Restorative neurology and neuroscience最新文献

{"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":"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":"349-359"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400802/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Effectiveness Between Bilateral and Unilateral Training for Distal Upper Extremity among Patients with Stroke: A Systematic Review and Meta-Analysis.","authors":"Kuo-Cheng Liu, Hander Wang, Jian-Jia Huang, Yu-Cheng Pei","doi":"10.1177/09226028261446461","DOIUrl":"10.1177/09226028261446461","url":null,"abstract":"<p><p>PurposeHemiplegia in the distal upper extremity (dUE) is a common post-stroke impairment that severely limits daily activities and functional recovery. Although upper-extremity rehabilitation typically focuses on unilateral training (UT), bilateral training (BT) is gaining recognition for its effectiveness in promoting post-stroke motor recovery. Few studies have characterized the effect of BT on dUE; therefore, the degree to which the effectiveness of BT can be predicted by clinical factors, such as patient characteristics and intervention settings, remains unclear. This study investigated the effectiveness of BT versus that of UT on dUE hemiplegia and analyzed the factors determining BT effectiveness.MethodsA systematic literature search was conducted in PubMed, Embase, Cochrane Library, Scopus, and Web of Science for randomized controlled trials (RCTs) published before March 2024. The study included RCTs that evaluated motor recovery in post-stroke patients with dUE hemiplegia, using outcome measures such as the Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Action Research Arm Test, Wolf Motor Function Test, Box and Block Test, and the modified Ashworth Scale. Data were extracted on the effectiveness of BT and UT, focusing on motor function improvements. Subgroup analyses were conducted based on stroke onset timing and intervention settings.ResultsA total of 12 RCTs were included. The results showed that BT led to greater improvements in UE motor function (FMA-UE score, <i>P</i> = 0.04) and dUE function (FMA-UE distal score, <i>P</i> = 0.02) compared to UT. Subgroup analyses identified that stroke survivors with ≥4 weeks post-stroke onset (<i>P</i> = 0.03), and a treatment duration of at least 4 weeks (<i>P</i> = 0.0006) showed greater benefit from BT.ConclusionBT was more effective than UT for post-stroke motor recovery in both UE and dUE. Although stroke onset timing and intervention settings may influence BT outcomes, caution is needed when applying these findings due to the small number of studies and the heterogeneity of the included studies.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"311-328"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147932979","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":"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":"329-348"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400841/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise Density Influences the Expression of a Postexercise Inhibitory Control Benefit: Evidence from a Low-Volume Interval Exercise Protocol.","authors":"Antonio Mendes, Lila Gavigan, Grace Gall, Fabian Herold, Liye Zou, Matthew Heath","doi":"10.1177/09226028261469816","DOIUrl":"https://doi.org/10.1177/09226028261469816","url":null,"abstract":"<p><p>Executive function (EF) is improved following a single bout of exercise. Recently, it has been proposed the timing between exercise and rest intervals (i.e., <i>exercise density</i>) within a single bout of exercise (or across days or months of exercise) may serve as an important moderator in the expression and/or magnitude of an EF benefit. Here, participants (N = 25) completed separate interval exercise conditions - as well as a non-exercise control - wherein ten 1-min intervals of exercise (40% of 1 repetition max leg extensions at 0.25 Hz) were interspersed with 1-min (high-density: HD) or 2-min (low-density: LD) of rest. Prior to and following exercise (∼5-min), the antisaccade task (i.e., saccade mirror-symmetrical to a target) was used to assess the inhibitory control component of EF. Antisaccades were selected given the task's hands- and language-free nature and because they are mediated via EF networks showing task-dependent single-bout exercise changes. Peak systolic middle cerebral artery velocity (MCAv_peak), perceived exertion, arousal and neuromuscular fatigue were measured to identify a potential psychophysiological metric associated with a putative density-linked postexercise EF change. Frequentist and Bayesian statistics demonstrated that the LD - but not HD - condition produced a pre- to postexercise reduction in antisaccade reaction times (RTs), and across LD and HD conditions psychophysiological metrics did not demonstrate an association with postexercise antisaccade RT changes. Hence, results provide nascent evidence that density may moderate a single bout postexercise inhibitory control benefit and demonstrate that density may provide a framework to understand the interdependent psychophysiological mechanisms contributing to the benefit.