Neurorehabilitation and Neural Repair最新文献

{"title":"Relationships Among Environmental Variables, Physical Capacity, Balance Self-Efficacy, and Real-World Walking Activity Post-Stroke.","authors":"Allison Miller,&nbsp;Ryan T Pohlig,&nbsp;Darcy S Reisman","doi":"10.1177/15459683221115409","DOIUrl":"https://doi.org/10.1177/15459683221115409","url":null,"abstract":"<p><strong>Background: </strong>Social and physical environmental factors affect real-world walking activity in individuals with stroke. However, environmental factors are often non-modifiable, presenting a challenge for clinicians working with individuals with stroke whose real-world walking is limited due to environmental barriers.</p><p><strong>Objective: </strong>The purpose of this work was to test a model hypothesizing the relationships among environmental factors (specifically, living situation and area deprivation), modifiable factors, and real-world walking activity to understand opportunities for intervention. We hypothesized that balance self-efficacy would mediate the relationship between the environment and real-world walking and that physical capacity would moderate this mediation.</p><p><strong>Methods: </strong>This was a cross-sectional study of 282 individuals with chronic (≥6 months) stroke. We tested the indirect effect to determine if mediation was present. Multiple group structural equation modeling was used to test if physical capacity moderated this mediation. A <i>χ</i>² difference test was used to compare the moderation model against the null (no moderation) model.</p><p><strong>Results: </strong>Balance self-efficacy mediated the relationship between area deprivation and real-world walking (indirect effect: <i>β</i> = -0.04, <i>P</i> = .04). Both the moderation and null models fit the data equally well statistically (χ²(5) = 6.9, <i>P</i> = .23). We therefore accepted the simpler (null) model and concluded that the mediation was not moderated.</p><p><strong>Conclusions: </strong>Targeting balance self-efficacy may be an effective approach to improving real-world walking in persons with stroke who experience barriers within the physical environment. A stroke survivor's physical capacity may not impact this approach. Future work should consider utilizing more specific measures of the social and physical environment to better understand their influences on real-world walking activity in individuals with stroke. However, the results of this work provide excellent targets for future longitudinal studies targeting real-world walking activity in stroke.</p>","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":" ","pages":"535-544"},"PeriodicalIF":4.2,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9377718/pdf/nihms-1822160.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40669771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Prospective Memory Rehabilitation Plus Metacognitive Skills Training for Adults With Traumatic Brain Injury: A Randomized Controlled Trial.","authors":"Jennifer Fleming,&nbsp;Tamara Ownsworth,&nbsp;Emmah Doig,&nbsp;Christy Hogan,&nbsp;Caitlin Hamilton,&nbsp;Sarah Swan,&nbsp;Janelle Griffin,&nbsp;Melissa Kendall,&nbsp;David Shum","doi":"10.1177/15459683221110886","DOIUrl":"https://doi.org/10.1177/15459683221110886","url":null,"abstract":"<p><strong>Background: </strong>Prospective memory (PM) failure can limit independence and productivity following traumatic brain injury (TBI). Compensatory strategy use may ameliorate the effect of PM impairment on daily life but requires sufficient self-awareness. Metacognitive skills training (MST) can facilitate self-awareness and strategy use and may improve the efficacy of PM rehabilitation.</p><p><strong>Objective: </strong>To evaluate the effectiveness of compensatory strategy training (COMP) with an MST component (COMP-MST) for reducing everyday PM failure and improving psychosocial integration in adults with moderate-severe TBI, compared to COMP alone and a control condition. Secondary aims were to evaluate the effect of training on psychometric PM test scores, strategy use, self-awareness, and level of care.</p><p><strong>Methods: </strong>Assessor and participant-blinded randomized controlled trial with 52 participants (77% male, mean age = 39.0. SD = 13.6) allocated to 3 groups: COMP-MST, COMP, and waitlist control. Interventions were delivered over 6 weekly sessions. Measures were collected pre- and post-intervention and 3-month follow-up. Data were analyzed using unstructured linear mixed-effects modeling for repeated measures and planned contrasts between time-points for each group.</p><p><strong>Results: </strong>The models showed no significant differences between the groups on primary or secondary outcome measures. Significant pre-post intervention improvements were found for significant other's ratings of everyday PM failure for both intervention groups but not the control group, with medium to large effect sizes. Clinically relevant improvements on primary outcomes were found for participants across all 3 groups.