Neurorehabilitation and neural repair最新文献

{"title":"Editorial: Advancing Rigor and Relevance in Neurorehabilitation: New Article Types at <i>Neurorehabilitation and Neural Repair</i>.","authors":"Randolph J Nudo","doi":"10.1177/15459683261432095","DOIUrl":"10.1177/15459683261432095","url":null,"abstract":"","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"263-264"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446361","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":"To Treat or Not to Treat? A Point of View on the Clinical Translation of Non-Invasive Neuromodulation Therapy for Post-Stroke Upper Limb Recovery.","authors":"Pablo Cruz Gonzalez, Jack Jiaqi Zhang, Ananda Sidarta, Karen Sui Geok Chua","doi":"10.1177/15459683251399155","DOIUrl":"10.1177/15459683251399155","url":null,"abstract":"<p><p>Background and PurposeThis Point of View paper offers a commentary on challenges and opportunities discussed during the 6th International Brain Stimulation Conference held in February 2025 in Kobe, Japan, with a focus on the clinical application of repetitive transcranial magnetic stimulation (rTMS) in post-stroke rehabilitation. We argue that the major barrier lies in the field's overreliance on standardized, one-size-fits-all protocols and its reluctance to embrace personalization in the pursuit of precision.ResultsDuring the conference, 2 research cultures were evident: the \"Systematicists,\" who rely on conventional clinical trials, and the \"Personalizers,\" who tailor non-invasive brain stimulation (NIBS) protocols to individual patient characteristics. This dichotomy reflects a broader challenge: how can we reconcile the need for standardization with the demand for personalization in translational research? The future of NIBS may lie in patient-specific, biomarker-driven neuromodulatory protocols that incorporate deep phenotyping and brain state-dependent stimulation, such as closed-loop TMS guided by Hebbian plasticity principles. This approach recognizes that post-stroke recovering brain is a 4-dimensional structure, shaped by space and time, which contributes to substantial intra- and inter-individual variability.ConclusionUnderstanding how NIBS interacts with each uniquely recovering brain is essential. Addressing this complexity remains a challenge for designing rigorous clinical trials and moving the field closer to effective, personalized integration in stroke rehabilitation. By delineating key components of personalization, we aim to reframe the discussion from \"if\" NIBS works to \"for whom, for what and why, for where and when, and how\" it can facilitate clinically meaningful recovery.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"333-342"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145852087","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":"Standardized International Manual of the Fugl-Meyer Assessment of Motor Function After Stroke.","authors":"Julie Hervé-Colas, Sarah P Newton, Stefan T Engelter, Kathryn S Hayward, Jeremia P O Held, Nadine Intering, Gert Kwakkel, Johannes Pohl, Darcy S Reisman, Anne Schwarz, Katharina S Sunnerhagen, Janne Marieke Veerbeek, Karin Wiesner, Sarah B Zandvliet, Margit Alt Murphy","doi":"10.1177/15459683251412300","DOIUrl":"10.1177/15459683251412300","url":null,"abstract":"<p><p>BackgroundFugl-Meyer Assessment of upper and lower extremity is the recommended primary clinical outcome measure of motor function in stroke rehabilitation. However, variations between different manuals undermine the reliability of the assessment, making it difficult to compare results and pool data across trials and centers.ObjectiveTo develop a consensus-based international Fugl-Meyer Assessment (FMA) manual aligned with the original assessment along with agreed recommendations for assessor training. Additionally, the study aims to provide a critical review of current evidence on the measurement properties.MethodsFourteen experienced health professionals and expert FMA users, working in 3 different continents, 6 countries and 13 research centers, participated in an iterative consensus process to generate a comprehensive agreed FMA manual. Agreement of at least 75% determined by voting was the minimum accepted threshold for each section of the manual. Consensus on assessor training was also sought. The evidence on measurement properties was compiled through a systematic literature review.ResultsGreater than 79% agreement was reached for each section of the final FMA manual. Assessors should have strong foundation in neurorehabilitation and clinical assessment. Novice assessors should undergo structured training including supervised practical training with patients to ensure consistent and accurate scoring. Previous research adherent to the original FMA assessment, confirms strong validity and reliability, but provide limited information of minimal clinically important difference thresholds.ConclusionsThis internationally agreed manual provides a common ground for improved consistency in administration of FMA worldwide and thereby will enable reliable data pooling and increase the comparability of results in future trials and clinical practice.