Restorative neurology and neuroscience最新文献

{"title":"The Impact of Cognitive Impairment on Pedal Control and Crash Risk Following Stroke: A Pilot Study.","authors":"Stefan Delmas, Prakruti Patel, Agostina Casamento-Moran, Evangelos A Christou, Neha Lodha","doi":"10.1177/09226028251379341","DOIUrl":"10.1177/09226028251379341","url":null,"abstract":"<p><p>Driving after stroke requires complex coordination of cognitive and motor systems, yet the influence of post-stroke cognitive impairment on lower limb motor control during driving remains poorly understood. This pilot study examined the association between cognitive function and lower limb motor control of gas/brake pedal control in stroke survivors. We hypothesized that compromised cognitive function would be associated with worse gas and brake pedal control. Twenty stroke survivors (65.89 ± 9.67 years; 6 females) participated. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and Useful Field of View (UFOV) test scores for divided and selective attention. Participants performed a car-following task in a driving simulator requiring precise gas and brake control. Pedal control was quantified by gas pedal error, brake force error, and brake response time. Participants were categorized into cognitively normal and cognitively impaired groups (n=10 each). Driving behavior was assessed using the Driving Habits Questionnaire (DHQ), and crash risk was determined via UFOV classification. Increased gas pedal error was associated with poorer MoCA scores and selective attention deficits. Delayed brake response times correlated with lower MoCA scores and poorer divided and selective attention. Although self-reported driving behavior was comparable between groups, 60% of cognitively impaired participants demonstrated moderate to high crash risk compared to cognitively normal participants, who exhibited low crash risk. Cognitive impairment after stroke is significantly linked to impaired lower limb control during driving and elevated crash risk. These findings highlight an urgent need to integrate cognitive assessment along with motor assessments in post-stroke rehabilitation. Future advances in neuroengineering technologies, and personalized motor-cognitive interventions could play a critical role in restoring safe driving capabilities and mobility independence after stroke.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"102-111"},"PeriodicalIF":1.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13328925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125939","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":"Relationship Between Descending Neural Drives from the Non-Injured Hemisphere and Lower Limb Motor Function and Gait Ability in Patients Following Severe Stroke.","authors":"Sora Ohnishi, Naomichi Mizuta, Naruhito Hasui, Yuki Sato, Junji Taguchi, Tomoki Nakatani, Shu Morioka","doi":"10.1177/09226028251358166","DOIUrl":"10.1177/09226028251358166","url":null,"abstract":"<p><p>BackgroundThe relationship between the functional recovery of patients in the subacute phase of stroke and descending neural drives from the non-injured hemisphere to the paretic lower limb muscles during movement remains unclear. We investigated this relationship in patients with severe paralysis.MethodsTwenty-nine patients with stroke were recruited and categorized into three groups based on paralysis severity. Within 1 month of admission, each patient received 10 min of anodal tDCS applied to the cortical motor areas of the injured or non-injured hemispheres. Each stimulation condition was performed in a random order, one day at a time, with a 7-day washout period. Before and after each stimulation, patients performed multiple voluntary knee extensions on the paretic side 20% of their maximal strength, sustained for 6 s. Coherence analysis of EMG signals from proximal and distal segments of the vastus medialis muscle was conducted to quantify common neural drive from each cortical motor-related area based on coherence variations before and post stimulation in each condition. We investigated the relationship between the excitability of the descending neural pathway from the non-injured hemisphere in the initial phase and motor function recovery at 3 months.ResultsNo significant differences emerged across groups in the change in coherence values when the non-injured hemisphere stimulated. However, within the severe group, an increase in β-band coherence following non-injured hemisphere stimulation correlated with greater recovery of paretic-side muscle strength and trunk function at 3 months.ConclusionOur findings deepen understanding of paralysis pathophysiology based on severity level and may support the development of targeted neuromodulation strategies to enhance motor recovery.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"89-101"},"PeriodicalIF":1.