Neurorehabilitation and neural repair最新文献

{"title":"Diffusion Tensor Imaging Findings in Cerebral Sensorimotor Areas in Patients After Spinal Cord Injury Correlate With Neurophysiological Deficits.","authors":"Anna Zimny, Przemysław Podgórski, Weronika Machaj, Wojciech Fortuna, Juliusz Huber, Barbara Bobek-Billewicz, Paweł Tabakow","doi":"10.1177/15459683251345434","DOIUrl":"10.1177/15459683251345434","url":null,"abstract":"<p><p>ObjectivesAssessment of sensorimotor cortex and tracts degeneration using novel diffusion tensor imaging (DTI) templates in patients with chronic spinal cord injury (SCI) and its correlation with clinical and neurophysiological findings.MethodsSex and age-matched 29 patients with chronic SCI (paraplegic: p-SCI; tetraplegic: t-SCI) and 29 healthy controls underwent neurophysiological assessment including motor evoked potentials (MEP). DTI was performed on 3 T magnetic resonance imaging scanner and postprocessed using Human Motor Area and Sensorimotor Area Tract Templates. DTI parameters were compared using analysis of covariance with post hoc Scheffé and Bonferroni corrections. Spearman's rank test was used for correlations with <i>P</i> < .05 considered significant.ResultsCompared to controls, all SCI patients showed significantly lower fractional anisotropy (FA) in several tracts (primary motor [M1], somatosensory [S1], pre-supplementary motor area [preSMA], and dorsal premotor [PMd]) and cortices (M1, pre-SMA, and S1). There were no differences in DTI parameters between p-SCI and t-SCI or p-SCI and controls. Compared to controls, t-SCI showed significantly decreased FA within M1 and S1 tracts. In t-SCI higher motor scores were associated with higher FA from ventral premotor area (PMv) tracts and cortex; higher sensory scores were associated with higher FA from S1 tracts. Positive correlations were found between MEP amplitudes from rectus femoris muscles and FA for M1, PMd, PMv, pre-SMA, SMA tracts, and PMv cortex.ConclusionsDTI shows remote degeneration of sensorimotor cortex and supraspinal tracts in SCI correlating with several clinical motor and sensory scores, and MEP parameters. DTI metrics have the potential to become biomarkers of remote degeneration.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"701-714"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334705","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 Experience of Adult-Onset Hearing Loss and Adaptation to a Cochlear Implant.","authors":"Bruce H Dobkin","doi":"10.1177/15459683251372922","DOIUrl":"https://doi.org/10.1177/15459683251372922","url":null,"abstract":"<p><p>BackgroundSpoken language and environmental sounds hold rich and nuanced meaning for the listener, but depend on accurate hearing of the soundscape, including the timing, volume, and contrasts of its component pitches. Sensorineural hearing loss with aging degrades these properties, leading to progressive disability.ObjectivesThis case study and review describe my experience and behavioral accommodations to progressive bilateral hearing loss, limited compensation with hearing aids, and the stuttering evolution of gains after a unilateral cochlear implant (CI).ResultsDespite increasingly powerful hearing aids over 25 years, spoken phonemes and words became increasingly muffled, misheard, and often dissipated into ambient background noise. The cognitive effort to extract meaning and mask my disability grew exhausting. I gradually eliminated many of my usual family, medical career, and social roles. To try to recover some communication-dependent activities, I sought a bionic solution. A right-sided CI initially carried an ambiguous, fizzling code and unrecognizable synthetic voices. With 8 months of auditory rehabilitation, I better deciphered conversational speech and ambient sounds. By audiological testing, I improved from 10% hearing accuracy of single words to 65%, typical of post lingual adult users. Better hearing in ambient noise and for what had been excessively rapid speech evolved out to 18 months, allowing me to re-engage in many of my daily roles.ConclusionsHearing loss beyond the compensation of aids deeply challenges quality of life. Auditory rehabilitation after cochlear implantation engages neuroplasticity to re-establish functional communication.