• Title/Summary/Keyword: Cortical reorganization

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Medial Reorganization of Primary Motor Cortex in Patient with Traumatic Brain Injury: a fMRI Case Study (외상성 뇌손상 환자에서 대뇌피질의 재조직화: 사례보고)

  • Choi, Jin-Ho;Kwon, Yong-Hyun
    • The Journal of Korean Physical Therapy
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    • v.17 no.3
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    • pp.421-428
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    • 2005
  • The tenn 'Brain plasticity' has been identified that our central nervous system is continuously being adapted and modulated according to environmental needs and demands, and has been used to encompass the multifarious mechanisms related to learning, development, and recovery from damage to the nervous system. The purpose of this study was to demonstrate cortical reorganization in a 26-year-old right-handed hemiparetic patient with traumatic primary motor cortex (M1) injury, using functional MRI (fMRI). The unaffected (left) primary sensori-motor cortex centered on the precentral knob was activated during unaffected (right) hand movements. However, the medial area of the injured M1 was activated during affected (left) hand movements. It seems that the motor function of the affected hand in this patient was reorganized into the medial area of the injured precentral knob. These investigations provide a great useful information and clinical evidences with the specialized clinician in stroke physical therapy about patient's prognosis and therapeutic guidelines.

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Cortical Activation of the Somatosensory Hand Area in Hemiplegic Cerebral Palsy Patients. : fMRI Study. -Case Reports- (뇌성마비 편마비 환아의 체성감각피질 활성화에 대한 fMRI 연구 -증례 보고-)

  • Lee, Zee Ihn
    • Annals of Clinical Neurophysiology
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    • v.7 no.1
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    • pp.34-36
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    • 2005
  • Two hemiplegic cerebral palsy patients were studied to investigate the cortical mechanisms underlying preserved somatosensory capacity, using functional MRI(fMRI). Tactile stimulation was performed by brushing of palm, during fMRI study. By the affected hand stimulation, contralateral primary somatosensory cortex was activated in patient 1 and cortical area anterior to the lesion site was activated in patient 2. We suggest that reorganization of the somatosensory cortex after brain injury can be induced by recruitment of undamaged areas adjacent to lesion site.

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A Review of the Plasticity and Constraint Induced Movement Therapy : Children With Spastic Hemiplegic Cerebral Palsy (신경가소성 원리를 이용한 강제유도운동치료에 대한 고찰: 경직성 편마비형 뇌성마비 아동을 대상으로)

  • Cho, Sang-Yoon
    • Therapeutic Science for Rehabilitation
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    • v.2 no.1
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    • pp.13-23
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    • 2013
  • Constraint-Induced Movement Therapy(CIMT) is considered as one of the most interesting upper extremity rehabilitation in the field of neurorehabilitation. CIMT is an intensive training provided in the affected upper limb for 6 hours a day, 5 days a week for 2 weeks, while unaffected arm is restrained for 90% of waking hours. Recently, instead of CIMT, modified Constraint-Induced Movement Therapy(mCIMT) has been applied because of the clinical limitations of CIMT. CIMT or mCIMT studies have used various outcome instruments to measure different aspects of upper limb function after intervention. There are various kinds of evaluation tools to measure different aspects of upper limb function after CIMT intervention. It has been proven that Pediatric Motor Activity Log(PMAL), Quality of Upper Extremities Skills Test(QUEST), Melbourne Assessment of Unilateral Upper Limb Function(MAULF), Assisting Hand Assessment (AHA) are effective. The purpose of this study was to investigate the cortical change in children with hemiplegic cerebral palsy after CIMT. As a result, use-dependent cortical reorganization was revealed. Also, increased activity of the contralateral motor cortex and decreased activity of the ipsilateral cortex were found. It supports the mechanism of cortical reorganization, the principles of neural plasticity and specifically activation of the contralateral cortex, for improving upper limb function after CIMT.

