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1.
J Appl Biomech ; 40(4): 316-322, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-38925535

RESUMO

Different forearm postures can modulate corticospinal excitability. However, there is no consensus on whether handedness plays a role in such a mechanism. This study investigated the effects of 3 forearm postures (pronation, neutral, and supination) on the corticospinal excitability of muscles from the dominant and nondominant upper limbs. Surface electromyography was recorded from the abductor digiti minimi, flexor pollicis brevis, and flexor carpi radialis from both sides of 12 right-handed volunteers. Transcranial magnetic stimulation pulses were applied to each muscle's hotspot in both cerebral hemispheres. Motor-evoked potential peak-to-peak amplitude and latency and resting motor threshold were measured. The data were evaluated by analysis of variance. The level of significance was set at 5%. The resting motor threshold was similar for the 3 muscles and both sides. Motor-evoked potential peak-to-peak amplitude from flexor pollicis brevis was lower during supination, and the dominant upper limb latency was longer. The flexor carpi radialis presented lower motor-evoked potential peak-to-peak amplitudes for neutral and shorter latencies during supination. Abductor digiti minimi seemed not to be affected by posture or side. Different muscles from dominant and nondominant sides may undergo corticospinal modulation, even distally localized from a particular joint and under rest.


Assuntos
Eletromiografia , Potencial Evocado Motor , Antebraço , Mãos , Músculo Esquelético , Postura , Tratos Piramidais , Estimulação Magnética Transcraniana , Humanos , Músculo Esquelético/fisiologia , Masculino , Antebraço/fisiologia , Postura/fisiologia , Potencial Evocado Motor/fisiologia , Mãos/fisiologia , Feminino , Tratos Piramidais/fisiologia , Adulto , Lateralidade Funcional/fisiologia , Adulto Jovem
2.
Stat Med ; 42(22): 3956-3980, 2023 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-37665049

RESUMO

The power and commensurate prior distributions are informative prior distributions that incorporate historical data as prior knowledge in Bayesian analysis to improve inference about a phenomenon under study. Although these distributions have been developed for analyzing non-spatial data, little or no attention has been given to spatial geostatistical data. In this study, we extend these informative prior distributions to a Gaussian spatial process, which enables the elicitation of prior knowledge from historical geostatistical data for Bayesian analysis. Three informative prior distributions were developed for spatial modeling, and an efficient Markov Chain Monte Carlo algorithm was developed for performing Bayesian analysis. Simulation studies were used to assess the adequacy of the informative prior distributions. Hierarchical models combined with the developed informative prior distributions were applied to analyze transcranial magnetic stimulation (TMS) brain mapping data to gain insights into the spatial pattern of a patient's response to motor cortex stimulation. The study quantified the uncertainty in motor response and found that the primary motor cortex of the hand is responsible for most of the movement of the right first dorsal interosseous muscle. The findings provide a deeper understanding of the neural mechanisms underlying motor function and ultimately aid the improvement of treatment options for individuals with health issues.


Assuntos
Mapeamento Encefálico , Estimulação Magnética Transcraniana , Humanos , Teorema de Bayes , Algoritmos , Simulação por Computador
3.
Acta méd. colomb ; 47(4)dic. 2022.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1533451

RESUMO

Currently, transcranial stimulation for CVA treatment is based on the interhemispheric rivalry model. This model has proven to have many anomalies, necessitating a new paradigm. Spontaneous recovery from post-CVA hemiplegia has an ontogenetic pattern. We reanalyzed the 2008 longitudinal London study and found that cortical disinhibition is the mechanism for ontogenetic CVA recovery. We propose that transcranial stimulation with 10 Hz rTMS or anode electrical microstimulation can produce CVA recovery similar to spontaneous recovery. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2466).


Actualmente la aplicación de la estimulación transcraneal para el tratamiento del ACV se realiza con base en el modelo de rivalidad interhemisférica. Este modelo ha mostrado muchas anomalías que hacen necesario un nuevo paradigma. La recuperación espontánea de la hemiplejia post-ACV tiene patrón ontogénico. Reanalizamos el estudio longitudinal de Londres 2008 y encontramos que su propuesta corresponde al mecanismo de recuperación ontogénica del ACV. Planteamos que la estimulación transcraneal, utilizando EMTr a 10 Hz o microestimulación eléctrica anódica, podría recuperar el ACV de manera similar a la recuperación espontánea. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2466).

