Stroke is one of the most serious diseases that threaten human life and health.It is a major cause of death and disability in the clinic.New strategies for motor rehabilitation after stroke are undergoing exploration....Stroke is one of the most serious diseases that threaten human life and health.It is a major cause of death and disability in the clinic.New strategies for motor rehabilitation after stroke are undergoing exploration.We aimed to develop a novel artificial neural rehabilitation system,which integrates brain--computer interface(BCI)and functional electrical stimulation(FES)technologies,for limb motor function recovery after stroke.We conducted clinical trials(including controlled trials)in 32 patients with chronic stroke.Patients were randomly divided into the BCI-FES group and the neuromuscular electrical stimulation(NMES)group.The changes in outcome measures during intervention were compared between groups,and the trends of ERD values based on EEG were analyzed for BCI-FES group.Results showed that the increase in Fugl Meyer Assessment of the Upper Extremity(FMA-UE)and Kendall Manual Muscle Testing(Kendall MMT)scores of the BCI-FES group was significantly higher than that in the sham group,which indicated the practicality and superiority of the BCI-FES system in clinical practice.The change in the laterality coefficient(LC)values based onμ-ERD(ΔLCm-ERD)had high significant positive correlation with the change in FMA-UE(r=0.6093,P=0.012),which provides theoretical basis for exploring novel objective evaluation methods.展开更多
目的:研究双侧经颅直流电刺激(dual-hemispheric transcranial direct current stimulation,Dual-tDCS)对慢性期脑卒中患者上肢运动功能的影响,为治疗慢性期脑卒中上肢功能障碍提供基于神经机制的理论依据。方法:选取某院24例慢性期脑...目的:研究双侧经颅直流电刺激(dual-hemispheric transcranial direct current stimulation,Dual-tDCS)对慢性期脑卒中患者上肢运动功能的影响,为治疗慢性期脑卒中上肢功能障碍提供基于神经机制的理论依据。方法:选取某院24例慢性期脑卒中上肢运动功能障碍患者,按照随机数字表法将其分为研究组(n=13)和对照组(n=11)。对照组采用tDCS伪刺激联合常规康复治疗,研究组采用Dual-tDCS联合常规康复治疗。治疗前后,采用Fugl-Meyer运动功能评定量表上肢部分(Fugl-Meyer assessment upper limb scale,FMA-UL)及日常生活活动能力(activities of daily living,ADL)测评量表对患者活动能力进行评估。对比治疗前后初级运动皮层(M1区)与全脑功能连接(functional connectivity,FC)的变化。使用SPSS 24.0统计学软件进行数据分析。结果:治疗后,2组患者的FMA-UL、ADL评分比治疗前均显著提高,且研究组评分明显高于对照组,差异有统计学意义(P<0.05)。M1区与全脑FC分析显示,治疗后对照组健侧M1区到患侧枕中回、健侧舌回、健侧角回FC降低(P<0.01);患侧M1区未见FC变化脑区。治疗后研究组健侧M1区到健侧小脑、健侧小脑蚓部FC降低,到患侧中央前回FC增加(P<0.01);患侧M1区到患侧小脑、患侧颞中回FC增加,到健侧中央前回FC降低(P<0.01)。结论:Dual-tDCS对大脑的神经调控作用可改善慢性期卒中患者运动和非运动相关脑区的FC,可能是慢性期脑卒中上肢运动功能障碍的康复机制。展开更多
Strokes and cerebral vascular accidents (CVAs) and related disease events are an unfortunate circumstance that inflicts individuals around the world and impacts people every day as individuals and their caregivers. Th...Strokes and cerebral vascular accidents (CVAs) and related disease events are an unfortunate circumstance that inflicts individuals around the world and impacts people every day as individuals and their caregivers. The consequences of these strokes or CVA events are life-changing for all those involved. As a result of long-term disability related to strokes, the caregiver may undergo many emotional, psychological, and physical factors that impact their daily lives. There is a relatively short period of time to react to the necessary change and as a result there may be differences in coping associated with these unexpected health circumstances. Many stoke victims experience motor, cognitive, emotional, and psycho-social deficits and their caregivers may not be prepared for these abrupt life altering effects. The impact for caregivers, factors impacting strokes, and solutions for care will be addressed in the paper. Evidence suggests that post fatigue stroke (PFS) may be triggered by a dysfunction of the stress system. Family caregivers with a low level of social engagement may be more likely to perceived stress, and increased risk for caregiver role strain.展开更多
