Trials,
Journal Year:
2023,
Volume and Issue:
24(1)
Published: Dec. 4, 2023
Abstract
Background
Focal
brain
lesions
following
a
stroke
of
the
middle
cerebral
artery
induce
large-scale
network
disarray
with
potential
to
impact
multiple
cognitive
and
behavioral
domains.
Over
last
20
years,
non-invasive
neuromodulation
via
electrical
(tCS)
stimulation
has
shown
promise
modulate
motor
deficits
contribute
recovery.
However,
weak,
inconsistent,
or
at
times
heterogeneous
outcomes
using
these
techniques
have
also
highlighted
need
for
novel
strategies
assessment
their
efficacy
in
ad
hoc
controlled
clinical
trials.
Methods
We
here
present
double-blind,
sham-controlled,
single-center,
randomized
pilot
trial
involving
participants
having
suffered
unilateral
(MCA)
resulting
paralysis
contralateral
upper
limb.
Patients
will
undergo
10-day
regime
(5
days
week
2
consecutive
weeks)
newly
designed
high-definition
transcranial
direct
current
(HD-tDCS)
protocol.
Clinical
evaluations
(e.g.,
Fugl
Meyer,
NIHSS),
computer-based
assessments
(visuo-motor
adaptation
AX-CPT
attention
tasks),
electroencephalography
(resting-state
task-evoked
EEG)
be
carried
out
3
time
points:
(I)
Baseline,
(II)
Post-tDCS,
(III)
Follow-up.
The
study
consists
four-arm
comparing
on
recovery
three
active
anodal
tDCS
conditions:
ipsilesional
DLPFC
tDCS,
contralesional
cerebellar
combined
+
sham
intervention.
Fugl-Meyer
Assessment
extremity
(FMA-UE)
is
selected
as
primary
outcome
measure
quantify
In
every
session,
receive
min
high-density
(up
0.63
mA/
$${\mathrm{cm}}^{2}$$
cm2
)
$${\mathrm{\pi
cm}}^{2}$$
π
electrodes.
Electrode
scalp
positioning
relative
cortical
surface
(anodes
cathodes)
intensities
are
based
biophysical
optimization
model
distribution
ensuring
0.25
V/m
each
chosen
targets.
Discussion
Our
gauge
therapeutic
accumulative
sessions
HD-tDCS
improve
limb
dysfunctions
presented
by
patients.
parallel,
we
aim
characterizing
changes
electroencephalographic
(EEG)
activity
biomarkers
effects
identifying
interactions
between
performance
outcomes.
work
enrich
our
mechanistic
understanding
prefrontal
contributions
function
its
rehabilitation
damage.
Trial
registration
ClinicalTrials.gov
NCT05329818.
April
15,
2022.
Current Opinion in Neurobiology,
Journal Year:
2023,
Volume and Issue:
83, P. 102807 - 102807
Published: Nov. 17, 2023
Advancements
in
stroke
rehabilitation
remain
limited
and
call
for
a
reorientation.
Based
on
recent
results,
this
study
proposes
network-centric
perspective
stroke,
positing
that
it
not
only
causes
localized
deficits
but
also
affects
the
brain's
intricate
network
of
networks,
transiting
into
pathological
state.
Translating
these
system-level
insights
interventions
requires
brain
theory,
Distributed
Adaptive
Control
(DAC)
theory
offers
such
framework.
When
applied
gaming
system,
principles
demonstrate
superior
results
over
conventional
methods.
This
impact
stems
from
activating
extensive
particularly
executive
control
network,
focused
motor
learning,
maintaining
excitatory-inhibitory
balance,
which
is
essential
neural
repair
functional
reorganization.
The
analysis
stresses
uniting
preclinical
clinical
research
placing
architecture
embodied
volitional
at
centre
approaches.
Experimental Gerontology,
Journal Year:
2024,
Volume and Issue:
195, P. 112527 - 112527
Published: July 29, 2024
Stroke
is
recognized
as
a
network
communication
disorder.
Advances
in
neuroimaging
technologies
have
enhanced
our
comprehension
of
dynamic
cerebral
alterations.
