bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sucrose as an analgesic in relieving procedural pain in neonates
Authors: Basnet Srijana , Shrestha Laxman , Shrestha Prakash Sundar 
Published: December 2019

Objective: This study was undertaken to study physiological and behavioral pain responses of neonates and to assess the analgesic effect of orally administered sucrose as assessed by the behavioral pain rating scale [DAN (Douleur Aiguë du Nouveau-né) score] during venepuncture in neonates. Method: In 50 healthy neonates requiring bilirubin estimation, blood sugar was randomly assigned to receive 2ml of 30% sucrose two minutes before the venepuncture (intervention) in comparison to a group not receiving sucrose (control). During the procedure, pain was assessed by behavioral pain rating scale [Douleur Aiguë Nouveau-né (DAN) scale]. The heart rate, oxygen saturation before, during and after procedure as well as crying time was noted. Results: There was significantly lower pain (DAN) score in the intervention group compared to control group. Median (inter-quartile) DAN score in the group receiving sucrose was 3 (1.5–5.5) compared to 7 (5–9.5) in control group. The difference in median DAN score between two groups was statistically significant (p=0.0001). There was a significant increase in heart rate in the control group whereas in group receiving sucrose, no significant change in heart rate was observed. Similarly, oxygen saturation was also significantly reduced in control group when compared to intervention group. Conclusion: The analgesic effect of 30% sucrose was large enough to be clinically significant and can thus be detected by behavioral rating scale for acute pain (DAN). Sucrose reduces the physiological alteration occurring during venipuncture.
Recovery of injured cingulum in a patient with brain injury: Diffusion tensor tractography study
Authors: Seo Jeong Pyo , Jang Sung Ho 
Published: December 2019

Objectives: Little is known about neural recovery of an injured cingulum following brain injury. We report on a patient with brain injury who showed apparent neural recovery of an injured cingulum on follow up diffusion tensor tractography (DTT). Methods: A 53-year-old female patient had suffered hypoxic ischemic brain injury for a period of approximately nine hours following spontaneous subarachnoid hemorrhage and intraventricular hemorrhage, and underwent coiling of a left ruptured aneurysm of the posterior communicating artery. She showed severe cognitive impairment, so that she could not be evaluated on the Mini-Mental State Examination, however, her cognition showed improvement to 21 at five months after onset and 24 at 14 months after onset on the Mini-Mental State Examination. Results: On seven-day DTT for the fornix in the patient, we observed a discontinuation in the left crus and thinning of the right crus. However, on 14-month DTT, the thinned right fornical crus had disappeared. Regarding the cingulum, on seven-day DTTs, discontinuations of both cingulums anterior to the genu of the corpus callosum were observed. However, on 14-month follow up DTT, the right cingulum was elongated to the right basal forebrain and no change in the discontinuation of the left cingulum was observed. Conclusions: These changes observed on DTT in both cingulums appeared to indicate recovery of the injured cingulum in this patient. The results of this study may suggest a mechanism for recovery of injured cingulum following brain injury.
Cardiac autonomic status is associated with spasticity in post-stroke patients
Authors: Hung Chi-Yao , Tseng Sung-Hui , Chen Shih-Ching , Chiu Hou-Chang , Lai Chien-Hung , Kang Jiunn-Horng 
Published: December 2019

Background: Whether post-stroke spasticity is associated with autonomic status is unclear. The purpose of our study was to determine whether spasticity in post-stroke patients is associated with heart rate variability (HRV), an indicator of sympathetic and parasympathetic regulation. Objective: To determine whether HRV is associated with spasticity in post-stroke patients. Methods: Our cross-sectional observational study included 21 post-stroke patients with varying degrees of knee spasticity. We measured patients' heart rate variability (HRV) during the morning and afternoon of the same day using the modified Ashworth assessment and the pendulum test. The relationship between HRV and the spasticity parameters was evaluated based on the Pearson correlation coefficient (r). Results: The data for the morning measurements showed that the relaxation index negatively correlated with the high frequency (HF) power of HRV (r = −0.47, P < 0.05), and positively correlated with the low frequency (LF) power of HRV (r = 0.47, P < 0.05) and the LF/HF power ratio (r = 0.55, P < 0.05). Similar correlations were observed between the diurnal differences of HRV and the relaxation index. No correlation was observed among the data for the afternoon measurements. Conclusions: Higher parasympathetic tone and lower sympathetic tone are associated with a higher degree of knee spasticity in post-stroke patients. Further studies are warranted to confirm our findings and investigate the pathological mechanisms involved.
Language outcomes following neurosurgery for brain tumours: A systematic review
Authors: Finch Emma , Copland David A. 
Published: December 2019

