Increase in motor-cortex excitability after constraint-induced movement therapy in patients with congenital stroke

2006 ◽  
Vol 37 (01) ◽  
Author(s):  
M Walther ◽  
M Walther ◽  
V Brodbeck ◽  
H Jünger ◽  
M Staudt ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Movement Therapy ◽  
Constraint Induced Movement Therapy ◽  
Motor Cortex Excitability

Increase in motor-cortex excitability after constraint-induced movement therapy in patients with congenital stroke

2007 ◽  
Vol 118 (4) ◽  
pp. e111
Author(s):  
M. Walther ◽  
M. Walther ◽  
V. Brodbeck ◽  
H. Jünger ◽  
M. Staudt ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Movement Therapy ◽  
Constraint Induced Movement Therapy ◽  
Motor Cortex Excitability

Effects of constraint-induced movement therapy on motor cortex organization in chronic stroke patients

NeuroImage ◽  
1998 ◽  
Vol 7 (4) ◽  
pp. S24
Author(s):  
J. Liepert ◽  
H. Bauder ◽  
M. Sommer ◽  
W.H.R. Miltner ◽  
C. Dettmers ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Movement Therapy ◽  
Chronic Stroke ◽  
Stroke Patients ◽  
Constraint Induced Movement Therapy

scholarly journals A Concept for Extending the Applicability of Constraint-Induced Movement Therapy through Motor Cortex Activity Feedback Using a Neural Prosthesis

2007 ◽  
Vol 2007 ◽  
pp. 1-9 ◽  
Author(s):  
Tomas E. Ward ◽  
Christopher J. Soraghan ◽  
Fiachra Matthews ◽  
Charles Markham
Keyword(s):  
Infrared Spectroscopy ◽  
Motor Cortex ◽  
Healthy Subjects ◽  
Near Infrared ◽  
Primary Motor Cortex ◽  
Movement Therapy ◽  
Robotic Arm ◽  
Current Status ◽  
Constraint Induced Movement Therapy ◽  
Basic Technology

This paper describes a concept for the extension of constraint-induced movement therapy (CIMT) through the use of feedback of primary motor cortex activity. CIMT requires residual movement to act as a source of feedback to the patient, thus preventing its application to those with no perceptible movement. It is proposed in this paper that it is possible to provide feedback of the motor cortex effort to the patient by measurement with near infrared spectroscopy (NIRS). Significant changes in such effort may be used to drive rehabilitative robotic actuators, for example. This may provide a possible avenue for extending CIMT to patients hitherto excluded as a result of severity of condition. In support of such a paradigm, this paper details the current status of CIMT and related attempts to extend rehabilitation therapy through the application of technology. An introduction to the relevant haemodynamics is given including a description of the basic technology behind a suitable NIRS system. An illustration of the proposed therapy is described using a simple NIRS system driving a robotic arm during simple upper-limb unilateral isometric contraction exercises with healthy subjects.

Neurophysiological and Behavioral Effects of tDCS Combined With Constraint-Induced Movement Therapy in Poststroke Patients

2011 ◽  
Vol 25 (9) ◽  
pp. 819-829 ◽  
Author(s):  
Nadia Bolognini ◽  
Giuseppe Vallar ◽  
Carlotta Casati ◽  
Lydia Abdul Latif ◽  
Rasheda El-Nazer ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Handgrip Strength ◽  
Movement Therapy ◽  
Corticospinal Excitability ◽  
Behavioral Effects ◽  
Controlled Study ◽  
Double Blind ◽  
Transcallosal Inhibition ◽  
Constraint Induced Movement Therapy ◽  
Stimulation Of

Background. Recovery of motor function after stroke may depend on a balance of activity in the neural network involving the affected and the unaffected motor cortices. Objective. To assess whether transcranial direct current stimulation (tDCS) can increase the training-induced recovery of motor functions. Methods. In an exploratory study, 14 patients with chronic stroke and mean Fugl-Meyer Upper Extremity Motor Assessment of 29 (range = 8-50) entered a double-blind sham-controlled study, aimed to investigate neurophysiological and behavioral effects of bihemispheric tDCS (cathodal stimulation of the unaffected motor cortex and anodal stimulation of the affected motor cortex), combined with constraint-induced movement therapy (CIMT). Results. Patients in both groups demonstrated gains on primary outcome measures, that is, Jebsen Taylor Hand Function Test, Handgrip Strength, Motor Activity Log Scale, and Fugl-Meyer Motor Score. Gains were larger in the active tDCS group. Neurophysiological measurements showed a reduction in transcallosal inhibition from the intact to the affected hemisphere and increased corticospinal excitability in the affected hemisphere only in the active tDCS/CIMT group. Such neurophysiological changes correlated with the magnitude of the behavioral gains. Both groups showed a reduction in corticospinal excitability of the unaffected hemisphere. Conclusions. CIMT alone appears effective in modulating local excitability but not in removing the imbalance in transcallosal inhibition. Bihemispheric tDCS may achieve this goal and foster greater functional recovery.

