• Physical Therapy Rehabilitation Science
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• 제11권1호
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• pp.8-15
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• 2022

Objective: Post stroke motor recovery is facilitated by the brain reorganization or the neuroplastic changes. The therapeutic approach mentioned in the current case is one of the approaches for enhancing motor recovery by stimulating the damaged neural networks directing the motor behaviour of a person. The aim of the present study was to establish the changes in the balance and gait pattern of an individual through multi target stimulation of areas of cerebral cortex by utilising multichannel trans cranial direct current stimulation (M-tDCS) in a sub-acute stroke survivor. Design: A Case Report Methods: The present patient was the participant of the trial (CTRI/2021/02/031044).The patient was intervened with M-tDCS (anodes over left primary motor cortex that is C3 point and left dorsolateral prefrontal cortex i.e., F3 point and cathodes over supraorbital areas, Intensity - 1.2mA) for the duration of 20 minutes along with turbo med extern - an AFO to facilitate ankle dorsi flexion and conventional physiotherapy rehabilitation. The Fugl-Meyer assessment lower extremity (FMA-LE), Berg Balance Scale (BBS), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures were used for outcome assessment. Baseline assessment was done on day 0 followed by assessment on 10 and 20 post intervention. Results: Improvement was seen in all the tools i.e. (FMA -LE), BBS, SSQOL and WGS over the time period of 20 days. Conclusions: M-tDCS resulted in improvement in gait parameters, balance and motor functions of lower extremity of the patient.

• 대한임상검사과학회지
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• 제50권2호
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• pp.211-215
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• 2018

이 연구의 목적은 운동피질 주변의 뇌종양 환자를 대상으로 수술 중 피질척수로를 보존하고 운동 능력을 더 정확하게 평가하기 위함이다. 경두개운동유발전위는 위양성(false positive)과 위음성(false negative)이 혼재하는 검사이기 때문에 수술 중 검사상 파형의 변화가 없었다 할 지라도 검사의 내용을 완전히 신뢰할 수 없다. 보다 자세한 검사를 위해 대뇌피질을 선택적으로 자극할 수 있는 직접피질자극검사를 시행하였다. 직접피질자극 검사를 시행한 2케이스 에서는 수술 중 피질이 담당하는 부위를 찾고 지속적으로 진폭의 변화를 확인하며 검사할 수 있어 운동경로를 보존하며 수술 할 수 있었다. 하지만 직접피질 자극검사를 시행하지 않고 경두개운동유발전위 검사만을 시행한 환자에서는 수술 후 환자의 운동 능력이 감소되는 것을 경험할 수 있었다. 위와 같은 결과를 볼 때 직접피질자극 검사는 매우 유용한 검사이고 뇌종양 수술 시 경두개운동유발전위 검사와 병행하여 환자에게 올 수 있는 후유장애를 줄일 수 있는 방법이다.

• Korean Journal of Acupuncture
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• 제38권3호
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• pp.162-174
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• 2021

Objectives : We aimed to identify the antidepressant effect of liver tonification acupuncture treatment (ACU (LT); KI10, LR8, LU8, LR4) and four gate acupuncture treatment (ACU (FG); LI4, LR3) and its brain neural activity in the normal and chronic restraint stress (CRS)-induced mouse model. Methods : Firstly, normal mice were given ACU (LT) or ACU (FG) and the c-Fos expressions in each brain region were analyzed to examine brain neural activity. Secondly, CRS was administered to mice for 4 weeks, then ACU (LT) or ACU (FG) was performed for 2 weeks. The depression-like behavior was evaluated using open field test (OFT) before and after acupuncture treatment. Then, the c-Fos expressions in each brain region were analyzed to examine brain neural activity. Results : In normal mice, ACU (FG) regulated brain neural activities in the hypothalamus, hippocampus, and periaqueductal gray. ACU (LT) changed more brain regions in the prefrontal cortex, insular cortex, striatum, and hippocampus, including those altered by ACU (FG). In CRS-induced model, ACU (LT) alleviated depression-like behavior more than ACU (FG). Also, brain neural activities in the motor cortex area 2 (M2), agranular ventral part and piriform of insular cortex (AIV and Pir), and cornu ammonis (CA) 1 and CA3 of hippocampus were changed by ACU (LT), and those of AIV and CA3 were also changed by ACU (FG). As in normal mice, ACU (LT) resulted in changes in more brain regions, including those altered by ACU (FG) in CRS model. M2, Pir, and CA1 were only changed by ACU (LT) in depression model, suggesting that these brain regions reflect the specific effect of ACU (LT). Conclusions : ACU (LT) relieved depression-like behavior more than ACU (FG), and this acupuncture effect was associated with modulation of brain neural activities in the motor cortex, insular cortex, and hippocampus.