Background: Language function is susceptible to the effects of brain tumours during both the tumour growth phase and during neurosurgical resection. Aim: This paper aimed to systematically review existing literature to determine the current status of knowledge about language outcomes following neurosurgery. Methods: A systematic review was conducted involving a detailed literature search using online databases, quality assessment of relevant articles and data extraction. Results: Of the 1449 articles retrieved, nine articles satisfied the study criteria. Overall, these studies reported variable patterns of language function post-surgery, however, there was a trend towards an early post-surgical decline in language function that greatly improved by 3 months. The likelihood of developing post-surgical communication impairments was influenced by a number of factors including pre-operative aphasia and the identification of sub-cortical language tracts inside the tumour margin, however, further research is required to fully elucidate pertinent predictors. Conclusion: These findings have implications for rehabilitation programs following brain tumour surgery and suggest that there are a number of key gaps warranting further investigation.
Visual perceptual learning is similar across the extrafoveal	central visual fields
Authors: Neary K. , Anand S. , Hotson J.R. 
Published: December 2019

Purpose: Visual perceptual learning occurs with the presentation of novel visual stimuli at retinal sites near the fovea to 20° eccentricities. It was unclear if the magnitude and rate of visual learning were similar across the central visual fields or if visual learning decreased with increasing eccentricity. The robustness of learning across the visual fields may affect the magnitude of computer-aided visual recovery after visual brain injury. Therefore we determined if eccentricity was a factor that influenced perceptual learning. Methods: Subjects were trained to detect the presence or absence of a single line oriented differently (odd-element) from an array of lines that otherwise had the same orientation. The odd-element line was presented 3°, 9° or 18° from fixation. Results: Perceptual performance improved during training trials with a similar magnitude and similar learning curve slopes at all 3 eccentricities. Pre- and post-training performance improved to a similar magnitude at 3 vs 9° in 4 of 4 subjects tested and at 9° vs 18° in 4 of 5 subjects. In the fifth subject there was no post-training improvement in performance at 18°. Conclusion: Visual perceptual learning is similar across the extrafoveal central visual fields in almost all subjects.
Efficacy of EMG-triggered electrical arm stimulation in chronic	hemiparetic stroke patients
Authors: von Lewinski Friederike , Hofer Sabine , Kaus Jürgen , Merboldt Klaus-Dietmar , Rothkegel Holger , Schweizer Renate , Liebetanz David , Frahm Jens , Paulus Walter 
Published: December 2019

Purpose: EMG-triggered electrostimulation (EMG-ES) may improve the motor performance of affected limbs of hemiparetic stroke patients even in the chronic stage. This study was designed to characterize cortical activation changes following intensified EMG-ES in chronic stroke patients and to identify predictors for successful rehabilitation depending on disease severity. Methods: We studied 9 patients with severe residual hemiparesis, who underwent 8 weeks of daily task-orientated multi-channel EMG-ES of the paretic arm. Before and after treatment, arm function was evaluated clinically and cortical activation patterns were assessed with functional MRI (fMRI) and/or transcranial magnetic stimulation (TMS). Results: As response to therapy, arm function improved in a subset of patients with more capacity in less affected subjects, but there was no significant gain for those with Box & Block test values below 4 at inception. The clinical improvement, if any, was accompanied by an ipsilesional increase in the sensorimotor cortex (SMC) activation area in fMRI and enhanced intracortical facilitation (ICF) as revealed by paired TMS. The SMC activation change in fMRI was predicted by the presence or absence of motor-evoked potentials (MEPs) on the affected side. Conclusions: The present findings support the notion that intensified EMG-ES may improve the arm function in individual chronic hemiparetic stroke patients but not in more severely impaired individuals. Functional improvements are paralleled by increased ipsilesional SMC activation and enhanced ICF supporting neuroplasticity as contributor to rehabilitation. The clinical score at inception and the presence of MEPs have the best predictive potential.
Raised corticomotor excitability of M1 forearm area following	anodal tDCS is sustained during robotic wrist therapy in chronic stroke
Authors: Edwards D.J. , Krebs H.I. , Rykman A. , Zipse J. , Thickbroom G.W. , Mastaglia F.L. , Pascual-Leone A. , Volpe B.T. 
Published: December 2019

