Effect of intermittent theta burst stimulation combined with acoustic startle priming motor training on upper limb motor function and neural plasticity in stroke individuals: study protocol for a randomised controlled proof-of-concept trial

BMJ Open, Journal Year: 2025, Volume and Issue: 15(1), P. e090049 - e090049

Published: Jan. 1, 2025

Introduction Stroke is a major cause of acquired disability globally, yet the neural mechanisms driving motor recovery post-stroke remain elusive. Recent research has underscored growing significance subcortical pathways in plasticity and control. Among these, cortico-reticulospinal tract (CRST) gained attention rehabilitation due to its unique ascending descending structural features as well cellular properties which position it an excellent candidate compensate for inadequate control post-stroke. However, optimal strategies harness CRST unknown. Non-invasive modulation presents promising though challenging, therapeutic opportunity. Acoustic startle priming (ASP) training intermittent theta burst stimulation (iTBS) are emerging potential methods regulate function. This study aims investigate feasibility segmentally modulating cortico-reticular reticulospinal tracts through ASP iTBS while evaluating resulting effects. Methods analysis randomised, blinded interventional trial with three parallel groups. A total 36 eligible participants will be randomly assigned one groups: (1) iTBS+ASP group, (2) iTBS+non-ASP (3) sham group. The comprises four phases: baseline assessment, post-first intervention assessment after 3 weeks 4-week follow-up. primary outcomes changes Fugl-Meyer Assessment-Upper Extremity Modified Ashworth Scale 3-week intervention. Secondary include neurophysiological metrics neuroimaging results from diffusion tensor imaging resting-state functional MRI. Ethics dissemination registered Chinese Clinical Trial Registry (Registration No. ChiCTR2400085220) Medical Committee Tongji Hospital, affiliated College, Huazhong University Science Technology No.TJ-IRB20231109). It conducted Departments Rehabilitation Medicine Radiology at Hospital Wuhan, China. findings disseminated peer-reviewed journal publications presentations scientific conferences. registration number ChiCTR2400085220.

Language: Английский

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Cognitive Control and Consciousness in Open Biological Systems

Biosystems, Journal Year: 2025, Volume and Issue: unknown, P. 105457 - 105457

Published: April 1, 2025

Thermodynamically open biological systems not only sustain a life-supporting mutual relationship with their environment by exchanging matter and energy but constantly seek information to navigate probabilistic changes in surroundings. This work argues that cognition conscious thought should be viewed isolation rather as parts of an integral control identify act upon meaningful, semantic viability. Under this framework, the development key cognitive capacities centralized nervous resulting behavior are categorized into distinct Markov decision processes: decision-making partially observable sensory exteroceptive interoceptive information, learning memory, symbolic communication. It is proposed state arises from mechanism for speech production resembling actuator engineered systems. Also known phonological loop, feedback motor cortex provides third type flowing cortex. The continuous, dissipative loop updates fleeting working memory humans advanced layer through sense self, agency perception flow time. These define degrees fitness evolution information-powered organisms.

Language: Английский

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Alterations of static and dynamic changes in intrinsic brain activity and its relation to behavioral outcomes in subcortical ischemic stroke after one-month intervention

Scientific Reports, Journal Year: 2025, Volume and Issue: 15(1)

Published: April 8, 2025

Ischemic stroke is a prominent contributor to cognitive dysfunction and disability. Gaining comprehensive understanding of the neuronal activity longitudinal changes underlying crucial for designing effective rehabilitative strategies. However, neural mechanisms responsible reorganization following remain unclear. The objective this study was comprehensively investigate potential abnormalities in brain among patients before after one month intervention (antiplatelet therapy, as well intravenous citicoline). To achieve goal, we combined static dynamic functional imaging indicators analysis. Twenty ischemic at subacute stage seventeen age-matched healthy controls were included final analysis from center. Additionally, resting-state magnetic scans conducted on all twice with one-month interval between scans. Four intrinsic (static amplitude low-frequency fluctuation (sALFF), fractional (sfALFF), regional homogeneity (sReHo), degree centrality (sDC)), along their corresponding indicators, calculated detect alterations onset. Correlation analyses also performed these within areas exhibiting group differences clinical scale scores disease duration. Significant variations image observed stroke. There substantial overlap abnormal regions detected, primarily including decreased sALFF/sfALFF/dALFF bilateral central precuneus, increased sfALFF/sReHo/sDC/dReHo left superior sALFF/sReHo/dfALFF inferior temporal gyrus, sReHo/sDC anterior cingulate cortex, sReHo/dfALFF right parietal lobe, sfALFF/sDC fusiform sALFF/dALFF angular gyrus. Furthermore, disrupted some exhibited only partial recovery second time point. percentage (sfALFF sDC dALFF precuneus) two points positively correlated (FMA MBI). In combination, demonstrates that its can be achieved by integrating methods. Regions showing significant different consistent image-behavior relationships may have values predicting outcomes.

