NeuroRehabilitation - Volume 54, issue 3

Authors: Kamel, Roshdy M. | Khaireldin, Alaaeldin | Gad Allah, Mohamed A. | Bakhoom, Ramez Yousry Fawzy | Abdelhakiem, Nadia Mohamed | Mehrem, Elsayed S.

Article Type: Research Article

Abstract: BACKGROUND: Sensorineural hearing loss is the most common type of permanent hearing impairment and results in postural control and motor deficits in children that may affect or delay all developmental indicators. OBJECTIVE: The purpose of the study was to investigate the efficacy of balance exercises intervention on postural control-related impairment in children with sensorineural hearing loss. METHODS: Forty students of both genders, ages ranging from 10 to 16 years, diagnosed with severe to profound sensorineural hearing loss, were selected from the Public School for the Deaf and Hard of Hearing in El-Minia district, Minia governorate, Egypt. …They divided randomly into two groups, 20 (study group), received balance exercises in addition to their ordinary daily living activities. Meanwhile, the control group of 20 children practiced only the ordinary daily living activities. The outcome was assessed pre-treatment and post-treatment by Humac Balance System and Bruininks-Oseretsky Test (BOT-2) subtest (5) for balance. RESULTS: Regarding the Humac balance system and subtest (5) of BOT-2, there was a statistically significant difference between pre-treatment data and post-treatment data of the study group with a p value equal to 0.036 or less. However, no statistically significant difference was observed in the control group with a p value equal to 0.096 or more. Finally, there was a statistically significant difference between the groups with respect to the post-treatment data, where the p value was 0.014 or less. CONCLUSION: Postural control of children with sensorineural hearing loss has been improved by balance exercises. Show more

Keywords: Sensorineural hearing loss, balance exercise, postural control and Children

DOI: 10.3233/NRE-230284

Citation: NeuroRehabilitation, vol. 54, no. 3, pp. 349-358, 2024

Authors: Ramos-Usuga, Daniela | Jimenez-Marin, Antonio | Cabrera-Zubizarreta, Alberto | Benito-Sanchez, Itziar | Rivera, Diego | Martínez-Gutiérrez, Endika | Panera, Elena | Boado, Victoria | Labayen, Fermín | Cortes, Jesus M. | Arango-Lasprilla, Juan C.

Article Type: Research Article

Abstract: BACKGROUND: Multiple Organ failure (MOF) is one of the main causes of admission to the Intensive Care Unit (ICU) of patients infected with COVID-19 and can cause short- and long-term neurological deficits. OBJECTIVE: To compare the cognitive functioning and functional brain connectivity at 6–12 months after discharge in two groups of individuals with MOF, one due to COVID-19 and the other due to another cause (MOF-group), with a group of Healthy Controls (HC). METHODS: Thirty-six participants, 12 from each group, underwent a neuropsychological and neuroimaging assessment at both time-points. Functional connectivity of the …resting state networks was compared between COVID-19 and HC while controlling for the effect of MOF. The association between functional connectivity and neuropsychological performance was also investigated. RESULTS: Compared to the HC, COVID-19 group demonstrated hypoconnectivity between the Default Mode Network and Salience Network. This pattern was associated with worse performance on tests of attention and information processing speed, at both time-points. CONCLUSION: The study of the association between cognitive function and brain functional connectivity in COVID-19 allows the understanding of the short- and long-term neurological alterations of this disease and promotes the development of intervention programs to improve the quality of life for this understudied population. Show more

Keywords: COVID-19, neuropsychology, cognition, neuroimaging, intensive care, brain

DOI: 10.3233/NRE-230216

Citation: NeuroRehabilitation, vol. 54, no. 3, pp. 359-371, 2024

Authors: Vargas, Gary O. | Neaves, Stephanie | Pham, Tri | Huang, Mu | Turki, Ahmad Fawzi | Wang, Chaowei | Bell, Kathleen R. | Juengst, Shannon B. | Zhang, Rong | Li, Ming | Driver, Simon | Behbehani, Khosrow | Hynan, Linda S. | Ding, Kan

