Cortical waves and post‐stroke brain stimulation

2019 ◽  
Vol 42 (11) ◽  
pp. 3912-3928 ◽  
Author(s):  
Nikolai Bessonov ◽  
Anne Beuter ◽  
Sergei Trofimchuk ◽  
Vitaly Volpert
BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016566
Author(s):  
Eline C C van Lieshout ◽  
Johanna M A Visser-Meily ◽  
Sebastiaan F W Neggers ◽  
H Bart van der Worp ◽  
Rick M Dijkhuizen

IntroductionMany patients with stroke have moderate to severe long-term sensorimotor impairments, often including inability to execute movements of the affected arm or hand. Limited recovery from stroke may be partly caused by imbalanced interaction between the cerebral hemispheres, with reduced excitability of the ipsilesional motor cortex while excitability of the contralesional motor cortex is increased. Non-invasive brain stimulation with inhibitory repetitive transcranial magnetic stimulation (rTMS) of the contralesional hemisphere may aid in relieving a post-stroke interhemispheric excitability imbalance, which could improve functional recovery. There are encouraging effects of theta burst stimulation (TBS), a form of TMS, in patients with chronic stroke, but evidence on efficacy and long-term effects on arm function of contralesional TBS in patients with subacute hemiparetic stroke is lacking.Methods and analysisIn a randomised clinical trial, we will assign 60 patients with a first-ever ischaemic stroke in the previous 7–14 days and a persistent paresis of one arm to 10 sessions of real stimulation with TBS of the contralesional primary motor cortex or to sham stimulation over a period of 2 weeks. Both types of stimulation will be followed by upper limb training. A subset of patients will undergo five MRI sessions to assess post-stroke brain reorganisation. The primary outcome measure will be the upper limb function score, assessed from grasp, grip, pinch and gross movements in the action research arm test, measured at 3 months after stroke. Patients will be blinded to treatment allocation. The primary outcome at 3 months will also be assessed in a blinded fashion.Ethics and disseminationThe study has been approved by the Medical Research Ethics Committee of the University Medical Center Utrecht, The Netherlands. The results will be disseminated through (open access) peer-reviewed publications, networks of scientists, professionals and the public, and presented at conferences.Trial registration numberNTR6133


2013 ◽  
Vol 333 ◽  
pp. e524 ◽  
Author(s):  
E. Papuć ◽  
K. Obszańska ◽  
T. Trojanowski ◽  
Z. Stelmasiak ◽  
K. Rejdak

Pain ◽  
2009 ◽  
Vol 147 (1) ◽  
pp. 299-304 ◽  
Author(s):  
Anthony E. Pickering ◽  
Simon R. Thornton ◽  
Sarah J. Love-Jones ◽  
Charlotte Steeds ◽  
Nikunj K. Patel

2014 ◽  
Vol 8 (3) ◽  
pp. 207-215 ◽  
Author(s):  
Lucia Iracema Zanotto de Mendonça

Transcranial brain stimulation (TS) techniques have been investigated for use in the rehabilitation of post-stroke aphasia. According to previous reports, functional recovery by the left hemisphere improves recovery from aphasia, when compared with right hemisphere participation. TS has been applied to stimulate the activity of the left hemisphere or to inhibit homotopic areas in the right hemisphere. Various factors can interfere with the brain's response to TS, including the size and location of the lesion, the time elapsed since the causal event, and individual differences in the hemispheric language dominance pattern. The following questions are discussed in the present article: [a] Is inhibition of the right hemisphere truly beneficial?; [b] Is the transference of the language network to the left hemisphere truly desirable in all patients?; [c] Is the use of TS during the post-stroke subacute phase truly appropriate? Different patterns of neuroplasticity must occur in post-stroke aphasia.


Neurosurgery ◽  
2010 ◽  
Vol 67 (2) ◽  
pp. 549-550
Author(s):  
Patrick Schweder ◽  
Peter Hansen ◽  
Gerardine Quaghebeur ◽  
Alexander L. Green ◽  
Tipu Z. Aziz

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