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251372922"},"PeriodicalIF":3.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984409","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":"The Effects and Safety of Gamma Rhythm Stimulation on Cognitive Function in Alzheimer's Disease: A Systematic Review and Meta-Analysis.","authors":"Liuxia Wu, Yixin Wei, Kang He, Qiang Gao","doi":"10.1177/15459683251360733","DOIUrl":"https://doi.org/10.1177/15459683251360733","url":null,"abstract":"<p><p>ObjectiveResearchers have focused on gamma rhythm stimulation, particularly at 40 Hz, to enhance endogenous gamma oscillations and improve cognitive function and outcomes in Alzheimer's disease (AD). However, some studies disputed these findings. This review aimed to systematically analyze recent randomized controlled trials on the effects of gamma stimulation on cognitive function in AD and to perform a meta-analysis to assess the efficacy, safety, and differences between brain and sensory stimulation.MethodsA systematic search was conducted in PubMed, Web of Science, Ovid-Embase, and Ovid-MEDLINE from their inception to April 2024. A meta-analysis was performed to evaluate adverse events and cognitive function assessed using AD Assessment Scale-Cognitive Subscale (ADAS-cog), Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Face-Name Association Test (FNAT). Subgroup analyses were performed to explore the heterogeneity between the brain and sensory stimulation.ResultsEight studies involving 291 participants were included. Meta-analysis demonstrated a large benefit in cognitive function: FNAT (standardized mean difference [SMD] = 3.76; 95% confidence interval [CI] = 2.52-4.99; <i>I</i>² = 65%), MMSE (SMD = 3.09; 95% CI = 2.37-3.82; <i>I</i>² = 0%), ADAS-cog (SMD = -4.16; 95% CI = -6.60 to -2.62; <i>I</i>² = 0%), and MoCA (SMD = 2.17; 95% CI = -0.54 to 4.88; <i>I</i>² = 0%). There were no significant differences in adverse events between the intervention and sham groups (<i>P</i> = .06), suggesting the safety of gamma stimulation.ConclusionThis review highlights the safety and benefits of gamma stimulation for cognitive improvement in patients with AD, with sensory stimulation proving safe even in individuals with epilepsy.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251360733"},"PeriodicalIF":3.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984345","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":"Proprioceptive Thresholds Are Indicators of Upper Limb Perception After Stroke.","authors":"Joanna E Hoh, Stephen H Scott, Sean P Dukelow, Jennifer A Semrau","doi":"10.1177/15459683251363245","DOIUrl":"https://doi.org/10.1177/15459683251363245","url":null,"abstract":"<p><p>BackgroundProprioception is critical for daily activities and is often impaired after stroke. Recent studies have highlighted the prevalence of proprioceptive impairments of the upper limb in stroke; however, few studies have examined the relationship between proprioceptive impairments and motor function.ObjectiveWe examined how proprioceptive detection thresholds (movement discrimination thresholds [MDTs]) relate to existing assessments of upper limb proprioceptive, motor, and clinical function after stroke.MethodsStroke (N = 39) and control participants (N = 39) completed 5 tasks using the Kinarm Exoskeleton Lab: (1) MDT-a single-arm proprioceptive task assessing movement detection threshold, (2) Position Matching-a bilateral matching task assessing static limb position sense, (3) Kinesthetic Matching-a bilateral matching task assessing sense of limb motion, (4) Visually Guided Reaching-a task assessing upper limb motor control, and (5) Reaching without Vision-a task assessing upper limb motor control with increased reliance on proprioceptive feedback.ResultsStroke participants were significantly impaired on all