• 한국전문물리치료학회지
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• 제12권3호
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• pp.56-66
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• 2005

The purposes of this study were to test that complex motor training enhance motor function significantly, to test change in cerebellum, and to test the synaptic plasticity into the immunohistochemistry response of synaptophysin. Using an animal model of fetal alcohol syndrome - which equates peak blood alcohol concentrations across developmental period - the effects of alcohol on body weight during periods were examined. The effect of complex motor training on motor function and synaptic plasticity of rat exposed alcohol on postnatal days 4 through 10 were studied. Newborn rats were assigned to one of two groups: (1) normal group (NG), via artificial rearing to milk formula and (2) alcohol groups (AG), via 4.5 g/kg/day of ethanol in a milk solution. After completion of the treatments, the pups were fostered back to lactating dams, where they were raised in standard cages (two-and three animals per cage) until they were postnatal 48 days. Rats from alcohol group of postnatal treatment then spent 10 days in one of two groups: Alcohol-experimental group was had got complex motor training (learning traverse a set of 6 elevated obstacles) for 4 weeks. The alcohol-control group was not trained. Before consider replacing with "the experiment/study", (avoid using "got" in writing) the rats were examined during four behavioral tests and their body weights were measured, then their coronal sections were processed in rabbit polyclonal antibody synaptophysin. The synaptophysin expression in the cerebellar cortex was investigated using a light microscope. The results of this study were as follows: 1. The alcohol groups contained significantly higher alcohol concentrations than the normal group. 2. The alcohol groups had significantly lower body weights than the normal group. 3. In alcohol groups performed significantly lower than the normal group on the motor behavioral test. 4. In alcohol-control group showed significantly decreased immunohistochemistric response of the synaptophysin in the cerebellar cortex compared to the nomal group. These results suggest that improved motor function induced by complex motor training after postnatal exposure is associated with dynamically altered expression of synaptophysin in cerebellar cortex and that is related with synaptic plasticity. Also, these data can potentially serve as a model for therapeutic intervention.

• 국제물리치료학회지
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• 제1권2호
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• pp.91-98
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• 2010

This study is intended to examine the motor skill learning and treadmill exercise on motor performance and synaptic plasticity in the cerebellar injured rats by harmaline. Experiment groups were divided into four groups and assigned 15 rats to each group. Group I was a normal control group(induced by saline); Group II was a experimental control group(cerebellar injured by harmaline); Group III was a group of motor skill learning after cerebellar injured by harmaline; Group IV was a group of treadmill exercise after cerebellar injured by harmaline. In motor performance test, the outcome of group II was significantly lower than the group III, IV(especially group III)(p<.001). In histological finding, the experimental groups were destroy of dendrities and nucleus of cerebellar neurons. Group III, IV were decreased in degeneration of cerebellar neurons(especially group III). In immunohistochemistric response of synaptophysin in cerebellar cortex, experimental groups were decreased than group I. Group III's expression of synaptophysin was more increased than group II, IV. In electron microscopy finding, the experimental groups were degenerated of Purkinje cell. These result suggest that improved motor performance by motor skill learning after harmaline induced is associated with dynamically altered expression of synaptophysin in cerebellar cortex and that is related with synaptic plasticity.

• 한국전문물리치료학회지
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• 제21권4호
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• pp.1-8
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• 2014

Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity direct current to cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to investigate changes in various sensory functions after tDCS. We conducted a single-center, single-blinded, randomized trial to determine the effect of a single session of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies were performed in relation to the median sensory and motor nerves on the dominant hand to discriminate peripheral nerve lesions. The subjects received anodal tDCS with 1 mA for 15 minutes under two different conditions, with 25 subjects in each groups: the conditions were as follows tDCS on the primary motor cortex (M1) and sham tDCS on M1. We recorded the parameters of the CPT a with Neurometer$^{(R)}$ at frequencies of 2000, 250, and 5 Hz in the dominant index finger to assess the tactile sense, fast pain and slow pain, respectively. In the test to measure CPT values of the M1 in the tDCS group, the values of the distal part of the distal interphalangeal joint of the second finger statistically increased in all of 2000 Hz (p=.000), 250 Hz (p=.002), and 5 Hz (p=.008). However, the values of the sham tDCS group decreased in all of 2000 Hz (p=.285), 250 Hz (p=.552), and 5 Hz (p=.062), and were not statistically significant. These results show that M1 anodal tDCS can modulate sensory perception and pain thresholds in healthy adult volunteers. The study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.

