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Objective Recent studies have demonstrated gender differences in functional outcome after stroke. However, the underlying reasons for differences have been inconsistent. The present study examined whether gender differences in long-term functional outcomes exist among surviving patients with first-ever ischemic stroke and with individual subtypes of stroke. Methods A total of 997 patients (654 men, 343 women) were followed for 5 years after discharge. Patients were assigned to 4 subtypes of ischemic stroke (atherothrombotic, lacunar, cardioembolic and unclassified infarction

[Purpose] Maintaining high quality of life is crucial for the rehabilitation of patients with Parkinson’s disease. The quality of life scales currently in use do not assess all quality of life domains or their importance for each individual. Therefore, a new quality of life measure, the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting, was used to investigate quality of life in people with Parkinson’s disease. [Subjects and Methods] Fifteen people with idiopathic Parkinson’s disaese (average age = 80.0 years, standard deviation = 10.3 years, Hoehn & Yahr stages 1–4) were interviewed using the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting. Its quality of life constructs were tested by comparing them against disease-specific quality of life (39-items Parkinson’s Disease Questionnaire), motor functioning (Unified Parkinson’s Disease Rating Scale Part III), and activities of daily living (Barthel Index). [Results] Social connections such as “family” and “friends” were revealed as important constructs of life satisfaction. The Schedule for the Evaluation of Individual Quality of Life-Direct Weighting was not significantly correlated with the 39-items Parkinson’s Disease Questionnaire, Unified Parkinson’s Disease Rating Scale Part III, or Barthel Index but was significantly correlated with the “communication” dimension of the 39-items Parkinson’s Disease Questionnaire. [Conclusion] The Schedule for the Evaluation of Individual Quality of Life-Direct Weighting detected various domains of quality of life, especially social relationships with family and friends. “Being heard” was also revealed as an essential component of life satisfaction, as it provides patients with a feeling of acceptance and assurance, possibly resulting in better quality of life.

Horizontal intracortical projections for agonist and antagonist muscles exist in the primary motor cortex (M1), and reward may induce a reinforcement of transmission efficiency of intracortical circuits. We investigated reward-induced change in M1 excitability for agonist and antagonist muscles. Participants were 8 healthy volunteers. Probabilistic reward tasks comprised 3 conditions of 30 trials each: 30 trials contained 10% reward, 30 trials contained 50% reward, and 30 trials contained 90% reward. Each trial began with a cue (red fixation cross), followed by blue circle for 1 s. The subjects were instructed to perform wrist flexion and press a button with the dorsal aspect of middle finger phalanx as quickly as possible in response to disappearance of the blue circle without looking at their hand or the button. Two seconds after the button press, reward/non-reward stimulus was randomly presented for 2-s duration. The reward stimulus was a picture of Japanese 10-yen coin, and each subject received monetary reward at the end of experiment. Subjects were not informed of the reward probabilities. We delivered transcranial magnetic stimulation of the left M1 at the midpoint between center of gravities of agonist flexor carpi radialis (FCR) and antagonist extensor carpi radialis (ECR) muscles at 2 s after the red fixation cross and 1 s after the reward/non-reward stimuli. Relative motor evoked potential (MEP) amplitudes at 2 s after the red fixation cross were significantly higher for 10% reward probability than for 90% reward probability, whereas relative MEP amplitudes at 1 s after reward/non-reward stimuli were significantly higher for 90% reward probability than for 10% and 50% reward probabilities. These results implied that reward could affect the horizontal intracortical projections in M1 for agonist and antagonist muscles, and M1 excitability including the reward-related circuit before and after reward stimulus could be differently altered by reward probability.

Background: When assessing respiratory muscle strength using sniff nasal inspiratory pressure (SNIP), it is important to consider ethnic differences. Therefore, it is necessary to determine the mean values and lower limits of normal for SNIP in the Japanese population. Objective: To determine the mean values and lower limits of normal for SNIP, which is used as an assessment of inspiratory muscle strength, in healthy Japanese subjects. Methods: A total of 223 healthy Japanese volunteers (112 men, 111 women), aged 18–69 years, were studied; none had a history of pulmonary disease, heart disease, neuromuscular disease or sinusitis. To measure SNIP, a nasal plug was inserted into one nostril and the mouth was kept closed. Each subject was asked to take short, sharp sniffs with maximal effort from functional residual volume. Results: Based on the intraclass correlation coefficient, SNIP measurements showed good reproducibility in both men and women. The mean SNIP values were 76.8 ± 28.9 cm H₂O in men and 60.0 ± 20.0 cm H₂O in women; the values were significantly higher in men than in women (p < 0.01). On stepwise multiple linear regression analysis, the SNIP values were negatively related to age in men and positively related to body mass index (BMI) in women. The lower limits of normal for SNIP were 32.9 cm H₂O in men and 28.8 cm H₂O in women. Conclusions: In healthy Japanese subjects, the mean SNIP value was higher in men than in women. In Japanese subjects, SNIP values appear to be related to age in men and BMI in women.