This study investigated activation of cerebral cortex in patients with hemiplegia that was caused by neural damage. Key-point control movement therapy of Bobath was performed for 9 weeks in 3 subjects with hemiplegia and fMRI was used to compare and analyze activated degree of cerebral cortex in these subjects. fMRI was conducted using the blood oxygen level-dependent(BOLD) technique at 3.0T MR scanner with a standard head coil. The motor activation task consisted of finger flexion-extension exercise in six cycles(one half-cycles = 8 scans = $3\;sec{\times}\;8\;=\;24\;sec$). Subjects performed this task according to visual stimulus that sign of right hand or left hand twinkled(500ms on, 500ms off). After mapping activation of cerebral motor cortex on hand motor function, below results were obtained. 1. Activation decreased in primary motor area, whereas it increased in supplementary motor area and visual association area(p<.001). 2. Activation was observed in bilateral medial frontal gyrus, middle frontal gyrus of left cerebrum, inferior frontal gyrus, inter-hemispheric, fusiform gyrus of right cerebrum, superior parietal lobule of parietal lobe and precuneus in subjedt 1, parahippocampal gyrus of limbic lobe and cingulate gyrus in subject 2, and inferior frontal gyrus of right frontal lobe, middle frontal gyrus, and inferior parietal lobule of left cerebrum in subject 3 (p<.001). 3. Activation cluster extended in declive of right cellebellum posterior lobe in subject 1, culmen of anterior lobe and declive of posterior lobe in subject 2, and dentate gyrus of anterior lobe, culmen and tuber of posterior lobe in subject 3 (p<.001). In conclusion, these data showed that Key-point control movement therapy of Bobath after stroke affect cerebral cortex activation by increasing efficiency of cortical networks. Therefore mapping of brain neural network activation is useful for plasticity and reorganization of cerebral cortex and cortico-spinal tract of motor recovery mechanisms after stroke.
Objectives : This study has been carried out to look into the methods of early treatment of cerebral palsy and the treatment effect by ages. Methods : The fifteen theses dealing with treatment effects by ages were analyzed, which were selected from the 121 theses retrieved out of the wu-ruan(五軟), wu-chi(五遲), wu-ying(五硬), naotan(腦癱), naoxing-tanhuan(腦性癱癱), during the period between the January 2004 to August 2008 by using the China Academic Journal(CAJ) of China National Knowledge Infrastructure(CNKI). Results : 1. Among the study objects in the 15 theses, it was identified that there were 1.97 times more boys with cerebral palsy than that of girls, and it appeared that there was no significant relationship between gender and the treatment. 2. The early treatment referred to the treatment which was carried out based on the early diagnosis within 6 months to one year after the birth. This is the time when the adaptability and plasticity of the brain are high, and it was found out that the treatment effective as babies are young. 3. For the treatment of cerebral palsy, the combination of Traditional Chinese and Western Medicine Therapy was more frequently used than the exclusive Chinese medical treatment method, and it was more effective. Especially in the case, the Chinese medical treatment was focused on the acupuncture and the Tuina Massage. Conclusions : 1. For the treatment of cerebral palsy, when the age between one and two years old was established as the standard. The younger the babies were, the higher treatment effects were obtained. 2. It appeared that the early treatment of oriental medicine had relatively excellent effects on cerebral palsy, but it turned out that we needed more studies for accurate results.
Phasic and tonic ${\gamma}$-aminobutyric acidA ($GABA_A$) receptor-mediated inhibition critically regulate neuronal information processing. As these two inhibitory modalities have distinctive features in their receptor composition, subcellular localization of receptors, and the timing of receptor activation, it has been thought that they might exert distinct roles, if not completely separable, in the regulation of neuronal function. Inhibition should be maintained and regulated depending on changes in network activity, since maintenance of excitation-inhibition balance is essential for proper functioning of the nervous system. In the present study, we investigated how phasic and tonic inhibition are maintained and regulated by different signaling cascades. Inhibitory postsynaptic currents were measured as either electrically evoked events or spontaneous events to investigate regulation of phasic inhibition in layer 2/3 pyramidal neurons of the rat visual cortex. Tonic inhibition was assessed as changes in holding currents by the application of the $GABA_A$ receptor blocker bicuculline. Basal tone of phasic inhibition was maintained by intracellular $Ca^{2+}$ and $Ca^{2+}$/calmodulin-dependent protein kinase II (CaMKII). However, maintenance of tonic inhibition relied on protein kinase A activity. Depolarization of membrane potential (5 min of 0 mV holding) potentiated phasic inhibition via $Ca^{2+}$ and CaMKII but tonic inhibition was not affected. Thus, phasic and tonic inhibition seem to be independently maintained and regulated by different signaling cascades in the same cell. These results suggest that neuromodulatory signals might differentially regulate phasic and tonic inhibition in response to changes in brain states.
