{"title":"Update on Non-invasive Brain Stimulation on Stroke Motor Impairment: A Narrative Review.","authors":"Sejoon Kim, Hae-Yeon Park","doi":"10.12786/bn.2024.17.e5","DOIUrl":"https://doi.org/10.12786/bn.2024.17.e5","url":null,"abstract":"<p><p>Stroke is a leading global cause of death and disability, with motor impairment being one of the common post-stroke complications. Rehabilitation is crucial for functional recovery. Recently, non-invasive brain stimulation (NIBS) has emerged as a promising intervention that allows neuromodulation by activating or inhibiting neural activity in specific brain regions. This narrative review aims to examine current research on the effects of various NIBS techniques, including repetitive transcranial magnetic stimulation, transcranial direct current stimulation, vagus nerve stimulation, and transcranial focused ultrasound on post-stroke motor function.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"17 1","pages":"e5"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856086","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}
Hee-Mun Cho, Hyunji Kim, Jihui Jang, Seungwoo Cha, Won Kee Chang, Bong-Keun Jung, Dae-Sung Park, Sungju Jee, Sung-Hwa Ko, Joon-Ho Shin, Ji Soo Choi, Won-Seok Kim, Nam-Jong Paik
{"title":"Attitude Toward Virtual Rehabilitation and Active Video Games Among Therapists in Korea: A Nationwide Survey.","authors":"Hee-Mun Cho, Hyunji Kim, Jihui Jang, Seungwoo Cha, Won Kee Chang, Bong-Keun Jung, Dae-Sung Park, Sungju Jee, Sung-Hwa Ko, Joon-Ho Shin, Ji Soo Choi, Won-Seok Kim, Nam-Jong Paik","doi":"10.12786/bn.2024.17.e4","DOIUrl":"https://doi.org/10.12786/bn.2024.17.e4","url":null,"abstract":"<p><p>In this study, we conducted a survey targeting 191 physical therapists (PTs) and 159 occupational therapists (OTs) in South Korea to explore attitudes toward virtual rehabilitation. Utilizing the Korean version of the ADOPT VR by Glegg et al., OT exhibited significantly more experience with virtual reality (VR) and active video games (AVG) than PT. Therapists with VR/AVG experience scored significantly higher in most categories, and the scores in each category were significantly correlated with the Behavioral Intention category, reflecting the willingness to use VR/AVG. The biggest barriers identified were insufficient funds and setup assistance for the equipment. Differences in responses between the groups with and without VR/AVG experience were most prominent in terms of lack of interest and funding. Therapists' attitudes, perceptions, and intentions toward VR/AVG are crucial factors in the establishment and implementation of VR/AVG; thus, the results of this study provide valuable evidence for future policies related to VR/AVG in rehabilitation medicine.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"17 1","pages":"e4"},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873234","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":"Intrathecal Baclofen Injection Efficacy for Spasticity Management in Patients With Stroke: A Meta-Analysis.","authors":"Ki Deok Park, Min-Keun Song","doi":"10.12786/bn.2024.17.e3","DOIUrl":"https://doi.org/10.12786/bn.2024.17.e3","url":null,"abstract":"<p><p>Although intrathecal baclofen injections have been used for spasticity management regarding stroke, spinal cord injury, and central nervous system diseases, their relative efficacy is controversial. This systematic review scoured 3 multinational electronic databases (Cochrane Library, MEDLINE, and Embase) to isolate relevant studies. We analyzed non-randomized studies and randomized control trials (RCTs) with direct comparisons against other spasticity management interventions for adult stroke patients. Risk of Bias (RoB) and the Risk of Bias Assessment tool for Non-randomized Studies evaluations were implemented with Cochrane's RoB tool. Meta-analysis was performed with Revman 5.4, and evidence validity was assessed with the Grading of Recommendations, Assessment, Development, and Evaluations method. Lastly, the intrathecal baclofen injection meta-analysis included 2 RCTs and 7 non-RCTs for assessing spasticity and 4 non-RCTs to measure gait velocity. Based on this data, intrathecal baclofen injection significantly impacted spasticity and gait speed. Thus, intrathecal baclofen injection can potentially treat severe spasticity unresponsive to conventional spasticity therapy. Furthermore, clinicians must consider individual patient characteristics and conditions when contemplating intrathecal baclofen injection for spasticity intervention.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"17 1","pages":"e3"},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872391","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}
Young-Su Ku, Kyung-Lim Joa, Myeong-Ok Kim, Chang-Hwan Kim, Han-Young Jung