Anodal transcranial direct current stimulation (tDCS) can transiently increase corticomotor excitability of intrinsic hand muscles and improve upper limb function in patients with chronic stroke. As a preliminary study, we tested whether increased corticomotor excitability would be similarly observed in muscles acting about the wrist, and remain present during robotic training involving active wrist movements, in six chronic stroke patients with residual motor deficit. Methods: Transcranial magnetic stimulation (TMS) generated motor evoked potentials (MEP) in the flexor carpi radialis (FCR) and provided a measure of corticomotor excitability and short-interval cortical inhibition (SICI) before and immediately after a period of tDCS (1 mA, 20 min, anode and TMS applied to the lesioned hemisphere), and robotic wrist training (1hr). Results: Following tDCS, the same TMS current strength evoked an increased MEP amplitude (mean 168 ± 22%SEM; p < 0.05), that remained increased after robot training (166 ± 23%; p < 0.05). Conditioned MEPs were of significantly lower amplitude relative to unconditioned MEPs prior to tDCS (62 ± 6%, p < 0.05), but not after tDCS (89 ± 14%, p = 0.40), or robot training (91 ± 8%, p = 0.28), suggesting that the increased corticomotor excitability is associated with reduced intracortical inhibition. Conclusion: The persistence of these effects after robotic motor training, indicates that a motor learning and retraining program can co-exist with tDCS-induced changes in cortical motor excitability, and supports the concept of combining brain stimulation with physical therapy to promote recovery after brain injury.
A virtual reality-based system integrated with fmri to study	neural mechanisms of action observation-execution: A proof of concept	study
Authors: Adamovich S.V. , August K. , Merians A. , Tunik E. 
Published: December 2019

Purpose: Emerging evidence shows that interactive virtual environments (VEs) may be a promising tool for studying sensorimotor processes and for rehabilitation. However, the potential of VEs to recruit action observation-execution neural networks is largely unknown. For the first time, a functional MRI-compatible virtual reality system (VR) has been developed to provide a window into studying brain-behavior interactions. This system is capable of measuring the complex span of hand-finger movements and simultaneously streaming this kinematic data to control the motion of representations of human hands in virtual reality. Methods: In a blocked fMRI design, thirteen healthy subjects observed, with the intent to imitate (OTI), finger sequences performed by the virtual hand avatar seen in 1st person perspective and animated by pre-recorded kinematic data. Following this, subjects imitated the observed sequence while viewing the virtual hand avatar animated by their own movement in real-time. These blocks were interleaved with rest periods during which subjects viewed static virtual hand avatars and control trials in which the avatars were replaced with moving non-anthropomorphic objects. Results: We show three main findings. First, both observation with intent to imitate and imitation with real-time virtual avatar feedback, were associated with activation in a distributed frontoparietal network typically recruited for observation and execution of real-world actions. Second, we noted a time-variant increase in activation in the left insular cortex for observation with intent to imitate actions performed by the virtual avatar. Third, imitation with virtual avatar feedback (relative to the control condition) was associated with a localized recruitment of the angular gyrus, precuneus, and extrastriate body area, regions which are (along with insular cortex) associated with the sense of agency. Conclusions: Our data suggest that the virtual hand avatars may have served as disembodied training tools in the observation condition and as embodied "extensions" of the subject's own body (pseudo-tools) in the imitation. These data advance our understanding of the brain-behavior interactions when performing actions in VE and have implications in the development of observation- and imitation-based VR rehabilitation paradigms.
Working memory training in patients with multiple sclerosis –	comparison of two different training schedules
Authors: Vogt Annamarie , Kappos Ludwig , Calabrese Pasquale , Stöcklin Markus , Gschwind Leo , Opwis Klaus , Penner Iris-Katharina 
Published: December 2019