Motor cortex plasticity during constraint-induced movement therapy in stroke patients

1998 ◽  
Vol 250 (1) ◽  
pp. 5-8 ◽  
Author(s):  
J. Liepert ◽  
W.H.R. Miltner ◽  
H. Bauder ◽  
M. Sommer ◽  
C. Dettmers ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Movement Therapy ◽  
Stroke Patients ◽  
Constraint Induced Movement Therapy ◽  
Motor Cortex Plasticity

Constraint-Induced Movement Therapy Promotes Neural Remodeling and Functional Reorganization by Overcoming Nogo-A/NgR/RhoA/ROCK Signals in Hemiplegic Cerebral Palsy Mice

2021 ◽  
Vol 35 (2) ◽  
pp. 145-157
Author(s):  
Li-Ru Liu ◽  
Yu-Xin Wang ◽  
Lu He ◽  
Yun-Xian Xu ◽  
Jing-Yu Huang ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Motor Cortex ◽  
Motor Function ◽  
Movement Therapy ◽  
Control Group ◽  
Structural Reorganization ◽  
Constraint Induced Movement Therapy ◽  
Hemiplegic Cerebral Palsy ◽  
Transmission Electron ◽  
Neural Remodeling

Background. Little is known about the induction of functional and brain structural reorganization in hemiplegic cerebral palsy (HCP) by constraint-induced movement therapy (CIMT). Objective. We aimed to explore the specific molecular mechanism of functional and structural plasticity related to CIMT in HCP. Methods. The mice were divided into a control group and HCP groups with different interventions (unconstraint-induced movement therapy [UNCIMT], CIMT or siRNA-Nogo-A [SN] treatment): the HCP, HCP+UNCIMT, HCP+CIMT, HCP+SN, and HCP+SN+CIMT groups. Rotarod and front-limb suspension tests, immunohistochemistry, Golgi-Cox staining, transmission electron microscopy, and Western blot analyses were applied to measure motor function, neurons and neurofilament density, dendrites/axon areas, myelin integrity, and Nogo-A/NgR/RhoA/ROCK expression in the motor cortex. Results. The mice in the HCP+CIMT group had better motor function, greater neurons and neurofilament density, dendrites/axon areas, myelin integrity, and lower Nogo-A/NgR/RhoA/ROCK expression in the motor cortex than the HCP and HCP+UNCIMT groups ( P < .05). Moreover, the expression of Nogo-A/NgR/RhoA/ROCK, the improvement of neural remodeling and motor function of mice in the HCP+SN group were similar to those in the HCP+CIMT group ( P > .05). The neural remodeling and motor function of the HCP+SN+CIMT group were significantly greater than those in the HCP+SN and HCP+CIMT groups ( P < .05). Motor function were positively correlated with the density of neurons ( r = 0.450 and 0.309, respectively; P < .05) and neurofilament ( r = 0.717 and 0.567, respectively; P < .05). Conclusions. CIMT might promote the remodeling of neurons, neurofilament, dendrites/axon areas, and myelin in the motor cortex by partially inhibiting the Nogo-A/NgR/RhoA/ROCK pathway, thereby promoting the improvement of motor function in HCP mice.

Immediate constraint-induced movement therapy causes local hyperthermia that exacerbates cerebral cortical injury in rats

2004 ◽  
Vol 82 (4) ◽  
pp. 231-237 ◽  
Author(s):  
Suzanne B DeBow ◽  
John E McKenna ◽  
Bryan Kolb ◽  
Frederick Colbourne
Keyword(s):  
Motor Cortex ◽  
Stroke Rehabilitation ◽  
Brain Temperature ◽  
Movement Therapy ◽  
Cortical Lesion ◽  
Stroke Patients ◽  
Mild Hyperthermia ◽  
Cortical Injury ◽  
Constraint Induced Movement Therapy ◽  
Cortex Lesion

Constraint-induced movement therapy (CIMT), which involves restraint of the nonimpaired arm coupled with physiotherapy for the impaired arm, lessens impairment and disability in stroke patients. Surprisingly, immediate ipsilateral forelimb immobilization exacerbates brain injury in rats. We tested whether immediate ipsilateral restraint for 7 days aggravates injury after a devascularization lesion in rats. Furthermore, we hypothesized that ipsilateral restraint aggravates injury by causing hyperthermia. In experiment 1, each rat received two lesions, one in the motor cortex and one in the visual cortex. Ipsilateral restraint increased only the motor cortex lesion. In additional rats, no differences in core temperature occurred after ipsilateral or contralateral restraint. Thus, ipsilateral restraint does not aggravate injury by a systemic side effect. In experiment 2, we hypothesized that ipsilateral restraint causes hyperthermia in the region surrounding the initial cortical lesion. Brain temperature, measured via telemetry, was significantly higher (~1 °C for 24 h) with ipsilateral restraint. A third experiment similarly found that ipsilateral restraint aggravates injury and causes local cortical hyperthermia and that contralateral restraint with externally induced mild hyperthermia aggravates injury. In conclusion, immediate ipsilateral restraint aggravates injury apparently by localized events that include hyperthermia. Caution must be exercised in applying early CIMT to humans, as hyperthermia is detrimental.Key words: stroke, rehabilitation, hyperthermia, physical therapy techniques, motor cortex.

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