NeuroRehabilitation - Volume 35, issue 4

Authors: Wang, Zhun | Kou, Dangpei | Li, Zhaoduan | He, Yongjin | Yu, Wenli | Du, Hongyin

Article Type: Research Article

Abstract: Background: Due to the lack of efficient neuroprotective therapies, the ischemia-reperfusion (I/R) injury is a major medical problem urgently needed to be further studied. Objective: To investigate the neuro-protective effects of propofol-dexmedetomidine (dex) combination on I/R-induced cerebral injury and potential mechanisms. Methods: Sprague-Dawley rats were randomized to sham-operated, I/R, I/R plus propofol, I/R plus dex, and I/R plus propofol-dex combination group. I/R insult was induced by 2 h middle cerebral artery occlusion (MCAO) followed by 24 h reperfusion; Drugs were administered 20 min before the onset of ischemia and continued for another 2 h. Functional outcomes, …the expression of Superoxide dismutase (SOD), Methane Dicarboxylic Aldehyde (MDA), Tumor necrosis factor-α (TNF-α), Interleukin-1β (IL-1β), caspase-3 and protein kinase B (AKT) were tested. Results: Propofol-dex combination significantly mitigates I/R-induced neurological deficits in model rats compared to dex or propofol infusion alone. The decreased activity of SOD was significantly reversed following co-administration of propofol and dex, along with the down-regulated MDA content. Perioperative treatment with propofol and dex significantly suppressed I/R-up regulated TNF-α and IL-1β expressions, ameliorated AKT1 expression and caspase-3 activity. Conclusion: Propofol-dex combination exerted a stronger neuro-protection against I/R injury when compared with propofol or dex alone. Show more

Keywords: Propofol-dexmedetomidine combination, cerebral ischemia reperfusion injury, antioxidant, anti-inflammatory, anti-apoptosis, neuroprotection

DOI: 10.3233/NRE-141177

Citation: NeuroRehabilitation, vol. 35, no. 4, pp. 825-834, 2014

Authors: Xie, Caizhong | Shan, Chunlei | Liu, Beibei | Ding, Zhiqing | Ding, Qinneng | Wang, Tong

Article Type: Research Article

Abstract: Background: For a therapeutic intervention after spinal cord injury (SCI), it is important to take accurate and objective assessment tools. Objective: To explore the practicability of somatosensory evoked potentials (SEPs) and Modified Barthel Index (MBI) scale and describe the rehabilitation value of SEPs in different degrees of SCI. Methods: Thirty-six SCI patients were enrolled in this study. All the patients received comprehensive rehabilitation treatment, such as physical therapy, occupational therapy, functional electrical stimulation, and psychotherapy. The nerve function of the spinal cord was assessed by SEPs, the activities of daily living (ADL) was evaluated by MBI …scale, and SEP recordings and MBI scores were obtained before and after treatment. Results: There were statistically significant differences in SEPs latency among different grades of SCI before treatment. The SEPs latency after treatment was better than that before treatment in every grade (p < 0.05). Comparable differences among different grades were also detected by MBI scores before treatment (p < 0.05), and the MBI scores increased significantly after treatment (p < 0.05), higher in each group than another from grade A to B, C, and D. There was a linear correlation between SEPs latency and MBI scores before and after treatment. Conclusion: SEPs combined with MBI scale could objectively reflect the SCI degree and accurately monitor therapeutic intervention in SCI. SEPs have a greater value in monitoring SCI than MBI and their rehabilitation value varies in different grades of SCI. Show more

Keywords: Spinal cord injury, somatosensory evoked potentials, Modified Barthel Index, activities of daily living, rehabilitation treatment, outcome

DOI: 10.3233/NRE-141158

Citation: NeuroRehabilitation, vol. 35, no. 4, pp. 835-840, 2014

Authors: Morlett-Paredes, Alejandra | Perrin, Paul B. | Olivera, Silvia Leonor | Rogers, Heather L. | Perdomo, Jose Libardo | Arango, Jose Anselmo | Arango-Lasprilla, Juan Carlos

Article Type: Research Article

Abstract: Background/objective: The purpose of this study was to examine the influence of appraisal, belonging, and tangible social support on the mental health (depression, satisfaction with life, anxiety, and burden) of Colombian spinal cord injury (SCI) caregivers. Methods: Forty SCI caregivers from Neiva, Colombia completed questionnaires assessing their perceived social support and mental health. Results: Four multiple regressions found that the three social support variables explained 42.8% of the variance in caregiver depression, 22.3% of the variance in satisfaction with life, 24.1% of the variance in anxiety, and 16.5% of the variance in burden, although the effect …on burden was marginally significant. Within these regressions, higher belonging social support was uniquely associated with lower depression, and higher tangible social support was uniquely associated with higher caregiver satisfaction with life. Conclusions: Social support may have a particularly important influence on SCI caregiver mental health in Colombia, due in part to the high levels of collectivism and strong family values shown to exist in Latin America, and may therefore be an important target for SCI caregiver interventions in this region. Show more