robotic tasks compared to controls. We found that MDT was correlated with bilateral matching robotic tasks of proprioception, including Position Matching (ρ = .64, <i>P</i> < .001) and Kinesthetic Matching (ρ = .56, <i>P</i> < .001). However, MDT was not significantly correlated with robotic tasks of motor control or clinical measures.ConclusionsMDT, a single-arm measure that reduces motor requirements in proprioceptive testing, was significantly correlated to existing robotic measures of proprioception. MDT is capable of measuring impairments in perception that may be independent from impairments in action-based motor function.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251363245"},"PeriodicalIF":3.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984357","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":"Enhancing Social Cognition in Mild Cognitive Impairment with Non-Invasive Brain Stimulation: A Randomized Clinical Trial.","authors":"Gianna Carla Riccitelli, Francesca Beeching, Alessandro Lecchi, Guido Ongaro, William Pertoldi, Alain Kaelin-Lang, Leonardo Sacco","doi":"10.1177/15459683251360731","DOIUrl":"https://doi.org/10.1177/15459683251360731","url":null,"abstract":"<p><p>BackgroundThe effectiveness of non-invasive neuromodulation to improve social cognition (SC) in neurological disorders remains unclear. However, repetitive transcranial magnetic stimulation (rTMS) shows promise for treating cognitive abnormalities by promoting neuroplasticity.ObjectiveIn this randomized, double-blind, sham-controlled study, we investigated the effects of high-frequency rTMS on the medial prefrontal cortex (mPFC) and right temporal parietal junction (rTPJ) in patients with mild cognitive impairment (MCI) to enhance SC abilities and other cognitive and functional abilities related to the stimulated network, and their maintenance effects post-treatment.MethodsTwenty-four MCI patients were assigned to 2 groups: a Real-Real group (RR-Gr) that received 4 weeks of rTMS, and a Sham-Real group (SR-Gr) that received 2 weeks of sham stimulation followed by 2 weeks of real rTMS. All subjects underwent cognitive/functional assessments at baseline, week 2, and week 4 of the treatment, and 8 weeks post-intervention (12 weeks).ResultsAfter 2 weeks of treatment, the RR-Gr improved in empathy performance (<i>P</i> < .001), emotion-recognition (<i>P</i> < .001), social-behavior (SB) (<i>P</i> = .04), and executive function (<i>P</i> = .014). Following 4 weeks of rTMS, emotion-recognition improved further, and the benefits persisted at follow-up observation (all <i>P</i>s < .001). In RR-Gr, patients with higher education exhibited more significant improvements in SB abilities (<i>P</i> = .032). Both groups also improved attention, mobility, and quality of life over time (<i>P</i> range :<.001-.02).ConclusionsExcitatory rTMS treatment targeting 2 key social brain regions (mPFC and rTPJ) shows promise as a sustained intervention to improve SC and associated cognitive functions in the MCI population.Trial registrationClinicalTrials.gov ID: NCT04490616.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251360731"},"PeriodicalIF":3.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984416","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":"Cortical Network Topological Modifications Underlie Clinical Evolution in the Acute Phase of Ischemic Stroke.","authors":"Chiara Iacovelli, Giuseppe Reale, Giulia Baldazzi, Danilo Pani, Aurelia Zauli, Marco Moci, Paolo Manganotti, Lucio Marinelli, Simona Sacco, Giovanni Furlanis, Miloš Ajčević, Silvia Giovannini, Simona Crosetti, Matteo Grazzini, Marta Garbuglia, Pietro Caliandro","doi":"10.1177/15459683251363243","DOIUrl":"10.1177/15459683251363243","url":null,"abstract":"<p><p>BackgroundFollowing stroke, brain networks can be described by strength of local connections (clustering coefficient [<i>C</i>w]) and strength of global interconnections (path length [<i>L</i>w]) between nodes, and their balance (Small-worldness [<i>S</i>w]). <i>Objective</i>. To identify electroencephalography (EEG) networks predicting clinical evolution in stroke through a multicenter cross-sectional study.MethodsWe consecutively recruited 87 anterior circulation ischemic stroke patients. We obtained resting-state EEG (31 electrodes, 10-10 system) within 24 hours from stroke (<i>T</i>0) and at discharge from stroke unit (4-10 days after stroke; <i>T</i>1). EEG data were elaborated with EEGLAB and Lagged Linear Coherence among cortical sources of EEG signals was analyzed using eLORETA. We performed a multiple linear regression with National Institutes of Health Stroke Scale (NIHSS) at <i>T</i>0 and <i>T</i>1 as dependent variables and <i>C</i>w, <i>L</i>w, and <i>S</i>w of delta, theta, and alpha networks as independent variables.ResultsWe found a negative association between alpha1 <i>S</i>w and NIHSS at <i>T</i>0 (β = -.232, <i>P</i> = .04) meaning that the lower is alpha efficiency the higher is clinical severity and a positive association between delta <i>S</i>w and NIHSS at <i>T</i>1 (β = .423, <i>P</i> < .001) meaning that the higher is delta efficiency the higher is clinical severity. We found positive association between delta <i>S</i>w at <i>T</i>0 and NIHSS at <i>T</i>1 (β = .259, <i>P</i> = .02), meaning that the higher is delta efficiency in the hyperacute phase the higher is clinical severity at <i>T</i>1.ConclusionsA higher delta <i>S</i>w within 24 hours after stroke is associated to higher NIHSS within 10 days. Delta brain network rearrangement in the hyperacute phase is a potential neurophysiological measure to be integrated in multi-modal prognostic models.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251363243"},"PeriodicalIF":3.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884693","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":"Transcranial Direct Current Stimulation on Supplementary Motor Area Enhances the Effects of Exercise Therapy for Proprioception and Balance in People with Parkinson's: an Exploratory Pilot Trial.","authors":"Hasti Heydarpour, Mohammed N Ashtiani, Farid Bahrpeyma, Abbas Tafakhori, Shapour Jaberzadeh","doi":"10.1177/15459683251363242","DOIUrl":"10.1177/15459683251363242","url":null,"abstract":"<p><p>Background and PurposeParkinson's impairs movement control and proprioception. This pilot randomized controlled trial investigated whether anodal transcranial direct current stimulation (a-tDCS) combined with proprioceptive exercises improves these functions in people with Parkinson's.MethodsTwenty-four people with Parkinson's were randomly assigned (1:1) to either active a-tDCS (2mA, 20 minutes, 3 sessions/week for 2 weeks) or sham stimulation, followed by standardized proprioceptive training. The primary outcome was ankle joint proprioceptive acuity. Secondary outcomes included postural sway, gait initiation parameters, and quality of life. Participants were blinded to group allocation.ResultsThe active a-tDCS group showed significantly greater improvement in ankle joint repositioning error compared to the sham group (mean difference -2.9 degrees, 95% CI [-3.1, -2.7]; <i>P</i> = .012). Postural sway (elliptical sway area, eyes closed) was also significantly reduced in the active a-tDCS group (-2.6 cm², 95% CI [-4.6, -0.6]; <i>P</i> = .038). Gait initiation time decreased in both groups, but only the active a-tDCS group showed a significant reduction in step time (-168 ms, 95% CI [-175, -160]; <i>P</i> = .005). No significant between-group difference was found in quality of life (<i>P</i> = .687).Discussion and ConclusionsMultiple sessions of a-tDCS combined with proprioceptive exercises explored preliminary evidence of enhanced proprioceptive acuity and postural control in people with Parkinson's. Gait initiation also improved with a-tDCS. All a-tDCS sessions were well-tolerated by participants, with no adverse effects reported. Further research is needed to explore long-term effects and underlying mechanisms. This pilot study provides preliminary evidence for a-tDCS as a potential adjunctive therapy, though larger trials are needed to confirm clinical efficacy.Clinical trial registration code:IRCT20230820059201N2 (Iranian Registry for Clinical Trials)Clinical trial registration URL:https://irct.behdasht.gov.ir/trial/76791Clinical trial registration Name:Effect of Adding Trans-Cranial Direct Current Stimulation on Supplementary Motor Area to Exercise Therapy on Proprioception Acuity, Postural Control, Initiation of Gait, and Brain Cortical Activity in People with Parkinson's.