BackgroundLeprosy is an endemic infectious disease caused by Mycobacterium leprae that predominantly attacks the skin and peripheral nerves, leading to progressive impairment of motor, sensory and autonomic function. Little is known about how this peripheral neuropathy affects corticospinal excitability of handgrip muscles. Our purpose was to explore the motor cortex organization after progressive peripheral nerve injury and upper-limb dysfunction induced by leprosy using noninvasive transcranial magnetic stimulation (TMS).MethodsIn a cross-sectional study design, we mapped bilaterally in the primary motor cortex (M1) the representations of the hand flexor digitorum superficialis (FDS), as well as of the intrinsic hand muscles abductor pollicis brevis (APB), first dorsal interosseous (FDI) and abductor digiti minimi (ADM). All participants underwent clinical assessment, handgrip dynamometry and motor and sensory nerve conduction exams 30 days before mapping. Wilcoxon signed rank and Mann-Whitney tests were performed with an alpha-value of p<0.05.FindingsDynamometry performance of the patients’ most affected hand (MAH), was worse than that of the less affected hand (LAH) and of healthy controls participants (p = 0.031), confirming handgrip impairment. Motor threshold (MT) of the FDS muscle was higher in both hemispheres in patients as compared to controls, and lower in the hemisphere contralateral to the MAH when compared to that of the LAH. Moreover, motor evoked potential (MEP) amplitudes collected in the FDS of the MAH were higher in comparison to those of controls. Strikingly, MEPs in the intrinsic hand muscle FDI had lower amplitudes in the hemisphere contralateral to MAH as compared to those of the LAH and the control group. Taken together, these results are suggestive of a more robust representation of an extrinsic hand flexor and impaired intrinsic hand muscle function in the hemisphere contralateral to the MAH due to leprosy.ConclusionDecreased sensory-motor function induced by leprosy affects handgrip muscle representation in M1.
Introdução e objetivo: A termoterapia pode acelerar a recuperação dos tecidos lesionados. O objetivo deste estudo foi avaliar a temperatura superfi cial da pele na terapia por radiação infravermelha (RIV) e comparar a efi ciência entre os métodos de uso direto e aplicação de toalha úmida. Métodos: 30 sujeitos (9 homens e 21 mulheres) com média de idade de 22 ± 4,24 anos; altura 1,67 ± 0,10 m; massa 61,8 ± 11,5 kg e índice de massa corporal (IMC) de 21,9 ± 2,9 kg/ m2, participaram tanto do grupo experimental quanto do controle. Foi utilizado um termômetro infravermelho para verifi cação da temperatura superfi cial da pele antes, durante e após a aplicação da RIV. Resultados: A análise Two-Way ANOVA mostrou diferença estatisticamente signifi cativa para as três condições estudadas F(2,58) = 343.13, p = 0,0001. A análise Post-hoc com o teste de Tukey revelou diferença signifi cativa entre o grupo controle e o grupo sem toalha (p > 0,0001); o grupo controle e com toalha úmida (p = 0,0006) e grupo sem toalha e com toalha úmida (p = 0,0001). Conclusão: O grupo da RIV sem toalha úmida alcançou a média de 38,8 ºC após 20 minutos, enquanto que o uso da RIV com a toalha úmida foi de 36,0 ºC. A RIV sem a toalha úmida foi a estratégia de melhor efi ciência no aquecimento superfi cial da pele quando comparado com o uso da RIV com toalha úmida e grupo controle. Palavras-chave: aquecimento, fi sioterapia, métodos de aplicação
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.