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P-132 Bidirectional changes in corticospinal excitability following quadri-pulse theta burst stimulation with individually (I-wave) adapted and fixed interstimulus intervals – Preliminary results. Clin Neurophysiol 2023. [DOI: 10.1016/j.clinph.2023.02.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
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P 86 Plasticity induction in humans by individualized quadri theta burst stimulation – preliminary results. Clin Neurophysiol 2022. [DOI: 10.1016/j.clinph.2022.01.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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P76 Intra-individual variability of I-wave peaks – Preliminary results. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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The Multiple Sclerosis Inventory of Cognition for Adolescents (MUSICADO): A brief screening instrument to assess cognitive dysfunction, fatigue and loss of health-related quality of life in pediatric-onset multiple sclerosis. Eur J Paediatr Neurol 2019; 23:792-800. [PMID: 31551133 DOI: 10.1016/j.ejpn.2019.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 07/23/2019] [Accepted: 08/22/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Screening for cognitive impairment (CI), fatigue and also Health-related quality of life (HRQoL) in patients with pediatric-onset multiple sclerosis (POMS) is of utmost importance in clinical practice. The aim of this study was to establish a new and validated pediatric screening tool "MUSICADO" that is easy to use and time economical. METHODS 106 patients with POMS aged 12-18 years and 210 healthy controls (HCs) stratified for age and education underwent neuropsychological testing including a screening test "Multiple Sclerosis Inventory of Cognition" for adults and 8 standardized cognitive tests and established scales to assess fatigue and HRQoL. RESULTS The phonemic verbal fluency task (RWT "s-words"), the Trail Making Test A (TMT-A), and the Digit Span Forward discriminated significantly between patients and HCs (p = 0.000, respectively) and showed the highest proportion of test failure in patients (24.5%, 17.9%; 15.1%, respectively). Therefore, they were put together to form the cognitive part of the "MUSICADO". After applying a scoring algorithm with balanced weighting of the subtests and age and education correction and a cut-off score for impairment, 35.8% of patients were categorized to be cognitively impaired (specificity: 88.6%). Fatigue was detected in 37.1% of the patients (specificity: 94.0%) and loss of HRQoL in 41.8% (specificity 95.7%) with the screening version, respectively. CONCLUSION The MUSICADO is a newly designed brief and easy to use screening test to help to early identify CI, fatigue, and loss of HRQoL in patients with POMS as cut scores are provided for all three items. Further studies will have to show its usability in independent samples of patients with POMS.
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A De Novo Dominant Negative Mutation in DNM1L Causes Sudden Onset Status Epilepticus with Subsequent Epileptic Encephalopathy. Neuropediatrics 2019; 50:197-201. [PMID: 30939602 DOI: 10.1055/s-0039-1685217] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Mitochondrial dynamics such as fission and fusion play a vital role in normal brain development and neuronal activity. DNM1L encodes a dynamin-related protein 1 (Drp1), which is a GTPase essential for proper mitochondrial fission. The clinical phenotype of DNM1L mutations depends on the degree of mitochondrial fission deficiency, ranging from severe encephalopathy and death shortly after birth to initially normal development and then sudden onset of refractory status epilepticus with very poor neurologic outcome. We describe a case of a previously healthy 3-year-old boy with a mild delay in speech development until the acute onset of a refractory status epilepticus with subsequent epileptic encephalopathy and very poor neurologic outcome. The de novo missense mutation in DNM1L (c.1207C > T, p.R403C), which we identified in this case, seems to determine a unique clinical course, strikingly similar to four previously described patients in literature with the identical de novo heterozygous missense mutation in DNM1L.
