0000000000335910
AUTHOR
Kauko Pitkänen
Functional MRI and motor behavioral changes obtained with constraint-induced movement therapy in chronic stroke
Background: The clinical benefits of intensive stroke rehabilitation vary individually. We used multimodal functional imaging to assess the relationship of clinical gain and imaging changes in patients with chronic stroke whose voluntary motor control improved after constraint-induced movement therapy (CIMT). Methods: Eleven patients (37.6 ± 36.8 months from stroke) were studied by functional MRI (fMRI), transcranial magnetic stimulation (TMS), and behavioral assessment of hand motor control (Wolf Motor Function Test) before and after 2 weeks of CIMT. Individual and group-level changes in imaging and behavioral parameters were investigated. Results: Increase in fMRI activation in the sen…
Alterations in visual and auditory processing in hemispatial neglect: An evoked potential follow-up study
Hemispatial neglect is common after cerebrovascular stroke in the right hemisphere. Cortical electrophysiological studies, especially investigations of both visual and auditory processing in subjects with neglect are sparse. Our purpose was to assess whether and to which extent subjects with neglect may show impairments in both visual and auditory processing. Thereby, we assessed the evolution of changes in sensory processing and neglect symptoms over a 6 month follow-up period. Twenty-one stroke subjects with hemispatial neglect were studied at baseline, 3 weeks later and at 6 months follow-up. At enrollment, 12 patients were in Acute/subacute and 9 were in the chronic stage of stroke. Vis…
Functional electrical therapy for hemiparesis alleviates disability and enhances neuroplasticity
Impaired motor and sensory function is common in the upper limb in humans after cerebrovascular stroke and it often remains as a permanent disability. Functional electrical stimulation therapy is known to enhance the motor function of the paretic hand; however, the mechanism of this enhancement is not known. We studied whether neural plasticity has a role in this therapy-induced enhancement of the hand motor function in 20 hemiparetic subjects with chronic stroke (age 53 ± 6 years; 7 females and 13 males; 10 with cerebral infarction and 10 with cerebral haemorrhage; and time since incident 2.4 ± 2.0 years). These subjects were randomized to functional electrical therapy or conventional phys…
Hemispatial neglect reflected on visual memory
PURPOSE Recent studies of hemispatial neglect have revealed both lateralized and nonlateralized attention mechanisms contributing to the syndrome. In addition, neglect patients show impaired spatial working memory and diminished working memory capacity. The aim of this study was to investigate, how neglect would be reflected in their performances in commonly used clinical visual memory tests. METHODS Twelve patients with right hemisphere lesions and left neglect and twelve matched controls were assessed with the Behavioural Inattention Test, the visual reproduction of the WMS-R, the object memory test, the Rey figure test and the list learning test. Visuo-spatial span was explored with the …
Comparison of the Behavioural Inattention Test and the Catherine Bergego Scale in assessment of hemispatial neglect.
The objective of the study was to correlate visual and behavioural assessments of hemispatial neglect caused by cerebrovascular accident. We assessed 17 consecutive right-hemisphere stroke patients with hemispatial neglect: the Catherine Bergego Scale (CBS) was used to evaluate neglect in spontaneous behaviour and the conventional subtests of the Behavioural Inattention Test (BIT C) were used to assess visual neglect. The proportional severity of both visual and behavioural neglect was calculated in each individual patient. Dissociations were found between mild neglect in visual screening tasks and moderate or severe neglect in behaviour, although in most patients, neglect was equally evide…
Gait reveals bilateral adaptation of motor control in patients with chronic unilateral stroke.
Background and aims: Functional brain imaging has shown that bilateral brain reorganization may occur after unilateral cerebral damage. The present study searched for evidence of bilateral motor control changes in gait in patients with chronic unilateral stroke. Methods: Gait variables (temporal and spatial parameters, footprint peak times (FPPT) and footfall times (FFT)) were recorded in 48 patients with chronic unilateral stroke at their preferred speed, and in 10 healthy volunteers walking from very slowly to very fast on a pressure sensor walkway. The data were divided into 4 groups according to gait velocity. The functional outcome of stroke was measured by the Barthel Index. Results: …