Restorative Neurology and Neuroscience - Volume 33, issue 2

Authors: Freundlieb, Nils | Philipp, Stephan | Drabik, Anna | Gerloff, Christian | Forkert, Nils D. | Hummel, Friedhelm C.

Article Type: Research Article

Abstract: Purpose: Transcranial magnetic stimulation (TMS) and measurements of upper limb function were longitudinally applied to gain further insights into processes involved in functional recovery from the acute to the chronic stage after stroke. Methods: 10 acute stroke patients were monitored over 6 months behaviourally and with established TMS protocols. By using neuronavigated motor mapping, behavioural parameters, and a mixed model analysis, the role of the frontal and parietal part of the motor area of both hemispheres for functional recovery was determined. Results: Size and volume of the ipsilesional motor area (MAipsi ) were significantly decreased in the acute phase compared …to the contralesional motor area (MAcontra ). Size of MAipsi , especially its frontal part, changed over time and was positively correlated with functional recovery, whereas resting motor threshold, volume of both MA or the shift of its center of gravity did not show any association with recovery. Conclusion: The present data suggests the presence of a positive correlation between changes of the motor representation of the lesioned hemisphere and functional recovery after stroke. A possible interpretation is that rather (re-)activated corticomotor outputs are substrates of functional recovery after stroke than increased efficacy of residual, non-lesioned pathways. Show more

Keywords: Neuronavigation, transcranial magnetic stimulation, stroke, motor recovery, plasticity

DOI: 10.3233/RNN-140454

Citation: Restorative Neurology and Neuroscience, vol. 33, no. 2, pp. 221-231, 2015

Authors: Manthou, M. | Nohroudi, K. | Moscarino, S. | Rehberg, F. | Stein, G. | Jansen, R. | Abdulla, D. | Jaminet, P. | Semler, O. | Schoenau, E. | Angelov, D.N.

Article Type: Research Article

Abstract: Purpose: Based on several positive effects of whole-body-vibration (WBV) therapy on recovery after SCI, we looked for correlations between functional (analysis of locomotion), electrophysiological (H-reflex) and morphological (density of functioning capillaries) measurements after SCI and WBV-treatment. Methods: Severe compression SCI at low-thoracic level (T8) in adult female Wistar rats was followed by WBV twice a day (2 × WBV) over a 12-week post-injury period. Intact rats and rats with SCI but no WBV-therapy (“No-WBV”) served as controls. Recovery of locomotion was determined by BBB-locomotor rating, foot stepping angle (FSA), rump-height index (RHI), correct ladder steps (CLS) and H-reflex at 1, …3, 6, 9, and 12 weeks after SCI. Animals were sacrificed by an overdose of Isoflurane (Abbott). One hour later their spinal cords were fixed in 4% PFA for 24 h. Samples from the thoracic cord containing the lesion site and from the lumbar intumescence were cut into 10 μm thick longitudinal frozen sections. Results: All functioning capillaries were unequivocally identified because the endogenous peroxidase of the erythrocytes was clearly visualized with 0.05% diaminobenzidine (DAB). A determination of their absolute (in μm2 ) and proportional areas (percent of photographed tissue) revealed a significantly denser capillary network in the WBV-treated rats: 1,66 ± 0,41% in the “vibrated” rats versus 0,79 ± 0,19% in the “No-WBV” animals. The portion of the capillary network in intact rats was 1,51 ± 0,69%. Surprisingly, even though the vascularization in the treated animals was significantly increased, this had no beneficial influence on the recovery of functions after SCI. Conclusion: The results of this study provide for the first time evidence that intensive WBV-therapy leads to a significantly denser capillary network in the lesioned spinal cord. However, since this higher capillary density is not associated with improved functional recovery (possibly because it exceeded the balance necessary for functional improvements), optional treatments with lower intensity or less time of WBV-therapy should be tested. Show more

Keywords: Spinal cord injury, rehabilitation, whole body vibration, functional parameters, morphological changes, angiogenesis, revascularization, functional recovery, DAB

DOI: 10.3233/RNN-140434

Citation: Restorative Neurology and Neuroscience, vol. 33, no. 2, pp. 233-249, 2015