Archive for category Neuroplasticity

[WEB SITE] Music Training and Neuroplasticity

With our multi sensory brain, music harnesses powers of nature, culture, and mind. How much is the brain changed by the effects of music training and neuroplasticity?

Music is one of the most demanding cognitive and neural challenges, requiring very accurate timing of multiple actions, precise interval control of pitch not involved in language, and multiple different ways of producing sound. Auditory and motor actions influence each other in a constant interplay, which is largely unknown.

Brain Lesion Effects on Music

All brain imaging is done in a time scale of seconds, but the brain functions in the scale of milliseconds. Imaging studies do not really correlate exactly to mental states (see post on limits of imaging). Because of this limitation, a major way to study specific regions of brain related to music has been study of brain lesions.

  • A lesion in the auditory cortex causes “amusia” where a patient can speak and understand everyday sounds, but cannot notice wrong notes in tunes, or remember melodies.
  • Another case, a 71-year-old cellist, had encephalitis and lost ordinary memory, but remembers music. 
  • Patients with a lesion in right temporal can lose pitch perception.
  • Damage to right temporal lobe can distort sound to have negative response to music.
  • Patients with lesion in right temporal can lose pitch perception.

But, recent research shows that when studying infants these differences do not necessarily exist. In infancy there is much more overlap of music and language in the brain.  

What Is Known About Music in the Brain?

Perhaps some generalizations can be made:

Timing – some think timing is organized in the cerebellum (center of motor memory and learning.) Purely auditory perception has been observed in the cerebellum, but a single region does not control it.

Pitch – Different factors of a tune -contour, specific interval size, duration of notes, ratios of tones – are processed in different circuits throughout the brain. The right hemisphere does tonal processing.

Musical imagery is analyzed in regions of the frontal lobe.

Singing is dominant in right temporal lobe, while syntax of speech and music is left dominant.

The motor processes involve pre motor cortex, supplementary motor cortex, cerebellum, and basal ganglia, but in different amounts for different tasks.

Rhythm, Melody and emotion work in different parts of the brain

There are multiple different streams of neuronal activity for auditory processing pathways – the dorsal and ventral streams are important but especially dorsal with parietal and premotor cortex.

All neural systems – motor, sensory, emotional and analysis – are active in both performers and observersListening, as well as performing, use both motor and sensory systems, since observers trigger the muscles that are being utilized by the performers and dancers they are watching.

Recent studies show that learning absolute pitch, a very measurable skill, occurs only with genetic ability plus training before 12 to 15.[…]

 For more visit site —> Music Training and Neuroplasticity

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[ARTICLE] Plasticity induced by non-invasive transcranial brain stimulation: A position paper – Full Text

Abstract

Several techniques and protocols of non-invasive transcranial brain stimulation (NIBS), including transcranial magnetic and electrical stimuli, have been developed in the past decades. Non-invasive transcranial brain stimulation may modulate cortical excitability outlasting the period of non-invasive transcranial brain stimulation itself from several minutes to more than one hour. Quite a few lines of evidence, including pharmacological, physiological and behavioral studies in humans and animals, suggest that the effects of non-invasive transcranial brain stimulation are produced through effects on synaptic plasticity. However, there is still a need for more direct and conclusive evidence. The fragility and variability of the effects are the major challenges that non-invasive transcranial brain stimulation currently faces. A variety of factors, including biological variation, measurement reproducibility and the neuronal state of the stimulated area, which can be affected by factors such as past and present physical activity, may influence the response to non-invasive transcranial brain stimulation. Work is ongoing to test whether the reliability and consistency of non-invasive transcranial brain stimulation can be improved by controlling or monitoring neuronal state and by optimizing the protocol and timing of stimulation.