From the biopsychological point of view,learning could be defined as the processes to transfer the information that we obtain from environment to the neural circuits in the brain.In the studies to determine the biological substrates of learning and memory,there was a remarkable effort to identify neural circuits related with a specific type of learning and to describe the mechanixm of neural plasticity of learning and memory,under the assumption that the memory orinformation may be stored as a modificationof neural synapes in the central nerviys system.On the other hand,there was a different kind of tendency to analyze the mechanism of interactions between neural substrates involved in learning and memory,under the assumption that a specific information may be represented in the patterns of comples neural network of the central nervous system.The present review,in the former position.focused on the research methods and the chracteristics and finding of the investigations employing animal model systems to indentify the essential site of engram for learning and memory.Specifically,the review presents major advances in ourunderstanding of the memory trace circuit for a specific type of learning,with the use of animal model system,the detemination of the critical lodi of neuaral plastic chabges In learing abd memory,and the neurophysiological an biocemical mechanixms of the neural modifia by learint.
Objective : Determining language lateralization is important for the presurgical evaluation of patients with medically intractable epilepsy. The Wada test has been the gold standard for lateralization of language dominance before epilepsy surgery. However, it is an invasive test with risk, and have some limitations. Methods : We compared the volumetric analysis with Wada test, and studied the clinical potential of volumetric analysis to assess language laterality in large surgical candidates with temporal lobe epilepsy (TLE). To examine the efficacy of volumetric analysis to determine language lateralization during presurgical evaluation, we compared the volumetric analysis of the bilateral planum temporale with the results of Wada test in 59 patients with chronic intractable TLE (rTLE, n=32; lTLE, n=27) who underwent epilepsy surgery. We measured the gray matter volumes of planum temporale (PT) of each patients using the VoxelPlus2 program (Mevisys, Daejeon, Korea). Results : Overall congruence of the volumetric analysis with the Wada test was 97.75% in rTLE patients and 81.5% in lTLE patients. There were more significant leftward asymmetry of the PT in rTLE patients than lTLE patients. In lTLE patients, relatively high proportion (37%) of the patients showed bilateral or right hemispheric language dominance. Conclusion : These results provide evidence that the volumetric analysis of the PT could be used as an alternatives in language lateralization. Also, the results of the Wada test suggested that there was considerable plasticity of language representation in the brains of patients with intractable TLE and it was associated with an earlier age of brain injury.
Object : Nerve growth factor(NGF) is a protein involved in neuronal survival and plasticity in the central nervous system, which might play an important role in stress, depression and suicide. This study was performed to determine whether there is an alteration in plasma NGF concentrations in depressed patients with suicidal attempt. Methods : The subjects were 32 depressed patients who attempted suicide and admitted in emergency room. Forty-four hospitalized non-suicidal depressive patients and the 30 normal controls were closely matched with the suicidal group in terms of age and sex. Individuals in all 3 groups were evaluated independently by a semi-structured interview for the purpose of establishing a DSM-IV criteria diagnosis. The severity of depressive symptoms was evaluated using Hamilton depression rating scale(HDRS). The severity of the suicidal behavior was evaluated by Weisman and Worden's risk-rescue rating(RRR) system and the Lethality Suicide Attempt Rating Scale(LSARS). Plasma NGF level was measured by the enzyme linked immunosorbent assay(ELISA) method. Results : There were no statistically significant differences of the plasma NGF levels among groups. LSARS and RRR did not reveal any significant correlation with ${\beta}$-NGF level in suicidal depressive patients. Conclusion : This study do not support an association between ${\beta}$-NGF and suicidal depression. However it is necessary to investigate this association through other route such as postmortem brain.
Park, Ji-Won;Kim, Jong-Man;Seo, Jeong-Hwan;Kim, Yun-Hee
Physical Therapy Korea
/
v.9
no.3
/
pp.67-76
/
2002
We report the reorganization of motor network resulted from intensive unilateral coordination training and the effect of cross education on the untrained side in patient with traumatic brain injury using functional magnetic resonance imaging (fMRI). A 22 year-old male patient who had suffered from diffuse axonal injury for 58 months showed coordination deficit in the left hand at initial examination. Intensive motor training including complex finger movements and coordination activities using a metronome was introduced to the patient 4 hours per day for a week. FMRI was performed on a 3T ISOL Forte scanner. All functional images were analyzed using SPM-99 software. Hand function was improved after training not only in the trained left hand, but also in the untrained right hand. There was no activation in the right primary motor area (M1) during left hand movement before training whereas robust activation of left M1 was demonstrated by the right hand movement. Profuse activation of bilateral prefrontal lobes was seen during both hand movements before training. After training of left hand, right M1 became prominently activated during the left hand motion. The activation of bilateral prefrontal lobes disappeared after training not only for the left hand movement but also for the right, which clearly demonstrated the effect of cross education. This case report demonstrated the learning-dependent reorganization of the M1 and the effect of cross education.
