Neurophysiologie Clinique/Clinical Neurophysiology最新文献

{"title":"Neuromuscular fatigue in autoimmune myasthenia gravis: A cross-sectional study","authors":"Simone Birnbaum ,&nbsp;Tarek Sharshar ,&nbsp;Jacques Ropers ,&nbsp;Pierre Portero ,&nbsp;Jean-Yves Hogrel","doi":"10.1016/j.neucli.2023.102844","DOIUrl":"10.1016/j.neucli.2023.102844","url":null,"abstract":"<div><h3>Objectives</h3><p>To investigate the presence of increased neuromuscular fatigue (NMF) in individuals with myasthenia gravis (IwMG), compared to healthy controls. A secondary aim was to assess associations between NMF, strength and perceived health-related quality of life (HRQoL) and symptom severity in IwMG.</p></div><div><h3>Methods</h3><p>In this cross-sectional study, we assessed NMF using classical myoelectrical indicators (root mean square: RMS, mean power frequency: MPF) obtained from surface electromyography (sEMG) during a sustained submaximal isometric contraction of the right Biceps Brachii and the right Vastus Lateralis and by evaluating the post-effort decline in peak torque following a fatiguing task consisting of a 40-second sustained isometric contraction. Relationships with MG-specific clinical scores (Myasthenia Muscle Score for symptom severity, MGQOL-15-F for HRQoL) were investigated.</p></div><div><h3>Results</h3><p>Forty-one females with MG were compared to 18 control females of similar age. IwMG demonstrated reduced strength in both muscle groups, compared to control subjects. In both populations and both limbs, NMF was demonstrated by an increase in RMS and a decrease in MPF. However, IwMG did not demonstrate greater NMF based on these myoelectrical indicators nor based on post-effort peak torque decline.</p></div><div><h3>Discussion</h3><p>Despite a decrease in baseline strength, IwMG did not display greater NMF in this specific experimental paradigm. This cohort consisted of individuals with mild-to-moderately severe MG which was well-controlled and stable. Further studies are warranted to identify simple and reliable methods to measure NMF in MG and to understand the relationship between NMF and perceived fatigue in activities of daily living for IwMG.</p></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"53 4","pages":"Article 102844"},"PeriodicalIF":3.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10777349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients with neuropathic pain from lumbosacral radiculopathy demonstrate similar pressure pain thresholds and conditioned pain modulation to those with fibromyalgia","authors":"Aleksandar Knezevic ,&nbsp;Milena Kovacevic ,&nbsp;Milica Jeremic-Knezevic ,&nbsp;Zeljka Nikolasevic ,&nbsp;Snezana Tomasevic-Todorovic ,&nbsp;Zeljko Zivanovic ,&nbsp;Tijana Spasojevic ,&nbsp;Enis Garipi ,&nbsp;Larisa Vojnovic ,&nbsp;Dunja Popovic ,&nbsp;Randy Neblett","doi":"10.1016/j.neucli.2022.102841","DOIUrl":"10.1016/j.neucli.2022.102841","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of the study was to evaluate pain thresholds, impairment of the endogenous pain modulatory system, and self-reported cognitive-emotional and central sensitization-related symptoms among three subject groups: a rarely studied patient cohort with neuropathic pain from lumbosacral radiculopathy (NPLSR), patients with fibromyalgia (FM) and healthy controls (HC).</p></div><div><h3>Methods</h3><p>Patient-reported pain-related symptomology was evaluated with psychometricallyvalidated questionnaires. Pressure pain threshold (PPT), heat pain threshold (HPT), and cold pain threshold (CPT) were assessed in the low back and contralateral forearm. Conditioned pain modulation (CPM) was evaluated with a recently introduced methodology that accounts for a standard error of measurement.</p></div><div><h3>Results</h3><p>Compared to the HC subjects, the FM and NPLSR subjects had significantly lower pain thresholds and more CPM impairment. No significant differences in PPT and CPM were observed between the FM and NPLSR groups. Significant group differences were found in self-reported symptoms of depression, anxiety, stress, and central sensitization. Self-reported symptom severity increased in a stair-step fashion, with the HC group scoring lowest and FM group scoring highest.</p></div><div><h3>Conclusion</h3><p>The NPLSR group manifested CPM dysfunction and pressure hyperalgesia at similar levels to the FM group, indicating that these two chronic pain syndromes, likely based on different pathophysiological mechanisms, in fact share some common pain processing features. However, though both patient groups demonstrated similarities in pain processing, self-reported cognitive-emotional and central sensitization-related symptom severity was significantly higher in the FM cohort, which distinguished them from the chronic NPLSR cohort.