Brain lesions,such as those caused by stroke or traumatic brain injury(TBI),frequently result in persistent motor and cognitive impairments that significantly affect the individual patient's quality of life.Despit...Brain lesions,such as those caused by stroke or traumatic brain injury(TBI),frequently result in persistent motor and cognitive impairments that significantly affect the individual patient's quality of life.Despite differences in the mechanisms of injury,both conditions share a high prevalence of motor and cognitive impairments.These deficits show only limited natural recovery.展开更多
The mirror neuron system consists of a set of brain areas capable of matching action observation with action execution. One core feature of the mirror neuron system is the activation of motor areas by action observati...The mirror neuron system consists of a set of brain areas capable of matching action observation with action execution. One core feature of the mirror neuron system is the activation of motor areas by action observation alone. This unique capacity of the mirror neuron system to match action perception and action execution stimulated the idea that mirror neuron system plays a crucial role in the understanding of the content of observed actions and may participate in procedural learning. These features bear a high potential for neurorehabilitation of motor deficits and of aphasia following stroke. Since the first articles exploring this principle were published, a growing number of follow-up studies have been conducted in the last decade. Though, the combination of action observation with practice of the observed actions seems to constitute the most powerful approach. In the present review, we present the existing studies analyzing the effects of this neurorehabJlitative approach in clinical settings especially in the rehabilitation of stroke associated motor deficits and give a perspective on the ongoing trials by our research group. The data obtained up to date showed significant positive effect of action observation on recovery of motor functions of the upper limbs even in the chronic state after stroke, indicating that our approach might become a new standardized add-on feature of modern neurorehabilitative treatment schemes.展开更多
The present study observed the effects of the non-invasive, mirror neuron system application on neurorehabilitation. In primate studies, mirror neurons have been shown to fire when the subject observes or performs a s...The present study observed the effects of the non-invasive, mirror neuron system application on neurorehabilitation. In primate studies, mirror neurons have been shown to fire when the subject observes or performs a specific action, thereby allowing for observation of motor cortex activation. This activation of the mirror neuron system could serve as a treatment for stroke patients. In the present study, the combination of a mirror neuron system-based therapy was introduced for the treatment of patients with motor-deficits, who could not perform rehabilitation exercises. The results also indicate that this therapeutic method plays a positive role in emotional regulation in the same patients.展开更多
The present work investigates the application of virtual reality(VR)technology to neurorehabilitation.By consulting a wealth of data,the advantages of VR in neurorehabilitation are introduced,followed by the applicati...The present work investigates the application of virtual reality(VR)technology to neurorehabilitation.By consulting a wealth of data,the advantages of VR in neurorehabilitation are introduced,followed by the application status of VR in the rehabilitation of stroke patients,Parkinson’s patients,mental and psychological diseases.Besides,many research experiments on the application of VR technology in rehabilitation medicine at the present stage are investigated.The results indicate that compared with traditional balance training,the VR-based neurological rehabilitation training method can more effectively ease the tilt degree and strengthen the trunk control ability and balance function of patients with post-stroke tilt syndrome.When the effect of traditional rehabilitation training on the gait and balance of Parkinson’s patients is not good enough,VR-based rehabilitation training can at least be used as an alternative therapy.Moreover,VR games have made great breakthroughs in promoting limb rehabilitation and brain injury rehabilitation,which is of incredible benefit to those with motor and activity disorders.It is also beneficial to the treatment and recovery of mental disorders of patients with nerve injury.Although VR still has limitations such as high cost and technical breakthrough bottleneck,it has great advantages in relieving pain,enhancing interest,and recovering patients’mental health in neurological rehabilitation training.展开更多
Objective: to study whether the pediatric intelligence and motor function are improved in the treatment of pediatric cerebral palsy. Methods: the 36 children with cerebral palsy admitted from 2018 to 2019 were treated...Objective: to study whether the pediatric intelligence and motor function are improved in the treatment of pediatric cerebral palsy. Methods: the 36 children with cerebral palsy admitted from 2018 to 2019 were treated as the subjects of this study. Neurorehabilitation therapy was performed for all children to compare the effects before and after treatment;to compare the motor function (coarse and fine motor dealers) and intellectual development of all children. Results: patients did not improve at 3 months, 6,9 and 12 months, the gross exercise and fine exercise scores were significantly improved compared with before treatment, and the denver child developmental screening test (DDST) score increased significantly, and the difference was significant (P <0.05). Thirty-four of the 36 children with cerebral palsy had relatively ideal treatment results, with a total efficiency of 94.44%. Conclusion: after the continuous treatment of pediatric cerebral palsy for more than 3 months, its intelligence and motor function were significantly improved than before the treatment.展开更多
