Content - Volume 35, Issue 41

All articles

Rehabilitation medicine and the new neurobiology
Bengt H. Sjölund A1, Michael Nilsson A2, Gunnar Grimby A3
This article does not have an abstract.
Pages: 4-5
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Adaptive plasticity in motor cortex: implications for rehabilitation after brain injury
Randolph J. Nudo Center on Aging University of Kansas Medical Center Kansas City KS USA
It is now widely recognized that the cerebral cortex of adult human and non-human mammals is capable of widespread functional and structural plasticity. During the learning of new skills, cortical regions associated with sensorimotor function of the body parts most utilized for the skilled task come to be represented over larger cortical territories. More recent studies have shown that functional ...
Pages: 7-10
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Environmental influence on recovery after brain lesions - experimental and clinical data
Barbro B. Johansson
One aim of rehabilitation after brain lesions should be to optimise the function of the remaining intact brain. Experimental studies on focal cerebral infarcts in the rat have demonstrated that postischemic environmental enrichment significantly improves functional outcome, increases dendrite branching and number of dendritic spines in the contralateral cortex, influences expression of many genes ...
Pages: 11-16
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Neurogenesis and its implications for regeneration in the adult brain
Peter S. Eriksson
Recent findings concerning the regenerative potential of the adult brain suggest a more pronounced plasticity than previously thought. One such finding is the generation of new neurons in the adult brain (neurogenesis). Loss of neurons has long been considered to be irreversible in the adult human brain, i. e. , dead neurons are not replaced. The inability to generate replacement cells is thought ...
Pages: 17-19
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Transcranial magnetic stimulation to assess cortical plasticity: a critical perspective for stroke rehabilitation
Andrew J. Butler and Steven L. Wolf
Transcranial magnetic stimulation has gained increasing visibility as an evaluative and interventional tool during the past 15 years. Within the context of rehabilitation, transcranial magnetic stimulation has been applied to differentiate excitatory and inhibitory mechanisms and to assess cortical reorganization following specific interventions. This article reviews some of the more salient featu ...
Pages: 20-26
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Functional imaging in the assessment of capability for recovery after stroke
Wolf-Dieter Heiss, Alexander Thiel, Lutz Winhuisen, Beatrice Mühlberger, Josef Kessler, Karl Herholz
After an ischaemic lesion preserved components of a functional network are utilized for recovery from neurological defects. The hierarchy of the individual parts within the damaged network, however, determines the quality of the outcome. This could be clearly demonstrated for the complex network of language ability, for which the left temporal region plays an integrative role: only if the left tem ...
Pages: 27-33
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Constraint-induced movement therapy: bridging from the primate laboratory to the stroke rehabilitation laboratory
Edward Taub A1 and Gitendra Uswatte A1
In this laboratory we have developed a set of techniques that randomized controlled studies indicate can substantially reduce the motor deficit of patients with mild to moderately severe chronic strokes. The techniques, termed Constraint-Induced Movement therapy (CI therapy), involve motor restriction of the less-affected arm while at the same time intensively training the more-affected arm. The i ...
Pages: 34-40
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Constraint-induced movement therapy: some thoughts about theories and evidence
Johanna H. van der Lee
Constraint-Induced Movement Therapy (CIMT) is a type of treatment for hemiparetic stroke patients in which the patient is strongly encouraged to use the affected arm. One way of doing this is to immobilise the unaffected arm. This treatment is meant to help patients overcome 'learned nonuse'. The learned non-use theory is based on deafferentiation experiments in monkeys. In this review four random ...
Pages: 41-45
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Changes in neuronal properties and spinal reflexes during development of spasticity following spinal cord lesions and stroke: studies in animal models and patients
It is a well-known fact that spinal reflexes may gradually change and often become enhanced following spinal cord lesions. Although these phenomena are known, the underlying mechanisms are still unknown and under investigation, mainly in animal models. Over the last twenty years, new methods have been developed that can reliably estimate the activity of specific spinal pathways in humans at rest a ...
Pages: 46-55
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Botulinum toxin - mechanisms of action and clinical use in spasticity
Michael Barnes
Botulinum toxin is a potent neurotoxin produced by the bacterium Clostridium botulinum. There are seven sero- types, all of which block the release of acetylcholine from nerve endings, which gives the compound its theoretical base for reducing spasticity. Initial studies of the use of botulinum toxin in the management of spasticity were promising and now there are a number of well-designed, double ...
Pages: 56-59
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Long-term modification of spasticity
Anthony B. Ward
This review of the long-term management of spasticity addresses some of the clinical dilemmas in the management of patients with chronic disability. As it is important for clinicians to have clear objectives in patient treatment, the available treatment strategies are set out. Why is it important to treat spastic patients and what treatment does one use? When should one consider a change in the st ...
Pages: 60-65
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Cortical reorganisation and chronic pain: implications for rehabilitation
Herta Flor
Recent neuroscientific evidence has revealed that the adult brain is capable of substantial plastic change in such areas as the primary somatosensory cortex that were formerly thought to be modifiable only during early experience. These findings have implications for our understanding of chronic pain. Functional reorganisation in both the somatosensory and the motor system was observed in neuropat ...
Pages: 66-72
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Somatosensory imprinting in spinal reflex modules
Jens Schouenborg
Understanding how sensory information is used by motor systems for motor commands requires detailed knowledge about how the body shape and biomechanics are represented in the motor circuits. We have used the withdrawal reflex system as a model for studies of sensorimotor transformation. This system has a modular organisation in the adult. Each module performs a detailed and functionally adapted se ...
Pages: 73-80
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Animal models of spinal cord injury pain and their implications for pharmacological treatments
Jing-Xia Hao and Xiao-Jun Xu
Patients with spinal cord injury often develop chronic pain syndrome, which is difficult to treat. Several animal models of spinal cord injury have been developed in recent years which have significantly advanced our understandings of pathophysiology of this condition. This paper reviews some recent data in the pharmacological treatment of spinal cord injury pain using animal models, and discusses ...
Pages: 81-84
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Referred muscle pain/hyperalgesia and central sensitisation
Maria Adele Giamberardino Pathophysiology of Pain Laboratory 'G. D'Annunzio' University of Chieti Italy
Department of Medicine and Science of Aging 'G. D'Annunzio' University of Chieti Italy
Referred muscle pain, resulting from algogenic conditions in viscera or other deep somatic structures (another muscle, a joint), is most often accompanied by secondary hyperalgesia and trophic changes (hypotrophy). Referred pain/ hyperalgesia from viscera is partly due to central sensitisation of viscero-somatic convergent neurons (triggered by the massive afferent visceral barrage) but also proba ...
Pages: 85-88
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Fibromyalgia - from syndrome to disease. Overview of pathogenetic mechanisms
Karl G. Henriksson
According to the classification criteria proposed by the American College of Rheumatology, fibromyalgia is a longstanding multifocal pain condition combined with generalised allodynia/hyperalgesia. It is the generalised allodynia/hyperalgesia that distinguishes fibromyalgia from other conditions with chronic musculoskeletal pain. Central sensitisation of nociceptive neurons in the dorsal horn due ...
Pages: 89-94
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