Article Type: Research Article

Abstract: BACKGROUND: Individuals with moderate to severe traumatic brain injury (msTBI) have reported a lack of motivation, lack of time, and fatigue as perceived barriers to exercise. OBJECTIVE: To evaluate the effects of an exercise program on self-reported health-related symptoms and quality of life in persons 45-years and older with msTBI. METHODS: Post-hoc analysis of a prospective community-based 12-week exercise program of 20 adults, age 45–80 years, with msTBI. Ten were in aerobic exercise training (AET) program and 10 in a stretching and toning (SAT) program. The AET group was instructed to exercise based on …their estimated maximal heart rate (HR) for 150 minutes weekly. The SAT group was to stretch for the same target time without significantly increasing HR or level of exertion. Outcome measures were Traumatic Brain Injury Quality of Life (TBI-QOL) for global, cognitive, emotional, and social health, Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms, and Pittsburgh Sleep Quality Index (PSQI) for sleep quality. RESULTS: AET was associated with improved self-reported cognitive health and sleep compared to SAT. Moderate to large, positive effect sizes were also observed in the AET group in the QOL categories of global, emotional, and social health, and depressive symptoms. CONCLUSIONS: This study offers preliminary evidence that AET may improve health-related QOL, especially for cognition and sleep, in middle-aged and older adults with msTBI. Show more

Keywords: Traumatic brain injury, exercise, quality of life, sleep, cognition

DOI: 10.3233/NRE-230223

Citation: NeuroRehabilitation, vol. 54, no. 3, pp. 373-381, 2024

Authors: Kimoto, Shoko | Naito, Yasuo | Nishikawa, Takashi

Article Type: Research Article

Abstract: BACKGROUND: Patients with cerebrovascular disorders (CVDs) tend to exhibit impulsive behaviour without controlling their movements, leading to difficulty in performing activities of daily living and an increased risk of accidents. This hastiness, termed ‘pacing impairment’, has been studied but is not fully understood. OBJECTIVE: To experimentally examine the kinetic features of pacing impairment by focusing on changes in speed and investigating neuropsychological substrates. METHODS: We instructed 53 inpatients with CVDs, 20 orthopaedic inpatients, and 20 healthy participants to trace a 200 mm-sided square as slowly as possible for 120 seconds. We measured the tracing length and mean …acceleration and examined the relationship between these measurements, neuropsychological symptoms, and lesion sites. RESULTS: Gradual acceleration in drawing, i.e., decline in motor suppression, was observed more frequently in the CVD group than in the control groups. Excessive acceleration was associated with unilateral spatial neglect, frontal lobe signs, and attention disorders but not with motor impersistence. Additionally, the incidence of excessive acceleration did not differ between left and right hemisphere lesion subgroups and was not associated with any specific lesion site. CONCLUSION: Pacing impairment can manifest as general or holistic deficits in attentional function widely distributed throughout the cerebral hemispheres. Show more

Keywords: Humans, cerebrovascular disorders, neurobehavioural signs and symptoms, hemispheric specialisation, attention, acceleration, behaviour control

DOI: 10.3233/NRE-230375

Citation: NeuroRehabilitation, vol. 54, no. 3, pp. 383-390, 2024

Authors: Ni, Bo-Ye | Jin, Hua-Ping | Wu, Wei

Article Type: Research Article

Abstract: BACKGROUND: Stroke patients often experience difficulty swallowing. OBJECTIVE: To assist in the improvement of dysphagia symptoms by introducing a novel approach to the treatment of patients with post-stroke aspiration. METHODS: A total of 60 patients with post-stroke aspiration were enrolled and divided into an experimental group (n  = 30) and a control group (n  = 30). The control group received standard treatment, sham intraoral stimulation, and the Masako maneuver, while the experimental group was administered standard treatment, deep pharyngeal electrical stimulation (DPES), and a modified Masako maneuver. Changes in their Functional Oral Intake Scale (FOIS) and Rosenbek scale …scores were observed. RESULTS: The FOIS scores of both groups increased significantly after treatment (p  < 0.01, respectively). The Rosenbek scale scores of both groups decreased significantly after treatment, with the experimental group scoring significantly lower than the control group (1.01±0.09 vs. 2.30±0.82) (p  < 0.05). After treatment, the overall response rate in the experimental group (93.33%) was significantly higher than that in the control group (83.33%) (p  < 0.001). CONCLUSION: In terms of effectively improving dysphagia in aspiration patients after stroke, DPES combined with modified Masako maneuver is clinically recommended. Show more

Keywords: Masako maneuver, electrical stimulation, dysphagia, post-stroke aspiration

