Tuning brain networks: The emerging role of transcranial direct current stimulation on structural plasticity

Frontiers in Cellular Neuroscience, Journal Year: 2022, Volume and Issue: 16

Published: July 21, 2022

Transcranial direct current stimulation (tDCS) is a non-invasive brain technique (NIBS) that has been proven to promote beneficial effects in range of neurological and psychiatric disorders. Unfortunately, although widely investigated, the mechanism comprehension around tDCS presents still some gaps. Therefore, scientists are trying uncover cellular molecular mechanisms behind its positive permit more suitable application. Experimental models have provided converging evidence elicits improvements learning memory by modulating both excitability synaptic plasticity neurons. Recently, among neurobiological effects, neural synchronization dendritic structural changes reported physiological pathological conditions, suggesting possible at neuronal circuit level. In this review, we bring focus emerging on rewiring, with intent match these two aspects underpinning identified so far, providing new perspective work unveil novel therapeutic use treat dysfunctions.

Language: Английский

---

Using Transcranial Direct Current Stimulation to Augment the Effect of Motor Imagery-Assisted Brain-Computer Interface Training in Chronic Stroke Patients—Cortical Reorganization Considerations

Frontiers in Neurology, Journal Year: 2020, Volume and Issue: 11

Published: Aug. 27, 2020

Introduction: Transcranial direct current stimulation (tDCS) has been shown to modulate cortical plasticity, enhance motor learning and post-stroke upper extremity recovery. It also demonstrated facilitate activation of brain-computer interface (BCI) in stroke patients. We had previously that BCI-assisted imagery (MI-BCI) can improve impairment chronic participants. This study was carried out investigate the effects priming with tDCS prior MI-BCI training patients moderate severe paresis activity changes associated training. Methods: is a double-blinded randomised clinical trial. Participants were randomized receive 10 sessions 20-minute 1mA or sham-tDCS before MI-BCI, anode applied ipsilesional, cathode contralesional primary cortex (M1). Upper sub-scale Fugl-Meyer Assessment (UE-FM) corticospinal excitability measured by transcranial magnetic (TMS) assessed before, after 4 weeks intervention. Results:10 participants received real 9 sham tDCS. UE-FM improved significantly both groups Of those unrecordable evoked potential (MEP-) ipsilesional M1, significant improvement found real-tDCS group, but not group. Resting threshold (RMT) M1 decreased intervention Short intra-cortical inhibition (SICI) reduced following Correlation between baseline score SICI for all, as well RMT MEP- Conclusion: function stroke-affected arm impairment. did confer overall additional benefit although there trend towards greater benefit. Cortical functional suggests possible role recovery more severely affected important implications designing neuromodulatory interventions future studies tailoring treatment. The registered at https://clinicaltrials.gov (NCT01897025).

Language: Английский

---

A randomized controlled trial on the effects induced by robot-assisted and usual-care rehabilitation on upper limb muscle synergies in post-stroke subjects

Scientific Reports, Journal Year: 2021, Volume and Issue: 11(1)

Published: March 5, 2021

Abstract Muscle synergies are hypothesized to reflect connections among motoneurons in the spinal cord activated by central commands and sensory feedback. Robotic rehabilitation of upper limb post-stroke subjects has shown promising results terms improvement arm function motor control achieved reassembling muscle into a set more similar that healthy people. However, stroke survivors potentially neurophysiological changes induced robot-mediated learning versus usual care have not yet been investigated. We quantified deficits 32 through movement analysis two virtual untrained tasks object placing pronation. The sample analyzed this study is part larger bi-center included all who underwent kinematic were randomized robot groups. Post-stroke followed robotic showed improvements axial-to-proximal with respect those care. This was associated significant proximal kinematics. Both treatments had negative effects controlling distal district. supports definition new rehabilitative for improving recovery after stroke.

