The effects of a computer-based cognitive and physical training program in a healthy and mildly cognitive impaired aging sample

Objectives: The Long Lasting Memories (LLM) program concerns a newly integrated platform which combines cognitive exercises with physical activity within the context of advanced technologies. The main objective of this study was to present the preliminary results that determine the possible effectiveness of the LLM program in the improvement of cognitive functions and symptoms of depression in healthy elderly and subjects with mild cognitive impairment (MCI). Method: Fifty healthy and MCI subjects participated in the study. All of them received one hour's physical training and 35 minutes’ cognitive training, 3 times a week, during the 12 weeks of the program. Before and after the intervention all participants were assessed using a battery of neuropsychological tests.Results: The results showed a significant improvement after the LLM training in global cognitive function, in verbal memory, in attention, in episodic memory and symptoms of depression. Conclusion: This study indicates that LLM is a promising solution for older adults with and without cognitive impairment, maintaining their wellbeing with few professional and technical requirements.     

Utilization of predefined stimulation groups by essential tremor patients treated with VIM-DBS

ObjectiveTo identify the utilization and general acceptance of switching between predefined stimulation groups in essential tremor (ET) patients treated with deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) of the thalamus.MethodsThirty-eight patients treated with VIM-DBS completed a telephone survey. This was designed to identify the general utilization of patient controllers and the specific usage of stimulation groups.ResultsThirty-eight patients were interviewed via phone. More than half (21 of 38 patients, 55%) of all contacted ET patients were aware of the possibility of switching between pre-defined stimulation programs themselves. Again, more than half of these patients (13 of the 21 patients) switch between the different programs on a regular basis (8 monthly, 2 weekly, and 3 daily), mainly due to occurring side effects. Age did not differ between the group of patients switching between stimulation groups, and those who did not (65.38 years (±11.36) vs. 69.15 years (±9.92), p = 0.297).ConclusionSome patients frequently use different stimulation settings, mainly to be able to control side effects when necessary. All patients – independent of their age - and especially patients with stimulation induced side effects, should therefore be informed about the possibility to switch between predefined stimulation groups. We propose a training for patients by specialized nurses, to give them confidence in handling the patient controllers.     

Left posterior parietal theta burst stimulation affects gestural imitation regardless of semantic content

ObjectiveNeuro-imaging studies have suggested that the ability to imitate meaningless and meaningful gestures may differentially depend on superior (SPL) and inferior (IPL) parietal lobule. Therefore, we hypothesized that imaging-guided neuro-navigated continuous theta burst stimulation (cTBS) over left SPL mainly affects meaningless and over left IPL predominantly meaningful gestures.MethodsTwelve healthy subjects participated in this study. High resolution structural MRI was used for imaging guided neuro-navigation cTBS. Participants were targeted with one train of cTBS in three experimental sessions: sham stimulation over vertex and real cTBS over left SPL and IPL, respectively. An imitation task, including 24 meaningless and 24 meaningful gestures, was performed ‘offline’.ResultscTBS over both left IPL and SPL significantly interfered with gestural imitation. There was no differential effect of SPL and IPL cTBS on gesture type (meaningless versus meaningful).ConclusionsOur findings confirm that left posterior parietal cortex plays a predominant role in gestural imitation. However, the hypothesis based on the dual route model suggesting a differential role of SPL and IPL in the processing of meaningless and meaningful gestures could not be confirmed.SignificanceLeft SPL and IPL play a common role within the posterior–parietal network in gestural imitation regardless of semantic content.     

Withdrawal reflexes in the upper limb adapt to arm posture and stimulus location

Introduction: Withdrawal reflexes in the leg adapt in a context‐appropriate manner to remove the limb from noxious stimuli, but the extent to which withdrawal reflexes adapt in the arm remains unknown. Methods: We examined the adaptability of withdrawal reflexes in response to nociceptive stimuli applied in different arm postures and to different digits. Reflexes were elicited at rest, and kinetic and electromyographic responses were recorded under isometric conditions, thereby allowing motorneuron pool excitability to be controlled. Results: Endpoint force changed from a posterior–lateral direction in a flexed posture to predominantly a posterior direction in a more extended posture [change in force angle (mean ± standard deviation) 35.6 ± 5.0°], and the force direction changed similarly with digit I stimulation compared with digit V (change = 22.9 ± 2.9°). Conclusions: The withdrawal reflex in the human upper limb adapts in a functionally relevant manner when elicited at rest. Muscle Nerve 49 : 716–723, 2014     