DOI: 10.3233/NRE-240005

Citation: NeuroRehabilitation, vol. 54, no. 3, pp. 391-398, 2024

Authors: Babazadeh-Zavieh, Seyedeh Saeideh | Ansari, Noureddin Nakhostin | Ghotbi, Nastaran | Naghdi, Soofia | Jafar Haeri, Seyed Mohammad

Article Type: Research Article

Abstract: BACKGROUND: The positive contribution of dry needling (DN) in conjunction with exercise therapy for patients with stroke and spasticity remains uncertain. OBJECTIVE: To examine the effects of DN combined with exercise therapy on wrist flexor spasticity and motor function in patients with stroke. METHODS: Twenty-four participants with stroke were randomly assigned to either the DN and exercise therapy group or the DN alone group. Assessments were conducted at baseline, after the 4th treatment session, and 3 weeks post-treatment. RESULTS: A significant Group×Time interaction was observed for wrist active range of …motion (ROM) (P  = 0.046), favoring the DN with exercise therapy group (∼10° at baseline, ∼15° immediately after the 4th session, and 15.4° at follow-up). The improvements in spasticity, passive ROM, and H-reflex latency were sustained during follow-up. However, there were no significant between-group differences in any outcome at any measurement time point. CONCLUSION: The combined DN and exercise therapy did not exhibit superiority over DN alone concerning spasticity severity and motor function. However, it demonstrated additional advantages, particularly in improving motor neuron excitability and wrist passive extension. Show more

Keywords: Stroke, dry needling, exercise therapy, spasticity, motor neuron excitability

DOI: 10.3233/NRE-230081

Citation: NeuroRehabilitation, vol. 54, no. 3, pp. 399-409, 2024

Authors: Pavan, Arianna | Fasano, Alessio | Cortellini, Laura | Lattanzi, Stefania | Papadopoulou, Dionysia | Insalaco, Sabina | Germanotta, Marco | Aprile, Irene

Article Type: Research Article

Abstract: BACKGROUND: Many authors have emphasized the need for individualized treatments in rehabilitation, but no tailored robotic rehabilitation protocol for stroke patients has been established yet. OBJECTIVE: To evaluate the effectiveness of a robot-mediated upper limb rehabilitation protocol based on clinical assessment for customized treatment of stroke patients. METHODS: Clinical data from 81 patients with subacute stroke, undergoing an upper limb robot-mediated rehabilitation, were analyzed retrospectively. 49 patients were treated using a customized robotic protocol (experimental group, EG) based on a clinically guided flowchart, while 32 were treated without it (control group, CG). Fugl-Meyer …Assessment for Upper Extremity (FMA-UE), Motricity Index (MI), modified Barthel Index (mBI) and Numerical Rating Scale (NRS) measured before (T0) and after (T1) rehabilitation intervention were used as clinical outcomes. RESULTS: There was statistically significant improvement in both groups in terms of FMA-UE, MI, and mBI, while no change in NRS. Intergroup analysis showed significantly greater improvement of the FMA-UE (P  = 0.002) and MI (P  < 0.001) in the EG, compared with the CG. CONCLUSION: The implementation of our robotic protocol for customized treatment of stroke patients yielded greater recovery in upper limb motor function and strength over robotic treatment without a defined protocol. Show more

Keywords: Stroke, rehabilitation, upper extremity, robotics, robotic treatment protocols, customized robotic treatment

DOI: 10.3233/NRE-230367

Citation: NeuroRehabilitation, vol. 54, no. 3, pp. 411-420, 2024

Authors: Dai, Lei | Zhang, Wanying | Zhang, Huihuang | Fang, Linjie | Chen, Jianer | Li, Xiang | Yu, Hong | Song, Jianfei | Chen, Shishi | Zheng, Beisi | Zhang, Yujia | Li, Zhongyi

