S5-3. New strategy of therapeutic electrical stimulation for functional recovery among patients with central nervous system lesions

S5-3. New strategy of therapeutic electrical stimulation for functional recovery among patients with central nervous system lesions

e22 Society Proceedings / Clinical Neurophysiology 124 (2013) e19–e38 extremity in daily living by combining assistive neuromuscular electrical stim...

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Society Proceedings / Clinical Neurophysiology 124 (2013) e19–e38

extremity in daily living by combining assistive neuromuscular electrical stimulation with a wrist-hand splint for patients with moderate to severe hemiparesis. Usually in HANDS therapy, patients use these devices eight hours a day and perform intensive hand rehabilitation for three weeks. We examined the change of short intracortical inhibition (SICI) and reciprocal inhibition (RI) to examine the effects of the HANDS therapy to the cortico-spinal systems in chronic stroke patients. In many patients, the SICI in an affected hemisphere was decreased, and RI of a paretic arm was increased after HANDS therapy. It means the excitability of an affected cortex was increased and reciprocal inhibition of a paretic arm was enhanced in spinal level. These changes were correlated with improvement of motor function after treatment. Furthermore, in HANDS therapy, the change of neurophysiological factor and motor function was seen in stroke patients with chronic phase more than a few years from the onset of stroke. HANDS therapy might be considered a useful choice as a therapeutic approach to paretic hand of chronic stroke patients. doi:10.1016/j.clinph.2013.02.038

S5-3. New strategy of therapeutic electrical stimulation for functional recovery among patients with central nervous system lesions—Tomofumi Yamaguchi, Toshiyuki Fujiwara (Keio University, Tokyo, Japan) Supraspinal modulation and phase-related sensory input play an important role for the functional recovery of locomotion among patients with central nervous system (CNS) lesions. Reciprocal inhibition (RI) modulates reciprocating lower extremity movements such as locomotion and pedaling. The effects of therapeutic electrical stimulation (TES) on reciprocal inhibition are limited. Pedaling is widely used for rehabilitation of locomotion because it induces similar muscle activity to that observed during locomotion. We, therefore, applied pedaling and TES simultaneously and examined the effects on RI in healthy persons. Pedaling + TES induced stronger aftereffects on RI compared with either intervention alone. Furthermore, we combined anodal transcranial direct current stimulation (anodal tDCS) with patterned electrical stimulation (PES) on the peroneal nerve. We applied anodal tDCS + PES to patients with incomplete spinal cord injury. Combination of anodal tDCS with PES significantly modulated RI and improved ankle movements. Combination of TES with pedaling or anodal tDCS could be effective for the functional recovery of locomotion among patients with CNS lesions. doi:10.1016/j.clinph.2013.02.039

S5-5. Effects of repetitive transcranial magnetic stimulation with repetitive facilitation exercise in post-stroke patients—Shuji Matsumoto, Seiji Etoh, Kazumi Kawahira (Kagoshima University, Kirishima City, Japan) Repetitive magnetic stimulation (rTMS) induces functional and structural plasticity, while repetitive facilitation exercises (RFEs) promote the functional recovery of the hemiplegic upper limb and hand to a greater extent than the conventional therapy. The aim of this study was to investigate whether multiple sessions of 1-Hz rTMS facilitated the effect of RFEs on hemiplegic upper-limb function in chronic post-stroke patients. The study design was a randomized double-blinded crossover study. Eighteen patients with hemiplegia of the upper limb, were assigned to two groups: the motor-before-sham rTMS group, which performed motor rTMS sessions for two weeks followed by sham rTMS sessions for two weeks; or the motor-following-sham rTMS group, which performed

sham rTMS sessions for two weeks followed by motor rTMS sessions for two weeks. Patients received 1-Hz rTMS to the unaffected motor cortex for four minutes and performed RFEs for 40 min during motor rTMS sessions. The Fugl-Meyer assessment, Action Research Arm test and simple test for evaluating hand function were used to evaluate upper-limb function. Motor function improved significantly during the motor, but not sham, rTMS sessions. We concluded that multiple sessions of 1-Hz rTMS facilitated the effect of RFEs in improving the motor function of the affected upper limb. doi:10.1016/j.clinph.2013.02.040

S8-1. Principle of Time-Resolved Spectroscopy for quantitative tissue oxygenation monitoring—Yutaka Yamashita (Hamamatsu Photonics K.K., Hamamatsu, Japan) In Time-Resolved Spectroscopy (TRS), a temporal response of scattered light is measured after irradiation of ultra-short pulses, thereby giving a path-length distribution of detected photons traveling in the living tissue. Applying the photon diffusion theory into this response allows determination of the transport scattering coefficient and the absorption coefficient of the tissue. On the assumption that the absorption in the 700–900 nm range arises from the HbO2, Hb and water, it is possible to quantitate the hemoglobin concentration by multispectral measurement. Our two-channel TRS system (TRS20) carries a three-wave length (780, 800, 830 nm) picosecond light pulser and enables us to quantitate the hemoglobin concentration of the tissue. When it was used as a cerebral hemodynamics monitor in a coronary artery bypass grafting, we found a good correlation (r2 = 0.64) between the hemoglobin concentration obtained by TRS-20 and hematocrit value of arterial blood, reflecting blood dilution correctly during the operation. In addition, the trend of tissue oxygen saturation measured by TRS-20 was well consistent with the internal jugular vein oxygen saturation. These results demonstrated the usefulness of TRS as a quantitative monitor of cerebral hemodynamics. doi:10.1016/j.clinph.2013.02.041

S8-2. Prefrontal brain activity evaluated by using quantitative time-resolved near infrared spectroscopy during working memory task—Masahiro Tanida, Kaoru Sakatani (Shiseido Research Center, Yokohama, Japan) Working memory (WM) is a system for actively maintaining and manipulating information, and forms an integral part of the human memory system. Extensive data on human and non-human primates have suggested that the lateral prefrontal cortex (LPFC) plays a central role in WM. On the other side it has long been believed that the daily use of cosmetics improve decrement of cognitive function. However, the neural correlates of improved cognitive performance associated with treatment of such cosmetics are unclear. In the present study, employing quantitative time-resolved near infrared spectroscopy (TRS), we measured cerebral blood oxygenation in LPFC at baseline and during Stanberg’s test (ST) as a WM task, and compared the results with task performance. And using the same ST measurement, we examined how everyday use of cosmetics could affect neuronal activities at the prefrontal cortices for improving working memory performance of healthy female subjects in their forties. doi:10.1016/j.clinph.2013.02.042