Neurorehabilitation and neural repair最新文献

{"title":"Conditioning Electrical Stimulation Fails to Enhance Sympathetic Axon Regeneration.","authors":"Tina Tian, Kevin Patel, David Kim, HaoMin SiMa, Alandrea R Harris, Jordan N Owyoung, Patricia J Ward","doi":"10.1177/15459683251335321","DOIUrl":"10.1177/15459683251335321","url":null,"abstract":"<p><strong>Background: </strong>Peripheral nerve injuries are common, and there is a critical need for the development of novel treatments to complement surgical repair. Conditioning electrical stimulation (ES; CES) is a novel variation of the well-studied perioperative ES treatment paradigm. CES is a clinically attractive alternative because of its ability to be performed at the bedside prior to a scheduled nerve repair surgery.</p><p><strong>Objectives: </strong>Although 60 minutes of CES has been shown to enhance motor and sensory axon regeneration, the effects of CES on sympathetic regeneration are unknown. We investigated how 2 clinically relevant CES paradigms (10 and 60 minutes) impact sympathetic axon regeneration and distal target reinnervation.</p><p><strong>Results: </strong>Our results indicate that the growth of sympathetic axons is inhibited by CES at acute time points, and at a longer survival time point post-injury, there is no difference between sham CES and the CES groups. Furthermore, 10-minute CES did not enhance motor and sensory regeneration with a direct repair, and neither 60-minute nor 10-minute CES enhanced motor and sensory regeneration through a graft.</p><p><strong>Conclusion: </strong>We conclude sympathetic axons may retain some regenerative ability, but no enhancement is exhibited after CES, which may be accounted for by the inability of the ES paradigm to recruit the small-caliber sympathetic axons into activity. Further studies will be needed to optimize ES parameters to enhance the regeneration of all neuron types.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"515-528"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to: Murakami et al. (2023).","authors":"","doi":"10.1177/15459683251341565","DOIUrl":"10.1177/15459683251341565","url":null,"abstract":"","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"584-587"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlates of Processing Speed Change With Combined Cognitive Rehabilitation and Exercise in Progressive MS: Secondary Analysis of the CogEx Trial.","authors":"Brian M Sandroff, Robert W Motl, Roberto S Hernandez, Maria Pia Amato, Giampaolo Brichetto, Jeremy Chataway, Nancy D Chiaravalloti, Gary R Cutter, Ulrik Dalgas, John DeLuca, Rachel Farrell, Peter Feys, Massimo Filippi, Jennifer Freeman, Matilde Inglese, Cecilia Meza, Maria A Rocca, Amber Salter, Anthony Feinstein","doi":"10.1177/15459683251331586","DOIUrl":"10.1177/15459683251331586","url":null,"abstract":"<p><p>BackgroundCognitive rehabilitation and exercise training are promising approaches for improving cognition in persons with progressive multiple sclerosis (MS). Identifying heterogeneity of change and factors that influence the effects of cognitive rehabilitation and/or exercise training on cognitive outcomes at the individual level have direct relevance for developing tailored and optimized rehabilitation interventions for improving cognition in progressive MS.ObjectiveThis study involved a secondary data analysis from the CogEx trial in progressive MS. This study first described heterogeneity of change in cognitive processing speed (CPS) across the intervention conditions and then identified possible adherence/compliance, baseline performance, and demographic/clinical variables as correlates of rehabilitation-related CPS changes.MethodsA total of 311 persons with progressive MS who were pre-screened for impaired CPS completed 12 weeks of combined cognitive rehabilitation (or sham) and exercise training (or sham). CPS was measured before and after the 12-week period. As potential correlates of CPS changes, we measured adherence/compliance (ie, treatment exposure), performance outcomes at baseline, as well as demographic and clinical characteristics at baseline.ResultsThere was heterogeneity of change in CPS across the 4 intervention conditions. We further identified baseline learning and memory impairment and premorbid intelligence quotient (IQ), but not adherence/compliance, other baseline performance outcomes, or demographic/clinical characteristics as significant correlates of CPS changes across the 4 intervention conditions.ConclusionsThe overall pattern of results suggests that future trials in this area might account for impaired learning and memory and/or premorbid IQ as potential covariates, or more carefully consider the role of reserve within rehabilitation interventions in progressive MS.