The sensory side of post-stroke motor rehabilitation

Bolognini, Nadia; Russo, Cristina; Edwards, Dylan

doi:10.3233/rnn-150606

Cited by 154 publications

(167 citation statements)

References 133 publications

(156 reference statements)

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“…The current findings may extend our understanding of sensorimotor integration and can aid in the development of novel protocols for rehabilitation that are based on sensory approaches (Bolognini et al . ). Thus, mINB provides a potential method for modulating both S1 and M1 excitability.…”

Section: Discussionmentioning

confidence: 97%

Modified ischaemic nerve block of the forearm: use for the induction of cortical plasticity in distal hand muscles

Hayashi

Ogata

Nakazono

et al. 2019

The Journal of Physiology

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Key pointsr Ischaemic nerve block (INB) of the forearm rapidly reduces somatosensory input to a part of the body, which leads to the functional reorganization of the temporarily deafferented primary motor cortex (M1).r We applied a novel modified INB (mINB) to the forearm, maintaining mean blood pressure, to assess cortical plasticity in the primary somatosensory cortex (S1) and the M1 regions associated with small hand muscles. r S1 excitability was measured by median nerve somatosensory-evoked potentials (SEPs), while M1 excitability was evaluated by motor-evoked potentials (MEPS), using transcranial magnetic stimulation.r The finding that S1 excitability increased and M1 excitability decreased after the mINB was removed reflects the differential short-term cortical plasticity of the S1 and M1 regions.r These opposite effects observed for the S1 and M1 regions following the mINB may indicate a possible intra-hemispheric interaction between the S1 and M1 regions.Abstract Ischaemic nerve block (INB) causes short-term sensory deprivation, leading to functional reorganization in the deafferented motor cortex (M1). We used a modified INB (mINB) to evaluate cortical plasticity in the somatosensory cortex (S1) and M1 region associated with small hand muscles, because INB strongly inhibits muscles distal to the tourniquet. Thirty-three healthy adults participated in different combinations of four experiments. A pneumatic tourniquet was placed just below the right elbow and inflated to induce a mINB. We recorded the median nerve somatosensory-and motor-evoked potentials (SEPs and MEPs) before, during and after mINB placement and assessed spinal cord excitability using F-wave measurements. SEPs at Erb's point (N9) were abolished during the mINB; those at cortical N20 were suppressed. After removing the mINB, N20 amplitudes increased significantly, while those at N9 did not fully recover. P14 amplitudes after tourniquet deflation immediately recovered to baseline levels. M1-MEP amplitudes decreased during the mINB, and Erb-MEPs were suppressed. After the mINB was Ryutaro Hayashi is a PhD candidate at Kyushu University. He uses modified ischaemic nerve block (mINB) of the forearm to investigate plastic changes in the primary sensory (S1) and motor (M1) cortices. He found that mINB enhanced S1 excitability and reduced M1 excitability. This method could be useful for developing new neuromodulation protocols. His primary research focuses on understanding cortical plasticity that is induced by transcranial magnetic stimulation or transcranial alternating current stimulation, with the aim of improving our understanding of M1 function in humans. J Physiol 597.13 removed, M1-MEPs remained suppressed, while Erb-MEPs fully recovered. F-waves were not affected by the intervention. Therefore, sensory, but not motor, nerve function was affected by the mINB. S1 excitability was enhanced after the mINB was removed, indicating that S1 and M1 excitability were modulated in opposing directions after deflation. These after-effects may re...

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Section: Discussionmentioning

confidence: 97%

Modified ischaemic nerve block of the forearm: use for the induction of cortical plasticity in distal hand muscles

Hayashi

Ogata

Nakazono

et al. 2019

The Journal of Physiology

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“…We first need to establish the safest and most efficacious combination of sensory modalities in the stimulation strategy. A large literature is available on the mode of somatosensory stimulation including electrical, tactile, and thermal modalities utilized in stroke patients (Bolognini et al 2016). A similar sensory stimulation application can be utilized in OSA.…”

Section: Enhancing Sensory Function In Osamentioning

confidence: 99%

Dysfunctional Sensory Modalities, Locus Coeruleus, and Basal Forebrain: Early Determinants that Promote Neuropathogenesis of Cognitive and Memory Decline and Alzheimer’s Disease

