scholarly journals Limited capacity for ipsilateral secondary motor areas to support hand function post‐stroke

2020 ◽  
Vol 598 (11) ◽  
pp. 2153-2167 ◽  
Author(s):  
Kevin B. Wilkins ◽  
Jun Yao ◽  
Meriel Owen ◽  
Haleh Karbasforoushan ◽  
Carolina Carmona ◽  
...  
Keyword(s):  
Hand Function ◽  
Limited Capacity ◽  
Post Stroke ◽  
Motor Areas

scholarly journals Limited Capacity for Ipsilateral Secondary Motor Areas to Support Hand Function Post-Stroke

2019 ◽  
Author(s):  
Kevin B. Wilkins ◽  
Jun Yao ◽  
Meriel Owen ◽  
Haleh Karbasforoushan ◽  
Carolina Carmona ◽  
...  
Keyword(s):  
Hand Function ◽  
Shoulder Abduction ◽  
Limited Capacity ◽  
Post Stroke ◽  
Backup System ◽  
Reticulospinal Tract ◽  
Hemiparetic Stroke ◽  
Chronic Hemiparetic Stroke ◽  
Hand Opening ◽  
Motor Areas

AbstractRecent findings have shown connections of ipsilateral cortico-reticulospinal tract (CRST), predominantly originating from secondary motor areas, to not only proximal but also distal portions of the arm. In unilateral stroke, CRST from the ipsilateral side is intact and thus has been proposed as a possible backup system for post-stroke rehabilitation even for the hand. We argue that although CRST from ipsilateral secondary motor areas can provide control for proximal joints, it is insufficient to control either hand or coordinated shoulder and hand movements due to its extensive branching compared to contralateral corticospinal tract. To address this issue, we combined MRI, high-density EEG, and robotics in 17 individuals with severe chronic hemiparetic stroke and 12 age-matched controls. We tested for changes in structural morphometry of the sensorimotor cortex and found that individuals with stroke demonstrated higher gray matter density in secondary motor areas ipsilateral to the paretic arm compared to controls. We then measured cortical activity while participants attempted to generate hand opening either supported on a table or while lifting against a shoulder abduction load. The addition of shoulder abduction during hand opening increased reliance on ipsilateral secondary motor areas in stroke, but not controls. Crucially, increased use of ipsilateral secondary motor areas was associated with decreased hand opening ability while lifting the arm due to involuntary coupling between the shoulder and wrist/finger flexors. Together, this evidence implicates a compensatory role for ipsilateral (i.e., contralesional) secondary motor areas post-stroke, but with limited capacity to support hand function.

Abstract 123: Effects Of High-frequency RTMS Applied Over Bilateral Leg Motor Areas Using A Double Cone Coil On Walking Function In Post-stroke Patients

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Wataru Kakuda ◽  
Masahiro Abo ◽  
Ryo Momosaki
Keyword(s):  
High Frequency ◽  
Sham Group ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Double Cone ◽  
Anatomical Location ◽  
Cost Index ◽  
Magnetic Current ◽  
Post Stroke ◽  
Walking Velocity ◽  
Motor Areas

Objective: It is difficult to stimulate leg motor areas with magnetic current using a figure-of-eight coil due to the deep anatomical location of the areas. However, a double cone coil is useful for stimulating deep brain regions. We postulated that the use of the same coil may allow repetitive transcranial magnetic stimulation (rTMS) to modulate the neural activity of the same areas. The purpose of this study is to investigate the effect of high-frequency rTMS applied over bilateral leg motor areas with a double cone coil on walking function after stroke. Materials and methods: Eighteen post-stroke hemiparetic patients with gait disturbances attended two experimental sessions with more than 24 hours apart, in a cross-over, double-blind paradigm. In one session, high-frequency rTMS of 10 Hz was applied over the leg motor area bilaterally in a 10-sec train using a double cone coil for 20 minutes (total 2,000 pulses). In the other session, sham stimulation was applied for 20 minutes at the same site. To assess walking function, walking velocity and Physiological Cost Index (PCI) were evaluated serially before, immediately after, and 10 and 20 minutes after each intervention. Results: The walking velocity was significantly higher for 20 minutes after stimulation in the high-frequency rTMS group than the sham group. PCI was lower in the high-frequency rTMS group than the sham group, but this was significant only immediately after stimulation. Conclusions: High-frequency rTMS of bilateral motor areas using a double cone coil can potentially improve walking function in post-stroke hemiparetic patients.

Portable and Reconfigurable Wrist Robot Improves Hand Function for Post-Stroke Subjects

2017 ◽  
Vol 25 (10) ◽  
pp. 1864-1873 ◽  
Author(s):  
Kang Xiang Khor ◽  
Patrick Jun Hua Chin ◽  
Che Fai Yeong ◽  
Eileen Lee Ming Su ◽  
Aqilah Leela T. Narayanan ◽  
...  
Keyword(s):  
Hand Function ◽  
Post Stroke

A Virtual Reality—Based Exercise System for Hand Rehabilitation Post-Stroke

2005 ◽  
Vol 14 (2) ◽  
pp. 161-174 ◽  
Author(s):  
Sergei V. Adamovich ◽  
Alma S. Merians ◽  
Rares Boian ◽  
Jeffrey A. Lewis ◽  
Marilyn Tremaine ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Hand Function ◽  
Neurological Impairment ◽  
Lesion Size ◽  
Task Completion ◽  
Hand Rehabilitation ◽  
Oracle Database ◽  
Post Stroke ◽  
Real Objects ◽  
Movement Parameters

This paper presents preliminary results from a virtual reality (VR)-based system for hand rehabilitation that uses a CyberGlove and a Rutgers Master II-ND haptic glove. This computerized system trains finger range of motion, finger flexion speed, independence of finger motion, and finger strength using specific VR simulation exercises. A remote Web-based monitoring station was developed to allow telerehabilitation interventions. The remote therapist observes simplified versions of the patient exercises that are updated in real time. Patient data is stored transparently in an Oracle database, which is also Web accessible through a portal GUI. Thus the remote therapist or attending physician can graph exercise outcomes and thus evaluate patient outcomes at a distance. Data from the VR simulations is complemented by clinical measurements of hand function and strength. Eight chronic post-stroke subjects participated in a pilot study of the above system. In keeping with variability in both their lesion size and site and in their initial upper extremity function, each subject showed improvement on a unique combination of movement parameters in VR training. Importantly, these improvements transferred to gains on clinical tests, as well as to significant reductions in task-completion times for the prehension of real objects. These results are indicative of the potential feasibility of this exercise system for rehabilitation in patients with hand dysfunction resulting from neurological impairment.

scholarly journals Impact of internal capsule lesions on outcome of motor hand function at one year post-stroke

2008 ◽  
Vol 40 (2) ◽  
pp. 96-101 ◽  
Author(s):  
SK Schiemanck ◽  
G Kwakkel ◽  
MWM Post ◽  
LJ Kappelle ◽  
AJH Prevo
Keyword(s):  
Hand Function ◽  
Internal Capsule ◽  
Post Stroke ◽  
One Year
Sign in / Sign up

Export Citation Format

Share Document