Bo Mi Kwon, Yejin Lee, Hyun Haeng Lee, Nayeon Ko, Hyuntae Kim, Bo-Ram Kim, Won-Jin Moon, Jongmin Lee
{"title":"Relationship Between Ipsilesional Upper Extremity Motor Function and Corpus Callosum Integrity in Patients With Unilateral Stroke: A Diffusion Tensor Imaging Study.","authors":"Bo Mi Kwon, Yejin Lee, Hyun Haeng Lee, Nayeon Ko, Hyuntae Kim, Bo-Ram Kim, Won-Jin Moon, Jongmin Lee","doi":"10.12786/bn.2022.15.e7","DOIUrl":"https://doi.org/10.12786/bn.2022.15.e7","url":null,"abstract":"<p><p>This study aims to investigate the relationship between ipsilesional upper extremity (UE) motor function and the integrity of the subregions of the corpus callosum in hemiparetic stroke patients with motor deficits of the dominant or non-dominant ipsilesional side. Twenty participants with unilateral UE deficits after stroke were included. Each of the 10 participants had lesions on the left and right sides. The ipsilesional UE function was assessed with the Jebsen-Taylor hand function test (JHFT), the 9-hole peg test (9HPT), and grip and pinch strength tests. Fractional anisotropy (FA) was calculated for the integrity of the 5 subregions of the corpus callosum. Pearson's correlation analysis was conducted to investigate the relationship between UE function and the integrity of the callosal subregions. The results of JHFT and 9HPT showed a significant correlation with the FA value of the corpus callosum I projecting to the frontal lobe in the left lesion group (p < 0.05). There was no correlation between the ipsilesional UE motor function and the FA value of the ulnar subregion in the right lesion group (p > 0.05). These results showed that the motor deficits of the ipsilesional UE correlated with the integrity of callosal fiber projection to the prefrontal area when the ipsilesional side was non-dominant.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"15 1","pages":"e7"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3e/e6/bn-15-e7.PMC9833466.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10667740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bo Mi Kwon, Jin-Youn Lee, Nayeon Ko, Bo-Ram Kim, Won-Jin Moon, Dong-Hee Choi, Jongmin Lee
{"title":"Correlation of Hemispatial Neglect with White Matter Tract Integrity: A DTI Study.","authors":"Bo Mi Kwon, Jin-Youn Lee, Nayeon Ko, Bo-Ram Kim, Won-Jin Moon, Dong-Hee Choi, Jongmin Lee","doi":"10.12786/bn.2022.15.e6","DOIUrl":"https://doi.org/10.12786/bn.2022.15.e6","url":null,"abstract":"<p><p>We investigated the diffusion tensor image (DTI) parameters of superior longitudinal fasciculus (SLF) and inferior fronto-occipital fasciculus (IFOF), and their relationships with hemispatial neglect. Thirteen patients with first-ever ischemic stroke who had the right hemispheric lesion were included. Neglect was assessed using the Albert test and figure discrimination test of Motor-free Visual Perception Test 3 (MVPT-3). The SLF and IFOF were separated by diffusion tensor tractography (DTT) and tract volume (TV) was calculated. We measured the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in the total area, seed region of interest (ROI), and target ROI, respectively. Among thirteen patients, seven demonstrated signs of hemispatial neglect on neglect test. Tractography reconstruction showed significantly low TV of the right IFOF in patients with hemispatial neglect. FA values of the right SLF and the right IFOF were significantly lower in neglect patients. ADC values were not significantly different in two groups. This study suggests that damage of SLF and IFOF is associated with hemispatial neglect in right hemispheric stroke patients. DTI may be useful for predicting the severities of hemispatial neglect using values such as TV and FA of each tract.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"15 1","pages":"e6"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/be/c0/bn-15-e6.PMC9833463.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10667741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Multidisciplinary Rehabilitation for Relapsing Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease: A Case Report.","authors":"Jong Mi Park, Yongwook Kim, Soojin Choi","doi":"10.12786/bn.2022.15.e9","DOIUrl":"https://doi.org/10.12786/bn.2022.15.e9","url":null,"abstract":"<p><p>Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an inflammatory central nervous system disease that is driven by antibodies of the immunoglobulin G1 class. MOGAD has recently been recognized as an autoimmune disease; therefore, little is known about its rehabilitation. Here, we present a case of MOGAD that showed significant recovery after rehabilitation. A 58-year-old woman developed weakness in all extremities, dysarthria, and dysphagia. She visited the neurology department, and early brain and spine magnetic resonance imaging showed multifocal high intensity in the subcortical and periventricular white matter and the cervical cord. The patient's serum tested positive for anti-MOG antibodies. She was diagnosed with MOGAD and received intravenous steroid pulse therapy. After pharmacologic therapy, the patient was transferred to the rehabilitation department. Initially, her Functional Independence Measure (FIM) motor score was 26, allowing her to stand independently for only a few seconds. After 5 weeks of rehabilitation involving physical therapy, occupational therapy, and balance training, her FIM motor score improved to 60. However, 4 months after discharge, the disease relapsed with symptoms of motor weakness in all extremities, and steroid treatment was initiated. On the second admission, her FIM motor score was 42, but after continuous multidisciplinary rehabilitation, it improved to 76. Computerized cognitive therapy improved her cognitive function, from a Korean version of the Mini-Mental State Examination score of 23 on the first admission to 30 on final discharge. Since MOGAD is a relapsing disease, a favorable outcome can be achieved with continuous monitoring and multidisciplinary, symptom-specific rehabilitation.