Low frequency （≤ 1 Hz） repetitive transcranial magnetic stimulation （rTMS） can affect the excitability of the cerebral cortex and synaptic plasticity. Although this is a common method for clinical treatment of ce...Low frequency （≤ 1 Hz） repetitive transcranial magnetic stimulation （rTMS） can affect the excitability of the cerebral cortex and synaptic plasticity. Although this is a common method for clinical treatment of cerebral infarction, whether it promotes the recovery of motor function remains controversial. Twenty patients with cerebral infarction combined with hemiparalysis were equally and randomly divided into a low frequency rTMS group and a control group. The patients in the low frequency rTMS group were given 1-Hz rTMS to the contralateral primary motor cortex with a stimulus intensity of 90% motor threshold, 30 minutes/day. The patients in the control group were given sham stimulation. After 14 days of treatment, clinical function scores （National Institute of Health Stroke Scale, Barthel Index, and Fugl-Meyer Assessment） improved significantly in the low frequency rTMS group, and the effects were better than that in the control group. We conclude that low frequency （1 Hz） rTMS for 14 days can help improve motor function after cerebral infarction.展开更多
Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we p...Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle te展开更多
BACKGROUND Stroke is a type of cerebrovascular disease with high prevalence,mortality,and onset of disability.As a neurodevelopmental therapy,neuromuscular joint facilitation(NJF)is widely used in the treatment of ort...BACKGROUND Stroke is a type of cerebrovascular disease with high prevalence,mortality,and onset of disability.As a neurodevelopmental therapy,neuromuscular joint facilitation(NJF)is widely used in the treatment of orthopedic and neurological disorders in the clinical practice.It is mainly used for central nervous system diseases or orthopedic diseases,movement disorders,and pain rehabilitation.According to related studies,NJF can also be used as a rehabilitation treatment in patients with hemiplegic shoulder pain(HSP).AIM To investigate the clinical efficacy of acupuncture combined with NJF in patients with HSP.METHODS Forty patients with HSP were randomly divided into a treatment group and a control group.The treatment group was treated with acupuncture combined with NJF and the control group was treated with acupuncture alone.All patients were assessed by using the visual analogue scale(VAS),Fugl-Meyer assessment(FMA),Barthel index(BI),and passive range of motion(PROM)before and after the training.All the clinical data were analyzed using SPSS 20.0 statistical software.RESULTS There was no statistical difference in the general characteristics between the two groups.In the terms of duration of treatment,age,and pre-treatment indicators,the two groups were comparable(P>0.05).After the treatment,VAS,PROM,BI,and FMA scores were significantly improved in the two groups of patients(P<0.05).The VAS,PROM and FMA scores were significantly higher in the treatment group than in the control group(P<0.05).However,there was no significant difference in BI scores between the two groups(P>0.05).CONCLUSION Both acupuncture alone and acupuncture combined with NJF in the treatment of HSP are effective,and can improve the clinical symptoms of patients.Acupuncture combined with NJF can improve the upper limb motor function,relieve pain,and increase joint mobility in patients with HSP.The combination therapy is better than acupuncture alone.However,there is no significant difference in improving the score of patients’self-care abi展开更多
Hepatic myelopathy is a complication seen in patients with chronic liver failure with physiologic or iatrogenic portosystemic shunting. The main symptom is progressive lower limb dyskinesia. The role of the brain moto...Hepatic myelopathy is a complication seen in patients with chronic liver failure with physiologic or iatrogenic portosystemic shunting. The main symptom is progressive lower limb dyskinesia. The role of the brain motor control center in hepatic myelopathy is unknown. This study aimed to investigate the gray matter changes in patients with hepatic myelopathy secondary to transjugular intrahepatic portosystemic shunt and to examine their clinical relevance. This was a cross-sectional study. Twenty-three liver failure patients with hepatic myelopathy(hepatic myelopathy group), 23 liver failure patients without hepatic myelopathy(non-hepatic myelopathy group) after transjugular intrahepatic portosystemic shunt, and 23 demographically matched healthy volunteers were enrolled from March 2014 to November 2016 at Xijing Hospital, Air Force Military Medical University(Fourth Military Medical University), China. High-resolution magnetization-prepared rapid gradient-echo brain imaging was acquired. Group differences in regional gray matter were assessed using voxel-based morphometry analysis. The relationship between aberrant gray matter and motor characteristics was investigated. Results demonstrated that compared with the non-hepatic myelopathy group, gray matter volume abnormalities were asymmetric, with decreased volume in the left insula(P = 0.003), left thalamus(P = 0.029), left superior frontal gyrus(P = 0.006), and right middle cingulate cortex(P = 0.021), and increased volume in the right caudate nucleus(P = 0.017), corrected with open-source software. The volume of the right caudate nucleus in the hepatic myelopathy group negatively correlated with the lower limb clinical rating of the Fugl-Meyer Assessment(r = –0.53, P = 0.01). Compared with healthy controls, patients with and without hepatic myelopathy exhibited overall increased gray matter volume in both thalami, and decreased gray matter volume in both putamen, as well as in the globus pallidus, cerebellum, and vermis. The gray matter abnormalities we found展开更多
基金supported by the National Natural Science Foundation of China,No.30540058,30770714the Natural Science Foundation of Beijing of China,No.7052030+2 种基金the Talents Foundation of Organization Department of the Beijing Municipal Committee in Chinathe Beijing Science Plan Project Fund of China,No.Z0005187040191-1the Research Foundation of Capital Medical Development of China,No.2007-2068
文摘Low frequency （≤ 1 Hz） repetitive transcranial magnetic stimulation （rTMS） can affect the excitability of the cerebral cortex and synaptic plasticity. Although this is a common method for clinical treatment of cerebral infarction, whether it promotes the recovery of motor function remains controversial. Twenty patients with cerebral infarction combined with hemiparalysis were equally and randomly divided into a low frequency rTMS group and a control group. The patients in the low frequency rTMS group were given 1-Hz rTMS to the contralateral primary motor cortex with a stimulus intensity of 90% motor threshold, 30 minutes/day. The patients in the control group were given sham stimulation. After 14 days of treatment, clinical function scores （National Institute of Health Stroke Scale, Barthel Index, and Fugl-Meyer Assessment） improved significantly in the low frequency rTMS group, and the effects were better than that in the control group. We conclude that low frequency （1 Hz） rTMS for 14 days can help improve motor function after cerebral infarction.