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Epidemiologie – Sozialpädiatrie – Psychosomatik. PÄDIATRIE 2019. [PMCID: PMC7498394 DOI: 10.1007/978-3-662-57295-5_32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Sozialpädiatrie beschäftigt sich mit sozialen Determinanten für Erkrankungen. Diese können die Inzidenz bzw. Prävalenz von Morbidität und Mortalität verändern. Epidemiologie beschreibt zeitliche Trends in Populationen und untersucht deren Ursachen. Durch Prävention sollen Erkrankungsraten reduziert bzw. deren Prognose verbessert werden. Psychische Störungen sind häufige Phänomene und betreffen bis zu 20% der Kinder und Jugendlichen bis zum Erreichen des Erwachsenenalters. Die Besonderheit der Phänomenologie psychischer Störungen im Kindes- und Jugendalters ist ihre enge Verbindung zur Entwicklung des Individuums und ihre häufig starke Wechselwirkung mit körperlichen Funktionen und dem Auftreten somatischer Symptome. Aus diesem Grund bewährt sich für das Verständnis und die Versorgung zahlreicher psychischer Störungen ein biopsychosomatischer Ansatz im Kindes- und Jugendalter. Dieser Ansatz kann als Wechsel der Perspektive von einer primär auf das Organ zu einer mehr psychisch zentrierten Betrachtung in der Diagnostik und Behandlung von Störungen mit einer primär körperlichen Symptomatik verstanden werden. Dieser Vorstellung liegt zugrunde, dass keine somatische Symptomatik isoliert aufritt, ohne dass ein psychisches Korrelat besteht, was dann als somato-psychisches Phänomen beschrieben werden kann. Psychosomatische Erkrankungen sind z. B. die Essstörungen, die dissoziativen und die somatoformen Störungen.
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[Neuronal plasticity and neuromodulation in pediatric neurology]. DER NERVENARZT 2018; 89:1131-1139. [PMID: 30141068 DOI: 10.1007/s00115-018-0586-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Neuronal plasticity is a core mechanism for learning and memory. Abnormal neuronal plasticity has emerged as a key mechanism in many neurological and neuropediatric diseases. OBJECTIVE Chances and perspectives of neuromodulation techniques in neurological and neuropediatric diseases with altered neuronal plasticity. MATERIAL AND METHODS Presentation and discussion of own results of neuronal plasticity investigations in patients with neurodevelopmental disorders including RASopathies, autism spectrum disorders (ASD) and Gilles de la Tourette syndrome (GTS). RESULTS The results of neuronal plasticity studies in patients with RASopathies, ASD and GTS underline the pathophysiological relevance of abnormal neuronal plasticity in these diseases. Transcranial magnetic stimulation (TMS) is a useful tool to examine and also induce neuronal plasticity in these patients. CONCLUSION Neuronal plasticity appears to be an important pathophysiological factor in neuronal developmental disorders and can be investigated using TMS. New and innovative techniques may offer novel approaches for individualized TMS applications, particularly in children with neuropediatric conditions.
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P55. Probing homeostatic and metaplastic mechanisms of quadri-pulse theta burst stimulation using an inhibitory priming protocol. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.04.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Entwicklungsstörungen – pathophysiologische Aspekte. DAS GESUNDHEITSWESEN 2015. [DOI: 10.1055/s-0035-1563200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hypersalivation – Ersterstellung der S2k-Leitlinie (AWMF) in gekürzter Darstellung. Laryngorhinootologie 2014. [DOI: 10.1055/s-0033-1357200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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P680: Induction of neuronal plasticity by transcranial biphasic quadro-pulse stimulation with one or two full-sine cycles. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50771-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Induktion neuronaler Plastizität durch biphasische transkranielle Magnetstimulation (TMS) mittels Quattropulsen mit einfacher und doppelter Sinusvollwelle. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1371276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Validation of a screening to detect cognitive and psychoaffective deficits in children and juveniles with multiple sclerosis: The MUSICADO study. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.1414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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P 231. A physiological characterization of biphasic transcranial magnetic stimulation. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.04.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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P 167. Attention dependent induction of synaptic plasticity in healthy controls and patients with Noonan syndrome. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.04.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Hypersalivation describes a relatively excessive salivary flow, which wets the patient himself and his surroundings. It may result because of insufficient oro-motor function, dysphagia, decreased central control and coordination. This reduces social interaction chances and burdens daily care. Multidisciplinary diagnostic and treatment evaluation is recommended already at early stage and focus on dysphagia, and saliva aspiration. Therefore, a multidisciplinary S2k guideline was developed. Diagnostic tools such as fiberoptic endoscopic evaluation of swallowing and videofluoroscopic swallowing studies generate important data on therapy selection and control. Especially traumatic and oncologic cases profit from swallowing therapy programmes in order to activate compensation mechanisms. In children with hypotonic oral muscles, oralstimulation plates can induce a relevant symptom release because of the improved lip closure. In acute hypersalivation, the pharmacologic treatment with glycopyrrolate and scopolamine in various applications is useful but its value in long-term usage critical. The injection of botulinum toxin into the salivary glands has shown safe and effective results with long lasting saliva reduction. Surgical treatment should be reserved for isolated cases. External radiation is judged as ultima ratio. Therapy effects and symptom severity has to be followed, especially in neurodegenerative cases. The resulting xerostomia should be critically evaluated by the responsible physician regarding oral and dental hygiene.
