Exploiting interlimb coupling to improve paretic arm reaching performance in people with chronic stroke

OBJECTIVE: To determine whether paretic arm reaching performance is improved in bilateral compared with unilateral conditions. DESIGN: Cohort study. SETTING: University human performance laboratory. PARTICIPANTS: Thirty-two subjects with chronic stroke (57+/-14y; on Fugl-Meyer Assessment arm score, 37+/-14). INTERVENTION: Unilateral and bilateral reaching. Bilateral tasks included varying levels of weight on the nonparetic hand. MAIN OUTCOME MEASURES: An electromagnetic tracking system recorded hand peak acceleration, velocity, and movement time. A 2-way repeated-measures analysis of variance and Tukey-adjusted pairwise comparisons were used to analyze the results (alpha=.05). RESULTS: Paretic differed significantly from nonparetic peak acceleration and velocity in unilateral reaching but not bilateral reaching. Within limbs, the paretic arm attained a higher peak acceleration (P<.001) and velocity (P=.03) in the bilateral compared with the unilateral task, but movement time was unchanged between tasks. Nonparetic peak acceleration was higher (P=.015), velocity was unchanged, and movement time increased (P=.005) in the bilateral compared with the unilateral task. The addition of a weight to the nonparetic arm during bilateral reaching did not result in further improvement in paretic arm performance. CONCLUSIONS: Interlimb coupling effects during bilateral reaching are retained even after chronic stroke and can be used to produce an immediate improvement in paretic arm reaching performance.     

The role of the state in the social inclusion of complementary and alternative medical occupations

OBJECTIVE: To examine the views of government spokespersons regarding the efforts of five complementary and alternative medicine (CAM) groups (chiropractic, traditional Chinese medicine/acupuncture, naturopathy, homeopathy and Reiki) to take their place in the formal health care system. DESIGN: In this small scale, exploratory study, we conducted in-depth interviews with 10 key government officials at the federal (5), provincial (4) and municipal (1) levels. We used qualitative techniques such as constant comparison to describe and explain their responses to three main questions: (1) What should be the role of the state in the professionalization of CAM? (2) Is there a legitimate place for CAM groups in the formal health care system? and (3) Should CAM services be integrated with conventional medical care? SETTING: Ontario, Canada. RESULTS: The findings identify a fundamental tension between the various levels of government. Their mandate to protect the public comes into conflict with the obligation to respond to consumer pressure for CAM. Safety, efficacy and cost-containment were the chief explanations given for the government's slowness to catch up to consumers. They also mentioned fears of rising health care costs and the lack of cohesion among and between CAM groups as barriers to legitimacy and integration. CONCLUSION: Realizing the professional aspirations of CAM practitioners will depend on the outcome of a political contest between the public, the state and the established health care professions.     

Workshop on Neurobiology of Epilepsy appraisal: New systemic imaging technologies to study the brain in experimental models of epilepsy

Modern functional neuroimaging provides opportunities to visualize activity of the entire brain, making it an indispensable diagnostic tool for epilepsy. Various forms of noninvasive functional neuroimaging are now also being performed as research tools in animal models of epilepsy and provide opportunities for parallel animal/human investigations into fundamental mechanisms of epilepsy and identification of epilepsy biomarkers. Recent animal studies of epilepsy using positron emission tomography, tractography, and functional magnetic resonance imaging were reviewed. Epilepsy is an abnormal emergent property of disturbances in neuronal networks which, even for epilepsies characterized by focal seizures, involve widely distributed systems, often in both hemispheres. Functional neuroimaging in animal models now provides opportunities to examine neuronal disturbances in the whole brain that underlie generalized and focal seizure generation as well as various types of epileptogenesis. Tremendous advances in understanding the contribution of specific properties of widely distributed neuronal networks to both normal and abnormal human behavior have been provided by current functional neuroimaging methodologies. Successful application of functional neuroimaging of the whole brain in the animal laboratory now permits investigations during epileptogenesis and correlation with deep brain electroencephalography (EEG) activity. With the continuing development of these techniques and analytical methods, the potential for future translational research on epilepsy is enormous. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here     

Natural and lesion‐induced decrease in cell proliferation in the medial nucleus of the trapezoid body during hearing development

The functional interactions between neurons and glial cells that are important for nervous system function are presumably established during development from the activity of progenitor cells. In this study we examined proliferation of progenitor cells in the medial nucleus of the trapezoid body (MNTB) located in the rat auditory brainstem. We performed DNA synthesis labeling experiments to demonstrate changes in cell proliferation activity during postnatal stages of development. An increase in cell proliferation correlated with MNTB growth and the presence of S100β‐positive astrocytes among MNTB neurons. In additional experiments we analyzed the fate of newly born cells. At perinatal ages, newly born cells colabeled with the astrocyte marker S100β in higher numbers than when cells were generated at postnatal day 6. Furthermore, we identified newly born cells that were colabeled with caspase‐3 immunohistochemistry and performed comparative experiments to demonstrate that there is a natural decrease in cell proliferation activity during postnatal development in rats, mice, gerbils, and ferrets. Lastly, we found that there is a stronger decrease in MNTB cell proliferation after performing bilateral lesions of the auditory periphery in rats. Altogether, these results identify important stages in the development of astrocytes in the MNTB and provide evidence that the proliferative activity of the progenitor cells is developmentally regulated. We propose that the developmental reduction in cell proliferation may reflect coordinated signaling between the auditory brainstem and the auditory periphery. J. Comp. Neurol. 522:971–985, 2014. © 2013 Wiley Periodicals, Inc.