</p><p><strong>Conclusions: </strong>This study found no significant benefits of combining MST with COMP for improving everyday PM and psychosocial integration.</p><p><strong>Clinical trial registration: </strong>Australian and New Zealand Clinical Trials Registry https://www.anzctr.org.au/ ACTRN12615000996561.</p>","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":" ","pages":"487-499"},"PeriodicalIF":4.2,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40635499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of Prism Adaptation Treatment on Spatial Neglect and Rehabilitation Outcome: Dosage Matters.","authors":"Peii Chen, Kimberly Hreha, Chris Gonzalez-Snyder, Timothy J Rich, Robert W Gillen, Devan Parrott, A M Barrett","doi":"10.1177/15459683221107891","DOIUrl":"10.1177/15459683221107891","url":null,"abstract":"<p><p>We examined whether number of prism adaptation treatment (PAT) sessions in regular clinical practice would predict spatial neglect (SN) improvement and rehabilitation outcomes. We reviewed clinical records from 16 U.S. rehabilitation hospitals where neurological patients were assessed for SN using the Catherine Bergego Scale (CBS) and if SN was detected, and may have received PAT. Multiple linear regression was used to predict CBS Change (indicating SN improvement) in 520 patients who received PAT while considering age, sex, diagnosis, time post diagnosis, CBS at baseline, neglected side of space, and length of stay. Another set of regression models including the same variables and adding Function Independent Measure (FIM®) at admission was used to predict FIM Gains (indicating rehabilitation outcomes) in 1720 patients receiving PAT or not. We found that greater number of PAT sessions predicted greater CBS Change, especially in patients with moderate-to-severe neglect. Number of PAT sessions also positively correlated with Total FIM, Motor FIM, and Cognitive FIM Gains regardless of SN severity classification at baseline. Furthermore, number of PAT sessions predicted CBS Change and FIM Gains among patients completing ≤8 PAT sessions but not among patients with ≥8 sessions, who however, showed greater CBS Change with increased PAT frequency (i.e., fewer days between two consecutive sessions). Receiving more once-daily PAT sessions predicted greater improvement in SN and rehabilitation outcomes. Receiving PAT at a higher frequency for 8 or more sessions predicted better SN improvement. Thus, dosage matters. The study provides practice-based evidence that PAT is appropriate for inpatient rehabilitation.</p>","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":"36 1","pages":"500-513"},"PeriodicalIF":4.2,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45928784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tactile Sensation Improves Following Motor Rehabilitation for Chronic Stroke: The VIGoROUS Randomized Controlled Trial","authors":"Alexandra L Borstad, D. Nichols-Larsen, G. Uswatte, Nancy Strahl, Marie Simeo, Rachel Proffitt, Lynne V. Gauthier","doi":"10.1177/15459683221107893","DOIUrl":"https://doi.org/10.1177/15459683221107893","url":null,"abstract":"Background. Up to 85% of people with chronic stroke experience somatosensory impairment, which contributes to poor sensorimotor control and non-use of the affected limb. Neurophysiological mechanisms suggest motor rehabilitation may improve tactile sense post-stroke, however, somatosensory recovery has rarely been reported in controlled trials. Objective. To compare the effect of four upper limb motor rehabilitation programs on the recovery of tactile sensation in adults with chronic stroke. Methods. Adults with chronic stroke and mild or moderate upper extremity hemiparesis (n = 167) were enrolled in a multi-site randomized controlled trial. Participants completed three weeks of gaming therapy, gaming therapy with additional telerehabilition, Constraint-Induced Movement therapy, or traditional rehabilitation. Here, we report the results of a secondary outcome, tactile sensation, measured with monofilaments, before and after treatment, and 6 months later. Results. A mixed-effects general linear model revealed similar positive change in tactile sensitivity regardless of the type of training. On average, participants were able to detect a stimulus that was 32% and 33% less after training and at 6-month follow-up, respectively. One-third of participants experienced recategorization of their level of somatosensory impairment (e.g., regained protective sensation) following training. Poorer tactile sensation at baseline was associated with greater change. Conclusions. About one-third of individuals with mild/moderate chronic hemiparesis experience sustained improvements in tactile sensation following motor rehabilitation, regardless of the extent of tactile input in the rehabilitation program. Potential for sensory improvement is an additional motivator for those post-stroke. Characteristics of those who improve and mechanisms of improvement are important future questions. Clinicaltrials.gov