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Electro-acupuncture at Zusanli(ST 36) to improve lower extremity motor function in sensory disturbance patients with cerebral stroke A randomized controlled study of 240 cases

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Neural Regeneration Research 2009年第11期4卷 935-940页

作者： Weijun Gong Tong Zhang Lihua Cui YuqiYang Xinting Sun department of Neurological rehabilitation Beijing Boai Hospital China Rehabilitation Research Centre School of Rehabilitation MedicineCapital Medical University Beijing 100068 China

BACKGROUND： Studies have shown that sensory transduction is a way to introduce needle sensation. OBJECTIVE： To observe the influence of electro-acupuncture at the ＂Zusanll＂（ST 36） point on lower extremity motor function in various sensory disturbance patients with cerebral stroke. DESIGN, TIME AND SETTING： A randomized, controlled, clinical study was performed at the department of Neurological rehabilitation, China rehabilitation Research Centre from September 2006 to June 2008. PARTICIPANTS： Patients with first-time cerebral infarction or hemorrhage, or with a stroke history, but no neurodysfunction （single damage）, were selected for this study. The subjects were right-handed and disease state was stable. A total of 240 inpatients were randomly assigned to the following groups： electro-acupuncture （n = 124） and control （n = 116）. The two groups were further assigned into sub-groups： no sensory disturbance, superficial sensory disturbance, deep sensory disturbance, and deep and superficial sensory disturbance. METHODS： On the basis of routine limb function training, the acupoint Zusanliwas utilized in all patients from the electro-acupuncture group. Perpendicular acupuncture was 3.0-4.0 cm deep. An electric acupuncture instrument was connected when patients developed the needle sensation, deqi. A stimulation pattern consisting of distant and dense waves of 50 Hz was used to elicit slight dorsal foot extension. Acupuncture was administered 5 times per week, 30 minutes per session, for 6 weeks in total. MAIN OUTCOME MEASURES： FugI-Meyer assessment （FMA） was used to evaluate lower extremity motor function; Ver.1.0 gait analysis to estimate gait （step frequency, step speed, and step scope）; lower extremity Composite Spasticity Scale （CSS） to estimate muscle spastic degree. RESULTS： Following treatment, motor function improved in both groups. Compared with the control group, FMA score, step speed, step frequency, and step scope were increased in the electro-acupuncture

关键词： electro-acupuncture Zusanli (ST 36) sensory disturbance motor function sensory input

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Environmental enrichment combined with fasudil treatment inhibits neuronal death in the hippocampal CA1 region and ameliorates memory deficits

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Neural Regeneration Research 2021年第8期16卷 1460-1466页

作者： Gao-Jing Xu Qun Zhang Si-Yue Li Yi-Tong Zhu Ke-Wei Yu Chuan-Jie Wang Hong-Yu Xie Yi Wu department of rehabilitation Medicine Huashan HospitalFudan UniversityShanghaiChina department of rehabilitation Medicine Jinshan Hospital of Fudan UniversityShanghaiChina

Currently, no specific treatment exists to promote recovery from cognitive impairment after a stroke. Dysfunction of the actin cytoskeleton correlates well with poststroke cognitive declines, and its reorganization requires proper regulation of Rho-associated kinase(ROCK) proteins. Fasudil downregulates ROCK activation and protects neurons against cytoskeleton collapse in the acute phase after stroke. An enriched environment can reduce poststroke cognitive impairment. However, the efficacy of environmental enrichment combined with fasudil treatment remains poorly understood. A photothrombotic stroke model was established in 6-week-old male C57 BL/6 mice. Twenty-four hours after modeling, these animals were intraperitoneally administered fasudil(10 mg/kg) once daily for 14 successive days and/or provided with environmental enrichment for 21 successive days. After exposure to environmental enrichment combined with fasudil treatment, the number of neurons in the hippocampal CA1 region increased significantly, the expression and proportion of p-cofilin in the hippocampus decreased, and the distribution of F-actin in the hippocampal CA1 region increased significantly. Furthermore, the performance of mouse stroke models in the tail suspension test and step-through passive avoidance test improved significantly. These findings suggest that environmental enrichment combined with fasudil treatment can ameliorate memory dysfunction through inhibition of the hippocampal ROCK/cofilin pathway, alteration of the dynamic distribution of F-actin, and inhibition of neuronal death in the hippocampal CA1 region. The efficacy of environmental enrichment combined with fasudil treatment was superior to that of fasudil treatment alone. This study was approved by the Animal Ethics Committee of Fudan University of China(approval No. 2019-Huashan Hospital JS-139) on February 20, 2019.

