Restorative Neurology and Neuroscience - Volume 30, issue 5

Authors: Rickards, Tyler | Taub, Edward | Sterling, Chelsey | Graham, Michael J. | Barghi, Ameen | Uswatte, Gitendra | Mark, Victor W.

Article Type: Research Article

Abstract: Background and purpose: Infarct volume and location have a weak relationship with motor deficit in patients with chronic stroke. Recent research has focused on the relationship between spared or seemingly “healthy” neural tissue and motor function. In this study we examined MRI scans of patients with chronic stroke to determine if characteristics of seemingly normal parenchyma could predict either response to different forms of upper extremity physical rehabilitation or to pre-treatment motor status. Methods: Individuals with chronic stroke (ages 60.6 ± 11.9 years) and mild/moderate upper extremity hemiparesis were administered either CI therapy (n = 14) or a comparison therapy …(n = 29). The patients were assessed prior to and following therapy with MRI scans and the Wolf Motor Function Test (WMFT) Performance Time measure. Total voxels in combined grey matter (GM) and white matter (WM) segments (parenchymal volume) were divided by total voxels in GM, WM, and cerebrospinal fluid segments (intracranial volume) to obtain the brain parenchymal fraction (BPF). Results: BPF correlated with treatment gains on the WMFT (r(43) = −0.31, p = 0.04). Significant correlations between pre-treatment motor function and BPF were not observed. Conclusions: Individuals with greater BPFs after stroke show larger arm function gains after CI therapy, suggesting that reductions in volume of normal-appearing tissue may relate to ability to benefit from rehabilitation therapy in chronic stroke. Show more

Keywords: Stroke, rehabilitation, parenchyma, neuroimaging, CI therapy, hemiparesis

DOI: 10.3233/RNN-2012-110211

Citation: Restorative Neurology and Neuroscience, vol. 30, no. 5, pp. 355-361, 2012

Authors: Ozsoy, O. | Ozsoy, U. | Stein, G. | Semler, O. | Skouras, E. | Schempf, G. | Wellmann, K. | Wirth, F. | Angelova, S. | Ankerne, J. | Ashrafi, M. | Schönau, E. | Papamitsou-Sidoropolou, T. | Jaminet, P. | Sarikcioglu, L. | Irintchev, A. | Dunlop, S.A. | Angelov, D.N.

Article Type: Research Article

Abstract: Following spinal cord injury (SCI), loss of spinal and supraspinal control results in desynchronisation of detrusor vesicae (parasympathicus) and external urethral sphincter (sympathicus) activity. Despite recovery of lower urinary tract function being a high priority in patients with SCI, effective treatment options are unavailable largely because mechanisms are poorly understood. Purpose and methods: We used a clinically relevant model of thoracic SCI compression injury in adult female Wistar rats and confirmed that lesion volumes following severe injuries were significantly greater compared to moderate injuries (p < 0.05). Between 1–9 weeks, we assessed recovery of bladder function as well as return …of locomotor function using the Basso, Beattie and Bresnahan (BBB) score. Bladder morphometrics and overall intramural innervation patterns, as assessed with ß-III tubulin immunohistochemistry, were also examined. Results: Despite variability, bladder function was significantly worse following severe compared to moderate compression injury (p < 0.05); furthermore, the degree of bladder and locomotor dysfunction were significantly correlated (r = 0.59; p < 0.05). In addition, at 9 weeks after SCI we saw significantly greater increases in bladder dry weight (p < 0.05) and wall thickness following severe compared to moderate injury as well as increases in intramural axon density (moderate: 3× normal values; severe 5×; both p < 0.05) that also correlated with injury severity (r = 0.89). Conclusion: The moderate and severe compression models show consistent and correlated deficits in bladder and locomotor function, as well as in gross anatomical and histopathological changes. Increased intramural innervation may contribute to neurogenic detrusor overactivity and suggests the use of therapeutic agents which block visceromotoric efferents. Show more

Keywords: Compression spinal cord injury, injury severity, bladder function, BBB rating scale, urinary bladder innervation

DOI: 10.3233/RNN-2012-110203

Citation: Restorative Neurology and Neuroscience, vol. 30, no. 5, pp. 363-381, 2012

Authors: Sakakima, Harutoshi | Khan, Mushfiquddin | Dhammu, Tajinder S. | Shunmugavel, Anandakumar | Yoshida, Yoshihiro | Singh, Inderjit | Singh, Avtar K.

