The propose of the study was to evaluate the efficacy of the partial body weight support during treadmill training on the ambulation in elderly with chronic stroke. Fourteen hemiplegic volunteers participated and were divided into an experimental and control groups. In the experimental group, the body weight support during treadmill training was performed 3 times per week for 6 weeks. In the control group, usual treadmill training was applied. Before and after experiments, temporal-spatial gait parameters were measured. The date of 14 patients who carried out the whole experimental course were statistically analyzed. The results of the study were : 1. In the comparison of gait velocity before and after experiment, the gait velocity was significantly increased in the experimental group and the control group(p<.05). In the comparison of difference of the gait velocity between groups, there was not significant difference between the experimental group and the control group(p>.05). 2. In comparison of gait cadence before and after experiment, the gait cadence was significantly increased in both groups(p<.05). In the comparison of difference of the gait cadence between groups, there was not significant difference between the experimental group and the control group(p>.05). 3. In the comparison of step length before and after experiment, the step length was significantly increased in the experimental group and the control group(p<.05). In the comparison of difference of the step length between groups, there was not significant difference between the experimental group and the control group(p>.05). 4. In the comparison of vastus medialis root mean square(RMS) before and after experiment, the vastus medialis RMS was significantly increased in the experimental group(p<.05). In the comparison of vastus medialis root mean square(RMS) before and after experiment, the vastus medialis RMS was not significantly increased in the experimental group(p>.05). In the comparison of difference of the vastus medialis RMS between groups, there was not significant difference between the experimental group and the control group(p>.05). 5. In the comparison of latency of somatosensory evoke potential(SSEP) before and after experiment, the latency of SSEP was significantly increased in the experimental group(p<.05). In the comparison of latency of somatosensory evoke potential(SSEP) before and after experiment, the latency of SSEP was significantly decreased in the control group(p>.05). In the comparison of difference of the latency of SSEP between groups, there was not significant difference between the experimental group and the control group(p>.05). 6. In the comparison of functional ambulation profile(FAP) before and after experiment, the FAP was not significant difference in the experimental group and the control group(p>.05). In the comparison of difference of the FAP between groups, there was not significant difference between the experimental group and the control group(p>.05).
Background: Meralgia paresthetica(MP) which is characterized by paresthesias and sensory impairment without motor weakness in the anterolateral aspects of the thigh is produced by compression of the lateral femoral cutaneous nerve(LFCN). Even though the diagnosis of MP is mostly based on the clinical symptoms, electrophysiologic study is mandatory to confirm the disease objectively. It has been known that Somatosensory evoked potential(SSEP) study of LFCN is a simple and very useful method to evaluate MP, so we studied SSEP of LFCN in normal adults and offer normal values. Materials and Methods: Thirty six normal adults(23 males and 13 females) ages from 21 to 73 years old($mean{\pm}SD$:$42.06{\pm}15.74$) were studied SSEP of LFCN bilaterally. The stimulation site was anterolateral aspect of thighs and the recording site was Cz'. Results: The mean values($mean{\pm}SD$) of $LP_0$, $SP_0$, $LN_1$ and $SN_1$ of all subjects were 35.10(${\pm}2.42$), 33.80(${\pm}2.4$), 43.68(${\pm}1.88$) and 42.16(${\pm}2.12$) and the mean values($mean{\pm}SD$ of $DP_0$, $DN_1$ and DA(${\mu}V{\pm}SD$ were 1.30(${\pm}1.14$), 1.52(${\pm}1.38$) and 0.32(${\pm}0.33$). Conclusion: For the diagnosis of MP. comparison of latency difference between both sides is more reliable than simple value of latency itself because of individual differences of body types. According to our results. the latency difference should be less than 2 msec and the amplitude difference was less than 1.6 times in normal adults.
Purpose: The purpose of this study was to determine the effect of a 3-week somatosensory stimulation program on the integrity of the somatosensory pathway of patients with brain damage. Method: The sample consisted of two groups of patients with brain damage matched by Glasgow Coma Scale (GCS) scores and age:8 patients with a mean age of 56.75 years who were treated with somatosensory stimulation, and 8 patients with a mean age of 58.88 years, who were not treated with sensory intervention program. A repeated measures matched-control group design was used to assess functional recovery of the brain. The instrument used in this study was SSEP (somatosensory evoked potentials), a neurophysiological parameter, for the integrity of the somatosensory pathway. Results: The hypothesis that patients with brain damage who were treated with the somatosensory stimulation program will show higher SSEP wave form scores than the non-treatment group was supported (3rd week.: U=13.000, p=.014). Additional repeated measures analysis showed that there were no significant differences in recovery trends between the groups (F=1.945, p=.159). Conclusion: This study demonstrates that a somatosensory stimulation program is effective in promoting recovery of the integrity of the somatosensory pathway of patients with brain damage.
