0000000000441744
AUTHOR
Leonardo G. Cohen
Functional relevance of cross-modal plasticity in blind humans
Functional imaging studies of people who were blind from an early age have revealed that their primary visual cortex can be activated by Braille reading and other tactile discrimination tasks1. Other studies have also shown that visual cortical areas can be activated by somatosensory input in blind subjects but not those with sight2,3,4,5,6,7. The significance of this cross-modal plasticity is unclear, however, as it is not known whether the visual cortex can process somatosensory information in a functionally relevant way. To address this issue, we used transcranial magnetic stimulation to disrupt the function of different cortical areas in people who were blind from an early age as they i…
Contralateral hand anesthesia transiently improves poststroke sensory deficits.
Objective To test a possible strategy to alleviate somatosensory deficits after stroke. Methods Here, we applied ischemic nerve block to the intact hand of patients with chronic stroke, which in healthy subjects elicits improvements in sensibility of the other hand. Results We found that sensibility in the affected hand improved with intact hand anesthesia, but not with intact foot anesthesia or no anesthesia. Interpretation We conclude that reduction of sensory input from the intact hand leads to site-specific improvements in tactile discriminative skills in the affected hand after the period of anesthesia, a potentially relevant finding in designing neurorehabilitative interventions. Ann …
Influence of somatosensory input on motor function in patients with chronic stroke.
In healthy volunteers, reduction of somatosensory input from one hand leads to rapid performance improvements in the other hand. Thus, it is possible that reduction of somatosensory input from the healthy hand can influence motor function in the paretic hand of chronic stroke patients with unilateral hand weakness. To test this hypothesis, we had 13 chronic stroke patients perform motor tasks with the paretic hand and arm during cutaneous anesthesia of the healthy hand and healthy foot in separate sessions. Performance of a finger tapping task, but not a wrist flexion task, improved significantly with anesthesia of the hand, but not the foot. This effect progressed with the duration of anes…
EFFICACY OF REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION/TRANSCRANIAL DIRECT CURRENT STIMULATION IN COGNITIVE NEUROREHABILITATION
Summary: Cognitive deficits are a common consequence of neurologic disease, in particular, of traumatic brain injury, stroke, and neurodegenerative disorders, and there is evidence that specific cognitive training may be effective in cognitive rehabilitation. Several investigations emphasize the fact that interacting with cortical activity, by means of cortical stimulation, can positively affect the short-term cognitive performance and improve the rehabilitation potential of neurologic patients. In this respect, preliminary evidence suggests that cortical stimulation may play a role in treating aphasia, unilateral neglect, and other cognitive disorders. Several possible mechanisms can accou…
Enhancement of human cortico-motoneuronal excitability by the selective norepinephrine reuptake inhibitor reboxetine
It has been proposed that norepinephrine plays a critical role in the modulation of cortical excitability, which in turn is thought to influence functional recovery from brain lesions. The purpose of the present experiments was to determine if it is possible to modulate cortical excitability with the selective norepinephrine reuptake inhibitor reboxetine in intact humans. Recruitment curve and intracortical facilitation, assessed by transcranial magnetic stimulation, were increased after oral intake of 8 and 4 mg reboxetine, in the absence of changes in motor threshold, intracortical inhibition, M-response, F-wave or H-reflex. These results demonstrate that reboxetine enhances cortical exci…
Chapter 24 Bihemispheric plasticity after acute hand deafferentation
Publisher Summary This chapter summarizes experiments showing that deprivation of somatosensory input could also elicit organizational changes in the hemisphere contralateral to the deafferented one. The existence of interactions among homotopic sites within cortical representations in both hemispheres provides a substrate for such an effect. It has been proposed that chronic deafferentation, in association with long-term practice as in blind, deaf, or individuals with amputation results in compensatory gains in the same and in other sensory modalities. However, the long-term changes described are mild and the question whether blind or deaf people develop enhanced capacities of their remain…