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637896","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":"Announcement: Appointment of New Editor-in-Chief Henriette van Praag, MD, PhD as Co-Editor-in-Chief of Restorative Neurology and Neuroscience.","authors":"","doi":"10.1177/09226028251396770","DOIUrl":"10.1177/09226028251396770","url":null,"abstract":"","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":"43 3-4","pages":"79"},"PeriodicalIF":1.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369597","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":"Optimizing Repetitive Transcranial Magnetic Stimulation (rTMS) Protocols for Upper Limb Motor Recovery in Post-Stroke Patients: A Meta-Analysis.","authors":"Huda Alhalabi, Yitong Qiu, Yixin Wei, Yi Chen, Qiang Gao","doi":"10.1177/09226028251394303","DOIUrl":"10.1177/09226028251394303","url":null,"abstract":"<p><p>BackgroundRepetitive transcranial magnetic stimulation (rTMS) is a noninvasive intervention aimed at enhancing neuroplasticity and supporting motor recovery in stroke survivors. This meta-analysis examines the efficacy of rTMS in enhancing upper limb motor function and independance in daily activities, utilizing key assessment tools such as the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Wolf Motor Function Test (WMFT), Modified Barthel Index (MBI), and Action Research Arm Test (ARAT).MethodsA systematic review of 10 studies involving 382 participants was conducted. Outcomes were analyzed for mean differences (MD) and 95% confidence intervals (CI) using forest plots. Subgroup analyses examined the influence of stroke stage and session length. Evidence quality was assessed using the GRADE framework.ResultsrTMS significantly improved motor performance, with the FMA-UE showing the most consistent and clinically meaningful gains, where the overall standardized mean difference (SMD) was 1.28 (95% CI: 1.82 to 0.74, p < 0.0001, I² = 0%), particularly during subacute and subacute-to-chronic stages. Furthermore, protocols with 15-20 sessions yielded significantly better outcomes (SMD = 1.50, 95% CI: 1.90 to 1.10, p < 0.001) than shorter protocols. ARAT results were less consistent, indicating challenges in fine motor recovery, particularly in chronic stroke populations.ConclusionThis meta-analysis confirms that rTMS effectively enhances upper limb motor function and independence in post-stroke patients. Tailored protocols during subacute stages optimize recovery, though further research is needed to refine protocols and explore long-term outcomes.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"122-137"},"PeriodicalIF":1.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13328933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661737","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":"Abstracts from the 19th World Congress on Controversies in Neurology, Prague, Czech Republic, 20-22 March 2025.","authors":"","doi":"10.1177/09226028251367822","DOIUrl":"10.1177/09226028251367822","url":null,"abstract":"","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"3-76"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086923","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":"Effects of Pattern-Reversal Visual Stimulation on Brain Activity in Migraineurs and General Population.","authors":"Lívia Shirahige, Fernanda Nogueira, Lorena Melo, Ruxandra Ungureanu, Sérgio Rocha, Rodrigo Brito, Thyciane Mendonça, Abelardo de Farias, Maria das Graças Rodrigues de Araújo, Daniele Piscitelli, Kátia Monte-Silva","doi":"10.1177/09226028241292033","DOIUrl":"10.1177/09226028241292033","url":null,"abstract":"<p><p>BackgroundA better understanding of migraine pathophysiology through standardized methods could facilitate the development of more effective therapeutic approaches for migraine sufferers. However, neurophysiological studies with migraine sufferers present larger variability, as most contain only a single measurement.ObjectiveThis observational study aimed to compare the cortical and visual excitability of migraine sufferers, individuals with other types of headaches, and healthy participants in response to pattern-reversal visual stimulation.MethodsFifty-nine individuals were classified by a neurologist into the following groups: (i) migraineurs (n = 25); (ii) other types of headaches (n = 23); (iii) healthy (n = 11). Habituation during pattern-reversal visual stimulation was assessed by visual evoked potentials. Visual and motor cortex excitability were evaluated before and after pattern-reversal visual stimulation.ResultsWe found no intergroup differences in motor and visual excitability measures after pattern-reversal visual stimulation. Compared to the healthy group, migraineurs and individuals with other types of headaches displayed a reduction in phosphene threshold after pattern-reversal visual stimulation. Additionally, an increase in visual cortical excitability in these groups was also observed. Lastly, the habituation in individuals with migraines and other types of headaches was lower compared to healthy individuals. Therefore, the lack of habituation may not be exclusively associated with the pathophysiological mechanisms of migraine.ConclusionIndividuals who experience headaches, including migraineurs, have an increased visual cortical excitability in response to visual stimuli. This finding is promising for guiding future neurophysiological research to identify cortical biomarkers in migraineurs and in other types of headaches.