</p></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"53 4","pages":"Article 102841"},"PeriodicalIF":3.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10591493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the split hand phenomenon with the neurophysiological index","authors":"Cláudia Santos Silva ,&nbsp;Michael Swash ,&nbsp;Mamede de Carvalho","doi":"10.1016/j.neucli.2023.102864","DOIUrl":"10.1016/j.neucli.2023.102864","url":null,"abstract":"<div><p>In 164 subjects of different age groups, we studied the neurophysiological index (NI) ([CMAP amplitude/Distal motor latency] *[F-wave frequency]; CMAP=compound muscle action potential) for three hand muscles (APB= abductor pollicis brevis; FDI= first dorsal interosseous; ADM= abductor digiti minimi). A split hand index based on CMAP amplitude (SHI_CMAP) and NI (SHI_NI) were calculated ([APB CMAP amplitude or NI * FDI CMAP amplitude or NI]/[ADM CMAP amplitude or NI]). All these neurophysiological measurements differed between age groups (p&lt;0.001). Hand muscle NIs, as well as SHI_NI and SHI_CMAP were age dependent. This may be relevant for diagnostic purposes in motor neuron diseases.</p></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"53 4","pages":"Article 102864"},"PeriodicalIF":3.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9519023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged continuous theta burst stimulation increases motor corticospinal excitability and intracortical inhibition in patients with neuropathic pain: An exploratory, single-blinded, randomized controlled trial","authors":"Bhushan Thakkar ,&nbsp;Carrie L. Peterson ,&nbsp;Edmund O. Acevedo","doi":"10.1016/j.neucli.2023.102894","DOIUrl":"10.1016/j.neucli.2023.102894","url":null,"abstract":"<div><h3>Objectives</h3><p>A new paradigm for Transcranial Magnetic Stimulation (TMS), referred to as prolonged continuous theta burst stimulation (pcTBS), has recently received attention in the literature because of its advantages over high frequency repetitive TMS (HF-rTMS). Clinical advantages include less time per intervention session and the effects appear to be more robust and reproducible than HF-rTMS to modulate cortical excitability. HF-rTMS targeted at the primary motor cortex (M1) has demonstrated analgesic effects in patients with neuropathic pain but their mechanisms of action are unclear and pcTBS has been studied in healthy subjects only. This study examined the neural mechanisms that have been proposed to play a role in explaining the effects of pcTBS targeted at the M1 and DLPFC brain regions in neuropathic pain (NP) patients with Type 2 diabetes.</p></div><div><h3>Methods</h3><p>Forty-two patients with painful diabetic neuropathy were randomized to receive a single session of pcTBS targeted at the left M1 or left DLPFC. pcTBS stimulation consisted of 1,200 pulses delivered in 1 min and 44 s with a 35–45 min gap between sham and active pcTBS stimulation. Both the activity of the descending pain system which was examined using conditioned pain modulation and the activity of the ascending pain system which was assessed using temporal summation of pain were recorded using a handheld pressure algometer by measuring pressure pain thresholds. The amplitude of the motor evoked potential (MEP) was used to measure motor corticospinal excitability and GABA activity was assessed using short (SICI) and long intracortical inhibition (LICI). All these measurements were performed at baseline and post-pcTBS stimulation.</p></div><div><h3>Results</h3><p>Following a single session of pcTBS targeted at M1 and DLPFC, there was no change in BPI-DN scores and on the activity of the descending (measured using conditioned pain modulation) and ascending pain systems (measured using temporal summation of pain) compared to baseline but there was a significant improvement of &gt;13% in perception of acute pain intensity, increased motor corticospinal excitability (measured using MEP amplitude) and intracortical inhibition (measured using SICI and LICI).</p></div><div><h3>Conclusion</h3><p>In patients with NP, a single session of pcTBS targeted at the M1 and DLPFC modulated the neurophysiological mechanisms related to motor corticospinal excitability and neurochemical mechanisms linked to GABA activity, but it did not modulate the activity of the ascending and descending endogenous modulatory systems. In addition, although BPI-DN scores did not change, there was a 13% improvement in self-reported perception of acute pain intensity.