Posts Tagged brain

[VIDEO] Understanding Brain Injury. – Videos

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[VIDEO] Traumatic Brain Injuries: Effects of damage to different lobes of the brain – YouTube

http://www.ericratinoff.com Brain Injury Attorney Eric Ratinoff talks about traumatic brain injury – an area of personal injury he is proud to represent. He is always looking for opportunities to learn and share education on this topic, and he has created this video podcast on the areas of the brain and how they are affected by injury. Areas of the brain discussed are the frontal lobe, parietal lobe, occipital lobe, temporal lobe, cerebellum and brain stem. For more information about Traumatic Brain Injury, visit our online TBI Resource Center at http://www.ericratinoff.com/personal-…

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[WEB PAGE] Chemical imbalance in the brain: Myths and facts

Everything you need to know about chemical imbalances in the brain

Last reviewed 

A chemical imbalance in the brain occurs when a person has either too little or too much of certain neurotransmitters.

Neurotransmitters are the chemical messengers that pass information between nerve cells. Examples of neurotransmitters include serotonin, dopamine, and norepinephrine.

People sometimes call serotonin and dopamine the “happy hormones” because of the roles that they play in regulating mood and emotions.

A popular hypothesis is that mental health disorders, such as depression and anxiety, develop as a result of chemical imbalances in the brain.

While this theory may hold some truth, it runs the risk of oversimplifying mental illnesses. In reality, mood disorders and mental health illnesses are highly complex conditions that affect 46.6 million adults living in the United States alone.

In this article, we discuss conditions with links to chemical imbalances in the brain, myths surrounding this theory, possible treatment options, and when to see a doctor.

Myths

a man looking sad because he is experiencing a Chemical imbalance in the brain

Many factors may contribute to a person’s risk of mental illness.

Although chemical imbalances in the brain seem to have an association with mood disorders and mental health conditions, researchers have not proven that chemical imbalances are the initial cause of these conditions.

Other factors that contribute to mental health conditions include:

  • genetics and family history
  • life experiences, such as a history of physical, psychological, or emotional abuse
  • having a history of alcohol or illicit drug use
  • taking certain medications
  • psychosocial factors, such as external circumstances that lead to feelings of isolation and loneliness

While some studies have identified links between distinct chemical imbalances and specific mental health conditions, researchers do not know how people develop chemical imbalances in the first place.

Current biological testing also cannot reliably verify a mental health condition. Doctors do not, therefore, diagnose mental health conditions by testing for chemical imbalances in the brain. Instead, they make a diagnosis based on a person’s symptoms and the findings of a physical examination.

What conditions are linked to chemical imbalances?

Research has linked chemical imbalances to some mental health conditions, including:

Depression

Depression, also called clinical depression, is a mood disorder that affects many aspects of a person’s life, from their thoughts and feelings to their sleeping and eating habits.

Although some research links chemical imbalances in the brain to depression symptoms, scientists argue that this is not the whole picture.

For example, researchers point out that if depression were solely due to chemical imbalances, treatments that target neurotransmitters, such as selective serotonin reuptake inhibitors (SSRIs), should work faster.

The symptoms of depression vary widely among individuals, but they can include:

  • persistent feelings of sadness, hopelessness, anxiety, or apathy
  • persistent feelings of guilt, worthlessness, or pessimism
  • loss of interest in formerly enjoyable activities or hobbies
  • difficulty concentrating, making decisions, or remembering things
  • irritability
  • restlessness or hyperactivity
  • insomnia or sleeping too much
  • changes in appetite and weight
  • physical aches, cramps, or digestive problems
  • thoughts of suicide

It is possible to develop depression at any age, but symptoms usually begin when a person is in their teenage years or early 20s and 30s. Women are more likely than men to experience depression.

Many different types of depression exist. These include:

The dramatic hormonal changes that take place after giving birth are among the factors that can increase a woman’s risk of developing postpartum depression. According to the National Institute of Mental Health, 10–15% of women experience postpartum depression.