Language: Английский

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Assessing the utility of Fronto-Parietal and Cingulo-Opercular networks in predicting the trial success of brain-machine interfaces for upper extremity stroke rehabilitation

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2025, Volume and Issue: unknown

Published: April 11, 2025

Abstract For stroke participants undergoing motor rehabilitation, brain-machine/computer interfaces (BMI/BCI) can potentially improve the efficacy of robotic or exoskeleton-based therapies by ensuring patient engagement and active participation, through monitoring intent. In such interventions, exploring network-level understanding source space, in terms various cognitive dimensions as executive control versus reward processing is fruitful both improving existing therapy protocols well subject-level differences. This contrasts to traditional approaches that predominantly investigate rehabilitation from resting state data. Moreover, conventional BMIs used for barely accommodate people suffering moderate severe impairments. this first-of-the-kind study, we explore a BMI trial probing networks are core performance propose network connectivity-based measurement with potential characterize impairments patients closed-loop intervention. Specifically, tease apart extent evaluation aspects these patients, measuring activation power major network-the Cingulo-Opercular Network (CON) circuit-the Fronto-Parietal (FPN), connectivity between FPN-CON. We test our hypothesis previously collected dataset electroencephalography (EEG) structural imaging performed on upper limb impairments, while they underwent an intervention about 12 sessions over 4 weeks. Our logistic regression modeling results suggest FPN CON their powers predict failure accurately 84.2%. future, aim integrate observations into design adaptively difficulty passively increase subject’s motivation attention factor effective learning.

Language: Английский

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Transcranial direct current stimulation over the motor and premotor cortex with mirror therapy improves motor control, muscle function, and brain activity in chronic stroke: a double-blind randomized sham-controlled trial

Journal of NeuroEngineering and Rehabilitation, Journal Year: 2025, Volume and Issue: 22(1)

Published: April 26, 2025

Transcranial direct current stimulation (tDCS) is a popular approach to augment the effects of neurorehabilitation. Most studies stimulated ipsilesional primary motor cortex (iM1); nonetheless, success iM1 was variable, suggesting that it may not be optimal for improving recovery. Ipsilesional premotor (iPMC) an alternative candidate based on its likelihood survival post-stroke and contribution functions. This study aimed determine tDCS iPMC with mirror therapy (MT) control, muscle function, brain activity in chronic stroke. Thirty-six participants were randomly distributed into (1) iPMC-tDCS MT (PMC) (2), iM1-tDCS (M1), (3) sham (sham). Motor control assessed using kinematics. Muscle function modified Ashworth Medical Research Council Scales. The M1 PMC recorded electroencephalography (EEG), event-related desynchronization laterality index (LI) examined. Significant within-group differences identified kinematic outcomes. After interventions, group showed reduced paretic upper limb spasticity improved greater movement smoothness peak velocity. trunk compensation fewer displacement flexion. However, relied more compensation, demonstrating increased velocity smoothness. between-group also found displacement. Post-hoc analysis revealed than group. within-and EEG contralesional (cPMC) from pre-to-post intervention In contrast, decreased, LI declined pre- post-intervention activity, having activation Differential treatment benefits between iPMC- MT. uniquely while mitigated during reaching. These findings suggest both could stroke neurorehabilitation considered clinical applications. ClinicalTrials.gov Identifier: NCT04655209. Registered 15th November 2020. https://clinicaltrials.gov/study/NCT04655209 .