• 한국전문물리치료학회지
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• 제12권2호
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• pp.73-80
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• 2005

We investigated the activation of the cerebral cortex during active movement, passive movement, and functional electrical stimulation (FES), which was provided on wrist extensor muscles. A functional magnetic resonance imaging study was performed on 5 healthy volunteers. Tasks were the extension of right wrist by active movement, passive movement, and FES at the rate of .5 Hz. The regions of interest were measured in primary motor cortex (M1), primary somatosensory cortex (SI), secondary somatosensory cortex (SII), and supplementary motor area (SMA). We found that the contralateral SI and SII were significantly activated by all of three tasks. The additional activation was shown in the areas of ipsilateral S1 (n=2), and contralateral (n=1) or ipsilateral (n=2) SII, and bilateral SMA (n=3) by FES. Ipsilateral M1 (n=1), and contralateral (n=1) or ipsilateral SII (n=1), and contralateral SMA (n=1) were activated by active movement. Also, Contralateral SMA (n=3) was activated by passive movement. The number of activated pixels on SM1 by FES ($12{\pm}4$ pixels) was smaller than that by active movement ($18{\pm}4$ pixels) and nearly the same as that by passive movement ($13{\pm}4$ pixels). Findings reveal that active movement, passive movement, and FES had a direct effect on cerebral cortex. It suggests that above modalities may have the potential to facilitate brain plasticity, if applied with the refined-specific therapeutic intervention for brain-injured patients.

• 한국HCI학회:학술대회논문집
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• 한국HCI학회 2008년도 학술대회 1부
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• pp.728-732
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• 2008

본 연구는 운동 표상에 관한 뇌 메커니즘의 이해를 위해 fMRI를 이용한 측정 시스템을 개발하였다. 개발된 시스템의 검증을 위해 예비 실험을 시행하였다. fMRI task는 visual feedback을 제공하는 task와 차단하는 task 두 가지의 task로 구성되었다. 실험 결과 visual feedback이 제공되었을 때는 left superior orbital gyrus, bilateral precentral gyrus, left superior occipital gyrus, left supplementary motor area, right thalamus, right postcentral gyrus 그리고 right superior parietal lobule 같은 영역들이 활성화 되었다. Visual feedback이 차단되었을 때는 left precuneus, right middle temporal gyrus, bilateral supplementary motor area, right anterior cingulate cortex, left Inferior temporal gyrus, left insula lobe, right superior parietal lobule, bilateral postcentral gyrus 그리고 left precentral gyrus 같은 영역들이 활성화 되었다. 개발된 시스템을 통해서 visual feedback이 차단되었을 경우 운동 표상에 관한 뇌 메커니즘을 알아 볼 수 있었다.

• 대한임상검사과학회지
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• 제48권1호
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• pp.41-48
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• 2016

Motor evoked potential of spinal surgery is known to cause damage due to the movement path of the continuous scan operation and surgery can be performed with minimized disability after surgery. However, if it is not at all formed at the wave motion evoked potential can occur during surgery and, in some cases the size of the waveform to be measured is very small and intermittent. In this case, the surgery cannot provide information about whether there is neurological damage. Increased intensity of the wave-induced motion of the dislocation does not occur if it appears in a very small amplitude stimulus, but changing the inspection area that electrical stimulation of the waveform changes could not be found. However, stimulation of a wide area in the cerebral cortex was found to occur with a waveform in the patients who underwent examination. Through this study, we propose a useful motor evoked potential test. From November to December 2015 three spine surgery patients visited Samsung Medical Center as neurosurgery patients with omission discomfort, gait disturbance, and no symptom of strength before surgery. In spine surgery patients with motor grade weakness, when motor evoked potential waveform has not been measured, in examination of the site of electrical stimulation of the cerebral cortex from entering the C3+C5/C4+C6 or C3+C1/C4+C2 if by the activity of more motor neuron unit, it was found that the waveform is better formed.

• 대한한방내과학회지
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• 제22권2호
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• pp.263-269
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• 2001

Monoplegia is the paralysis of either the upper or lower limb. Monoplegia is commonly caused by an injury to the cerebral cortex; it is rarely caused by an injury to the internal capsule, brain stem, or spinal cord. Most cerebral cortex is derived from the occlusion of a brain cortex blood vessel due to thrombus or embolus. According to motor homunculus, lower limb monoplegia occurs from limited damage to the most upper part of the primary motor area(Brodmann's area 4, located in precentral gyrus). Clinically, lower limb monoplegia due to brain cortical infarction is commonly misunderstood as monoplegia due to spinal injury because the lesion is situated at the most upper part of precentral gyrus. We had many difficulties in finding lesion on brain CT, but we diagnosed two patients correctly by using an MRI, who have lower limb monoplegia due to brain cortical infarction oriental treatment.