4.
J Neurosurg Case Lessons ; 3(23): CASE21315, 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35733824

RESUMO

BACKGROUND: Primary central nervous system germinomas of the medulla oblongata are extremely rare and usually have been found in young female Asian patients. The authors present an illustrative case of a patient who presented with severe medullary and posterior cord syndrome, the first South American case published to date, to the authors' knowledge. OBSERVATIONS: Initially, the radiological differential diagnosis did not include this entity. The lesion was located at the obex and exhibited a well-delineated contrast enhancement without hydrocephalus. An emergency decompressive partial resection following functional limits was performed. After histological confirmation, radiotherapy was indicated, with complete remission achieved at a 6-month follow-up. The patient, however, continued to have a severe proprioceptive disorder. The literature review identified 21 other such patients. The mean age for this location was 23 years, with a strong female and Asian origin predilection. All tumors exhibited contrast enhancement, and only one presented with hydrocephalus. LESSONS: In the absence of elevated tumor markers, radiological clues such as a well-delineated, contrast-enhanced lesion arising from the obex, without hydrocephalus, associated with demographic features such as young age, female sex, and Asian heritage, should evoke a high level of suspicion for this diagnosis. Gross total resection must not be attempted, because this tumor is potentially curable with high-dose radiotherapy.

5.
Brain Topogr ; 35(3): 322-336, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35262840

RESUMO

Most of the motor mapping procedures using navigated transcranial magnetic stimulation (nTMS) follow the conventional somatotopic organization of the primary motor cortex (M1) by assessing the representation of a particular target muscle, disregarding the possible coactivation of synergistic muscles. In turn, multiple reports describe a functional organization of the M1 with an overlapping among motor representations acting together to execute movements. In this context, the overlap degree among cortical representations of synergistic hand and forearm muscles remains an open question. This study aimed to evaluate the muscle coactivation and representation overlapping common to the grasping movement and its dependence on the stimulation parameters. The nTMS motor maps were obtained from one carpal muscle and two intrinsic hand muscles during rest. We quantified the overlapping motor maps in size (area and volume overlap degree) and topography (similarity and centroid Euclidean distance) parameters. We demonstrated that these muscle representations are highly overlapped and similar in shape. The overlap degrees involving the forearm muscle were significantly higher than only among the intrinsic hand muscles. Moreover, the stimulation intensity had a stronger effect on the size compared to the topography parameters. Our study contributes to a more detailed cortical motor representation towards a synergistic, functional arrangement of M1. Understanding the muscle group coactivation may provide more accurate motor maps when delineating the eloquent brain tissue during pre-surgical planning.


Assuntos
Córtex Motor , Mapeamento Encefálico/métodos , Potencial Evocado Motor/fisiologia , Antebraço/fisiologia , Mãos , Humanos , Córtex Motor/fisiologia , Músculo Esquelético/fisiologia , Estimulação Magnética Transcraniana/métodos
6.
Front Neurosci ; 16: 985754, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36760794

RESUMO

Background: The ability to produce coordinated movement is dependent on dynamic interactions through transcallosal fibers between the two cerebral hemispheres of the brain. Although typically unilateral, stroke induces changes in functional and effective connectivity across hemispheres, which are related to sensorimotor impairment and stroke recovery. Previous studies have focused almost exclusively on interhemispheric interactions in the primary motor cortex (M1). Objective: To identify the presence of interhemispheric asymmetry (ASY) of somatosensory cortex (S1) excitability and to investigate whether S1 repetitive transcranial magnetic stimulation (rTMS) combined with sensory stimulation (SS) changes excitability in S1 and M1, as well as S1 ASY, in individuals with subacute stroke. Methods: A randomized clinical trial. Participants with a single episode of stroke, in the subacute phase, between 35 and 75 years old, were allocated, randomly and equally balanced, to four groups: rTMS/sham SS, sham rTMS/SS, rTMS/SS, and sham rTMS/Sham SS. Participants underwent 10 sessions of S1 rTMS of the lesioned hemisphere (10 Hz, 1,500 pulses) followed by SS. SS was applied to the paretic upper limb (UL) (active SS) or non-paretic UL (sham SS). TMS-induced motor evoked potentials (MEPs) of the paretic UL and somatosensory evoked potential (SSEP) of both ULs assessed M1 and S1 cortical excitability, respectively. The S1 ASY index was measured before and after intervention. Evaluator, participants and the statistician were blinded. Results: Thirty-six participants divided equally into groups (nine participants per group). Seven patients were excluded from MEP analysis because of failure to produce consistent MEP. One participant was excluded in the SSEP analysis because no SSEP was detected. All somatosensory stimulation groups had decreased S1 ASY except for the sham rTMS/Sham SS group. When compared with baseline, M1 excitability increased only in the rTMS/SS group. Conclusion: S1 rTMS and SS alone or in combination changed S1 excitability and decreased ASY, but it was only their combination that increased M1 excitability. Clinical trial registration: clinicaltrials.gov, identifier (NCT03329807).