Purpose: Evaluation of two different training schedules of a computer based working memory training (BrainStim) in patients with multiple sclerosis (MS). Method: Forty-five MS outpatients were allocated to two different training groups and a control group without training. Patients with treatment received 16 training sessions scheduled either as a high intensity training (4 times per week for 4 weeks) or as a distributed training (2 times per week for 8 weeks). A neuropsychological test battery including self-report measures was applied at baseline and at retest. The baseline assessment was performed twice at an interval of two weeks to control for possible learning effects. Results: In the outcome measures training for both intervention groups led to significantly improved fatigue symptoms as well as working memory -, and mental speed performances. Log files recorded during training showed a similar increase in levels of difficulty for both intervention groups as training progressed. No effects were found on short term memory, quality of life or depression. Conclusions: Since comparable improvements were observed in both training groups, BrainStim can be applied as a therapeutic intervention adjusted to the personal agenda of MS patients.
Long-term levodopa admnistration in chronic stroke patients. A	clinical and neurophysiologic single-blind placebo-controlled cross-over pilot	study
Authors: Acler M. , Fiaschi A. , Manganotti P. 
Published: December 2019

Purpose: Promising new rehabilitative approaches to improve the substantial motor disability associated with chronic stroke include pharmacotherapy to enhance motor recovery. We conducted a single-blind placebo-controlled crossover pilot study to investigate the effects of prolonged treatment with L-DOPA in stroke patients. Methods: Ten chronic (10–48 months) stroke patients received placebo or L-DOPA 100 mg daily for 5 weeks. During drug's treatment patients suspended physiotherapy. Patients underwent clinical evaluation (Rivermead Motor Assessment, Nine Hole Peg Test, and 10 meter walking test) and transcranial magnetic stimulation recordings from the affected and unaffected hemisphere (resting motor threshold, motor evoked potential amplitude and cortical silent period) before and after 5 weeks of treatment. Results: After L-DOPA treatment patients improved their walking speed (p< 0.01) and manual dexterity (p< 0.01) with the affected hand, the cortical silent period over the affected hemisphere lengthened (p< 0.01), while no changes were found in placebo-group. Conclusion: A 5-week course of oral L-DOPA in a single daily dose substantially improves motor performance in patients with chronic stroke and could do so by modulating motor cortical excitability (cortical silent period lengthening) suggesting that cortical inhibitory mechanisms have a role in motor recovery after stroke. Pharmacotherapy could be a useful therapeutic approach for chronic stroke patients.
Drug screening of neuroprotective agents on an organotypic-based	model of spinal cord excitotoxic damage
Authors: Guzmán-Lenis Mónica-Sofía , Navarro Xavier , Casas Caty 
Published: December 2019