Wearable ultrasound devices represent a transformative advancement in therapeutic applications,offering noninvasive,continuous,and targeted treatment for deep tissues.These systems leverage flexible materials(e.g.,pie...Wearable ultrasound devices represent a transformative advancement in therapeutic applications,offering noninvasive,continuous,and targeted treatment for deep tissues.These systems leverage flexible materials(e.g.,piezoelectric composites,biodegradable polymers)and conformable designs to enable stable integration with dynamic anatomical surfaces.Key innovations include ultrasound-enhanced drug delivery through cavitation-mediated transdermal penetration,accelerated tissue regeneration via mechanical and electrical stimulation,and precise neuromodulation using focused acoustic waves.Recent developments demonstrate wireless operation,real-time monitoring,and closed-loop therapy,facilitated by energy-efficient transducers and AI-driven adaptive control.Despite progress,challenges persist in material durability,clinical validation,and scalable manufacturing.Future directions highlight the integration of nanomaterials,3D-printed architectures,and multimodal sensing for personalized medicine.This technology holds significant potential to redefine chronic disease management,postoperative recovery,and neurorehabilitation,bridging the gap between clinical and home-based care.展开更多
Dear Editor,We very much appreciate the letter from Dr.Li et al.regarding“Two Sides of One Coin:Neurorestoratology and Neurorehabilitation”.We agree that“Both disciplines emphasize the recovery of function”.As sta...Dear Editor,We very much appreciate the letter from Dr.Li et al.regarding“Two Sides of One Coin:Neurorestoratology and Neurorehabilitation”.We agree that“Both disciplines emphasize the recovery of function”.As stated in our article,1“combining therapies from Neurorestoratology and Neurorehabilitation(i.e.,restoring the impaired nervous system itself and targeted treatment to change the consequences of neurological impairments via neurorehabilitation are likely to enhance therapeutic outcomes”.展开更多
Emerging new technologies are reshaping healthcare.At the cutting edge of this transformation stands artificial intelligence,which has presented the potential to significantly enhance healthcare outcomes.As a pivotal ...Emerging new technologies are reshaping healthcare.At the cutting edge of this transformation stands artificial intelligence,which has presented the potential to significantly enhance healthcare outcomes.As a pivotal branch of artificial intelligence,machine learning(ML)involves the development of intelligent algorithms with self-improvement through experience.In recent years,ML has been shown to be instrumental in tackling complex challenges in numerous medical domains,that is,disease diagnosis,1 medical device development,2 and biological networks.3 As we will discuss below,there are opportunities for moving the field forward by integrating pediatric neurorehabilitation with novel ML approaches.展开更多
Dear Editor,We would like to express our sincere appreciation for your recent Editorial,titled"Two sides of one coin:Neurorestoratology and Neurorehabilitation".1 In this article,you have provided profound i...Dear Editor,We would like to express our sincere appreciation for your recent Editorial,titled"Two sides of one coin:Neurorestoratology and Neurorehabilitation".1 In this article,you have provided profound insights into the disciplines of neurorestoratology and neurorehabilitation,and have provided a clear explanation of these two easily confused emerging fields.A major highlight of this article is the emphasis of the Beijing Declaration of the International Association of Neurorestoratology(IANR),which asserts that neural function can be achievable after nerve injury or degenerative changes.2 This is also the common background for the development of both disciplines,understood as complementary and cooperative fields.展开更多
In current medical systems,in addition to classical clinical medicine focusing on disease diagnosis and treatment,there are emerging fields of preventive medicine,rehabilitation medicine,and restorative medicine(medic...In current medical systems,in addition to classical clinical medicine focusing on disease diagnosis and treatment,there are emerging fields of preventive medicine,rehabilitation medicine,and restorative medicine(medical restoratology).The combination of these fields constitutes an important platform in modern medicine.1 The current editorial focuses on the branches of restorative medicine and rehabilitation medicine,namely Neurorestoratology and Neurorehabilitation,as well as their characteristics and differences.展开更多
Study design:Longitudinal prospective cohort study.Objectives:To assess the coefficient of efficacy and the influence of various demographic and neurological factors on changes in Spinal Cord Independence Measure Ⅲ(S...Study design:Longitudinal prospective cohort study.Objectives:To assess the coefficient of efficacy and the influence of various demographic and neurological factors on changes in Spinal Cord Independence Measure Ⅲ(SCIM-Ⅲ)scores over time in traumatic spinal cord injury(TSCI)patients.Setting:Patient recruitment and evaluations were conducted at the Brain and Spinal Injury Research Center in Imam Khomeini Hospital Complex,Tehran,Iran.Methods:The study was performed over an 8-year period in our outpatient rehabilitation setting.Changes in SCIM-Ⅲ scores were assessed in 559 TSCI patients(of 1460 enrolled patients)who fit the inclusion criteria.All included patients participated in our outpatient rehabilitation program,which consisted of a multidisciplinary education program combined with occupational therapy,physical therapy,and home nursing as a rehabilitation package for a 6-month period.Patients then received follow-up assessments every 6 months.Results:Predictors of the SCIM-Ⅲ score as a rehabilitation outcome tool,and of its change over time,included age(younger patients had better outcomes,p=0.067),marital status(married patients had better outcomes,p?0.031),education level(patients with university education had better outcomes,p=0.003),occupation status(employed patients had better outcomes,p=0.009),and neurological level of injury(patients with injuries at lower levels had better outcomes,p<0.001).However,sex and injury severity as per the American Spinal Injury Association Impairment Scale(AIS)had no significant effects on functional outcomes(i.e.,SCIM-Ⅲ score changes over time).Conclusion:Age,marital status,education level,employment,and neurological level all affected the final SCIM-Ⅲ scores of SCI patients.By contrast,sex and AIS grade were not significant predictors of SCIM-Ⅲ outcomes.Further studies that include additional factors may be useful for future SCIM-Ⅲ models.展开更多