Bipolar disorder

Bipolar disorder is a mood disorder that causes alternating periods of mania and depression. These periods can last anywhere from a few days to a few years.

Mania refers to a state of having abnormally high energy. A person experiencing a manic episode may exhibit the following characteristics:

  • feeling elated or euphoric
  • having unusually high levels of energy
  • participating in several activities at once
  • leaving tasks unfinished
  • talking extremely fast
  • being agitated or irritable
  • frequently coming into conflict with others
  • engaging in risky behavior, such as gambling or drinking excessive quantities of alcohol
  • a tendency to experience physical injuries

Severe episodes of mania or depression can cause psychotic symptoms, such as delusions and hallucinations.

People who have bipolar disorder can experience distinct changes in their mood and energy levels. They may have an increased risk of substance abuse and a higher incidence of certain medical conditions, such as:

The exact cause of bipolar disorder remains unknown. Researchers believe that changes in the dopamine receptors — resulting in altered dopamine levels in the brain — may contribute to the symptoms of bipolar disorder.

Anxiety

pensive woman

A person with an anxiety disorder may experience excessive worry.

However, people who have an anxiety disorder often experience persistent anxiety or excessive worry that worsens in response to stressful situations.

According to the authors of a 2015 review article, evidence from neuroscience research suggests that the gamma aminobutyric acid (GABA) neurotransmitter may play a crucial role in anxiety disorders.

The GABA neurotransmitter reduces neuronal activity in the amygdala, which is the part of the brain that stores and processes emotional information.

GABA is not the only neurotransmitter that anxiety disorders involve. Other neurotransmitters that may contribute to these disorders include:

  • serotonin
  • endocannabinoids
  • oxytocin
  • corticotropin-releasing hormone
  • opioid peptides
  • neuropeptide Y

Treatment

Doctors can prescribe a class of medications called psychotropics to rebalance the concentration of particular neurochemicals in the brain.

Doctors use these medications to treat a range of mental health conditions, including depression, anxiety, and bipolar disorder.

Examples of psychotropics include:

  • Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft).
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs), including venlafaxine (Effexor XR), duloxetine (Cymbalta), and desvenlafaxine (Pristiq).
  • Tricyclic antidepressants (TCAs), such as amitriptyline (Elavil), desipramine (Norpramin), and nortriptyline (Pamelor).
  • Benzodiazepines, including clonazepam (Klonopin) and lorazepam (Ativan).

According to 2017 researchantidepressants improved symptoms in an estimated 40–60% of individuals with moderate-to-severe depression within 6–8 weeks.

While some people experience reduced symptoms within a few weeks, it can sometimes take months for others to feel the effects.

Different psychotropics have varying side effects. People can discuss the benefits and risks of these medications with their doctor.

The side effects of psychotropic medications can include:

Suicide prevention

  • If you know someone at immediate risk of self-harm, suicide, or hurting another person:
  • Call 911 or the local emergency number.
  • Stay with the person until professional help arrives.
  • Remove any weapons, medications, or other potentially harmful objects.
  • Listen to the person without judgment.
  • If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours a day at 1-800-273-8255.

When to see a doctor

man talking to doctor in her office both smiling

If a person experiences anxiety and mood changes every day for longer than 2 weeks, they should consider speaking to their doctor.

These symptoms should not cause alarm if they are mild and resolve within a few days.

However, people may wish to consider speaking with a doctor or trained mental health professional if they experience emotional, cognitive, or physical symptoms every day for more than 2 weeks.

Summary

Mental health is complex and multifaceted, and numerous factors can affect a person’s mental well-being.

Although chemical imbalances in the brain may not directly cause mental health disorders, medications that influence the concentration of neurotransmitters can sometimes provide symptom relief.

People who experience signs and symptoms of a mental health problem for more than 2 weeks may wish to speak to a doctor.

