Alpha2-adrenergic receptor activation reinstates motor deficits in rats recovering from cortical injury

Norepinephrine plays an important role in motor functional recovery after a brain injury caused by ferrous chloride.Inhibition of norepinephrine release by clonidine is correlated with motor deficits after motor cortex injury.The aim of this study was to analyze the role ofα-adrenergic receptors in the restoration of motor deficits in recovering rats after brain damage.The rats were randomly assigned to the sham and injury groups and then treated with the following pharmacological agents at 3 hours before and 8 hours,3 days,and 20 days after ferrous chloride-induced cortical injury:saline,clonidine,efaroxan(a selective antagonist ofα-adrenergic receptors)and clonidine+efaroxan.The sensorimotor score,the immunohistochemical staining forα-adrenergic receptors,and norepinephrine levels were evaluated.Eight hours post-injury,the sensorimotor score and norepinephrine levels in the locus coeruleus of the injured rats decreased,and these effects were maintained 3 days post-injury.However,20 days later,clonidine administration diminished norepinephrine levels in the pons compared with the sham group.This effect was accompanied by sensorimotor deficits.These effects were blocked by efaroxan.In conclusion,an increase inα-adrenergic receptor levels was observed after injury.Clonidine restores motor deficits in rats recovering from cortical injury,an effect that was prevented by efaroxan.The underlying mechanisms involve the stimulation of hypersensitiveα-adrenergic receptors and inhibition of norepinephrine activity in the locus coeruleus.The results of this study suggest thatαreceptor agonists might restore deficits or impede rehabilitation in patients with brain injury,and therefore pharmacological therapies need to be prescribed cautiously to these patients.

Assessment of hindlimb motor recovery affer severe thoracic spinal cord injury in rats: classification of CatWalk XT■ gait analysis parameters

Assessment of locomotion recovery in preclinical studies of experimental spinal cord injury remains challenging. We studied the CatWalk XT■gait analysis for evaluating hindlimb functional recovery in a widely used and clinically relevant thoracic contusion/compression spinal cord injury model in rats. Rats were randomly assigned to either a T9 spinal cord injury or sham laminectomy. Locomotion recovery was assessed using the Basso, Beattie, and Bresnahan open field rating scale and the CatWalk XT■gait analysis. To determine the potential bias from weight changes, corrected hindlimb(H) values(divided by the unaffected forelimb(F) values) were calculated. Six weeks after injury, cyst formation, astrogliosis, and the deposition of chondroitin sulfate glycosaminoglycans were assessed by immunohistochemistry staining. Compared with the baseline, a significant spontaneous recovery could be observed in the CatWalk XT■parameters max intensity, mean intensity, max intensity at%, and max contact mean intensity from 4 weeks after injury onwards. Of note, corrected values(H/F) of CatWalk XT■parameters showed a significantly less vulnerability to the weight changes than absolute values, specifically in static parameters. The corrected CatWalk XT■parameters were positively correlated with the Basso, Beattie, and Bresnahan rating scale scores, cyst formation, the immunointensity of astrogliosis and chondroitin sulfate glycosaminoglycan deposition. The CatWalk XT■gait analysis and especially its static parameters, therefore, seem to be highly useful in assessing spontaneous recovery of hindlimb function after severe thoracic spinal cord injury. Because many CatWalk XT■parameters of the hindlimbs seem to be affected by body weight changes, using their corrected values might be a valuable option to improve this dependency.

Effect of scalp acupuncture combined with language rehabilitation training in treating post-stroke motor aphasia:A systematic review and meta-analysis