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"9226028261469816"},"PeriodicalIF":1.8,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648974","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":"Whole-Body Vibration After Compressive Spinal Cord-Injury in Rats Restores Dorsal Horn Synaptic Relations and Alleviates Pain-Associated Behavior.","authors":"Svenja Rink-Notzon, Martin Krueger, Milen Zamfirov, Muthuraman Muthuraman, Diana Schaufler, Levent Sarikcioglu, Süreyya Bilmen, Johannes Vogt, Heiko Endle, Lyudmila Belenska-Todorova, Stoyan Pavlov, Maria Eleni Manthou, Doychin N Angelov","doi":"10.1177/09226028261464314","DOIUrl":"10.1177/09226028261464314","url":null,"abstract":"<p><p>Spinal cord injury (SCI) induces neuronal loss and demyelination, leading to maladaptive neuronal circuits that drive persistent central neuropathic pain (PCNP). While pharmacological, psychological, and physiotherapeutic approaches have been applied, including whole-body vibration (WBV), synaptic-level mechanisms of WBV remain largely unexplored. Here, we assessed the post-SCI pain-associated behavior index (PAB, based on established behavioral criteria) and compared synapse counts (SYN+, VGLUT1+, ChAT+, VGAT+), CGRP+- and SER+-structures, as well as astrocytic and microglial populations in the lumbar dorsal horn following thoracic SCI in WBV-treated and untreated rats. Animals received WBV from postoperative week 3 to 12, and outcomes were compared with non-treated controls. PAB was consistently reduced in WBV-treated animals. STED-microscopy quantification showed that WBV increased the linear density of VGAT + and VGLUT1 + perisomatic terminals, as well as the number of SER + fibers. Conversely, WBV reduced CGRP + structures in the dorsal horn, decreased the density of CGRP + perisomatic and axo-axonic synapses, and lowered astrocytic and microglial populations. Our data indicate that the WBV-induced frequent (15-30 Hz) muscle contractions and proprioceptive impulses contribute to spasticity modulation (via VGAT-related mechanisms) and attenuation of post-SCI hyperalgesia (CGRP-associated). Together with the reduced astro- and microglia amounts, the described synaptic alterations are considered essential prerequisites for better motor recovery. These findings provide preclinical evidence for the functional benefits of WBV in an animal SCI model and warrant further investigations to determine mechanisms underpinning this non-invasive, low-cost and easily applicable rehabilitation approach.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"9226028261464314"},"PeriodicalIF":1.8,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550055","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":"Perceptions of Exercise in Latin Americans and Non-Hispanic Whites with Overweight and Obesity.","authors":"Marcelo Bigliassi, Dayanne S Antonio, Ekaterina Oparina, Jason R Kostrna","doi":"10.1177/09226028261436633","DOIUrl":"https://doi.org/10.1177/09226028261436633","url":null,"abstract":"<p><p>This study sought to explore the neural and affective responses to exercise- and sedentary-related imagery among Latin Americans and Non-Hispanic Whites with overweight and obesity, aiming to understand the influence of cultural background on exercise behaviors. Using electroencephalography, the research investigates differences in directional brain connectivity patterns and emotional reactions between the two groups. Participants were shown images depicting exercise and sedentary behaviors, with affective responses recorded via the <i>Self-Assessment Manikin</i> and neural connectivity assessed using Granger Causality Analysis. Results indicate significant differences in brain connectivity between groups and conditions. Non-Hispanic Whites showed stronger connectivity within frontal-parietal networks during exercise imagery, while Latin Americans displayed more distributed connectivity during sedentary imagery, suggesting