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Noninvasive Brain Stimulation in Neurorehabilitation |
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Ajouter le résultat dans votre panierAssessment of Inter-Hemispheric Imbalance Using Imaging and Noninvasive Brain Stimulation in Patients With Chronic Stroke / David A. Cunningham in Archives of Physical Medicine and Rehabilitation, 2015/4 suppl. (2015)
Titre : Assessment of Inter-Hemispheric Imbalance Using Imaging and Noninvasive Brain Stimulation in Patients With Chronic Stroke Type de document : Article Auteurs : David A. Cunningham ; Andre Machado ; Daniel Janini Article en page(s) : p. S94-S103 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Imagerie par résonance magnétique ; Imagerie par tenseur de diffusion ; Rééducation et réadaptation ; Stimulation magnétique transcranienneMots-clés : Diffusion tensor imaging Motor cortex Cortex moteur Magnetic Resonance Imaging Stroke Transcranial magnetic stimulation Résumé : Objective
To determine how interhemispheric balance in stroke, measured using transcranial magnetic stimulation (TMS), relates to balance defined using neuroimaging (functional magnetic resonance [fMRI], diffusion-tensor imaging [DTI]) and how these metrics of balance are associated with clinical measures of upper-limb function and disability.
Design
Cross sectional.
Setting
Laboratory.
Participants
Patients with chronic stroke (N=10; age, 63+9y) in a population-based sample with unilateral upper-limb paresis.
Interventions
Not applicable.
Main Outcome Measures
Interhemispheric balance was measured with TMS, fMRI, and DTI. TMS defined interhemispheric differences in the recruitment of corticospinal output, size of the corticomotor output maps, and degree of mutual transcallosal inhibition that they exerted on one another. fMRI studied whether cortical activation during the movement of the paretic hand was lateralized to the ipsilesional or to the contralesional primary motor cortex (M1), premotor cortex (PMC), and supplementary motor cortex (SMA). DTI was used to define interhemispheric differences in the integrity of the corticospinal tracts projecting from the M1. Clinical outcomes tested function (upper extremity Fugl-Meyer [UEFM]) and perceived disability in the use of the paretic hand (Motor Activity Log [MAL] amount score).
Results
Interhemispheric balance assessed with TMS relates differently to fMRI and DTI. Patients with high fMRI lateralization to the ipsilesional hemisphere possessed stronger ipsilesional corticomotor output maps (M1: r=.831, P=.006; PMC: r=.797, P=.01) and better balance of mutual transcallosal inhibition (r=.810, P=.015). Conversely, we found that patients with less integrity of the corticospinal tracts in the ipsilesional hemisphere show greater corticospinal output of homologous tracts in the contralesional hemisphere (r=.850, P=.004). However, an imbalance in integrity and output do not relate to transcallosal inhibition. Clinically, although patients with less integrity of corticospinal tracts from the ipsilesional hemisphere showed worse impairments (UEFM) (r=–.768, P=.016), those with low fMRI lateralization to the ipsilesional hemisphere had greater perception of disability (MAL amount score) (M1: r=.883, P=.006; PMC: r=.817, P=.007; SMA: r=.633, P=.062).
Conclusions
In patients with chronic motor deficits of the upper limb, fMRI may serve to mark perceived disability and transcallosal influence between hemispheres. DTI-based integrity of the corticospinal tracts, however, may be useful in categorizing the range of functional impairments of the upper limb. Further, in patients with extensive corticospinal damage, DTI may help infer the role of the contralesional hemisphere in recovery.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]
in Archives of Physical Medicine and Rehabilitation > 2015/4 suppl. (2015) . - p. S94-S103[article] Assessment of Inter-Hemispheric Imbalance Using Imaging and Noninvasive Brain Stimulation in Patients With Chronic Stroke [Article] / David A. Cunningham ; Andre Machado ; Daniel Janini . - p. S94-S103.
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > 2015/4 suppl. (2015) . - p. S94-S103
Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Imagerie par résonance magnétique ; Imagerie par tenseur de diffusion ; Rééducation et réadaptation ; Stimulation magnétique transcranienneMots-clés : Diffusion tensor imaging Motor cortex Cortex moteur Magnetic Resonance Imaging Stroke Transcranial magnetic stimulation Résumé : Objective
To determine how interhemispheric balance in stroke, measured using transcranial magnetic stimulation (TMS), relates to balance defined using neuroimaging (functional magnetic resonance [fMRI], diffusion-tensor imaging [DTI]) and how these metrics of balance are associated with clinical measures of upper-limb function and disability.