Language: Английский

---

Robot-assisted distal training improves upper limb dexterity and function after stroke: a systematic review and meta-regression

Neurological Sciences, Journal Year: 2022, Volume and Issue: 43(3), P. 1641 - 1657

Published: Jan. 28, 2022

Language: Английский

---

Effectiveness of soft robotic glove versus repetitive transcranial magnetic stimulation in post-stroke patients with severe upper limb dysfunction: A randomised controlled trial

Frontiers in Neurology, Journal Year: 2023, Volume and Issue: 13

Published: Jan. 11, 2023

To explore the difference in rehabilitation effect between soft robot gloves and repetitive transcranial magnetic stimulation (rTMS) patients with severe upper limb motor dysfunction after a stroke.A total of 69 post-stroke were randomly assigned to group, robotic glove conventional treatment group. The primary outcomes Fugl-Meyer Upper Extremity Assessment (FMA-UE) Modified Barthel Index (MBI). secondary endpoints amplitude surface electromyogram extensor wrist muscle (sEMG) cerebral hemispheric resting threshold (RMT).The change FMA-UE score group was significantly better than that (median difference: 2 points; 95% confidence interval [1, 3]; P < 0.05), but there no significant compared 0 [-1, 2]; [0.547] > 0.05). There MBI groups [F = 2.458, [0.093] 0.05]. sEMG [H 0.042, [0.980] Additionally, RMT inferior [difference: -1.09; [-2.048, 0.048]; 0.05], 0.31 [-0.879, 0.358]; [0.495] 0.05].For dyskinesia stroke, are as effective may be good choice for home rehabilitation. In addition, combined or produced alone.

Language: Английский

---

Combining transcranial direct current stimulation with hand robotic rehabilitation in chronic stroke patients: a double blind randomized clinical trial

American Journal of Physical Medicine & Rehabilitation, Journal Year: 2024, Volume and Issue: unknown

Published: Feb. 6, 2024

This study aimed to assess the impact of combining transcranial direct current stimulation with end-effector robot-assisted treatment on upper limb function, spasticity, and hand dexterity in chronic stroke patients.

Language: Английский

---

The Impact of Robotic Rehabilitation on the Motor System in Neurological Diseases. A Multimodal Neurophysiological Approach

International Journal of Environmental Research and Public Health, Journal Year: 2020, Volume and Issue: 17(18), P. 6557 - 6557

Published: Sept. 9, 2020

Motor disability is a key feature of many neurological diseases, influencing the social roles affected patients and their ability to perform daily life activities. Current rehabilitation capacities are overwhelmed by age-related increase motor dysfunctions seen, for example, in stroke, extrapyramidal or neuromuscular diseases. As patient personnel ration increases, robotic solutions might establish possibility rapidly satisfy increasing demand rehabilitation. This paper presents an inaugural exploratory study which investigates interchangeability novel experimental device system with classical physical therapy, using multimodal neurophysiological assessment system-quantitative electroencephalogram (EEG), conduction times turn/amplitude analysis. Preliminary results show no significant difference between two methods; however, effect therapy was found on different pathologies (beneficial vascular extrapyramidal, limited, only preventing reduction joint movements neuromuscular).

Language: Английский

---

Robotic arm training in neurorehabilitation enhanced by augmented reality – a usability and feasibility study

Journal of NeuroEngineering and Rehabilitation, Journal Year: 2023, Volume and Issue: 20(1)

Published: Aug. 12, 2023

Robotic therapy and serious gaming support motor learning in neurorehabilitation. Traditional monitor-based outputs cannot adequately represent the third dimension, whereas virtual reality headsets lack connection to real world. The use of Augmented Reality (AR) techniques could potentially overcome these issues. objective this study was thus evaluate usability, feasibility functionality a novel arm rehabilitation device for neurorehabilitation (RobExReha system) based on robotic (LBR iiwa, KUKA AG) using AR headset HoloLens (Microsoft Inc.).The RobExReha system tested with eleven adult inpatients (mean age: 64.4 ± 11.2 years; diagnoses: 8 stroke, 2 spinal cord injury, 1 Guillain-Barré-Syndrome) who had paretic impairments their upper limb. Five therapists administered evaluated system. Data compared Reference Group (eleven inpatients; mean 64.3 9.1 10 injury) trained commercially available devices (ArmeoPower or ArmeoSpring, Hocoma AG). Patients used standardized questionnaires evaluating usability comfort (Quebec User Evaluation Satisfaction assistive technology [QUEST]), workload (Raw Task Load Index [RTLX]) questionnaire rating visual perception scenario. Therapists QUEST, System Usability Scale short version Experience Questionnaire.Therapy safe feasible patients therapists, no adverse events being reported. were generally satisfied usability. patients' ratings significantly higher two items QUEST: reliability ease use. Workload (RTLX) did not differ between groups. Nearly all perceived scenario as functioning despite eight having stereoscopic vision. valued system's approach interesting inventive.We demonstrated clinical combining limb robot an AR-serious game setting. To ensure high future applications, reliable easy-to-use that can be task-oriented training should implemented.Ethical approval obtained trial registered at German Clinical Trials Register (DRKS00022136).