BACKGROUND Autism spectrum disorder(ASD)is a complex neurodevelopmental disorder with multifaceted origins.In recent studies,neuroinflammation and immune dysregulation have come to the forefront in its pathogenesis.Th...BACKGROUND Autism spectrum disorder(ASD)is a complex neurodevelopmental disorder with multifaceted origins.In recent studies,neuroinflammation and immune dysregulation have come to the forefront in its pathogenesis.There are studies suggesting that stem cell therapy may be effective in the treatment of ASD.AIM To evolve the landscape of ASD treatment,focusing on the potential benefits and safety of stem cell transplantation.METHODS A detailed case report is presented,displaying the positive outcomes observed in a child who underwent intrathecal and intravenous Wharton’s jelly-derived mesenchymal stem cells(WJ-MSCs)transplantation combined with neurorehabilitation.RESULTS The study demonstrates a significant improvement in the child’s functional outcomes(Childhood Autism Rating Scale,Denver 2 Developmental Screening Test),especially in language and gross motor skills.No serious side effects were encountered during the 2-year follow-up.CONCLUSION The findings support the safety and effectiveness of WJ-MSC transplantation in managing ASD.展开更多
A large body of evidence shows that spinal circuits are significantly affected by training, and that intrinsic circuits that drive locomotor tasks are located in lumbosacral spinal segments in rats with complete spina...A large body of evidence shows that spinal circuits are significantly affected by training, and that intrinsic circuits that drive locomotor tasks are located in lumbosacral spinal segments in rats with complete spinal cord transection. However, after incomplete lesions, the effect of treadmil training has been debated, which is likely because of the difficulty of separating spontaneous stepping from specific training-induced effects. In this study, rats with moderate spinal cord contusion were sub-jected to either step training on a treadmil or used in the model （control） group. The treadmil training began at day 7 post-injury and lasted 20 ± 10 minutes per day, 5 days per week for 10 weeks. The speed of the treadmil was set to 3 m/min and was increased on a daily basis according to the tolerance of each rat. After 3 weeks of step training, the step training group exhibited a sig-nificantly greater improvement in the Basso, Beattie and Bresnahan score than the model group. The expression of growth-associated protein-43 in the spinal cord lesion site and the number of tyrosine hydroxylase-positive ventral neurons in the second lumbar spinal segment were greater in the step training group than in the model group at 11 weeks post-injury, while the levels of brain-derived neurotrophic factor protein in the spinal cord lesion site showed no difference between the two groups. These results suggest that treadmil training significantly improves functional re-covery and neural plasticity after incomplete spinal cord injury.展开更多
Although plasticity in the neural system underlies working memory, and working memory can be improved by training, there is thus far no evidence that children with developmental dyslexia can benefit from working-memor...Although plasticity in the neural system underlies working memory, and working memory can be improved by training, there is thus far no evidence that children with developmental dyslexia can benefit from working-memory training. In the present study, thirty dyslexic children aged 8-11 years were recruited from an elementary school in Wuhan, China. They received working-memory training including training in visuospatial memory, verbal memory, and central executive tasks. The difficulty of the tasks was adjusted based on the performance of each subject, and the training sessions lasted 40 minutes per day, for 5 weeks. The results showed that working-memory training significantly enhanced performance on the nontrained working memory tasks such as the visuospatial, the verbal domains, and central executive tasks in children with developmental dyslexia. More importantly, the visual rhyming task and reading fluency task were also significantly improved by training. Progress on working memory measures was related to changes in reading skills. These experimental findings indicate that working memory is a pivotal factor in reading development among children with developmental dyslexia, and interventions to improve working memory may help dyslexic children to become more proficient in reading.展开更多
Brain stimulation techniques offer powerful means of modulating the physiology of specific neural structures. In recent years, non-invasive brain stimulation techniques, such as transcranial magnetic stimulation(TMS) ...Brain stimulation techniques offer powerful means of modulating the physiology of specific neural structures. In recent years, non-invasive brain stimulation techniques, such as transcranial magnetic stimulation(TMS) and transcranial direct current stimulation, have emerged as therapeutic tools for neurology and neuroscience. However, the possible repercussions of these techniques remain unclear, and there are few reports on the incisive recovery mechanisms through brain stimulation. Although several studies have recommended the use of non-invasive brain stimulation in clinical neuroscience, with a special emphasis on TMS, the suggested mechanisms of action have not been confirmed directly at the neural level. Insights into the neural mechanisms of non-invasive brain stimulation would unveil the strategies necessary to enhance the safety and efficacy of this progressive approach. Therefore, animal studies investigating the mechanisms of TMSinduced recovery at the neural level are crucial for the elaboration of non-invasive brain stimulation. Translational research done using animal models has several advantages and is able to investigate knowledge gaps by directly targeting neuronal levels. In this review, we have discussed the role of TMS in different animal models, the impact of animal studies on various disease states, and the findings regarding brain function of animal models after TMS in pharmacology research.展开更多
BACKGROUND Recent innovations in intensive care have improved the prognosis of patients with severe brain injuries and brought more patients with disorders of consciousness(DoC).Data are lacking regarding the long-ter...BACKGROUND Recent innovations in intensive care have improved the prognosis of patients with severe brain injuries and brought more patients with disorders of consciousness(DoC).Data are lacking regarding the long-term outcomes of those patients in China.It is necessary to study the long-term outcomes of patients with prolonged DoC in light of many factors likely to influence crucial decisions about their care and their life.AIM To present the preliminary results of a DoC cohort.METHODS This was a two-center prospective cohort study of inpatients with vegetative state(VS)/unresponsive wakefulness syndrome(UWS).The study outcomes were the recovery from VS/UWS to minimally conscious state(MCS)and the long-term status of patients with prolonged DoC considered in VS/UWS or MCS for up to 6 years.The patients were evaluated using the