关键词： cognitive environment hippocampus injury neuroprotection pathway repair stroke

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Prospects for the application of transcranial magnetic stimulation in diabetic neuropathy

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Neural Regeneration Research 2021年第5期16卷 955-962页

作者： Xi Xu Dong-Sheng Xu department of rehabilitation Medicine Affiliated Hospital of Nantong UniversityNantongJiangsu ProvinceChina department of rehabilitation Medicine Yueyang Hospital of Integrated Traditional Chinese and Western MedicineShanghaiChina School of rehabilitation Science Shanghai University of Traditional Chinese MedicineShanghaiChina

Encouraging results have been reported for the use of transcranial magnetic stimulationbased nerve stimulation in studies of the mechanisms of neurological regulation,nerve injury repair,and nerve ***,to date,there are only a few reviews on the use of transcranial magnetic stimulation for diabetic *** with diabetic neuropathy vary in disease progression and show neuropathy in the early stage of the disease with mild symptoms,making it difficult to screen and *** the later stage of the disease,irreversible neurological damage occurs,resulting in treatment *** this review,we summarize the current state of diabetic neuropathy research and the prospects for the application of transcranial magnetic stimulation in diabetic *** review significant studies on the beneficial effects of transcranial magnetic stimulation in diabetic neuropathy treatment,based on the outcomes of its use to treat neurodegeneration,pain,blood flow change,autonomic nervous disorders,vascular endothelial injury,and ***,the studies suggest that transcranial magnetic stimulation can produce excitatory/inhibitory stimulation of the cerebral cortex or local areas,promote the remodeling of the nervous system,and that it has good application prospects for the localization of the injury,neuroprotection,and the promotion of nerve ***,transcranial magnetic stimulation is useful for the screening and early treatment of diabetic *** magnetic stimulation can also alleviate pain symptoms by changing the cortical threshold and inhibiting the conduction of sensory information in the thalamo-spinal pathway,and therefore it has therapeutic potential for the treatment of pain and pain-related depressive symptoms in patients with diabetic ***,based on the effect of transcranial magnetic stimulation on local blood flow and its ability to change heart rate and urine protein conten

关键词： autonomic neuropathy central nervous system depression inflammation oxidative stress pain peripheral nerve plasticity recovery regeneration vascular

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Effectiveness of oral motor respiratory exercise and vocal intonation therapy on respiratory function and vocal quality in patients with spinal cord injury:a randomized controlled trial

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Neural Regeneration Research 2021年第2期16卷 375-381页

作者： Xiao-Ying Zhang Yi-Chuan Song Chang-Bin Liu Chuan Qin Song-Huai Liu Jian-Jun Li School of rehabilitation Medicine Capital Medical UniversityBeijingChina China rehabilitation Science Institute BeijingChina Beijing Key Laboratory of Neural Injury and rehabilitation BeijingChina Center of Neural Injury and Repair Beijing Institute for Brain DisordersBeijingChina Music Therapy Center Department of PsychologyChina Rehabilitation Research CenterBeijingChina department of rehabilitation Medicine Beijing Tiantan HospitalCapital Medical UniversityBeijingChina department of Spinal and Neural Functional Reconstruction China Rehabilitation Research CenterBeijingChina

Singing,as a method of combining respiratory function exercise and vocal intonation therapy,provides a new direction for respiratory function exercise in patients with spinal cord *** randomized controlled trial investigated the effects of oral motor respiratory exercise and vocal intonation therapy on respiratory function and vocal quality in patients with spinal cord *** 31 included patients with spinal cord injury,18 completed the *** 18 patients were randomly assigned to undergo music therapy(intervention group,30 min/d,5 times a week,for a total of 12 weeks;n=9,7 males and 2 females;30.33±11.74 years old)or normal respiratory training(control group,n=9;8 males and 1 female;34.78±11.13 years old).Both patient groups received routine treatment *** and at 6 and 12 weeks after intervention,a standard respiratory function test,a voice test,the ***'s Respiratory Questionnaire,and a quality of life questionnaire were *** results showed that the inspiratory capacity,forced expiratory volume in 1 second,forced vital capacity,maximal mid-expiratory flow rate,sing-loud pressure level,and sustained note length were significantly increased in the intervention group compared with the control *** ***'s Respiratory Questionnaire and quality of life results of patients in the intervention group were significantly superior to those in the control *** findings suggest that oral motor respiratory exercise and vocal intonation therapy,as respiratory training methods in music therapy,are effective and valuable for improving respiratory dysfunction and vocal quality in patients with spinal cord *** study was approved by the Ethics Committee of China rehabilitation Research Center(approval No.2019-78-1)on May 27,2019 and was registered with the Chinese Clinical Trial Registry(registration number:Chi CTR1900026922)on October 26,2019.