7.
Acupunct Med ; 40(2): 178-185, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34886714

RESUMO

INTRODUCTION: There is evidence that electroacupuncture (EA) acts through the modulation of brain activity, but little is known about its influence on corticospinal excitability of the primary motor cortex (M1). OBJECTIVE: To investigate the influence of EA parameters on the excitability of M1 in healthy individuals. METHODS: A parallel, double blind, randomized controlled trial in healthy subjects, evaluating the influence of an EA intervention on M1 excitability. Participants had a needle inserted at LI4 in the dominant hand and received electrical stimulation of different frequencies (10 or 100 Hz) and amplitude (sensory or motor threshold) for 20 min. In the control group, only a brief (30 s) electrical stimulation was applied. Single and paired pulse transcranial magnetic stimulation coupled with electromyography was applied before and immediately after the EA intervention. Resting motor threshold, motor evoked potential, short intracortical inhibition and intracortical facilitation were measured. RESULTS: EA increased corticospinal excitability of M1 compared to the control group only when administered with a frequency of 100 Hz at the sensory threshold (p < 0.05). There were no significant changes in the other measures. CONCLUSION: The results suggest that EA with an intensity level at the sensorial threshold and 100 Hz frequency increases the corticospinal excitability of M1. This effect may be associated with a decrease in the activity of inhibitory intracortical mechanisms. TRIAL REGISTRATION NUMBER: U1111-1173-1946 (Registro Brasileiro de Ensaios Clínicos; http://www.ensaiosclinicos.gov.br/).


Assuntos
Eletroacupuntura , Córtex Motor , Eletromiografia , Potencial Evocado Motor/fisiologia , Humanos , Estimulação Magnética Transcraniana/métodos
8.
Med Biol Eng Comput ; 59(2): 449-456, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33496910

RESUMO

Transcranial magnetic stimulation (TMS) allows the assessment of stroke patients' cortical excitability and corticospinal tract integrity, which provide information regarding motor function recovery. However, the extraction of features from motor-evoked potentials (MEP) elicited by TMS, such as amplitude and latency, is performed manually, increasing variability due to observer-dependent subjectivity. Therefore, an automatic methodology could improve MEP analysis, especially in stroke, which increases the difficulty of manual MEP measurements due to brain lesions. A methodology based on time-frequency features of stroke patients' MEPs that allows to automatically select and extract MEP amplitude and latency is proposed. The method was validated using manual measurements, performed by three experts, computed from patients' affected and unaffected hemispheres. Results showed a coincidence of 58.3 to 80% between automatic and manual MEP selection. There were no significant differences between the amplitudes and latencies computed by two of the experts with those obtained with the automatic method, for most comparisons. The median relative error of amplitudes and latencies computed by the automatic method was 5% and 23%, respectively. Therefore, the proposed method has the potential to reduce processing time and improve the computation of MEP features, by eliminating observer-dependent variability due to the subjectivity of manual measurements.