Glasgow coma scale,coma recovery scale-revised,and Glasgow outcome scale.The endpoint of follow-up was recovery of full consciousness or death.The changes in the primary clinical outcome improvement in clinical diagnosis were evaluated at 12 mo compared with baseline.RESULTS The study population included 93 patients(62 VS/UWS and 31 MCS).The postinjury interval range was 28-634 d.Median follow-up was 20 mo(interquartile range,12-37 mo).At the endpoint,33 transitioned to an emergence from MCS or full consciousness,eight had a locked-in syndrome,and there were 35 patients remaining in a VS/UWS and 11 in an MCS.Seven(including one locked-in syndrome)patients(7.5%)died within 12 mo of injury.Compared with the unresponsive group(n=52)at 12 mo,the responsive group(n=41)had a higher proportion of males(87.8%vs 63.5%,P=0.008),shorter time from injury(median,40.0 d vs 65.5 d,P=0.006),higher frequency of vascular etiology(68.3%vs 38.5%,P=0.007),higher Glasgow coma scale score at admission(median,9 vs 6,P<0.001),higher coma recovery scale-revised score at admission(median,9 vs 2.5,P<0.001),at 1 mo(median,14 vs 5,P<0.001),and at 3 mo(median,20 vs 6,P<0.001),lower frequency of VS/UWS(36.6%vs 90.0%,P<0.001),and more favorable Glasgow outcome scale outcome(P<0.001).CONCLUSION Patients with severe DoC,despite having strong predictors of poor prognosis,might recover consciousness after a prolonged time of rehabilitation.An accurate initial diagnosis of patients with DoC is critical for predicting outcome and a long-term regular follow-up is also important.展开更多
Percutaneous electrical nerve stimulation of an injured nerve can promote and accelerate peripheral nerve regeneration and improve function.When performing acupuncture and moxibustion,locating the injured nerve using ...Percutaneous electrical nerve stimulation of an injured nerve can promote and accelerate peripheral nerve regeneration and improve function.When performing acupuncture and moxibustion,locating the injured nerve using ultrasound before percutaneous nerve stimulation can help prevent further injury to an already injured nerve.However,stimulation parameters have not been standardized.In this study,we constructed a multi-layer human forearm model using finite element modeling.Taking current density and activated function as optimization indicators,the optimal percutaneous nerve stimulation parameters were established.The optimal parameters were parallel placement located 3 cm apart with the injury site at the midpoint between the needles.To validate the efficacy of this regimen,we performed a randomized controlled trial in 23 patients with median nerve transection who underwent neurorrhaphy.Patients who received conventional rehabilitation combined with percutaneous electrical nerve stimulation experienced greater improvement in sensory function,motor function,and grip strength than those who received conventional rehabilitation combined with transcutaneous electrical nerve stimulation.These findings suggest that the percutaneous electrical nerve stimulation regimen established in this study can improve global median nerve function in patients with median nerve transection.展开更多
After intraperitoneal injection of 20 mg/kg lead acetate, rats received 8 weeks of treadmill exercise （15-22 m/min, 25-64 minutes） and/or treadmill exercise at 1.6 km/h until exhaustion. The markers related to neuro...After intraperitoneal injection of 20 mg/kg lead acetate, rats received 8 weeks of treadmill exercise （15-22 m/min, 25-64 minutes） and/or treadmill exercise at 1.6 km/h until exhaustion. The markers related to neurotoxicity were measured by enzyme-linked immunosorbent assay method. 8 weeks of treadmill exercise significantly increased brain-derived neurotrophic factor level in the hippocampus （P = 0.04） and plasma level of total antioxidant capacity of rats exposed to lead acetate （P 〈 0.001）, and significantly decreased plasma level of malondialdehyde （P 〈 0.001）. Acute exercise only decreased the hippocampal malondialdehyde level （P = 0.09） and increased brain-derived neurotrophic factor level in the hippocampus （P = 0.66）. Acute exercise also enhanced the total antioxidant capacity in rats exposed to lead acetate, insignificantly （P = 0.99）, These findings suggest that chronic treadmill exercise can significantly decrease neurotoxicity and alleviate oxidative stress in rats exposed to lead acetate. However, acute endurance exercise was not associated with these beneficial effects.展开更多
Inhibitory control of movement in motor learning requires the ability to suppress an inappropriate action, a skill needed to stop a planned or ongoing motor response in response to changes in a variety of environments...Inhibitory control of movement in motor learning requires the ability to suppress an inappropriate action, a skill needed to stop a planned or ongoing motor response in response to changes in a variety of environments. This study used a stop-signal task to determine whether transcranial direct-current stimulation over the pre-supplementary motor area alters the reaction time in motor inhibition. Forty healthy subjects were recruited for this study and were randomly assigned to either the transcranial direct-current stimulation condition or a sham-transcranial direct-current stimulation condition. All subjects consecutively performed the stop-signal task before, during, and after the delivery of anodal transcranial direct-current stimulation over the pre-supplementary motor area （pre-transcranial direct-current stimulation phase, transcranial direct-current stimulation phase, and post-transcranial direct-current stimulation phase）. Compared to the sham condition, there were significant reductions in the stop-signal processing times during and after transcranial direct-current stimulation, and change times were significantly greater in the transcranial direct-current stimulation condition. There was no significant change in go processing-times during or after transcranial direct-current stimulation in either condition. Anodal transcranial direct-current stimulation was feasibly coupled to an interactive improvement in inhibitory control. This coupling led to a decrease in the stop-signal process time required for the appropriate responses between motor execution and inhibition. However, there was no transcranial direct-current stimulation effect on the no-signal reaction time during the stop-signal task. Transcranial direct-current stimulation can adjust certain behaviors, and it could be a useful clinical intervention for patients who have difficulties with response inhibition.展开更多
