• Physical Therapy Korea
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• v.21 no.4
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• pp.1-8
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• 2014

Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity direct current to cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to investigate changes in various sensory functions after tDCS. We conducted a single-center, single-blinded, randomized trial to determine the effect of a single session of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies were performed in relation to the median sensory and motor nerves on the dominant hand to discriminate peripheral nerve lesions. The subjects received anodal tDCS with 1 mA for 15 minutes under two different conditions, with 25 subjects in each groups: the conditions were as follows tDCS on the primary motor cortex (M1) and sham tDCS on M1. We recorded the parameters of the CPT a with Neurometer$^{(R)}$ at frequencies of 2000, 250, and 5 Hz in the dominant index finger to assess the tactile sense, fast pain and slow pain, respectively. In the test to measure CPT values of the M1 in the tDCS group, the values of the distal part of the distal interphalangeal joint of the second finger statistically increased in all of 2000 Hz (p=.000), 250 Hz (p=.002), and 5 Hz (p=.008). However, the values of the sham tDCS group decreased in all of 2000 Hz (p=.285), 250 Hz (p=.552), and 5 Hz (p=.062), and were not statistically significant. These results show that M1 anodal tDCS can modulate sensory perception and pain thresholds in healthy adult volunteers. The study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.

• Journal of Korea Entertainment Industry Association
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• v.14 no.6
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• pp.269-277
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• 2020

The purpose of this study is to investigate the recovery of sensation and the restoration of upper limb function according to transcranial direct current stimulation over the primary somatosensory cortex in patients with chronic stroke with sensory deficit. 20 patients with chronic stroke divided into 10 experimental groups and 10 control groups. Patients received transcranial direct current stimulations over the primary somatosensory cortex on the side of the stroke lesion, and The control group applied sham tDCS to the same location. Intervention was conducted 5 times a week, 20 minutes per session for a total of 2 weeks. Assessment was performed using the Erasmus MC modifications to the Nottingham Sensory Assessment(EmNSA), Semmes-Weinstein monofilament examination(SWME) for somatosensory, and Fugle-Meyer Assessment(FMA), Motor Activity Log(MAL), and accelerometer for upper extremity function. Assessment was conducted before and after the intervention. As a result of the study, the experimental group showed a significant improvement in the overall tactile sense, proprioception, cortical sense, and perception sensitivity than the control group, and showed a statistically significant difference in the usage amount of the upper limb. Based on the results of this study, it is thought that the possibility of effective clinical application of transcranial direct current stimulation for recovery of somatosensory and upper extremity function is thought to be increased.

• The Journal of Korean Physical Therapy
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• v.22 no.5
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• pp.103-108
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• 2010

Purpose: The aim of this study is to investigate whether motor cortex excitability by transcranial direct current stimulation (tDCS) over primary motor cortex (M1) affects motor performance of serial reaction task. Methods: Cathodal, anodal and sham tDCS (1 mA) are applied over right M1 of 24 subjects for 30 minutes including 11minutes for task period time. We applied two electrodes at the same position to both an experimental group and a sham-controlled group, and we made 2 groups recognize to be applicated of stimulation. Flexion, extension of wrist and thumb flexion are carried out following colors of arrows on the monitor. Serial reaction time task was applied to confirm the difference of the reaction time between 2 groups. Results: Reaction time is decreased in both tDCS-group and Sham-controlled tDCS group, and the degree of reduction is much greater in the post-test than pre-test. Reduction of reaction time between groupsis statistically significant. Conclusion: We consider that anodal tDCS increased the cortical excitability of the underlying motor cortex and it can be helpful to modulate motor performance. It seems that tDCS is an effective modality to modulate brain function, and it will be great help to mediate strategy for the brain injury patients.