关键词： central nervous system clinical trial injury oral motor randomized repair respiratory exercise spinal cord

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Effects of Repetitive Transcranial Magnetic Stimulation on Astrocytes Proliferation and nNOS Expression in Neuropathic Pain Rats

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Current Medical Science 2018年第3期38卷 482-490页

作者： Lu YANG Sai-hua WANG Yan HU Yan-fang SUI Tao PENG Tie-cheng GUO department of rehabilitation Medicine Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 China department of rehabilitation Medicine Hankou Hospital Wuhan 430014 China department of rehabilitation Medicine Wuhan FirstHospital Wuhan 430022 China department of rehabilitation Medicine Zhongnan Hospital of Wuhan University Wuhan 430071 China department of rehabilitation Medicine Haikou Hospital Haikou 570208 China

This study investigated the effects of different frequencies of repetitive transcranial magnetic stimulation （rTMS） on chronic neuropathic pain in rats. The behavior of rats with experimental chronic neuropathic pain was observed, and the expression of neuronal nitric oxide synthase （nNOS） in the ipsilateral dorsal root ganglions （DRGs） and the activation and proliferation of astrocytes in the ipsilateral spinal dorsal horn were detected. Thirty-two male Sprague-Dawley rats were randomly divided into four groups： sham-operated group, sham-rTMS group, 1 Hz group and 20 Hz group （8 rats in each group）. Chronic constriction nerve injury induced by sciatic nerve ligation was made to establish the models of the chronic neuropathic pain in rats except those in the sham-operated group. Then we applied different frequencies of rTMS to the primary motor cortex （M1） contralateral to the pain side once daily for 10 consecutive days. Pain behavior scores were observed before and after treatment. Western blot analysis was used to detect the expression of nNOS in ipsilateral L4-6 DRGs. Double immunofluorescent labeling for glial fibrillary acidic protein （GFAP） and 5-bromo-2- deoxyuridine （BrdU） was employed to observe the activation and proliferation of astrocytes in the ipsilateral L4-6 spinal dorsal horn. After rTMS treatment, the spontaneous pain behavior scores were significantly lower in the 20 Hz group than those in the sham-rTMS group （P〈0.05）. Moreover, the brush-evoked pain behavior scores were significantly lower in the 20 Hz group than those in the sham-rTMS and 1 Hz group （P〈0.05）, suggesting that the spontaneous pain and brush-evoked pain in the 20 Hz group were significantly alleviated. Western blot analysis revealed that the expression of nNOS in ipsilateral L4-6 DRGs was significantly decreased in the 20 Hz group as compared with the sham-rTMS group and the 1 Hz group （P〈0.01） after rTMS treatment. Double immunofluorescence suggested that the expression of GFAP a

关键词： neuropathic pain repetitive transcranial magnetic stimulation neuronal nitric oxide synthase astrocyte glial fibrillary acidic protein 5-bromo-2-deoxyuridine

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Significant improvement after sensory tricks and trunk strength training for Parkinson’s disease with antecollis and camptocormia:A case report

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World Journal of Clinical Cases 2024年第2期12卷 443-450页

作者： Jia-Ren Wang Yue Hu department of Neurology and Neurological rehabilitation Shanghai Yangzhi Rehabilitation Hospital(Shanghai Sunshine Rehabilitation Center)Shanghai 201619China

BACKGROUND Patients with Parkinson's disease(PD)exhibit symptoms such as antecollis(AC)and camptocormia(CC).The pathology of these two conditions is ***,standard treatment methods have not been *** article reports the case of a 65-year-old female patient with AC and CC who was treated with central and peripheral interventions to alleviate *** SUMMARY We present the case of a 65-year-old female PD patient with AC and *** course of the disease was 5 *** was treated with rehabilitation strategies such as sensory tricks and trunk strength *** the inpatient period,we compared and analyzed the patient's gait,rehabilitation assessment scale score,and angles of her abnormal trunk posture in the first week,the third week,and the fifth *** patient's stride length increased,indicating that the patient's walking ability was *** Unified Parkinson's Disease Scale Part Three score and CC severity score ***,the score of the other scale *** addition,the patient showed significant improvements in AC,upper CC,and lower CC *** This case study suggested that sensory tricks and trunk strength training are beneficial and safe for patients with AC and CC.