Article Type: Research Article

Abstract: BACKGROUND: The therapeutic effect and mechanism of robot-assisted upper limb training (RT) combined with intermittent theta burst stimulation (iTBS) for stroke patients are unclear. OBJECTIVE: The purpose of this study was to evaluate changes in brain activation after combination therapy and RT alone using functional near-infrared spectroscopy (fNIRS). METHODS: Patients were randomly assigned to two groups (iTBS + RT Group, n  = 18, and RT Group, n  = 18). Training was conducted five times a week for four weeks. fNIRS was used to measure changes in oxyhemoglobin in both the primary motor cortex (M1) and pre-motor and …supplementary motor area (pSMA) during affected limb movement. Fugl-Meyer Assessment-Upper Extremity (FMA-UE) was employed for evaluating the function of upper limbs. RESULTS: Thirty-two patients with subacute stroke completed the study. The cortex of both hemispheres was extensively activated prior to treatment in the RT group. After training, overactivation decreased. The brain activation of the combined treatment group transferred to the affected side after the treatment. There was a notable enhancement in the FMA-UE scores for both groups, with the combined group’s progress significantly surpassing that of the RT group. CONCLUSION: RT combined with iTBS can improve the motor function of stroke patients and promote the balance between cerebral hemispheres. Show more

Keywords: Stroke, rehabilitation, upper extremity, transcranial magnetic stimulation, robotics, near-infrared spectroscopy

DOI: 10.3233/NRE-230355

Citation: NeuroRehabilitation, vol. 54, no. 3, pp. 421-434, 2024

Authors: Jeong, Taewoong | Chung, Yijung

Article Type: Research Article

Abstract: BACKGROUND: Patients with stroke depend on visual information due to balance deficits. Therefore, it is believed that appropriate visual deprivation training could have an impact on improving balance abilities. OBJECTIVE: The purpose of this study was to compare the effects of balance training performed in visual deprivation and feedback conditions on balance in stroke survivors. METHODS: The 39 participants were randomly assigned to either the Visual Deprivation Group (VDG; n  = 13), the Visual Feedback Group (VFG; n  = 13), or the Control Group (CG; n  = 13). The training sessions were conducted five times a …week for three weeks. Participants completed the Berg Balance Scale (BBS), Timed Up and Go test (TUG), Four Square Step Test (FSST), and Limit of Stability (LOS) assessments. RESULTS: The VDG showed significant improvements in BBS, FSST, TUG, and LOS. In VFG, significant improvements were observed in BBS and TUG. There were statistically significant differences among the groups in all variables related to balance. CONCLUSION: The results of this study suggest that balance training under visual deprivation is effective in improving static and dynamic balance and gait in patients with stroke. In other words, patients with stroke need to reduce their over-reliance on visual information. Show more

Keywords: Visual acuity, postural balance, balance training, feedback, sensory, stroke

DOI: 10.3233/NRE-230358

Citation: NeuroRehabilitation, vol. 54, no. 3, pp. 435-448, 2024

Authors: Morone, Giovanni | Princi, Alessandro Antonio | Iosa, Marco | Montemurro, Rebecca | Ciancarelli, Irene | Coiro, Paola | Lisi, Danilo | Savo, Riccardo | Granieri, Matteo Notturno | De Angelis, Domenico | Tramontano, Marco

Article Type: Research Article

Abstract: BACKGROUND: Despite advances in stroke rehabilitation, challenges in upper limb motor recovery and postural stability persist, negatively affecting overall well-being. Arm slings and shoulder braces have been proposed to address these issues, but their efficacy in promoting postural stability remains unclear. OBJECTIVE: This pilot randomized controlled study aimed to evaluate the impact of a new shoulder brace (N1-Neurosling) on trunk postural stability during walking, pain, and upper limb muscle strength in chronic stroke survivors. METHODS: Twenty-four adult chronic stroke patients were involved and randomly assigned to the shoulder brace group (SBg) or control …group (CTRLg). Were assessed at baseline (T0) and after 4 weeks (T1) through the Trunk Control Test, the Numerical Rating Scale, the Motricity Index, Manual Muscle Test, and instrumental wearable-based assessment. RESULTS: After 4 weeks, the SBg showed significant improvement in Trunk Control Test scores (p  = 0.020) and smoothness of gait measured by log dimensionless jerk along the Antero-Posterior axis (– 5.31±0.25 vs. – 5.18±0.27, p  = 0.018) compared to the CTRLg. The SBg also demonstrated a reduction in pain in the shoulder girdle and enhanced upper limb muscle strength. CONCLUSION: The use of the N1-Neurosling shoulder brace led to improvements in postural stability and smoothness of gait in stroke patients. Show more