 

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[WEB SITE] Bring Back Handwriting: It’s Good for Your Brain

People are losing the brain benefits of writing by hand as the practice becomes less common

Illustration: Kieran Blakey

NNot so long ago, putting pen to paper was a fundamental feature of daily life. Journaling and diary-keeping were commonplace, and people exchanged handwritten letters with friends, loved ones, and business associates.

While longhand communication is more time-consuming and onerous, there’s evidence that people may in some cases lose out when they abandon handwriting for keyboard-generated text.

Psychologists have long understood that personal, emotion-focused writing can help people recognize and come to terms with their feelings. Since the 1980s, studies have found that “the writing cure,” which normally involves writing about one’s feelings every day for 15 to 30 minutes, can lead to measurable physical and mental health benefits. These benefits include everything from lower stress and fewer depression symptoms to improved immune function. And there’s evidence that handwriting may better facilitate this form of therapy than typing.

A commonly cited 1999 study in the Journal of Traumatic Stress found that writing about a stressful life experience by hand, as opposed to typing about it, led to higher levels of self-disclosure and translated to greater therapeutic benefits. It’s possible that these findings may not hold up among people today, many of whom grew up with computers and are more accustomed to expressing themselves via typed text. But experts who study handwriting say there’s reason to believe something is lost when people abandon the pen for the keyboard.

Psychologists have long understood that personal, emotion-focused writing can help people recognize and come to terms with their feelings.

“When we write a letter of the alphabet, we form it component stroke by component stroke, and that process of production involves pathways in the brain that go near or through parts that manage emotion,” says Virginia Berninger, a professor emerita of education at the University of Washington. Hitting a fully formed letter on a keyboard is a very different sort of task — one that doesn’t involve these same brain pathways. “It’s possible that there’s not the same connection to the emotional part of the brain” when people type, as opposed to writing in longhand, Berninger says.

Writing by hand may also improve a person’s memory for new information. A 2017 study in the journal Frontiers in Psychology found that brain regions associated with learning are more active when people completed a task by hand, as opposed to on a keyboard. The authors of that study say writing by hand may promote “deep encoding” of new information in ways that keyboard writing does not. And other researchers have argued that writing by hand promotes learning and cognitive development in ways keyboard writing can’t match.

The fact that handwriting is a slower process than typing may be another perk, at least in some contexts. A 2014 study in the journal Psychological Science found that students who took notes in longhand tested higher on measures of learning and comprehension than students who took notes on laptops.

“The primary advantage of longhand notes was that it slowed people down,” says Daniel Oppenheimer, co-author of the study and a professor of psychology at Carnegie Mellon University. While the students who typed could take down what they heard word for word, “people who took longhand notes could not write fast enough to take verbatim notes — instead they were forced to rephrase the content in their own words,” Oppenheimer says. “To do that, people had to think deeply about the material and actually understand the arguments. This helped them learn the material better.”

Slowing down and writing by hand may come with other advantages. Oppenheimer says that because typing is fast, it tends to cause people to employ a less diverse group of words. Writing longhand allows people more time to come up with the most appropriate word, which may facilitate better self-expression. He says there’s also speculation that longhand note-taking can help people in certain situations form closer connections. One example: “A doctor who takes notes on a patient’s symptoms by longhand may build more rapport with patients than doctors who are typing into a computer,” he says. Also, a lot Berninger’s NIH-funded work found that learning to write first in print and then in cursive helps young people develop critical reading and thinking skills.

Finally, there’s a mountain of research that suggests online forms of communication are more toxic than offline dialogue. Most of the researchers who study online communication speculate that a lack of face-to-face interaction and a sense of invisibility are to blame for the nasty and brutish quality of many online interactions. But the impersonal nature of keyboard-generated text may also, in some small way, be contributing to the observed toxicity. When a person writes by hand, they have to invest more time and energy than they would with a keyboard. And handwriting, unlike typed text, is unique to each individual. This is why people usually value a handwritten note more highly than an email or text, Berninger says. If words weren’t quite so easy to produce, it’s possible that people would treat them — and maybe each other — with a little more care.