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"15 1","pages":"e9"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/5d/bn-15-e9.PMC9833465.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10660618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Importance of Nutrition in Neurological Disorders and Nutrition Assessment Methods.","authors":"Hosun Lee","doi":"10.12786/bn.2022.15.e1","DOIUrl":"https://doi.org/10.12786/bn.2022.15.e1","url":null,"abstract":"<p><p>Neurological disorders can change patients' nutritional status by directly or indirectly affecting dietary intake through mechanisms such as dysphagia, movement disorders, cognitive impairment, and depression. Malnutrition contributes to complications, resulting in delayed rehabilitation and increased morbidity and mortality. It is important to prevent malnutrition in patients with neurological disorders and to improve their nutritional status by identifying nutritional deterioration at an early stage and implementing appropriate nutritional interventions. This review examines the nutritional screening and assessment process in patients with neurological disorders, with a particular focus on stroke patients undergoing rehabilitation. Nutritional assessment, the first step of clinical nutrition management, identifies nutritional problems and their causes, signs, and symptoms through an overall evaluation including anthropometric measurements, dietary assessments, biochemical assessment, nutrition-related physical examinations, and functional assessment data. Based on the assessment, a nutritional intervention plan is established. By synthesizing the assessment results of selected subjective and objective indicators, nutritional screening tools to screen patients at risk of malnutrition and nutritional assessment tools to diagnose malnutrition were developed. It is important to use those tools with a clear understanding of their characteristics and scope.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"15 1","pages":"e1"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/82/46/bn-15-e1.PMC9833464.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10667742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Erratum: Effect of Repetitive Transcranial Magnetic Stimulation on Post-stroke Non-fluent Aphasia in Relation with Broca's Area.","authors":"Sung-Hwa Ko","doi":"10.12786/bn.2022.15.e11","DOIUrl":"https://doi.org/10.12786/bn.2022.15.e11","url":null,"abstract":"<p><p>[This corrects the article e15 in vol. 14.].</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"15 1","pages":"e11"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e4/63/bn-15-e11.PMC9833458.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9221492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Successful Control of Intractable Myoclonus in a Patient With Hypoxic Brain Injury After Intrathecal Baclofen Therapy: A Case Report.","authors":"Geon Jae Lee, Hyoung Seop Kim","doi":"10.12786/bn.2022.15.e10","DOIUrl":"https://doi.org/10.12786/bn.2022.15.e10","url":null,"abstract":"<p><p>Myoclonus is an abrupt arrhythmic condition with shock-like movements that can be triggered by sensory stimuli, affecting the trunk or limbs during voluntary movement. Since motor symptoms are often not easily treatable, various pharmacological treatment options have been suggested. We report a case of using intrathecal baclofen (ITB) therapy in a patient with hypoxic brain injury (HBI), leading to the alleviation of myoclonus. A 29-year-old woman repeatedly presented with generalized myoclonus and multiple joint contractures at both upper and lower limbs after resuscitation. She cried during intractable myoclonus events, making it difficult for her to maintain a good sleep pattern. Due to the persistent status of multiple joint contractures and intractable myoclonus, we offered an ITB trial to control her symptoms. After ITB, her total scores on the Unified Myoclonus Rating Scale progressively improved as the doses of baclofen increased. Therefore, ITB therapy should be considered as a substantial option in the management of intractable myoclonus in patients with HBI to prevent various complications and improve the quality of life.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"15 1","pages":"e10"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/fd/bn-15-e10.PMC9833462.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10667737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rehabilitation Service for Traumatic Brain Injury in Korea: Increasing Burden and Challenges.","authors":"Sung-Hwa Ko","doi":"10.12786/bn.2021.14.e21","DOIUrl":"10.12786/bn.2021.14.e21","url":null,"abstract":"","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"14 3","pages":"e21"},"PeriodicalIF":0.0,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f1/ce/bn-14-e21.PMC9879378.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10716082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nayeon Ko, Hyun Haeng Lee, Kyungmin Kim, Bo-Ram Kim, Won-Jin Moon, Jongmin Lee
