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functional electrical stimulation-facilitated proliferation and regeneration of neural precursor cells in the brains of rats with cerebral infarction

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Neural Regeneration Research 2014年第3期9卷 243-251页

作者： Yun Xiang Huihua Liu Tiebin Yan Zhiqiang Zhuang Dongmei Jin Yuan Peng Department of Rehabilitation Medicine Sun Yat-sen Memorial Hospital Sun Yat-sen University Department of Rehabilitation Medicine Shenzhen Sixth People’s Hospital Department of Rehabilitation Medicine Guangzhou First People’s Hospital

Previous studies have shown that proliferation of endogenous neural precursor cells cannot alone compensate for the damage to neurons and axons. From the perspective of neural plastici- ty, we observed the effects of functional electrical stimulation treatment on endogenous neural precursor cell proliferation and expression of basic fibroblast growth factor and epidermal growth factor in the rat brain on the infarct side. functional electrical stimulation was performed in rat models of acute middle cerebral artery occlusion. Simultaneously, we set up a placebo stimulation group and a sham-operated group. Immunohistochemical staining showed that, at 7 and 14 days, compared with the placebo group, the numbers of nestin （a neural precursor cell marker）-positive cells in the subgranular zone and subventricular zone were increased in the functional electrical stimulation treatment group. Western blot assays and reverse-transcription PCR showed that total protein levels and gene expression of epidermal growth factor and basic fibroblast growth factor were also upregulated on the infarct side. Prehensile traction test results showed that, at 14 days, prehension function of rats in the functional electrical stimulation group was significantly better than in the placebo group. These results suggest that functional electrical stimulation can promote endogenous neural precursor cell proliferation in the brains of acute cerebral infarction rats, enhance expression of basic fibroblast growth factor and epidermal growth factor, and improve the motor function of rats.

关键词： nerve regeneration brain injury functional electrical stimulation neural precursor cells neurogenesis basic fibroblast growth factor epidermal growth factor nestin stroke rats NSFC grant neural regeneration

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functional electrical stimulation increases neural stem/progenitor cell proliferation and neurogenesis in the subventricular zone of rats with stroke

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Chinese Medical Journal 2013年第12期126卷 2361-2367页

作者： LIU Hui-hua XIANG Yun YAN Tie-bin TAN Zhi-mei LI Sheng-huo HE Xiao-kuo Department of Rehabilitation Medicine bun Yat-sen lviemorlal Hospital Sun Yat-sen University Guangzhou Guangdong 510120 China Department of Rehabilitation Medicine Sixth People's Hospital of Shenzhen Shenzhen Guangdong 518052 China Department of Rehabilitation Medicine First Affiliated Hospital of Zhengzhou University Zhengzhou Henan 450000 China Department of Rehabilitation Medicine Second Affiliated Hospital of Guangzhou Medical College Guangzhou Guangdong 510260 China

Background functional electrical stimulation （FES） is known to promote the recovery of motor function in rats with ischemia and to upregulate the expression of growth factors which support brain neurogenesis.In this study,we investigated whether postischemic FES could improve functional outcomes and modulate neurogenesis in the subventricular zone （SVZ） after focal cerebral ischemia.Methods Adult male Sprague-Dawley rats with permanent middle cerebral artery occlusion （MCAO） were randomly assigned to the control group,the placebo stimulation group,and the FES group.The rats in each group were further assigned to one of four therapeutic periods （1,3,7,or 14 days）.FES was delivered 48 hours after the MCAO procedure and divided into two 10-minute sessions on each day of treatment with a 10-minute rest between them.Two intraperitoneal injections of bromodeoxyuridine （BrdU） were given 4 hours apart every day beginning 48 hours after the MCAO.Neurogenesis was evaluated by immunofluorescence staining.Wnt-3 which is strongly implicated in the proliferation and differentiation of neural stem cells （NSCs） was investigated by Western blotting analysis.The data wera subjected to oneway analysis of variance （ANOVA）,followed by a Tukey/Kramer or Dunnett post hoc test.Results FES significantly increased the number of BrdU-positive cells and BrdU/glial flbrillary acidic protein doublepositive neural progenitor cells in the SVZ on days 7 and 14 of the treatment （P 〈0.05）.The number of BrdU/doublecortin （DCX） double-positive migrating neuroblast cells in the ipsilateral SVZ on day 14 of the FES treatment group （（522.77±33.32） cells/mm2） was significantly increased compared with the control group （（262.58±35.11） cells/mm2,P 〈0.05） and the placebo group （（266.17±47.98） cells/mm2,P 〈0.05）.However,only a few BrdU/neuron-specific nuclear protein-positive cells were observed by day 14 of the treatment.At day 7,Wnt-3 was upregulated in the ipsilateral SVZs of the rats receiving FES （（0.44±0.05）%） compared with those of the control group

