Restorative neurology and neuroscience最新文献

{"title":"Home-based Functional Electrical Stimulation for Treatment of Patients with Facial Nerve Paralysis.","authors":"Maren Geitner, Jonas Ballmaier, Johannes Krauß, Gabriel Meincke, Anna-Maria Kuttenreich, Dirk Arnold, Winfried Mayr, Carsten Klingner, Valeria Mastryukova, Orlando Guntinas-Lichius, Gerd Fabian Volk","doi":"10.1177/09226028251395721","DOIUrl":"10.1177/09226028251395721","url":null,"abstract":"<p><p>Peripheral facial paralysis results in complete loss of contractibility in facial muscles, atrophy and asymmetry. Patients performed functional electrical stimulation (FES) home training twice daily over 1 year to show its effect and define stimulation parameters. A specific response was obtained in all 10 patients. Since the mean phase duration (PD) could be reduced (155.0 ± 55.0 to 51.0 ± 12.4 msec), this allowed the mean stimulation frequency to be increased (1.3 ± 0.5 to 5.0 Hz ± 1.5 Hz). The PD reduction to generate the same charge increased the voltage (16.2 ± 2.5 to 27.2 V ± 5.9). A suitable combination of PD and amplitude elicited a selective response without activation of other facial muscles using a PD of ≥ 25 ms (> 25 000 µs). FES changes the stimulation parameters for improving the training effect on denervated facial muscles. It prevents denervation atrophy and stops facial asymmetry.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"3-14"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12881159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596821","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":"A Picture is Worth a Thousand Clinical Assessments: Use of Video-Based Pose Estimation to Augment Post-Stroke Upper Limb Assessment of Bilateral Tasks.","authors":"Rachel L Hawe, Shelby Ziccardi, Desmond Asante, Stephen J Guy","doi":"10.1177/09226028251408783","DOIUrl":"10.1177/09226028251408783","url":null,"abstract":"<p><p>Clinical assessments of the post-stroke upper limbs have several limitations in that they focus primarily on unilateral movements, rely on observer-based ordinal scales, and give limited insight into movement quality. Human pose estimation uses computer vision to extract motion data from videos, making it a clinically feasible tool to assess movement and overcome many challenges of traditional clinical assessments. Our objective of this work was to demonstrate the use of video-based pose estimation to enhance the assessment of bilateral tasks in individuals post-stroke through visualizations and quantitative metrics. Using single camera video recordings of the Chedoke Hand and Arm Activity Inventory in two individuals with chronic stroke and one neurologically intact individual, we demonstrate differences in movement patterns including increased compensatory movements of proximal joints and asymmetries. We were able to detect differences that the traditional assessment scoring could not, demonstrating the potential of computer vision to enhance clinical assessment.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"37-48"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13044263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811153","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":"Neuraltherapeutic Medicine in Post-Acute COVID-19 Vaccination Syndrome (PACVS): A Critical Review with a Case Report.","authors":"Carlos Bustamante, Laura Bibiana Pinilla-Bonilla, Mauricio Patiño Soler, Mauro Estravis","doi":"10.1177/09226028251412573","DOIUrl":"https://doi.org/10.1177/09226028251412573","url":null,"abstract":"<p><p>IntroductionPost-acute COVID-19 vaccination syndrome (PACVS) emerges as a syndrome of persistent symptoms of a multisystemic nature, even in previously healthy people. Its pathophysiology involves a neural phase characterized by the neuroimmune reflex and persistent secondary neurogenic inflammation. Frequent manifestations such as dysautonomia, neurological alterations, and musculoskeletal symptoms have been described.ObjectiveTo review the current evidence on PACVS and explore the therapeutic potential of Neuraltherapeutic Medicine (NTM), illustrated with a clinical case.Material and methodsA targeted literature review search was conducted in MEDLINE (up to June 2024) using the terms \"post-COVID-19 vaccination syndrome\", \"covid vaccine adverse effects\", \"inflammatory reflex\" and \"neural therapy\". In addition, a clinical case of a 75-year-old patient with persistent musculoskeletal pain post-vaccination, treated with NTM, was documented.ResultsThe pathophysiology of PACVS includes neuroimmune mechanisms such as response, neurogenic inflammation, and autonomic dysfunction. NTM has shown the ability to modulate the nervous system by desensitizing sources of irritation. In the case presented, the application of 0.5% procaine to the vaccination site and contralateral reflex zone resulted in complete resolution of pain within 48 h and sustained functional improvement during the three months of follow-up.ConclusionsNTM could represent a therapeutic option in the management of PACVS and other syndromes involving neurogenic inflammation. Controlled studies are required to validate its efficacy and establish standardized protocols.