Kim, Sung Tae;Paeng, Sung Hwa;Jeong, Dong Mun;Lee, Kun Soo
Journal of Korean Neurosurgical Society
/
v.56
no.6
/
pp.513-516
/
2014
We report a case of cervicomedullary compression by an anomalous vertebral artery treated using microsurgical decompression with intraoperative monitoring. A 68-year-old woman presented with posterior neck pain and gait disturbance. MRI revealed multiple abnormalities, including an anomalous vertebral artery that compressed the spinal cord at the cervicomedullary junction. Suboccipital craniectomy with C1 laminectomy was performed. The spinal cord was found to be compressed by the vertebral arteries, which were retracted dorsolaterally. At that time, the somatosensory evoked potential (SSEP) changed. After release of the vertebral artery, the SSEP signal normalized instantly. The vertebral artery was then lifted gently and anchored to the dura. There was no other procedural complication. The patient's symptoms improved. This case demonstrates that intraoperative monitoring may be useful for preventing procedural complications during spinal cord microsurgical decompression.
International journal of advanced smart convergence
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v.9
no.1
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pp.37-46
/
2020
Cerebral vascular surgery can damage patients' motor and sensory nerves; therefore, neuromonitoring is performed intraoperatively. Patients with diabetes often have peripheral neuropathy and may be prone to nerve damage during surgery. This study aimed to identify factors that should be considered when diabetic patients undergo intraoperative neuromonitoring during brain vascular surgery and to present new criteria. Methods: In patients with and without diabetes who underwent cerebrovascular surgery (n = 30/group), we compared the intraoperative stimulation intensity, postoperative motor power and sensory, glycated hemoglobin (HbA1c) and glucose levels, and imaging findings. Results: Fasting glucose, blood glucose, and HbA1c levels were 10%, 12.1%, and 9.7%, respectively; they were higher in patients with than in patients without diabetes. Two patients with diabetes had weakness, and 10 required increased Somato sensory evoked potential (SSEP) stimulation, while in 16, motor power recovered over time rather than immediately. The non-diabetic group had no weakness after surgery, but 10 patients required more increased SSEP stimulation. The diabetic group showed significantly more abnormal test results than the non-diabetic group. Conclusion: For patients with diabetes undergoing surgery with intraoperative neuromonitoring, whether diabetic peripheral neuropathy is present, their blood glucose level and the anesthetic used should be considered.
Shin, Hyun Chul;Park, Yong Gou;Lee, Bae Hwan;Ryou, Jae Wook;Zhao, Chun Zhi;Chung, Sang Sup
Journal of Korean Neurosurgical Society
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v.30
no.7
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pp.831-841
/
2001
Objective : Somatosensory evoked potentials(SSEPs) have been used widely both experimentally and clinically to monitor the function of central nervous system and peripheral nervous system. Studies of SSEPs have reported the various recording techniques and patterns of SSEP. The previous SSEP studies used scalp recording electrodes, showed mean vector potentials which included relatively constant brainstem potentials(far-field potentials) and unstable thalamocortical pathway potentials(near-field potentials). Even in invasive SSEP recording methods, thalamocortical potentials were variable according to the kinds, depths, and distance of two electrodes. So they were regarded improper method for monitoring of upper level of brainstem. The present study was conducted to investigate the characteristics of somatosensory evoked field potentials(SSEFPs) of the cerebral cortex that evoked by hindlimb stimulation using ball electrode and the pathways of SSEFP by recording the potentials simultaneously in the cortex, VPL nucleus of thalamus, and nucleus gracilis. Methods : In the first experiment, a specially designed recording electrode was inserted into the cerebral cortex perpendicular to the cortical surface in order to recording the constant cortical field potentials and SSEFPs mapped from different areas of somatosensory cortex were analyzed. In the second experiment, SSEPs were recorded in the ipsilateral nucleus gracilis, the contralateral ventroposterolateral thalamic nucleus(VPL), and the cerebral cortex along the conduction pathway of somatosensory information. Results : In the first experiment, we could constantly obtain the SSEFPs in cerebral cortex following the transcutaneous electrical stimulation of the hind limb, and it revealed that the first large positive and following negative waves were largest at the 2mm posterior and 2mm lateral to the bregma in the contralateral somatosensory cortex. The second experiment showed that the SSEPs were conducted by way of posterior column somatosensory pathway and thalamocortical pathway and that specific patterns of the SSEPs were recorded from the nucleus gracilis, VPL, and cerebral cortex. Conclusion : The specially designed recording electrode was found to be very useful in recording the localized SSEFPs and the transcutaneous electrical stimulation using ball electrode was effective in evoking SSEPs. The characteristic shapes, latencies, and conduction velocities of each potentials are expected to be used the fundamental data for the future study of brain functions, including the hydrocephalus model, middle cerebral artery ischemia model, and so forth.