1. Introduction

Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are the most commonly used methods of non-invasive transcranial brain stimulation that has been abbreviated by previous authors as either as NIBS or NTBS. Here we use NIBS since it seems to be the most common term at the present time. When it was first introduced in 1985, TMS was employed primarily as a tool to investigate the integrity and function of the human corticospinal system (Barker et al., 1985). Single pulse stimulation was used to elicit motor evoked potentials (MEPs) that were easily evoked and measured in contralateral muscles (Rothwell et al., 1999). The robustness and repeatability of measures of conduction time, stimulation threshold and “hot spot” location allowed TMS to be developed into a standard tool in clinical neurophysiology.

As we review below, a number of NIBS protocols can lead to effects on brain excitability that outlast the period of stimulation. These may reflect basic synaptic mechanisms involving long-term potentiation (LTP)- or long-term depression (LTD)-like plasticity, and because of this there has been great interest in using the methods as therapeutic interventions in neurological and psychiatric diseases. Furthermore, recently they are more frequently applied to modify memory processes and to enhance cognitive function in healthy individuals. However, apart from success in treating some patients with depression (Lefaucheur et al., 2014; Padberg et al., 2002, 1999), there is little consensus that they have improved outcomes in a clinically meaningful fashion in any other conditions. The reason for this is probably linked to the reason why many other protocols failed to reach routine clinical neurophysiology: they are too variable both within and between individuals to make them practically useful in a health service setting (Goldsworthy et al., 2014; Hamada et al., 2013; Lopez-Alonso et al., 2014, 2015).

Below we review the evidence for the mechanisms underlying the “neuroplastic” effects of NIBS, and then consider the problems in reproducibility and offer some potential ways forward in research. […]

Continue —> Plasticity induced by non-invasive transcranial brain stimulation: A position paper – ScienceDirect

There are three major lines of evidence supporting NIBS produces effects…

Fig. 1. There are three major lines of evidence supporting NIBS produces effects through mechanisms of synaptic plasticity: (1) Drugs that modulate the function of critical receptors/channels for plasticity, e.g. Ca2+ channels and NMDA receptors, alter the effect of NIBS; (2) NIBS mainly changes I-waves rather than the D-wave in the epidural recording of descending volleys evoked by TMS, suggesting the effect of NIBS occurs trans-synaptically; and (3) NIBS interacts between protocols and with motor practice and cognitive learning processes, suggesting the effect of NIBS is involves in plasticity-related motor and psychological processes.

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[WEB SITE] Neuroplasticity: The 10 Fundamentals Of Rewiring Your Brain

by Debbie Hampton

ON OCTOBER 28, 2015

Neuroplasticity has become a buzzword in psychology and scientific circles, as well as outside of them, promising that you can “re-wire” your brain to improve everything from health and mental wellbeing to quality of life. There’s a lot of conflicting, misleading, and erroneous information out there.

So, exactly how does it work?

Via: Thawornnurak and Ioan Panaite | Shutterstock

Via: Thawornnurak and Ioan Panaite | Shutterstock

What Is Neuroplasticity

Just in case you’ve managed to miss all the hype, neuroplasticity is an umbrella term referring to the ability of your brain to reorganize itself, both physically and functionally, throughout your life due to your environment, behavior, thinking, and emotions. The concept of neuroplasticity is not new and mentions of a malleable brain go all of the way back to the 1800s, but with the relatively recent capability to visually “see” into the brain allowed by functional magnetic resonance imaging (fMRI), science has confirmed this incredible morphing ability of the brain beyond a doubt.

The concept of a changing brain has replaced the formerly held belief that the adult brain was pretty much a physiologically static organ or hard-wired after critical developmental periods in childhood. While it’s true that your brain is much more plastic during the early years and capacity declines with age, plasticity happens all throughout your life.

For a thorough explanation of how plasticity physically happens in your brain, see blog: “Masterpiece Or Mess.”