Design
Cross sectional.
Setting
Laboratory.
Participants
Patients with chronic stroke (N=10; age, 63+9y) in a population-based sample with unilateral upper-limb paresis.
Interventions
Not applicable.
Main Outcome Measures
Interhemispheric balance was measured with TMS, fMRI, and DTI. TMS defined interhemispheric differences in the recruitment of corticospinal output, size of the corticomotor output maps, and degree of mutual transcallosal inhibition that they exerted on one another. fMRI studied whether cortical activation during the movement of the paretic hand was lateralized to the ipsilesional or to the contralesional primary motor cortex (M1), premotor cortex (PMC), and supplementary motor cortex (SMA). DTI was used to define interhemispheric differences in the integrity of the corticospinal tracts projecting from the M1. Clinical outcomes tested function (upper extremity Fugl-Meyer [UEFM]) and perceived disability in the use of the paretic hand (Motor Activity Log [MAL] amount score).
Results
Interhemispheric balance assessed with TMS relates differently to fMRI and DTI. Patients with high fMRI lateralization to the ipsilesional hemisphere possessed stronger ipsilesional corticomotor output maps (M1: r=.831, P=.006; PMC: r=.797, P=.01) and better balance of mutual transcallosal inhibition (r=.810, P=.015). Conversely, we found that patients with less integrity of the corticospinal tracts in the ipsilesional hemisphere show greater corticospinal output of homologous tracts in the contralesional hemisphere (r=.850, P=.004). However, an imbalance in integrity and output do not relate to transcallosal inhibition. Clinically, although patients with less integrity of corticospinal tracts from the ipsilesional hemisphere showed worse impairments (UEFM) (r=–.768, P=.016), those with low fMRI lateralization to the ipsilesional hemisphere had greater perception of disability (MAL amount score) (M1: r=.883, P=.006; PMC: r=.817, P=.007; SMA: r=.633, P=.062).
Conclusions
In patients with chronic motor deficits of the upper limb, fMRI may serve to mark perceived disability and transcallosal influence between hemispheres. DTI-based integrity of the corticospinal tracts, however, may be useful in categorizing the range of functional impairments of the upper limb. Further, in patients with extensive corticospinal damage, DTI may help infer the role of the contralesional hemisphere in recovery.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]
Titre : Safety of Primed Repetitive Transcranial Magnetic Stimulation and Modified Constraint-Induced Movement Therapy in a Randomized Controlled Trial in Pediatric Hemiparesis Type de document : Article Auteurs : Bernadette T. Gillick ; Linda E. Krach ; Tim Feyma Article en page(s) : p. S104-S113 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Pédiatrie ; Rééducation et réadaptation ; Securité ; Stimulation magnétique transcranienneMots-clés : Pediatrics Safety Stroke Transcranial magnetic stimulation Résumé : Objective
To investigate the safety of combining a 6-Hz primed low-frequency repetitive transcranial magnetic stimulation (rTMS) intervention in the contralesional hemisphere with a modified constraint-induced movement therapy (mCIMT) program in children with congenital hemiparesis.
Design
Phase 1 randomized, double-blinded, placebo-controlled pretest/posttest trial.
Setting
University academic facility and pediatric specialty hospital.
Participants
Subjects (N=19; age range, 8–17y) with congenital hemiparesis caused by ischemic stroke or periventricular leukomalacia. No subject withdrew because of adverse events. All subjects included completed the study.
Interventions
Subjects were randomized to 1 of 2 groups: either real rTMS plus mCIMT (n=10) or sham rTMS plus mCIMT (n=9).
Main Outcome Measures
Adverse events, physician assessment, ipsilateral hand function, stereognosis, cognitive function, subject report of symptoms assessment, and subject questionnaire.
Results
No major adverse events occurred. Minor adverse events were found in both groups. The most common events were headaches (real: 50%, sham: 89%; P=.14) and cast irritation (real: 30%, sham: 44%; P=.65). No differences between groups in secondary cognitive and unaffected hand motor measures were found.