Objective:To evaluate the efficacy of scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia.Methods:CNKI,VIP,Wan Fang Database,MEDLINE,Embase,Web of Science and Cochrane Library were searched for published researches up to March,2021.Randomized controlled trials RCTs that focused on scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia were included.We managed the data analysis with RevMan 5.3 software.Results:A total of 16 RCTs with 1323 patients were involved.The results of meta-analysis showed that:①The effective rate of scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia after stroke was significantly better than that of simple language rehabilitation training[OR=3.94,95%CI(2.73,5.68),P<0.00001];②In the evaluation of language function,compared with the language rehabilitation training,the scalp acupuncture combined with language rehabilitation training can significantly improve the reading ability of the patients with motor aphasia after stroke[MD=7.22,95%CI(3.55,10.89),P=0.0001],writing ability[MD=6.51,95%CI(3.61,9.41),P<0.0001],expressive ability[MD=4.13,95%CI(2.37,5.89),P<0.0001],retelling ability[MD=5.00,95%CI(2.38,7.63),P=0.0002],listening comprehension ability[MD=5.36,95%CI(3.12,7.61),P<0.00001]and naming ability[MD=5.60,95%CI(4.20,7.00),P<0.00001];③Compared with simple language rehabilitation training,scalp acupuncture combined with language rehabilitation can significantly improve the daily life language communication ability of patients with motor aphasia,and the difference was statistically significant[MD=30.01,95%CI(11.30,48.72),P=0.002].Conclusion:Scalp acupuncture combined with language rehabilitation training has a significant effect on motor aphasia.However,due to the small sample size,more RCTs are needed to confirm that.

Artificial intelligence and machine learning in motor recovery: A rehabilitation medicine perspective

Artificial intelligence(AI)and machine learning(ML)are powerful technologies with the potential to revolutionize motor recovery in rehabilitation medicine.This perspective explores how AI and ML are harnessed to assess,diagnose,and design personalized treatment plans for patients with motor impairments.The integration of wearable sensors,virtual reality,augmented reality,and robotic devices allows for precise movement analysis and adaptive neurorehabilitation approaches.Moreover,AI-driven telerehabilitation enables remote monitoring and consultation.Although these applications show promise,healthcare professionals must interpret AI-generated insights and ensure patient safety.While AI and ML are in their early stages,ongoing research will determine their effectiveness in rehabilitation medicine.

Blended Regenerative Anti-Lock Braking System and Electronic Wedge Brake Coordinate Control Ensuring Maximal Energy Recovery and Stability of All-Wheel-Motor-Drive Electric Vehicles

ABS is an active safety system which showed a valuable contribution to vehicle safety and stability since it was first introduced. Recently, EVs with in-wheel-motors have drawn increasing attention owing to their greatest advantages. Wheels torques are precisely and swiftly controlled thanks to electric motors and their advanced driving techniques. In this paper, a regenerative-ABS control RABS is proposed for all-in-wheel-motors-drive EVs. The RABS is realized as a pure electronic braking system called brake-by-wire. A coordination strategy is suggested to control RABS compromising three layers. First, wheels slip control takes place, and braking torque is calculated in the higher layer. In the coordinate interlayer, torque is allocated between actuators ensuring maximal energy recovery and vehicle stability. While in the lower layer, actuator control is performed. The RABS effectiveness is validated on a 3-DOF EVSimulink model through two straight-line braking manoeuvres with low and high initial speeds of 50 km/h and 150 km/h, respectively. Both regular and emergency braking manoeuvres are considered with ABS enabled and disabled for comparison. Simulation results showed the high performance of the proposed RABS control in terms of vehicle stability, brake response, stopping distance, and battery re-charging.

Action observation as a tool for neurorehabilitation to moderate motor deficits and aphasia following stroke

The mirror neuron system consists of a set of brain areas capable of matching action observation with action execution. One core feature of the mirror neuron system is the activation of motor areas by action observation alone. This unique capacity of the mirror neuron system to match action perception and action execution stimulated the idea that mirror neuron system plays a crucial role in the understanding of the content of observed actions and may participate in procedural learning. These features bear a high potential for neurorehabilitation of motor deficits and of aphasia following stroke. Since the first articles exploring this principle were published, a growing number of follow-up studies have been conducted in the last decade. Though, the combination of action observation with practice of the observed actions seems to constitute the most powerful approach. In the present review, we present the existing studies analyzing the effects of this neurorehabJlitative approach in clinical settings especially in the rehabilitation of stroke associated motor deficits and give a perspective on the ongoing trials by our research group. The data obtained up to date showed significant positive effect of action observation on recovery of motor functions of the upper limbs even in the chronic state after stroke, indicating that our approach might become a new standardized add-on feature of modern neurorehabilitative treatment schemes.