Via: GaudiLab | Shutterstock

Via: GaudiLab | Shutterstock

How Neuroplasticity Shows Up In Your Life

Neuroplasticity makes your brain extremely resilient and is the process by which all permanent learning takes place in your brain, such as playing a musical instrument or mastering a different language. Neuroplasticity also enables people to recover from stroke, injury, and birth abnormalities, overcome autism, ADD and ADHD, learning disabilities and other brain deficits, pull out of depression and addictions, and reverse obsessive compulsive patterns. (Read more: “You’re Not Stuck With The Brain You’re Born With.”)

Neuroplasticity has far-reaching implications and possibilities for almost every aspect of human life and culture from education to medicine. It’s limits are not yet known. However, this same characteristic, which makes your brain amazingly resilient, also makes it vulnerable to outside and internal, usually unconscious, influences. In his book The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science, Norman Doidge calls this the “plastic paradox.” (Read more: “Your Plastic Brain: The Good, The Bad, and The Ugly.”)

I know the power of neuroplasticity first hand, as I devised and performed my own home-grown, experience-dependant neuroplasticity based exercises for years to recover from a brain injury, the result of a suicide attempt. Additionally, through extensive cognitive behavioral therapy, meditation, and mindfulness practices, all of which encourage neuroplastic change, I overcame depression, anxiety, and totally revamped my mental health and life.

But it was because of neuroplastic change that I became entrenched in depressive, anxious, obsessive, and over-reactive patterns in the first place.

Via: Sergey Nivens | Shutterstock

Via: Sergey Nivens | Shutterstock

Ten Fundamentals Of Neuroplasticity 

Science has confirmed that you can access neuroplasticity for positive change in your own life in many ways, but it’s not quite as easy as some of the neuro-hype would have you believe. In the article, “Neuroplasticity: can you rewire your brain?,” Dr. Sarah McKay, neuroscientist, says:

“Plasticity dials back ‘ON’ in adulthood when specific conditions that enable or trigger plasticity are met. ‘What recent research has shown is that under the right circumstances, the power of brain plasticity can help adults minds grow. Although certain brain machinery tends to decline with age, there are steps people can take to tap into plasticity and reinvigorate that machinery,’ explains Merzenich. These circumstances include focused attention, determination, hard work and maintaining overall brain health.”

In his book, Soft-Wired: How the New Science of Brain Plasticity Can Change Your Life, Dr. Michael Merzenich (which Dr. McKay cites above), a leading pioneer in brain plasticity research and co-founder of Posit Science, lists ten core principles necessary for the remodeling of your brain to take place:

1. Change is mostly limited to  those situations in which the brain is in the mood for it. If you are alert, on the ball, engaged, motivated, ready for action, the brain releases the neurochemicals necessary to enable brain change. When disengaged, inattentive, distracted, or doing something without thinking that requires no real effort, your neuroplastic switches are “off.”

2. The harder you try, the more you’re motivated, the more alert you are, and the better (or worse)  the potential outcome, the bigger the brain change. If you’re intensely focused on the task and really trying to master something for an important reason, the change experienced will be greater.

3. What actually changes in the brain are the strengths of the connections of neurons that are engaged together, moment by moment, in time. The more something is practiced, the more connections are changed and made to include all elements of the experience (sensory info, movement, cognitive patterns). You can think of it like a “master controller” being formed for that particular behavior, which allows it to be performed with remarkable facility and reliability over time.

4. Learning-driven changes in connections increase cell-to cell cooperation, which is crucial for increasing reliability. Merzenich explains this by asking you to imagine the sound of a football stadium full of fans all clapping at random versus the same people clapping in unison. He explains, “The more powerfully coordinated your [nerve cell] teams are, the more powerful and more reliable their behavioral productions.”

5. The brain also strengthens its connections between teams of neurons representing separate moments of successive things that reliably occur in serial time. This allows your brain to predict what happens next and have a continuous “associative flow.” Without this ability, your stream of consciousness would be reduced to “a series of separate, stagnating puddles,” explains Merzenich.