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"181-192"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459316","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":"Hippocampal long-term potentiation is modulated by exercise-induced alterations in dopaminergic synaptic transmission in mice selectively bred for high voluntary wheel running.","authors":"Jessica Mai-Phuong Phan, Jiwon Yi, Julia Hope Amor Foote, Asia Rei Katsura Ayabe, Kevin Guan, Theodore Garland, Karen Diane Parfitt","doi":"10.1177/09226028241290400","DOIUrl":"10.1177/09226028241290400","url":null,"abstract":"<p><p>BackgroundHigh-Runner (HR) mice, selectively bred for increased voluntary wheel running behavior, exhibit heightened motivation to run. Exercise has been shown to influence hippocampal long-term potentiation (LTP) and memory, and is neuroprotective in several neurodegenerative diseases.ObjectiveThis study aimed to determine the impact of intense running in HR mice with wheel access on hippocampal LTP, compared to HR mice without wheels and non-selected control (C) mice with/without wheels. Additionally, we investigated the involvement of D1/D5 receptors and the dopamine transporter (DAT) in LTP modulation and examined levels of these proteins in HR and C mice.MethodsAdult female HR and C mice were individually housed with/without running wheels for at least two weeks. Hippocampal LTP of extracellular field excitatory postsynaptic potentials (fEPSPs) was measured in area CA1, and SKF-38393 (D1/D5 receptor agonist) and GBR 12909 (DAT inhibitor) were used to probe the role of D1/D5 receptors and DAT in LTP differences. Western blot analyses assessed D1/D5 receptor and DAT expression in the hippocampus, prefrontal cortex, and cerebellum.ResultsHR mice with wheel access showed significantly increased hippocampal LTP compared to those without wheels and to C mice with/without wheels. Treatment with SKF-38393 or GBR 12909 prevented the heightened LTP in HR mice with wheels, aligning it with levels in C mice. Hippocampal D1/D5 receptor levels were lower, and DAT levels were higher in HR mice compared to C mice. No significant changes were observed in other brain regions.ConclusionsThe increased hippocampal LTP seen in HR mice with wheel access may be related to alterations in dopaminergic synaptic transmission that underlie the neurophysiological basis of hyperactivity, motor disorders, and/or motivation.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"193-208"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459301","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 Recovery After Surgical Neurolysis in Brachial Plexus Neuropathy: A Case Study and Systematic Review.","authors":"José Damián Carrillo-Ruiz, Armando Armas-Salazar, José Luis Navarro-Olvera, Ana Isabel García-Jerónimo, Fátima Ximena Cid-Rodríguez, José Antonio Rodríguez, Hannia Fernanda González-Morales, Edgar Abarca-Rojano","doi":"10.1177/09226028241290981","DOIUrl":"10.1177/09226028241290981","url":null,"abstract":"<p><p><b>Objective:</b> The aim of this study is to assess the motor outcomes of patients undergoing surgical neurolysis and to conduct a comprehensive review of existing literature to ascertain the efficacy and utility of this technique. Surgical neurolysis is a procedure designed to liberate an injured nerve from scar tissue or adjacent structure, thereby facilitating nerve regeneration in cases of brachial plexus neuropathy (BPN). <b>Methods:</b> This study presents a case series of patients diagnosed with BPN who underwent surgical neurolysis. The primary focus was on the clinical assessment of recovery using the British Medical Research Council motor grading scale (BMRC). Additionally, a comprehensive literature review was conducted to analyze motor recovery outcomes related to surgical neurolysis for BPN. 18 patients with BPN who underwent surgical neurolysis were included. <b>Results:</b> It was experienced a notable increase of 58% in muscle strength as assessed by the BMRC. The average preoperative state of 2.17 ± 1.15 improved significantly to a postoperative condition of 3.44 ± 1.34 (p = 0.003, d = 0.913) The systematic review identified 2298 relevant articles, out of which 8 articles published between 1995 and 2021 were selected for qualitative analysis, demonstrated that surgical neurolysis was associated with favorable motor recovery outcomes in 75.82% of the patients. <b>Conclusions:</b> Both the case series and the literature review reveal significant motor recovery following surgical neurolysis. It is crucial to conduct well-designed, adequately powered, randomized, and blinded clinical trials. Such studies will provide robust evidence to support or refute the utility of this approach in motor recovery.