Posts Tagged brain lesion

[WEB SITE] Gait Rehabilitation Improvement Approach for Stroke Survivors Receives Research Funding

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RehabRobot

 

For stroke survivors whose ability to walk has been impaired by neurological damage, rehabilitation using robotics has proven to be an effective therapy to improve their gait. However, one of the major issues with this type of rehabilitation is that following training with a robotic device, motor improvements are not maintained in the patient’s daily life.

Gelsy Torres-Oviedo, assistant professor of bioengineering at the University of Pittsburgh Swanson School of Engineering, was awarded a $805,670 CAREER Award by the National Science Foundation to apply a novel approach to improve locomotor learning in stroke patients. She is the fifth Swanson School CAREER Award recipient in 2019, tying the school’s record from 2017.

“Our bodies adjust their movement to adapt to changes in the environment, but the very first thing that we need to do is sense that environment,” Torres-Oviedo, who directs the Sensorimotor Learning Laboratory at Pitt, explains in a media release.

“We then use this sensory information as input to our motor system, which drives our movement.”

The challenge with measuring sensation in people is that it is an internal variable; therefore, Torres-Oviedo’s group will use mathematical tools and perception experiments to estimate what individuals feel.

“We think that some stroke survivors have difficulty perceiving their asymmetric movement, and these proposed studies will help us characterize this deficit and indicate if split-belt walking – in which the legs move at different speeds – can correct it,” she says.

In the first part of this study, the lab will track how patients with brain lesions perceive asymmetries in their gait. They will then measure how their perception is adjusted once their movements are adapted in the split-belt environment.

In the second part of this study, the lab will use these data and a unique method to manipulate how people perceive their movement and create the illusion of error-free performance during split-belt walking, the release, from the University of Pittsburgh, continues.

They will use a human-in-the-loop (HITL) method, which is a closed-loop approach in which the behavioral output is feedback to tune the input to the motor system – in this case, the speed difference. This strategy creates an individualized outcome for each subject, which is a more effective method for training purposes.

“The idea is that if we understand how each patient adjusts their perceived movements, we can create the illusion of error-free performance where they think that they’re walking normally even though their movements are changing,” Torres-Oviedo explains.

“If they never perceive that they are doing something different, the hope is that changes in their movements can be carried over to the patient’s daily life.”

This research aims to enhance the generalization of movements from devices like treadmills and exoskeletons to daily activities.

“If Professor Torres-Oviedo and her group are successful in their work, it could have a profound effect on gait rehabilitation for stroke survivors,” notes Sanjeev G. Shroff, Distinguished Professor and the Gerald E. McGinnis Chair of Bioengineering.

Torres-Oviedo will also use this project as a way to increase the participation of students from underrepresented minorities (URM) in science and engineering. She will recruit, mentor, and prepare URM students from K-12 and college to pursue advanced education, with the ultimate goal of broadening the professional opportunities for this population, the release concludes.

[Source(s): University of Pittsburgh, EurekAlert]

 

via Gait Rehabilitation Improvement Approach for Stroke Survivors Receives Research Funding – Rehab Managment

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[Abstract] Assessment of the Ipsilesional Hand Function in Stroke Survivors: The Effect of Lesion Side 

Background

The aim of this study was to examine the effect of the side of brain lesion on the ipsilesional hand function of stroke survivors.

Methods

Twenty-four chronic stroke survivors, equally allocated in 2 groups according to the side of brain lesion (right or left), and 12 sex- and age-matched healthy controls performed the Jebsen-Taylor Hand Function Test (JTHFT), the Nine-Hole Peg Test (9HPT), the maximum power grip strength (PwGSmax) test, and the maximum pinch grip strength (PnGSmax) test. Only the ipsilesional hand of the stroke survivors and both hands (left and right) of the controls were assessed.

Results

PwGS max and PnGS max were similar among all tested groups. Performances in JTHFT and 9HPT were affected by the brain injury. Individuals with left brain damage showed better performance in 9HPT than individuals with right brain damage, but performance in JTHFT was similar.