Assuntos
Acidente Vascular Cerebral , Estimulação Magnética Transcraniana , Eletromiografia , Potencial Evocado Motor , Humanos , Recuperação de Função Fisiológica
10.
Distúrb. comun ; 32(3): 406-413, set. 2020. tab
Artigo em Português | LILACS | ID: biblio-1397554

RESUMO

Introdução: a avaliação vestibular é realizada tradicionalmente por meio da prova calórica para avaliação do labirinto em indivíduos com tonturas, porém este exame não avalia toda a via vestibular. Os potenciais evocados miogênicos vestibulares (VEMP) consistem em um exame de rápida execução, considerado método de escolha para avaliação dos órgãos otolíticos e do nervo vestibular. Objetivo: analisar as respostas do exame VEMP cervical (cVEMP) e ocular (oVEMP) em indivíduos com doenças vestibulares e compará-las àquelas obtidas em indivíduos de mesma faixa etária e sexo sem queixas de tontura pregressas e atuais. Métodos: Estudo observacional, transversal e analítico. Os participantes foram divididos em dois grupos: grupo com tontura (GT), composto por indivíduos com diversas doenças vestibulares e o grupo sem queixa de tontura (GC). Ambos os grupos foram submetidos à meatoscopia, ao VEMP cervical e ocular. Resultados: A amostra foi composta por 45 indivíduos com a idade entre 23 e 68 anos, sendo 27 indivíduos do grupo GC e 18 do grupo GT. No exame cVEMP as latências, amplitudes, índice de assimetria e o índice de assimetria corrigido foram iguais no GT quando comparado com o GC. No exame oVEMP encontrou-se a amplitude esquerda maior e a latência N10 menor estatisticamente no grupo GT quando comparado ao grupo GC. Dentre as doenças do grupo GT os indivíduos com deiscência de canal superior tiveram valores maiores na amplitude esquerda, o que pode ter interferido nos resultados. Conclusão: Não foram evidenciadas diferenças nas respostas do cVEMP entre os grupos neste estudo. Encontrou-se aumento da amplitude esquerda e o valor menor da latência N10 direita no grupo com tontura na análise do exame oVEMP. Acredita-se que a heterogeneidade de doenças vestibulares no grupo com tontura e o reduzido número de participantes em ambos os grupos tenham contribuído para esse desfecho.


Introduction: The vestibular assessment is traditionally carried out with the caloric test to evaluate the labyrinth in individuals with dizziness. However, this examination does not evaluate the entire vestibular pathway. The vestibular evoked myogenic potentials (VEMP) are a quick test, considered a choice method to assess the otolith organs and the vestibular nerve. Purpose: To analyze the responses of the cervical (cVEMP) and ocular VEMP (oVEMP) examinations in individuals with vestibular diseases and compare them with the results obtained in individuals of the same age group and gender without previous and current complaints of dizziness. Methods: In this observational, cross-sectional, analytical study, the participants were divided into two groups: the dizziness group (DG), composed of individuals with several vestibular diseases, and the group without complaints of dizziness (CG). Both groups underwent meatoscopy, and cervical and ocular VEMP. Results: The sample comprised 45 individuals aged 23 to 68 years ­ 27 individuals in the CG and 18 in the DG. In the cVEMP exam, the latencies, amplitudes, asymmetry index, and the corrected asymmetry index were the same in the GT when compared to the GC. In the cVEMP examination, the latencies, amplitudes, asymmetry index, and corrected asymmetry index were equal in the DG when compared with the CG. In the oVEMP examination, the left amplitude was statistically greater and the N10 latency, smaller in the DG when compared with the CG. Of the diseases in the DG, individuals with superior canal dehiscence had higher left amplitude values, which may have interfered with the results.Conclusion: There were no differences in cVEMP responses between the groups in this study. An increase in the left amplitude and the lower value in the right N10 latency were found in the DG in the analysis of the oVEMP examination. It is believed that the heterogeneity of vestibular diseases in the DG and the small number of participants in both groups have contributed to this outcome.