However,
different
levels
motor
function
impairment
after
stroke
may
patterns
brain
reorganization.
Abnormal
and
adaptive
activity
mild-to-moderate
impairments
remain
still
underexplored.
We
aim
to
identify
remodeling
patients
with
function.
fMRI
data
were
obtained
from
30
31
healthy
controls
establish
spatiotemporal
multilayer
modularity
model.
Then,
graph-theoretic
measures,
including
modularity,
flexibility,
cohesion,
disjointedness,
calculated
quantify
reconfiguration.
Our
findings
reveal
that
the
post-stroke
exhibited
higher
modular
organization,
well
heightened
compared
HCs.
Moreover,
analyzing
level,
we
found
increased
disjointedness
flexibility
Default
mode
(DMN),
indicating
regions
tend
switch
more
frequently
independently
between
communities
changes
mainly
driven
by
DMN.
Notably,
modified
functional
dynamics
positively
correlated
performance
impairment.
Collectively,
research
uncovered
community
reconstruction
networks
following
stroke.
offer
new
insights
into
complex
reorganization
neural
brain.
Nature Communications,
Journal Year:
2024,
Volume and Issue:
15(1)
Published: Oct. 18, 2024
Stroke,
a
major
cause
of
disability,
disrupts
brain
function
and
motor
skills.
Previous
research
has
mainly
focused
on
reorganization
the
system
post-stroke,
but
effects
other
areas
their
influence
recovery
is
poorly
understood.
Here,
we
use
functional
neuroimaging
in
nonhuman
primate
model
(23
male
Cynomolgus
Macaques),
explore
how
ischemic
stroke
affects
whole-brain
cortical
architecture
its
relation
to
spontaneous
behavioral
recovery.
By
projecting
patterns
connectivity
onto
low-dimensional
manifold
space,
find
that
several
regions
both
sensorimotor
cortex
higher-order
transmodal
exhibit
significant
shifts
embedding
from
pre-
post-stroke.
Furthermore,
observe
changes
default
mode
limbic
network
regions,
not
preserved
are
associated
with
animal
These
results
establish
stroke,
suggest
an
important
role
for
post-stroke
outcomes.
Using
advanced
imaging
macaques,
authors
show
such
as
those
involved
emotion
cognition,
after
which
linked
better
Research Square (Research Square),
Journal Year:
2024,
Volume and Issue:
unknown
Published: Feb. 13, 2024
Abstract
The
acute
phase
of
ischemic
stroke
presents
a
critical
window
for
therapeutic
intervention,
where
novel
approaches
such
as
hyper-acute
cerebral
flow
augmentation
offer
promising
avenues
neuroprotection.
In
this
study,
we
investigated
the
effects
two
therapies,
NEH
(a
combination
norepinephrine
and
hydralazine)
Sanguinate
(pegylated
bovine
carboxyhemoglobin),
on
resting-state
functional
connectivity,
global
mean
signal
(GMS),
blood
oxygen
level-dependent
(BOLD)
time
lag
in
pre-clinical
canine
model
via
permanent
occlusion
middle
artery
(total
n
=
40
IACUC-approved
mongrel
canines
randomly
split
into
control/natural
history
treatment
groups).
Utilizing
group
independent
component
analysis
(ICA),
identified
examined
integrity
sensorimotor
visual
networks
both
pre-and
post-occlusion,
across
control
groups.
Our
results
demonstrated
that
while
exhibited
significant
disruptions
these
following
stroke,
groups
showed
remarkable
preservation
network
integrity.
Voxel-wise
connectivity
revealed
less
pronounced
alterations
groups,
suggesting
maintained
neural
connections.
Notably,
treatments
stabilized
GMS,
with
only
minimal
reductions
observed
post-occlusion
compared
to
decreases
group.
Furthermore,
BOLD
time-lag
unity
plots
indicated
consistent
hemodynamic
response
timing,
evidenced
by
tighter
clustering
around
line
unity,
potential
neuroprotective
effect.
These
findings
were
underscored
robust
statistical
analyses,
including
paired
T-tests
Mann-Whitney
U
tests,
which
confirmed
significance
changes
observed.
correlation
variations
outcomes
highlighted
clinical
relevance
neuroimaging
parameters
evaluating
impact
efficacy
interventions.
study
supports
inclusion
protocols
suggests
their
extend
improve
patient
outcomes.
