http://link.springer.com/content/pdf/10.1134/S0362119713030055.pdf
Abstract
Methods that, on the
one hand, can ensure patient’s mobility and, on the other hand, activate
afferent inputs are the main in the rehabilitation treatment. Recent
studies have shown that plasticity is the structural basis of recovery
after central nervous system lesions. Reorganization of cortical areas,
increase in the efficiency of the functioning of preserved structures;
and active use of alternative ascending pathways, e.g., intensification
of afferent input, constitute the anatomical basis of plasticity.
However, sensory correction methods, without accounting of functional
condition of patients, may lead to the formation of pathological
symptoms: spasticity, hyperreflexia, etc. So, the main aim is to study
adequate management of the neuroplasticity process. This problem cannot
be solved without modern methods of neuroimaging and brain mapping. The
new approach for the study of cortical mechanisms of neuroplasticity,
responsible for locomotion, was developed in the present study. This
approach is an integrated use of functional magnetic resonance imaging
(fMRI) and navigation transcranial magnetic stimulation (nTMS). It has
been shown that vast fMRI activation area in the first and second
sensorimotor areas emerges with a passive sensorimotor paradigm usage
that imitates backing load during walking. The Korvit mechanical
stimulator of backing zones of footsteps is used to create this
paradigm. The nTMS examination used after fMRI helps to localize motor
representation of muscles which control locomotion more accurately. We
assume that the new approach can be used for studying the
neuroplasticity process and assessing neuroplasticity changes when
taking rehabilitation measures to restore and correct the walking
process.
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