Congenital mirror movements retard typical hand functions, but no definite therapeutic modality is available to treat such movements. We report an 8-year-old boy with severe mirror movements of both hands. His mirror ...Congenital mirror movements retard typical hand functions, but no definite therapeutic modality is available to treat such movements. We report an 8-year-old boy with severe mirror movements of both hands. His mirror movements were assessed using the Woods and Teuber grading scale and his fine motor skills were also evaluated by the Purdue Pegboard Test. A 2-week regimen of repetitive transcranial magnetic stimulation produced markedly diminished mirror movement symptoms and increased the fine motor skills of both hands. Two weeks after the completion of the regimen, mirror movement grades had improved from grade 4 to 1 in both hands and the Purdue Pegboard Test results of the right and left hands also improved from 12 to 14 or 13. These improvements were maintained for 1 month after the 2-week repetitive transcranial magnetic stimulation regimen. After 18 months, the mirror movement grade was maintained and the Purdue Pegboard test score had improved to 15 for the right hand while the left hand score was maintained at 13. This occurred without any additional repetitive transcranial magnetic stimulation or other treatment. These findings suggest that repetitive transcranial magnetic stimulation for this patient had a therapeutic and long-term effect on mirror movements.展开更多
基金supported by the Defitech Foundation(Morges,CH)to FCHthe Bertarelli Foundation-Catalyst program(Gstaad,CH)to FCH+2 种基金the Wyss Center for Bio and Neuroengineering the Lighthouse Partnership for AI-guided Neuromodulation to FCHthe Fonds de recherche du Quebec-Sante(FRQS#342969)to CEPthe Neuro X Postdoctoral Fellowship Program to CEP。
文摘Brain lesions,such as those caused by stroke or traumatic brain injury(TBI),frequently result in persistent motor and cognitive impairments that significantly affect the individual patient's quality of life.Despite differences in the mechanisms of injury,both conditions share a high prevalence of motor and cognitive impairments.These deficits show only limited natural recovery.
文摘The mirror neuron system consists of a set of brain areas capable of matching action observation with action execution. One core feature of the mirror neuron system is the activation of motor areas by action observation alone. This unique capacity of the mirror neuron system to match action perception and action execution stimulated the idea that mirror neuron system plays a crucial role in the understanding of the content of observed actions and may participate in procedural learning. These features bear a high potential for neurorehabilitation of motor deficits and of aphasia following stroke. Since the first articles exploring this principle were published, a growing number of follow-up studies have been conducted in the last decade. Though, the combination of action observation with practice of the observed actions seems to constitute the most powerful approach. In the present review, we present the existing studies analyzing the effects of this neurorehabJlitative approach in clinical settings especially in the rehabilitation of stroke associated motor deficits and give a perspective on the ongoing trials by our research group. The data obtained up to date showed significant positive effect of action observation on recovery of motor functions of the upper limbs even in the chronic state after stroke, indicating that our approach might become a new standardized add-on feature of modern neurorehabilitative treatment schemes.
文摘The present study observed the effects of the non-invasive, mirror neuron system application on neurorehabilitation. In primate studies, mirror neurons have been shown to fire when the subject observes or performs a specific action, thereby allowing for observation of motor cortex activation. This activation of the mirror neuron system could serve as a treatment for stroke patients. In the present study, the combination of a mirror neuron system-based therapy was introduced for the treatment of patients with motor-deficits, who could not perform rehabilitation exercises. The results also indicate that this therapeutic method plays a positive role in emotional regulation in the same patients.
文摘The present work investigates the application of virtual reality(VR)technology to neurorehabilitation.By consulting a wealth of data,the advantages of VR in neurorehabilitation are introduced,followed by the application status of VR in the rehabilitation of stroke patients,Parkinson’s patients,mental and psychological diseases.Besides,many research experiments on the application of VR technology in rehabilitation medicine at the present stage are investigated.The results indicate that compared with traditional balance training,the VR-based neurological rehabilitation training method can more effectively ease the tilt degree and strengthen the trunk control ability and balance function of patients with post-stroke tilt syndrome.When the effect of traditional rehabilitation training on the gait and balance of Parkinson’s patients is not good enough,VR-based rehabilitation training can at least be used as an alternative therapy.Moreover,VR games have made great breakthroughs in promoting limb rehabilitation and brain injury rehabilitation,which is of incredible benefit to those with motor and activity disorders.It is also beneficial to the treatment and recovery of mental disorders of patients with nerve injury.Although VR still has limitations such as high cost and technical breakthrough bottleneck,it has great advantages in relieving pain,enhancing interest,and recovering patients’mental health in neurological rehabilitation training.
文摘Objective: to study whether the pediatric intelligence and motor function are improved in the treatment of pediatric cerebral palsy. Methods: the 36 children with cerebral palsy admitted from 2018 to 2019 were treated as the subjects of this study. Neurorehabilitation therapy was performed for all children to compare the effects before and after treatment;to compare the motor function (coarse and fine motor dealers) and intellectual development of all children. Results: patients did not improve at 3 months, 6,9 and 12 months, the gross exercise and fine exercise scores were significantly improved compared with before treatment, and the denver child developmental screening test (DDST) score increased significantly, and the difference was significant (P <0.05). Thirty-four of the 36 children with cerebral palsy had relatively ideal treatment results, with a total efficiency of 94.44%. Conclusion: after the continuous treatment of pediatric cerebral palsy for more than 3 months, its intelligence and motor function were significantly improved than before the treatment.