6. Initial changes are temporary. Your brain first records the change, then determines whether it should make the change permanent or not. It only becomes permanent if your brain judges the experience to be fascinating or novel enough or if the behavioral outcome is important, good or bad.

7. The brain is changed by internal mental rehearsal in the same ways and involving precisely the same processes that control changes achieved through interactions with the external world. According to Merzenich, “You don’t have to move an inch to drive positive plastic change in your brain. Your internal representations of things recalled from memory work just fine for progressive brain plasticity-based learning.”

8. Memory guides and controls most learning. As you learn a new skill, your brain takes note of and remembers the good attempts, while discarding the not-so-good trys. Then, it recalls the last good pass, makes incremental adjustments, and progressively improves.

9. Every movement of learning provides a moment of opportunity for the brain to stabilize — and reduce the disruptive power of — potentially interfering backgrounds or “noise.” Each time your brain strengthens a connection to advance your mastery of a skill, it also weakens other connections of neurons that weren’t used at that precise moment. This negative plastic brain change erases some of the irrelevant or interfering activity in the brain.

10. Brain plasticity is a two-way street; it is just as easy to generate negative changes as it is positive ones. You have a “use it or lose it” brain. It’s almost as easy to drive changes that impair memory and physical and mental abilities as it is to improve these things. Merzenich says that older people are absolute masters at encouraging plastic brain change in the wrong direction.

Source: Neuroplasticity: The 10 Fundamentals Of Rewiring Your Brain – Reset.me

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[VIDEO] After watching this, your brain will not be the same – Lara Boyd | – YouTube

Published on Dec 15, 2015
In a classic research-based TEDx Talk, Dr. Lara Boyd describes how neuroplasticity gives you the power to shape the brain you want. Recorded at TEDxVancouver at Rogers Arena on November 14, 2015. YouTube Tags: brain science, brain, stroke, neuroplasticity, science, motor learning, identity, TED, TEDxVancouver, TEDxVancouver 2015, Vancouver, TEDx, Rogers Arena, Vancouver speakers, Vancouver conference, ideas worth spreading, great idea, Our knowledge of the brain is evolving at a breathtaking pace, and Dr. Lara Boyd is positioned at the cutting edge of these discoveries. In 2006, she was recruited by the University of British Columbia to become the Canada Research Chair in Neurobiology and Motor Learning. Since that time she has established the Brain Behaviour Lab, recruited and trained over 40 graduate students, published more than 80 papers and been awarded over $5 million in funding. Dr. Boyd’s efforts are leading to the development of novel, and more effective, therapeutics for individuals with brain damage, but they are also shedding light on broader applications. By learning new concepts, taking advantage of opportunities, and participating in new activities, you are physically changing who you are, and opening up a world of endless possibility. This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at http://ted.com/tedx

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[WEB SITE] Brain Training: Improve Your Neuroplasticity in 9 Easy Steps

Can we improve our capacity for creativity, memory and analysis through brain training exercises? Do online brain training games really work? The simple answer to these questions is yes; we can improve the brain’s ability to function, and we can actually reshape the physical structure of our brains through neuroplasticity training exercises.

Happily in improving your brain’s ability to function, it is not necessary to pay for expensive online games, that ultimately add nothing to the quality of your life. These nine training tips are free to engage in, will improve your brain’s function, and entice you to live life to its fullest!

How We Can Increase Brain Function As We Age

A study of randomly chosen individuals age 57-71 showed improved brain function after just 12 hours of strategic brain training exercises. Using MRIs of the participants brains both before and after, researchers saw upwards of an 8% improvement in blood flow and other indices that indicate improved brain function.

Improved brain function included improved ability to strategize, remember and draw big-picture conclusions from lengthy texts of information.

Remarkably, in a follow up study using MRIs again on the participants, researchers found that the benefits derived from the single training session were still in place one year later. Enhanced synaptic plasticity means that we can think faster, listen better, respond to situations faster and concentrate with greater focus. Creativity is enhanced as well.