Electroacupuncture promotes the recovery of motor neuron function in the anterior horn of the injured spinal cord

Acupuncture has been shown to lessen the inflammatory reaction after acute spinal cord injury and reduce secondary injury.However,the mechanism of action remains unclear.In this study,a rat model of spinal cord injury was established by compressing the T8-9 segments using a modified Nystrom method.Twenty-four hours after injury,Zusanli（ST36）,Xuanzhong（GB39）,Futu（ST32）and Sanyinjiao（SP6）were stimulated with electroacupuncture.Rats with spinal cord injury alone were used as controls.At 2,4 and 6 weeks after injury,acetylcholinesterase（ACh E）activity at the site of injury,the number of medium and large neurons in the spinal cord anterior horn,glial cell line-derived neurotrophic factor（GDNF）m RNA expression,and Basso,Beattie and Bresnahan locomotor rating scale scores were greater in the electroacupuncture group compared with the control group.These results demonstrate that electroacupuncture increases ACh E activity,up-regulates GDNF m RNA expression,and promotes the recovery of motor neuron function in the anterior horn after spinal cord injury.

Prediction of motor recovery after ischemic stroke using diffusion tensor imaging： A meta-analysis

BACKGROUND: This systematic review aims to investigate the prediction value of diffusion tensor imaging for motor function recovery of ischemic stroke patients.METHODS: Cochrane Central Register of Controlled Trials(CENTRAL)(the Cochrane Library 2016, Issue 9), Pub Med, Embase, Clarivate Analytics, Scopus, CINAHL, Chinese Biomedical Literature Database, China National Knowledge Infrastructure and Google Scholar were searched for either motor recovery or corticospinal tract integrity by diffusion tensor imaging in different stroke phase from January 1, 1970, to October 31, 2016. The study design and participants were subjected to metrological analysis. Correlation coeffi cient(r) was used for evaluating the relationship between fractional anisotropy(FA) and motor function outcome. Correlation coeffi cient values were extracted from each study, and 95% confidence intervals(CIs) were calculated by Fisher's z transformation. Meta-analysis was conducted by STATA software.RESULTS: Fifteen studies with a total of 414 patients were included. Meta-analysis showed that FA in the subacute phase had the signifi cant correlation with motor function outcome(ES=0.75, 95%CI 0.62–0.87), which showed moderate quality based on GRADE system. The weight correlation coeffi cient revealed that an effect size(ES) of FA in acute phase and chronic phase was 0.51(95%CI 0.33–0.68) and 0.62(95%CI 0.47–0.77) respectively.CONCLUSION: This meta-analysis reveals that FA in the subacute phase after ischemic stroke is a good predictor for functional motor recovery, which shows moderate quality based on the GRADE system.

Unusual long-term motor recovery in a patient with corona radiata infarct

The majority of motor recovery following stroke occurs within 6 months after onset.The present study examined a patient with a corona radiata infarct,who exhibited an unusual long-term recovery（24 months after onset）.The patient was a 64-year-old female,who presented with severe paralysis of the left extremities resulting from a corona radiate infarct.Motor recovery from the weakness progressed slowly over a 24-month period following onset,even at 6-12 months after onset.Diffusion tensor tractography at 2 weeks from onset showed disruption of the corticospinal tract of the affected hemisphere resulting from the infarct.However,at 12 and 24 months after onset,the corticospinal tract was elongated to the cortex level,as shown by diffusion tensor tractography.A 2-week transcranial magnetic stimulation showed no motor-evoked potential for the affected hemisphere,but a motor-evoked potential of the corticospinal tract was observed at12 and 24 months.These results suggest that motor function recovery in cerebral infarct patients can occur at least up to 24 months after stroke onset.