different neural engagement strategies. Affective data revealed that participants reported higher valence for exercise-related images, with Latin Americans exhibiting higher perceived activation for sedentary images. Qualitative analysis of semi-structured interviews identified key themes, including family support, motivation to exercise, and time constraints. Both groups emphasized the importance of social influences on physical activity; however, Latin Americans expressed more ambivalence toward exercise. Network analysis of interview data further highlighted the complex interplay between these psychosocial factors. This study provides novel insights into how cultural differences shape both neural and emotional responses to exercise, informing the development of culturally tailored interventions to promote physical activity in populations with higher obesity prevalence.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"9226028261436633"},"PeriodicalIF":1.8,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148278542","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":"Neuroprotective Effects of <i>Moringa Peregrina</i> Leaf Alcoholic Extract on Compression Model of Spinal Cord Injury in Rats.","authors":"Mohammad Hassan Tajik, Mohammad-Reza Delnavazi, Maedeh Hashemi, Morteza Gholaminejhad, Neda Ghaffari, Maryam Shabani, AmirMohammad RezaeiRashnoudi, Kobra Mehrania, Gholamreza Hassanzadeh","doi":"10.1177/09226028261441206","DOIUrl":"https://doi.org/10.1177/09226028261441206","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injury (SCI) is a devastating condition characterized by inflammation, oxidative stress, and neuronal damage. These factors contribute significantly to the secondary injury phase, exacerbating tissue degeneration and impairing recovery. While many therapeutic approaches focus on reducing these detrimental processes, the use of natural products like <i>Moringa peregrina</i> (M.P), a plant known for its antioxidant and anti-inflammatory properties, remains underexplored. This study investigates the neuroprotective effects of the alcoholic extract of <i>Moringa peregrina</i> leaves on SCI, evaluating its impact on oxidative stress, inflammation, and both structural and functional recovery.</p><p><strong>Materials and methods: </strong>In this study, fifty-four male Wistar rats were randomly assigned to three groups: laminectomy (sham), SCI (injection of saline intraperitoneally for 21 days), and SCI + <i>Moringa peregrina</i> (150 mg/kg of M.P extract injected intraperitoneally for 21 days). Motor function was assessed using the Basso, Beattie, and Bresnahan (BBB) scale throughout the study period. At 21 days post-injury, we measured the activity of antioxidant enzymes (superoxide dismutase [SOD], catalase [CAT], glutathione peroxidase [GPx], total antioxidant capacity [TAC]), the oxidative stress marker malondialdehyde (MDA), and inflammatory cytokines (TNF-α, IL-1β, IL-6, IL-18), alongside nuclear factor kappa B (NF-κB). Histological analyses were performed using hematoxylin and eosin (H&E) and cresyl violet staining to evaluate neuronal damage and tissue density.</p><p><strong>Results: </strong>Intraperitoneal administration of <i>Moringa peregrina</i> extract significantly reduced the levels of pro-inflammatory cytokines (TNF-α, IL-1β, IL-6, IL-18) and the oxidative stress marker MDA, while enhancing the activity of SOD, GPx, CAT, and TAC. These changes were associated with a marked reduction in NF-κB expression. Histological analysis revealed less cellular damage and increased tissue density in the SCI + <i>Moringa peregrina</i> group compared to the SCI group, indicating preserved neuronal structure. Furthermore, motor function recovery was significantly improved in the SCI + <i>Moringa peregrina</i> group, as evidenced by higher BBB scores compared to the untreated SCI group.</p><p><strong>Conclusion: </strong>The findings of this study demonstrate that the alcoholic extract of <i>Moringa peregrina</i> leaves exerts neuroprotective effects through modulation of oxidative stress, inflammation, and structural preservation. The improvement in both motor function and spinal cord tissue integrity highlights the potential therapeutic value of <i>Moringa peregrina</i> in the treatment of SCI.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"9226028261441206"},"PeriodicalIF":1.