Article Type: Research Article

Abstract: Purpose: Stroke disability stems from insufficient neurorepair mechanisms. Improvement of functions has been achieved through rehabilitation or therapeutic agents. Therefore, we combined exercise with a neurovascular protective agent, S-nitrosoglutathione (GSNO), to accelerate functional recovery. Methods: Stroke was induced by middle cerebral artery occlusion for 60 min followed by reperfusion in adult male rats. Animals were treated with vehicle (IR group), GSNO (0.25 mg/kg, GSNO group), rotarod exercise (EX group) and GSNO plus exercise (GSNO+EX group). The groups were studied for 14 days to determine neurorepair mechanisms and functional recovery. Results: Treated groups showed reduced infarction, decreased neuronal cell death, enhanced …neurotrophic factors, and improved neurobehavioral functions. However, the GSNO+EX showed greater functional recovery (p < 0.05) than the GSNO or the EX group. A GSNO sub group, treated 24 hours after IR, still showed motor function recovery (p < 0.001). The protective effect of GSNO or exercise was blocked by the inhibition of Akt activity. Conclusions: GSNO and exercise aid functional recovery by stimulating neurorepair mechanisms. The improvements by GSNO and exercise depend mechanistically on the Akt pathway. A combination of exercise and GSNO shows greater functional recovery. Improved recovery with GSNO, even administered 24 hours post-IR, demonstrates its clinical relevance. Show more

Keywords: GSNO, IR, motor exercise, neurorepair, neurobehavior, rehabilitation, S-nitrosylation, stroke

DOI: 10.3233/RNN-2012-110209

Citation: Restorative Neurology and Neuroscience, vol. 30, no. 5, pp. 383-396, 2012

Authors: Caliandro, Pietro | Masciullo, Marcella | Padua, Luca | Simbolotti, Chiara | Di Sante, Gabriele | Russo, Giuseppina | Garattini, Claudia | Silvestri, Gabriella | Rossini, Paolo M.

Article Type: Research Article

Abstract: Purpose: 1) to verify if prefrontal cortex (PFC) is activated during over ground walking in ataxic patients, 2) to correlate the clinical parameters of gait with the PFC activation patterns. Methods: Fourteen patients and 20 healthy subjects were studied. Ataxia was assessed by the Scale for the Assessment and Rating of Ataxia (SARA). A 2-channel near-infrared system was used to investigate the changes in oxygenated ([O2Hb]t) and deoxygenated ([HHb]t) hemoglobin concentrations on the PFC during gait. [O2Hb] baseline-corrected activation values ([O2Hb]c) were calculated by the difference between [O2Hb]t and [O2Hb] during upright posture ([O2Hb]b). Results: [O2Hb]t was increased for both …channels (respectively p < 0.01 and p = 0.01) only in the patients. No variation was observed in [HHB]t. The correlation coefficient between [O2Hb]c and the SARA gait score was respectively r: 0.878 (p < 0.01) and r: 0.839 (p < 0.01) for the right and left PFC, between [O2Hb]c and the SARA stance score respectively r: 0.893 (p < 0.01) and r: 0.832 (p < 0.01). Conclusions: During over ground gait PFC is bilaterally activated in patients with severe chronic ataxia. These findings may be associated with compensatory mechanisms which are involved in severe conditions when other nervous centers controlling balance are functionally not efficient. Show more

Keywords: Prefrontal cortex, ataxia, gait, balance, NIRS

DOI: 10.3233/RNN-2012-120239

Citation: Restorative Neurology and Neuroscience, vol. 30, no. 5, pp. 397-405, 2012

Authors: Di Pino, G. | Porcaro, C. | Tombini, M. | Assenza, G. | Pellegrino, G. | Tecchio, F. | Rossini, P.M.