{"title":"Role of Cortico-ponto-cerebellar Tract from Supplementary Motor Area in Ataxic Hemiparesis of Supratentorial Stroke Patients.","authors":"Nayeon Ko, Hyun Haeng Lee, Kyungmin Kim, Bo-Ram Kim, Won-Jin Moon, Jongmin Lee","doi":"10.12786/bn.2021.14.e22","DOIUrl":"https://doi.org/10.12786/bn.2021.14.e22","url":null,"abstract":"<p><p>Cortical lesions of the supplementary motor area (SMA) are important in balance control and postural recovery in stroke patients, while the role of subcortical lesions of the SMA has not been studied. This study aimed to investigate the subcortical projections of the SMA and its relationship with ataxia in supratentorial stroke patients. Thirty-three patients with hemiparesis were divided into 3 groups (severe ataxia, n = 9; mild to moderate ataxia, n = 13; no ataxia, n = 11). Ataxia severity was assessed using the Scale for Ataxia Rating Assessment. Diffusion tensor imaging analysis used the fractional anisotropy (FA) values and tract volume as parameters of white matter tract degeneration. The FA values of regions related to ataxia were analyzed, that is the SMA, posterior limb of the internal capsule, basal ganglia, superior cerebellar peduncle, middle cerebellar peduncle, inferior cerebellar peduncle, and cerebellum. Tract volumes of the corticostriatal tract and cortico-ponto-cerebellar (CPC) tract originating from the SMA were evaluated. There were significant differences among the 3 groups in FA values of the subcortical regions of the CPC tract. Furthermore, the volume of the CPC tract originating from the SMA showed significant negative correlation with ataxia severity. There was no correlation between ataxia and corticostriatal tract volume. Therefore, we found that subcortical lesions of the CPC tract originating from the SMA could contribute to ataxia severity in stroke patients with ataxic hemiparesis.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"14 3","pages":"e22"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f9/23/bn-14-e22.PMC9879374.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10661229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sang Wan Lee, Hojin Lee, Jeehyun Yoo, Jiyong Kim, Kil-Byung Lim
{"title":"Sick Sinus Syndrome Combined with Wallenberg Syndrome: a Case Report.","authors":"Sang Wan Lee, Hojin Lee, Jeehyun Yoo, Jiyong Kim, Kil-Byung Lim","doi":"10.12786/bn.2021.14.e27","DOIUrl":"https://doi.org/10.12786/bn.2021.14.e27","url":null,"abstract":"<p><p>Cardiac arrhythmia is a rare manifestation of the Wallenberg syndrome; lesions are located in the brainstem, especially the lower medulla, which regulates sympathetic and parasympathetic activity. A 55-year-old man was admitted to the university hospital with symptoms including ataxia, left ptosis, decreased sensation of pain and temperature on the right side, left facial numbness, and dizziness. Brain magnetic resonance imaging revealed an infarction in the left dorsolateral medulla. Therefore, he was diagnosed with Wallenberg syndrome. While he underwent conservative treatment for Wallenberg syndrome, he experienced several events of self-limiting heart pounding, which required an evaluation of cardiac function. The 24-hour Holter monitor showed an increased RR interval with bradycardia and prolonged sinus pause. As a result, the diagnosis of sick sinus syndrome combined with Wallenberg syndrome was made. Sick sinus syndrome is a rare cardiac complication of the Wallenberg syndrome, and clinicians could overlook it when the initial electrocardiography shows a normal sinus rhythm. Sick sinus syndrome can cause sudden death without appropriate medical intervention. Therefore, clinicians should consider further evaluation, including a 24-hour Holter monitor, to check for the potential presence of sick sinus syndrome in the acute phase of Wallenberg syndrome.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"14 3","pages":"e27"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a1/ca/bn-14-e27.PMC9879381.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10661228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gyu Seong Kim, Yeon Gyu Jeong, Yoon Jeong Jeong, Seo Yeon Yoon
{"title":"Hemidystonia after Pontine Hemorrhage Successfully Treated with Pharmacotherapy and Intensive Rehabilitation: a Case Report.","authors":"Gyu Seong Kim, Yeon Gyu Jeong, Yoon Jeong Jeong, Seo Yeon Yoon","doi":"10.12786/bn.2021.14.e28","DOIUrl":"https://doi.org/10.12786/bn.2021.14.e28","url":null,"abstract":"<p><p>Dystonia is a movement disorder characterized by involuntary contraction of muscles resulting in repetitive or twisting movements. Dystonia is generally caused by basal ganglia dysfunction. Recent studies have reported an association between dystonia and brainstem disorders. However, the pathological mechanism is uncertain, and detailed management strategies are limited. Here, we report a case of hemidystonia with abnormal posture and impaired proprioception after pontine hemorrhage that was effectively treated with pharmacotherapy combined with early intensive comprehensive rehabilitation. A 45-year-old man presented with abnormal posture and dystonic movement in the right hand and foot after a pontine hemorrhagic stroke. Pharmacotherapy with clonazepam and benztropine was administered, and comprehensive rehabilitation programs were implemented intensively from the early stages of symptom onset. After 3 months, the patient was able to walk independently, go up and down a few stairs without the use of a handrail, and was able to perform activities of daily living with minimal assistance.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"14 3","pages":"e28"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4c/ec/bn-14-e28.PMC9879375.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10661227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}