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"306-319"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345783","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":"Post-Stroke Motor Fatigability: Defining and Studying the Impairments That Emerge During Prolonged Motor Tasks.","authors":"Adarsh Mavathaveedu, Jennifer Paige Hepple, David A Cunningham, Ania C Busza","doi":"10.1177/15459683251412273","DOIUrl":"10.1177/15459683251412273","url":null,"abstract":"<p><p>BackgroundFatigue, a complex and multidimensional complaint, is highly prevalent after stroke and contributes to adverse outcomes and impaired motor recovery. Here, we focus on post-stroke motor fatigability (PSMF), which refers to objective limitations in continuous motor performance post-stroke. PSMF can impair the performance of activities of daily living and may significantly hinder rehabilitation efforts, limiting progress and recovery.ObjectivesThe purpose of this review is to summarize the current understanding of PSMF and to evaluate various tools used to investigate its underlying mechanisms.ResultsPrior studies on PMSF differ significantly in their approaches, with some employing neurophysiology and neurostimulation to investigate neural mechanisms, while others focus on functional assessments. Inconsistent terminology and the lack of standardized methodology are key barriers to reaching meaningful conclusions. While there is some consensus that central factors in the neuromuscular pathway limit sustained motor activity more than peripheral factors, additional research is needed to understand the timing and pathophysiology of PSMF including its relationship with other impairments of motor control. We present several specific recommendations for future studies, including the use of proper taxonomy to demystify the patient complaint, consistent paradigms to evoke fatigability, and neurophysiological tools to locate its origin.ConclusionApplying these guidelines to future investigations will help researchers better identify stroke-specific limitations in continuous motor performance and develop tailored interventions to help patients adjust to the persistent, repetitive demands of daily life.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"320-332"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12970584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367801","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":"A Streamlined 4-item Wolf Motor Function Test for Efficient Assessment of Upper Extremity Motor Function in Chronic Stroke Survivors.","authors":"Bokkyu Kim, Nicolas Schweighofer, Steven L Wolf, Carolee Winstein","doi":"10.1177/15459683251412278","DOIUrl":"10.1177/15459683251412278","url":null,"abstract":"<p><p>BackgroundThe Wolf Motor Function Test (WMFT) is a well-recognized measure for assessing upper extremity motor function in stroke rehabilitation. However, prolonged administration time limits the WMFT in clinical use.ObjectiveThis study aimed to reduce the number of WMFT tasks using machine learning and explore its measurement structure and psychometric properties, using data from 3 stroke rehabilitation trials that together engaged 543 participants with a wide range of motor impairment during subacute and chronic recovery phases.MethodsWMFT performance time data were converted to rates and outliers were eliminated using multivariate normality tests. Random forest regression with the elbow method was employed to determine the optimal number of items in the WMFT. Further, a machine learning technique with cross-validation and bootstrapping was used to select items. We used confirmatory factor analysis to determine the measurement structure of the original and shortened version of WMFT. Psychometric properties of the shortened version were also assessed.ResultsMachine learning-based item reduction identified 4 items (Hand to Table, Hand to Box, Extend Elbow Without Weight, and Lift Can) as representative tasks. Factor analysis revealed a 2-factor structure for both original and shorten versions, comprising non-manipulative/transport and manipulative/dexterity factors. WMFT-4 showed strong convergent validity with WMFT-15 (R = 0.98, <i>P</i> < .001) and moderate cross-domain validity with the Fugl-Meyer Assessment of Upper Extremity (FMA-UE) (R = 0.523, <i>P</i> < .001), comparable to the original WMFT-15 (R = 0.526, <i>P</i> < .001).ConclusionThe streamlined WMFT-4 enhances the feasibility of the WMFT for both clinical and research settings while maintaining its original measurement characteristics.