Leap Motion-based virtual reality training for improving motor functional recovery of upper limbs and neural reorganization in subacute stroke patients

Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patients. Most virtual reality systems are only applicable to the proximal upper limbs （arms） because of the limitations of their capture systems. Nevertheless, the functional recovery of an affected hand is most difficult in the case of hemiparesis rehabilitation after a stroke. The recently developed Leap Motion controller can track the fine movements of both hands and fingers. Therefore, the present study explored the effects of a Leap Motion-based virtual reality system on subacute stroke. Twenty-six subacute stroke patients were assigned to an experimental group that received virtual reality training along with conventional occupational rehabilitation, and a control group that only received conventional rehabilitation. The Wolf motor func- tion test （WMFT） was used to assess the motor function of the affected upper limb; functional magnetic resonance imaging was used to measure the cortical activation. After four weeks of treatment, the motor functions of the affected upper limbs were significantly improved in all the patients, with the improvement in the experimental group being significantly better than in the control group. The action perfor- mance time in the WMFT significantly decreased in the experimental group. Furthermore, the activation intensity and the laterality index of the contralateral primary sensorimotor cortex increased in both the experimental and control groups. These results confirmed that Leap Motion-based virtual reality training was a promising and feasible supplementary rehabilitation intervention, could facilitate the recovery of motor functions in subacute stroke patients. The study has been registered in the Chinese Clinical Trial Registry （registration number： ChiCTR-OCH- 12002238）.

A Special Electroencephalography Pattern Might Help in the Diagnosis of Antibody-positive Encephalitis

Background： Patterns observed with electroencephalography （EEG） for patients who have encephalitis are usually known as generalized nonspecific cerebral abnormalities. The aim of this study was to investigate the presence of a special EEG pattern for patients with encephalitis and to explore features related to this special and uncommon pattern. Methods： EEG monitoring was performed for every patient aged 〉15 years with encephalitis who was hospitalized between December 2011 and March 2014. Clinical characteristics and EEG recordings were collected and evaluated. Results： Filly-two patients with encephalitis were enrolled in our study with a 2-h median EEG recording time, and extreme beta brushes （EBBs） occurred in 17 patients （32.7%）. Its presence was not significant regarding gender, age, psychiatric medication use, EEG rhythmic disorganization （P 〉 0.05）. Nevertheless, among the patients with EBBs, nine patients （52.9%） had epileptic seizures that had a significant detection rate （P 〈 0.05）： moreover, the cerebrospinal fluid （CSF） or serum of 15 patients （88.2%） with EBBs was positive for antibodies （P 〈 0.05）. Four patients （23.5%） who had EBB had corresponding regional distributions on neurnimaging scans. The EBBs completely correlated with the regional distributions of spike discharges for four patients. Conclusion： EBB is a special EEG pattern for patients with encephalitis, especially those with epileptic seizures or who have antibody-positive CSF/serum, and should be considered in clinical practice.