Language: Английский

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Brain activity dynamics after traumatic brain injury indicate increased state transition energy and preference of lower order states

NeuroImage Clinical, Journal Year: 2025, Volume and Issue: 46, P. 103799 - 103799

Published: Jan. 1, 2025

Traumatic Brain Injury (TBI) can cause structural damage to the neural tissue and white matter connections in brain, disrupting its functional coactivation patterns. Although there are a wealth of studies investigating TBI-related changes brain's connectomes, fewer have investigated dynamic landscape. Network control theory is framework that integrates connectomes time-series quantify brain dynamics. Using this approach, we analyzed longitudinal trajectories dynamics from acute chronic injury phases two cohorts individuals with mild moderate severe TBI, compared them non-brain-injured, age- sex-matched individuals' trajectories. Our analyses suggest TBI initially activity similar controls but then shift subacute stages (1 month 12 months post-injury) favor lower-order visual-dominant states higher-order default mode dominant states. We further find that, controls, overall decreased entropy increased transition energy demand sub-acute correlates poorer attention performance. Finally, found asymmetry top-down bottom-up energies possibly indicating efficacy inhibition. replicate most findings dataset, their robustness, notable exception finding opposite correlation between global mean reaction time (MRT). attribute differences cohorts' varied severity, perhaps stronger compensatory mechanism TBI. Overall, our reveal shifting after relate behavioral measures attention, shedding light on post-injury mechanisms recovery.

Language: Английский

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Larger lesion volume in people with multiple sclerosis is associated with increased transition energies between brain states and decreased entropy of brain activity

Network Neuroscience, Journal Year: 2022, Volume and Issue: 7(2), P. 539 - 556

Published: Nov. 22, 2022

Quantifying the relationship between brain's functional activity patterns and its structural backbone is crucial when relating severity of brain pathology to disability in multiple sclerosis (MS). Network control theory (NCT) characterizes energetic landscape using connectome over time. We applied NCT investigate brain-state dynamics energy landscapes controls people with MS (pwMS). also computed entropy investigated association dynamic landscape's transition lesion volume. Brain states were identified by clustering regional vectors, was compute required these states. found that negatively correlated volume energy, larger energies associated pwMS disability. This work supports notion shifts pattern without results decreased compared controls, but, as this shift evolves disease, increase beyond occurs. Our provide first evidence volumes result greater activity.

Language: Английский

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Disrupted brain state dynamics in opioid and alcohol use disorder: attenuation by nicotine use

Neuropsychopharmacology, Journal Year: 2023, Volume and Issue: 49(5), P. 876 - 884

Published: Nov. 7, 2023

Language: Английский

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Moving toward elucidating alternative motor pathway structures post-stroke: the value of spinal cord neuroimaging

Frontiers in Neurology, Journal Year: 2024, Volume and Issue: 15

Published: Feb. 14, 2024

Stroke results in varying levels of motor and sensory disability that have been linked to the neurodegeneration neuroinflammation occur infarct peri-infarct regions within brain. Specifically, previous research has identified a key role corticospinal tract dysfunction recovery post-stroke. Of note, neuroimaging studies utilized magnetic resonance imaging (MRI) brain describe timeline tandem with function following stroke. However, suggested alternate pathways may also underlie disease progression degree functional Here, we assert expanding techniques beyond could expand our knowledge pathway structure In present work, will highlight findings suggest contribute post-stroke recovery, such as reticulospinal rubrospinal tract. Then review electrophysiological evaluate populations stroke other neurodegenerative disorders. We then outline spinal cord being used disorders provide insight into

Language: Английский

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Rehabilitation Modulates High-Order Interactions Among Large-Scale Brain Networks in Subacute Stroke

IEEE Transactions on Neural Systems and Rehabilitation Engineering, Journal Year: 2023, Volume and Issue: 31, P. 4549 - 4560

Published: Jan. 1, 2023

The recovery of motor functions after stroke is fostered by the functional integration large-scale brain networks, including network (MN) and high-order cognitive controls such as default mode (DMN) executive control (ECN) networks. In this paper, electroencephalography signals are used to investigate interactions among these three resting state networks (RSNs) in subacute patients rehabilitation. A novel metric, O-information rate (OIR), quantify balance between redundancy synergy complex RSNs, well its causal decomposition identify direction information flow. paper also employs conditional spectral Granger causality assess pairwise directed connectivity RSNs. After rehabilitation, a increase RSNs found, especially driven MN. From description, reduced towards MN enhanced treatment. Besides, inter-network changes associated with recovery, for which mediation role ECN seems play relevant role, both from perspective.

Language: Английский

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