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Aufmerksamkeitsabhängige Induktion synaptischer Plastizität bei gesunden Probanden und Patienten mit Noonan Syndrom. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Effekte von Lovastatin auf kortikaler und Amygdala-abhängiger synaptischer Plastizität im BDNF Val/Met Genotyp. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Induktion kortikaler Plastizität durch biphasische transkranielle Magnetstimulation (TMS) mit Quattropulsen. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Physiologische Eigenschaften der transkraniellen Magnetstimulation mit biphasischer Pulskonfiguration. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Influence of current direction on short-interval intracortical facilitation probed with paired-pulse TMS. KLIN NEUROPHYSIOL 2012. [DOI: 10.1055/s-0032-1301602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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A practical guide to diagnostic transcranial magnetic stimulation: report of an IFCN committee. Clin Neurophysiol 2012; 123:858-82. [PMID: 22349304 DOI: 10.1016/j.clinph.2012.01.010] [Citation(s) in RCA: 775] [Impact Index Per Article: 64.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Revised: 01/16/2012] [Accepted: 01/22/2012] [Indexed: 11/29/2022]
Abstract
Transcranial magnetic stimulation (TMS) is an established neurophysiological tool to examine the integrity of the fast-conducting corticomotor pathways in a wide range of diseases associated with motor dysfunction. This includes but is not limited to patients with multiple sclerosis, amyotrophic lateral sclerosis, stroke, movement disorders, disorders affecting the spinal cord, facial and other cranial nerves. These guidelines cover practical aspects of TMS in a clinical setting. We first discuss the technical and physiological aspects of TMS that are relevant for the diagnostic use of TMS. We then lay out the general principles that apply to a standardized clinical examination of the fast-conducting corticomotor pathways with single-pulse TMS. This is followed by a detailed description of how to examine corticomotor conduction to the hand, leg, trunk and facial muscles in patients. Additional sections cover safety issues, the triple stimulation technique, and neuropediatric aspects of TMS.
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Lovastatin improves impaired LTP-like plasticity in patients with Neurofibromatosis Type 1. KLIN NEUROPHYSIOL 2011. [DOI: 10.1055/s-0031-1272756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hip lateralisation in children with bilateral spastic cerebral palsy treated with botulinum toxin type A: a 2-year follow-up. Neuropediatrics 2011; 42:18-23. [PMID: 21500143 DOI: 10.1055/s-0031-1275344] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We investigated the effect of BoNT/A injection on hip lateralisation in children with bilateral spastic cerebral palsy and bilateral adductor spasticity. Pelvic radiographs using Reimers' migration index (MI) were evaluated from 27 children (n=9 females, n=18 males; mean age 5.2 ± 1.96 years; range: 2-10 years; initial MI <50%) with bilateral spastic cerebral palsy over a time period of 2 years. All received injections of BoNT/A (Dysport) every 12 weeks with a dose of 30 Units per kilogram body weight into adductor and medial hamstring muscles on both sides. The MI was calculated before treatment and after 1 and 2 years. The mean MI increased from 25.5% (range: 0-48) to 26.7% (+1.2%, range: 0-79) on the right side and from 28.0% (range: 0-40) to 30.6% (+2.6%, range: 3-84) on the left side over 2 years, respectively. Hips of one patient dislocated bilaterally. The mean MI remained stable over 2 years. Although a specific BoNT/A effect cannot be proven because of the open design of this study, we provide strong evidence that the MI can be kept stable for a time period of 2 years under non-surgical management including therapy with BoNT/A even in CP patients with a high risk for hip dislocation.