Conclusions
Primed rTMS can be used safely with mCIMT in congenital hemiparesis. We provide new information on the use of rTMS in combination with mCIMT in children. These findings could be useful in research and future clinical applications in advancing function in congenital hemiparesis.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]
in Archives of Physical Medicine and Rehabilitation > 2015/4 suppl. (2015) . - p. S104-S113[article] Safety of Primed Repetitive Transcranial Magnetic Stimulation and Modified Constraint-Induced Movement Therapy in a Randomized Controlled Trial in Pediatric Hemiparesis [Article] / Bernadette T. Gillick ; Linda E. Krach ; Tim Feyma . - p. S104-S113.
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > 2015/4 suppl. (2015) . - p. S104-S113
Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Pédiatrie ; Rééducation et réadaptation ; Securité ; Stimulation magnétique transcranienneMots-clés : Pediatrics Safety Stroke Transcranial magnetic stimulation Résumé : Objective
To investigate the safety of combining a 6-Hz primed low-frequency repetitive transcranial magnetic stimulation (rTMS) intervention in the contralesional hemisphere with a modified constraint-induced movement therapy (mCIMT) program in children with congenital hemiparesis.
Design
Phase 1 randomized, double-blinded, placebo-controlled pretest/posttest trial.
Setting
University academic facility and pediatric specialty hospital.
Participants
Subjects (N=19; age range, 8–17y) with congenital hemiparesis caused by ischemic stroke or periventricular leukomalacia. No subject withdrew because of adverse events. All subjects included completed the study.
Interventions
Subjects were randomized to 1 of 2 groups: either real rTMS plus mCIMT (n=10) or sham rTMS plus mCIMT (n=9).
Main Outcome Measures
Adverse events, physician assessment, ipsilateral hand function, stereognosis, cognitive function, subject report of symptoms assessment, and subject questionnaire.
Results
No major adverse events occurred. Minor adverse events were found in both groups. The most common events were headaches (real: 50%, sham: 89%; P=.14) and cast irritation (real: 30%, sham: 44%; P=.65). No differences between groups in secondary cognitive and unaffected hand motor measures were found.
Conclusions
Primed rTMS can be used safely with mCIMT in congenital hemiparesis. We provide new information on the use of rTMS in combination with mCIMT in children. These findings could be useful in research and future clinical applications in advancing function in congenital hemiparesis.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]
Titre : Intensity Dependent Effects of Transcranial Direct Current Stimulation on Corticospinal Excitability in Chronic Spinal Cord Injury Type de document : Article Auteurs : Lynda M. Murray ; Dylan J. Edwards ; Giulio Ruffini Article en page(s) : p. S114-S121 Langues : Anglais (eng) Descripteurs : HE Vinci
Membre supérieur ; Rééducation et réadaptation ; Stimulation transcrânienne par courant continu ; Traumatismes de la moelle épinièreMots-clés : Transcranial Direct Current Stimulation Spinal cord injuries Upper extremity Résumé : Objective
To investigate the effects of anodal transcranial direct current stimulation (a-tDCS) intensity on corticospinal excitability and affected muscle activation in individuals with chronic spinal cord injury (SCI).
Design
Single-blind, randomized, sham-controlled, crossover study.
Setting
Medical research institute and rehabilitation hospital.
Participants
Volunteers (N=9) with chronic SCI and motor dysfunction in wrist extensor muscles.
Interventions
Three single session exposures to 20 minutes of a-tDCS (anode over the extensor carpi radialis [ECR] muscle representation on the left primary motor cortex, cathode over the right supraorbital area) using 1mA, 2mA, or sham stimulation, delivered at rest, with at least 1 week between sessions.
Main Outcome Measures
Corticospinal excitability was assessed with motor-evoked potentials (MEPs) from the ECR muscle using surface electromyography after transcranial magnetic stimulation. Changes in spinal excitability, sensory threshold, and muscle strength were also investigated.
Results
Mean MEP amplitude significantly increased by approximately 40% immediately after 2mA a-tDCS (pre: 0.36+0.1mV; post: 0.47+0.11mV; P=.001), but not with 1mA or sham. Maximal voluntary contraction measures remained unaltered across all conditions. Sensory threshold significantly decreased over time after 1mA (P=.002) and 2mA (P=.039) a-tDCS and did not change with sham. F-wave persistence showed a nonsignificant trend for increase (pre: 32%+12%; post: 41%+10%; follow-up: 46%+12%) after 2mA stimulation. No adverse effects were reported with any of the experimental conditions.