基金the support from the start-up of the University of Missouri-Columbia。
文摘Wearable ultrasound devices represent a transformative advancement in therapeutic applications,offering noninvasive,continuous,and targeted treatment for deep tissues.These systems leverage flexible materials(e.g.,piezoelectric composites,biodegradable polymers)and conformable designs to enable stable integration with dynamic anatomical surfaces.Key innovations include ultrasound-enhanced drug delivery through cavitation-mediated transdermal penetration,accelerated tissue regeneration via mechanical and electrical stimulation,and precise neuromodulation using focused acoustic waves.Recent developments demonstrate wireless operation,real-time monitoring,and closed-loop therapy,facilitated by energy-efficient transducers and AI-driven adaptive control.Despite progress,challenges persist in material durability,clinical validation,and scalable manufacturing.Future directions highlight the integration of nanomaterials,3D-printed architectures,and multimodal sensing for personalized medicine.This technology holds significant potential to redefine chronic disease management,postoperative recovery,and neurorehabilitation,bridging the gap between clinical and home-based care.
文摘Dear Editor,We very much appreciate the letter from Dr.Li et al.regarding“Two Sides of One Coin:Neurorestoratology and Neurorehabilitation”.We agree that“Both disciplines emphasize the recovery of function”.As stated in our article,1“combining therapies from Neurorestoratology and Neurorehabilitation(i.e.,restoring the impaired nervous system itself and targeted treatment to change the consequences of neurological impairments via neurorehabilitation are likely to enhance therapeutic outcomes”.
基金supported by the Featured Clinical Technique of Guangzhou(2023C-TS59)the Natural Science Foundation of Guangdong Province(2021A1515012543)the Scientific and Technological Planning Project of Guangzhou City(2024A03J01274)
文摘Emerging new technologies are reshaping healthcare.At the cutting edge of this transformation stands artificial intelligence,which has presented the potential to significantly enhance healthcare outcomes.As a pivotal branch of artificial intelligence,machine learning(ML)involves the development of intelligent algorithms with self-improvement through experience.In recent years,ML has been shown to be instrumental in tackling complex challenges in numerous medical domains,that is,disease diagnosis,1 medical device development,2 and biological networks.3 As we will discuss below,there are opportunities for moving the field forward by integrating pediatric neurorehabilitation with novel ML approaches.
文摘Dear Editor,We would like to express our sincere appreciation for your recent Editorial,titled"Two sides of one coin:Neurorestoratology and Neurorehabilitation".1 In this article,you have provided profound insights into the disciplines of neurorestoratology and neurorehabilitation,and have provided a clear explanation of these two easily confused emerging fields.A major highlight of this article is the emphasis of the Beijing Declaration of the International Association of Neurorestoratology(IANR),which asserts that neural function can be achievable after nerve injury or degenerative changes.2 This is also the common background for the development of both disciplines,understood as complementary and cooperative fields.
文摘In current medical systems,in addition to classical clinical medicine focusing on disease diagnosis and treatment,there are emerging fields of preventive medicine,rehabilitation medicine,and restorative medicine(medical restoratology).The combination of these fields constitutes an important platform in modern medicine.1 The current editorial focuses on the branches of restorative medicine and rehabilitation medicine,namely Neurorestoratology and Neurorehabilitation,as well as their characteristics and differences.
文摘Study design:Longitudinal prospective cohort study.Objectives:To assess the coefficient of efficacy and the influence of various demographic and neurological factors on changes in Spinal Cord Independence Measure Ⅲ(SCIM-Ⅲ)scores over time in traumatic spinal cord injury(TSCI)patients.Setting:Patient recruitment and evaluations were conducted at the Brain and Spinal Injury Research Center in Imam Khomeini Hospital Complex,Tehran,Iran.Methods:The study was performed over an 8-year period in our outpatient rehabilitation setting.Changes in SCIM-Ⅲ scores were assessed in 559 TSCI patients(of 1460 enrolled patients)who fit the inclusion criteria.All included patients participated in our outpatient rehabilitation program,which consisted of a multidisciplinary education program combined with occupational therapy,physical therapy,and home nursing as a rehabilitation package for a 6-month period.Patients then received follow-up assessments every 6 months.Results:Predictors of the SCIM-Ⅲ score as a rehabilitation outcome tool,and of its change over time,included age(younger patients had better outcomes,p=0.067),marital status(married patients had better outcomes,p?0.031),education level(patients with university education had better outcomes,p=0.003),occupation status(employed patients had better outcomes,p=0.009),and neurological level of injury(patients with injuries at lower levels had better outcomes,p<0.001).However,sex and injury severity as per the American Spinal Injury Association Impairment Scale(AIS)had no significant effects on functional outcomes(i.e.,SCIM-Ⅲ score changes over time).Conclusion:Age,marital status,education level,employment,and neurological level all affected the final SCIM-Ⅲ scores of SCI patients.By contrast,sex and AIS grade were not significant predictors of SCIM-Ⅲ outcomes.Further studies that include additional factors may be useful for future SCIM-Ⅲ models.
文摘BACKGROUND Autism spectrum disorder(ASD)is a complex neurodevelopmental disorder with multifaceted origins.In recent studies,neuroinflammation and immune dysregulation have come to the forefront in its pathogenesis.There are studies suggesting that stem cell therapy may be effective in the treatment of ASD.AIM To evolve the landscape of ASD treatment,focusing on the potential benefits and safety of stem cell transplantation.METHODS A detailed case report is presented,displaying the positive outcomes observed in a child who underwent intrathecal and intravenous Wharton’s jelly-derived mesenchymal stem cells(WJ-MSCs)transplantation combined with neurorehabilitation.RESULTS The study demonstrates a significant improvement in the child’s functional outcomes(Childhood Autism Rating Scale,Denver 2 Developmental Screening Test),especially in language and gross motor skills.No serious side effects were encountered during the 2-year follow-up.CONCLUSION The findings support the safety and effectiveness of WJ-MSC transplantation in managing ASD.