关键词： Antecollis Camptocormia Parkinson's disease Sensory tricks Trunk strength training Case report

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Traditional Chinese Medicine comprehensive therapy for the improvement of motor function in spinal cord injury patients

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Journal of Traditional Chinese Medicine 2016年第5期36卷 618-624页

作者： Wang Yuanhui Zhang Lei Pan Guodong Liu Jing Zhang Hongrui Song Xu Wang Qiang Clinical Medical School Jining Medical University department of rehabilitation Medicine the Affiliated Hospital of Jining Medical University department of rehabilitation Medicine the Affiliated Hospital of Qingdao University

OBJECTIVE: To study the effect of early comprehensive therapy of Traditional Chinese Medicine(TCM) on motor function of in patients with spinal cord ***: Fifty-one standard spinal cord injury patients with paraplegia were randomly assigned to an experimental or control group. The experimental group received TCM comprehensive therapy, and the control group received modern Western Medicine(WM) treatment for 4 weeks. The motor score(MS), Barthel Index(BI) and American Spinal Injury Association(ASIA) grading were measured in both groups before and after ***: After treatment, the MS and BI scores of the TCM comprehensive therapy group improved significantly(P 0.05). The differences between the experimental and control groups after treatment were not significant(P > 0.05).CONCLUSION: Early TCM comprehensive therapy is an effective method for improving motor function in patients with spinal cord injury.

关键词： Spinal cord injuries Medicine Chinese traditional treatment outcome

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Neuroimaging mechanisms of high-frequency repetitive transcranial magnetic stimulation for treatment of amnestic mild cognitive impairment:a double-blind randomized sham-controlled trial

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Neural Regeneration Research 2021年第4期16卷 707-713页

作者： Li-Qiong Yuan Qing Zeng Dan Wang Xiu-Yun Wen Yu Shi Fen Zhu Shang-Jie Chen Guo-Zhi Huang department of rehabilitation Medicine and Physiotherapy Zhujiang Hospital of Southern Medical UniversityGuangzhouGuangdong ProvinceChina department of rehabilitation Medicine and Physiotherapy Shenzhen Baoan Hospital of Southern Medical UniversityShenzhenGuangdong ProvinceChina rehabilitation School of Southern Medical University GuangzhouGuangdong ProvinceChina

Individuals with amnestic mild cognitive impairment(aMCI)have a high risk of developing Alzheimer’s *** repetitive transcranial magnetic stimulation(rTMS)is considered a potentially effective treatment for cognitive impairment in patients with aMCI,the neuroimaging mechanisms are poorly ***,we performed a double-blind randomized sham-controlled trial in which rTMS was applied to the left dorsolateral prefrontal cortex of aMCI patients recruited from a community near the Third Hospital Affiliated to Sun Yat-sen University,***-four patients with aMCI were randomly assigned to receive true rTMS(treatment group,n=12,6 men and 6 women;age 65.08±4.89 years)or sham stimulation(sham group,n=12,5 men and 7 women;age 64.67±4.77 years).rTMS parameters included a stimulation frequency of 10 Hz,stimulation duration of 2 seconds,stimulation interval of 8 seconds,20 repetitions at 80%of the motor threshold,and 400 pulses per ***/sham stimulation was performed five times per week over a period of 4 consecutive *** results showed that compared with baseline,Montreal Cognitive Assessment scores were significantly increased and the value of the amplitude of low-frequency fluctuation(ALFF)was significantly increased at the end of treatment and 1 month after *** with the sham group,the ALFF values in the right inferior frontal gyrus,triangular part of the inferior frontal gyrus,right precuneus,left angular gyrus,and right supramarginal gyrus were significantly increased,and the ALFF values in the right superior frontal gyrus were significantly decreased in the treatment *** findings suggest that high-frequency rTMS can effectively improve cognitive function in aMCI patients and alter spontaneous brain activity in cognitive-related brain *** study was approved by the Ethics Committee of Shenzhen Baoan Hospital of Southern Medical University,China(approval ***20190901)on September 3,2019 and registered

关键词： Alzheimer’s disease clinical trial cognitive function cognitive impairment functional magnetic resonance imaging neurological function repetitive transcranial magnetic stimulation

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Electroacupuncture improves learning and memory functions in a rat cerebral ischemia/reperfusion injury model through PI3K/Akt signaling pathway activation

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Neural Regeneration Research 2021年第6期16卷 1011-1016页