</p></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"53 4","pages":"Article 102894"},"PeriodicalIF":3.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10592401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10141335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of the TENS device, Exopulse Mollii Suit, on pain related to fibromyalgia: An open-label study","authors":"Naji Riachi ,&nbsp;Moussa A. Chalah ,&nbsp;Rechdi Ahdab ,&nbsp;Feroza Arshad ,&nbsp;Samar S. Ayache","doi":"10.1016/j.neucli.2023.102863","DOIUrl":"10.1016/j.neucli.2023.102863","url":null,"abstract":"<div><p>Fibromyalgia is characterized by diffuse and chronic pain, that is often only partially alleviated by the available pharmacological treatments. Therefore, nonpharmacological interventions such as transcutaneous electrical stimulation (TENS) are highly needed to improve the quality of life of this population. However, the classical TENS devices offer a limited number of electrodes and are not adapted to this diffuse painful condition. For these reasons, we aimed to assess the effects of a new TENS device, the Exopulse Mollii Suit, that can stimulate up to 40 muscle groups integrated into pants and jackets and connected to a control unit. We report the data of 50 patients who received one session of active stimulation (pulse intensity 2 mA, and pulse frequency 20 Hz). Pain intensity was evaluated by means of the visual analogue scale (VAS), before (T0) and after the session (T1), and 24 h later (T24). Compared to baseline scores, a significant decrease in VAS was observed after the session (<em>p</em>&lt;0.001), and 24 h later (<em>p</em>&lt;0.001). T1 scores were significantly lower than T24 scores (<em>p</em>&lt;0.001). Therefore, this new system seems to exert analgesic effects whose mechanisms primarily evoke the theory of \"gate control\". The effects were transient and started to decrease the following day, highlighting the need for additional studies to better evaluate the long-term effects of this intervention on pain, mood, and quality of life.</p></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"53 4","pages":"Article 102863"},"PeriodicalIF":3.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9514625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motor corticospinal excitability abnormalities differ between distinct chronic low back pain syndromes","authors":"Marcelo Luiz da Silva ,&nbsp;Ana Mércia Fernandes ,&nbsp;Valquíria A. Silva ,&nbsp;Ricardo Galhardoni ,&nbsp;Valter Felau ,&nbsp;Joaci O. de Araujo ,&nbsp;Jefferson Rosi Jr ,&nbsp;Roger S. Brock ,&nbsp;Gabriel T. Kubota ,&nbsp;Manoel J. Teixeira ,&nbsp;Lin T Yeng ,&nbsp;Daniel Ciampi de Andrade","doi":"10.1016/j.neucli.2023.102853","DOIUrl":"10.1016/j.neucli.2023.102853","url":null,"abstract":"<div><h3>Objectives</h3><p>It is not known whether cortical plastic changes reported in low-back pain (LBP) are present in all etiologies of LBP. Here we report on the assessment of patients with three LBP conditions: non-specific-LBP (ns-LBP), failed back surgery syndrome (FBSS), and sciatica (Sc).</p></div><div><h3>Methods</h3><p>Patients underwent a standardized assessment of clinical pain, conditioned pain modulation (CPM), and measures of motor evoked potential (MEPs)-based motor corticospinal excitability (CE) by transcranial magnetic stimulation, including short interval intracortical inhibition (SICI), and intracortical facilitation (ICF). Comparisons were also made with normative data from sex- and age-matched healthy volunteers.</p></div><div><h3>Results</h3><p>60 patients (42 women, 55.1±9.1 years old) with LBP were included (20 in each group). Pain intensity was higher in patients with neuropathic pain [FBSS (6.8±1.3), and Sc (6.4±1.4)] than in those with ns-LBP (4.7±1.0, P&lt;0.001). The same was shown for pain interference (5.9±2.0, 5.9±1.8, 3.2±1.9, P&lt;0.001), disability (16.4±3.3, 16.3±4.3, 10.4±4.3, P&lt;0.001), and catastrophism (31.1±12.3, 33.0±10.4, 17.4±10.7, P&lt;0.001) scores for FBSS, Sc, and ns-LBP groups, respectively. Patients with neuropathic pain (FBSS, Sc) had lower CPM (-14.8±1.9, -14.1±16.7, respectively) compared to ns-LBP (-25.4±16.6; P&lt;0.02). 