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"499-514"},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discordance Between Balance Ability and Perception and Its Relation to Falls in Parkinson's Disease: A Replication Analysis.","authors":"Jason K Longhurst, Andrew Hooyman, Franziska Albrecht, Erika Franzén, Daniel S Peterson","doi":"10.1177/15459683251335316","DOIUrl":"10.1177/15459683251335316","url":null,"abstract":"<p><strong>Background: </strong>Falls are a common challenge for people with Parkinson's disease (PwPD), driven by balance impairments and misaligned perceptions of balance abilities.</p><p><strong>Objective: </strong>This study investigated the replicability and generalizability of the relationship between balance ability and perception discordance and fall risk.</p><p><strong>Methods: </strong>Using baseline data from 2 clinical trials involving 171 PwPD, discordance was calculated using the Activities Specific Balance Confidence Scale and Timed Up and Go (TUG) or the Mini Balance Evaluation System's Test (MiniBEST).</p><p><strong>Results: </strong>Findings supported the replicability of discordance as a predictor of fall risk, with results consistent across measures. While TUG-derived discordance was statistically significant, MiniBEST-derived discordance showed generalizability without statistical inferiority.</p><p><strong>Conclusion: </strong>These results emphasize the relevance of balance perception and its misalignment with ability as fall risk predictors.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"555-558"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035185","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":"Sleep Following a Stroke: Multimodal Evaluation of Sleep Health and Disruptions and Impact on Recovery During Acute Inpatient Rehabilitation.","authors":"Jacob Sindorf, Silvia Campagnini, Megan K O'Brien, Aashna Sunderrajan, Kristen L Knutson, Phyllis C Zee, Lisa Wolfe, Vineet M Arora, Arun Jayaraman","doi":"10.1177/15459683251335332","DOIUrl":"10.1177/15459683251335332","url":null,"abstract":"<p><p>BackgroundOur understanding of sleep during early stroke care and its impact on rehabilitation outcomes remains limited. The objectives of this work were to (1) evaluate multidimensional sleep health and disruptions during acute inpatient rehabilitation for individuals with stroke, and (2) explore the relationship between sleep health/disruptions and functional recovery.MethodsData from 103 individuals with stroke were analyzed during acute inpatient rehabilitation. Sleep health/disruptions were assessed via patient reports, actigraphy, and biometric sensors. Functional outcomes were measured at admission and discharge. Generalized Linear Models (GLMs) were used to describe changes in sleep health over time, and multivariate regressions analyzed sleep disruptions and sleep-related predictors of functional recovery.ResultsOver inpatient stays, sleep improved with a 23% reduction in wake after sleep onset and 15% fewer multiple overnight disruptions. GLMs revealed that improved sleep quality was associated with reduced overnight activity and increased heart rate over time. Poor initial sleep quality and cognitive status were associated with more overnight disruptions. Lastly, minimal associations were found between sleep health and functional recovery.ConclusionsSleep health during inpatient stroke rehabilitation is generally poor, though improves over time. Sleep is affected by neurological recovery and hospital environment. Overnight activity and autonomic biomarkers were associated with perceived sleep health, and both physiological and environmental factors triggered disruptions. The association between functional recovery and indirect indicators of sleep health requires further investigation. These findings reveal new insights about inpatient sleep which can inform early, targeted sleep interventions to optimize post-stroke outcomes.SIESTA, ClinicalTrials.gov (NCT04254484).</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"529-541"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035186","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":"Cognition and Measures of Physical Activity, Mobility, and Gait in Individuals With Multiple Sclerosis: A Systematic Review.","authors":"Myeongjin Bae, Michael VanNostrand","doi":"10.1177/15459683251335315","DOIUrl":"10.1177/15459683251335315","url":null,"abstract":"<p><p>IntroductionImpairments in cognition are prominent for individuals with multiple sclerosis (MS) and have been linked to low levels of physical activity (PA) and walking impairment. However, this relationship remains inconsistent, necessitating the synthesis of current literature to yield collective knowledge.ObjectiveTo investigate the relationship between cognition and measures of PA, mobility, and gait quality in individuals with MS.MethodsRelevant, peer-reviewed research articles were identified through a systematic search of MEDLINE, EMBASE, PsycINFO, SPORTSDiscus, and CINAHL from inception to April 2, 2024. Eligible studies explored the relationship between cognition and measures of PA, mobility, and gait quality. The Standard Quality Assessment Criteria for quantitative studies was employed for quality assessment.ResultsTwenty-six studies with a total of 3248 