Keywords: Stroke, postural control, shoulder brace, neurorehabilitation

DOI: 10.3233/NRE-230250

Citation: NeuroRehabilitation, vol. 54, no. 3, pp. 449-456, 2024

Authors: García-Rudolph, Alejandro | Wright, Mark Andrew | Devilleneuve, Emilien Amar | Castillo, Eulalia | Opisso, Eloy | Hernandez-Pena, Elena

Article Type: Research Article

Abstract: BACKGROUND: Most studies focus on the risk factors associated with the development of pressure ulcers (PUs) during acute phase or community care for individuals with spinal cord injury (SCI). OBJECTIVES: This study aimed to i) compare clinical and demographic characteristics of inpatients after SCI with PUs acquired during rehabilitation vs inpatients without PUs and ii) evaluate an existing PU risk assessment tool iii) identify first PU predictors. METHODS: Individuals (n  = 1,135) admitted between 2008 and 2022 to a rehabilitation institution within 60 days after SCI were included. Admission Functional Independence Measure (FIM), American …Spinal Injury Association Impairment Scale (AIS) and mEntal state, Mobility, Incontinence, Nutrition, Activity (EMINA) were assessed. Kaplan-Meier curves and Cox proportional hazards models were fitted. RESULTS: Overall incidence of PUs was 8.9%. Of these, 40.6% occurred in the first 30 days, 47.5% were sacral, 66.3% were Stage II. Patients with PUs were older, mostly with traumatic injuries (67.3%), AIS A (54.5%), lower FIM motor (mFIM) score and mechanical ventilation. We identified specific mFIM items to increase EMINA specificity. Adjusted Cox model yielded sex (male), age at injury, AIS grade, mFIM and diabetes as PUs predictors (C-Index = 0.749). CONCLUSION: Inpatients can benefit from combined assessments (EMINA + mFIM) and clinical features scarcely addressed in previous studies to prevent PUs. Show more

Keywords: Pressure ulcers, pressure injuries, wounds and injuries, spinal cord injuries, inpatients, risk assessment, spinal cord, diabetes mellitus

DOI: 10.3233/NRE-230234

Citation: NeuroRehabilitation, vol. 54, no. 3, pp. 457-472, 2024

Authors: Savoie, Félix-Antoine | Benoit, Simon | Riesco, Eléonor | Tanguay, Andréanne

Article Type: Research Article

Abstract: BACKGROUND: Adapted boxing can help improve the physical functioning and health-related quality of life (HRQoL) of individuals with Parkinson’s disease (PD). Whether these benefits persist longitudinally is unclear. OBJECTIVE: The purpose of this retrospective study was to evaluate the impact of a community-based adapted boxing program on the physical functioning and HRQoL of individuals with PD over 1–1.5 years. METHODS: Twenty-six individuals with PD agreed to share their results on tests administered upon enrollment in the program (PRE) and ∼431 days later (POST). The tests included the Fullerton Advanced Balance scale, (FAB), the …Timed Up-and-Go test (TUG), the 30-second Sit-to-Stand test (30-STS), and the PD questionnaire-39 (PDQ-39). RESULTS: From PRE to POST, performance significantly improved on the TUG and 30-STS tests (both p  < 0.001), but not on the FAB (p  = 0.79). Over the same period, PDQ-39 scores significantly increased (p  = 0.05). No PRE to POST changes surpassed the minimal detectable change threshold. CONCLUSION: The results of this study suggest that adapted boxing is at worst non-detrimental and at best potentially beneficial for muscle strength, endurance, and functional mobility in individuals with PD. However, adapted boxing probably cannot fully counteract the HRQoL decrements that accompany PD progression. Show more

Keywords: Community-based adapted boxing, Parkinson’s disease, exercise, functional capacity, health-related quality of life, physical functioning

DOI: 10.3233/NRE-230382

Citation: NeuroRehabilitation, vol. 54, no. 3, pp. 473-484, 2024

Authors: Ito, Shun | Abe, Hiroaki | Okanuka, Toru | Nanka, Kosuke | Nagasawa, Takuma | Oki, Kazuto | Suzukamo, Yoshimi | Izumi, Shin-Ichi