Daulatzai

2016

Neurotox Res

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Sporadic Alzheimer's disease (AD) is a devastating neurodegenerative disorder. It is essential to unravel its etiology and pathogenesis. This should enable us to study the presymptomatic stages of the disease and to analyze and reverse the antemortem behavioral, memory, and cognitive dysfunction. Prima facie, an ongoing chronic vulnerability involving neural insult may lead normal elderly to mild cognitive impairment (MCI) and then to AD. Development of effective preventive and therapeutic strategies to thwart the disease pathology obviously requires a thorough delineation of underlying disruptive neuropathological processes. Our sensory capacity for touch, smell, taste, hearing, and vision declines with advancing age. Declines in different sensory attributes are considered here to be the primary "first-tier pathologies." Olfactory loss is among the first clinical signs of neurodegenerative diseases including AD and Parkinson's disease (PD). Sensory dysfunction in the aged promotes pathological disturbances in the locus coeruleus, basal forebrain, entorhinal cortex, hippocampus, and several key areas of neocortex and brainstem. Hence, sensory dysfunction is the pivotal factor that may upregulate cognitive and memory dysfunction. The age-related constellation of comorbid pathological factors may include apolipoprotein E (APOE) genotype, obesity, diabetes, hypertension, alcohol abuse, head trauma, and obstructive sleep apnea. The concepts and trajectories delineated here are the dynamic pillars of the current hypothesis presented-it postulates that the sensory decline, in conjunction with the above pathologies, is crucial in triggering neurodegeneration and promoting cognitive/memory dysfunction in aging and AD. The application of this thesis can be important in formulating new multifactorial preventive and treatment strategies (suggested here) in order to attenuate cognitive and memory decline and ameliorate pathological dysfunction in aging, MCI, and AD.

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“…Evidence from cross‐sectional studies of stroke populations, however, does not demonstrate strong associations between lower limb tactile sensation and functional outcomes . Moreover, retraining of sensory impairments tend to be largely overlooked in favor of motor rehabilitation . One interpretation contributing to this position may lie with the methods of tactile sensory assessment utilized in research and clinical settings.…”

Section: Introductionmentioning

confidence: 99%

“…10,13 Moreover, retraining of sensory impairments tend to be largely overlooked in favor of motor rehabilitation. 14,15 One interpretation contributing to this position may lie with the methods of tactile sensory assessment utilized in research and clinical settings.…”

Section: Introductionmentioning

confidence: 99%

Assessing Plantar Sensation in the Foot Using the Foot Roughness Discrimination Test (FoRDT): A Reliability and Validity Study in Stroke

Gorst

Freeman

Yarrow

et al. 2019

PM&R

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Background The plantar foot represents a sensory dynamometric map and is essential for balance and gait control. Sensory impairments are common, yet often difficult to quantify in neurological conditions, particularly stroke. A functionally oriented and quantifiable assessment, the Foot Roughness Discrimination Test (FoRDT), was developed to address these shortcomings. Objective To evaluate inter‐ and intrarater reliability, convergent and discriminant validity of the FoRDT. Design Test‐retest design. Setting Hospital outpatient. Participants Thirty‐two people with stroke (mean age 70 years) at least 3 months after stroke, and 32 healthy, age‐matched controls (mean age 70). Main Outcome Measures Roughness discrimination thresholds were quantified utilizing acrylic foot plates, laser cut to produce graded spatial gratings. Stroke participants were tested on three occasions, and by two different raters. Inter‐ and intrarater reliability and agreement were evaluated with Intraclass Correlation Coefficients and Bland‐Altman plots. Convergent validity was evaluated through Spearman rank correlation coefficients (rho) between the FoRDT and the Erasmus modified Nottingham Sensory Assessment (EmNSA). Results Intra‐ and interrater reliability and agreement were excellent (ICC =0.86 [95% CI 0.72‐0.92] and 0.90 [95% CI 0.76‐0.96]). Discriminant validity was demonstrated through significant differences in FoRDT between stroke and control participants (P < .001). Stroke fallers had statistically significant higher FoRDT scores compared with nonfallers (P = .01). Convergent validity was demonstrated through significant and strong correlations (rho) with the Erasmus MC Nottingham Sensory Assessment (r = .69, P < .01). Receiver operator characteristic curve analysis indicated the novel test to have excellent sensitivity and specificity in predicting the presence of self‐reported sensory impairments. Functional Reach test significantly correlated with FoRDT (r = .62, P < .01) whereas measures of postural sway and gait speed did not (r = .16‐.26, P > .05). Conclusions This simple and functionally oriented test of plantar sensation is reliable, valid, and clinically feasible for use in an ambulatory, chronic stroke and older population. It offers clinicians and researchers a sensitive and robust sensory measure and may further support the evaluation of rehabilitation targeting foot sensation. Level of Evidence III.

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The sensory side of post-stroke motor rehabilitation

Cited by 154 publications

References 133 publications

Modified ischaemic nerve block of the forearm: use for the induction of cortical plasticity in distal hand muscles

Modified ischaemic nerve block of the forearm: use for the induction of cortical plasticity in distal hand muscles

Dysfunctional Sensory Modalities, Locus Coeruleus, and Basal Forebrain: Early Determinants that Promote Neuropathogenesis of Cognitive and Memory Decline and Alzheimer’s Disease

Assessing Plantar Sensation in the Foot Using the Foot Roughness Discrimination Test (FoRDT): A Reliability and Validity Study in Stroke

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