MRI of the Brain

By Nevit Dilmen (Own work)(http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
By Nevit Dilmen (Own work)(http://creativecommons.org/licenses/by-sa/3.0)%5D, via Wikimedia Commons

[…]

more —> Brain Training: Improve Your Neuroplasticity in 9 Easy Steps | HealDove

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[Editorial] Motor Priming for Motor Recovery: Neural Mechanisms and Clinical Perspectives – Neurology

Editorial on the Research Topic

Motor Priming for Motor Recovery: Neural Mechanisms and Clinical Perspectives

The Oxford dictionary defines the term priming as “a substance that prepares something for use or action.” In this special issue, we define motor priming as a technique, experience, or activity targeting the motor cortex resulting in subsequent changes in motor behavior. Inadequate functional recovery after neural damage is a persisting burden for many, and this insufficiency highlights the need for new neurorehabilitation paradigms that facilitate the capacity of the brain to learn and recover. The concept of motor priming has gained importance in the last decade. Numerous motor priming paradigms have emerged to demonstrate success to improve functional recovery after injury. Some of the successful priming paradigms that have shown to alter motor behavior and are easily implementable in clinical practice include non-invasive brain stimulation, movement priming, motor imagery, and sensory priming. The full clinical impact of these priming paradigms has not yet been realized due to limited evidence regarding neural mechanisms, safety and effectiveness, dosage, individualization of parameters, identification of the appropriate therapies that need to be provided in combination with the priming technique, and the vital time window to maximize the effectiveness of priming. In this special issue, four manuscripts address critical questions that will enhance our understanding of motor priming paradigms and attempt to bridge the gap between neurophysiology and clinical implementation.

In their study, “Non-Invasive Brain Stimulation to Enhance Upper Limb Motor Practice Poststroke: A Model for Selection of Cortical Site,” Harris-Love and Harrington elegantly address the extremely important issue of individualizing brain stimulation for upper limb stroke recovery. Many brain stimulation techniques show high interindividual variability and low reliability as the “one-size-for-all” does not fit the vast heterogeneity in recovery observed in stroke survivors. In this article, the authors propose a novel framework that personalizes the application of non-invasive brain stimulation based on understanding of the structural anatomy, neural connectivity, and task attributes. They further provide experimental support for this idea with data from severely impaired stroke survivors that validate the proposed framework.

The issue of heterogeneity poststroke is also addressed by Lefebvre and Liew in “Anatomical Parameters of tDCS to modulate the motor system after stroke: A review.” These authors discuss the variability in research using tDCS for the poststroke population. According to the authors, the most likely sources of variability include the heterogeneity of poststroke populations and the experimental paradigms. Individually based variability of results could be related to various factors including: (1) molecular factors such as baseline measures of GABA, levels of dopamine receptor activity, and propensity of brain-derived neurotropic factor expression; (2) time poststroke, (3) lesion location; (4) type of stroke; and (5) level of poststroke motor impairment. Variability related to experimental paradigms include the timing of the stimulation (pre- or post-training), the experimental task, and whether the protocol emphasizes motor performance (a temporary change in motor ability) or motor learning based (more permanent change in motor ability). Finally, the numerous possibilities of electrode placement, neural targets, and the different setups (monocephalic versus bi-hemispheric) add further complexity. For future work with the poststroke population, the authors suggest that tDCS experimental paradigms explore individualized neural targets determined by neuronavigation.

In another exciting study in this issue, Estes et al. tackle the timely topic of spinal reflex excitability modulated by motor priming in individuals with spinal cord injury. The authors choose to test four non-pharmacological interventions: stretching, continuous passive motion, transcranial direct current stimulation, and transcutaneous spinal cord stimulation to reduce spasticity. Three out of four techniques were associated with reduction in spasticity immediately after treatment, to an extent comparable to pharmacological approaches. These priming approaches provide a low-cost and low-risk alternative to anti-spasticity medications.