The purpose of the present study was to evaluate the effects of a trunk exercise program on the gait and muscle activity in stroke patients. The participants of this pilot study included six hemiplegic stroke patients...The purpose of the present study was to evaluate the effects of a trunk exercise program on the gait and muscle activity in stroke patients. The participants of this pilot study included six hemiplegic stroke patients. The outcomes were surface electromyography (sEMG) and spatiotemporal gait parameters. In analysis of sEMG, no statistically difference was found between pre- and post-training of Maximal Voluntary Isometric Contraction (MVIC) in rectus abdominis and external abdominal oblique muscle, but it tended to increase. However, the gait parameter significantly increased in walking speed, walking cycle, and affected stride length in stroke patients. These results suggest that the trunk exercise program may in part improve the gait of chronic stroke patients.展开更多
Poststroke recovery processes include restoration or compensation of function,respectively functions initially lost or new functions acquired after an injury.Therapeutic interventions can enhance these processes and/o...Poststroke recovery processes include restoration or compensation of function,respectively functions initially lost or new functions acquired after an injury.Therapeutic interventions can enhance these processes and/or reduce processes impeding regeneration.Numerous experimental studies suggest great opportunities for such treatments,but the results from recent large clinical trials using neuromodulators such as dopamine and fluoxetine are disappointing.The reasons for this are manifold affecting forward translation of results from animals models into the human situation.This"translational road block"is defined by differences between animals and humans with regard to the genetic and epigenetic background,size and anatomy of the brain,cerebral vascular anatomy,immune system,as well as clinical function and behavior.Backward blockade includes the incompatible adaption of targets and outcomes in clinical trials with regard to prior preclinical findings.For example,the design of clinical recovery trials varies widely and was characterized by the selection of different clinical endpoints,the inclusion a broad spectrum of stroke subtypes and clinical syndromes as well as different time windows for treatment initiation after infarct onset.This review will discuss these aspects based on the results of the recent stroke recovery trials with the goal to contribute to the currently biggest unmet need in stroke research-the development of a recovery enhancing therapy that improves the functional outcome of a chronic stroke patient.展开更多
目的探讨慢性心功能不全患者外周血单个核细胞(peripheral blood mononuclear cells,PBMCs)微小RNA(microRNAs,miRNAs)差异表达与患者脑血管疾病的关系。方法这是一项对2019年1月至2022年4月期间从西安交通大学第一附属医院出院的274例...目的探讨慢性心功能不全患者外周血单个核细胞(peripheral blood mononuclear cells,PBMCs)微小RNA(microRNAs,miRNAs)差异表达与患者脑血管疾病的关系。方法这是一项对2019年1月至2022年4月期间从西安交通大学第一附属医院出院的274例失代偿性心力衰竭患者的观察性研究。对患者进行随访,直到2023年1月,观察患者缺血性脑血管事件情况。miRNA微阵列用于分析基线循环miRNAs水平。通过实时定量聚合酶链反应(quantitative real time polymerase chain reaction,qRT-PCR)验证差异表达的miRNAs。采用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析候选miRNAs对缺血性脑血管事件的预测价值。结果在随访期间[422(184~939)d],有24例患者发生缺血性脑血管事件。与未发生缺血性脑血管事件的患者相比,发生缺血性脑血管事件的患者服用抗凝剂、维生素K拮抗剂的患者比例显著降低,差异有统计学意义(P<0.05)。在两组基线PBMCs样本中分析了2549个miRNA的表达,并鉴定了20个差异表达的miRNAs(定义为FC>1.3和P<0.05)。qRT-PCR验证结果显示,与非缺血性脑血管事件患者相比,发生缺血性脑血管事件患者的PBMCs样本中hsa-miR-1273g-3p、hsa-miR-2861表达水平显著上调,hsa-miR-483-5p表达水平显著下调,差异有统计学意义(P<0.05)。ROC分析表明,hsa-miR-1273g-3p[曲线下面积(area under the curve,AUC)=0.745]预测心力衰竭患者缺血性脑血管事件的灵敏度和特异度分别为81%、56%,hsa-miR-2861(AUC=0.614)的灵敏度和特异度分别为76%、62%,hsa-miR-483-5p(AUC=0.821)的灵敏度和特异度分别为76%、80%。3种候选miRNAs联合的预测价值优于单独一种miRNA,其AUC、灵敏度和特异度分别为0.941、90%、98%。结论PBMCs中hsa-miR-1273g-3p、hsa-miR-2861表达水平上调和hsa-miR-483-5p表达水平下调可能与心力衰竭患者缺血性脑卒中风险增加有关。展开更多
基金This work was supported by the National Key Research and Development Program of China(No.2017YFB1300302)National Natural Science Foundation of China(Nos.81630051,91648122,and 81601565)Tianjin Key Technology R&D Program(Nos.17ZXRGGX00020 and 16ZXHLSY00270).
