Discriminative Sensory Dysfunction After Unilateral Stroke

Kim, Jong Seung; Choi-Kwon, Smi

doi:10.1161/01.str.27.4.677

Cited by 148 publications

(111 citation statements)

References 25 publications

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“…1C), the fact that the new forelimb representation spent significantly more time responding to forelimb stimulation suggests that there may be more subtle disturbances to sensory function. Indeed, clinical data has shown that 50 -85% of human stroke patients display deficits in the ability to accurate sense and discriminate tactile stimuli (Kim and Choi-Kwon, 1996;Blennerhassett et al, 2007). Our data provide a neurophysiological explanation for these deficits and a model system that future therapeutic interventions can use to help sharpen the temporal precision of cortical circuits after stroke.…”

Section: Mechanisms and Functional Significance Of Prolonged Sensory mentioning

confidence: 68%

In VivoVoltage-Sensitive Dye Imaging in Adult Mice Reveals That Somatosensory Maps Lost to Stroke Are Replaced over Weeks by New Structural and Functional Circuits with Prolonged Modes of Activation within Both the Peri-Infarct Zone and Distant Sites

Brown

Aminoltejari²,

Erb³

et al. 2009

J. Neurosci.

288

295

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After brain damage such as stroke, topographically organized sensory and motor cortical representations remap onto adjacent surviving tissues. It is conceivable that cortical remapping is accomplished by changes in the temporal precision of sensory processing and regional connectivity in the cortex. To understand how the adult cortex remaps and processes sensory signals during stroke recovery, we performed in vivo imaging of sensory-evoked changes in membrane potential, as well as multiphoton imaging of dendrite structure and tract tracing. In control mice, forelimb stimulation evoked a brief depolarization in forelimb cortex that quickly propagated to, and dissipated within, adjacent motor/hindlimb areas (Ͻ100 ms). One week after forelimb cortex stroke, the cortex was virtually unresponsive to tactile forelimb stimulation. After 8 weeks recovery, forelimb-evoked depolarizations reemerged with a characteristic pattern in which responses began within surviving portions of forelimb cortex (Ͻ20 ms after stimulation) and then spread horizontally into neighboring peri-infarct motor/hindlimb areas in which depolarization persisted 300 -400% longer than controls. These uncharacteristically prolonged responses were not limited to the remapped peri-infarct zone and included distant posteromedial retrosplenial cortex, millimeters from the stroke. Structurally, the remapped peri-infarct area selectively exhibited high levels of dendritic spine turnover, shared more connections with retrosplenial cortex and striatum, and lost inputs from lateral somatosensory cortical regions. Our findings demonstrate that sensory remapping during stroke recovery is accompanied by the development of prolonged sensory responses and new structural circuits in both the peri-infarct zone as well as more distant sites.

show abstract

Section: Mechanisms and Functional Significance Of Prolonged Sensory mentioning

confidence: 68%

In VivoVoltage-Sensitive Dye Imaging in Adult Mice Reveals That Somatosensory Maps Lost to Stroke Are Replaced over Weeks by New Structural and Functional Circuits with Prolonged Modes of Activation within Both the Peri-Infarct Zone and Distant Sites

Brown

Aminoltejari²,

Erb³

et al. 2009

J. Neurosci.

288

295

View full text Add to dashboard Cite

show abstract

“…Somatosensory dysfunction is common in stroke patients and new therapies to enhance plasticity in sensory circuits are desperately needed to improve poststroke sensation (Byl, 2003;Kim, 1996). The mechanisms responsible for the improvement seen in this patient are not yet known.…”

Section: Discussionmentioning

confidence: 99%

“…Impaired proprioception, stereognosis, and tactile sensation are common after stroke and are associated with poor functional outcomes (Kim, 1996). There is no established method to restore tactile sensation following stroke.…”

Section: Introductionmentioning

confidence: 99%

Vagus nerve stimulation paired with tactile training improved sensory function in a chronic stroke patient