Conclusions
The a-tDCS can transiently raise corticospinal excitability to affected muscles in patients with chronic SCI after 2mA stimulation. Sensory perception can improve with both 1 and 2mA stimulation. This study gives support to the safe and effective use of a-tDCS using small electrodes in patients with SCI and highlights the importance of stimulation intensity.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]
in Archives of Physical Medicine and Rehabilitation > 2015/4 suppl. (2015) . - p. S114-S121[article] Intensity Dependent Effects of Transcranial Direct Current Stimulation on Corticospinal Excitability in Chronic Spinal Cord Injury [Article] / Lynda M. Murray ; Dylan J. Edwards ; Giulio Ruffini . - p. S114-S121.
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > 2015/4 suppl. (2015) . - p. S114-S121
Descripteurs : HE Vinci
Membre supérieur ; Rééducation et réadaptation ; Stimulation transcrânienne par courant continu ; Traumatismes de la moelle épinièreMots-clés : Transcranial Direct Current Stimulation Spinal cord injuries Upper extremity Résumé : Objective
To investigate the effects of anodal transcranial direct current stimulation (a-tDCS) intensity on corticospinal excitability and affected muscle activation in individuals with chronic spinal cord injury (SCI).
Design
Single-blind, randomized, sham-controlled, crossover study.
Setting
Medical research institute and rehabilitation hospital.
Participants
Volunteers (N=9) with chronic SCI and motor dysfunction in wrist extensor muscles.
Interventions
Three single session exposures to 20 minutes of a-tDCS (anode over the extensor carpi radialis [ECR] muscle representation on the left primary motor cortex, cathode over the right supraorbital area) using 1mA, 2mA, or sham stimulation, delivered at rest, with at least 1 week between sessions.
Main Outcome Measures
Corticospinal excitability was assessed with motor-evoked potentials (MEPs) from the ECR muscle using surface electromyography after transcranial magnetic stimulation. Changes in spinal excitability, sensory threshold, and muscle strength were also investigated.
Results
Mean MEP amplitude significantly increased by approximately 40% immediately after 2mA a-tDCS (pre: 0.36+0.1mV; post: 0.47+0.11mV; P=.001), but not with 1mA or sham. Maximal voluntary contraction measures remained unaltered across all conditions. Sensory threshold significantly decreased over time after 1mA (P=.002) and 2mA (P=.039) a-tDCS and did not change with sham. F-wave persistence showed a nonsignificant trend for increase (pre: 32%+12%; post: 41%+10%; follow-up: 46%+12%) after 2mA stimulation. No adverse effects were reported with any of the experimental conditions.
Conclusions
The a-tDCS can transiently raise corticospinal excitability to affected muscles in patients with chronic SCI after 2mA stimulation. Sensory perception can improve with both 1 and 2mA stimulation. This study gives support to the safe and effective use of a-tDCS using small electrodes in patients with SCI and highlights the importance of stimulation intensity.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]
Titre : Focal Hand Dystonia: Individualized Intervention With Repeated Application of Repetitive Transcranial Magnetic Stimulation Type de document : Article Auteurs : Teresa Jacobson Kimberley ; Michael R. Borich ; Rebekah L. Schmidt Article en page(s) : p. S122-S128 Langues : Anglais (eng) Descripteurs : HE Vinci
Dystonie ; Etude clinique ; Rééducation et réadaptation ; Stimulation magnétique transcranienneMots-clés : Clinical Study Dystonic Disorders Troubles dystoniques Dystonia Transcranial magnetic stimulation Résumé : Objectives
To examine for individual factors that may predict response to inhibitory repetitive transcranial magnetic stimulation (rTMS) in focal hand dystonia (FHD); to present the method for determining optimal stimulation to increase inhibition in a given patient; and to examine individual responses to prolonged intervention.
Design
Single-subject design to determine optimal parameters to increase inhibition for a given subject and to use the selected parameters once per week for 6 weeks, with 1-week follow-up, to determine response.
Setting
Clinical research laboratory.
Participants
A volunteer sample of subjects with FHD (N=2). One participant had transcranial magnetic stimulation responses indicating impaired inhibition, and the other had responses within normative limits.
Interventions
There were 1200 pulses of 1-Hz rTMS delivered using 4 different stimulation sites/intensity combinations: primary motor cortex at 90% or 110% of resting motor threshold (RMT) and dorsal premotor cortex (PMd) at 90% or 110% of RMT. The parameters producing the greatest within-session increase in cortical silent period (CSP) duration were then used as the intervention.
Main Outcome Measures
Response variables included handwriting pressure and velocity, subjective symptom rating, CSP, and short latency intracortical inhibition and facilitation.