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"9226028251412573"},"PeriodicalIF":1.6,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019505","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":"Homosynaptic Depression of the Soleus Predicts Post-Stroke Gait Speed.","authors":"J Sebastián Correa, Ricardo Siu, Dana Lorenz, Kristine Hansen, David A Cunningham, James S Sulzer","doi":"10.1177/09226028251413958","DOIUrl":"https://doi.org/10.1177/09226028251413958","url":null,"abstract":"<p><p>Homosynaptic depression (HD) refers to the reduction in the magnitude of the monosynaptic spinal reflex resulting from prior activation of the circuit, often evoked with the H-reflex. Previous literature has reported HD of the soleus H-reflex is reduced post-stroke. However, it remains unclear if HD plays a role in functional impairments. The goal of this study was to characterize HD of the soleus H-reflex in individuals with post-stroke gait impairments and examine the relationship with functional measures of gait. Our results revealed that individuals after stroke experienced reduced depression at longer (8s) interstimulus intervals compared to age-matched neurologically intact individuals. However, we did not observe a difference in the change in HD across interstimulus intervals between groups, contrary to previous reports. This finding could not be explained by age of participants. In addition, we found a strong correlation between faster gait speed and reduced change in depression in individuals after stroke. While the underlying mechanisms linking HD with gait are unclear, this finding represents the first piece of evidence of the potential role of HD in function. Further research is needed to understand the parameters that guide HD and clarify how useful the mechanism is for improving the assessment and treatment of post-stroke impairments.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"9226028251413958"},"PeriodicalIF":1.6,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012145","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":"Pyroptosis in Ischemic Stroke: Roles, Mechanisms, and Therapeutic Strategies.","authors":"Tingting Qi, Zhen Xiao, Yufeng Peng, Yinjuan Zhou, Wen Wang, Changxi Li, Jinhao Kang, Tingting Zhao, Guoming Mao, Yujie Weng, Haiping Wei","doi":"10.1177/09226028251410011","DOIUrl":"https://doi.org/10.1177/09226028251410011","url":null,"abstract":"<p><p>Ischemic stroke, a leading cause of neurological disability and mortality, involves a multifactorial cascade of oxidative stress, mitochondrial dysfunction, and inflammation. Yet, conventional paradigms centered on apoptosis and necrosis fail to fully explain the inflammatory amplification that drives secondary brain injury-underscoring the emerging significance of pyroptosis as a distinct and targetable death program. This review delineates the mechanistic architecture of pyroptosis in ischemic stroke, integrating canonical (NLRP3-caspase-1-GSDMD) and noncanonical (caspase-4/5/11-GSDMD) inflammasome cascades with apoptosis-, necroptosis-, and ferroptosis-linked pathways within a unified PANoptotic continuum. Upstream regulators-such as mitochondrial ROS-TXNIP coupling, STING-mediated innate immune signaling, and astrocytic LCN2/24p3R activation-coordinate oxidative stress with neuroinflammatory propagation and blood-brain barrier disruption. Pharmacological inhibition of inflammasomes (MCC950, CY-09, OLT1177), caspases (VX-765, Ac-YVAD-CMK), or gasdermins (disulfiram, necrosulfonamide) markedly reduces IL-1β/IL-18 release and preserves neurovascular integrity in preclinical models, highlighting pyroptosis as a therapeutically tractable axis in ischemic stroke. Despite these advances, challenges remain in defining temporal-cellular specificity and achieving clinical translation. Integrating single-cell multi-omics, spatial imaging, and nanocarrier-based delivery systems may enable precise, phase-adaptive modulation of pyroptosis, transforming destructive inflammation into controlled neurovascular recovery.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"9226028251410011"},"PeriodicalIF":1.6,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985398","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":"A Brief Mindfulness Intervention for Pain Management in Fibromyalgia: A Single-arm Open-Label Study.","authors":"Perianen Ramasawmy, Luise Charlotte Heim, Elisabeth Fechner, Samuel Enrico Schumann, Thuy Tien Mai, Oscar Moschner, Yong Jiang, Xue Guo, Azadeh Lesani, Frank Petzke, Andrea Antal, Olga-Lucia Gamboa Arana","doi":"10.1177/09226028251410014","DOIUrl":"https://doi.org/10.1177/09226028251410014","url":null,"abstract":"<p><p>In this open-label single-arm study, we tested the preliminary therapeutic effects of a four-week mindfullness-based intervention (MBI) tailored for fibromyalgia, including weekly online group meetings and daily mindfulness practices. Forty-six patients completed the intervention. The primary outcome was pain intensity scored on a numerical rating scale (NRS). Secondary outcomes included verbal fluency and self-reports of affective