Environmental enrichment combined with fasudil promotes motor function recovery and axonal regeneration after stroke

Fasudil,a Rho-associated protein kinase(ROCK)inhibitor,has a protective effect on the central nervous system.In addition,environmental enrichment is a promising technique for inducing the recovery of motor impairments in ischemic stroke models.The present study aimed to explore whether environmental enrichment combined with fasudil can facilitate motor function recovery and induce cortical axonal regeneration after stroke.First,a mouse model of ischemic cerebral stroke was established by photochemical embolization of the left sensorimotor cortex.Fasudil solution(10 mg/kg per day)was injected intraperitoneally for 21 days after the photothrombotic stroke.An environmental enrichment intervention was performed on days 7-21 after the photothrombotic stroke.The results revealed that environmental enrichment combined with fasudil improved motor function,increased growth-associated protein 43 expression in the infarcted cerebral cortex,promoted axonal regeneration on the contralateral side,and downregulated ROCK,p-LIM domain kinase(LIMK)1,and p-cofilin expression.The combined intervention was superior to monotherapy.These findings suggest that environmental enrichment combined with fasudil treatment promotes motor recovery after stroke,at least partly by stimulating axonal regeneration.The underlying mechanism might involve ROCK/LIMK1/cofilin pathway regulation.This study was approved by the Institutional Animal Care and Use Committee of Fudan University,China(approval No.20160858A232)on February 24,2016.

Total flavonoids of hawthorn leaves promote motor function recovery via inhibition of apoptosis after spinal cord injury

Flavonoids have been reported to have therapeutic potential for spinal cord injury.Hawthorn leaves have abundant content and species of total flavonoids,and studies of the effects of the total flavonoids of hawthorn leaves on spinal cord injury have not been published in or outside China.Therefore,Sprague-Dawley rats were used to establish a spinal cord injury model by Allen's method.Rats were intraperitoneally injected with 0.2 m L of different concentrations of total flavonoids of hawthorn leaves(5,10,and 20 mg/kg)after spinal cord injury.Injections were administered once every 6 hours,three times a day,for 14 days.After treatment with various concentrations of total flavonoids of hawthorn leaves,the Basso,Beattie,and Bresnahan scores and histological staining indicated decreases in the lesion cavity and number of apoptotic cells of the injured spinal cord tissue;the morphological arrangement of the myelin sheath and nerve cells tended to be regular;and the Nissl bodies in neurons increased.The Basso,Beattie,and Bresnahan scores of treated spinal cord injury rats were increased.Western blot assays showed that the expression levels of pro-apoptotic Bax and cleaved caspase-3 were decreased,but the expression level of the anti-apoptotic Bcl-2 protein was increased.The improvement of the above physiological indicators showed a dose-dependent relationship with the concentration of total flavonoids of hawthorn leaves.The above findings confirm that total flavonoids of hawthorn leaves can reduce apoptosis and exert neuroprotective effects to promote the recovery of the motor function of rats with spinal cord injury.This study was approved by the Ethics Committee of the Guangxi Medical University of China(approval No.201810042)in October 2018.

Change in connection between corticospinal tract and Broca's area during motor recovery in a patient with an intracerebral hemorrhage

The present study reported a 42-year-old male patient who underwent conservative management for a spontaneous intracerebral hemorrhage in the left corona radiata and the basal ganglia. The patient presented with complete weakness of the right upper and lower extremities at the onset of intracerebral hemorrhage; however, he showed progressive motor recovery to the level that he was able to extent the affected extremities against some resistance at 5 weeks after onset. The corticospinal tract of the affected （left） hemisphere connected to the left Broca＇s area at 3 weeks after onset as shown by diffusion tensor tractography. By contrast, this connection had disappeared at 5 weeks after onset as shown by diffusion tensor tractogaphy. Transcranial magnetic stimulation study showed that no motor evoked potential was elicited from the affected （left） hemisphere at 3 weeks after onset, but motor evoked potentials were elicited at 5 weeks after onset. These findings suggest that the connection between the injured corticospinal tract and Broca＇s area in this patient appears to be a compensation for severe motor weakness; consequently, the connection seems to disappear with motor recovery.