via Bring Back Handwriting: It’s Good for Your Brain – Elemental

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[Infographic] MUSIC & THE BRAIN

 

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[Infographic] The Effects of Music on the Brain

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[ARTICLE] Food for Thought: Basic Nutrition Recommendations for the Mature Brain – Archives of Physical Medicine and Rehabilitation

Mild changes in memory and the way that we think can be normal as we age, but there are actions you can do to take charge of your brain health! We now better understand the importance of healthy eating for brain health in older adults. Doctors recommend healthy lifestyle changes to maintain or improve brain health, which include getting enough sleep, physical activity, and eating healthy foods. With your brain in mind, we created this page to help you adopt a healthy lifestyle. Most of the foods that we discuss can be found at grocery stores around your neighborhood. In addition, table 1 has useful online resources to help you keep your brain healthy.

Table 1Resources
Alzheimer’s Association: Alzheimer’s and Public Health Resource Center https://www.alz.org/
Caregiver Tips and Tools

The MIND diet

https://www.alz.org/help-support/caregiving/daily-care/food-eating https://www.alz.org/help-support/caregiving/caregiver-health/be_a_healthy_caregiver The MIND diet and tips on how to follow it.
Adopt a Healthy Diet https://www.alz.org/brain-health/adopt_healthy_diet.asp The DASH and Mediterranean Diets
Administration for Community Living https://www.acl.gov
Nutrition Services https://www.acl.gov/programs/health-wellness/nutrition-services The Administration for Community Living’s Administration on aging nutrition programs targeting older adults.
Global Council on Brain Health www.GlobalCouncilOnBrainHealth.org
Brain-Food https://www.aarp.org/health/brain-health/global-council-on-brain-health/nutrition/ Recommendations on nourishing your brain health.
National Institute on Aging
Healthy Eating https://www.nia.nih.gov/health/healthy-eating Choosing healthy meals as you get older, overcoming roadblocks to healthy eating, serving and portion sizes, maintaining a healthy weight

Abbreviations: DASH, Dietary Approaches to Stop Hypertension; MIND, Mediterranean-DASH Intervention for Neurodegenerative Delay.

General dietary recommendations for the aging brain

Plan your meals keeping these tips in mind. It is important to meet with a registered dietitian for individual dietary advice.1, 2, 3, 4, 5

  • 1.

    Eat whole grains with every meal

    • Sources include whole grain bread (wheat, rye, or barley), whole grain pasta, brown or wild rice, quinoa, and oats.

    • By eating at least 3 portions of whole grains a day you give your brain energy in the form of complex carbohydrates, B vitamins (thiamine, riboflavin, niacin, and folate), and minerals (iron, magnesium, and selenium).

  • 2.

    Eat a variety of fruits and vegetables every day

    • Make your plate colorful!

    • Eat berries, especially blueberries, at least twice per week as they are packed with protective substances called antioxidants.

    • Eat dark green leafy and cruciferous vegetables (spinach, kale, parsley, broccoli, asparagus, and Brussel sprouts) at least 6 times per week as these are rich in antioxidants, vitamins K and C, and folate.

  • 3.

    Eat legumes 3 or more times per week

    • Legumes (peas, beans, lentils, soybeans, and peanuts) are good sources of complex carbohydrates, protein, folate, and fiber.

  • 4.

    Limit red meat to once or twice a week

    • Swap out red meat, which is high in unhealthy saturated fat (lamb, beef, pork, and sausages), for poultry (chicken or turkey), fish, and beans and other legumes.

  • 5.

    Focus on healthy fats

    • Use extra-virgin olive oil instead of butter, margarine, or vegetable shortening.

    • Eat omega-3 rich foods from animal sources such as fish (sardines, mackerel, herring, salmon, sea bass, and trout) at least once a week. Vegetarian? No problem! Plant sources of omega-3 fatty acids include flax seeds, walnuts, and their oils, and Chia seeds.

    • Other sources of healthy fats include almonds, nut butters (eg, peanut butter), seeds, olives, and avocados.