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"222-230"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042063","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":"Quantitative EEG Metrics for Determining HD-tDCS Induced Alteration of Brain Activity in Stroke Rehabilitation.","authors":"Jordan N Williamson, Shirley A James, Beni Mulyana, Sally Kim, Dorothy He, Sheng Li, Evgeny V Sidorov, Yuan Yang","doi":"10.1177/09226028251347427","DOIUrl":"10.1177/09226028251347427","url":null,"abstract":"<p><p>High-definition transcranial direct current stimulation (HD-tDCS) is a promising approach for stroke rehabilitation, which may induce functional changes in the cortical sensorimotor areas to facilitate movement recovery. However, it lacks an objective measure that can indicate the effect of HD-tDCS on alteration of brain activity. Quantitative electroencephalography (qEEG) has shown promising results as an indicator of post-stroke functional recovery. Therefore, this study aims to determine whether qEEG metrics could serve as quantitative measures to assess alteration in brain activity induced by HD-tDCS. Resting state EEG was collected from stroke participants before and after (1) anodal HD-tDCS of the lesioned hemisphere, (2) cathodal stimulation of the non-lesioned hemisphere, and (3) sham. The average power spectrum was calculated using the Fast Fourier Transform for frequency bands alpha, beta, delta, and theta. In addition, delta-alpha ratio (DAR), Delta-alpha-beta-theta ratio (DTABR), and directional brain symmetry index (BSI) were also evaluated. We found that both anodal and cathodal stimulation significantly decreased the DAR and BSI over various frequency bands, which are associated with reduced motor impairments and improved nerve conduction velocity from the brain to muscles. This result indicates that qEEG metrics DAR and BSI could be quantitative indicators to assess alteration of brain activity induced by HD-tDCS in stroke rehabilitation. This would allow future development of EEG-based neurofeedback system to guide and evaluate the effect of HD-tDCS on improving movement-related brain function in stroke.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"209-221"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302787","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":"No Evidence of Hysteresis in Quadriceps or Hamstring Active Motor Evoked Potentials.","authors":"Adam Gardi, Kazandra M Rodriguez, Thomas E Augenstein, Riann M Palmieri-Smith, Chandramouli Krishnan","doi":"10.1177/09226028251330850","DOIUrl":"10.1177/09226028251330850","url":null,"abstract":"<p><p>BackgroundThe excitability of the corticospinal tract (<i>i.e.,</i> corticospinal excitability) is a valuable tool for assessing neurophysiology and the effectiveness of interventions in individuals with and without neurological and/or orthopaedic injuries. Corticospinal excitability is often measured with an input-output recruitment curve, which is produced by stimulating the motor cortex via transcranial magnetic stimulation (TMS) at several intensities and measuring the changes in the evoked responses. However, it is currently unclear if hysteresis in motor evoked potentials (MEPs) (<i>i.e.,</i> changes in MEP amplitude due to the order of stimulus intensities) affects the resulting measure of excitability, particularly in lower extremity muscles.ObjectiveTo evaluate whether the order of stimulus intensity (ascending, descending, randomized) affects input-output recruitment curves measured in the lower extremity muscles.MethodsRecruitment curves were produced in neurologically intact individuals by stimulating the primary motor cortex at 70% to 140% of active motor threshold in 10% increments. We examined three stimulus intensity ordering paradigms: ascending (70<math><mo>→</mo></math>140), descending (140<math><mo>→</mo></math>70), and randomized. We measured MEPs of the quadriceps and the antagonistic hamstring muscles using surface electromyography in addition to quadriceps motor evoked torque. We computed the area under the recruitment curve (AUC) of the raw and normalized motor evoked responses and used classical and Bayesian inference methods to comprehensively evaluate hysteresis in MEPs.ResultsClassical hypothesis testing revealed no significant main effects of stimulus order. Bayesian analyses also confirmed that the null model was more favored than the main effects model.ConclusionsCorticospinal excitability of the quadriceps and antagonistic hamstring muscles were not influenced by stimulus intensity order. Any of the three approaches (ascending, descending, randomized) may be used when measuring recruitment curves for the quadriceps and hamstring muscles.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"231-241"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043091","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}