关键词： functional electrical stimulation subventricular zone ischemia neurogenesis

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Rebuilding motor function of the spinal cord based on functional electrical stimulation

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Neural Regeneration Research 2016年第8期11卷 1327-1332页

作者： Xiao-yan Shen Wei Du Wei Huang Yi Chen Electronic Information School Nantong University Co-innovation Center of Neuroregeneration Nantong University Medical School Nantong University

Rebuilding the damaged motor function caused by spinal cord injury is one of the most serious challenges in clinical neuroscience.The function of the neural pathway under the damaged sites can be rebuilt using functional electrical stimulation technology.In this study,the locations of motor function sites in the lumbosacral spinal cord were determined with functional electrical stimulation technology.A three-dimensional map of the lumbosacral spinal cord comprising the relationship between the motor function sites and the corresponding muscle was drawn.Based on the individual experimental parameters and normalized coordinates of the motor function sites,the motor function sites that control a certain muscle were calculated.Phasing pulse sequences were delivered to the determined motor function sites in the spinal cord and hip extension,hip flexion,ankle plantarflexion,and ankle dorsiflexion movements were successfully achieved.The results show that the map of the spinal cord motor function sites was valid.This map can provide guidance for the selection of electrical stimulation sites during the rebuilding of motor function after spinal cord injury.

关键词： nerve regeneration spinal cord injury functional electrical stimulation rebuilding motor function movement control spinal cord lumbosacral spinal cord motor function sites hip extension movement hip flexion movement ankle plantarflexion ankle dorsiflexion neural regeneration

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A novel functional electrical stimulation-control system for restoring motor function of post-stroke hemiplegic patients

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Neural Regeneration Research 2014年第23期9卷 2102-2110页

作者： Zonghao Huang Zhigong Wang Xiaoying Lv Yuxuan Zhou Haipeng Wang Sihao Zong Institute of RF-&OE-ICs Southeast University Co-innovation Center of Neuroregeneration Nantong University State Key Lab of Bioelectronics Southeast University

Hemiparesis is one of the most common consequences of stroke. Advanced rehabilitation techniques are essential for restoring motor function in hemiplegic patients. functional electrical stimulation applied to the affected limb based on myoelectric signal from the unaffected limb is a promising therapy for hemiplegia. In this study, we developed a prototype system for evaluating this novel functional electrical stimulation-control strategy. Based on surface electromyography and a vector machine model, a self-administered, muki-movement, force-modulation functional electrical stimulation-prototype system for hemiplegia was implemented. This paper discusses the hardware design, the algorithm of the system, and key points of the self-oscillation-prone system. The experimental results demonstrate the feasibility of the prototype system for further clinical trials, which is being conducted to evaluate the efficacy of the proposed rehabilitation technique.

关键词： nerve regeneration stroke motor function rehabilitation functional electrical stimulation surface electromyography stimulator circuit neural regeneration

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Therapeutic effectiveness of a single exercise session combined with WalkAide functional electrical stimulation in post-stroke patients:a crossover design study

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Neural Regeneration Research 2021年第5期16卷 805-812页

作者： Viviane Rostirola Elsner Lucieli Trevizol Isadora de Leon Marcos da Silva ThaynáWeiss Milena Braga Daniela Pochmann Amanda Stolzenberg Blembeel Caroline Dani Elenice Boggio Curso de Fisioterapia do Centro Universitário Metodista-IPA Porto AlegreRSBrasil Programa de Pós-Graduação em Biociências e Reabilitação do Centro Universitário Metodista-IPA Porto AlegreRSBrasil Programa de Pós-Graduação em Ciências Biológicas:Fisiologia Universidade Federal do Rio Grande do SulPorto AlegreRSBrasil

A growing body of evidence has suggested that the imbalance of epigenetic markers and oxidative stress appears to be involved in the pathophysiology and progression of stroke.Thus,strategies that modulate these biomarkers might be considered targets for neuroprotection and novel therapeutic opportunities for these patients.Physical exercise has been reported to induce changes in these epigenetic markers and improve clinical outcomes in different populations.However,little is reported on this in post-stroke patients.The purpose of this study was to investigate the effect of a single exercise session with WalkAide functional electrical stimulation(FES)on cognitive performance,clinical functional parameters,oxidative stress and epigenetic modulation in post-stroke individuals.In this crossover design study,12 post-stroke individuals aged 54–72 years of either sexes were included and subjected to a single session of exercise(45 minutes)without WalkAide functional electrical stimulation(EXE alone group),followed by another single session of exercise(45 minutes)with WalkAide functional electrical stimulation(EXE+FES group).The clinical functional outcome measures,cognitive performance and blood collections for biomarker measurements were assessed pre-and post-intervention.After intervention,higher Berg Balance Scale scores were obtained in the EXE+FES group than in the EXE alone group.There was no significant difference in the Timed Up and Go test results post-intervention between EXE alone and EXE+FES groups.After intervention,a better cognitive performance was found in both groups compared with before the intervention.After intervention,the Timed Up and Go test scores were higher in the EXE+FES group than in the EXE alone group.In addition,the intervention induced lower levels of lipid peroxidation.After intervention,carbonyl level was lower,superoxide dismutase activity and superoxide dismutase/catalase activity ratio were higher in the EXE+FES group,compared with the EXE group alone.In each group,both histone deace