    • Limit baked goods, fast foods, and fried foods since they contain unhealthy saturated and trans fatty acids.

  • 6.

    Don’t forget about dark chocolate

    • Dark chocolate has been shown to aid in brain health and to improve mood, learning, memory, and attention.

    • Aim for a small square (2cm×2cm) of dark chocolate (>70% cocoa) 2 to 3 times a week.

  • 7.

    Spice up meals with herbs and spices

    • Cook with herbs and spices and limit the use of salt.

    • Turmeric, cinnamon, clove, cumin, basil, parsley, cayenne pepper, oregano, and sage can all be helpful for brain health.

  • 8.

    Stay hydrated

    • Drink 6-8 8-oz glasses of water or non-caffeinated herbal teas per day. This helps to keep your entire body, including your brain, in tip top shape.6, 7

  • 9.

    Drink caffeine, but in moderation

    • Caffeine and antioxidants found in coffee can improve mood and increase alertness and attention.8

    • Daily cups of green or black tea brewed from tea leaves have been linked to brain health.

    • However, aim for no more than 1-3 cups of caffeinated tea or coffee daily, and limit drinking caffeine in the afternoon and at night as this can lead to poor sleep.

  • 10.

    If you consume alcohol, enjoy a glass of red wine with meals

    • Red wine contains a number of antioxidants, such as resveratrol, which have been shown to be helpful for the brain.

    • It is best to enjoy red wine in moderation, in other words, one glass a night and always consume with meals.

  • 11.

    Practice balance and do not overeat

    • Control your portion sizes and eat protein-packed snacks such as low fat yogurt with walnuts or seeded bread or rice/quinoa cakes with peanut butter, low fat cheese, or egg whites to help prevent you from overeating.

Practical cooking tips

  • 1.

    Cooking whole grains? Cook the whole bag and store the extra portions in your freezer for later use.

  • 2.

    Make sure you always have lentils in your pantry as they are the quickest legumes to prepare.

  • 3.

    Roasting salmon or other fatty fish? Roast an extra filet and make a fish spread for tomorrow’s sandwiches (puree the fish in a food processor with herbs and add a tablespoon of olive oil or tahini).

  • 4.

    Store berries and other fruits in your freezer to use in shakes or frozen desserts or to put on top of yogurt and hot cereals.

  • 5.

    Increase your vegetable intake by making an antipasto! Mix a variety of vegetables with a few tablespoons of olive oil and roast 20 minutes in a 450°F (230°C) oven.

  • 6.

    Legumes are not only for vegans! Replace beans for half of the meat you are cooking.

  • 7.

    Make homemade soft drinks! Place fruit slices and herbs (eg, mint, lemongrass) in a large container of water and set aside to allow the flavors to blend.

  • 8.

    Thicken soup using nuts! Add a handful of nuts to a soup and puree with a blender to thicken and add flavor.

  • 9.

    Experiment with spices! Cardamom goes great with cauliflower and sage works well with pumpkin.

  • 10.

    Make your own sauces! Mix 4 tablespoons of olive oil, 4 tablespoons of soy sauce, 1 crushed garlic clove, and 1 tablespoon of chopped spring onion for a great sauce that can be used on pasta or meat.

Authorship

This page was developed by the members of the American Congress of Rehabilitation Medicine (ACRM) Neurodegenerative Diseases Networking Group and the ACRM Culinary Medicine Task Force: Elena Philippou, RD, PhD (e-mail address: Philippou.e@unic.ac.cy), Rani Polak, MD, Chef, MBA, Ana Michunovich, DO, Michele York, PhD, Julie M. Faieta, MOT, OTR/L, Mark A. Hirsch, PhD, and Patricia C. Heyn, PhD, FGSA, FACRM.

Disclaimer

This information is not meant to replace the advice of a medical professional. You should always talk to your health care provider if you have any specific medical concerns or questions about treatment. This Information/Education Page may be used noncommercially by health care professionals to help educate patients and their caregivers. Any other reproduction is subject to approval by the publisher.

