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Advances of Neurorehabilitation and the Neural Basis

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A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Neuroscience and Neural Engineering".

Deadline for manuscript submissions: closed (20 January 2023) | Viewed by 7252

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Special Issue Editor

Prof. Dr. Shigeru Obayashi

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Guest Editor

Department of Rehabilitation Medicine, Saitama Medical University Saitama Medical Center, Kawagoe 350-8550, Japan
Interests: neuromoduration; neuromuscular electrical simuration; repetitive peripheral magnetic stimulation; tDCS; rTMS; neural plasticity

Special Issue Information

Dear Colleagues,

Nowadays, neuromodulation technologies, such as neuromuscular electrical stimulation (NMES), repetitive peripheral magnetic stimulation (rPMS), repetitive transcranial magnetic stimulation (rTMS), and transcranial direct current stimulation (t-DCS), play an important part in the neurorehabilitation management of patients suffering from a wide range of pathologies (stroke, spinal cord injuries, traumatic brain injuries, spasticity, dysphagia, etc.). A new type of rPMS has recently appeared, which is easier to handle than the conventional one with a round coil or figure of 8. In addition, the possibility of a brain–machine interface combined with NMES applied to tetraplegia after spinal cord injury has been demonstrated. Additionally, there is increasing evidence of the beneficial effect of neuromodulation techiniques in improvement of different disabilities. However, it remains unclear how neuromodulation techniques could facilitate improvements in disabilities. Given that recovery of motor paresis after stroke and tetraplegia due to spinal cord injury has been closely associated with cortical reorganization in the brain, it is plausible that neuromodulation might enhance the plastic change.

This Special Issue on “Advances of Neurorehabilitation and the Neural Basis” will explore the implementations and future prospects of the techniques. In this Special Issue, we would like to share concerns for heterogeneous stimulus conditions among studies and discuss possible neural mechanism underlying the benefit of neuromodulation. Our ultimate goal is to conquer disabilities, which is realized by maximizing the benefit of neuromodulation techniques, and it is why we should investigate further the possible neural mechanisms as well as the pros and cons of the techniques.

Prof. Dr. Shigeru Obayashi
Guest Editors

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Keywords

neuromoduration
neuromuscular electrical simuration
repetitive peripheral magnetic stimulation
tDCS
rTMS
neural plasticity

Published Papers (4 papers)

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Research

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8 pages, 3509 KiB

Open AccessCommunication

Kinematic Analysis for Repetitive Peripheral Magnetic Stimulation of the Intrinsic Muscles of the Hand

by Kenta Fujimura, Hitoshi Kagaya and Hiroki Tanikawa

Appl. Sci. 2022, 12(18), 9015; https://0-doi-org.brum.beds.ac.uk/10.3390/app12189015 - 08 Sep 2022

Cited by 1 | Viewed by 1157

Abstract

The intrinsic muscles of the hand are responsible for finger flexion and extension. The purpose of this study was to investigate the usefulness of stimulating the intrinsic muscles of the hand using repetitive peripheral magnetic stimulation (rPMS). We evaluated angular changes in the finger joints by studying active motion and rPMS. Ten healthy adults were instructed to perform the following tests in random order: (1) maximum active metacarpophalangeal joint flexion; (2) maximum active metacarpophalangeal joint abduction; and (3) repetitive peripheral magnetic stimulation for 2 s at maximum stimulation intensity. A three-dimensional motion analysis system was used to measure angular changes. Pain during stimulation was graded on a numerical rating scale (NRS). The maximum flexion and abduction of the metacarpophalangeal joint were not significantly different between active motion and rPMS. The proximal interphalangeal joint (p = 0.009) and distal interphalangeal joint (p = 0.005) were significantly extended by rPMS. The median NRS score for pain during rPMS was 2. rPMS can produce the same extent of metacarpophalangeal joint flexion and abduction as active movement with less pain. This technique can effectively stimulate the intrinsic muscles of the hand and may be used as a treatment for various diseases that cause immobility of the metacarpophalangeal joints. Full article

(This article belongs to the Special Issue Advances of Neurorehabilitation and the Neural Basis)

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12 pages, 870 KiB

Open AccessFeature PaperArticle

Implicit Body Representation of the Hand Enlarged by Repetitive Peripheral Magnetic Stimulation within the Boundary of a Real Hand

by Yunxiang Xia, Tatsuma Okazaki, Kenya Uemura and Shinichi Izumi

Appl. Sci. 2022, 12(10), 5250; https://0-doi-org.brum.beds.ac.uk/10.3390/app12105250 - 23 May 2022