Introducción: La evaluación vestibular se lleva a cabo tradicionalmente a través de la prueba calórica para evaluar el laberinto en individuos con mareos, sin embargo, este examen no evalúa toda la vía vestibular. Los potenciales miogénicos evocados vestibulares (VEMP) consisten en una prueba de funcionamiento rápido, considerada el método de elección para evaluar los órganos otolíticos y el nervio vestibular. Objetivo: Analizar las respuestas del examen VEMP cervical y ocular en individuos con enfermedades vestibulares y compararlas con las obtenidas en individuos del mismo grupo de edad y sexo sin quejas de mareos previas y actuales. Métodos:Estudio observacional, transversal y analítico. Los participantes se dividieron en dos grupos: grupo con mareos (GT), compuesto por individuos con varias enfermedades vestibulares y el grupo sin quejas de mareos (CG). Ambos grupos se sometieron a meatoscopia, VEMP cervical y ocular. Resultados: La muestra consistió en 45 individuos con edades comprendidas entre 23 y 68 años, 27 individuos del grupo GC y 18 del grupo GT. En el examen cVEMP, las latencias, amplitudes, índice de asimetría y el índice de asimetría corregido fueron los mismos en el GT en comparación con el CG. En el examen oVEMP, la amplitud izquierda fue mayor y la latencia N10 fue estadísticamente menor en el grupo GT en comparación con el grupo CG. Entre las enfermedades en el grupo GT, los individuos con dehiscencia del canal superior tenían valores más altos en la amplitud izquierda, lo que puede haber interferido con los resultados. Conclusión: No hubo diferencias en las respuestas de cVEMP entre los grupos en este estudio. Se encontró un aumento en la amplitud izquierda y un valor más bajo de la latencia N10 derecha en el grupo con mareos en el análisis del examen oVEMP. Se cree que la heterogeneidad de las enfermedades vestibulares en el grupo de mareos y el pequeño número de participantes en ambos grupos contribuyeron a este resultado.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Doenças Vestibulares/diagnóstico , Tontura/diagnóstico , Potenciais Evocados Miogênicos Vestibulares , Testes de Função Vestibular , Estudos Transversais , Distribuição por Idade e Sexo
12.
Braz. j. otorhinolaryngol. (Impr.) ; Braz. j. otorhinolaryngol. (Impr.);83(3): 330-340, May-June 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-889267

RESUMO

Abstract Introduction: The vestibular evoked myogenic potential is a potential of mean latency that measures the muscle response to auditory stimulation. This potential can be generated from the contraction of the sternocleidomastoid muscle and also from the contraction of extraocular muscles in response to high-intensity sounds. This study presents a combined or simultaneous technique of cervical and ocular vestibular evoked myogenic potential in individuals with changes in the vestibular system, for use in otoneurologic diagnosis. Objective: To characterize the records and analyze the results of combined cervical and ocular VEMP in individuals with vestibular hyporeflexia and in those with Ménière's disease. Methods: The study included 120 subjects: 30 subjects with vestibular hyporeflexia, 30 with Ménière's disease, and 60 individuals with normal hearing. Data collection was performed by simultaneously recording the cervical and ocular vestibular evoked myogenic potential. Results: There were differences between the study groups (individuals with vestibular hyporeflexia and individuals with Ménière's disease) and the control group for most of wave parameters in combined cervical and ocular vestibular evoked myogenic potential. For cervical vestibular evoked myogenic potential, it was observed that the prolongation of latency of the P13 and N23 waves was the most frequent finding in the group with vestibular hyporeflexia and in the group with Ménière's disease. For ocular vestibular evoked myogenic potential, prolonged latency of N10 and P15 waves was the most frequent finding in the study groups. Conclusion: Combined cervical and ocular vestibular evoked myogenic potential presented relevant results for individuals with vestibular hyporeflexia and for those with Ménière's disease. There were differences between the study groups and the control group for most of the wave parameters in combined cervical and ocular vestibular evoked myogenic potential.