References

  1. Institute of Medicine. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate.National Academies PressWashington (DC)2005
  2. Institute of Medicine. Dietary reference intakes. The essential guide to nutrient requirements.National Academies PressWashington (DC)2006
  3. Masento, N.A., Golightly, M., Field, D.T., Butler, L.T., and van Reekum, C.M. Effects of hydration status on cognitive performance and mood. Br J Nutr20141111841–1852
  4. Morris, M.C., Tangney, C.C., Wang, Y., Sacks, F.M., Bennett, D.A., and Aqqarwal, N.T. MIND diet associated with reduced incidence of Alzheimer’s disease. Alzheimers Dement2015111007–1014
  5. Ngandu, T., Lehtisalo, J., Solomon, A. et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet20153852255–2263
  6. Panza, F., Solfrizzi, V., Barulli, M.R. et al. Coffee, tea, and caffeine consumption and prevention of late-life cognitive decline and dementia: a systematic review. J Nutr Health Aging201519313–328
  7. Petersson, S.D. and Philippou, E. Mediterranean diet, cognitive function, and dementia: a systematic review of the evidence. Adv Nutr20167889–904
  8. Solfrizzi, V., Custodero, C., Lozupone, M. et al. Relationships of dietary patterns, foods, and micro- and macronutrients with Alzheimer’s disease and late-life cognitive disorders: a systematic review. J Alzheimers Dis201759815–849

via Food for Thought: Basic Nutrition Recommendations for the Mature Brain – Archives of Physical Medicine and Rehabilitation

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[ARTICLE] Neurotechnology-aided interventions for upper limb motor rehabilitation in severe chronic stroke – Full Text

Abstract

Upper limb motor deficits in severe stroke survivors often remain unresolved over extended time periods. Novel neurotechnologies have the potential to significantly support upper limb motor restoration in severely impaired stroke individuals. Here, we review recent controlled clinical studies and reviews focusing on the mechanisms of action and effectiveness of single and combined technology-aided interventions for upper limb motor rehabilitation after stroke, including robotics, muscular electrical stimulation, brain stimulation and brain computer/machine interfaces. We aim at identifying possible guidance for the optimal use of these new technologies to enhance upper limb motor recovery especially in severe chronic stroke patients. We found that the current literature does not provide enough evidence to support strict guidelines, because of the variability of the procedures for each intervention and of the heterogeneity of the stroke population. The present results confirm that neurotechnology-aided upper limb rehabilitation is promising for severe chronic stroke patients, but the combination of interventions often lacks understanding of single intervention mechanisms of action, which may not reflect the summation of single intervention’s effectiveness. Stroke rehabilitation is a long and complex process, and one single intervention administrated in a short time interval cannot have a large impact for motor recovery, especially in severely impaired patients. To design personalized interventions combining or proposing different interventions in sequence, it is necessary to have an excellent understanding of the mechanisms determining the effectiveness of a single treatment in this heterogeneous population of stroke patients. We encourage the identification of objective biomarkers for stroke recovery for patients’ stratification and to tailor treatments. Furthermore, the advantage of longitudinal personalized trial designs compared to classical double-blind placebo-controlled clinical trials as the basis for precise personalized stroke rehabilitation medicine is discussed. Finally, we also promote the necessary conceptual change from ‘one-suits-all’ treatments within in-patient clinical rehabilitation set-ups towards personalized home-based treatment strategies, by adopting novel technologies merging rehabilitation and motor assistance, including implantable ones.

Introduction

Stroke constitutes a major public health problem affecting millions of people worldwide with considerable impacts on socio-economics and health-related costs. It is the second cause of death (Langhorne et al., 2011), and the third cause of disability-adjusted life-years worldwide (Feigin et al., 2014): ∼8.2 million people were affected by stroke in Europe in 2010, with a total cost of ∼€64 billion per year (Olesen et al., 2012). Due to ageing societies, these numbers might still rise, estimated to increase 1.5–2-fold from 2010 to 2030 (Feigin et al., 2014).