participants were identified in this review, of which 21 studies indicated strong methodological quality. Our review found that processing speed holds a significant relationship with PA volume, but not PA intensity metrics. Mobility and gait quality outcomes were associated with varying cognitive domains, including processing speed, executive function, verbal memory, and visuospatial memory. The magnitudes of the association between cognition and PA, mobility, and gait quality were mostly weak-to-moderate.ConclusionProcessing speed appears to be collectively associated with PA volume, mobility, and gait quality. However, the evidence supporting this conclusion is largely based on correlational studies involving individuals with mild-to-moderate ambulation disability, warranting future research.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"559-577"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher Doses of Intensive Upper Limb Rehabilitation for Moderate to Severe Impairment in Acute, Subacute Stroke: Phase I Dose Escalation Study.","authors":"Lisa Tedesco Triccas, Peter Hallet, Sofie Cardeynaels, Nick Ward, Nele Bertels, Liselot Thijs, Thierry Lejeune, Ilse Lamers, Annemie Spooren, Peter Feys","doi":"10.1177/15459683251338797","DOIUrl":"https://doi.org/10.1177/15459683251338797","url":null,"abstract":"<p><strong>Background: </strong>Optimizing moderate to severe upper limb recovery is likely to require a higher dose of rehabilitation training than is currently delivered, but the feasibility and acceptability of higher dose regimes is unclear in the early-stage post stroke. <b><i>Objective</i>:</b> To determine the maximum time spent on upper limb rehabilitation in people with moderate to severe impairment in acute and early sub-acute stage of stroke, in a phase I dose-escalation study.</p><p><strong>Methods: </strong>Participants were recruited using a 3+3 study design from 2 stroke units and rehabilitation centers in Belgium. Patients received standard care plus escalating doses of upper limb motor training at 4 dose time-on-task levels: 1 (40 minutes), 2 (67 minutes), 3 (100 minutes) and 4 (133 minutes). Treatment was provided for 3 daily sessions, starting with 3 participants at level 1 and if dose was completed based on dose-limiting toxicity criteria, it was escalated to the next level with 3 new participants.</p><p><strong>Results: </strong>Eighteen participants were recruited (median days post-stroke: 7.5 [Q1:5; Q3: 23.3]) with a mean Fugl Meyer Assessment Upper Extremity score of 29.4 (SD: 11.2). The maximum tolerated time-on-task of upper limb rehabilitation was, 100 minutes per day, with an additional 35 minutes of routine upper limb therapy provided as part of standard care. Level of fatigue and rate of perceived exertion were highest at dose level 4, resulting in participants not completing the dose of 133 minutes.</p><p><strong>Conclusions: </strong>Confirmative with existing literature using a different intervention, individuals with moderate to severe impairment in the early-stage of stroke, can tolerate higher doses of upper limb rehabilitation than those typically administered in standard care. These findings support future investigation into phase I/IIa dose-finding clinical trials exploring long-duration, high-intensity upper limb rehabilitation programs in the early post-stroke period.</p><p><strong>Registration: </strong>NCT04973553 (July 22, 2021). https://classic.</p><p><strong>Clinicaltrials: </strong>gov/ct2/show/NCT04973553.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251338797"},"PeriodicalIF":0.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of Motor Recovery after Subacute Cerebral Infarction: Role of Corticocerebellar Pathway Integrity.","authors":"Jing Liu, Yi Shan, Bi-Xiao Cui, Shao-Zhen Yan, Lin-Lin Ye, Lei Cao, Miao Zhang, Jie Lu","doi":"10.1177/15459683251351879","DOIUrl":"https://doi.org/10.1177/15459683251351879","url":null,"abstract":"<p><p>BackgroundThe cerebellar cortex has gradually become a promising therapeutic target for improving motor recovery post-cerebral infarction, potentially dependent on the structural integrity of motor-related corticocerebellar pathways (CCP). However, the relationship between the imaging markers of motor-related CCP and motor prognosis remains inadequately explored. Utilizing diffusion tensor imaging (DTI), this study aims to longitudinally assess the role of motor-related CCP in predicting motor recovery for both upper and lower extremities following cerebral infarction.MethodsTwenty-nine patients with right middle cerebral artery (MCA) infarction underwent 2 DTI scans 7 to 14 and 30 days after onset, and 29 age-sex matched controls received 1 scan. Fractional anisotropy (FA) values were measured for corticospinal tract (CST) and CCP (cortico-pontocerebellar tract, CPCT; dentate-thalamocortical tract, DTCT; dorsal-spinocerebellar tract, DSCT). Multivariate regression analyses were performed to examine the relationships between DTI parameters and Fugl-Meyer Assessment (FMA).ResultsCompared to the control group, FA and FA asymmetry index (FA-AI) of CST, DTCT, and DSCT on the affected side were significantly reduced. In the linear regression model, the decreased FA-AI of DTCT was a strong predictor for upper FMA (<i>R</i>²_<i>adj</i> = 0.271, <i>P</i> = .022), while the FA-AI of DSCT independently predicted lower limb FMA (<i>R</i>²_<i>adj</i> = 0.400, <i>P</i> = .019).ConclusionsIn patients of MCA infarction, FA-AI of motor-related CCP may be a valuable imaging indicator for predicting motor outcomes. The DTI-assessed structural integrity of the cerebellar ascending fiber tracts (DTCT and DSCT) may correlate with the motor recovery of the upper and lower extremities, respectively.