{"title":"Quadriplegia, Dysphagia and Ataxia Manifested in a Child With COVID-19 Related Acute Necrotizing Encephalopathy: A Case Report.","authors":"Young-Su Ku, Kyung-Lim Joa, Myeong-Ok Kim, Chang-Hwan Kim, Han-Young Jung","doi":"10.12786/bn.2024.17.e2","DOIUrl":"https://doi.org/10.12786/bn.2024.17.e2","url":null,"abstract":"<p><p>Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, presents primarily with respiratory symptoms. However, children with COVID-19 are usually asymptomatic or mild acute symptoms and also neurological manifestations have also been observed. We report the case of a 7-year-old girl who presented with high fever and altered mental status, leading to a diagnosis of COVID-19 and acute necrotizing encephalopathy (ANE). The patient received intensive medical care in the intensive care unit and subsequently underwent rehabilitation programs due to neurological functional sequelae. Neurological complications in COVID-19, including ANE, may result from potential viral nerve involvement, cytokine storms, and the blood-brain barrier disruption. Early rehabilitation plays a pivotal role in managing COVID-19-related neurological complications and enhancing patients' functional outcomes. Further research is essential to gain a better understanding of the mechanisms and treatment strategies for neurological manifestations in pediatric COVID-19 patients, particularly those with multisystem inflammatory syndrome in child.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"17 1","pages":"e2"},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862049","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}
Mijung Jang, Heedong Park, Miyoung Kim, Galam Kang, Hayan Shin, Donghyun Shin, KyooSang Kim
{"title":"Health-Related Quality of Life of Post-Stroke Patients in a Public Hospital.","authors":"Mijung Jang, Heedong Park, Miyoung Kim, Galam Kang, Hayan Shin, Donghyun Shin, KyooSang Kim","doi":"10.12786/bn.2024.17.e1","DOIUrl":"https://doi.org/10.12786/bn.2024.17.e1","url":null,"abstract":"<p><p>This study aimed to identify the correlation between influencing factors of activities of daily living (ADLs), mental health, and health-related quality of life (HRQoL) among post-stroke patients who enrolled in a transitional care service in a public hospital. This cross-sectional study involved 67 stroke patients who were enrolled in a transitional care service and visited the outpatient clinic at a public hospital in Seoul between March and December 2022. Their general characteristics, ADLs, mental health, and HRQoL were assessed. The data were analyzed using independent samples t-tests, analysis of variance, and Pearson correlation analysis, and the influencing factors were analyzed using regression analysis. HRQoL showed a statistically significant difference between patients living in different types of arrangements (t = 2.50, p = 0.015), and patients scores on the modified Rankin Scale (t = 7.08, p < 0.001). HRQoL was also significantly correlated with ADLs and mental health in stroke patients (r = -0.59, p < 0.001; r = -0.41, p < 0.001, respectively). Meanwhile, stroke severity (β = -0.30, p = 0.002), living arrangements (β = -0.30, p = 0.009) and ADLs (β = -0.45, p < 0.001) were found to influence HRQoL (F = 6.87, p < 0.001, R<sup>2</sup> = 0.47). Reduced dependence for ADLs, improvements in symptoms consequent to stroke, and support related to living arrangements contributed to improved HRQoL and interventions for post-stroke patients in the transitional care service of a public hospital.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"17 1","pages":"e1"},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140875056","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":"Cerebral Infarction and Recovery in a 12-Year-Old Child With Intracranial Fibromuscular Dysplasia.","authors":"Min Hwan Kim, Jae In Lee, Shin-Seung Yang","doi":"10.12786/bn.2023.16.e35","DOIUrl":"10.12786/bn.2023.16.e35","url":null,"abstract":"<p><p>Fibromuscular dysplasia (FMD) is a congenital vascular anomaly resulting in arterial stenosis and weakening of typically medium-sized arteries. It is a noninflammatory, nonatherosclerotic arterial disease that affects most commonly the renal and internal carotid arteries, but intracranial FMD in the pediatric population is very rare. We report a young age-onset ischemic stroke patient with FMD affecting the middle cerebral artery (MCA). A 14-year-old boy was admitted with left-side weakness during physical education at school. The brain magnetic resonance (MR) imaging revealed an acute ischemic stroke in the right basal ganglia and internal capsule, while the MR angiogram showed segmental intraluminal stenosis in the left proximal MCA. The transfemoral angiography revealed the pathognomonic sign of a \"string of beads\" at the proximal MCA area. The clinical course was stable, and the boy gradually recovered from the motor weakness of his arm and leg. FMD should be considered as a potential cause of pediatric stroke.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"16 3","pages":"e35"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10689862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479682","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}
Jeongeun Lee, Eunjee Lee, Shahid Bashir, Gyu Jin Kim, Suk Hoon Ohn, Kwang-Ik Jung, Woo-Kyoung Yoo
{"title":"Compensatory Hyperactivity of the Ipsilesional Red Nucleus in a Patient With Somatosensory Cortex Damage: A Case Report.","authors":"Jeongeun Lee, Eunjee Lee, Shahid Bashir, Gyu Jin Kim, Suk Hoon Ohn, Kwang-Ik Jung, Woo-Kyoung Yoo","doi":"10.12786/bn.2023.16.e33","DOIUrl":"10.12786/bn.2023.16.e33","url":null,"abstract":"<p><p>This case study describes a patient who experienced motor recovery and involuntary movements following damage to the right primary somatosensory cortex caused by an intracranial hemorrhage. The patient initially suffered from paralysis in her left arm and leg, but exhibited significant motor recovery later, accompanied by multiple episodes of ballistic movement during the recovery process. A diffusion tensor imaging analysis was performed to investigate changes in sensorimotor-related brain areas in the patient. The patient had higher fractional anisotropy and lower mean diffusivity values in the ipsilesional red nucleus (RN) than age-matched controls. We assume that hyperactivity of the ipsilesional RN might play a role in motor recovery after damage to the primary somatosensory cortex, potentially through its involvement in sensorimotor integration. Our findings demonstrated the potential for adaptive changes in the ipsilesional RN following damage to the primary somatosensory cortex.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"16 3","pages":"e33"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10689868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479684","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}