Improving upper limb functioning is a major therapeutic target in stroke rehabilitation (Pollock et al., 2014Veerbeek et al., 2017) to maximize patients’ functional recovery and reduce long-term disability (Nichols-Larsen et al., 2005Veerbeek et al., 2011Pollock et al., 2014). Motor impairment of the upper limb occurs in 73–88% first time stroke survivors and in 55–75% of chronic stroke patients (Lawrence et al., 2001). Constraint-induced movement therapy (CIMT), but also standard occupational practice, virtual reality and brain stimulation-based interventions for sensory and motor impairments show positive rehabilitative effects in mildly and moderately impaired stroke victims (Pollock et al., 2014Raffin and Hummel, 2018). However, stroke survivors with severe motor deficits are often excluded from these therapeutic approaches as their deficit does not allow easily rehabilitative motor training (e.g. CIMT), treatment effects are negligible and recovery unpredictable (Byblow et al., 2015Wuwei et al., 2015Buch et al., 2016Guggisberg et al., 2017).

Recent neurotechnology-supported interventions offer the opportunity to deliver high-intensity motor training to stroke victims with severe motor impairments (Sivan et al., 2011). Robotics, muscular electrical stimulation, brain stimulation, brain computer/machine interfaces (BCI/BMI) can support upper limb motor restoration including hand and arm movements and induce neuro-plastic changes within the motor network (Mrachacz-Kersting et al., 2016Biasiucci et al., 2018).

The main hurdle for an improvement of the status quo of stroke rehabilitation is the fragmentary knowledge about the physiological, psychological and social mechanisms, their interplay and how they impact on functional brain reorganization and stroke recovery. Positive stimulating and negatively blocking adaptive brain reorganization factors are insufficiently characterized except from some more or less trivial determinants, such as number and time of treatment sessions, pointing towards the more the better (Kwakkel et al., 1997). Even the long accepted model of detrimental interhemispheric inhibition of the overactive contralesional brain hemisphere on the ipsilesional hemisphere is based on an oversimplification and lack of differential knowledge and is thus called into question (Hummel et al., 2008Krakauer and Carmichael, 2017Morishita and Hummel, 2017).

Here, we take a pragmatic approach of comparing effectiveness data, keeping this lack of knowledge of mechanisms in mind and providing novel ideas towards precision medicine-based approaches to individually tailor treatments to the characteristics and needs of the individual patient with severe chronic stroke to maximize rehabilitative outcome.[…]

Continue —>   Neurotechnology-aided interventions for upper limb motor rehabilitation in severe chronic stroke | Brain | Oxford Academic

Conceptualization of longitudinal personalized rehabilitation-treatment designs for patients with severe chronic stroke. Ideally, each patient with severe chronic stroke with a stable motor recovery could be stratified based on objective biomarkers of stroke recovery in order to select the most appropriate/promising neurotechnology-aided interventions and/or their combination for the specific case. Then, these interventions can be administered in the clinic and/or at home in sequence, moving from one to another only when patient’s motor recovery plateaus. In this way, comparisons of the efficacy of each intervention (grey arrows) are still possible, and if the selected interventions and/or their combination are suitable, motor recovery could increase.

Conceptualization of longitudinal personalized rehabilitation-treatment designs for patients with severe chronic stroke. Ideally, each patient with severe chronic stroke with a stable motor recovery could be stratified based on objective biomarkers of stroke recovery in order to select the most appropriate/promising neurotechnology-aided interventions and/or their combination for the specific case. Then, these interventions can be administered in the clinic and/or at home in sequence, moving from one to another only when patient’s motor recovery plateaus. In this way, comparisons of the efficacy of each intervention (grey arrows) are still possible, and if the selected interventions and/or their combination are suitable, motor recovery could increase.

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[NEWS] New Virtual Reality Therapy game could offer relief for patients with chronic pain, mobility issues

News-MedicalA Virtual Reality Therapy game (iVRT) which could introduce relief for patients suffering from chronic pain and mobility issues has been developed by a team of UK researchers.