作者： Hui-Ling Wang Fei-Lai Liu Rui-Qing Li Ming-Yue Wan Jie-Ying Li Jing Shi Ming-Li Wu Jun-Hua Chen Wei-Juan Sun Hong-Xia Feng Wei Zhao Jin Huang Ren-Chao Liu Wen-Xue Hao Xiao-Dong Feng rehabilitation Center the First Affiliated Hospital of Henan University of Traditional Chinese MedicineZhengzhouHenan ProvinceChina department of rehabilitation Medicine Fujian University of Chinese MedicineFuzhouFujian ProvinceChina department of rehabilitation Medicine Henan University of Chinese MedicineZhengzhouHenan ProvinceChina

Electroacupuncture has been widely used to treat cognitive impairment after cerebral ischemia,but the underlying mechanism has not yet been fully *** have shown that autophagy plays an important role in the formation and development of cognitive impairment,and the phosphoinositide 3-kinase(PI3K)/Akt signaling pathway plays an important role in autophagy *** investigate the role played by the PI3K/Akt signaling pathway in the electroacupuncture treatment of cerebral ischemia/reperfusion rat models,we first established a rat model of cerebral ischemia/reperfusion through the occlusion of the middle cerebral artery using the suture *** at 2 hours after modeling,electroacupuncture was delivered at the Shenting(GV24)and Baihui(GV20)acupoints,with a dilatational wave(1-20 Hz frequency,2 mA intensity,6 V peak voltage),for 30 minutes/day over 8 consecutive *** results showed that electroacupuncture reduced the infarct volume in a rat model of cerebral ischemia/reperfusion injury,increased the mRNA expression levels of the PI3K/Akt signaling pathwayrelated factors Beclin-1,mammalian target of rapamycin(mTOR),and PI3K,increased the protein expression levels of phosphorylated Akt,Beclin-1,PI3K,and mTOR in the ischemic cerebral cortex,and simultaneously reduced p53 mRNA and protein expression *** the Morris water maze test,the latency to find the hidden platform was significantly shortened among rats subjected to electroacupuncture stimulation compared with rats without electroacupuncture *** the spatial probe test,the number of times that a rat crossed the target quadrant was increased in rats subjected to electroacupuncture stimulation compared with rats without electroacupuncture *** stimulation applied to the Shenting(GV24)and Baihui(GV20)acupoints activated the PI3K/Akt signaling pathway and improved rat learning and memory *** study was approved by the Animal Ethics Committee

关键词： acupuncture brain central nervous system factor neurological function pathways protein stroke

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Increased activation of the caudate nucleus and parahippocampal gyrus in Parkinson's disease patients with dysphagia after repetitive transcranial magnetic stimulation:a case-control study

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Neural Regeneration Research 2022年第5期17卷 1051-1058页

作者： Pei-Ling Huang Song-Jian Wang Rui-Feng Sun Zi-Man Zhu Xiao-Ling Li Wen-Shan Li Meng-Yue Wang Meng Lin Wei-Jun Gong department of Neurological rehabilitation Beijing Rehabilitation Hospital of Capital Medical UniversityBeijingChina Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application School of Biomedical EngineeringCapital Medical UniversityBeijingChina department of Neurological rehabilitation Beijing Rehabilitation Medicine AcademyCapital Medical UniversityBeijingChina

Repetitive transcranial magnetic stimulation(r TMS)has been shown to effectively improve impaired swallowing in Parkinson's disease(PD)patients with ***,little is known about how r TMS affects the corresponding brain regions in this patient *** this casecontrol study,we examined data from 38 PD patients with dysphagia who received treatment at Beijing rehabilitation Medicine Academy,Capital Medical *** patients received high-frequency r TMS of the motor cortex once per day for 10 successive *** in brain activation were compared via functional magnetic resonance imaging in PD patients with dysphagia and healthy *** results revealed that before treatment,PD patients with dysphagia showed greater activation in the precentral gyrus,supplementary motor area,and cerebellum compared with healthy controls,and this enhanced activation was weakened after ***,before treatment,PD patients with dysphagia exhibited decreased activation in the parahippocampal gyrus,caudate nucleus,and left thalamus compared with healthy controls,and this activation increased after *** addition,PD patients with dysphagia reported improved subjective swallowing sensations after r *** findings suggest that swallowing function in PD patients with dysphagia improved after r TMS of the motor *** may have been due to enhanced activation of the caudate nucleus and parahippocampal *** study protocol was approved by the Ethics Committee of Beijing rehabilitation Hospital of Capital Medical University(approval No.2018 bkky017)on March 6,2018 and was registered with Chinese Clinical Trial Registry(registration *** CTR 1800017207)on July 18,2018.

关键词： brain regions caudate clinical trial dysphagia functional magnetic resonance imaging parahippocampal gyrus Parkinson's disease precentral gyrus repetitive transcranial magnetic stimulation saliva swallowing task

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