detection of obstacles at different …heights, and narrow beams to provide active sensing that can potentially increase the user's spatial perception of the environment. Participants were tasked with using the EyeCane for several basic tasks with minimal training. Results: Blind and blindfolded-sighted participants were able to use the EyeCane successfully for distance estimation, simple navigation and simple obstacle detection after only several minutes of training. Conclusions: These results demonstrate the EyeCane's potential for mobility rehabilitation. The short training time is especially important since available mobility training resources are limited, not always available, and can be quite expensive and/or entail long waiting periods. Show more

Keywords: Blind, mobility, rehabilitation, sensory substitution, SSD, active sensing

DOI: 10.3233/RNN-130351

Citation: Restorative Neurology and Neuroscience, vol. 32, no. 6, pp. 813-824, 2014

Authors: Wang, Chien-Chih | Wang, Chih-Pin | Tsai, Po-Yi | Hsieh, Chin-Yi | Chan, Rai-Chi | Yeh, Shih-Ching

Article Type: Research Article

Abstract: Purpose: The premotor cortex plays a major role in motor planning and control, exhibiting hierarchical importance comparable to that of the primary motor cortex (M1). In this study, we compared the effects of cPMd modulation, which was achieved using inhibitory repetitive transcranial magnetic stimulation (rTMS), with those of contralesional M1 (cM1) modulation, to elucidate the roles of both regions on longitudinal motor recovery following a stroke. Methods: Forty-four patients who had sustained hemiplegia for 3 to 12 months were randomly allocated to a cPMd group, cM1 group, or sham group and received 10 sessions of 1-Hz rTMS. The Medical Research …Council (MRC) Scale, Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), and a cortical excitability test were administered pre- and post- rTMS intervention. Results: cPMd modulation yielded significant improvements in MRC, FMA, and WMFT scores compared with sham stimulation and a significant effect on cortical excitability suppression equivalent to that of cM1 modulation, but engendered effects on motor improvement inferior to those of cM1 modulation. Conclusions: In patients with chronic stroke, the cPMd can fulfill a role similar to that of the cM1 in interhemispheric imbalance, which can be ameliorated by applying inhibitory rTMS to achieve substantial motor restoration. Show more

Keywords: Repetitive transcranial magnetic stimulation (rTMS), stroke, dorsal premotor cortex (PMd), primary motor cortex (M1), motor recovery, neuromodulation

DOI: 10.3233/RNN-140410

Citation: Restorative Neurology and Neuroscience, vol. 32, no. 6, pp. 825-835, 2014

Article Type: Other

Citation: Restorative Neurology and Neuroscience, vol. 32, no. 6, pp. 837-842, 2014