Dr Andrew Wilson and colleagues from Birmingham City University built the CRPS app in collaboration with clinical staff at Sandwell and West Birmingham Hospitals NHS Trust for a new way to tackle complex regional pain syndrome and to aid people living with musculoskeletal conditions.

Using a head mounted display and controllers, the team created an immersive and interactive game which mimics the processes used in traditional ‘mirror therapy’ treatment. Within the game, players are consciously and subconsciously encouraged to stretch, move and position the limbs that are affected by their conditions.

Mirror therapy is a medical exercise intervention where a mirror is used to create areflective illusion that encourages patient’s brain to move their limb more freely. This intervention is often used by occupational therapists and physiotherapists to treat CRPS patients who have experienced a stroke. This treatment has proven to be successful exercises are often deemed routine and mundane by patients, which contributes to decline in the completion of therapy.

Work around the CRPS project, which could have major implications for other patient rehabilitation programmes worldwide when fully realised, was presented at the 12th European Conference on Game Based Learning (ECGBL) in France late last year.

Dr Wilson, who leads Birmingham City University’s contribution to a European research study into how virtual reality games can encourage more physical activity, and how movement science in virtual worlds can be used for both rehabilitation and treatment adherence, explained, “The first part of the CRPS project was to examine the feasibility of being able to create a game which reflects the rehabilitation exercises that the clinical teams use on the ground to reduce pain and improve mobility in specific patients.”

“By making the game enjoyable and playable we hope family members will play too and in doing so encourage the patient to continue with their rehabilitation. Our early research has shown that in healthy volunteers both regular and casual gamers enjoyed the game which is promising in terms of our theory surrounding how we may support treatment adherence by exploiting involvement of family and friends in the therapy processes.”

The CRPS project was realized through collaborative working between City Hospital, Birmingham, and staff at the School of Computing and Digital Technology, and was developed following research around the provision of a 3D virtual reality ophthalmoscopy trainer.

Andrea Quadling, Senior Occupational Therapist at Sandwell Hospital, said “The concept of using virtual reality to treat complex pain conditions is exciting, appealing and shows a lot of potential. This software has the potential to be very helpful in offering additional treatment options for people who suffer with CRPS.”

via New Virtual Reality Therapy game could offer relief for patients with chronic pain, mobility issues

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[NEWS] Pill that reverses brain damage could be on the horizon

 

Researchers at the University of Pennsylvania have made important progress in designing a drug that could recover brain function in cases of severe brain damage due to injury or diseases such as Alzheimer’s.

brain cellsVitaly Sosnovskiy | Shutterstock

The work builds on a previous study where the team managed to convert human fetal glial cells called astrocytes into functional neurons. However, that required using a combination of nine molecules – too many for the formula to be translated into a clinically useful solution.

As reported in the journal Stem Cell Reports, the team has now successfully streamlined the process so that only four molecules are needed – an achievement that could lead to pill for repairing brain damage.

We identified the most efficient chemical formula among the hundreds of drug combinations that we tested. By using four molecules that modulate four critical signaling pathways in human astrocytes, we can efficiently turn human astrocytes — as many as 70 percent — into functional neurons.”

Jiu-Chao Yin, Study Author

The researchers report that the new neurons survived for more than seven months in the laboratory environment and that they functioned like normal brain cells, forming networks and communicating with one another using chemical and electrical signaling.

“The most significant advantage of the new approach is that a pill containing small molecules could be distributed widely in the world, even reaching rural areas without advanced hospital systems,” says Chen.

“My ultimate dream is to develop a simple drug delivery system, like a pill, that can help stroke and Alzheimer’s patients around the world to regenerate new neurons and restore their lost learning and memory capabilities,” he continued.

Now, the years of effort the team has put into simplifying the drug formula has finally paid off and taken the researchers a step closer towards realizing that dream.

via Pill that reverses brain damage could be on the horizon

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