Change in Movement-Related Cortical Potentials Following Constraint-Induced Movement Therapy (CIMT) After Stroke

Abstract

Abstract. Patients with chronic stroke were given Constraint-Induced Movement Therapy (CIMT) over an intensive two-week course of treatment. The intervention resulted in a large improvement in use of the more-affected upper extremity in the laboratory and in the real-world environment. High-resolution electroencephalography (EEG) showed that the treatment produced marked changes in cortical activity that correlated with the significant rehabilitative effects. Repetitive unilateral self-paced voluntary movements showed a large increase after treatment in the amplitudes of the late components of the Bereitschaftspotential (BP) both in the hemisphere contralateral to the more-affected arm and in the ipsilateral hemisphere. Simultaneous electromyographic recordings (EMG) and other aspects of the data indicate that the emergence of the movement-related neural source in the healthy hemisphere was not due to mirror movements of the non-test hand and that the increase in BP amplitudes was not the result of an increase in the force or effort of the response pre- to post-treatment. The results are consistent with the rehabilitation treatment having produced a use-dependent cortical reorganization and is a case where the physiological data interdigitates with and provides additional credibility to the clinical data.

Lateralized Deficits of Disgust Processing After Insula-Basal Ganglia Damage

“…Patients were recruited following participation in a rehabilitative program run by the Department of Clinical Psychology at the Friedrich Schiller University, Jena ( Miltner et al, 1999 , 2016 ). Inclusion criteria were: (1) unilateral lesions due to an ischaemic or haemorrhagic middle cerebral artery stroke, centrally affecting the IC-BG complex, as corroborated by high-resolution structural MRI data and neuroradiological report; (2) stable lesions (at least 1 year after lesion onset); (3) no cognitive deficits compromising understanding of instructions and task performance (i.e., global aphasia, attention deficits, amnesia, disorders of reasoning, visual neglect); (4) no history of neurodegenerative disorders, epilepsy, brain tumors, or brain trauma; (5) no history of substance induced disorders; (6) no history of psychiatric disorders; (7) motor ability to participate in the experimental procedure; (8) male gender, since previous single case findings on disgust processing have been mainly derived from the examination of male patients.…”

“…Patients were recruited following participation in a rehabilitative program run by the Department of Clinical Psychology at the Friedrich Schiller University, Jena (Miltner et al, 1999(Miltner et al, , 2016. Inclusion criteria were: (1) unilateral lesions due to an ischaemic or haemorrhagic middle cerebral artery stroke, centrally affecting the IC-BG complex, as corroborated by highresolution structural MRI data and neuroradiological report;…”

Lateralized deficits in arousal processing after insula lesions: behavioral and autonomic evidence

“…Nineteen patients (nine females) with a history of either left ( n = 10) or right ( n = 9) damage centrally affecting the insular cortex were enrolled in the study. Patients were recruited to the research programme through the Department of Neurology, University Hospital Muenster, Muenster, Germany ( n = 7), or following participation in a rehabilitative programme (Miltner et al, 1999, 2016) offered by the Department of Clinical Psychology, Friedrich Schiller University Jena, Jena, Germany and the Department of Neurology, University Hospital Jena, Jena, Germany ( n = 12). Inclusion criteria were as follows: (1) unilateral lesions due to middle-cerebral-artery stroke, centrally affecting the insular cortex, as confirmed by three experts in clinical neuroimaging (CP, WS and NM) from CT or MRI scans of the brain; (2) stable lesions (at least 1 year after lesion onset); (3) no cognitive deficits compromising the understanding of task instructions and task performance (i.e., global aphasia, attention deficits, amnesia, disorders of reasoning, or visual neglect); (4) no history of neurodegenerative disorders, epilepsy, brain tumours, or brain trauma; (5) no history of substance-induced disorders; (6) no history of psychiatric disorders.…”

The effects of emotional valence and intensity on cognitive and affective empathy after insula lesions

“…Twenty patients (6 females) with a history of either left ( n = 13) or right ( n = 7) damage centred on the insula were enrolled in the study. Patients were recruited to the research programme through the Department of Neurology, University Hospital Muenster, Muenster, Germany ( n = 11), or following participation in a rehabilitative programme (Miltner et al, 1999, 2016) run by the Department of Clinical Psychology, Friedrich Schiller University Jena, Jena, Germany, and the Department of Neurology, University Hospital Jena, Jena, Germany ( n = 9). Inclusion criteria were as follows: (1) unilateral lesions due to middle-cerebral-artery stroke, centrally affecting the insula, as confirmed by three experts in clinical neuroimaging (CP, WS and NM) from CT or MRI scans of the brain; (2) stable lesions (at least 1 year after lesion onset); (3) no cognitive deficits compromising the understanding of task instructions and task performance (i.e., global aphasia, attention deficits, amnesia, disorders of reasoning, or visual neglect); (4) no history of neurodegenerative disorders, epilepsy, brain tumours, or brain trauma; (5) no history of substance-induced disorders; (6) no history of psychiatric disorders; (7) motor ability to participate in the experimental procedure.…”

“…Twenty patients (6 females) with a history of either left (n = 13) or right (n = 7) damage centred on the insula were enrolled in the study. Patients were recruited to the research programme through the Department of Neurology, University Hospital Muenster, Muenster, Germany (n = 11), or following participation in a rehabilitative programme (Miltner et al, 1999(Miltner et al, , 2016 Informed written consent was obtained from each participant, and financial compensation was given for participation. The experimental procedures conformed to the Declaration of Helsinki and were approved by and performed in accordance with the guidelines of the Ethics Committee of the German Society of Psychology (TS032013_rev).…”