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251351879"},"PeriodicalIF":0.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resting-state Alpha Reactivity Is Reduced in Parkinson's Disease and Associated With Gait Variability.","authors":"Ellen Lirani-Silva, Layla C S Silva, Diego Orcioli-Silva, Victor S Beretta, Lucas G S França, Daniel B Coelho, Rodrigo Vitorio","doi":"10.1177/15459683251347631","DOIUrl":"https://doi.org/10.1177/15459683251347631","url":null,"abstract":"<p><p>BackgroundThe extent to which the cholinergic system contributes to gait impairments in Parkinson's disease (PD) remains unclear. Electroencephalography (EEG) alpha reactivity, which refers to change in alpha power over occipital electrodes upon opening the eyes, has been suggested as a marker of cholinergic function. We compared alpha reactivity between people with PD and healthy individuals and explored its potential association with gait measures.MethodsEyes-closed and eyes-open resting-state EEG data were recorded from 20 people with idiopathic PD and 19 healthy individuals with a 64-channel EEG system. Alpha reactivity was calculated as the relative change in alpha power (8-13 Hz) over occipital electrodes from eyes-closed to eyes-open. Gait spatiotemporal measures were obtained with an electronic walkway.ResultsAlpha reactivity was reduced in people with PD compared to healthy individuals (<i>U</i> = 105, <i>P</i> = .017); the rank-biserial correlation of .447 indicated a moderate effect size. When controlling for global cognition (Mini Mental State Examination), the group difference in alpha reactivity was no longer significant. Alpha reactivity associated with measures of gait variability only (ρ = -.437 to -.532).ConclusionsResting-state alpha reactivity is reduced in PD, suggesting impaired cholinergic function. Reduced alpha reactivity was associated with greater gait variability, indicating a role of the cholinergic system in the mechanisms underlying gait variability. Therefore, the cholinergic system may represent a target for treatments aiming to reduce gait variability and alpha reactivity should be further explored as an endpoint for clinical trials.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251347631"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loss of Joint Individuation and Abnormal Synergy Post Stroke in Upper Limb Movements.","authors":"Kyung Koh, Giovanni Oppizzi, Raziyeh Baghi, Glenn Joseph Kehs, Li-Qun Zhang","doi":"10.1177/15459683251340914","DOIUrl":"10.1177/15459683251340914","url":null,"abstract":"<p><p>BackgroundStroke often leads to long-term impairments in upper extremity motor function, including muscle weakness, spasticity, and abnormal joint synergies, which hinder independent joint control and daily activities.ObjectiveThis study examined multi-joint motor impairments and characterized abnormal synergy patterns post-stroke using a robotic exoskeleton.MethodsThe exoskeleton independently controlled shoulder, elbow, and wrist joints while measuring responses across all joints during horizontal plane movements. Fifty-three stroke survivors and 24 age-matched controls performed single-joint movements under constrained (fixed joints) and unconstrained (free joints) conditions. Coupled range of torques and range of motion at non-instructed joints were calculated relative to instructed joint movements and summarized in a 3 × 3 matrix.ResultsStroke survivors showed significantly higher coupling torques and motions at non-instructed joints compared to controls, with the greatest impairments in isolating distal movements, particularly in a proximal-to-distal gradient. Abnormal synergy patterns were systematically identified, revealing that stroke survivors exhibited two common patterns for shoulder and elbow tasks, marked by excessive coupling at neighboring joints. For wrist movement tasks, four distinct patterns emerged, involving excessive coupling at both shoulder and elbow joints.ConclusionThese findings demonstrate characteristic impairments in joint individuation and synergy following a stroke, providing a framework to understand motor deficits and guide rehabilitation strategies aimed at restoring joint-specific control.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251340914"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}