Motor recovery via aberrant pyramidal tract in a patient with a cerebral peduncle infarct

The presence of the aberrant pyramidal tract has been demonstrated by several studies; however, little is known about its role in motor recovery in stroke patients. In the present study, we reported a 69-year-old right-handed female patient with an infarct in the mid to lateral portion of the left cerebra peduncle, who showed an aberrant pyramidal tract by diffusion tensor tractography. The patient presented with severe weakness of the right extremities at stroke onset. The patient showed progressive motor recovery as much as being able to extend the affected extremities against some resistance at 6 months after onset. At 20 months after stroke onset, motor function of the left extremities had recovered to a nearly normal state. Diffusion tensor tractography results showed that the PT was disrupted at the lower midbrain of the affected （left） hemisphere at 3 weeks after stroke onset and this disruption was not changed at 20 months. An aberrant pyramidal tract in the left hemisphere was also observed, which originated from the primary motor cortex and descended through the corona radiata, posterior limb of the internal capsule, thalamus, the medial lemniscus pathway from the midbrain to the pons, and then entered into the pyramidal tract area at the pontomedullary junction. Transcranial magnetic stimulation did not elicit motor evoked potential from the affected hand muscle at 3 weeks, but it elicited motor evoked potential with mildly delayed latency and low amplitude in the affected hand muscle at 20 months. The main motor functions of the affected extremities in this patient appeared to be recovered via this aberrant pyramidal tract.

Astrocytes in the cerebral cortex play a role in the spontaneous motor recovery following experimental striatal hemorrhage

Intracerebral hemorrhage （ICH） is a stroke subtype caused by spontaneous rupture of small vessels and bleeding into the brain paren- chyma, resulting in cell death and sensorimotor deficits. Despite the greater prevalence of the ischemic form of stroke （87%）, ICH has the highest mortality rate of all stroke subtypes. The striatum is the most affected structure in hemorrhagic stroke （35-70%）, followed by cere- bral cortex （15-30%）, brain stem and cerebellum （5-10%）; patients suffering striatal and/or cortical ICH bear persistent sensorimotor disabilities. Although chronic sensorimotor impairment is established, a considerable amount of patients experience some degree of spontaneous recovery during the first six months after stroke （Qureshi et al., 2009）, and the neurobiological basis of this process is not understood.

Evaluation of the Curative Effect of "Xingnao Kaiqiao" Acupuncture Based on Brunnstrom Staging on Upper Limb and Hand Motor Function in the Recovery Period after Stroke

Objective: To observe the effects of Xingnao Kaiqiao acupuncture(醒脑开窍针) on the motor function of upper limb and hand in the recovery period after stroke. Methods: Seventy-six cases of hemiplegia patients with ischemic stroke were divided into the treatment group and the control group(n=38 in each). Based on the Brunnstrom's stage of Xingnao Kaiqiao acupuncture combined with rehabilitation training was used in the treatment group, and the control group was given rehabilitation training. FuglMeyer Assessment of the upper extremity(FMA-UE), Action Research Arm Test(ARAT) and Simple Test for Evaluating hand Function(STEF) were adopted separately to compare scores before treatment and 8 weeks after treatment. Results: The difference was not statistically significant in the two groups of patients for comparison of FMA-UE, ARAT and STEF scores before treatment(P>0.05). The difference was statistically significant in the two groups of score comparison of FMA-UE, ARAT and STEF after treatment(P<0.05). Conclusion: The Xingnao Kaiqiao acupuncture has its unique advantages in improving recovery of motor function of upper limb and hand in recovery period after stroke.

考虑道路识别的四驱电动汽车再生制动策略

为了充分利用路面附着条件分配再生制动力,提高制动能量回收率,根据双电动机四驱结构电动汽车复合制动系统的特点,对其制动能量回收控制策略进行了研究.分析了驱动轮与地面附着特性,设计了道路识别器来计算每个轮胎与当前路面之间的峰值附着系数,并使用模糊控制策略确定每个车轮与8种道路的滑移率和附着利用率的相似输入.根据双电动机外部特性的制动力分配关系,提出了使更多制动能量回馈给电池的策略.结果表明:制动强度为0.3时,能量回收率为65.55%,具有较高的回收效率.