基金sponsored by the National Natural Science Foundation of China,No.30872604,81171862
文摘A large body of evidence shows that spinal circuits are significantly affected by training, and that intrinsic circuits that drive locomotor tasks are located in lumbosacral spinal segments in rats with complete spinal cord transection. However, after incomplete lesions, the effect of treadmil training has been debated, which is likely because of the difficulty of separating spontaneous stepping from specific training-induced effects. In this study, rats with moderate spinal cord contusion were sub-jected to either step training on a treadmil or used in the model （control） group. The treadmil training began at day 7 post-injury and lasted 20 ± 10 minutes per day, 5 days per week for 10 weeks. The speed of the treadmil was set to 3 m/min and was increased on a daily basis according to the tolerance of each rat. After 3 weeks of step training, the step training group exhibited a sig-nificantly greater improvement in the Basso, Beattie and Bresnahan score than the model group. The expression of growth-associated protein-43 in the spinal cord lesion site and the number of tyrosine hydroxylase-positive ventral neurons in the second lumbar spinal segment were greater in the step training group than in the model group at 11 weeks post-injury, while the levels of brain-derived neurotrophic factor protein in the spinal cord lesion site showed no difference between the two groups. These results suggest that treadmil training significantly improves functional re-covery and neural plasticity after incomplete spinal cord injury.
基金supported by grants from the National Natural Science Foundation of China, No. 30872132
文摘Although plasticity in the neural system underlies working memory, and working memory can be improved by training, there is thus far no evidence that children with developmental dyslexia can benefit from working-memory training. In the present study, thirty dyslexic children aged 8-11 years were recruited from an elementary school in Wuhan, China. They received working-memory training including training in visuospatial memory, verbal memory, and central executive tasks. The difficulty of the tasks was adjusted based on the performance of each subject, and the training sessions lasted 40 minutes per day, for 5 weeks. The results showed that working-memory training significantly enhanced performance on the nontrained working memory tasks such as the visuospatial, the verbal domains, and central executive tasks in children with developmental dyslexia. More importantly, the visual rhyming task and reading fluency task were also significantly improved by training. Progress on working memory measures was related to changes in reading skills. These experimental findings indicate that working memory is a pivotal factor in reading development among children with developmental dyslexia, and interventions to improve working memory may help dyslexic children to become more proficient in reading.
文摘Brain stimulation techniques offer powerful means of modulating the physiology of specific neural structures. In recent years, non-invasive brain stimulation techniques, such as transcranial magnetic stimulation(TMS) and transcranial direct current stimulation, have emerged as therapeutic tools for neurology and neuroscience. However, the possible repercussions of these techniques remain unclear, and there are few reports on the incisive recovery mechanisms through brain stimulation. Although several studies have recommended the use of non-invasive brain stimulation in clinical neuroscience, with a special emphasis on TMS, the suggested mechanisms of action have not been confirmed directly at the neural level. Insights into the neural mechanisms of non-invasive brain stimulation would unveil the strategies necessary to enhance the safety and efficacy of this progressive approach. Therefore, animal studies investigating the mechanisms of TMSinduced recovery at the neural level are crucial for the elaboration of non-invasive brain stimulation. Translational research done using animal models has several advantages and is able to investigate knowledge gaps by directly targeting neuronal levels. In this review, we have discussed the role of TMS in different animal models, the impact of animal studies on various disease states, and the findings regarding brain function of animal models after TMS in pharmacology research.
基金Supported by the National Natural Science Foundation of China,No.81371194 and No.81873723.
文摘BACKGROUND Recent innovations in intensive care have improved the prognosis of patients with severe brain injuries and brought more patients with disorders of consciousness(DoC).Data are lacking regarding the long-term outcomes of those patients in China.It is necessary to study the long-term outcomes of patients with prolonged DoC in light of many factors likely to influence crucial decisions about their care and their life.AIM To present the preliminary results of a DoC cohort.METHODS This was a two-center prospective cohort study of inpatients with vegetative state(VS)/unresponsive wakefulness syndrome(UWS).The study outcomes were the recovery from VS/UWS to minimally conscious state(MCS)and the long-term status of patients with prolonged DoC considered in VS/UWS or MCS for up to 6 years.The patients were evaluated using the Glasgow coma scale,coma recovery scale-revised,and Glasgow outcome scale.The endpoint of follow-up was recovery of full consciousness or death.The changes in the primary clinical outcome improvement in clinical diagnosis were evaluated at 12 mo compared with baseline.RESULTS The study population included 93 patients(62 VS/UWS and 31 MCS).The postinjury interval range was 28-634 d.Median follow-up was 20 mo(interquartile range,12-37 mo).At the endpoint,33 transitioned to an emergence from MCS or full consciousness,eight had a locked-in syndrome,and there were 35 patients remaining in a VS/UWS and 11 in an MCS.Seven(including one locked-in syndrome)patients(7.5%)died within 12 mo of injury.Compared with the unresponsive group(n=52)at 12 mo,the responsive group(n=41)had a higher proportion of males(87.8%vs 63.5%,P=0.008),shorter time from injury(median,40.0 d vs 65.5 d,P=0.006),higher frequency of vascular etiology(68.3%vs 38.5%,P=0.007),higher Glasgow coma scale score at admission(median,9 vs 6,P<0.001),higher coma recovery scale-revised score at admission(median,9 vs 2.5,P<0.001),at 1 mo(median,14 vs 5,P<0.001),and at 3 mo(median,20 vs 6,P<0.001),lower frequency of VS/UWS(36.6%vs 90.0%,P<0.001),and more favorable Glasgow outcome scale outcome(P<0.001).CONCLUSION Patients with severe DoC,despite having strong predictors of poor prognosis,might recover consciousness after a prolonged time of rehabilitation.An accurate initial diagnosis of patients with DoC is critical for predicting outcome and a long-term regular follow-up is also important.