pain, quality of life, sleep quality, mood, emotion regulation, and psychological impairment. Transcranial magnetic stimulation was used to measure mindfulness-induced cortical excitability changes. Participants reported statistically reduced pain intensity post-training, with only 15.3% of the patients demonstrating clinically meaningful pain relief. A moderate improvement in quality of life, with only 45.6% clinical responders, were noted. Small-to-medium improvements in affective pain level, mindfulness level, and resilience as well as increase in long-interval intracortical inhibition-a measure of GABA_Bergic inhibition-were observed. The study introduces a novel MBI tailored for fibromyalgia. Nonetheless, given the current study design and the lack of clinical significance of the findings despite statistical significance, the results are insufficient to draw firm conclusions regarding its potential therapeutic efficacy. Future sham-controlled randomized clinical trials are necessary to validate and expand upon these results.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"9226028251410014"},"PeriodicalIF":1.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966945","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":"Contralesional Crossed Facilitation Impairs Bimanual Force Coordination in Chronic Stroke Survivors with Moderate-to-Mild Motor Impairment.","authors":"Rifeng Jin, Jisung Yuk, Shreya Ramani, David A Cunningham","doi":"10.1177/09226028251395702","DOIUrl":"10.1177/09226028251395702","url":null,"abstract":"<p><strong>Background: </strong>After stroke, impaired bimanual coordination reduces quality of life, where precise coordination of force between arms is essential for daily activities. Effective coordination relies on balanced interhemispheric communication, which induces crossed facilitation between primary motor cortices (M1). Intracortical inhibition influences both crossed facilitation and bimanual coordination in neurologically intact individuals. This study examines whether GABA_B-mediated inhibition in ipsilesional M1 influences crossed facilitation from contralesional M1 and its relationship with bimanual coordination post-stroke.</p><p><strong>Methods: </strong>Thirteen chronic stroke participants performed dynamic and isometric bimanual force grip task. In the dynamic task, the paretic hand maintained 30% of maximal voluntary contraction while the non-paretic hand varied force levels (low-mid-high). Cross-covariance coefficient between hands measured interference from non-paretic hand to paretic hand. In the isometric task, transcranial magnetic stimulation assessed crossed facilitation via motor evoked potential (MEP) and intracortical inhibition via cortical silent period (CSP) in ipsilesional M1 under varying bimanual force conditions (paretic: rest, 5%, 30%; non-paretic: rest, 10%, 30%, 70%).</p><p><strong>Results: </strong>Results showed variable bimanual interference post-stroke, with greater interference in less impaired individuals and under high non-paretic force. Crossed facilitation increased with higher force asymmetry and lower paretic effort, particularly in less impaired participants, but became more variable as paretic effort increased (during PH 30%: NPH 70%). Under the high asymmetry condition, GABA_B-mediated disinhibition was most pronounced and greater crossed facilitation was associated with increased bimanual interference.</p><p><strong>Conclusion: </strong>These findings suggest that reduced inhibitory tone may contribute to the regulation of crossed facilitation, and bimanual coordination deficits may be driven by excessive crossed facilitation. Future work will examine other ipsilesional factors regulating crossed facilitation, as targeted asymmetric training and neuromodulation may help improve bimanual coordination in individuals with moderate-to-mild motor impairment.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"9226028251395702"},"PeriodicalIF":1.6,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13093856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145857599","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":"Ten Recommendations for Improving Research on Stroke Motor Rehabilitation: A Unified Perspective.","authors":"Chandramouli Krishnan, Thomas E Augenstein, Rajiv Ranganathan","doi":"10.1177/09226028251392269","DOIUrl":"10.1177/09226028251392269","url":null,"abstract":"<p><p>Stroke motor rehabilitation research is critical for improving functional recovery and quality of life. However, the success of therapeutic interventions is highly dependent on the theoretical basis and methodological rigor of the studies that evaluate them. This paper outlines ten essential recommendations/guidelines for stroke motor rehabilitation research aimed at enhancing the scientific quality and reliability of findings. Our recommendations span issues related to mechanistic understanding, methodological rigor, and transparency, while providing specific suggestions for implementation in the context of stroke motor rehabilitation research. To improve our mechanistic understanding of <i>how</i> and <i>why</i> an intervention works, these