Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:

Tuesday, December 6, 2016

The Mirror Illusion Increases Motor Cortex Excitability in Children With and Without Hemiparesis

Can your doctor make the leap to apply this to adults? Or will this never get written into a protocol?
  1. Sebastian Grunt, MD, PhD1
  2. Christopher J. Newman, MD2
  3. Stefanie Saxer, MSc1,3
  4. Maja Steinlin, MD1
  5. Christian Weisstanner, MD4
  6. Alain Kaelin-Lang, MD, PhD5,6
  1. 1Division of Neuropaediatrics, Development and Rehabilitation, University Children’s Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Switzerland
  2. 2Paediatric Neurology and Neurorehabilitation Unit, Lausanne University Hospital, Lausanne, Switzerland
  3. 3Institute of Human Movement Sciences and Sport, ETH Zürich, Switzerland
  4. 4University Institute of Diagnostic and Interventional Neuroradiology, University Hospital, Bern, Switzerland
  5. 5University Clinic of Neurology, University Hospital, Bern, Switzerland
  6. 6Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland
  1. Sebastian Grunt, Department of Neuropaediatrics, Development and Rehabilitation, University Children’s Hospital, Inselspital, Bern, Switzerland. Email:


Background. Mirror therapy provides a visual illusion of a normal moving limb by using the mirror reflection of the unaffected arm instead of viewing the paretic limb and is used in rehabilitation to improve hand function. Little is known about the mechanism underlying its effect in children with hemiparesis. 
Objective. To investigate the effect of the mirror illusion (MI) on the excitability of the primary motor cortex (M1) in children and adolescents.  
Methods. Twelve patients with hemiparesis (10-20 years) and 8 typically developing subjects (8-17 years) participated. Corticospinal reorganization was classified as contralateral (projection from contralateral hemisphere to affected hand) or ipsilateral (projection from ipsilateral hemisphere to affected hand). M1 excitability of the hemisphere projecting to the affected (nondominant in typically developing subjects) hand was obtained during 2 different conditions using single-pulse transcranial magnetic stimulation (TMS). Each condition (without/with mirror) consisted of a unimanual and a bimanual task. Motor-evoked potentials (MEPs) were recorded from the abductor pollicis brevis and flexor digitorum superficialis muscles.  
Results. MEP amplitudes were significantly increased during the mirror condition (P = .005) in typically developing subjects and in patients with contralateral reorganization. No significant effect of MI was found in subjects with ipsilateral reorganization. MI increased M1 excitability during active movements only. This increase was not correlated to hand function.  
Conclusion. MI increases the excitability of M1 in hemiparetic patients with contralateral corticospinal organization and in typically developing subjects. This finding provides neurophysiological evidence supporting the application of mirror therapy in selected children and adolescents with hemiparesis.

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