Keywords: SCI caregivers, social support, mental health

DOI: 10.3233/NRE-141164

Citation: NeuroRehabilitation, vol. 35, no. 4, pp. 841-849, 2014

Authors: Sobry, Vinciane | Badin, Philippe | Cernaianu, Sorina | Agnani, Olivier | Toussaint, Michel

Article Type: Research Article

Abstract: Background: Neuroplastic compensations are reported to improve static balance in visually impaired people (VIP). Objective: To compare the static balance of VIP with control sighted subjects in different conditions of proprioceptive disturbance. Methods: Thanks to a stabilometric platform, static balance was determined by measuring (1) the speed of displacement of the center of pressure of the subjects and (2) its total surface. Recordings on surfaces with (foam) or without (hard) proprioceptive disturbance were taken with both open and closed eyes. Results: We compared 38 VIP to 36 control subjects. On hard surface, the speed …of displacement was always higher in VIP than in control. On the foam surface, the speed was higher in VIP with open eyes while no difference was seen with closed eyes. The total surface of displacement was larger in VIP on the foam surface with open eyes while there was no difference either with closed eyes or on hard surface between VIP and control. Conclusions: Static balance with open eyes is more precarious in VIP than in control. Nevertheless, VIP subjects do as well as control sighted subjects with closed eyes as shown by similar total surface of displacement irrespective with the type of surface. Show more

Keywords: Balance (static), visual handicap, Vietnamese, stabilometric platform

DOI: 10.3233/NRE-141181

Citation: NeuroRehabilitation, vol. 35, no. 4, pp. 851-861, 2014

Authors: Bach, Laura J.

Article Type: Case Report

Abstract: Background: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an auto immune-disorder. It is a life threatening condition that typically presents with viral illness, headaches, severe psychiatric symptoms, seizures, behavioural changes, decreasing levels of unconsciousness and progressive unresponsiveness, cognitive impairment, abnormal movements (e.g., dyskinesia), ataxia and hypoventilation. Objective: This paper describes the long term outcome and rehabilitation management of patients with NMDAR encephalitis and highlights the diverse outcome of this condition and the unique and individual long term management needs associated with this disorder. Methods: This is a case report study of three different patients with NMDAR encephalitis. All …three cases are young women, two of whom presented with ovarian teratoma. Patient KH is the most impaired and was resident in a slow stream rehabilitation care home and presented with challenging behaviour. Patients RM and OA both lived in the community and presented with similar anxieties but diverse levels of cognition and motivation. A review of the literature is provided summarizing the disorder, interventions, management and challenges of this varied and complex condition. Standard neuropsychological tests and questionnaires to assess community integration (BICRO-39), quality of life (QOLIBRI-OS) and mood (HADS) were administered. Results: Positive outcomes were achieved for all three patients using a variety of interventions which included behavioural management, family psycho-education and an integrated holistic multi-disciplinary team community approach. Memory and executive deficits were persistent in the long term and severity of impairments showed wide variability between patients. Emotional distress and behavioural difficulties were prominent and persistent and had a pronounced impact on rehabilitation. Continence issues were also a major factor impacting on the rehabilitation. Conclusions: Long term integrated and multi-disciplinary input by a variety of therapies and health disciplines is required in order to improve the long term outcome and quality of life for NMDAR patients and their families, and ultimately leads to improved positive outcomes. Each of these cases had markedly differing cognitive profiles suggesting that in the context of long term rehabilitation outcome, cognition may have less valence than emotional and behavioural factors. Guidelines and standardised procedures for ethical issues and counselling for iatrogenic infertility should be developed and integrated into long term programmes of rehabilitation care. Show more

Keywords: NMDAR, rehabilitation outcome, community integration, BICRO, QOLIBRI, quality of life, fertility, cognition

DOI: 10.3233/NRE-141176

Citation: NeuroRehabilitation, vol. 35, no. 4, pp. 863-875, 2014

Article Type: Other

DOI: 10.3233/NRE-2014-35426

Citation: NeuroRehabilitation, vol. 35, no. 4, pp. 877-884, 2014

Article Type: Other

DOI: 10.3233/NRE-2014-35427

Citation: NeuroRehabilitation, vol. 35, no. 4, pp. 885-888, 2014