脊髓重复磁刺激对骶上脊髓损伤后神经源性膀胱的影响

目的观察脊髓重复磁刺激对骶上脊髓损伤(SCI)后神经源性膀胱患者下尿路功能和生活质量的影响。方法纳入骶上SCI后膀胱功能无再改善的神经源性膀胱患者15例。试验采取前、后对照设计, 第一阶段, 为期2周, 期间所有患者只接受饮水计划和间歇导尿治疗;第二阶段, 为期4周, 所有患者在饮水计划和间歇导尿的基础上增加脊髓重复磁刺激干预, 刺激位于第1腰椎棘突水平, 刺激频率1 Hz, 每日1次, 每周5 d, 连续干预4周。于入组时、第2周结束时和第6周结束时, 记录15例患者的排尿日记, 并分别对其进行尿流动力学检测, 以及神经源性膀胱症状评分(NBSS)和生活质量评分。结果第6周结束时, 15例患者的导尿次数和平均自排尿量与第2周结束时和入组前比较, 差异均有统计学意义(P<0.01)。第6周结束时, 15例患者的储尿期最大逼尿肌压, 最大膀胱容量, 排尿期最大尿道压和排尿效率与第2周结束时和入组前比较, 差异均有统计学意义(P<0.01)。第6周结束时, 15例患者的NBSS和生活质量评分分别为(23.80±6.88)分和(3.53±1.36)分, 与第2周结束时和入组时比较...     

Crossed responses found in human trapezius muscles are not H‐reflexes

Introduction: We sought to confirm the presence of crossed short‐latency reflexes in trapezius. Methods: Mmax and Hmax were measured in the ipsilateral trapezius in 10 subjects by percutaneous electrical stimulation of the accessory nerve and the cervical nerves of C3/4 respectively. Repeated stimulation of the C3/4 cervical nerves was performed during 3 different tasks (relaxation, contraction of ipsilateral side, contraction of contralateral side). Results: Ipsilaterally, responses increased significantly with an increase in the prestimulus electromyogram (EMG) and decreased significantly with a decrease in prestimulus EMG. Contralateral potentials increased significantly with contraction of the trapezius ipsilateral to the stimulus compared with contraction of the muscle in which they were recorded and decreased significantly with increasing distance from the ipsilateral side. Conclusions: We found ipsilateral and contralateral responses consistent with previous findings. However, we conclude that the contralateral response in trapezius is not a crossed reflex. Muscle Nerve 49 :362–369, 2014     

重复经颅磁刺激联合康复训练治疗腰椎间盘突出症的疗效观察

目的观察重复经颅磁刺激(rTMS)联合康复训练治疗腰椎间盘突出症(LDH)的疗效。方法选取LDH患者72例, 按照随机数字表法将其分为rTMS组、训练组、联合组, 每组24例。rTMS组给予2 Hz rTMS治疗, 训练组给予康复训练(麦肯基力学疗法和腰背部核心肌群稳定性训练), 联合组给予康复训练和rTMS治疗, 每日治疗1次, 每周6次, 连续8周。治疗前、治疗8周后(治疗后)、治疗结束后8周(随访时), 采用视觉模拟评分法(VAS)、Oswestry功能障碍指数(ODI)对3组患者的疼痛和功能障碍程度进行评定。治疗后, 采用改良的Macnab标准评估治疗效果。所有患者均随访12个月, 记录复发情况。结果治疗前, 3组患者VAS、ODI评分比较, 差异无统计学意义(P>0.05)。治疗后, 3组患者的疼痛和功能障碍均有所缓解(P<0.05)。与rTMS组比较, 训练组治疗后和随访时的VAS评分较高、ODI评分较低。联合组治疗后和随访时的VAS、ODI评分均较rTMS组和训练组低(P<0.05)。治疗后, rTMS组、训练组、联合组的总有效率分别为62.5%、95....