Kilgard

Rennaker

Alexander

et al. 2018

NRE

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BACKGROUND:Recent studies indicate that vagus nerve stimulation (VNS) paired with rehabilitation can enhance neural plasticity in the primary sensory and motor cortices, improve forelimb function after stroke in animal models and improve motor function in patients with arm weakness after stroke. OBJECTIVE:To gain "first-in-man" experience of VNS paired with tactile training in a patient with severe sensory impairment after stroke. METHODS:During the long-term follow-up phase of a clinical trial of VNS paired with motor rehabilitation, a 71-year-old man who had made good motor recovery had ongoing severe sensory loss in his left hand and arm. He received VNS paired with tactile therapy in an attempt to improve his sensory function. During twenty 2-hour sessions, each passive and active tactile event was paired with a 0.5 second burst of 0.8 mA VNS. Sensory function was measured before, halfway through, and after this therapy. RESULTS:The patient did not report any side effects during or following VNS+Tactile therapy. Quantitative measures revealed lasting and clinically meaningful improvements in tactile threshold, proprioception, and stereognosis. After VNS+Tactile therapy, the patient was able to detect tactile stimulation to his affected hand that was eight times less intense, identify the joint position of his fingers in the affected hand three times more often, and identify everyday objects using his affected hand seven times more often, compared to baseline. CONCLUSIONS:Sensory function significantly improved in this man following VNS paired with tactile stimulation. This approach merits further study in controlled clinical trials.

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“…Baskett et al 13 analyzed 20 subjects with acute stroke and found slow responses in tests that measured sensorimotor function of the ipsilesional hemibody. Kim and Choi-Know 14 found bilateral deficits in discriminative touch (17 of 39 patients) and astereognosis (7 of 38 patients) in subjects in the acute phase of stroke.…”

mentioning

confidence: 95%

Sensory deficits in ipsilesional upper-extremity in chronic stroke patients

Lima

Menegatti

et al. 2015

Arq. Neuro-Psiquiatr.

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Objective To investigate somatosensory deficits in the ipsilesional wrist and hand in chronic stroke patients and correlate these deficits with contralesional sensorimotor dysfunctions, functional testing, laterality and handedness.Methods Fifty subjects (twenty-two healthy volunteers and twenty-eight stroke patients) underwent evaluation with Semmes-Weinstein monofilaments, the sensory and motor Fugl-Meyer Assessment, the Nottingham Sensory Assessment in both wrists and hands and functional tests.Results Twenty-five patients had sensory changes in the wrist and hand contralateral to the stroke, and eighteen patients (64%) had sensory deficits in the ipsilesional wrist and hand. The most significant ipsilesional sensory loss was observed in the left-handed patients. We found that the patients with brain damage in the right hemisphere had better scores for ipsilesional tactile sensation.Conclusions A reduction in ipsilesional conscious proprioception, tactile or thermal sensation was found in stroke subjects. Right hemisphere damage and right-handed subjects had better scores in ipsilesional tactile sensation.

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Discriminative Sensory Dysfunction After Unilateral Stroke

Cited by 148 publications

References 25 publications

In VivoVoltage-Sensitive Dye Imaging in Adult Mice Reveals That Somatosensory Maps Lost to Stroke Are Replaced over Weeks by New Structural and Functional Circuits with Prolonged Modes of Activation within Both the Peri-Infarct Zone and Distant Sites

In VivoVoltage-Sensitive Dye Imaging in Adult Mice Reveals That Somatosensory Maps Lost to Stroke Are Replaced over Weeks by New Structural and Functional Circuits with Prolonged Modes of Activation within Both the Peri-Infarct Zone and Distant Sites

Vagus nerve stimulation paired with tactile training improved sensory function in a chronic stroke patient

Sensory deficits in ipsilesional upper-extremity in chronic stroke patients

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