Purpose: Damage to segmental motoneurons and to spinal cord parenchyma cause denervation atrophy to the muscles, contributing to the chronic disability originated by spinal cord injury (SCI) and spinal motor neuron diseases. After SCI, damage is promoted by several underlying mechanisms, including release of glutamate and consequent over-activation of glutamate receptors, mainly NMDA receptors, that lead to neuronal death. Due to the lack of effective treatments for such conditions, new alternatives need to be explored. Methods: In order to perform a relatively quick and high-fidelity drug screening, we optimized a postnatal rat organotypic spinal cord culture. By using a glutamate excitotoxic model of spinal cord damage on the explants, we compared the neuroprotective efficacy of four agents: methylprednisolone, erythropoietin, riluzole and rolipram. We evaluated the number of surviving ventral motor neurons stained with the SMI32 antibody and estimated the cord tissue preservation by quantifying the amount of EthD fluorescent probe incorporated into the cells. Results: The best tissue protection was achieved with riluzole (98%) whereas the highest motoneuron preservation was obtained with methylprednisolone (92%). Conclusion: The in vitro model used may serve to initiate comparative analyses of new compounds to narrow the choice for future neuroprotective agents to be tested in vivo.
Restoration of electroretinogram activity in exenterated swine	eyes following ophthalmic artery anastomosis
Authors: Shi Jun , Ellenberg David , Kim Jae Yong , Qian Haohua , Ripps Harris , Jain Sandeep , Chang Jin-Hong , Azar Dimitri T. 
Published: December 2019

Purpose: To determine the feasibility of restoring electroretinogram (ERG) activity of exenterated swine eyes following in vivo arterial anastomosis. Methods: The carotid artery was exposed and cannulated. The eye was exenterated along with the extraocular muscles and surrounding connective tissue. Prior to eye transplantation, the ophthalmic artery was identified and anastomosed to the carotid artery. Perfusion was confirmed by injecting FITC-conjugated tomato lectin into the anastomotic tubing and performing confocal microscopy of retinal flat-mounts. Dark-adapted ERG and optic nerve responses were analyzed to assess retinal function, and dilated eye examination and retinal imaging were performed. Results: Arterial anastomosis resulted in perfusion of blood from the carotid artery through the anastomosis and into the ophthalmic artery. Arterial perfusion was confirmed by the presence of tomato lectin-stained retinal vessels. Immediately following the anastomosis, ERG and optic nerve activities were minimal. However, an "a" wave (representing photoreceptor activity), "b" wave (representing bipolar cell activity), and optic nerve responses (representing RGC activity) were detected 30 min after reperfusion. Conclusions: Electroretinographic function is partially recovered following re-anastomosis of exenterated swine eyes. This model would be useful for further studies on eye transplantation.
Can we change brain functioning with cognition-focused	interventions in Alzheimer's disease? The role of functional neuroimaging
Authors: van Paasschen Jorien , Clare Linda , Woods Robert T. , Linden David E.J. 
Published: December 2019

Purpose: This review considers the application of functional magnetic resonance imaging (fMRI) to identify treatment effects and brain plasticity in cognition-focused interventions aimed at people with Alzheimer's disease (AD). At present there is little evidence available that bears directly on this question. Associative memory function is affected in the early stages of AD and also deteriorates disproportionately in comparison to other types of memory in healthy ageing. Methods: We review paradigms from the literature on face-name learning in fMRI in three groups (AD, mild cognitive impairment, and healthy ageing) with the aim of developing a paradigm to measure treatment effects and functional plasticity following cognitive intervention. Results: Previous studies have commonly selected participants with high levels of education, and have generally used challenging tasks, with considerable variations in level of task performance across studies. The findings of the review indicate that there is a need a simple face-name learning paradigm that can be used with people with AD, and which can be applied either as a single assessment tool to compare various subject groups or as an outcome tool to assess functional changes following a period of cognitive intervention. Conclusions: We make recommendations for such a paradigm and discuss pilot data showing the successful application of our paradigm in an individual with MCI.
Far transfer in cognitive training of older adults
Authors: Zelinski Elizabeth M. 
Published: December 2019

Purpose: This article reviews the literature on far transfer effects in training of older adults. Methods: Adapting a taxonomy of transfer developed by Barnett and Ceci (2002), to rehabilitation or enhancement of existing cognitive skills; results of studies assessing transfer effects from training of memory, reasoning, UFOV, dual task performance, and complex training are classified. Results: Comparisons of the transfer outcomes of both strategy training and extended practice approaches suggest that far transfer has been observed. Conclusions: Outcomes for strategy studies training memory have had less success than extended practice studies in obtaining far transfer. Reasons for this are discussed, as are suggestions for improved assessment of transfer outcomes.