Results
The individual with baseline transcranial magnetic stimulation responses indicating impaired inhibition responded favorably to the repeated intervention, with reduced handwriting force, an increase in the CSP, and subjective report of moderate symptom improvement at 1-week follow-up. The individual with normative baseline responses failed to respond to the intervention. In both subjects, 90% of RMT to the PMd produced the greatest lengthening of the CSP and was used as the intervention.
Conclusions
An individualized understanding of neurophysiological measures can be an indicator of responsiveness to inhibitory rTMS in focal dystonia, with further work needed to determine likely responders versus nonresponders.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]
in Archives of Physical Medicine and Rehabilitation > 2015/4 suppl. (2015) . - p. S122-S128[article] Focal Hand Dystonia: Individualized Intervention With Repeated Application of Repetitive Transcranial Magnetic Stimulation [Article] / Teresa Jacobson Kimberley ; Michael R. Borich ; Rebekah L. Schmidt . - p. S122-S128.
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > 2015/4 suppl. (2015) . - p. S122-S128
Descripteurs : HE Vinci
Dystonie ; Etude clinique ; Rééducation et réadaptation ; Stimulation magnétique transcranienneMots-clés : Clinical Study Dystonic Disorders Troubles dystoniques Dystonia Transcranial magnetic stimulation Résumé : Objectives
To examine for individual factors that may predict response to inhibitory repetitive transcranial magnetic stimulation (rTMS) in focal hand dystonia (FHD); to present the method for determining optimal stimulation to increase inhibition in a given patient; and to examine individual responses to prolonged intervention.
Design
Single-subject design to determine optimal parameters to increase inhibition for a given subject and to use the selected parameters once per week for 6 weeks, with 1-week follow-up, to determine response.
Setting
Clinical research laboratory.
Participants
A volunteer sample of subjects with FHD (N=2). One participant had transcranial magnetic stimulation responses indicating impaired inhibition, and the other had responses within normative limits.
Interventions
There were 1200 pulses of 1-Hz rTMS delivered using 4 different stimulation sites/intensity combinations: primary motor cortex at 90% or 110% of resting motor threshold (RMT) and dorsal premotor cortex (PMd) at 90% or 110% of RMT. The parameters producing the greatest within-session increase in cortical silent period (CSP) duration were then used as the intervention.
Main Outcome Measures
Response variables included handwriting pressure and velocity, subjective symptom rating, CSP, and short latency intracortical inhibition and facilitation.
Results
The individual with baseline transcranial magnetic stimulation responses indicating impaired inhibition responded favorably to the repeated intervention, with reduced handwriting force, an increase in the CSP, and subjective report of moderate symptom improvement at 1-week follow-up. The individual with normative baseline responses failed to respond to the intervention. In both subjects, 90% of RMT to the PMd produced the greatest lengthening of the CSP and was used as the intervention.
Conclusions
An individualized understanding of neurophysiological measures can be an indicator of responsiveness to inhibitory rTMS in focal dystonia, with further work needed to determine likely responders versus nonresponders.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]
Titre : Noninvasive Brain Stimulation: The Potential for Use in the Rehabilitation of Pediatric Acquired Brain Injury Type de document : Article Auteurs : Melissa G. Chung ; Warren D. Lo Article en page(s) : p. S129-S137 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Enfant ; Paralysie cérébrale ; Rééducation et réadaptation ; Stimulation magnétique transcranienne ; Stimulation transcrânienne par courant continuMots-clés : Cerebral palsy Child Stroke Transcranial direct current stimulation Transcranial magnetic stimulation Résumé : Noninvasive brain stimulation (NIBS) offers the potential to modulate neural activity and recovery after acquired brain injury. There are few studies of NIBS in children, but a survey of those studies might provide insight into the potential for NIBS to modulate motor rehabilitation, seizures, and behavior in children. We surveyed the published literature prior to July 2014 for articles pertaining to children and NIBS with a focus on case series or trials. We also reviewed selected articles involving adults to illustrate specific points where the literature in children is lacking. A limited number of articles suggest that NIBS can transiently improve motor function. The evidence for an effect on seizures is mixed. Two open-label studies reported improvement of mood in adolescents with depression. NIBS may serve as a tool for pediatric neurorehabilitation, but many gaps in our knowledge must be filled before NIBS can be adopted as a clinical intervention. To move forward, the field needs adequately powered trials that can answer these questions. Such trials will be challenging to perform, will likely require multicenter collaboration, and may need to adopt novel trial designs that have been used with rare disorders. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]
in Archives of Physical Medicine and Rehabilitation > 2015/4 suppl. (2015) . - p. S129-S137[article] Noninvasive Brain Stimulation: The Potential for Use in the Rehabilitation of Pediatric Acquired Brain Injury [Article] / Melissa G. Chung ; Warren D. Lo . - p. S129-S137.