Activations of Cerebral and Cerebellar Cortex Induced by Repetitive Bilateral Motor Excercise (반복적 양측 운동학습에 따른 대뇌 및 소뇌 피질 활성화)

  • Tae, Ki-Sik;Song, Sung-Jae;Kim, Young-Ho
    • Journal of Biomedical Engineering Research
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    • v.28 no.1
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    • pp.139-147
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    • 2007
  • The aim of this study was to evaluate effects of short-tenn repetitive-bilateral excercise on the activation of motor network using functional magnetic resonance imaging (fMRI). The training program was performed at 1 hr/day, 5 days/week during 6 weeks. Fugl-Meyer Assessments (FMA) were performed every two weeks during the training. We compared cerebral and cerebellar cortical activations in two different tasks before and after the training program: (1) the only unaffected hand movement (Task 1); and (2) passive movements of affected hand by the active movement of unaffected hand (Task 2). fMRI was performed at 3T with wrist flexion-extension movement at 1 Hz during the motor tasks. All patients showed significant improvements of FMA scores in their paretic limbs after training. fMRI studies in Task 1 showed that cortical activations decreased in ipsilateral sensorimotor cortex but increased in contralateral sensorimotor cortex and ipsilateral cerebellum. Task 2 showed cortical reorganizations in bilateral sensorimotor cortex, premotor area, supplemetary motor area and cerebellum. Therefore, this study demonstrated that plastic changes of motor network occurred as a neural basis of the improvement subsequent to repetitive-bilateral excercise using the symmetrical upper-limb ann motion trainer.

뇌졸중 환자에서 반복적인 양측성 운동학습 적용이 상지기능에 미치는 영향

  • Lee Myoung-Hee
    • The Journal of Korean Physical Therapy
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    • v.15 no.3
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    • pp.202-222
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    • 2003
  • Chronic upper extremity hemiparesis is a leading cause of functional disability after stroke. The purpose of this study were to identify effects of a 6weeks repetitive bilateral arm training on upper motor function and the reorganization of motor network. Four chronic stroke patients participated in this study. They performed for 6 consecutive weeks, 3 days a week, 30 minutes a day. In the single group study, four 5-minute periods per session of bilateral arm training were performed with the use of a custom-designed arm training machine. The results of this study was as follows. 1. Following the 6weeks period of RBAT, patient exhibited a improvement in FMA and BBT. 2. Following the 6weeks period of RBAT, it showed improvement in reaching time, symbol digit substitution and finger tapping speed of KCNT. 3. fMRI activation after RBAT showed a focal map in lesional cortical area and perilesional motor areas. These fMRI data suggest that hemodynamics response to RBAT reflect sensorimotor reorganization in contralateral hemisphere. In conclusion, these date suggest that improved upper extremity function induced by repetitive bilateral arm training after stroke is associated with reorganization of motor network as a neural basis for the improvement of paratic upper extremity function.

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An EEG-based Brain Mapping to Determine Mirror Neuron System in Patients with Chronic Stroke during Action Observation

  • Kuk, Eun-Ju;Kim, Jong-man
    • The Journal of Korean Physical Therapy
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    • v.27 no.3
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    • pp.135-139
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    • 2015
  • Purpose: The aim of this study was to compare EEG topographical maps in patients with chronic stroke after action observation physical training. Methods: Ten subjects were recruited from a medical hospital. Participants observed the action of transferring a small block from one box to another for 6 sessions of 1 minute each, and then performed the observed action for 3 minutes, 6 times. An EEG-based brain mapping system with 32 scalp sites was used to determine cortical reorganization in the regions of interest (ROIs) during observation of movement. The EEG-based brain mapping was comparison in within-group before and after training. ROIs included the primary sensorimotor cortex, premotor cortex, superior parietal lobule, inferior parietal lobule, superior temporal lobe, and visual cortex. EEG data were analyzed with an average log ratio in order to control the variability of the absolute mu power. The mu power log ratio was in within-group comparison with paired t-tests. Results: Participants showed activation prior to the intervention in all of the cerebral cortex, whereas the inferior frontal gyrus, superior frontal gyrus, precentral gyrus, and inferior parietal cortex were selectively activated after the training. There were no differences in mu power between each session. Conclusion: These findings suggest that action observation physical training contributes to attaining brain reorganization and improving brain functionality, as part of rehabilitation and intervention programs.

Effects of the Symmetric Upper Extremity Motion Trainer on the Motor Function Recovery after Brain Injury: An fMRI Study (뇌손상 후 운동신경기능 회복에 대한 대칭형 상지 운동기구의 효과: 기능적 뇌 자기공명영상 연구)

  • Tae Ki-Sik;Choi Hue-Seok;Song Sung-Jae;Kim Young-Ho
    • Progress in Medical Physics
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    • v.16 no.1
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    • pp.1-9
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    • 2005
  • The effect of the developed symmetric upper extremity motion trainer on the cortical activation pattern was investigated in three chronic hemiparetic patients using both fMRI and Fugl-Meyer test. The training program was performed at 1 hr/day, 5 days/week during 6 weeks. Fugl-Meyer tests were performed every two weeks during the training. fMRI was performed at 3T scanner with wrist flexion-extension in two different tasks before and after the training program: the only unaffected hand movement (Task 1) and passive movements of affected hand by the active movement of unaffected hand (Task 2). fMRI studies in Task 1 showed that cortical activations decreased in ipsilateral SMC but increased in contralateral SMC. Task 2 showed cortical reorganizations in bilateral SMC, PMA and SMA. Therefore, it seems that the cortical reorganization in chronic hemiparetic patients can be induced by the training with the developed symmetric upper extremity motion trainer.