文摘Stroke is one of the most serious diseases that threaten human life and health.It is a major cause of death and disability in the clinic.New strategies for motor rehabilitation after stroke are undergoing exploration.We aimed to develop a novel artificial neural rehabilitation system,which integrates brain--computer interface(BCI)and functional electrical stimulation(FES)technologies,for limb motor function recovery after stroke.We conducted clinical trials(including controlled trials)in 32 patients with chronic stroke.Patients were randomly divided into the BCI-FES group and the neuromuscular electrical stimulation(NMES)group.The changes in outcome measures during intervention were compared between groups,and the trends of ERD values based on EEG were analyzed for BCI-FES group.Results showed that the increase in Fugl Meyer Assessment of the Upper Extremity(FMA-UE)and Kendall Manual Muscle Testing(Kendall MMT)scores of the BCI-FES group was significantly higher than that in the sham group,which indicated the practicality and superiority of the BCI-FES system in clinical practice.The change in the laterality coefficient(LC)values based onμ-ERD(ΔLCm-ERD)had high significant positive correlation with the change in FMA-UE(r=0.6093,P=0.012),which provides theoretical basis for exploring novel objective evaluation methods.
文摘目的:研究双侧经颅直流电刺激(dual-hemispheric transcranial direct current stimulation,Dual-tDCS)对慢性期脑卒中患者上肢运动功能的影响,为治疗慢性期脑卒中上肢功能障碍提供基于神经机制的理论依据。方法:选取某院24例慢性期脑卒中上肢运动功能障碍患者,按照随机数字表法将其分为研究组(n=13)和对照组(n=11)。对照组采用tDCS伪刺激联合常规康复治疗,研究组采用Dual-tDCS联合常规康复治疗。治疗前后,采用Fugl-Meyer运动功能评定量表上肢部分(Fugl-Meyer assessment upper limb scale,FMA-UL)及日常生活活动能力(activities of daily living,ADL)测评量表对患者活动能力进行评估。对比治疗前后初级运动皮层(M1区)与全脑功能连接(functional connectivity,FC)的变化。使用SPSS 24.0统计学软件进行数据分析。结果:治疗后,2组患者的FMA-UL、ADL评分比治疗前均显著提高,且研究组评分明显高于对照组,差异有统计学意义(P<0.05)。M1区与全脑FC分析显示,治疗后对照组健侧M1区到患侧枕中回、健侧舌回、健侧角回FC降低(P<0.01);患侧M1区未见FC变化脑区。治疗后研究组健侧M1区到健侧小脑、健侧小脑蚓部FC降低,到患侧中央前回FC增加(P<0.01);患侧M1区到患侧小脑、患侧颞中回FC增加,到健侧中央前回FC降低(P<0.01)。结论:Dual-tDCS对大脑的神经调控作用可改善慢性期卒中患者运动和非运动相关脑区的FC,可能是慢性期脑卒中上肢运动功能障碍的康复机制。
文摘Strokes and cerebral vascular accidents (CVAs) and related disease events are an unfortunate circumstance that inflicts individuals around the world and impacts people every day as individuals and their caregivers. The consequences of these strokes or CVA events are life-changing for all those involved. As a result of long-term disability related to strokes, the caregiver may undergo many emotional, psychological, and physical factors that impact their daily lives. There is a relatively short period of time to react to the necessary change and as a result there may be differences in coping associated with these unexpected health circumstances. Many stoke victims experience motor, cognitive, emotional, and psycho-social deficits and their caregivers may not be prepared for these abrupt life altering effects. The impact for caregivers, factors impacting strokes, and solutions for care will be addressed in the paper. Evidence suggests that post fatigue stroke (PFS) may be triggered by a dysfunction of the stress system. Family caregivers with a low level of social engagement may be more likely to perceived stress, and increased risk for caregiver role strain.