NCT02631850","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":"36 1","pages":"525 - 534"},"PeriodicalIF":4.2,"publicationDate":"2022-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44507541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic and Neurophysiological Biomarkers of Neuroplasticity Inform Post-Stroke Language Recovery.","authors":"Haley C Dresang,&nbsp;Denise Y Harvey,&nbsp;Sharon X Xie,&nbsp;Priyanka P Shah-Basak,&nbsp;Laura DeLoretta,&nbsp;Rachel Wurzman,&nbsp;Shreya Y Parchure,&nbsp;Daniela Sacchetti,&nbsp;Olufunsho Faseyitan,&nbsp;Falk W Lohoff,&nbsp;Roy H Hamilton","doi":"10.1177/15459683221096391","DOIUrl":"https://doi.org/10.1177/15459683221096391","url":null,"abstract":"<p><strong>Background: </strong>There is high variability in post-stroke aphasia severity and predicting recovery remains imprecise. Standard prognostics do not include neurophysiological indicators or genetic biomarkers of neuroplasticity, which may be critical sources of variability.</p><p><strong>Objective: </strong>To evaluate whether a common polymorphism (Val⁶⁶Met) in the gene for brain-derived neurotrophic factor (BDNF) contributes to variability in post-stroke aphasia, and to assess whether BDNF polymorphism interacts with neurophysiological indicators of neuroplasticity (cortical excitability and stimulation-induced neuroplasticity) to improve estimates of aphasia severity.</p><p><strong>Methods: </strong>Saliva samples and motor-evoked potentials (MEPs) were collected from participants with chronic aphasia subsequent to left-hemisphere stroke. MEPs were collected prior to continuous theta burst stimulation (cTBS; index for cortical excitability) and 10 minutes following cTBS (index for stimulation-induced neuroplasticity) to the right primary motor cortex. Analyses assessed the extent to which BDNF polymorphism interacted with cortical excitability and stimulation-induced neuroplasticity to predict aphasia severity beyond established predictors.</p><p><strong>Results: </strong>Val⁶⁶Val carriers showed less aphasia severity than Val⁶⁶Met carriers, after controlling for lesion volume and time post-stroke. Furthermore, Val⁶⁶Val carriers showed expected effects of age on aphasia severity, and positive associations between severity and both cortical excitability and stimulation-induced neuroplasticity. In contrast, Val⁶⁶Met carriers showed weaker effects of age and negative associations between cortical excitability, stimulation-induced neuroplasticity and aphasia severity.</p><p><strong>Conclusions: </strong>Neurophysiological indicators and genetic biomarkers of neuroplasticity improved aphasia severity predictions. Furthermore, BDNF polymorphism interacted with cortical excitability and stimulation-induced neuroplasticity to improve predictions. These findings provide novel insights into mechanisms of variability in stroke recovery and may improve aphasia prognostics.</p>","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":"36 6","pages":"371-380"},"PeriodicalIF":4.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9133188/pdf/nihms-1797167.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9320686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individuals with Higher Levels of Physical Activity after Stroke Show Comparable Patterns of Myelin to Healthy Older Adults.","authors":"Brian Greeley, Cristina Rubino, Ronan Denyer, Briana Chau, Beverley Larssen, Bimal Lakhani, Lara Boyd","doi":"10.1177/15459683221100497","DOIUrl":"10.1177/15459683221100497","url":null,"abstract":"<p><strong>Background: </strong>Myelin asymmetry ratios (MARs) relate and contribute to motor impairment and function after stroke. Physical activity (PA) may induce myelin plasticity, potentially mitigating hemispheric myelin asymmetries that can occur after a stroke.</p><p><strong>Objective: </strong>The aim of this study was to determine whether individuals with higher levels of PA showed lower MAR compared to individuals with lower levels of PA.</p><p><strong>Methods: </strong>Myelin water fraction was obtained from 5 bilateral motor regions in 22 individuals with chronic stroke and 26 healthy older adults. Activity levels were quantified with wrist accelerometers worn for a period of 72 hours (3 days). Higher and lower PA levels were defined by a cluster analysis within each group.</p><p><strong>Results: </strong>MAR was similar regardless of PA level within the older adult group. Compared to the higher PA stroke group, lower PA stroke participants displayed greater MAR. There was no difference in MAR between the stroke and older adult higher PA groups. Within the lower PA groups, individuals with stroke showed greater MAR compared to the older adults. Arm impairment, lesion volume, age, time since stroke, and preferential arm use were not different between the PA stroke groups, suggesting that motor impairment severity and extent of brain damage did not drive differences in PA.