guidelines emphasize the importance of having a clear <i>scientific rationale</i> for the active ingredient in the proposed therapy (<i>e.g.,</i> physical or occupational therapy), ensuring <i>manipulation checks</i> for key therapeutic components, and <i>assessing outcomes at multiple levels</i> using the ICF framework. To improve methodological rigor, the paper also highlights the necessity of <i>adequately dose-matched control groups</i>, minimizing baseline imbalances and biased treatment effects through <i>randomization and blinding</i>, and <i>employing larger sample sizes</i> to minimize the risk of false-positive trials. Finally, to enhance transparency and reproducibility, we advocate for <i>pre-registering</i> outcomes and protocols, performing <i>robustness checks</i>, <i>presenting data in multiple formats</i>, and the publication of <i>open data</i>. We anticipate that following these recommendations will pave the way for more reliable, impactful results that advance the development of effective therapeutic interventions.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"9226028251392269"},"PeriodicalIF":1.6,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811240","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":"Soft vs. Traditional AFOs: A Comparative Study on Gait Kinematics, Kinetics, and Muscle Activity.","authors":"Thomas E Augenstein, Breanna Bordine, Nyari Bhatt, Shreeya Buddaraju, Olugbenga P Adeeko, Edward P Washabaugh, Chandramouli Krishnan","doi":"10.1177/09226028251395707","DOIUrl":"https://doi.org/10.1177/09226028251395707","url":null,"abstract":"<p><p>Reduced toe clearance during the swing phase of gait, often referred to as foot drop, is a common cause of walking disability in clinical populations like stroke, cerebral palsy, or multiple sclerosis. Individuals with foot drop often wear an ankle-foot orthosis (AFO) to prevent excessive plantarflexion, but many commercially available AFOs overly restrict ankle mobility or make the wearer feel unstable/uncomfortable. Soft AFOs-AFOs with soft attachment points and elastic assistance-are designed to retain ankle mobility and comfort. However, their effect on gait biomechanics, as compared to traditional AFOs, is not well understood. Therefore, the objective of the current study was to perform a comprehensive biomechanical and neurophysiological comparison of soft AFOs with traditional AFOs. Sagittal plane kinematics, ground reaction forces, and lower extremity muscle activation were measured in 23 neurologically intact individuals while walking on a treadmill without assistance from an AFO (No AFO) and then with unilateral assistance from four commercially available AFOs (rigid anterior, flexible posterior leaf spring, and two soft AFOs). We found that soft AFOs allowed for greater ankle dorsiflexion velocity, plantarflexion velocity, and plantarflexion angle while retaining or increasing dorsiflexion during the swing phase. We also found that the traditional AFOs reduced propulsive ground reaction forces compared to the soft AFOs, and the rigid anterior AFO reduced plantarflexor muscle activity compared to the soft AFOs. These results highlight the differences between different commercially available AFOs and present soft AFOs as an exciting alternative to traditional AFOs when ankle mobility is desired.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"9226028251395707"},"PeriodicalIF":1.6,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701781","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":"Are Kinematic Assessments from a Planar Reaching Task Better Than Standardized Clinical Assessments at Predicting Functional Independence in Chronic Stroke Survivors?","authors":"Beth Albrecht, Zaynab Kassam, Pramisha Thapa, Shanie Al Jayasinghe","doi":"10.1177/09226028251391999","DOIUrl":"10.1177/09226028251391999","url":null,"abstract":"<p><p>Kinematic assessments provide a quantitative evaluation of movement outcomes in chronic stroke survivors. However, it is unclear whether these assessments provide an added benefit to standardized clinical assessments when evaluating functional independence. We hypothesized that kinematic assessments of ipsilesional arm motor and cognitive performance would be better at predicting functional independence compared to their standardized clinical assessment counterparts. We recruited 21 chronic stroke survivors with severe hemiparesis to complete 2 clinical assessments (Jebsen-Taylor Hand Function Test, Grooved Pegboard Test) and 2 kinematic assessments on the Kinereach motion tracking system (a simple reaching task and a cognitively challenging reaching task). We found moderate-to-weak correlations between the Functional Independence Measure (FIM) and each of the kinematic outcomes. The clinical assessments had weak correlations with the FIM. Thus, kinematic assessments provided no significant advantage over clinical assessments in predicting functional independence.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"9226028251391999"},"PeriodicalIF":1.6,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145438897","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}