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"214-225"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12826297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013136","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":"Standardizing the Measurement and Definition of Post-Stroke Cognitive Impairment: Implications for Stroke Recovery and Rehabilitation.","authors":"Morgan L Kelly, Sylwia Lipior, Sydney Y Schaefer, S Duke Han, Kristan A Leech","doi":"10.1177/15459683251399133","DOIUrl":"10.1177/15459683251399133","url":null,"abstract":"<p><p>Cognitive impairment is highly prevalent post-stroke and is associated with poor functional outcomes. Stroke experts have highlighted 2 fundamental barriers to progress in rehabilitation and research related to post-stroke cognitive impairment: (1) there is no agreed-upon definition of post-stroke cognitive impairment, and (2) there is no consensus on the appropriate screening and diagnostic procedures. In this paper, we will discuss recent progress and remaining challenges to developing a standard general definition and understanding of post-stroke cognitive impairment. We will provide recommendations to advance the definition of post-stroke cognitive impairment, informed by the steps taken to develop a general definition for mild cognitive impairment. Finally, we discuss the impact these advances might have on stroke rehabilitation, highlighting the potential impact on motor rehabilitation, as an example.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"246-257"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12755724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145859866","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":"Pre-Frontal Cortical Activity During Gait is Altered in Pre-Manifest and Early Spinocerebellar Ataxia.","authors":"Martina Mancini, Carla Silva-Batista, Vrutangkumar V Shah, Fay B Horak, Patricia Carlson-Kuhta, Delaram Safarpour, Christopher M Gomez","doi":"10.1177/15459683251395729","DOIUrl":"10.1177/15459683251395729","url":null,"abstract":"<p><p>BackgroundSpinocerebellar ataxia (SCA) is a degenerative cerebellar disease, causing progressive impairment of gait and balance in adults. To identify the ideal subjects for disease-modifying therapies it is critical to identify biomarkers for the earliest stages of SCA.ObjectiveWe investigated whether prefrontal cortex activity is increased during walking in in early SCA or in pre-manifest SCA compared to healthy control subjects.MethodsSixteen participants with genetically determined SCA and 15 age-matched healthy controls participated in the study. The SARA was administered by a movement disorders specialist before the gait assessment. An 8-channel, mobile, fNIRS, with 2 reference channels, was used to record changes in oxygenated hemoglobin (HbO₂) and deoxygenated hemoglobin within the PFC. Participants walked for 2-minutes at a comfortable pace while wearing wireless, inertial sensors to derive gait characteristics.ResultsOf the 16 individuals with SCA, 9 were classified as pre-manifest (SARA < 3) and 7 as early SCA (SARA < 10). PFC activity (HbO₂) while walking was greater than controls of similar age in people with SCA. Increased PFC activity was also present even in the pre-manifest stage of SCA. Increase in PFC activity was related to worse gait (double-support time and toe-out angle).ConclusionsPFC activity is increased in pre-manifest SCA, even when clinical scores are normal in the pre-manifest stage of the disease, and may serve as a biomarker that precedes onset of clinical disease. Increased PFC activity is consistent less automatic, cortical control of gait to compensate for impaired automatic, cerebellar control, even in early stages of ataxia.