• Annals of Clinical Neurophysiology
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• v.1 no.2
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• pp.112-117
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• 1999

Background : Posterior tibial nerve somatosensory evoked potentials (PTSEP) have cortical potentials on primary sensory area of foot around 40 msec. The direct cortical recordings of the cortical potentials shows high voltage positive wave on medial hemisphere, especially on paracentral lobule (PCL). However, it is so difficult to record the potential directly on PCL that the cortical potential of PTSEP is not well understood. We investigated the cortical potential of PTSEP on subdural electrodes. Methods : We recorded cortical potentials to posterior tibial nerve stimulation on subdural electrodes which were on medial hemisphere near PCL in 15 intractable neocortical epilepsy patients. The numbers of subdural electrodes were 8 in 10 subjects ($1{\times}8array$) and 16 in 5 subjects ($2{\times}8arrays$). Seven subjects had three-dimensional imaging fusion (3D-fusion) of MRI and the electrodes using Analyze program. We investigated the amplitude, latency, polarity, and phase of the waves regarding location. Results : The waves had maximal amplitude on PCL in 4 subjects, precuneus in 1, cingulate gyrus nearest to PCL in 2 among 7 subjects with 3D-fusion. Also the electrodes were located on posterior area of PCL (2 out of 2 subjects with more than two electrodes put on PCL in 3D-fusion) and superior area of it (5 out of 5 subjects with $2{\times}8arrays $). All the high (more than 20 uV) amplitude around 40msec had positive polarity in 7 subjects. The phase reversals were detected between the electrodes with the highest amplitude and the just posterior (2 subjects) or anterior (6 subjects) located electrodes. The just posterior located electrodes had sharper phase reversal than the anterior one. Conclusion : PTSEP might have maximal amplitude of cortical potentials on the more superior and posterior area of PCL. The highest amplitude potential has positivity. The wave with maximal amplitude could have phase reversal of cortical potentials with surrounding electrodes, especially shaper with posterior part than with anterior one.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.1
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• pp.445-452
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• 2015

Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers a low-intensity direct current to the cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to examine the changes in various sensory functions after tDCS. A single-center, single-blinded, randomized trial was conducted to determine the effect of a single session (August 4 to August 29) of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies (NCS) were performed in relation to the median sensory and motor nerves on the dominant hand to discriminate peripheral nerve lesions. The subjects received anodal tDCS with 1mA for 15 minutes under two different conditions, with 25 subjects in each group. The conditions were as follows: tDCS on the dorsolateral prefrontal cortex (DLPFC) and sham tDCS on DLPFC. The parameters of the CPT was recorded with a Neurometer$^{(R)}$ at frequencies of 2000, 250 and 5 Hz in the dominant index finger to assess the tactile sense, fast pain and slow pain, respectively. In the test to measure the CPT values of the DLPFC in the anodal tDCS group, the values increased significantly in all of 250 and 5 Hz. All CPT values decreased for the sham tDCS. These results showed that DLPFC anodal tDCS can modulate the sensory perception and pain thresholds in healthy adult volunteers. This study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.2
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• pp.211-215
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• 2018

The aim of this study was to preserve the corticospinal tract during surgery and assess more accurately the motor performance in brain tumor patients around the motor cortex. TceMEP is not entirely reliable, even though there has been no change in waveforms due to a mixture of false positive and false negative signals. For a more detailed examination, DCS was employed to selectively stimulate the motor cortex. In both cases, the indications could find the region to which the cortex was responsible, and constantly check and examine the changes in amplitude, thereby preserving the motor pathway and performing surgery. On the other hand, patients who did not implement the DCS but did implement the TceMEP experienced a decrease in their postoperative motor performance. DCS is a very useful examination and it is a method that can reduce the post-surgery disorder that may occur in patients with the TceMEP in brain tumor surgery.

• Physical Therapy Korea
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• v.12 no.2
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• pp.73-80
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• 2005

We investigated the activation of the cerebral cortex during active movement, passive movement, and functional electrical stimulation (FES), which was provided on wrist extensor muscles. A functional magnetic resonance imaging study was performed on 5 healthy volunteers. Tasks were the extension of right wrist by active movement, passive movement, and FES at the rate of .5 Hz. The regions of interest were measured in primary motor cortex (M1), primary somatosensory cortex (SI), secondary somatosensory cortex (SII), and supplementary motor area (SMA). We found that the contralateral SI and SII were significantly activated by all of three tasks. The additional activation was shown in the areas of ipsilateral S1 (n=2), and contralateral (n=1) or ipsilateral (n=2) SII, and bilateral SMA (n=3) by FES. Ipsilateral M1 (n=1), and contralateral (n=1) or ipsilateral SII (n=1), and contralateral SMA (n=1) were activated by active movement. Also, Contralateral SMA (n=3) was activated by passive movement. The number of activated pixels on SM1 by FES ($12{\pm}4$ pixels) was smaller than that by active movement ($18{\pm}4$ pixels) and nearly the same as that by passive movement ($13{\pm}4$ pixels). Findings reveal that active movement, passive movement, and FES had a direct effect on cerebral cortex. It suggests that above modalities may have the potential to facilitate brain plasticity, if applied with the refined-specific therapeutic intervention for brain-injured patients.