Resumo Introdução: O potencial evocado miogênico vestibular é um potencial de média latência que avalia a resposta muscular decorrente de estimulação auditiva. Pode ser gerado a partir da contração do músculo esternocleidomastóideo e também a partir da contração de músculos extraoculares em resposta a sons de elevada intensidade. Este estudo apresenta uma técnica combinada ou simultânea de potencial evocado miogênico vestibular cervical e ocular em indivíduos com alterações no sistema vestibular para que possa ser usada no diagnóstico otoneurológico. Objetivo: Caracterizar o registro e analisar os resultados do potencial evocado miogênico vestibular cervical e ocular combinado em indivíduos com hiporreflexia vestibular e em indivíduos com doença de Ménière. Método: Participaram do estudo 120 indivíduos, 30 com hiporreflexia vestibular, 30 com doença de Ménière e 60 com audição dentro dos padrões de normalidade. A coleta de dados foi feita por meio do potencial evocado miogênico vestibular cervical e ocular registrados simultaneamente. Resultados: Houve diferença entre o grupo de estudo (indivíduos com hiporreflexia vestibular e indivíduos com doença de Ménière) e o grupo controle para a maioria dos parâmetros das ondas no potencial evocado miogênico vestibular cervical e ocular combinado. Para o potencial evocado miogênico vestibular cervical observou-se que o prolongamento da latência das ondas P13 e N23 foi a alteração mais encontrada no grupo de indivíduos com hiporreflexia vestibular e no grupo de indivíduos com doença de Ménière. Para o potencial evocado miogênico vestibular ocular o prolongamento da latência das ondas N10 e P15 foi a alteração mais encontrada no grupo de estudo. Conclusão: O potencial evocado miogênico vestibular cervical e ocular combinado apresentou resultados relevantes para os indivíduos com hiporreflexia vestibular e para os indivíduos com doença de Ménière. Houve diferença entre o grupo de estudo e o grupo controle para a maioria dos parâmetros das ondas no potencial evocado miogênico vestibular cervical e ocular combinado.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Reflexo Vestíbulo-Ocular/fisiologia , Vértebras Cervicais/fisiopatologia , Reflexo Anormal/fisiologia , Potenciais Evocados Miogênicos Vestibulares/fisiologia , Doença de Meniere/fisiopatologia , Testes de Função Vestibular
13.
Braz J Otorhinolaryngol ; 83(3): 330-340, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27320652

RESUMO

INTRODUCTION: The vestibular evoked myogenic potential is a potential of mean latency that measures the muscle response to auditory stimulation. This potential can be generated from the contraction of the sternocleidomastoid muscle and also from the contraction of extraocular muscles in response to high-intensity sounds. This study presents a combined or simultaneous technique of cervical and ocular vestibular evoked myogenic potential in individuals with changes in the vestibular system, for use in otoneurologic diagnosis. OBJECTIVE: To characterize the records and analyze the results of combined cervical and ocular VEMP in individuals with vestibular hyporeflexia and in those with Ménière's disease. METHODS: The study included 120 subjects: 30 subjects with vestibular hyporeflexia, 30 with Ménière's disease, and 60 individuals with normal hearing. Data collection was performed by simultaneously recording the cervical and ocular vestibular evoked myogenic potential. RESULTS: There were differences between the study groups (individuals with vestibular hyporeflexia and individuals with Ménière's disease) and the control group for most of wave parameters in combined cervical and ocular vestibular evoked myogenic potential. For cervical vestibular evoked myogenic potential, it was observed that the prolongation of latency of the P13 and N23 waves was the most frequent finding in the group with vestibular hyporeflexia and in the group with Ménière's disease. For ocular vestibular evoked myogenic potential, prolonged latency of N10 and P15 waves was the most frequent finding in the study groups. CONCLUSION: Combined cervical and ocular vestibular evoked myogenic potential presented relevant results for individuals with vestibular hyporeflexia and for those with Ménière's disease. There were differences between the study groups and the control group for most of the wave parameters in combined cervical and ocular vestibular evoked myogenic potential.


Assuntos
Vértebras Cervicais/fisiopatologia , Doença de Meniere/fisiopatologia , Reflexo Anormal/fisiologia , Reflexo Vestíbulo-Ocular/fisiologia , Potenciais Evocados Miogênicos Vestibulares/fisiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes de Função Vestibular , Adulto Jovem
14.
Front Hum Neurosci ; 10: 361, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27486393

RESUMO

The current priority of investigations involving transcranial direct current stimulation (tDCS) and neurorehabilitation is to identify biomarkers associated with the positive results of the interventions such that respondent and non-respondent patients can be identified in the early phases of treatment. The aims were to determine whether: (1) present motor evoked potential (MEP); and (2) injuries involving the primary motor cortex, are associated with tDCS-enhancement in functional outcome following gait training in children with cerebral palsy (CP). We reviewed the data from our parallel, randomized, sham-controlled, double-blind studies. Fifty-six children with spastic CP received gait training (either treadmill training or virtual reality training) and tDCS (active or sham). Univariate and multivariate logistic regression analyses were employed to identify clinical, neurophysiologic and neuroanatomic predictors associated with the responsiveness to treatment with tDCS. MEP presence during the initial evaluation and the subcortical injury were associated with positive effects in the functional results. The logistic regression revealed that present MEP was a significant predictor for the six-minute walk test (6MWT; p = 0.003) and gait speed (p = 0.028), whereas the subcortical injury was a significant predictor of gait kinematics (p = 0.013) and gross motor function (p = 0.021). In this preliminary study involving children with CP, two important prediction factors of good responses to anodal tDCS combined with gait training were identified. Apparently, MEP (integrity of the corticospinal tract) and subcortical location of the brain injury exerted different influences on aspects related to gait, such as velocity and kinematics.