80.0% of the FBSS group had defective ICF compared to the other two groups (52.5% for ns-LBP, P=0.025 and 52.5% for Sc, P=0.046). MEPs (140%-rest motor threshold) were low in 50.0% of patients in the FBSS group compared to 20.0% of ns-LBP (P=0.018) and 15.0% of Sc (P=0.001) groups. Higher MEPs were correlated with mood scores (r=0.489), and with lower neuropathic pain symptom scores(r=-0.415) in FBSS.</p></div><div><h3>Conclusions</h3><p>Different types of LBP were associated with different clinical, CPM and CE profiles, which were not uniquely related to the presence of neuropathic pain. These results highlight the need to further characterize patients with LBP in psychophysics and cortical neurophysiology studies.</p></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"53 3","pages":"Article 102853"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10183752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous theta-burst stimulation in patients with drug-resistant epilepsy: A single-blind placebo-controlled cross-over pilot study","authors":"Lale Gundogdu Celebi,&nbsp;Nermin Gorkem Sirin,&nbsp;Ayse Deniz Elmali,&nbsp;Betul Baykan,&nbsp;Ali Emre Oge,&nbsp;Nerses Bebek","doi":"10.1016/j.neucli.2023.102896","DOIUrl":"10.1016/j.neucli.2023.102896","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate the effect of continuous theta-burst stimulation (cTBS) in patients with drug-resistant epilepsy (DRE).</p></div><div><h3>Methods</h3><p>Twelve patients with DRE (five with idiopathic generalized and seven with focal epilepsy) were included in this cross-over design study and randomized to either first sham or first active stimulation, each applied for 5 consecutive days. A round coil over the vertex was used in generalized epilepsy or a figure-of-8 coil over the “epileptogenic area” in focal epilepsy. Sham stimulation was given by placing the coil 90° perpendicular to the head. The number of seizures, electroencephalography findings, Quality of Life in Epilepsy Inventory (QOLIE-84), and Symptom Check List (SCL-90) scores evaluated during the 8–12 weeks before and after active and sham stimulations were compared statistically.</p></div><div><h3>Results</h3><p>Eight patients could complete both active and sham stimulation periods of 5 days and two patients completed active stimulation sessions, without any significant adverse effects. The number of seizures significantly reduced after active cTBS, but not after sham stimulation, when compared with those recorded before the stimulation period. QOLIE scores were increased, but interictal epileptiform discharges and SCL-90 scores showed no difference after cTBS. Active stimulation was stopped in one patient after he experienced an aggravation of myoclonic seizures.</p></div><div><h3>Conclusions</h3><p>cTBS seemed to be relatively safe and gave promising results in reducing the frequency of seizures in patients with both generalized and focal DRE. This time-saving technique may ease the introduction of repetitive transcranial magnetic stimulation into the routine practice of busy epilepsy clinics.</p></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"53 3","pages":"Article 102896"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10188119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcranial direct current stimulation alters the process of reward processing in children with ADHD: Evidence from cognitive modeling","authors":"Vahid Nejati ,&nbsp;Fateme Mirikaram ,&nbsp;Jamal Amani Rad","doi":"10.1016/j.neucli.2023.102884","DOIUrl":"10.1016/j.neucli.2023.102884","url":null,"abstract":"<div><h3>Background</h3><p>The ventromedial prefrontal cortex (vmPFC) and dorsolateral prefrontal cortex (dlPFC) are the neural underpinnings of reward processing, which is impaired in individuals with attention deficit hyperactivity disorder (ADHD). In the present study, we aimed to explore the impact of the vmPFC and the dlPFC regulation on reward processing.</p></div><div><h3>Methods</h3><p>Twenty-six children with ADHD performed the balloon analogue risk-taking task (BART) and chocolate delay discounting task (CDDT) during five different sessions of transcranial direct current stimulation (tDCS), separated by a one-week interval: anodal left dlPFC/cathodal right vmPFC, the reversed electrode positioning, anodal left dlPFC stimulation with extracranial return electrode, anodal right vmPFC stimulation with extracranial return electrodes, and sham stimulation. Four-parameter and constant-sensitivity models were used to model the data.