Authors:
Kirton A; Andersen J; Herrero M; Nettel-Aguirre A; Carsolio L; Damji O; Keess J; Mineyko A; Hodge J; Hill MD. Institution Kirton, Adam. From the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children’s Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children’s Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children’s Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada. adam.kirton@ahs.ca. Andersen, John. From the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children’s Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children’s Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children’s Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada. Herrero, Mia. From the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children’s Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children’s Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children’s Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada. Nettel-Aguirre, Alberto. From the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children’s Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children’s Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children’s Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada. Carsolio, Lisa. From the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children’s Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children’s Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children’s Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada. Damji, Omar. From the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children’s Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children’s Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children’s Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada. Keess, Jamie. From the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children’s Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children’s Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children’s Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada. Mineyko, Aleksandra. From the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children’s Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children’s Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children’s Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada. Hodge, Jacquie. From the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children’s Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children’s Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children’s Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada. Hill, Michael D. From the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children’s Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children’s Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children’s Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada. Title Brain stimulation and constraint for perinatal stroke hemiparesis: The PLASTIC CHAMPS Trial. Source Neurology. 86(18):1659-67, 2016 May 03.
Abstract OBJECTIVE:
To determine whether the addition of repetitive transcranial magnetic stimulation (rTMS) and/or constraint-induced movement therapy (CIMT) to intensive therapy increases motor function in children with perinatal stroke and hemiparesis.
METHODS:
A factorial-design, blinded, randomized controlled trial (clinicaltrials.gov/NCT01189058) assessed rTMS and CIMT effects in hemiparetic children (aged 6-19 years) with MRI-confirmed perinatal stroke. All completed a 2-week, goal-directed, peer-supported motor learning camp randomized to daily rTMS, CIMT, both, or neither. Primary outcomes were the Assisting Hand Assessment and the Canadian OccupationalPerformance Measure at baseline, and 1 week, 2 and 6 months postintervention. Outcome assessors were blinded to treatment. Interim safety analyses occurred after 12 and 24 participants. Intention-to-treat analysis examined treatment effects over time (linear mixed effects model). RESULTS: All 45 participants completed the trial. Addition of rTMS, CIMT, or both doubled the chances of clinically significant improvement. Assisting Hand Assessment gains at 6 months were additive and largest with rTMS + CIMT (beta coefficient = 5.54 [2.57-8.51], p = 0.0004). The camp alone produced large improvements in Canadian Occupational Performance Measure scores, maximal at 6 months (Cohen d = 1.6, p = 0.002). Quality-of-life scores improved. Interventions were well tolerated and safe with no decrease in function of either hand. CONCLUSIONS: Hemiparetic children participating in intensive, psychosocial rehabilitation programs can achieve sustained functional gains. Addition of CIMT and rTMS increases the chances of improvement.
CLASSIFICATION OF EVIDENCE:
This study provides Class II evidence that combined rTMS and CIMT enhance therapy-induced functional motor gains in children with stroke-induced hemiparetic cerebral palsy. Authors Clayton E; Kinley-Cooper SK; Weber RA; Adkins DL. Institution Clayton, E. Department of Neurosciences, Medical University of South Carolina, Charleston, SC 29425, United States. Kinley-Cooper, S K. Department of Neurosciences, Medical University ofSouth Carolina, Charleston, SC 29425, United States. Weber, R A. Department of Neurosciences, Medical University of South Carolina, Charleston, SC 29425, United States. Adkins, D L. Department of Neurosciences, Medical University of South Carolina, Charleston, SC 29425, United States; Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC 29425, United States; Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC 29425, United States. Electronic address: adkinsdl@musc.edu.
Title:
Brain stimulation: Neuromodulation as a potential treatment for motor recovery following traumatic brain injury. [Review] Source Brain Research. 1640(Pt A):130-8, 2016 Jun 01.
Abstract:
There is growing evidence that electrical and magnetic brain stimulation can improve motor function and motor learning following brain damage. Rodent and primate studies have strongly demonstrated that combining cortical stimulation (CS) with skilled motor rehabilitative training enhances functional motor recovery following stroke. Brain stimulation following traumatic brain injury (TBI) is less well studied, but early pre-clinical and human pilot studies suggest that it is a promisingtreatment for TBI-induced motor impairments as well. This review will first discuss the evidence supporting brain stimulation efficacy derived from the stroke research field as proof of principle and then will review the few studies exploring neuromodulation in experimental TBI studies.
This article is part of a Special Issue entitled SI:Brain injury and recovery.
Authors:
Lanza G; Bramanti P; Cantone M; Pennisi M; Pennisi G; Bella R. Institution Lanza, Giuseppe. Department of Neurology IC, I.R.C.C.S. “Oasi” Institutefor Research on Mental Retardation and Brain Aging, 73 Via Conte Ruggero, 94018 Troina, Italy. Bramanti, Placido. I.R.C.C.S. Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy. Cantone, Mariagiovanna. Department of Neurology IC, I.R.C.C.S. “Oasi” Institute for Research on Mental Retardation and Brain Aging, 73 Via ConteRuggero, 94018 Troina, Italy. Pennisi, Manuela. Spinal Unit, Emergency Hospital “Cannizzaro”, 829 Via Messina, 95126 Catania, Italy. Pennisi, Giovanni. Department of Surgery and Medical-Surgical Specialties, University of Catania, 78 Via S. Sofia, 95123 Catania, Italy. Bella, Rita. Department of Medical and Surgical Sciences and Advanced Technology, Section of Neurosciences, University of Catania, 78 Via S.Sofia, 95123 Catania, Italy. Title Vascular Cognitive Impairment through the Looking Glass of Transcranial Magnetic Stimulation. [Review] Source Behavioural Neurology. 2017:1421326, 2017.
Abstract:
In the last years, there has been a significant growth in the literature exploiting transcranial magnetic stimulation (TMS) with the aim at gaining further insights into the electrophysiological and neurochemical basis underlying vascular cognitive impairment (VCI). Overall, TMS points at enhanced brain cortical excitability and synaptic plasticity in VCI,especially in patients with overt dementia, and neurophysiological changes seem to correlate with disease process and progress. These findings have been interpreted as part of a glutamate-mediated compensatory effect in response to vascular lesions. Although a single TMS parameter owns low specificity, a panel of measures can support the VCI diagnosis, predict progression, and possibly identify early markers of “brain at risk” for future dementia, thus making VCI a potentially preventable cause of both vascular and degenerative dementia in late life. Moreover, TMS can be also exploited to select and evaluate the responders to specific drugs, as well as to become an innovative rehabilitative tool in the attempt to restore impaired neural plasticity. The present review provides a perspective of the different TMS techniques by further understanding the cortical electrophysiology and the role of distinctive neurotransmission pathwaysand networks involved in the pathogenesis and pathophysiology of VCI andits subtypes. **(depression) Authors Reti IM; Schwarz N; Bower A; Tibbs M; Rao V. Institution