As numbers of serotonin's function are so many, studies of serotonin are numerous nowadays. In the beginning, concentration of metabolites such as 5-HIAA was a key issue, but recent studies have been challenged for serotonin receptor genes and their relation to mood disoder. Serotonin transporter(5-HTT) gene is a strong candidate gene of mood disoder for following reason. Serotonin transporter is a key protein in the serotonin pathway as it regulate the concentration of serotonin in the synaptic clept and essential pathophysiology of depression is dysregulation of 5-HTT so that all antidepressants have effect of 5-HTT antagonist. The decrease of 5-HTT in the platelet and in brain of the depressive patients is much consistent results in the studies of the pathophysiology of mood disorder till now. By this, we will be able to develop simple and easy marker for diagnosis, type, and treatment monitoring of depression. Many psychiatrists have sought the independent genes in relation to depression or schizophrenia. Obviously, the hereditary vulnerability contributes to etiology of mood disorders, but it is difficult to discriminate the independent genes because of many environmental factors. Moreover, in the hereditarily complex diseases such as mood disorder, the only vulnerability of gene can not sufficiently explain the etiology. In the future, to exclude the role of the gene-environmental interaction, the methods such as gene transfer can be considered. In the opposite direction, by using the gene destruction method, the role of target genes can be examined. As yet the concept of the gene expression, neural plasticity, neurogenesis and etc, is the elementary stage. The development of this field will help to establish the treatment strategy of chronic and refractory mood disorders.
The effects of crude saponin (SAP) and alkaloid (ALK) fractions of Panax ginseng C.A. Meyer on the detrimental effects of electroconvulsive shock (ECS) and scopolamine on passive avoidance response (PAR) were studied in male Sprague-Dawley rats, referring their effects on the neuronal injury and plasticity of hippocampus in response to electrolytic lesion of left entorhinal cortex (ECL). The detrimental ECS effect on PAR was attenuated by pre- and post-treatments with SAP and ALK, respectively, or by pretreatment with aminoguanidine (AG), an inhibitor of diamine oxidase and NO synthase. And the detrimental scopolamine effect on PAR was also inhibited by pre-treatment with ALK or AG, and by post- treatment with SAP or ALK, respectively. On the 7th day after ECL, the brain sections stained by cresyl violet and by acetylcholinesterase (AChE) histochemistry, respectively, showed the chromatolysis and numeral decrease of neurons and the reduction of AChE reactivity in the hippocampus CA1 area and to a lesser extent, in the dentate gyrus. The neuronal cell death of the CA1 area was significantly reduced by SAP, ALK, or AG, and the reduction of AChE reactivity was significantly attenuated by SAP or ALK and to a lesser extent by AG. These results suggests that the protective effect of ginseng SAP and ALK fractions on ECS- or scopolamine-induced impairment of PAR may be ascribed in part to preservation of hippocampal neurons, particularly cholinergic neurons.
Purpose: Previous studies have suggested that BDNF has a role in plasticity and survival following spinal cord injury and treadmill exercise increases BDNF levels in the normal brain and spinal cord. We attempted to determine whether swimming exercise improve motor function following experimental contusive spinal cord injury and whether motor outcome is associated with BDNF expression. Methods: Thirty six Sprague-Dawley rats (weight, 250 to 300 g) were divided into control (n=18) and experimental swimming group (n=18). Spinal cord injury was produced using NYU-spinal impactor at the eleven thoracic levels in both groups. Swimming exercise started $7^{th}$ day from SCI operation, lasted 5 min per day, 5 days a week for 4 weeks and then exercise times a day were increased in one number to each week. Motor functional recovery was determined by the Basso-Beattie-Bresnahan (BBB) locomotor rating scale, modified inclined board plane test, histological findings, H&E and BDNF expression observed at $1^{th}$, $3^{rd}$, $7^{th}$, $14^{th}$, $21^{st}$ and $28^{th}$day after injury. Results: 1. The BBB scores were higher in experimental group than control group at $14^{th}$, $21^{st}$ day (left hind limb) and at $21^{th}$ day (right hind limb) (p<0.05) after injury. 2. The inclined board plane test were significantly greater in experimental group than control group at $7^{th}$ day (p<0.05), $14^{th}$ and $28^{th}$ day (p<0.01) after injury. 3. The BDNF expression was severe revealed in experimental group than control group at $7^{th}$, $14^{th}$ and $28^{th}$ day after injury. Conclusion: This study suggests that swimming applied from the early phase after spinal cord injury be beneficial effects in motor functional recovery.
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