</p><p><strong>Conclusion: </strong>Individuals who have had a stroke and are also physically active display lower MAR (i.e., similar myelin in both hemispheres) in motor regions. High levels of PA may be neuroprotective and mitigate myelin asymmetries once a neurological insult, such as a stroke, occurs. Alternately, it is possible that promoting high levels of PA after a stroke may reduce myelin asymmetries.</p>","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":"36 1","pages":"381-389"},"PeriodicalIF":3.7,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9127936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42203948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early, Intensive, Lower Extremity Rehabilitation Shows Preliminary Efficacy After Perinatal Stroke: Results of a Pilot Randomized Controlled Trial.","authors":"Caitlin Hurd, Donna Livingstone, Kelly Brunton, Allison Smith, Monica Gorassini, Man-Joe Watt, John Andersen, Adam Kirton, Jaynie F Yang","doi":"10.1177/15459683221090931","DOIUrl":"10.1177/15459683221090931","url":null,"abstract":"<p><strong>Background: </strong>Perinatal stroke injures motor regions of the brain, compromising movement for life. Early, intensive, active interventions for the upper extremity are efficacious, but interventions for the lower extremity remain understudied.</p><p><strong>Objective: </strong>To determine the feasibility and potential efficacy of ELEVATE-Engaging the Lower Extremity Via Active Therapy Early-on gross motor function.</p><p><strong>Methods: </strong>We conducted a single-blind, two-arm, randomized controlled trial (RCT), with the Immediate Group receiving the intervention while the Delay Group served as a 3-month waitlist control. A separate cohort living beyond commuting distance was trained by their parents with guidance from physical therapists. Participants were 8 months to 3 years old, with MRI-confirmed perinatal ischemic stroke and early signs of hemiparesis. The intervention was play-based, focused on weight-bearing, balance and walking for 1 hour/day, 4 days/week for 12 weeks. The primary outcome was the Gross Motor Function Measure-66 (GMFM-66). Secondary outcomes included steps and gait analyses. Final follow-up occurred at age 4.</p><p><strong>Results: </strong>Thirty-four children participated (25 RCT, 9 Parent-trained). The improvement in GMFM-66 over 12 weeks was greater for the Immediate than the Delay Group in the RCT (average change 3.4 units higher) and greater in younger children. Average step counts reached 1370-3750 steps/session in the last week of training for all children. Parent-trained children also improved but with greater variability.</p><p><strong>Conclusions: </strong>Early, activity-intensive lower extremity therapy for young children with perinatal stroke is feasible and improves gross motor function in the short term. Longer term improvement may require additional bouts of intervention.</p><p><strong>Clinical trial registration: </strong>This study was registered at ClinicalTrials.gov (NCT01773369).</p>","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":"36 1","pages":"360-370"},"PeriodicalIF":3.7,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9127938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42162630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline Predictors of Response to Repetitive Task Practice in Chronic Stroke","authors":"M. Dimyan, Stacey Harcum, Elsa Ermer, A. Boos, Susan S. Conroy, Fang Liu, L. B. Horn, Huichun Xu, M. Zhan, Hegang Chen, J. Whitall, G. Wittenberg","doi":"10.1177/15459683221095171","DOIUrl":"https://doi.org/10.1177/15459683221095171","url":null,"abstract":"Background Repetitive task practice reduces mean upper extremity motor impairment in populations of patients with chronic stroke, but individual response is highly variable. A method to predict meaningful reduction in impairment in response to training based on biomarkers and other data collected prior to an intervention is needed to establish realistic rehabilitation goals and to effectively allocate resources. Objectives To identify prognostic factors and better understand the biological substrate for reductions in arm impairment in response to repetitive task practice among patients with chronic (≥6 months) post-stroke hemiparesis. Methods The intervention is a form of repetitive task practice using a combination of robot-assisted therapy and functional arm use in real-world tasks. Baseline measures include the Fugl-Meyer Assessment, Wolf Motor Function Test, Action Research Arm Test, Stroke Impact Scale, questionnaires on pain and expectancy, MRI, transcranial magnetic stimulation, kinematics, accelerometry, and genomic testing. Results Mean increase in FM-UE was 4.6 ± 1.0 SE, median 2.5. Approximately one-third of participants had a clinically meaningful response to the intervention, defined as an increase in FM ≥ 5. The selected logistic regression model had a receiver operating curve with AUC = .988 (Std Error = .011, 95% Wald confidence limits: .967–1) showed little evidence of overfitting. Six variables that predicted response represented