Language: Английский

---

Does the alternating timing of rTMS combined with soft-hand rehabilitation robot affect the recovery of hand function in patients after stroke? A study protocol for a multicentre randomised controlled trial

BMJ Open, Journal Year: 2025, Volume and Issue: 15(3), P. e094672 - e094672

Published: March 1, 2025

Combining repetitive transcranial magnetic stimulation (rTMS) with robotic training could result in more significant improvements motor function than either treatment alone. The efficacy of this combination may depend on the sequencing interventions. However, few studies have explored possibility interleaving or alternating between two modalities within a single session over shorter time frame. objective study is to evaluate rTMS and soft-hand rehabilitation robot therapy enhance upper limb hand patients ischaemic stroke. This multicentre will be conducted as single-blind, controlled, randomised trial, enrolling 132 post-stroke disease duration ranging from 1 week 3 months. participants randomly assigned group A (n=44), B (n=44) C (n=44). All undergo 4-week neurological programme, which includes standardised physical occupational administered by experienced therapists. Group receive 10 Hz high-frequency (HF-rTMS) ipsilesional primary cortex (iM1) for 20 min, followed min training. 5 HF-rTMS iM1 training, repeated four times. sham other parameters identical those A. above treatments once daily, days week, 4 weeks. outcome measurement Fugl-Meyer assessment extremity (FMA-UE). secondary measurements include Hong Kong edition Functional Test Hemiplegic Upper Extremity (FTHUE-HK), Modified Ashworth Scale (MAS), International Classification Functioning, Disability Health entries (ICF-Upper Entries). Assessments at baseline after weeks treatment. has been approved Ethics Committee First Affiliated Hospital Nanjing Medical University (2024-SR-515). findings spread through networks scientists, professionals general public, well peer-reviewed scientific papers presentations pertinent conferences. ChiCTR2400089583.

Language: Английский

---

A Paradigm Shift: Rehabilitation Robotics, Cognitive Skills Training, and Function After Stroke

Frontiers in Neurology, Journal Year: 2019, Volume and Issue: 10

Published: Oct. 15, 2019

Introduction: Robot-assisted therapy for upper extremity (UE) impairments post-stroke has yielded modest gains in motor capacity and little evidence of improved UE performance during activities daily living. A paradigm shift that embodies principles learning exercise dependent neuroplasticity may improve robot outcomes by incorporating active problem solving, salience trained tasks, strategies to facilitate the transfer acquired skills use paretic arm hand everyday activities. Objective: To pilot test feasibility a novel protocol, Active Learning Program Stroke (ALPS), designed complement repetitive, robot-assisted UE. Key ALPS ingredients included training cognitive (e.g., STOP, THINK, DO, CHECK) goal-directed home action plan (HAP) self-management skill transfer. Methods: Ten participants with moderate function >6 months after stroke received eighteen 1-h treatment sessions 2-3/x week over 6-8 weeks. In addition training, individuals were randomly assigned either (RT) or task-oriented (RT-TOT) trial whether inclusion TOT reinforced participants' understanding implementation strategies. Results: Statistically significant group differences found limb subtest Fugl-Meyer Assessment (FMA-UE) at discharge one-month follow-up favoring RT group. Analyses examine overall effects protocol RT-TOT showed large on FMA-UE, Motor Activity Log, Wolf Function Test, portion Impact Scale. Conclusion: The was first extend strategy therapy. intervention this development concept feasible well-tolerated, good potential optimize following

Language: Английский

---