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251363242"},"PeriodicalIF":3.7,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862748","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":"12-Week Aerobic Interval Training Boosts Neuroplasticity and Motor Function in Parkinson's Disease: Insights From BDNF, [¹⁸F]Fluorodopa PET/CT, and EEG.","authors":"Karolina Lorek, Małgorzata Chalimoniuk, Józef Langfort, Joanna Mączewska, Leszek Królicki, Katarzyna Markowska, Sławomir Budrewicz, Magdalena Koszewicz, Zbigniew Wroński, Jarosław Marusiak","doi":"10.1177/15459683251360729","DOIUrl":"https://doi.org/10.1177/15459683251360729","url":null,"abstract":"<p><p>BackgroundAnimal models suggest that intensive physical training may promote neuroplasticity in Parkinson's disease (PD), but its effects in humans remain underexplored.ObjectivesTo investigate the effects of aerobic interval training (AIT) on brain-derived neurotrophic factor (BDNF) levels, striatal [¹⁸F]fluorodopa positron emission tomography/computed tomography (PET/CT) uptake ([¹⁸F]DOPA_PET/CT), electroencephalography (EEG), and motor function, and to explore their interrelations.MethodsThirty PD patients were randomly assigned to a 12-week moderate-intensity AIT group (PD Training Group [PD-TR], n = 15) or a non-training group (PD Non-Training Group, n = 15). Pre- and post-intervention assessments included BDNF levels, striatal [¹⁸F]DOPA_PET/CT, EEG during motor task-evoked desynchronization (ERD_MT) and rest-evoked synchronization (ERS_REST) in primary motor cortex (M1) and supplementary motor area (SMA), and motor function assessed using the Unified PD Rating Scale (UPDRS) Part III and the Manual Bradykinesia Score for the Affected Upper Extremity (MBS-AUE) calculated as the sum of UPDRS items 3.4 to 3.6.ResultsThe PD-TR group showed increased BDNF levels (<i>P</i> < .001) and improved motor scores (UPDRS III and MBS-AUE; <i>P</i> < .05). Both groups exhibited increased EEG-ERS_REST M1 (<i>P</i> < .05) over time, with no changes in striatal [¹⁸F]DOPA_PET/CT uptake. Significant group differences were observed in correlations between changes (Δ = POST minus PRE) in: ΔBDNF with Δ[¹⁸F] DOPA_PET/CT uptake in the putamen and ΔEEG-ERD_MT M1 (<i>P</i> < .001); Δ[¹⁸F]DOPA_PET/CT uptake in the putamen with Δ[¹⁸F]DOPA_PET/CT uptake in the caudate and ΔEEG-ERS_REST SMA (<i>P</i> < .05); ΔMBS-AUE scores with ΔEEG-ERS_REST SMA (<i>P</i> < .001).ConclusionsTwelve-week AIT enhanced BDNF levels and motor function in PD-TR, with central nervous system neuroplasticity supporting motor recovery.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251360729"},"PeriodicalIF":3.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823568","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":"Temporal Parameters Determine the Efficacy of Vagus Nerve Stimulation Directed Neural Plasticity.","authors":"Juliet J A Addo, Connor L Neifert, Tanya T T Danaphongse, Stephanie T Abe, Vikram Ezhil, Michael P Kilgard, Seth A Hays","doi":"10.1177/15459683251360725","DOIUrl":"https://doi.org/10.1177/15459683251360725","url":null,"abstract":"<p><strong>Background: </strong>Combining vagus nerve stimulation (VNS) with rehabilitation represents an emerging treatment for a range of neurological disorders, and identifying stimulation parameters that maximize the effects of VNS may provide a means to optimize this therapy. Prior studies show that varying the intensity of stimulation, which influences activity of the locus coeruleus and nucleus basalis in response to VNS, determines the strength of VNS-dependent enhancement of synaptic plasticity in cortical circuits. <i>Objective:</i> The impact of the temporal parameters of stimulation, such as frequency and distribution of pulses within a stimulation train, remains underexplored. In this study, we evaluated how varying these temporal parameters impacts the magnitude of VNS-directed plasticity.