基金supported by the National Natural Science Foundation of China,No.81801787(to XZS)China Postdoctoral Science Foundation,No.2018M640238(to XZS)the Natural Science Foundation of Tianjin,No.20JCQNJC01690(to XLC)。
文摘Percutaneous electrical nerve stimulation of an injured nerve can promote and accelerate peripheral nerve regeneration and improve function.When performing acupuncture and moxibustion,locating the injured nerve using ultrasound before percutaneous nerve stimulation can help prevent further injury to an already injured nerve.However,stimulation parameters have not been standardized.In this study,we constructed a multi-layer human forearm model using finite element modeling.Taking current density and activated function as optimization indicators,the optimal percutaneous nerve stimulation parameters were established.The optimal parameters were parallel placement located 3 cm apart with the injury site at the midpoint between the needles.To validate the efficacy of this regimen,we performed a randomized controlled trial in 23 patients with median nerve transection who underwent neurorrhaphy.Patients who received conventional rehabilitation combined with percutaneous electrical nerve stimulation experienced greater improvement in sensory function,motor function,and grip strength than those who received conventional rehabilitation combined with transcutaneous electrical nerve stimulation.These findings suggest that the percutaneous electrical nerve stimulation regimen established in this study can improve global median nerve function in patients with median nerve transection.
文摘After intraperitoneal injection of 20 mg/kg lead acetate, rats received 8 weeks of treadmill exercise （15-22 m/min, 25-64 minutes） and/or treadmill exercise at 1.6 km/h until exhaustion. The markers related to neurotoxicity were measured by enzyme-linked immunosorbent assay method. 8 weeks of treadmill exercise significantly increased brain-derived neurotrophic factor level in the hippocampus （P = 0.04） and plasma level of total antioxidant capacity of rats exposed to lead acetate （P 〈 0.001）, and significantly decreased plasma level of malondialdehyde （P 〈 0.001）. Acute exercise only decreased the hippocampal malondialdehyde level （P = 0.09） and increased brain-derived neurotrophic factor level in the hippocampus （P = 0.66）. Acute exercise also enhanced the total antioxidant capacity in rats exposed to lead acetate, insignificantly （P = 0.99）, These findings suggest that chronic treadmill exercise can significantly decrease neurotoxicity and alleviate oxidative stress in rats exposed to lead acetate. However, acute endurance exercise was not associated with these beneficial effects.
基金supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology of Korea of Republic, No. 2012R1A1B4003477
文摘Inhibitory control of movement in motor learning requires the ability to suppress an inappropriate action, a skill needed to stop a planned or ongoing motor response in response to changes in a variety of environments. This study used a stop-signal task to determine whether transcranial direct-current stimulation over the pre-supplementary motor area alters the reaction time in motor inhibition. Forty healthy subjects were recruited for this study and were randomly assigned to either the transcranial direct-current stimulation condition or a sham-transcranial direct-current stimulation condition. All subjects consecutively performed the stop-signal task before, during, and after the delivery of anodal transcranial direct-current stimulation over the pre-supplementary motor area （pre-transcranial direct-current stimulation phase, transcranial direct-current stimulation phase, and post-transcranial direct-current stimulation phase）. Compared to the sham condition, there were significant reductions in the stop-signal processing times during and after transcranial direct-current stimulation, and change times were significantly greater in the transcranial direct-current stimulation condition. There was no significant change in go processing-times during or after transcranial direct-current stimulation in either condition. Anodal transcranial direct-current stimulation was feasibly coupled to an interactive improvement in inhibitory control. This coupling led to a decrease in the stop-signal process time required for the appropriate responses between motor execution and inhibition. However, there was no transcranial direct-current stimulation effect on the no-signal reaction time during the stop-signal task. Transcranial direct-current stimulation can adjust certain behaviors, and it could be a useful clinical intervention for patients who have difficulties with response inhibition.
基金supported by Yeungnam University research grants in 2010
文摘Congenital mirror movements retard typical hand functions, but no definite therapeutic modality is available to treat such movements. We report an 8-year-old boy with severe mirror movements of both hands. His mirror movements were assessed using the Woods and Teuber grading scale and his fine motor skills were also evaluated by the Purdue Pegboard Test. A 2-week regimen of repetitive transcranial magnetic stimulation produced markedly diminished mirror movement symptoms and increased the fine motor skills of both hands. Two weeks after the completion of the regimen, mirror movement grades had improved from grade 4 to 1 in both hands and the Purdue Pegboard Test results of the right and left hands also improved from 12 to 14 or 13. These improvements were maintained for 1 month after the 2-week repetitive transcranial magnetic stimulation regimen. After 18 months, the mirror movement grade was maintained and the Purdue Pegboard test score had improved to 15 for the right hand while the left hand score was maintained at 13. This occurred without any additional repetitive transcranial magnetic stimulation or other treatment. These findings suggest that repetitive transcranial magnetic stimulation for this patient had a therapeutic and long-term effect on mirror movements.