Jeongeun Lee, Gyu Jin Kim, Shahid Bashir, Eunjee Lee, Suk Hoon Ohn, Kwang-Ik Jung, Woo-Kyoung Yoo
{"title":"Heterogeneous Diffusion Metrics Patterns in Delayed Encephalopathy After Acute Carbon Monoxide Poisoning: A Case Report.","authors":"Jeongeun Lee, Gyu Jin Kim, Shahid Bashir, Eunjee Lee, Suk Hoon Ohn, Kwang-Ik Jung, Woo-Kyoung Yoo","doi":"10.12786/bn.2023.16.e34","DOIUrl":"10.12786/bn.2023.16.e34","url":null,"abstract":"<p><p>Delayed encephalopathy (DE) following acute carbon monoxide (CO) poisoning is characterized by a wide range of neurological symptoms, including akinetic mutism, cognitive impairment, and gait disturbances. Herein, we reported the case of a 61-year-old patient with DE after acute CO poisoning, who displayed heterogeneous patterns of cortical and subcortical structural integrity on diffusion tensor imaging (DTI). Four distinct patterns of diffusion tensor metrics (fractional anisotropy [FA] and mean diffusivity [MD]) were observed in the patient compared to age-matched controls (a decrease in FA and an increase in MD, a decrease in FA only, an increase in MD only, and an increase in FA and MD). This study revealed heterogeneous patterns of cortical and subcortical damage associated with DE after CO poisoning, contributing to a deeper understanding of the diverse clinical symptoms observed in this patient.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"16 3","pages":"e34"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10689858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479686","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}
Marya Hameed, Fatima Siddiqui, Fahad Hassan Sheikh, Muhammad Khuzzaim Khan, Bushra Admani, Prasanna Kumar Gangishetti
{"title":"Borjeson-Forssman-Lehmann Syndrome: Clinical Features and Diagnostic Challenges.","authors":"Marya Hameed, Fatima Siddiqui, Fahad Hassan Sheikh, Muhammad Khuzzaim Khan, Bushra Admani, Prasanna Kumar Gangishetti","doi":"10.12786/bn.2023.16.e32","DOIUrl":"10.12786/bn.2023.16.e32","url":null,"abstract":"<p><p>Borjeson-Forssman-Lehmann syndrome (BFLS) is an X-linked recessive disorder resulting from mutations in the <i>PHF6</i> gene. The syndrome is characterized by short stature, obesity, hypogonadism, hypotonia, intellectual disability, distinctive facial features, fleshy ears, and finger and toe abnormalities. However, the diagnostic challenge in identifying BFLS remains a topic of interest. In this case report, we present the clinical characteristics of a proband with BFLS, highlighting the additional features of hypotonia, intellectual disability, and distinctive facial features. While no definitive treatment exists for BFLS, patients benefit from specialized education and ongoing supervision from early childhood through adulthood. Symptomatic treatment, including close follow-up, may be necessary for complications such as seizures and hearing problems. Mastectomy or testosterone replacement therapy may be considered on a case-by-case basis. Genetic counseling for X-linkage should be offered to affected families.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"16 3","pages":"e32"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10689860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138480029","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":"Spontaneous Cortical Intracerebral Hemorrhage Causing Ipsilateral Hand and Oral Sensory Change Without Motor Deficit: A Case Report.","authors":"Minwoo Kim, Donghyun Shin, Songi Han, Jusun Oh","doi":"10.12786/bn.2023.16.e30","DOIUrl":"10.12786/bn.2023.16.e30","url":null,"abstract":"<p><p>Intracerebral hemorrhage (ICH) is the second most common stroke subtype associated with high morbidity and mortality rates. Although various brain regions are susceptible to ICH, putaminal hemorrhage is the most common, whereas cortical ICH is less common. Here, we report the case of a 69-year-old man who developed a parietal cortical ICH. The patient developed hypoesthesia and paresthesia in the right upper lip and hand; however, the weakness was not severe. Twenty-five days after the ICH onset, the manual muscle test results were normal, but he had difficulty eating and shaving because of decreased hand dexterity. The rehabilitation focused on improving fine hand motor function and endurance. On the 94th day after ICH onset, paresthesia remained only in the fingertips, and the upper lip sensory change disappeared. Patients with sensory symptoms in the perioral area, hands, and brain lesions were previously referred to as having cheiro-oral syndrome (COS). With the advancement of neuroimaging, the use of this term has decreased, as cerebrovascular events can explain patient symptoms in correlation with neuroanatomy, etiology, and pathogenesis. We report a patient with cortical ICH, also known as COS, which is a stroke syndrome with a good prognosis.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"16 3","pages":"e30"},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10689855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479688","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}