</p><p><strong>Methods: </strong>In the first experiment, rats received trains of VNS at 1 of 3 moderate pulse frequencies (20, 30, or 45 Hz) concurrent with a simple motor task. After 5 days of training, we evaluated cortical movement representations using intracortical microstimulation. In a second experiment, we used a similar paradigm to explore whether burst stimulation (125 ms of 30 Hz pulses, repeated 4 times over 2000 ms), would enhance VNS-dependent plasticity.</p><p><strong>Results: </strong>All 3 moderate pulse frequencies produced equivalent increases in cortical representation of the paired movement compared to sham stimulation. Unexpectedly, both burst stimulation or a matched number of pulses distributed evenly in time failed to produce significant enhancement of plasticity compared to sham stimulation, whereas moderate pulse frequency stimulation did.</p><p><strong>Conclusions: </strong>These findings illustrate the importance of the temporal dynamics of stimulation in determining the effects of VNS and provide guidelines for designing novel VNS sequences.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251360725"},"PeriodicalIF":3.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823569","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":"Exercise Intensity Matters in the Rehabilitation of Stroke in the Acute Stage: A Randomized Controlled Trial.","authors":"Elogni Renaud Amanzonwé, Sènadé Inès Noukpo, Thierry Adoukonou, Bruno Bonnechère, Peter Feys, Dominique Hansen, Oyéné Kossi","doi":"10.1177/15459683251356969","DOIUrl":"https://doi.org/10.1177/15459683251356969","url":null,"abstract":"<p><strong>Background: </strong>High-intensity interval training (HIIT) has emerged as a potentially effective exercise promoting functional recovery post-stroke.</p><p><strong>Objective: </strong>This study examined the efficacy of adding HIIT cycling vs. combining unloaded cycling (SHAM) to conventional physiotherapy on exercise capacity, functional ability, disability level, and health-related quality of life (HRQoL) early post-stroke.</p><p><strong>Methods: </strong>Forty-four acute stroke survivors were randomly assigned to the HIIT cycling or SHAM group for 6 weeks of exercise training, 3 days/week. The primary outcome was exercise capacity (peak work load [WRpeak]) measured by a maximal exercise test. Secondary outcomes included balance: Berg Balance Scale, walking ability: 6-minute and 10-meter walk tests (6MWT and 10mWT), lower-extremity muscle strength: 5-Repetition Sit-To-Stand test, disability level: modified Rankin Scale (mRS), and HRQoL by EuroQOL 5-dimension questionnaire.</p><p><strong>Results: </strong>The 2-way factorial analysis of variance showed a significant interaction of time × group on WRpeak (<i>P</i> < .001), 6MWT (<i>P</i> < .001), 10mWT (<i>P</i> < .001), and mRS (<i>P</i> = .012). The significant interaction indicates that the change in WRpeak (mean +17.7 W [95% CI, 10.2-25.1]), 6MWT (mean +126.8 m [77.9-175.7]), 10mWT (mean +0.5 m/s [0.3-0.7]), and mRS (mean -0.7 point [-1.2 to -0.2]) after 6-week of training was significantly greater for HIIT cycling versus SHAM. These changes are also significantly greater in the HIIT group vs the SHAM group up to 6 months (<i>P</i> < .001) post-training.</p><p><strong>Conclusions: </strong>In individuals with acute stroke, individuals, combining HIIT cycling with conventional physiotherapy significantly maximizes recovery of exercise capacity and walking ability, and reduces the level of disability early post-stroke, compared to SHAM.Protocol Registration number:NCT06179173.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683251356969"},"PeriodicalIF":3.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818937","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}