15.
Rev. bras. med. esporte ; Rev. bras. med. esporte;19(5): 328-331, set.-out. 2013. graf, tab
Artigo em Português | LILACS | ID: lil-696046

RESUMO

INTRODUÇÃO: Estudos da condução nervosa têm sido focados para o público em geral, porém não para atletas, havendo carência de informações sobre medidas da velocidade de condução nervosa motora (VCNM) em indivíduos treinados, especialmente quando diferentes esportes são comparados. OBJETIVO: Medir a VCNM do nervo mediano e fibular comum, em três grupos de modalidades esportivas. Métodos: Foram analisados: um grupo de meio-fundistas (Gmf, n = 6), um grupo de velocistas (Gvel, n = 4) e um grupo de jogadores de handebol (Ghan, n = 5) e comparados com um grupo controle (Gcon, n = 9). Cada voluntário foi submetido a um único exame, no qual foram obtidos os dados para calcular a VCNM dos membros inferiores do Gmf e do Gvel, dos membros superiores do Ghan, e membros superiores e inferiores do Gcon. Os dados da pesquisa apresentaram distribuição normal e variâncias homogêneas, assim, utilizamos o teste t de Student para amostras independentes na comparação das médias da VCNM dos grupos de atletas com as do Gcon e as do Gvel com as do Gmf (comparações intergrupo). O teste t pareado foi usado para comparar as médias da VCNM entre membro dominante (Md) e membro não dominante (Mnd) (comparações intragrupo). RESULTADOS: Na análise intergrupo foram encontradas diferenças significativas nas comparações entre o Gvel e o Gcon e entre o Gmf e o Gcon (diferença apenas nas comparações entre os Md's). Por outro lado, a análise intragrupo, exibiu diferença significativa apenas nas comparações entre Md e Mnd do Ghan. CONCLUSÃO: O estudo sugere que a VCNM é beneficiada pelo esforço físico, principalmente em esportes com uso predominante dos membros inferiores, e que a maior utilização de um membro superior sobre outro pode levar a diferença significativa nos valores da VCNM do Md e Mnd.


INTRODUCTION: Electrodiagnostic tests such as nervous conduction studies are mainly aimed at the general public, not at athletes. Therefore, information about motor nervous conduction velocity (MNCV) is scarce for trained subjects, especially when different sports are compared. OBJECTIVE: to measure the MNCV of the median and common fibular nerves in three groups of sport modalities. Methods: A group of middle distance runners (M RG, n=6), a group of sprinter runners (S RG, n=4) and a group of handball players (H G, n=5) were analyzed and compared to a control group (C G, n=9). Each volunteer was submitted to a single examination where data necessary to measure MNCV from the lower limbs of M RG and of S RG; upper limbs of H G and both upper and lower limbs of C G were collected. Data analysis presented normal distribution and homogeneous variances in all cases; therefore, a Student's t test for independent samples was used to compare means of MNCV of the athlete groups and the C G, as well as in the mean comparison of S RG and M RG (intergroup comparison). The paired Student's t test was used to compare MNCV means of the dominant limb (DL) and non-dominant limb (NDL) (intragroup comparison). RESULTS: Significant differences were found in the comparison between S RG and CG and between M RG and CG, but only in the DL comparison in the last case. On the other hand, in the intragroup comparison, there was significant difference only in the comparison between D L and N DL of the H G. CONCLUSION: This study suggests that MNCV benefits from physical exercise, especially in those sports where lower limbs are predominantly used. It also suggests that greater use of one upper limb over the other could lead to significant differences in MNCV values of D L and N DL.

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