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > 2015/4 suppl. (2015) . - p. S129-S137
Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Enfant ; Paralysie cérébrale ; Rééducation et réadaptation ; Stimulation magnétique transcranienne ; Stimulation transcrânienne par courant continuMots-clés : Cerebral palsy Child Stroke Transcranial direct current stimulation Transcranial magnetic stimulation Résumé : Noninvasive brain stimulation (NIBS) offers the potential to modulate neural activity and recovery after acquired brain injury. There are few studies of NIBS in children, but a survey of those studies might provide insight into the potential for NIBS to modulate motor rehabilitation, seizures, and behavior in children. We surveyed the published literature prior to July 2014 for articles pertaining to children and NIBS with a focus on case series or trials. We also reviewed selected articles involving adults to illustrate specific points where the literature in children is lacking. A limited number of articles suggest that NIBS can transiently improve motor function. The evidence for an effect on seizures is mixed. Two open-label studies reported improvement of mood in adolescents with depression. NIBS may serve as a tool for pediatric neurorehabilitation, but many gaps in our knowledge must be filled before NIBS can be adopted as a clinical intervention. To move forward, the field needs adequately powered trials that can answer these questions. Such trials will be challenging to perform, will likely require multicenter collaboration, and may need to adopt novel trial designs that have been used with rare disorders. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]
Titre : Preliminary Guidelines for Safe and Effective Use of Repetitive Transcranial Magnetic Stimulation in Moderate to Severe Traumatic Brain Injury Type de document : Article Auteurs : Dylan M. Nielson ; Curtis A. McKnight ; Riddhi N. Patel Article en page(s) : p. S138-S144 Langues : Anglais (eng) Descripteurs : HE Vinci
Dépression ; Rééducation et réadaptation ; Stimulation magnétique transcranienneMots-clés : Brain injuries Lésions encéphaliques Transcranial magnetic stimulation Résumé : Transcranial magnetic stimulation has generated extensive interest within the traumatic brain injury (TBI) rehabilitation community, but little work has been done with repetitive protocols, which can produce prolonged changes in behavior. This is partly because of concerns about the safety of repetitive transcranial magnetic stimulation (rTMS) in subjects with TBI, particularly the risk of seizures. These risks can be minimized by careful selection of the rTMS protocol and exclusion criteria. In this article, we identify guidelines for safe use of rTMS in subjects with TBI based on a review of the literature and illustrate their application with a case study. Our subject is a 48-year-old man who sustained a severe TBI 5 years prior to beginning rTMS for the treatment of post-TBI depression. After a 4-week baseline period, we administered daily sessions of low-frequency stimulation to the right dorsolateral prefrontal cortex for 6 weeks. After stimulation, we performed monthly assessments for 3 months. The Hamilton Depression Rating Scale (HAMD) was our primary outcome measure. The stimulation was well tolerated and the patient reported no side effects. After 6 weeks of stimulation, the patient's depression was slightly improved, and these improvements continued through follow-up. At the end of follow-up, the patient's HAMD score was 49% of the average baseline score. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]
in Archives of Physical Medicine and Rehabilitation > 2015/4 suppl. (2015) . - p. S138-S144[article] Preliminary Guidelines for Safe and Effective Use of Repetitive Transcranial Magnetic Stimulation in Moderate to Severe Traumatic Brain Injury [Article] / Dylan M. Nielson ; Curtis A. McKnight ; Riddhi N. Patel . - p. S138-S144.