关键词： cognition epigenetic exercise functional electrical stimulation functional mobility oxidative stress stroke WalkAide

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EEG-controlled functional electrical stimulation rehabilitation for chronic stroke:system design and clinical application

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Frontiers of Medicine 2021年第5期15卷 740-749页

作者： Long Chen Bin Gu Zhongpeng Wang Lei Zhang Minpeng Xu Shuang Liu Feng He Dong Ming Neural Engineering&Rehabilitation Laboratory Department of Biomedical EngineeringCollege of Precision Instruments and Optoelectronics EngineeringTianjin UniversityTianjin 300072China Academy of Medical Engineering and Translational Medicine Tianjin UniversityTianjin 300072China

Stroke is one of the most serious diseases that threaten human life and health.It is a major cause of death and disability in the clinic.New strategies for motor rehabilitation after stroke are undergoing exploration.We aimed to develop a novel artificial neural rehabilitation system,which integrates brain--computer interface(BCI)and functional electrical stimulation(FES)technologies,for limb motor function recovery after stroke.We conducted clinical trials(including controlled trials)in 32 patients with chronic stroke.Patients were randomly divided into the BCI-FES group and the neuromuscular electrical stimulation(NMES)group.The changes in outcome measures during intervention were compared between groups,and the trends of ERD values based on EEG were analyzed for BCI-FES group.Results showed that the increase in Fugl Meyer Assessment of the Upper Extremity(FMA-UE)and Kendall Manual Muscle Testing(Kendall MMT)scores of the BCI-FES group was significantly higher than that in the sham group,which indicated the practicality and superiority of the BCI-FES system in clinical practice.The change in the laterality coefficient(LC)values based onμ-ERD(ΔLCm-ERD)had high significant positive correlation with the change in FMA-UE(r=0.6093,P=0.012),which provides theoretical basis for exploring novel objective evaluation methods.

关键词： brain-computer interface functional electrical stimulation electroencephalogram laterality coefficient chronic stroke

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A Survey of Lower Limb Rehabilitation Systems and Algorithms Based on functional electrical stimulation

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Computers, Materials & Continua 2020年第1期62卷 281-292页

作者： Mingxu Sun Xueyan Wu Qi Liu Centre for Health Sciences Research University of SalfordThe CrescentSalfordM54WTUK Jiangsu Collaborative Innovation Center of Atmospheric Environment and Equipment Technology(CICAEET) Nanjing University of Information Science&TechnologyNanjing210044China School of Computing Edinburgh Napier University10 Colinton RoadEdinburgh EH105DTUK

functional electrical stimulation is a method of repairing a dysfunctional limb in a stroke patient by using low-intensity electrical stimulation.Currently,it is widely used in smart medical treatment for limb rehabilitation in stroke patients.In this paper,the development of FES systems is sorted out and analyzed in a time order.Then,the progress of functional electrical stimulation in the field of rehabilitation is reviewed in details in two aspects,i.e.,system development and algorithm progress.In the system aspect,the development of the first FES control and stimulation system,the core of the lower limb-based neuroprosthesis system and the system based on brain-computer interface are introduced.The algorithm optimization for control strategy is introduced in the algorithm.Asynchronous stimulation to prolong the function time of the lower limbs and a method to improve the robustness of knee joint modeling using neural networks.Representative applications in each of these aspects have been investigated and analyzed.

关键词： functional electrical stimulation lower limb systems algorithms rehabilitation

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Observation of the Effect of Gait-induced functional electrical stimulation on Stroke Patients with Foot Drop

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Journal of Advances in Medicine Science 2022年第1期5卷 12-18页

作者： Anqi Zhang Mengjiao Wu Luxi Mao Qianhuan Zhang Bingqian Zhou Jingxin Wang Zhengzhou Central Hospital Affiliated to Zhengzhou University ZhengzhouHenan450000China

