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  • SAGE Publications  (2)
  • 2005-2009  (2)
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  • SAGE Publications  (2)
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  • 2005-2009  (2)
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  • 1
    Online Resource
    Online Resource
    SAGE Publications ; 2009
    In:  Neurorehabilitation and Neural Repair Vol. 23, No. 7 ( 2009-09), p. 641-656
    In: Neurorehabilitation and Neural Repair, SAGE Publications, Vol. 23, No. 7 ( 2009-09), p. 641-656
    Abstract: Background and purpose. Within the concept of interhemispheric competition, technical modulation of the excitability of motor areas in the contralesional and ipsilesional hemisphere has been applied in an attempt to enhance recovery of hand function following stroke. This review critically summarizes the data supporting the use of novel electrophysiological concepts in the rehabilitation of hand function after stroke. Summary of review. Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are powerful tools to inhibit or facilitate cortical excitability. Modulation of cortical excitability may instantaneously induce plastic changes within the cortical network of sensorimotor areas, thereby improving motor function of the affected hand after stroke. No significant adverse effects have been noted when applying brain stimulation in stroke patients. To date, however, the clinical effects are small to moderate and short lived. Future work should elucidate whether repetitive administration of rTMS or tDCS over several days and the combination of these techniques with behavioral training (ie, physiotherapy) could result in an enhanced effectiveness. Conclusion. Brain stimulation is a safe and promising tool to induce plastic changes in the cortical sensorimotor network to improve motor behavior after stroke. However, several methodological issues remain to be answered to further improve the effectiveness of these new approaches.
    Type of Medium: Online Resource
    ISSN: 1545-9683 , 1552-6844
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2009
    detail.hit.zdb_id: 2100545-X
    detail.hit.zdb_id: 1491637-X
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  • 2
    In: Journal of Cerebral Blood Flow & Metabolism, SAGE Publications, Vol. 29, No. 6 ( 2009-06), p. 1216-1225
    Abstract: Focal cerebral ischemia elicits strong inflammatory responses involving activation of resident microglia and recruitment of monocytes/macrophages. These cells express peripheral benzodiazepine receptors (PBRs) and can be visualized by positron emission tomography (PET) using [ 11 C]PK11195 that selectively binds to PBRs. Earlier research suggests that transient ischemia in rats induces increased [ 11 C]PK11195 binding within the infarct core. In this study, we investigated the expression of PBRs during permanent ischemia in rats. Permanent cerebral ischemia was induced by injection of macrospheres into the middle cerebral artery. Multimodal imaging 7 days after ischemia comprised (1) magnetic resonance imaging that assessed the extent of infarcts; (2) [ 18 F]-2-fluoro-2-deoxy-d-glucose ([ 18 F]FDG)-PET characterizing cerebral glucose transport and metabolism; and (3) [ 11 C]PK11195-PET detecting neuroinflammation. Immunohistochemistry verified ischemic damage and neuroinflammatory processes. Contrasting with earlier data for transient ischemia, no [ 11 C]PK11195 binding was found in the infarct core. Rather, permanent ischemia caused increased [ 11 C]PK11195 binding in the normoperfused peri-infarct zone (mean standard uptake value (SUV): 1.93 ± 0.49), colocalizing with a 60% increase in the [ 18 F]FDG metabolic rate constant with accumulated activated microglia and macrophages. These results suggest that after permanent focal ischemia, neuroinflammation occurring in the normoperfused peri-infarct zone goes along with increased energy demand, therefore extending the tissue at risk to areas adjacent to the infarct.
    Type of Medium: Online Resource
    ISSN: 0271-678X , 1559-7016
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2009
    detail.hit.zdb_id: 2039456-1
    detail.hit.zdb_id: 604628-9
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