Article Type: Research Article

Abstract: Purpose: This work investigates how a direct bidirectional connection between brain and hand prosthesis modifies the bi-hemispheric sensorimotor system devoted to the movement control of the lost limb. Hand prostheses are often unable to satisfy users' expectations, mostly due to the poor performance of their interfacing system. Neural Interfaces implanted inside nerves of the stump offer the advantage of using the bidirectional neural pathways ‘naturally’ dispatching signals to control proper hand actions and feed-back sensations. Learning to control a neurally-interfaced hand prosthesis and decode sensory information was previously observed to reduce the inter-hemispheric asymmetry of cortical motor maps and the …clinical symptoms of phantom limb syndrome. Methods: Electroencephalographic (EEG) data was analysed using Functional Source Separation (FSS), a semi-blind method that incorporates prior knowledge about the signal of interest into data decomposition to give access to cortical patch activities. Results: Bi-hemispheric cortices showed normalization of their activity (topographical and spectral patterns) and of functional connectivity between homologous hand controlling areas, during the delivery of the motor command to the cybernetic prosthesis. Conclusions: The re-establishment of central-peripheral communication with the lost limb induced by a neurally-interfaced hand prosthesis produces beneficial plastic reorganization, not only restructuring contralateral directly-connected control areas, but also their functional balance within the bi-hemispheric system necessary for motor control. Show more

Keywords: Functional source separation, hand prosthesis, neural interface, inter-hemispheric coherence, neurorehabilitation

DOI: 10.3233/RNN-2012-120224

Citation: Restorative Neurology and Neuroscience, vol. 30, no. 5, pp. 407-418, 2012

Authors: Szelag, Elzbieta | Skolimowska, Justyna

Article Type: Research Article

Abstract: Purposes: The study offers a promising direction for rehabilitation, as for the first time cognitive benefits of training in temporal information processing (TIP) using Fast ForWord were identified in elderly adults. As TIP creates a fundamental basis for human cognition, we focussed on two questions: (1) can TIP be improved by Fast ForWord training? (2) can a transfer of the trained skill from the time domain to the untrained cognitive domain be observed after the training? Methods: 30 healthy seniors were classified according to three groups which underwent either temporal Fast ForWord training (Group A) or non-temporal control training (Group …B). Group C was comprised of non-active controls. Various cognitive functions, i.e., TIP, as well as some aspects of attention and short-term memory, were compared before and after the training. Results: Only for Group A was the improved TIP accompanied by amelioration of both attentional and memory resources. The observed improvements were maintained for up to 18 months. Although in Group B some improvements in TIP were also evidenced after the training, significant improvements were observed neither in Group B nor C. Conclusions: Temporal training is effective for amelioration of cognitive function in seniors. Its application may foster improved life quality in increasingly aging societies. Show more

Keywords: Temporal information processing, timing, Fast ForWord, cognitive function, healthy aging

DOI: 10.3233/RNN-2012-120240

Citation: Restorative Neurology and Neuroscience, vol. 30, no. 5, pp. 419-434, 2012

Authors: Ozyener, Fadil | Çetinkaya, Merih | Alkan, Tulin | Gören, Bülent | Kafa, Ilker Mustafa | Kurt, Mustafa Ayberk | Koksal, Nilgun

Article Type: Research Article

Abstract: Purpose: The objective of this study was to compare the effects of two neuroprotective agents; melatonin, a free radical scavenger and topiramate, AMPA/kainate receptor antagonist, administered alone or in combination in neonatal hypoxic-ischemic model. Methods: After being anesthetized, 7-day-old pups underwent ischemia followed by exposure to hypoxia. The pups were divided into 4 groups in order to receive the vehicle, melatonin, topiramate and combination of topiramate and melatonin. These were administered intraperitoneally for three times; the first before ischemia, the second after hypoxia and the third 24 hours after the second dose. After sacrification, infarct volume and apoptosis were evaluated. …Results: Percent infarcted brain volume was significantly reduced in rats which received drugs compared with those which received the vehicle. The number of TUNEL positive cells per unit area in hippocampus and cortex were markedly reduced in drug treated groups compared with control group. No significant differences were found regarding percent infarcted brain volume and number of TUNEL positive cells among drug-treated groups. Conclusions: Melatonin and topiramate, administered either alone or in combination significantly reduced the percent infarcted brain volume and number of TUNEL positive cells suggesting that these agents may confer benefit in treatment of infants with hypoxic-ischemic encephalopathy. Show more

Keywords: Combination therapy, hypoxia-ischemia, melatonin, neuroprotection, topiramate

DOI: 10.3233/RNN-2012-120217

Citation: Restorative Neurology and Neuroscience, vol. 30, no. 5, pp. 435-444, 2012