Background: Neuromodulation therapy has been used to an adjunctive treatment promoting motor recovery in stroke patients. The objective of the study was to determine the effect of repetitive transcranial magnetic stimulation (rTMS) on neurobehavioral recovery and evoked potentials in rats with middle cerebral artery occlusion. Methods: Seventy Sprague-Daley rats were induced permanent middle cerebral artery occlusion (MCAO) stroke model and successful stroke rats (n=56) assigned to the rTMS (n=28) and sham (n=28) group. The 10 Hz, high frequency rTMS gave on ipsilesional forepaw motor cortex during 2 weeks in rTMS group. The somatosensory evoked potential (SSEP) and motor evoked potential (MEP) were used to evaluate the electrophysiological changes. Behavioral function of the stroke rat was evaluated by the Rota rod and Garcia test. Results: Forty rats ($N_{rTMS}=20;\;N_{sham}=20$) completed all experimental course. The rTMS group showed better performance than sham group in Rota rod test and Garcia test at day 11 (p<0.05) but not day 18 (p>0.05). The amplitude of MEP and SSEP in rTMS group was larger than sham group at day 18 (p<0.05). Conclusions: These data confirm that the high frequency rTMS on ipsilesional cerebral motor cortex can help the early recovery of motor performance in permanent middle cerebral artery stroke model and it may simultaneously associate with changes in neurophysiological activity in brain.
Kim, Dong-Seok;Lee, Kwang-Soo;Park, Yong-Goo;Kim, Se-Hyuk;Choi, Joong-Uhn;Lee, Bae-Hwan;Ryou, Jae-Wook;Zhao, Chun-Zhi
Journal of Korean Neurosurgical Society
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v.29
no.1
/
pp.5-14
/
2000
Objective : Somatosensory evoked potential(SSEP) has been known to be a good method for evaluating brain stem function, but it is not sufficient to check the fine changes of cortical functions. A fine change of cortical function can be expressed with somatosensory evoked cortical field potential(SSEFP) rather than general SSEP. To confirm the usefulness of SSEFP for evaluating the cortical function, the authors simultaneously measured SSEFP and the intracranial pressure-volume index(PVI) in kaolin-induced hydrocephalic rats. Method : Hydrocephalus was induced with injection of 0.1ml kaolin-suspended solution into the cisterna magna in 60 Sprague-Dawley rats. The authors measured PVI and SSEFP 1 week after injection of kaolin-suspended solution. To evaluate the severity of induced hydrocephalus, we measured the transverse diameter of the lateral ventricle on the coronal slice of the rat brain 0.40mm posterior to the bregma. Result : The typical wave form of SSEFP in control rats showed a negative-positive complex wave at early latency. In SSEFP of normal rats, N0 is 10.0 msec, N1 15.3 msec, P1 31.2 msec and N1-P1 amplitude $15.4{\mu}V$. As hydrocephalus progressed, the peak latency of N1 and P1 were delayed. In mild hydrocephalus, negative peak waves were split. The N1-P1 amplitude was decreased only in severe hydrocephalus. The changes of the characteristics of SSEFP according to the severity of hydrocephalus were well correlated with the changes of PVI. Shunting normalized the characteristics of SSEFP in relation to ventricular sizes and PVI in hydrocephalic rats. Conclusion : SSEFP may be useful for evaluating the impairment of cortical function in hydrocephalus.
Lim, Sung Hyuk;Park, Sang Ku;Baek, Jae Seung;Kim, Kab Kyu;Kim, Ki Eob;Lee, Yu Ji
Korean Journal of Clinical Laboratory Science
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v.51
no.2
/
pp.198-204
/
2019
Various treatments can be attempted in patients with intractable epilepsy, in whom the symptoms of seizures are not controlled by various drugs. On the other hand, in patients requiring a surgical method, a preoperative examination is needed to determine the portion of seizure site to be resected. Electrodes are inserted into the cerebral cortex for accurate lesion measurements and safe operation. The electrodes inserted in the cortex not only record the electroencephalography (EEG), but also allow various tests to confirm the function of the part. One of these methods is the evoked potential test. From January 2015 to December 2018, the trends of measured waveforms in were analyzed 70 patients. The somatosensory evoked potential (SSEP) recorded on the electrode inserted in the cerebral cortex can be searched for the pathway of the central sulcus to avoid the primary motor area and primary sensory area. In addition, using the middle latency auditory evoked potentials (MLAEP) and flash visual evoked potentials (FVEP), the functional cortex in the auditory cortex and the visual cortex were compared with the seizure focus point on the EEG to help determine the location of the ablation and minimize functional impairment after surgery.
Face transplantation has been reported over the last six years, and it started in 2004 with the announcement of Cleveland Clinic granting the world's first IRB approval to proceed with human face transplantation. Composite tissue allografts (CTAs) in the facial region are considered to be more immunogenic than other solid organ transplants, so these kinds of animal experiments were also considered as challengeable activities to the facial reconstructive surgeons. For the better understanding of CTAs in the oral and maxillofacial fields, we reviewed several recent articles about facial composite transplantation animal model, and summarized some knowledges of composite midface allotransplantation model with sensory and motor reinnervation in this review article.
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