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Beeinflusst die kortikospinale (Re)Organisation bei unilateraler Zerebralparese das Ansprechen auf Constraint-Induced Movement Therapy? PHYSIOSCIENCE 2010. [DOI: 10.1055/s-0029-1245405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Influence of current direction in transcranial magnetic stimulation (TMS) on MEP amplitude and latency – opportunity of I wave specific evaluation and stimulation. KLIN NEUROPHYSIOL 2010. [DOI: 10.1055/s-0030-1250943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Impaired long term potentiation (LTP)-like plasticity in patients with high functiong autism and Asperger syndrome (HFA/AS). KLIN NEUROPHYSIOL 2010. [DOI: 10.1055/s-0030-1250941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Intrinsic plasticity in human motor cortex. KLIN NEUROPHYSIOL 2010. [DOI: 10.1055/s-0030-1250944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Occlusion of synaptic plasticity by gating. KLIN NEUROPHYSIOL 2010. [DOI: 10.1055/s-0030-1250948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Impaired motor cortex plasticity in patients with Noonan-Syndrome. KLIN NEUROPHYSIOL 2010. [DOI: 10.1055/s-0030-1250935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Impact of the number of cycles per pulse on the efficiency of single-pulse transcranial magnetic stimulation. KLIN NEUROPHYSIOL 2010. [DOI: 10.1055/s-0030-1250946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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„Focus Cerebralparese“. Monatsschr Kinderheilkd 2009. [DOI: 10.1007/s00112-009-2036-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Vorhergehende niederfrequente Stimulation verhindert bidirektionale Plastizität im motorischen Kortex. KLIN NEUROPHYSIOL 2009. [DOI: 10.1055/s-0029-1216211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Therapiemanagement bei Kindern mit MS an der Universitäts-Kinderklinik Freiburg. KLINISCHE PADIATRIE 2009. [DOI: 10.1055/s-0029-1214327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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55. Neuroplastic changes after constraint-induced movement therapy: Patients with contralateral cortico-spinal organisation. Clin Neurophysiol 2009. [DOI: 10.1016/j.clinph.2008.07.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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56. Neuroplastizität nach Constraint-Induced Movement Therapy: Patienten mit ipsilateraler kortikospinaler Organisation. Clin Neurophysiol 2009. [DOI: 10.1016/j.clinph.2008.07.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Do patients with congenital hemiparesis and ipsilateral corticospinal projections respond differently to constraint-induced movement therapy? Dev Med Child Neurol 2008; 50:898-903. [PMID: 18811703 DOI: 10.1111/j.1469-8749.2008.03119.x] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study investigates whether the type of corticospinal reorganization (identified by transcranial magnetic stimulation) influences the efficacy of constraint-induced movement therapy (CIMT). Nine patients (five males, four females; mean age 16y [SD 6y 5mo], range 11-30y) controlling their paretic hand via ipsilateral corticospinal projections from the contralesional hemisphere and seven patients (three males, four females; mean age 17y [SD 7y], range 10-30y) with preserved crossed corticospinal projections from the affected hemisphere to the paretic hand underwent 12 consecutive days of CIMT. A Wolf motor function test applied before and after CIMT revealed a significant improvement in the quality of upper extremity movements in both groups. Only in patients with preserved crossed projections, however, was this amelioration accompanied by a significant gain in speed, whereas patients with ipsilateral projections tended to show speed reduction. These data, although preliminary, suggest that patients with congenital hemiparesis and ipsilateral corticospinal projections respond differently to CIMT.
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Neuroplasticity after Constraint Induced Movement Therapy: Patients with ipsilateral cortico-spinal organisation. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1072850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Does navigated transcranial magnetic stimulation (TMS) decrease the variability of MEP-amplitudes? KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1072971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Preceding repetitive stimulation diminishes long-term potentiation-like plasticity in human motor cortex. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1072940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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41
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Neuroplastic changes after Constraint-Induced Movement Therapy: Patients with contralateral cortico-spinal organisation. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1072849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Cortical neuromodulation by constraint-induced movement therapy in congenital hemiparesis: an FMRI study. Neuropediatrics 2007; 38:130-6. [PMID: 17985262 DOI: 10.1055/s-2007-985904] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to assess neuromodulative effects of CIMT in congenital hemiparesis. PATIENTS AND METHODS Ten patients (age range: 10-30 years) with congenital hemiparesis due to unilateral cortico-subcortical infarctions in the middle cerebral artery territory, and with preserved cortico-spinal projections from the affected hemisphere to the paretic hand, were included. After a twelve-day period of constraint-induced movement therapy (CIMT), all showed a significant improvement of paretic hand function. Immediately before and after therapy, functional MRI during active and passive hand movements was performed to monitor cortical activation. RESULTS Four patients showed consistent increases in cortical activation during movements of the paretic hand in the primary sensorimotor cortex of the affected hemisphere. Of the remaining six patients, three showed similar changes, but these results were potentially contaminated by an improved task performance after therapy. No significant alteration in activation was observed in two patients, and one showed movement artifacts. CONCLUSIONS Even a short period of CIMT can induce changes of cortical activation in congenital hemiparesis. In our sample, increases in fMRI activation were consistently observed in the primary sensorimotor cortex of the affected hemisphere. Thus, the potential for neuromodulation is preserved in the affected hemisphere after early brain lesions.