Scientific Reports,
Journal Year:
2024,
Volume and Issue:
14(1)
Published: July 23, 2024
The
acute
phase
of
ischemic
stroke
presents
a
critical
window
for
therapeutic
intervention,
where
novel
approaches
such
as
hyper-acute
cerebral
flow
augmentation
offer
promising
avenues
neuroprotection.
In
this
study,
we
investigated
the
effects
two
therapies,
NEH
(a
combination
norepinephrine
and
hydralazine)
Sanguinate
(pegylated
bovine
carboxyhemoglobin),
on
resting-state
functional
connectivity,
global
mean
signal
(GMS),
blood
oxygen
level-dependent
(BOLD)
time
lag
in
pre-clinical
canine
model
via
permanent
occlusion
middle
artery
(total
n
=
40
IACUC-approved
mongrel
canines
randomly
split
into
control/natural
history
treatment
groups).
Utilizing
group
independent
component
analysis
(ICA),
identified
examined
integrity
sensorimotor
visual
networks
both
pre-
post-occlusion,
across
control
groups.
Our
results
demonstrated
that
while
exhibited
significant
disruptions
these
following
stroke,
groups
showed
remarkable
preservation
network
integrity.
Voxel-wise
connectivity
revealed
less
pronounced
alterations
groups,
suggesting
maintained
neural
connections.
Notably,
treatments
stabilized
GMS,
with
only
minimal
reductions
observed
post-occlusion
compared
to
decreases
group.
Furthermore,
BOLD
time-lag
unity
plots
indicated
consistent
hemodynamic
response
timing,
evidenced
by
tighter
clustering
around
line
unity,
potential
neuroprotective
effect.
These
findings
were
underscored
robust
statistical
analyses,
including
paired
T-tests
Mann–Whitney
U
tests,
which
confirmed
significance
changes
observed.
correlation
variations
neuroimaging
biomarkers
highlighted
impact
efficacy
early
interventions.
study
supports
further
therapies
protocols
suggests
should
be
explored
an
effort
improve
patient
outcomes.
Frontiers in Neuroscience,
Journal Year:
2024,
Volume and Issue:
18
Published: Nov. 13, 2024
The
growing
interest
in
complementary
interventions
for
stroke
recovery
necessitates
the
need
neural
insights
to
aid
making
evidence-based
clinical
decisions.
This
systematic
review
examined
brain
activation
effects
of
therapies,
including
acupuncture
(
Neural Plasticity,
Journal Year:
2024,
Volume and Issue:
2024(1)
Published: Jan. 1, 2024
Objective:
The
investigation
of
brain
functional
network
dynamics
offers
a
promising
approach
to
understanding
reorganization
poststroke.
This
study
aims
explore
the
dynamic
configurations
associated
with
motor
recovery
in
stroke
patients
and
assess
their
predictive
potential
using
multilayer
analysis.
Methods:
Resting‐state
magnetic
resonance
imaging
data
were
collected
from
subacute
within
2
weeks
onset
matched
healthy
controls
(HCs).
Group‐independent
component
analysis
sliding
window
utilized
construct
networks.
A
model
was
applied
quantify
switching
rates
individual
nodes,
subnetworks,
global
across
network.
Correlation
analyses
assessed
relationship
between
function
recovery,
while
linear
regression
models
evaluated
rate
on
outcomes.
Results:
Stroke
exhibited
significant
increase
specific
regions,
including
medial
frontal
gyrus,
precentral
inferior
parietal
lobule,
anterior
cingulate,
superior
postcentral
compared
HCs.
Additionally,
elevated
observed
frontoparietal
network,
default
mode
cerebellar
These
increased
positively
correlated
baseline
Fugl–Meyer
assessment
(FMA)
scores
changes
FMA
at
90
days
Importantly,
network’s
emerged
as
predictor
patients.