impairment, functional, and genomic measures. Conclusion A simple weighted sum of 6 baseline factors can accurately predict clinically meaningful impairment reduction after outpatient intensive practice intervention in chronic stroke. Reduction of impairment may be a critical first step to functional improvement. Further validation and generalization of this model will increase its utility in clinical decision-making.","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":"36 1","pages":"426 - 436"},"PeriodicalIF":4.2,"publicationDate":"2022-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42088892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Impairments in Visuomotor Adaptation After Stroke","authors":"R. T. Moore, M. Piitz, Nishita Singh, S. Dukelow, T. Cluff","doi":"10.1177/15459683221095166","DOIUrl":"https://doi.org/10.1177/15459683221095166","url":null,"abstract":"Background: Motor impairment in the arms is common after stroke and many individuals participate in therapy to improve function. It is assumed that individuals with stroke can adapt and improve their movements using feedback that arises from movement or is provided by a therapist. Here we investigated visuomotor adaptation in individuals with sub-acute and chronic stroke. Objective: We examined the impact of the stroke-affected arm (dominant or non-dominant), time post-stroke, and relationships with clinical measures of motor impairment and functional independence. Methods: Participants performed reaching movements with their arm supported in a robotic exoskeleton. We rotated the relationship between the motion of the participant’s hand and a feedback cursor displayed in their workspace. Outcome measures included the amount that participants adapted their arm movements and the number of trials they required to adapt. Results: Participants with stroke (n = 36) adapted less and required more trials to adapt than controls (n = 29). Stroke affecting the dominant arm impaired the amount of adaptation more than stroke affecting the non-dominant arm. Overall, 53% of participants with stroke were impaired in one or more measures of visuomotor adaptation. Initial adaptation was weakly correlated with time post-stroke, and the amount of adaptation correlated moderately with clinical measures of motor impairment and functional independence. Conclusion: Our findings reveal impairments in visuomotor adaptation that are associated with motor impairment and function after stroke. Longitudinal studies are needed to understand the relationship between adaptation and recovery attained in a therapy setting.","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":"36 1","pages":"415 - 425"},"PeriodicalIF":4.2,"publicationDate":"2022-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44682725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Repetitive Transcranial Magnetic Stimulation on Motor Symptoms in Parkinson’s Disease: A Meta-Analysis","authors":"Ruoyu Li, Yijing He, Wenting Qin, Zhuoyu Zhang, Junhui Su, Q. Guan, Yuhui Chen, Lingjing Jin","doi":"10.1177/15459683221095034","DOIUrl":"https://doi.org/10.1177/15459683221095034","url":null,"abstract":"Background Transcranial magnetic stimulation (TMS) is a non-invasive neuromodulation technique that has been closely examined as a possible treatment for Parkinson’s disease (PD). Owing to various rTMS protocols and results, the optimal mode and suitable PD symptoms have yet to be established. Objectives This study intends to systematically evaluate the efficacy of rTMS intervention and identify optimal stimulation protocol of rTMS for specific motor symptoms. Methods PubMed and web of Science databases were searched before January 2022. Eligible studies included sham-controlled and randomized clinical trials of rTMS intervention for motor dysfunction in patients with PD. Standard mean difference (SMD) was calculated with random-effects models. The effects of rTMS on motor symptoms were mainly estimated by the UPDRS-III. Results A total of 1172 articles were identified, of which 32 articles met the inclusion criteria for meta-analysis. The pooled evidence suggested that rTMS relieves motor symptoms of patients with PD (SMD 0.64, 95%CI [0.47, 0.80]). High frequency stimulation on M1 is the most effective mode of intervention (SMD 0.79, 95%CI [0.52, 1.07]). HF rTMS has significant therapeutic effects on limbs motor function (SMD 1.93, 95%CI [0.73, 3.12] for upper limb function and SMD 0.88, 95%CI [0.43, 1.33] for lower limb function), akinesia (SMD 1.17, 95%CI [0.43, 1.92), rigidity (SMD 1.02, 95%CI [0.12, 1.92]) and tremor(SMD 0.91, 95%CI [0.15, 1.67]). Conclusion rTMS therapy is an effective treatment for motor symptoms of PD and the individualized stimulation protocols for different symptoms would further improve its clinical efficacy.","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":"36 1","pages":"395 - 404"},"PeriodicalIF":4.2,"publicationDate":"2022-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48175197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}