</p></div><div><h3>Results</h3><p>In the BART, anodal dlPFC/cathodal vmPFC stimulation facilitated conservative decision making, anodal tDCS over dlPFC with extracranial return electrode increased positive beliefs about the explosion of a balloon, and anodal vmPFC/cathodal dlPFC stimulation reduced ongoing learning in the process of decision making. In the CDDT, anodal vmPFC stimulation with extracranial return electrode decreased impatience in the process of the task.</p></div><div><h3>Conclusion</h3><p>These results suggest a role of the left dlPFC and right vmPFC in the outcome of decision making and the process of risky decision making and delay discounting.</p></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"53 3","pages":"Article 102884"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10192814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of prefrontal transcranial direct current stimulation on sexual arousal: A proof of concept study","authors":"Katrin Sakreida ,&nbsp;Marissa E. Köhler ,&nbsp;Berthold Langguth ,&nbsp;Martin Schecklmann ,&nbsp;Timm B. Poeppl","doi":"10.1016/j.neucli.2023.102847","DOIUrl":"10.1016/j.neucli.2023.102847","url":null,"abstract":"<div><p>There is preliminary evidence that high-frequency repetitive transcranial magnetic stimulation targeting the right dorsolateral prefrontal cortex (DLPFC) could reduce cue-induced sexual arousal. Here, we aimed to replicate this finding by using transcranial direct current stimulation (tDCS). In a randomized, double-blind, sham-controlled crossover study design, 24 healthy male participants received anodal tDCS over right DLPFC, anodal tDCS over left DLPFC, and sham tDCS with exposure to neutral and sexual video cues before and after each intervention. None of the interventions significantly reduced subjective sexual arousal. Stimulation parameters should be varied in further studies to identify factors relevant to the intended effect.</p></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"53 3","pages":"Article 102847"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10563135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of bihemispheric and unihemispheric M1 transcranial direct current stimulations during physical therapy in subacute stroke patients: A randomized controlled trial","authors":"Hussein Youssef ,&nbsp;Nema Abd El-Hameed Mohamed ,&nbsp;Mohamed Hamdy","doi":"10.1016/j.neucli.2023.102895","DOIUrl":"10.1016/j.neucli.2023.102895","url":null,"abstract":"<div><h3>Background</h3><p>Despite the central origin of stroke affecting the primary motor cortex M1, most physical and occupational rehabilitation programs focus on peripheral treatments rather than addressing the central origin of the problem. This highlights the urgent need for effective protocols to improve neurological rehabilitation and achieve better long-term functional outcomes.</p></div><div><h3>Objectives</h3><p>Our hypothesis was that the bihemispheric delivery of transcranial direct current stimulation (tDCS) is superior to unihemispheric in enhancing motor function after stroke, in both the upper and lower extremities.</p></div><div><h3>Methods</h3><p>35 sub-acute ischemic stroke survivors were randomly divided into three groups: bihemispheric and unihemispheric treatment groups, or sham groups. Each participant received a 20-minute session of tDCS with an intensity of 2 mA during physical therapy sessions, three days a week, for four weeks. The outcomes were measured using Fugl-Meyer assessment scale, modified Ashworth scale, Berg balance scale, and serum brain-derived neurotrophic factor (BDNF) levels.</p></div><div><h3>Results</h3><p>One-way ANOVA test indicated a significant effect of both treatment protocols on the upper extremity (<em>p</em> = &lt; 0.001) and lower extremity (<em>p</em> = .034) for motor measures, but there was no difference between the two (<em>p</em> = .939). Kruskal Wallis test for spasticity showed a significant improvement in both treatment groups for elbow (<em>p</em> = .036) and wrist flexors (<em>p</em> = .025), compared to the sham group. However, there was no statistically significant difference in spasticity between uni- and bihemispheric stimulation for elbow (<em>p</em> = .731) or wrist flexors (<em>p</em> = .910).</p></div><div><h3>Conclusion</h3><p>There is no statistically significant difference in efficacy between bihemispheric and unihemispheric tDCS in patients presenting with acute ischemic stroke. .</p></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"53 3","pages":"Article 102895"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10186061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}