芒针“循经透刺”结合语言康复训练治疗脑卒中后运动性失语临床研究

目的:观察芒针“循经透刺”结合语言康复训练治疗脑卒中后运动性失语的临床疗效。方法:64例脑卒中后运动性失语患者随机分为观察组和对照组各32例,观察组予以芒针透刺联合语言康复治疗,对照组给予普通针刺法+语言康复治疗,每周治疗6 d,连续治疗3周,采用汉语失语症检查法(ABC法)评价语言功能,中国式功能性语言沟通能力检测法(CFCP)评价语言沟通能力,波士顿诊断性失语症检查法(BDAE)分级标准评定患者运动性失语的分级,蒙特利尔认知评估量表(MoCA)评分评估患者认知能力。结果:治疗3周后,观察组语言功能(听理解、谈话、复述和命名)评分均较治疗前提高,差异具有统计学意义(P<0.05),观察组语言沟通能力评分、失语程度和认知功能评分均较治疗前改善明显,差异具有统计学意义(P<0.05),治疗后,观察组语言功能评分、认知功能评分、言语沟通能力评分和失语程度改善均优于对照组,差异具有统计学意义(P<0.05)。观察组总有效率为93.75%(30/32),优于对照组的75%(24/32),差异具有统计学意义(P<0.05)。结论:语言康复训练的基础上联合芒针“循经透刺”可促进脑卒中后运动性失语患者的语言功能恢复,降低失语严重程度,改善患者认知功能,疗效显著。

经颅磁刺激在脑卒中运动功能障碍康复中的研究进展

脑卒中是一种高发病率的急性脑血管疾病,常伴随肢体运动功能障碍的后遗症。经颅磁刺激(transcranial magnetic stimulation,TMS)作为一种非侵入式的脑刺激方法,大量临床实验证明其对卒中后运动功能障碍有明显的康复作用,但背后的神经康复机制仍不明确,需要更多的研究和探索。本文从TMS在运动功能评估、干预和康复预测模型的建立等方面入手,梳理、总结了近年来TMS在脑卒中运动康复领域的发展进程和研究现状,以期为后续研究提供参考。

深井泵用永磁同步潜水电机性能分析与成本计算

目前在深井泵市场中,感应潜水电机的应用较为广泛,但是普遍体积大、效率低,水泵耗能严重。永磁同步电机具有高效率、高功率因数以及大功率密度等优点。因此用永磁同步电机代替感应电机作为深井泵的驱动设备,既能提高电机的性能,又能节能减费,响应国家“碳减排”的号召。为了满足最新电机能效等级的要求,根据深井泵对其配套电机要求的特殊性,针对市面上一款22 kW的深井泵用感应潜水电机,设计出一款相同型号的永磁同步潜水电机。运用有限元分析计算,对其在额定工况下性能参数以及各类损耗和感应电机的数据进行对比分析,并对所设计的永磁同步电机进行温度场仿真验证其合理性。对两种电机生产成本以及能耗值进行经济效益评估,计算结果证明所设计的永磁同步潜水电机在一定的时间内便可以完成电机的成本回收,性价比优越,同时为同类深井泵用电机的设计分析提供参考。

基于四配流轴向柱塞马达的制动能回收方法

针对大惯性回转机构在制动时,动能都以热能的方式损失的问题,提出一种四配流轴向柱塞马达和蓄能器结合的制动能回收方法。不同体积、初始压力的蓄能器对惯性负载的回转制动能的回收和再利用的效果不同,为寻求较合理的蓄能器参数以达到较高的能量回收效果,手动调整仿真参数较为繁琐,提出采用基于多核CPU的快速并行优化方法用于蓄能器参数优化。首先,大惯性负载的驱动机构采用四配流轴向柱塞马达,其能量系统回收模型在Simulation X搭建,进而导出成具有CVODE求解加速的可执行程序,脱离仿真软件平台,在Windows操作系统独立运行;然后,利用导出的可执行程序与VC++进行二次开发,以微粒群算法解决特定工况下蓄能器选型的问题,充分利用多核CPU实现并行优化以提高仿真速度。仿真结果表明,在特定负载下得到优化后的蓄能器的参数,蓄能器回收并释放的能量占惯性动能的24.5%,回收油液全部得到释放。采用基于多核CPU的并行优化方法,仿真效率提高了10倍以上,该方法对系列化液压产品的快速开发具有一定的借鉴价值。