NeuroRehabilitation - Volume 1, issue 1

Article Type: Other

DOI: 10.3233/NRE-1991-1101

Citation: NeuroRehabilitation, vol. 1, no. 1, pp. 3-3, 1991

Authors: Zasler, Nathan D. | Kreutzer, Jeffrey S.

Article Type: Editorial

DOI: 10.3233/NRE-1991-1102

Citation: NeuroRehabilitation, vol. 1, no. 1, pp. 5-5, 1991

Authors: Zasler, Nathan D.

Article Type: Introduction

DOI: 10.3233/NRE-1991-1103

Citation: NeuroRehabilitation, vol. 1, no. 1, pp. 6-6, 1991

Authors: Dalmady-Israel, Christina

Article Type: Research Article

Abstract: The intensity and duration of a drug’s pharmacologic effect are directly correlated to the concentration of the agent at its site of action. This concentration is determined by the drug’s pharmacokinetic properties: absorption, distribution, metabolism, and elimination. Alterations in any of these pharmacokinetic parameters may affect drug concentration at the site of action and thus modify the pharmacologic effect. In this article, basic pharmacokinetic processes and factors that may influence them are reviewed. The utility and limitations of serum drug concentrations are also discussed.

DOI: 10.3233/NRE-1991-1104

Citation: NeuroRehabilitation, vol. 1, no. 1, pp. 7-14, 1991

Authors: Katz, Richard T.

Article Type: Research Article

Abstract: This article considers various pharmacologic approaches for the treatment of spastic hypertonia. The functional impairment caused by spasticity must be carefully assessed before any treatment is considered. Drug actions, side effects, and dosage of oral medications such as baclofen, diazepam, dantrolene sodium, and clonidine are discussed, as well as intrathecal administration of baclofen, an exciting recent development in the treatment of spastic hypertonia.

DOI: 10.3233/NRE-1991-1105

Citation: NeuroRehabilitation, vol. 1, no. 1, pp. 15-21, 1991

Authors: Linsenmeyer, Todd A.

Article Type: Research Article

Abstract: Voiding dysfunctions often occur after various disabilities such as stroke, multiple sclerosis, and spinal cord injury. Pharmacologic treatments can be effective as primary treatment or to augment nonpharmacologie management strategies. There are several important keys to effective neurourologic pharmacologic management. Potentially reversible causes of voiding dysfunction such as stool impaction or urinary tract infections should be investigated and treated. The type of voiding dysfunction needs to be clearly defined. This will usually require a urodynamic evaluation. An understanding of the normal neurophysiology of voiding is important. It is also essential to know the indications, benefits, limitations, and adverse effects of …various pharmacologic agents in treating voiding dysfunction. Show more

DOI: 10.3233/NRE-1991-1106

Citation: NeuroRehabilitation, vol. 1, no. 1, pp. 22-32, 1991

Authors: Boyeson, Michael G.

Article Type: Research Article

Abstract: This article reviews the relationships between alterations in several neurotransmitter systems and functional recovery of sensory and motor functions after trauma to the central nervous system in animal models. The timing of administration of promising therapeutic agents is discussed in relationship to the role of rehabilitation while the subject is under the influence of these agents. If caution is not employed in administering some drugs after injury, deleterious effects on recovery can be observed. Finally, attention is given to the mechanisms of drug-induced recovery and speculation concerning possible links to protein kinases and accessing of learned behaviors that are transiently …depressed after brain injury. Show more

DOI: 10.3233/NRE-1991-1107

Citation: NeuroRehabilitation, vol. 1, no. 1, pp. 33-43, 1991

Authors: O’Shanick, Gregory J.

Article Type: Research Article

Abstract: Cognitive deficits following traumatic brain injury are the result of structural and neurochemicdal changes. Differential diagnosis of impaired cognition should include consideration of preinjury factors, injury-specific factors, and early pharmacologic management, which can have potentially adverse effects on later cognitive functioning. The primary treatment strategy for cognitive dysfunction is the removal of agents that are known or presumed to have adverse cognitive effects. In this article, the use of catecholamine agonists, cholinergic agonists, opiate antagonists, neuropeptides, nootropes, and other agents is discussed. The use of pharmacologic agents to facilitate cognition has thus far been disappointing.

DOI: 10.3233/NRE-1991-1108

Citation: NeuroRehabilitation, vol. 1, no. 1, pp. 44-49, 1991

Authors: Lyeth, Bruce G. | Jenkins, Larry W. | Hayes, Ronald L.

Article Type: Research Article

Abstract: Traumatic brain injury can produce neurochemical alterations in the brain that are of sufficient magnitude to cause neurological and cognitive deficits. These alterations are associated with a period of excessive neurotransmitter-receptor stimulation involving the N-Methyl-D-aspartate (NMDA) glutamate receptor, as well as other receptors. This abnormal stimulation can produce lasting disruption of neuronal signaling and functional deficits. A number of laboratory studies suggest that NMDA receptor antagonists administered before or soon after traumatic brain injury may provide some protection against pathophysiological effects. The likelihood that functional deficits associated with traumatic brain injury may be at least partly dependent on neurotransmitter-receptor interactions …suggests that this component of the injury process may be particularly amenable to pharmacologic treatment. Although a number of highly selective and potent NMDA receptor blockers are available, issues of dosing and toxicity need to be further examined before these agents are considered for human clinical trials. Show more

DOI: 10.3233/NRE-1991-1109

Citation: NeuroRehabilitation, vol. 1, no. 1, pp. 50-57, 1991

Authors: Auerbach, Vivian | Jann, Brigitta

Article Type: Research Article

Abstract: Medication uses in neurorehabilitation include treatment of acute complications, chronic comorbidities, and cognitive and behavioral impairments; pain management; and direct treatment of other neurological sequelae. The clinical use of pharmacologic agents with neurorehabilitation patients is complicated by the paucity of controlled studies on the efficacy and side effects of medications with this population, as well as the changing legal standards for practitioner accountability and patient rights. The application of legal standards for psychiatric settings and psychopharmacologic treatments to the rehabilitation setting may necessitate greater involvement of patients and guardians in medication decision making and more vigilant assessment of each patients …mental competence. Show more

DOI: 10.3233/NRE-1991-1110

Citation: NeuroRehabilitation, vol. 1, no. 1, pp. 58-63, 1991