Conclusions:
reveals
crucial
insights
into
mechanisms
recovery.
findings
suggest
that
metrics
reorganization,
particularly
rate,
may
offer
robust
Research Square (Research Square),
Journal Year:
2023,
Volume and Issue:
unknown
Published: Nov. 16, 2023
Abstract
Stroke
is
recognized
as
a
network
communication
disorder.
Advances
in
neuroimaging
technologies
have
enhanced
our
comprehension
of
dynamic
cerebral
alterations.
However,
abnormal
and
adaptive
brain
activity
patterns
after
stroke
are
still
underexplored.
We
aim
to
identify
remodeling
patients
with
hemiplegia.
fMRI
data
were
obtained
from
50
35
healthy
controls
establish
spatiotemporal
multilayer
modularity
model.
Then,
graph-theoretic
measures,
including
modularity,
flexibility,
cohesion
disjointedness
calculated
quantify
reconfiguration.
Our
findings
reveal
that
the
post-stroke
exhibited
higher
modular
organization,
well
heightened
flexibility
compared
HCs;
specifically,
increased
disjointedness,
observed
Sensorimotor
network,
Default
mode
Attentional
indicating
nodes
tend
switch
more
frequently
independently
between
communities,
changes
mainly
driven
by
motor
control
cognition-related
networks.
Notably,
modified
functional
dynamics
positively
correlated
better
performance
mild
impairment.
Collectively,
research
uncovered
high
global
hyper-flexibility,
independent
reorganization
following
stroke.
may
offer
new
insights
into
complex
neural
function
brain.
Trials,
Journal Year:
2023,
Volume and Issue:
24(1)
Published: Dec. 4, 2023
Abstract
Background
Focal
brain
lesions
following
a
stroke
of
the
middle
cerebral
artery
induce
large-scale
network
disarray
with
potential
to
impact
multiple
cognitive
and
behavioral
domains.
Over
last
20
years,
non-invasive
neuromodulation
via
electrical
(tCS)
stimulation
has
shown
promise
modulate
motor
deficits
contribute
recovery.
However,
weak,
inconsistent,
or
at
times
heterogeneous
outcomes
using
these
techniques
have
also
highlighted
need
for
novel
strategies
assessment
their
efficacy
in
ad
hoc
controlled
clinical
trials.
Methods
We
here
present
double-blind,
sham-controlled,
single-center,
randomized
pilot
trial
involving
participants
having
suffered
unilateral
(MCA)
resulting
paralysis
contralateral
upper
limb.
Patients
will
undergo
10-day
regime
(5
days
week
2
consecutive
weeks)
newly
designed
high-definition
transcranial
direct
current
(HD-tDCS)
protocol.
Clinical
evaluations
(e.g.,
Fugl
Meyer,
NIHSS),
computer-based
assessments
(visuo-motor
adaptation
AX-CPT
attention
tasks),
electroencephalography
(resting-state
task-evoked
EEG)
be
carried
out
3
time
points:
(I)
Baseline,
(II)
Post-tDCS,
(III)
Follow-up.
The
study
consists
four-arm
comparing
on
recovery
three
active
anodal
tDCS
conditions:
ipsilesional
DLPFC
tDCS,
contralesional
cerebellar
combined
+
sham
intervention.
Fugl-Meyer
Assessment
extremity
(FMA-UE)
is
selected
as
primary
outcome
measure
quantify
In
every
session,
receive
min
high-density
(up
0.63
mA/
$${\mathrm{cm}}^{2}$$
cm2
)
$${\mathrm{\pi
cm}}^{2}$$
π
electrodes.
Electrode
scalp
positioning
relative
cortical
surface
(anodes
cathodes)
intensities
are
based
biophysical
optimization
model
distribution
ensuring
0.25
V/m
each
chosen
targets.
Discussion
Our
gauge
therapeutic
accumulative
sessions
HD-tDCS
improve
limb
dysfunctions
presented
by
patients.
parallel,
we
aim
characterizing
changes
electroencephalographic
(EEG)
activity
biomarkers
effects
identifying
interactions
between
performance
outcomes.
work
enrich
our
mechanistic
understanding
prefrontal
contributions
function
its
rehabilitation
damage.
Trial
registration
ClinicalTrials.gov
NCT05329818.
April
15,
2022.