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > 2015/4 suppl. (2015) . - p. S138-S144
Descripteurs : HE Vinci
Dépression ; Rééducation et réadaptation ; Stimulation magnétique transcranienneMots-clés : Brain injuries Lésions encéphaliques Transcranial magnetic stimulation Résumé : Transcranial magnetic stimulation has generated extensive interest within the traumatic brain injury (TBI) rehabilitation community, but little work has been done with repetitive protocols, which can produce prolonged changes in behavior. This is partly because of concerns about the safety of repetitive transcranial magnetic stimulation (rTMS) in subjects with TBI, particularly the risk of seizures. These risks can be minimized by careful selection of the rTMS protocol and exclusion criteria. In this article, we identify guidelines for safe use of rTMS in subjects with TBI based on a review of the literature and illustrate their application with a case study. Our subject is a 48-year-old man who sustained a severe TBI 5 years prior to beginning rTMS for the treatment of post-TBI depression. After a 4-week baseline period, we administered daily sessions of low-frequency stimulation to the right dorsolateral prefrontal cortex for 6 weeks. After stimulation, we performed monthly assessments for 3 months. The Hamilton Depression Rating Scale (HAMD) was our primary outcome measure. The stimulation was well tolerated and the patient reported no side effects. After 6 weeks of stimulation, the patient's depression was slightly improved, and these improvements continued through follow-up. At the end of follow-up, the patient's HAMD score was 49% of the average baseline score. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]
Titre : Effects of Repetitive Transcranial Magnetic Stimulation on Recovery of Function After Spinal Cord Injury Type de document : Article Auteurs : Toshiki Tazoe ; Monica A. Perez Article en page(s) : p. S145-S155 Langues : Anglais (eng) Descripteurs : HE Vinci
Plasticité neuronale ; Rééducation et réadaptationMots-clés : Pyramidal Tracts Tractus pyramidaux Motor cortex Cortex moteur Neuronal Plasticity Résumé : A major goal of rehabilitation strategies after spinal cord injury (SCI) is to enhance the recovery of function. One possible avenue to achieve this goal is to strengthen the efficacy of the residual neuronal pathways. Noninvasive repetitive transcranial magnetic stimulation (rTMS) has been used in patients with motor disorders as a tool to modulate activity of corticospinal, cortical, and subcortical pathways to promote functional recovery. This article reviews a series of studies published during the last decade that used rTMS in the acute and chronic stages of paraplegia and tetraplegia in humans with complete and incomplete SCI. In the studies, rTMS has been applied over the arm and leg representations of the primary motor cortex to target 3 main consequences of SCI: sensory and motor function impairments, spasticity, and neuropathic pain. Although some studies demonstrated that consecutive sessions of rTMS improve aspects of particular functions, other studies did not show similar effects. We discuss how rTMS parameters and postinjury reorganization in the corticospinal tract, motor cortical, and spinal cord circuits might be critical factors in understanding the advantages and disadvantages of using rTMS in patients with SCI. The available data highlight the limited information on the use of rTMS after SCI and the need to further understand the pathophysiology of neuronal structures affected by rTMS to maximize the potential beneficial effects of this technique in humans with SCI. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]
in Archives of Physical Medicine and Rehabilitation > 2015/4 suppl. (2015) . - p. S145-S155[article] Effects of Repetitive Transcranial Magnetic Stimulation on Recovery of Function After Spinal Cord Injury [Article] / Toshiki Tazoe ; Monica A. Perez . - p. S145-S155.
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > 2015/4 suppl. (2015) . - p. S145-S155
Descripteurs : HE Vinci
Plasticité neuronale ; Rééducation et réadaptationMots-clés : Pyramidal Tracts Tractus pyramidaux Motor cortex Cortex moteur Neuronal Plasticity Résumé : A major goal of rehabilitation strategies after spinal cord injury (SCI) is to enhance the recovery of function. One possible avenue to achieve this goal is to strengthen the efficacy of the residual neuronal pathways. Noninvasive repetitive transcranial magnetic stimulation (rTMS) has been used in patients with motor disorders as a tool to modulate activity of corticospinal, cortical, and subcortical pathways to promote functional recovery. This article reviews a series of studies published during the last decade that used rTMS in the acute and chronic stages of paraplegia and tetraplegia in humans with complete and incomplete SCI. In the studies, rTMS has been applied over the arm and leg representations of the primary motor cortex to target 3 main consequences of SCI: sensory and motor function impairments, spasticity, and neuropathic pain. Although some studies demonstrated that consecutive sessions of rTMS improve aspects of particular functions, other studies did not show similar effects. We discuss how rTMS parameters and postinjury reorganization in the corticospinal tract, motor cortical, and spinal cord circuits might be critical factors in understanding the advantages and disadvantages of using rTMS in patients with SCI. The available data highlight the limited information on the use of rTMS after SCI and the need to further understand the pathophysiology of neuronal structures affected by rTMS to maximize the potential beneficial effects of this technique in humans with SCI. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]
Titre : Repetitive Transcranial Magnetic Stimulation in Chronic Pain: A Review of the Literature Type de document : Article Auteurs : Ricardo Galhardoni ; Guilherme S. Correia ; Haniel Araujo Article en page(s) : p. S156-S172 Langues : Anglais (eng) Descripteurs : HE Vinci
Analgésie ; Douleur chronique ; Fibromyalgie ; Lombalgie ; Nevralgie ; Rééducation et réadaptation ; Stimulation magnétique transcranienneMots-clés : Analgesia Chronic pain Complex regional pain syndromes Syndrome douloureux régional complexe Fibromyalgia Low back pain Neuralgia Transcranial magnetic stimulation Résumé : Objective
To review the literature on the analgesic effects of repetitive transcranial magnetic stimulation (rTMS) in chronic pain according to different pain syndromes and stimulation parameters.