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Action Observation and Cortical Connectivity: Evidence from EEG Analysis

  • Kim, Sik-Hyun;Cho, Jeong-Sun
    • The Journal of Korean Physical Therapy
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    • v.28 no.6
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    • pp.398-407
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    • 2016
  • Purpose: The purpose of this study was to examine the changes in electroencephalogram (EEG) coherence and brain wave activity for first-person perspective action observation (1AO) and third-person perspective action observation (3AO) of healthy subjects. Methods: Thirty healthy subjects participated in this study. EEG was simultaneously recorded during the Relax period, the 1AO, and the 3AO, with event-related desynchronization (ERD) and coherence connectivity process calculations for brain wave (alpha, beta and mu) rhythms in relation to the baseline. Results: Participants showed increased coherence in beta wave activity in the frontal and central areas (p<0.05), during the 1AO using right-hand activity. Conversely, the coherence of the alpha wave decreased statistically significantly decreased in the frontocentral and parieto-occipital networks during the observation of the 1AO and the 3AO. The ERD values were larger than 40% for both central regions but were slightly higher for the C4 central region. The high relative power of the alpha wave during 1AO and 3AO was statistically significantly decreased in the frontal, central, parietal, and occipital regions. However, the relative power of the beta wave during 1AO and 3AO was statistically significantly increased in the parietal and occipital regions. Especially during 1AO, the relative power of the beta wave in the C3 area was statistically significantly increased (p<0.05). Conclusion: These findings suggest that 1AO and 3AO action observations are relevant to modifications of specific brain wave coherence and ERD values. EEG cortical activity during action observation may contribute to neural reorganization and to adaptive neuroplasticity in clinical intervention.

Cerebral cortical or Cerebellar Nuclear Lesion-induced Synaptic Reorganization in the Basilar Pons of the Rat (대뇌피질 또는 소뇌핵 병변에 따른 쥐 교핵내 연접구조의 변화)

  • 이현숙
    • The Korean Journal of Zoology
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    • v.34 no.3
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    • pp.382-388
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    • 1991
  • 쥐의 교핵내에서 대뇌피질(또는 소뇌핵) 면면시 소뇌교핵계(또는 대뇌교핵계)의 연접구조의 변화에 대한 전자현미경적 관찰결과, 대뇌교핵계의 수입로 차단의 경우 소뇌교핵계의 신경섬유는 교핵세포의 원위 가지돌기쪽으로 발아하며, 소뇌핵 병변시 서뇌교핵계의 신경섬유는 근위가지돌기와 연접을 형성하거나 또는 여러개의 가지돌기 부속물들과 사구체형 연접복합체를 형성함이 밝혀졌다. 이상의 연구는 광학현미경적 관찰에서 언급된 대뇌피질(또는 소뇌핵) 병변에 따른 교핵내 신경종말의 밀도증가에 대한 보고를 뒷받침해주며, 소뇌핵 병변시 운동결핍증의 시간경과에 따른 회복에 대한 신경해부학적 근거를 제시한다.

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Diagnosis of complex regional pain syndrome

  • Kim, Young-Do
    • Annals of Clinical Neurophysiology
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    • v.24 no.2
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    • pp.35-45
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    • 2022
  • Complex regional pain syndrome (CRPS) is a chronic regional pain disorder that most frequently affects the limbs. It is characterized by hyperalgesia, allodynia, edema, motor disturbance, and vasomotor instability, and typically occurs following surgery or trauma. In type-I CRPS there is no confirmed nerve injury, while peripheral nerve injury is present in type-II CRPS. The multifactorial pathophysiological etiology of CRPS includes inflammation, autoimmune responses, abnormal cytokine production, autonomic dysfunction, altered blood flow, psychological factors, and central cortical reorganization. There are no specific laboratory diagnostic tools for CRPS, and so it is diagnosed clinically. The Budapest criteria are currently the most-accepted diagnostic criteria.