Article Type: Research Article

Abstract: BACKGROUND: Stroke often induces gait abnormality, such as buckling knee pattern, compromising walking ability. Previous studies indicated that an adequate trailing limb angle (TLA) is critical for recovering walking ability. OBJECTIVE: We hypothesized that correcting gait abnormality by immobilizing the knee joint using a knee orthosis (KO) would improve walking patterns and increase the TLA, and investigated whether walking training using a KO would increase the TLA in post-stroke patients. METHODS: In a randomized controlled trial, thirty-four participants were assigned to KO (walking training using a KO) and non-KO (without using a KO) …groups. Twenty-nine completed the three-week gait training protocol. TLA was measured at baseline and after training. A two-way repeated ANOVA was performed to evaluate TLA increases with training type and time as test factors. A t -test compared TLA changes (Δ TLA) between the two groups. RESULTS: ANOVA showed a main effect for time (F = 64.5, p  < 0.01) and interaction (F = 15.4, p  < 0.01). Δ TLA was significantly higher in the KO group (14.6±5.8) than in the non-KO group (5.0±7.0, p  < 0.001). CONCLUSION: Walking training using a KO may be practical and effective for increasing TLA in post-stroke patients. Show more

Keywords: Trailing limb angle, gait training, gait abnormality, Knee brace, walking pattern

DOI: 10.3233/NRE-230372

Citation: NeuroRehabilitation, vol. 54, no. 3, pp. 485-494, 2024

Authors: Yan, Jie | Zha, Fubing | Zhou, Juan | Zhou, Jing | Zhao, Jingpu | Zhang, Qingfang | Long, Jianjun | Hou, Dianrui | Song, Zhenhua | Wang, Yulong

Article Type: Research Article

Abstract: BACKGROUND: Patients with prolonged disorders of consciousness (pDOC) pose significant challenges to healthcare workers due to their severe motor impairments and limited interaction with the environment. Non-invasive brain stimulation such as high-definition transcranial direct current stimulation (HD-tDCS) and music stimulation show promise in awakening this population. OBJECTIVE: In this study, we present a protocol aiming at investigating the efficacy of combined HD-tDCS and music stimulation in awakening patients with pDOC through a single-blind, randomized controlled trial. METHODS: Ninety patients with pDOC will be randomly divided into three groups: active HD-tDCS with music stimulation, …active HD-tDCS, and sham HD-tDCS. All participants will receive 20 treatment sessions over a period of 10 days and the Coma Recovery Scale-Revised, Glasgow Outcome Scale and electroencephalogram will be used as assessment measures to evaluate their level of consciousness throughout the study. Adverse events and complications will be recorded during treatment. Within-group pre-post comparisons and between-group efficacy comparisons will be conducted to identify the most effective intervention approach. Statistical analysis will be performed using SPSS software with a significance level set at P  < 0.05. CONCLUSION: The pursuit of awakening therapy for patients with pDOC remains a clinical research challenge. This study protocol is designed with the aim of introducing an innovative non-pharmacological approach which combined HD-tDCS and music stimulation to facilitate the reinstatement of consciousness in patients with pDOC. Show more

Keywords: High-definition transcranial direct current stimulation, music stimulation, disorders of consciousness, randomized controlled trial, electroencephalography, neuromodulation

DOI: 10.3233/NRE-230282

Citation: NeuroRehabilitation, vol. 54, no. 3, pp. 495-504, 2024

Authors: Sen, Ekin Ilke

Article Type: Other

Abstract: BACKGROUND: Post-stroke depression (PSD) is a prevalent condition that can significantly influence the recovery process. OBJECTIVE: To assess the effects of pharmacological, non-invasive brain stimulation and psychological interventions, and their combination on PSD. METHODS: A summary of the Cochrane Review by Allida et al. (2023) , with comments from a rehabilitation perspective. RESULTS: Sixty-one studies with 5831 participants were included in the Cochrane Review. Very low-certainty evidence indicated favorable treatment effects of pharmacological interventions, psychological therapies, and the combination of pharmacological intervention and non-invasive brain stimulation on PSD. Pharmacological intervention has resulted in increased …side effects associated with the central nervous system and gastrointestinal system, with very low-certainty evidence. CONCLUSION: Evidence for the effectiveness of pharmacological, psychological, and combination therapies for the management of PSD is uncertain, as the quality of the evidence has been assessed as very low. Therefore, further studies with improved methods should investigate pharmacological and non-pharmacological interventions for the treatment of depression in stroke survivors. Show more

Keywords: Depression, stroke, drug intervention, non-invasive brain stimulation, psychological intervention

DOI: 10.3233/NRE-246003

Citation: NeuroRehabilitation, vol. 54, no. 3, pp. 505-508, 2024