Data Sources
Publications on rTMS and chronic pain were searched in PubMed and Google Scholar using the following key words: chronic pain, analgesia, transcranial magnetic stimulation, neuropathic pain, fibromyalgia, and complex regional pain syndrome.
Study Selection
This review only included double-blind, controlled studies with >10 participants in each arm that were published from 1996 to 2014 and written in English. Studies with relevant information for the understanding of the effects of rTMS were also cited.
Data Extraction
The following data were retained: type of pain syndrome, type of study, coil type, target, stimulation intensity, frequency, number of pulses, orientation of induced current, number of session, and a brief summary of intervention outcomes.
Data Synthesis
A total of 33 randomized trials were found. Many studies reported significant pain relief by rTMS, especially high-frequency stimulation over the primary motor cortex performed in consecutive treatment sessions. Pain relief was frequently >30% compared with control treatment. Neuropathic pain, fibromyalgia, and complex regional pain syndrome were the pain syndromes more frequently studied. However, among all published studies, only a few performed repetitive sessions of rTMS.
Conclusions
rTMS has potential utility in the management of chronic pain; however, studies using maintenance sessions of rTMS and assessing the effects of rTMS on the different aspects of chronic pain are needed to provide a more solid basis for its clinical application for pain relief.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]
in Archives of Physical Medicine and Rehabilitation > 2015/4 suppl. (2015) . - p. S156-S172[article] Repetitive Transcranial Magnetic Stimulation in Chronic Pain: A Review of the Literature [Article] / Ricardo Galhardoni ; Guilherme S. Correia ; Haniel Araujo . - p. S156-S172.
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > 2015/4 suppl. (2015) . - p. S156-S172
Descripteurs : HE Vinci
Analgésie ; Douleur chronique ; Fibromyalgie ; Lombalgie ; Nevralgie ; Rééducation et réadaptation ; Stimulation magnétique transcranienneMots-clés : Analgesia Chronic pain Complex regional pain syndromes Syndrome douloureux régional complexe Fibromyalgia Low back pain Neuralgia Transcranial magnetic stimulation Résumé : Objective
To review the literature on the analgesic effects of repetitive transcranial magnetic stimulation (rTMS) in chronic pain according to different pain syndromes and stimulation parameters.
Data Sources
Publications on rTMS and chronic pain were searched in PubMed and Google Scholar using the following key words: chronic pain, analgesia, transcranial magnetic stimulation, neuropathic pain, fibromyalgia, and complex regional pain syndrome.
Study Selection
This review only included double-blind, controlled studies with >10 participants in each arm that were published from 1996 to 2014 and written in English. Studies with relevant information for the understanding of the effects of rTMS were also cited.
Data Extraction
The following data were retained: type of pain syndrome, type of study, coil type, target, stimulation intensity, frequency, number of pulses, orientation of induced current, number of session, and a brief summary of intervention outcomes.
Data Synthesis
A total of 33 randomized trials were found. Many studies reported significant pain relief by rTMS, especially high-frequency stimulation over the primary motor cortex performed in consecutive treatment sessions. Pain relief was frequently >30% compared with control treatment. Neuropathic pain, fibromyalgia, and complex regional pain syndrome were the pain syndromes more frequently studied. However, among all published studies, only a few performed repetitive sessions of rTMS.
Conclusions
rTMS has potential utility in the management of chronic pain; however, studies using maintenance sessions of rTMS and assessing the effects of rTMS on the different aspects of chronic pain are needed to provide a more solid basis for its clinical application for pain relief.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]