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Increase in motor-cortex excitability after constraint-induced movement therapy in patients with congenital stroke. Clin Neurophysiol 2007. [DOI: 10.1016/j.clinph.2006.11.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Intracortical inhibition and facilitation after congenital stroke. Clin Neurophysiol 2007. [DOI: 10.1016/j.clinph.2006.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Constraint-Induced Movement Therapy bei kongenitaler Hemiparese mit unterschiedlicher kortikospinaler Reorganisation: Eine TMS-Studie. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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46
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Intracorticale Inhibition bei Patienten mit kongenitaler Hemiparese. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Optimierung eines motorischen Lernparadigmas. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Constraint-Induced Movement Therapy bei kongenitaler Hemiparese mit unterschiedlicher kortikospinaler Reorganisation: Eine fMRT-Studie. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Modulation of soleus H-reflexes during gait in healthy children. Exp Brain Res 2006; 178:252-60. [PMID: 17061093 DOI: 10.1007/s00221-006-0730-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2006] [Accepted: 09/22/2006] [Indexed: 10/24/2022]
Abstract
During locomotion spinal short latency reflexes are rhythmically modulated and depressed compared to rest. In adults this modulation is severely disturbed after bilateral spinal lesions indicating a role for supra-spinal control. Soleus reflex amplitudes are large in the stance phase and suppressed in the swing phase contributing to the reciprocal muscle activation pattern required for walking. In early childhood the EMG pattern during gait underlies an age-dependent process changing from co-contraction of agonists and antagonists to a reciprocal pattern at the age of 5-7 years. It is unknown whether at this stage apart from the EMG also reflexes are modulated, and if so, whether the reflex modulation is fully mature or still underlies an age-dependent development. This may give important information about the maturation of CNS structures involved in gait control. Soleus Hoffmann H-reflexes were investigated in 36 healthy children aged 7-16 years during treadmill walking at 1.2 km/h and 3.0 km/h. At 7 years old a rhythmic modulation similar to adults was observed. The H-reflex size during the stance phase decreased significantly with age while the maximum H-reflex (H (max)) at rest remained unchanged. At 3.0 km/h H-reflexes were significantly larger during the stance phase and smaller during the swing phase as compared to 1.2 km/h but the age-dependent suppression was observed at both walking velocities. In conclusion H-reflex modulation during gait is already present in young children but still underlies an age-dependent process independent of the walking velocity. The finding that the rhythmic part of the modulation is already present at the age of 7 years may indicate that the supra-spinal structures involved mature earlier than those involved in the tonic reflex depression. This may reflect an increasing supra-spinal control of spinal reflexes under functional conditions with maturation.
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Abstract
OBJECTIVE To develop and evaluate a clinical Spastic Paraplegia Rating Scale (SPRS) to measure disease severity and progression. METHODS A 13-item scale was designed to rate functional impairment occurring in pure forms of spastic paraplegia (SP). Additional symptoms constituting a complicated form of SP are recorded in an inventory. Two independent patient cohorts were evaluated in a two-step validation procedure. RESULTS Application of SPRS requires less than 15 minutes and does not require any special equipment, so it is suitable for an outpatient setting. Interrater agreement of SPRS was high (intraclass correlation coefficient = 0.99). Reliability was further supported by high internal consistency (Cronbach alpha = 0.91). SPRS values were almost normally distributed without apparent floor or ceiling effect. Construct validity was shown by high correlation of SPRS to Barthel Index and the International Cooperative Ataxia Rating Scale (convergent validity) and low correlation to Mini-Mental Status Examination (discriminant validity). CONCLUSION The Spastic Paraplegia Rating Scale is a reliable and valid measure of disease severity.
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