基金supported by a grant from the Supporting Program of the"Eleventh Five-year Plan"for Science&Technology Research of China,Ministry of Science and Technology of China,No.2006BAI12B02a grant from the Scientific Research Fund for Talent Introduction in the Gansu University of Chinese Medicine of China,No.2012-11
文摘Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle te
文摘BACKGROUND Stroke is a type of cerebrovascular disease with high prevalence,mortality,and onset of disability.As a neurodevelopmental therapy,neuromuscular joint facilitation(NJF)is widely used in the treatment of orthopedic and neurological disorders in the clinical practice.It is mainly used for central nervous system diseases or orthopedic diseases,movement disorders,and pain rehabilitation.According to related studies,NJF can also be used as a rehabilitation treatment in patients with hemiplegic shoulder pain(HSP).AIM To investigate the clinical efficacy of acupuncture combined with NJF in patients with HSP.METHODS Forty patients with HSP were randomly divided into a treatment group and a control group.The treatment group was treated with acupuncture combined with NJF and the control group was treated with acupuncture alone.All patients were assessed by using the visual analogue scale(VAS),Fugl-Meyer assessment(FMA),Barthel index(BI),and passive range of motion(PROM)before and after the training.All the clinical data were analyzed using SPSS 20.0 statistical software.RESULTS There was no statistical difference in the general characteristics between the two groups.In the terms of duration of treatment,age,and pre-treatment indicators,the two groups were comparable(P>0.05).After the treatment,VAS,PROM,BI,and FMA scores were significantly improved in the two groups of patients(P<0.05).The VAS,PROM and FMA scores were significantly higher in the treatment group than in the control group(P<0.05).However,there was no significant difference in BI scores between the two groups(P>0.05).CONCLUSION Both acupuncture alone and acupuncture combined with NJF in the treatment of HSP are effective,and can improve the clinical symptoms of patients.Acupuncture combined with NJF can improve the upper limb motor function,relieve pain,and increase joint mobility in patients with HSP.The combination therapy is better than acupuncture alone.However,there is no significant difference in improving the score of patients’self-care abi
文摘Hepatic myelopathy is a complication seen in patients with chronic liver failure with physiologic or iatrogenic portosystemic shunting. The main symptom is progressive lower limb dyskinesia. The role of the brain motor control center in hepatic myelopathy is unknown. This study aimed to investigate the gray matter changes in patients with hepatic myelopathy secondary to transjugular intrahepatic portosystemic shunt and to examine their clinical relevance. This was a cross-sectional study. Twenty-three liver failure patients with hepatic myelopathy(hepatic myelopathy group), 23 liver failure patients without hepatic myelopathy(non-hepatic myelopathy group) after transjugular intrahepatic portosystemic shunt, and 23 demographically matched healthy volunteers were enrolled from March 2014 to November 2016 at Xijing Hospital, Air Force Military Medical University(Fourth Military Medical University), China. High-resolution magnetization-prepared rapid gradient-echo brain imaging was acquired. Group differences in regional gray matter were assessed using voxel-based morphometry analysis. The relationship between aberrant gray matter and motor characteristics was investigated. Results demonstrated that compared with the non-hepatic myelopathy group, gray matter volume abnormalities were asymmetric, with decreased volume in the left insula(P = 0.003), left thalamus(P = 0.029), left superior frontal gyrus(P = 0.006), and right middle cingulate cortex(P = 0.021), and increased volume in the right caudate nucleus(P = 0.017), corrected with open-source software. The volume of the right caudate nucleus in the hepatic myelopathy group negatively correlated with the lower limb clinical rating of the Fugl-Meyer Assessment(r = –0.53, P = 0.01). Compared with healthy controls, patients with and without hepatic myelopathy exhibited overall increased gray matter volume in both thalami, and decreased gray matter volume in both putamen, as well as in the globus pallidus, cerebellum, and vermis. The gray matter abnormalities we found