文摘The purpose of the present study was to evaluate the effects of a trunk exercise program on the gait and muscle activity in stroke patients. The participants of this pilot study included six hemiplegic stroke patients. The outcomes were surface electromyography (sEMG) and spatiotemporal gait parameters. In analysis of sEMG, no statistically difference was found between pre- and post-training of Maximal Voluntary Isometric Contraction (MVIC) in rectus abdominis and external abdominal oblique muscle, but it tended to increase. However, the gait parameter significantly increased in walking speed, walking cycle, and affected stride length in stroke patients. These results suggest that the trunk exercise program may in part improve the gait of chronic stroke patients.
文摘Poststroke recovery processes include restoration or compensation of function,respectively functions initially lost or new functions acquired after an injury.Therapeutic interventions can enhance these processes and/or reduce processes impeding regeneration.Numerous experimental studies suggest great opportunities for such treatments,but the results from recent large clinical trials using neuromodulators such as dopamine and fluoxetine are disappointing.The reasons for this are manifold affecting forward translation of results from animals models into the human situation.This"translational road block"is defined by differences between animals and humans with regard to the genetic and epigenetic background,size and anatomy of the brain,cerebral vascular anatomy,immune system,as well as clinical function and behavior.Backward blockade includes the incompatible adaption of targets and outcomes in clinical trials with regard to prior preclinical findings.For example,the design of clinical recovery trials varies widely and was characterized by the selection of different clinical endpoints,the inclusion a broad spectrum of stroke subtypes and clinical syndromes as well as different time windows for treatment initiation after infarct onset.This review will discuss these aspects based on the results of the recent stroke recovery trials with the goal to contribute to the currently biggest unmet need in stroke research-the development of a recovery enhancing therapy that improves the functional outcome of a chronic stroke patient.
文摘目的探讨慢性心功能不全患者外周血单个核细胞(peripheral blood mononuclear cells,PBMCs)微小RNA(microRNAs,miRNAs)差异表达与患者脑血管疾病的关系。方法这是一项对2019年1月至2022年4月期间从西安交通大学第一附属医院出院的274例失代偿性心力衰竭患者的观察性研究。对患者进行随访,直到2023年1月,观察患者缺血性脑血管事件情况。miRNA微阵列用于分析基线循环miRNAs水平。通过实时定量聚合酶链反应(quantitative real time polymerase chain reaction,qRT-PCR)验证差异表达的miRNAs。采用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析候选miRNAs对缺血性脑血管事件的预测价值。结果在随访期间[422(184~939)d],有24例患者发生缺血性脑血管事件。与未发生缺血性脑血管事件的患者相比,发生缺血性脑血管事件的患者服用抗凝剂、维生素K拮抗剂的患者比例显著降低,差异有统计学意义(P<0.05)。在两组基线PBMCs样本中分析了2549个miRNA的表达,并鉴定了20个差异表达的miRNAs(定义为FC>1.3和P<0.05)。qRT-PCR验证结果显示,与非缺血性脑血管事件患者相比,发生缺血性脑血管事件患者的PBMCs样本中hsa-miR-1273g-3p、hsa-miR-2861表达水平显著上调,hsa-miR-483-5p表达水平显著下调,差异有统计学意义(P<0.05)。ROC分析表明,hsa-miR-1273g-3p[曲线下面积(area under the curve,AUC)=0.745]预测心力衰竭患者缺血性脑血管事件的灵敏度和特异度分别为81%、56%,hsa-miR-2861(AUC=0.614)的灵敏度和特异度分别为76%、62%,hsa-miR-483-5p(AUC=0.821)的灵敏度和特异度分别为76%、80%。3种候选miRNAs联合的预测价值优于单独一种miRNA,其AUC、灵敏度和特异度分别为0.941、90%、98%。结论PBMCs中hsa-miR-1273g-3p、hsa-miR-2861表达水平上调和hsa-miR-483-5p表达水平下调可能与心力衰竭患者缺血性脑卒中风险增加有关。