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"190-198"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851988","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":"Serum Soluble Low-Density Lipoprotein Receptor-Related Protein 1 (sLRP1) is Negatively Associated With Functional Outcome Improvement From 3 to 12 Months After Acute Ischemic Stroke.","authors":"Mingxi Chen, Keying Wu, Huan Wang, Yuyi Zhu, Yaqi Chen, Ting Cui, Zhen Liu, Xinyi Leng, Zilong Hao, Deren Wang","doi":"10.1177/15459683251395691","DOIUrl":"10.1177/15459683251395691","url":null,"abstract":"<p><p>AimsSerum soluble low-density lipoprotein receptor-related protein 1 (sLRP1) has been implicated in the severity of ischemia-reperfusion injury in experimental stroke models. Its potential prognostic value in ischemic stroke recovery warrants further investigation. This study aims to explore the association between serum sLRP1 levels and functional outcome improvement from 3 to 12 months following acute ischemic stroke (AIS).MethodsWe included patients hospitalized for AIS within 24 hours of symptom onset. Serum sLRP1 levels at admission were analyzed for their association with functional outcome improvement, defined as a ≥1-point decrease in the modified Rankin Scale (mRS) score between 3 and 12 months. Multivariate binary logistic regression was employed to adjust for potential confounders. Improvements in predictive performance by including sLRP1 were assessed using the net reclassification index (NRI) and integrated discrimination improvement (IDI).ResultsA total of 171 patients were enrolled (median age: 65 years; 64.9% male). Functional outcome improvement was observed in 53 patients (31.0%). After adjusting for confounding factors, patients in the second and third tertiles of sLRP1 had significantly lower odds of functional outcome improvement compared to those in the lowest tertile (Tertile 2, odds ratio [OR] 0.19, 95% confidence interval [CI]: 0.08-0.49, <i>P</i> = .001; Tertile 3, OR 0.10, 95% CI: 0.03-0.27, <i>P</i> < .001). Incorporating sLRP1 into predictive models alongside conventional factors significantly enhanced reclassification accuracy (NRI = 46%, <i>P</i> = .004; IDI = 4%, <i>P</i> = .014).ConclusionsLower serum sLRP1 levels at admission are independently associated with functional outcome improvement after AIS. These findings suggest that modulating sLRP1 may represent a promising therapeutic strategy to enhance recovery in stroke patients.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"181-189"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822636","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 Accuracy of the PREP2 Prediction Tool for Upper Limb Outcomes After Stroke as Part of Routine Clinical Care.","authors":"Harry Jordan, Olivia Norrie, Cathy M Stinear","doi":"10.1177/15459683251412283","DOIUrl":"10.1177/15459683251412283","url":null,"abstract":"<p><p>BackgroundThe Predict REcovery Potential-2 (PREP2) prediction tool uses clinical assessments and transcranial magnetic stimulation (TMS) within 1 week post-stroke to predict individuals' upper limb functional outcome at 3 months (3M) post-stroke. PREP2 was successfully implemented in clinical care at Auckland City Hospital, New Zealand in 2017.ObjectiveThe primary aim was to evaluate the accuracy of PREP2 predictions made by clinicians during routine clinical care, with a threshold of 70% accuracy for validation. A secondary aim was to identify new baseline predictors that could increase PREP2 accuracy.MethodsEighty-three patients who received PREP2 predictions were recruited within 1 week of stroke and had their upper limb outcome assessed at 3M post-stroke with the Action Research Arm Test. Cognition and sensation were evaluated within 1 week of stroke.ResultsOverall accuracy of the PREP2 prediction tool in clinical practice was 66% (95% confidence interval, 55%-76%). Accuracy was highest for the Excellent (80%) and Poor (100%) categories and lowest for the Good category (36%). Prediction accuracy for Good outcomes was 67% for patients who did not require TMS and 27% for patients who did. Finger extension differentiated participants predicted to have a Good outcome using TMS who did and did not have a favorable upper limb outcome.ConclusionsExcellent and Poor predictions are highly accurate when used in clinical practice, however the full PREP2 tool is not yet validated in clinical practice. Future studies with larger samples could investigate additional measures to enhance accuracy of the Good prediction category.Clinical trial registration number ACTRN12619000225112, https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12619000225112.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"235-245"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12936143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032220","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":"Preregistration and Transparency in Neurorehabilitation Research.","authors":"Randolph J Nudo, Gert Kwakkel","doi":"10.1177/15459683261426286","DOIUrl":"10.1177/15459683261426286","url":null,"abstract":"","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"179-180"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208501","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}