Objective:To explore the effects of functional electrical stimulation and functional mid frequency electrical stimulation on lower limb function and balance function in stroke patients.Methods:20 cases of stroke patients with foot drop after admission were randomly divided into the observation group and the control group,10 cases in each group.On the basis of the two groups of patients,the observation group used the gait induced functional electrical stimulation to stimulate the peroneal nerve and the pretibial muscle in the observation group.The control group used the computer medium frequency functional electrical stimulation to stimulate the peroneal nerve and the anterior tibial muscle for 2 weeks.Before and after treatment,the lower extremity simple Fugl-Meyer scale(FMA),the Berg balance scale(BBS)and the improved Ashworth scale were evaluated respectively,and the comparative analysis was carried out in the group and between the groups.Results:After 2 weeks of treatment,the scores of FMA and BBS in the two groups were significantly higher than those before the treatment(Pfunctional electrical stimulation or computer intermediate frequency functional electrical stimulation can significantly improve lower limb function and balance function in patients with ptosis,and the therapeutic effect of functional electrical stimulation combined with gait is better.

关键词： Foot drop functional electrical stimulation Lower limb function Balance function

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Development of a functional electrical stimulation system base on the body area network for stroke and SCI rehabilitation

Development of a functional electrical stimulation system ba...

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中国神经科学学会第九届全国学术会议暨第五次会员代表大会

作者： Hong-En QU,Ting WANG,Ning LAN~* The Institute of Rehabilitation Engineering,The Med-X Research Institute,School of Biomedical Engineering, Shanghai Jiao Tong University,Shanghai 200030,China

＜正＞Objective This paper describes a functional electrical stimulation（FES） system based on the body area network（BAN） for helping the stroke survivors and SCI patients in the rehabilitation.This FES system not only has very high performance to perform the stimulation and control deciding required in the application of relearning or restoring the motor function,but also has the high flexibility to expand to other related clinical applications such as the medical monitoring platform and rehabilitation robotic.Methods To achieve the aim,we design three main hardware components of the networked FES system including a master unit（MU）,a distributed stimulation-sensor unit（DSSU）,and a clinical computer.And we also develop a Body Area Network and use it to organize the whole FES system following the network management.The MU as the controller of this system manages all distributed stimulation-sensor units as the stimulation channels as the network node in BAN.In this structure,the FES system can conveniently provide the multi-channel preprogrammed stimulation current at the same time.Results We have completed a prototype of system including the hardware and software developments.The test of the FES system shows that the stimulation current amplitude ranges from 1 mA to 58 mA and that the stimulation pulse width can be from 10μs to 1 000μs with 1 us resolution.Conclusion The evaluation test indicates that the system performance meets design specifications.The BAN FES system has been designed and tested for feasibility.The MU and DSSU design in the networked FES system is proposed and a prototype has been constructed and tested in laboratory.

关键词： functional electrical stimulation body area network motor rehabilitation

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Effects of functional electrical stimulation on bFGF and endogenous neural stem cell proliferation in brain of rats with acute cerebral infarction

Effects of functional electrical stimulation on bFGF and end...

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中国神经科学学会第四次会员代表大会暨第八届全国学术会议

作者： Yun XIANG~1,Zhi-Qiang ZHUANG~1,Tie-Bin YAN~(1,*),Dong-Mei JIN~1,Yuan PENG~1 1 Department of Rehabilitation Medicine,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,510120, China

Objective To investigate the therapeutic effects of functional electrical stimulation(FES) on the behavior of rats and the impact of FES on endogenous neural stem cells(NSC) in hippocampal dentate gyrus and subventricular zone of rats with permanent cerebral infarction.Methods One hundred and eight rats were randomly allocated into FES group, placebo stimulation group and sham-operated group(36 rats/each group).Following the surgery of middle cerebral artery occlusion(MCAO),rats in FES group were treated with FES device for 3 d,7 d or 14 d(10min/d) while ones in placebo stimulation group were treated with the same device but without electricity and rats in sham-operated group which subjected to middle cerebral artery occlusion(MCAO) surgery without filament occlusion got nothing special treatment. At each assessment point,behavioral function evaluation(beam-walking test,rotated pole test and prehensile traction test) were carried out and nestin positive cells in the hippocampus and subventricular zone were observed under microscope while protein expression level of basic fibroblast growth factor(bFGF) was measured by western blot analysis and gene transcript of bFGF was also detected by RT-PCR analysis.Results Rats in FES group exhibited a significantly improved performance in prehensile traction test at 14 d after FES treatment when it was compared to placebo stimulation group(Pstimulation group at 7 d and 14 d(P<0.05) while the protein expression level and gene transcript of bFGF were also up-regulated significantly at 7 d and 14 d after FES treatment(P<0.05). Conclusions FES could facilitate the behavioral function recovery of the paralyzed limbs and promote proliferation of endogenous NSCs which could be one of the mechanisms of FES to activate the neuronal plasticity in the brain of rats with permanent cerebral infarction.

关键词： functional electrical stimulation neural stem cell nestin cerebral infarction rat

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