Cited by 1 | Viewed by 1273

Abstract

Deafferentation induced by local anesthesia causes a larger perceived area than the real area of the mouth, which, in the perspective of body representation, belongs to implicit body representation. In this study, we applied repetitive peripheral magnetic stimulation (rPMS) on the motor branch of the radial nerve of participants’ non-dominant-side forearm to induce extension movements of wrist and fingers. This intervention was supposed to increase proprioception to the brain and had an enlargement effect on implicit body representation of the hand in our hypothesis. A total of 39 participants were randomly allocated to the real rPMS group (n = 19) or the sham rPMS group (n = 20). Implicit representation of the hand was measured by a simplified paradigm based on the proposal of Longo and Haggard that depicted perceived locations of fingertips and metacarpophalangeal joints of participants’ occluded hand, in which they showed that implicit body representation of the hand was smaller than the real hand. We compare the main effect of real rPMS vs. sham rPMS and its interaction effect with time by setting four timepoints—before stimulation, right after stimulation, 10 min after stimulation and 20 min after stimulation—to demonstrate the possible short-lasting effect. Results showed that real rPMS had a short-lasting enlargement effect on implicit representation of the hand in general, which was significant especially on the ulnar side of fingers. What is more, the enlarged implicit body representation of the hand was still within the boundary of a real hand, which might indicate the identification role of a real body part. Full article

(This article belongs to the Special Issue Advances of Neurorehabilitation and the Neural Basis)

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Review

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11 pages, 1527 KiB

Open AccessFeature PaperReview

Advanced Equipment Development and Clinical Application in Neurorehabilitation for Spinal Cord Injury: Historical Perspectives and Future Directions

by Yuji Kasukawa, Yoichi Shimada, Daisuke Kudo, Kimio Saito, Ryota Kimura, Satoaki Chida, Kazutoshi Hatakeyama and Naohisa Miyakoshi

Appl. Sci. 2022, 12(9), 4532; https://0-doi-org.brum.beds.ac.uk/10.3390/app12094532 - 29 Apr 2022

Cited by 2 | Viewed by 2040

Abstract

Partial to complete paralysis following spinal cord injury (SCI) causes deterioration in health and has severe effects on the ability to perform activities of daily living. Following the discovery of neural plasticity, neurorehabilitation therapies have emerged that aim to reconstruct the motor circuit of the damaged spinal cord. Functional electrical stimulation (FES) has been incorporated into devices that reconstruct purposeful motions in the upper and lower limbs, the most recent of which do not require percutaneous electrode placement surgery and thus enable early rehabilitation after injury. FES-based devices have shown promising results for improving upper limb movement, including gripping and finger function, and for lower limb function such as the ability to stand and walk. FES has also been employed in hybrid cycling and rowing to increase total body fitness. Training using rehabilitation robots is advantageous in terms of consistency of quality and quantity of movements and is particularly applicable to walking training. Initiation of motor reconstruction at the early stage following SCI is likely to advance rapidly in the future, with the combined use of technologies such as regenerative medicine, brain machine interfaces, and rehabilitation robots with FES showing great promise. Full article

(This article belongs to the Special Issue Advances of Neurorehabilitation and the Neural Basis)

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18 pages, 3004 KiB

Open AccessReview

Neuromuscular Stimulation as an Intervention Tool for Recovery from Upper Limb Paresis after Stroke and the Neural Basis

by Shigeru Obayashi and Hirotaka Saito

Appl. Sci. 2022, 12(2), 810; https://0-doi-org.brum.beds.ac.uk/10.3390/app12020810 - 13 Jan 2022

Cited by 1 | Viewed by 2198

Abstract

Neuromodulators at the periphery, such as neuromuscular electrical stimulation (NMES), have been developed as add-on tools to regain upper extremity (UE) paresis after stroke, but this recovery has often been limited. To overcome these limits, novel strategies to enhance neural reorganization and functional recovery are needed. This review aims to discuss possible strategies for enhancing the benefits of NMES. To date, NMES studies have involved some therapeutic concerns that have been addressed under various conditions, such as the time of post-stroke and stroke severity and/or with heterogeneous stimulation parameters, such as target muscles, doses or durations of treatment and outcome measures. We began by identifying factors sensitive to NMES benefits among heterogeneous conditions and parameters, based on the “progress rate (PR)”, defined as the gains in UE function scores per intervention duration. Our analysis disclosed that the benefits might be affected by the target muscles, stroke severity and time period after stroke. Likewise, repetitive peripheral neuromuscular magnetic stimulation (rPMS) is expected to facilitate motor recovery, as already demonstrated by a successful study. In parallel, our efforts should be devoted to further understanding the precise neural mechanism of how neuromodulators make UE function recovery occur, thereby leading to overcoming the limits. In this study, we discuss the possible neural mechanisms. Full article

(This article belongs to the Special Issue Advances of Neurorehabilitation and the Neural Basis)

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