In another clinical study in individuals with spinal cord injury, Gomes-Osman et al. examined effects of two different approaches to priming. Participants were randomized to either peripheral nerve stimulation (PNS) plus functional task practice, PNS alone, or conventional exercise therapy. The findings were unexpected. There was no change in somatosensory function or power grip strength in any of the groups. Interestingly, all of the interventions produced changes in precision grip of the weaker hand following training. However, only PNS plus functional task practice improved precision grip in both hands. The authors found that baseline corticospinal excitability were significantly correlated to changes in precision grip strength of the weaker hand. The lack of change in grip strength in any of the groups was surprising. Previous evidence suggests, however, that the corticomotor system is more strongly activated during precision grip as compared to power grip, and the authors suggest that interventions targeting the corticomotor system (i.e., various priming methods) may more strongly effect precision grip.

Overall, this special issue brings together an array of original research articles and reviews that further enhance our understanding of motor priming for motor recovery with an emphasis on neural mechanisms and clinical implementation. We hope that the studies presented encourage future studies on motor priming paradigms to optimize the potential for functional recovery in the neurologically disadvantaged population, and further our understanding of neuroplasticity after injury.

Author Contributions

SM and MS have made a substantial, direct, and intellectual contribution to the work and approved it for publication.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Funding

SM is supported by funding from the National Institutes of Health (R01HD075777).

Source: Frontiers | Editorial: Motor Priming for Motor Recovery: Neural Mechanisms and Clinical Perspectives | Neurology

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[Abstract] A pilot study on the optimal speeds for passive wrist movements by a rehabilitation robot of stroke patients: A functional NIRS study  

Abstract:

The optimal conditions inducing proper brain activation during performance of rehabilitation robots should be examined to enhance the efficiency of robot rehabilitation based on the concept of brain plasticity. In this study, we attempted to investigate differences in cortical activation according to the speeds of passive wrist movements performed by a rehabilitation robot for stroke patients. 9 stroke patients with right hemiparesis participated in this study. Passive movements of the affected wrist were performed by the rehabilitation robot at three different speeds: 0.25 Hz; slow, 0.5Hz; moderate and 0.75 Hz; fast. We used functional near-infrared spectroscopy to measure the brain activity during the passive movements performed by a robot. Group-average activation map and the relative changes in oxy-hemoglobin (ΔOxyHb) in two regions of interest: the primary sensory-motor cortex (SM1); premotor area (PMA) and region of all channels were measured. In the result of group-averaged activation map, the contralateral SM1, PMA and somatosensory association cortex (SAC) showed the greatest significant activation according to the movements at 0.75 Hz, while there is no significantly activated area at 0.5 Hz. Regarding ΔOxyHb, no significant diiference was observed among three speeds regardless of region. In conclusion, the contralateral SM1, PMA and SAC showed the greatest activation by a fast speed (0.75 Hz) rather than slow (0.25 Hz) and moderate (0. 5 Hz) speed. Our results suggest an optimal speed for execution of the wrist rehabilitation robot. Therefore, we believe that our findings might point to several promising applications for future research regarding useful and empirically-based robot rehabilitation therapy.

Source: A pilot study on the optimal speeds for passive wrist movements by a rehabilitation robot of stroke patients: A functional NIRS study – IEEE Xplore Document

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[Abstract] Preliminary results of testing the recoveriX system on stroke patients 

Abstract

Motor imagery based brain-computer interfaces (BCI) extract the movement intentions of subjects in real-time and can be used to control a cursor or medical devices. In the last years, the control of functional electrical stimulation (FES) devices drew researchers’ attention for the post-stroke rehabilitation field. In here, a patient can use the movement imagery to artificially induce movements of the paretic arms through FES in real-time.