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842218","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":"Determining the Validity of 2D Motion Capture for Estimating Lower Extremity Joint Quasi-Stiffness During Gait in Chronic Stroke Survivors.","authors":"Sierra A Foley, Andrew F Moul, Chandramouli Krishnan, Edward P Washabaugh","doi":"10.1177/09226028251384400","DOIUrl":"10.1177/09226028251384400","url":null,"abstract":"<p><p>Altered joint stiffness is common after stroke, yet clinically feasible tools to objectively quantify joint stiffness during walking are lacking. Quasi-stiffness, defined as the slope of the joint torque-angle curve, can serve as a surrogate measure of stiffness; however, it typically requires expensive 3D motion capture systems. 2D motion capture is a potential low-cost alternative for measuring quasi-stiffness in the sagittal plane; however, it is unclear if it can accurately estimate quasi-stiffness in patient populations that often exhibit out-of-plane motions. Therefore, in this study, we aimed to identify the minimal data required to accurately estimate joint quasi-stiffness. To do so, we evaluated the agreement between quasi-stiffness measurements obtained from 3D data in fifteen individuals with chronic stroke and from a simulated set of 2D data reconstructed from the 3D coordinates. Lower-extremity kinematic and kinetic data during overground walking were collected using a 3D motion capture system and an embedded force plate. To simulate 2D data, 3D maker data were projected to a simulated camera lens positioned to view sagittal motions, and medio-lateral components of the ground reaction force data were removed. Joint angles and moments at the hip, knee, and ankle were computed for both datasets using inverse dynamics, and quasi-stiffnesses of these joints were estimated during the stance phase. A linear mixed model was used to evaluate the effects of quantification method (2D, 3D) and stroke limb (paretic, non-paretic) on quasi-stiffness. Bland-Altman analyses and Intraclass correlation coefficients (ICCs) were used to evaluate the agreement between 2D and 3D measurements. The results indicated that 2D quasi-stiffness measurements were generally in agreement with the 3D quasi-stiffness measurements (Δ: -0.008-0.007 Nm/deg/kg; ICC: 0.576-0.927 [range]), although the 2D measurements slightly overestimated quasi-stiffness for some joints. Additionally, we found that quasi-stiffness was significantly higher in the paretic limb when the ankle was plantarflexing (Δ: 0.024 Nm/deg/kg) compared to the non-paretic limb. The results of this study suggest that quasi-stiffness can be validly estimated using 2D data, supporting the development of low-cost 2D systems for clinical settings to measure and monitor joint stiffness after stroke.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"170-185"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225587","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":"Harnessing Neuroplasticity: The Role of Priming in Enhancing Post Stroke Motor Function.","authors":"Sangeetha Madhavan","doi":"10.1177/09226028251358162","DOIUrl":"10.1177/09226028251358162","url":null,"abstract":"<p><p>Stroke remains a leading cause of disability worldwide, highlighting the need for innovative neurorehabilitation strategies to enhance recovery. Recent advancements emphasize neuroplasticity-the brain's ability to reorganize and form new connections-through targeted interventions. Among these, cortical priming has emerged as a promising approach to enhance neuroplasticity and improve motor recovery post-stroke by modulating brain excitability for optimal motor learning. This review explores the role of cortical priming in stroke rehabilitation, highlighting its ability to enhance neural excitability and plasticity in motor-related brain regions. Various priming techniques, including non-invasive brain stimulation (rTMS, tDCS), deep brain stimulation (DBS), vagus nerve stimulation (VNS), brain-computer interfaces (BCIs), movement-based priming, aerobic exercise, and sensory stimulation, are examined. Despite promising findings, challenges remain in optimizing protocols and addressing individual variability. Future directions focus on biomarker-driven rehabilitation, personalized strategies, and large-scale trials to integrate cortical priming into clinical practice.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"80-97"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761142","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":"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":"118-130"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","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}