Conclusions

Individuals after a brain injury have the capacity to produce maximum strength preserved when using their ipsilesional hand. However, the dexterity of their hands and digits is affected, in particular for stroke individuals with right brain lesion.

Source: Assessment of the Ipsilesional Hand Function in Stroke Survivors: The Effect of Lesion Side – Journal of Stroke and Cerebrovascular Diseases

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[ARTICLE] Lower urinary tract dysfunction in patients with brain lesions – Full Text PDF

INTRODUCTION

In brain lesions, lower urinary tract dysfunction (LUTD) may be an integrated part of the neurologic syndrome (i.e., a neurogenic LUTD, most often urinary incontinence [UI]), or it may be due to other conditions. LUTD may also be a consequence of associated deficits; in particular motor and cognitive dysfunction may lead to UI, which in this case is called “functional.” Both neurogenic and functional UI may be combined. Patients themselves, however, rarely link the LUT symptoms to the neurologic disorder.

The spectrum of brain diseases includes multiple etiologies, but for most, after the initial impact of disease onset, unless there is complete restitution of function, there is the burden of a residual impairment and chronicity of symptoms, often including LUTD. Therefore, regardless of the nature of the disorder, it is important to identify the symptoms and complications that can lead to further health impairment and poorer quality of life (Vodusek, 2004; Fowler et al., 2008; Birder and Drake, 2009; Fowler and Griffiths, 2010).

In this chapter, LUTD in patients with brain diseases is addressed in the context of particular diseases, and then the importance of the localization of lesions is discussed to some extent separately. It should be remembered that inasmuch as LUTD is a direct consequence of a brain lesion, it is because of the particular location of that lesion. Description of the brain neural control of the LUT, a functional pairing of the bladder and the sphincter, can be found in previous chapters. Much of that knowledge is based on data recently acquired by functional neuroimaging; but prior to the advent of these powerful techniques, our knowledge of the association of the cortical and deep brain areas in the control of LUT relied on carefully observed clinical cases: patients presenting with specific symptoms of LUTD, who had been found to have lesions at particular brain sites. Initially the lesion studies were based on observations made in life correlated with postmortem or surgical specimens, but with increasingly better means of imaging it becomes possible to correlate symptoms with smaller, more discrete abnormalities.

As a new insight, effects of diffuse brain lesions have recently emerged as a significant factor to produce overactive bladder (OAB) in the elderly. The chapter concludes with a short discussion of appropriate management of LUTD in brain diseases.

Full Text PDF

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[WEB SITE]  Penn Researchers: New Neuroimaging Method Better Identifies Epileptic Lesions

15/10/2015 08:29:00

PHILADELPHIA – Epilepsy affects more than 65 million people worldwide. One-third of these patients have seizures that are not controlled by medications. In addition, one-third have brain lesions, the hallmark of the disease, which cannot be located by conventional imaging methods.

Researchers at the Perelman School of Medicine at the University of Pennsylvania have piloted a new method using advanced noninvasive neuroimaging to recognize the neurotransmitter glutamate, thought to be the culprit in the most common form of medication-resistant epilepsy. Their work is published today in Science Translational Medicine.

Glutamate is an amino acid which transmits signals from neuron to neuron, telling them when to fire. Glutamate normally docks with the neuron, gives it the signal to fire and is swiftly cleared. In patients with epilepsy, stroke and possibly ALS, the glutamate is not cleared, leaving the neuron overwhelmed with messages and in a toxic state of prolonged excitation.

In localization-related epilepsy, the most common form of medication-resistant epilepsy, seizures are generated in a focused section of the brain; in 65 percent of patients, this occurs in the temporal lobe. Removal of the seizure-generating region of the temporal lobe, guided by preoperative MRI, can offer a cure. However, a third of these patients have no identified abnormality on conventional imaging studies and, therefore, more limited surgical options.

Continue —> Health News – Penn Researchers: New Neuroimaging Method Better Identifies Epileptic Lesions

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