Five patients who had a stroke that affected the motor system participated in the current study, and were trained across 10 to 24 sessions lasting about 40 min each with the recoveriX® system. The patients had to imagine 80 left and 80 right hand movements. The electroencephalogram (EEG) data was analyzed with Common Spatial Patterns (CSP) and linear discriminant analysis (LDA) and a feedback was provided in form of a cursor on a computer screen. If the correct imagination was classified, the FES device was also activated to induce the right or left hand movement.

In at least one session, all patients were able to achieve a maximum accuracy above 96%. Moreover, all patients exhibited improvements in motor function. On one hand, the high accuracies achieved within the study show that the patients are highly motivated to participate into a study to improve their lost motor functions. On the other hand, this study reflects the efficacy of combining motor imagination, visual feedback and real hand movement that activates tactile and proprioceptive systems.

Source: O174 Preliminary results of testing the recoveriX system on stroke patients – Clinical Neurophysiology

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[Abstract] Effect of reciprocal pedaling exercise on cortical reorganization and gait in stroke patients

Abstract

Objectives

Functional impairment of the lower limb is a major complication in stroke patients. The involvement of the cortex in pedaling has critical clinical implications to control of cyclical motor functions in patients with damaged cortical structures or cortical pathways.The study aimed at determining the effect of reciprocal pedaling exercise (RPE) on the gait and cortical reorganization in the stroke patients.

Methods

Forty patients suffering from stroke with hemiparesis will be included in this study. They were divided to Group I treated by training for lower limb muscles of the affected side. While Group II were treated by the same program as group I in addition to RPE. Quantitative EEG (QEEG) was carried for all patients before and after the treatment programs. The midline frontal, central and parietal regions (Fz, Cz and Pz) were studied for evidence of plasticity induced by RPE.

Results

Neuroplasticity was noticed among patients of group II in the midline frontal region (Fz) and to a lesser extent the midline central region (Cz).

Discussion

The rhythmic and reciprocal nature of cycling motion permits patients to generate timely symmetrical and reciprocal powers from both limbs required for locomotion.

Conclusions

Leg cycling exercise, and thus RPE, is a rehabilitation program that improves the function of ambulation in stroke patients.

Significance

Post stroke physical therapy can utilize RPE for better rehabilitation.

Source: S186 Effect of reciprocal pedaling exercise on cortical reorganization and gait in stroke patients – Clinical Neurophysiology

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[Abstract] The effect of bilateral arm training on motor areas excitability in chronic stroke patients

Abstract

Objectives

Physical therapy exercises that do not enhance motor areas neuroplasticity lead to motor impairment especially at the upper extremity (UE) in the chronic stroke patients. The aim of this study was to assess the effect of using bilateral arm training on motor areas excitability (neuroplasticity) in the chronic stroke patients.

Methods

Thirty male chronic stroke patients with moderate impairment of UE were assigned into two equal groups. The changes of motor areas excitability (neuroplasticity) were assessed before and after arm training by spectral analysis of mapping electroencephalogram (EEG). Delta, theta, alpha, beta 1 and beta 2 waves were recorded. The equation which was used to detect the neural plasticity and the changing at motor areas excitability was dividing the fast wave/slow waves or detecting the ratio of mean frequency of (beta 2 + beta 1 + alpha/theta + delta).

Results

Patients in group 1 (G1) received unilateral arm training and patients in group 2 (G2) received bilateral arm training. The Results: Showed significant increase in the excitability (neuroplasticity) at (F4 + F8) and (C4) motor areas in G2 comparing to G1 (p!9 .006) and (p!9 .036 ) respectively.

Discussion

Bimanual training leads to activation of extensive networks in both hemispheres.

Conclusions

It was concluded that bilateral arm training is a recommended method to enhance the motor areas excitability (neuroplasticity) in the chronic stroke patients.

Significance

Post stroke physical therapy can make use of bimanual training for better rehabilitation.

Source: S185 The effect of bilateral arm training on motor areas excitability in chronic stroke patients – Clinical Neurophysiology

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