NeuroRehabilitation - Volume 29, issue 4

Authors: Kwon, Hyeok Gyu | Jang, Sung Ho

Article Type: Research Article

Abstract: The arcuate fasciculus (AF) is the neural tract that connects Wernicke's area and Broca's area. The main role of the AF is speech repetition; therefore, injury to the AF typically causes conduction aphasia. We report on a patient who showed excellent recovery of aphasia despite complete injury of the AF due to a cerebral infarct. A 54-year-old, right-handed male presented with aphasia and right hemiparesis. Brain MRI showed an infarct in the left centrum semiovale and corona radiata. Diffusion tensor tractography for the AF was reconstructed using DTI-studio software. The Korean-Western Aphasia Battery (K-WAB) was used for measurement of language …function. On K-WAB at 1 week after onset, his aphasia type was compatible with global aphasia (aphasia quotient: 12‰, fluency: 5‰, comprehension: 24‰, repetition: 15‰, and naming: 31‰). The patient underwent rehabilitative therapy, including language therapy and medication, which is known to facilitate recovery from aphasia, for a period of 24 months. His aphasia had improved to a nearly normal state at 30 months after onset; aphasia quotient: 93‰ (fluency: 91‰, comprehension: 92‰, repetition: 85‰, and naming: 96‰). The left AF showed a complete disruption on 27-month diffusion tensor tractography. Findings from this study suggest the possibility that aphasia might show good recovery, even in cases of severe injury of the AF. Show more

Keywords: Diffusion tensor imaging, diffusion tensor tractography, stroke, arcuate fasciculus, aphasia

DOI: 10.3233/NRE-2011-0718

Citation: NeuroRehabilitation, vol. 29, no. 4, pp. 401-404, 2011

Authors: Folland, Jonathan P. | Haas, Bernhard | Castle, Paul C.

Article Type: Research Article

Abstract: The specific neuromuscular mechanisms for compromised muscle strength with PD, and the improvement that occurs with medication, have not been clearly delineated. This study assessed knee extension and flexion strength of PD patients whilst on and off medication and examined the neural mechanisms responsible for any changes. Ten idiopathic PD patients were assessed whilst on and off medication (⩾ 12-h after drug withdrawal), ∼ 7 days apart. Isometric strength of the knee extensors and flexors was assessed, and the interpolated twitch technique used to measure activation of the knee extensors. Surface EMG was also used to measure neural drive to …the agonists and antagonists. Without medication isometric strength of the knee extensors (7%) and flexors (11%) was impaired and the interpolated twitch technique revealed activation of the knee extensors was reduced (8%, P = 0.005). Maximum agonist amplitudes for nkee extension and flexion were unchanged off-medication (0.59 < P < 0.77). The agonist and antagonist EMG-force relationships, and the maximum antagonist EMG, were unaffected by medication withdrawal. The decrease in knee extension strength when PD patients were off medication was due to reduced activation of the agonist muscle, rather than any change in antagonist co-activation, and these changes were associated with reduced locomotory performance. Show more

Keywords: Parkinson's disease, muscle strength, medication, activation, co-activation, interpolated twitch technique

DOI: 10.3233/NRE-2011-0719

Citation: NeuroRehabilitation, vol. 29, no. 4, pp. 405-411, 2011

Authors: Vidal, Xavier | Morral, Antonio | Costa, Lluís | Tur, Miriam

Article Type: Research Article

Abstract: Aim: The aim of this study was to evaluate the efficacy and safety of radial extracorporeal shock wave therapy (rESWT) in the treatment of spasticity in patients with cerebral palsy. Methods: Fifteen patients with spastic cerebral palsy, 12 men and 3 women, aged 10–46 years (mean age 31). The 15 patients presented 40 spastic muscles that were divided in three groups using a computerized random-number generator. The first group, received rESWT in spastic muscle. The second group received rESWT in spastic muscle + rESWT in antagonist muscle. The third group received placebo. Range of motion and Ashworth Scale …were performed. This study is a randomized, placebo-controlled clinical trial. The patients were treated in 3 sessions at intervals of one week. Results: There are significant differences between groups treated with rESWT and group placebo. A significant decrease in the Ashworth Scale, an increase in the range of motion, were observed in all patients that were treated with rESWT. Positive results were maintained for at least 2 months after treatment. Interpretation: The treatment with rESWT is more effective than placebo in decreasing spasticity of patients with CP. Show more

Keywords: Cerebral palsy, spasticity, extracorporeal shock wave therapy, hypertonia, muscle tone

DOI: 10.3233/NRE-2011-0720

Citation: NeuroRehabilitation, vol. 29, no. 4, pp. 413-419, 2011

Article Type: Other

DOI: 10.3233/NRE-2011-29414

Citation: NeuroRehabilitation, vol. 29, no. 4, pp. 421-424, 2011

Article Type: Other

DOI: 10.3233/NRE-2011-29415

Citation: NeuroRehabilitation, vol. 29, no. 4, pp. 425-426, 2011