• Journal of Korean Neurosurgical Society
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• v.61 no.3
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• pp.363-375
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• 2018

Intraoperative monitoring (IOM) utilizes electrophysiological techniques as a surrogate test and evaluation of nervous function while a patient is under general anesthesia. They are increasingly used for procedures, both surgical and endovascular, to avoid injury during an operation, examine neurological tissue to guide the surgery, or to test electrophysiological function to allow for more complete resection or corrections. The application of IOM during pediatric brain tumor resections encompasses a unique set of technical issues. First, obtaining stable and reliable responses in children of different ages requires detailed understanding of normal age-adjusted brain-spine development. Neurophysiology, anatomy, and anthropometry of children are different from those of adults. Second, monitoring of the brain may include risk to eloquent functions and cranial nerve functions that are difficult with the usual neurophysiological techniques. Third, interpretation of signal change requires unique sets of normative values specific for children of that age. Fourth, tumor resection involves multiple considerations including defining tumor type, size, location, pathophysiology that might require maximal removal of lesion or minimal intervention. IOM techniques can be divided into monitoring and mapping. Mapping involves identification of specific neural structures to avoid or minimize injury. Monitoring is continuous acquisition of neural signals to determine the integrity of the full longitudinal path of the neural system of interest. Motor evoked potentials and somatosensory evoked potentials are representative methodologies for monitoring. Free-running electromyography is also used to monitor irritation or damage to the motor nerves in the lower motor neuron level : cranial nerves, roots, and peripheral nerves. For the surgery of infratentorial tumors, in addition to free-running electromyography of the bulbar muscles, brainstem auditory evoked potentials or corticobulbar motor evoked potentials could be combined to prevent injury of the cranial nerves or nucleus. IOM for cerebral tumors can adopt direct cortical stimulation or direct subcortical stimulation to map the corticospinal pathways in the vicinity of lesion. IOM is a diagnostic as well as interventional tool for neurosurgery. To prove clinical evidence of it is not simple. Randomized controlled prospective studies may not be possible due to ethical reasons. However, prospective longitudinal studies confirming prognostic value of IOM are available. Furthermore, oncological outcome has also been shown to be superior in some brain tumors, with IOM. New methodologies of IOM are being developed and clinically applied. This review establishes a composite view of techniques used today, noting differences between adult and pediatric monitoring.

• Biomolecules & Therapeutics
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• v.13 no.1
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• pp.26-31
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• 2005

The present study examined effects of a water-soluble fraction from mulberry leaves (ML water fraction) on the circulatory and autonomic nervous systems, which were compared with those of acetylcholine (ACh) used as a reference drug in order to elucidate its mechanism of action. Intravenous administration of ACh or a ML water fraction produced temporary depressor and tachycardiac responses in a dose-dependent manner in unrestrained, conscious Sprague-Dawley rats. The systemic hemodynamic effects of ACh and a ML water fraction were almost completely blocked by pretreatment with atropine, a muscarinic antagonist. The depressor responses to ACh and a ML water fraction were slightly enhanced and prolonged by pretreatment with neostigmine, an anticholinesterase, whereas the tachycardiac responses were remarkably blocked by pretreatment with pentolinium, a ganglionic blocking agent. In vitro experiments using the ileum isolated from rats showed that ACh and a ML water fraction increased ileal contractility in a dose-dependent manner. The increases in ileal contractility were also completely abolished in the presence of atropine. Finally, the specific binding of [$^3H$]quinuclidinyl benzilate, a muscarinic antagonist, to rat cortical synaptic membranes was inhibited by a ML water fraction in a concentration-dependent manner with an IC$_{50}$ value of 9.5 mg/ml. The results suggest that the effects of a ML water fraction are mediated through direct stimulation of muscarinic cholinergic receptors by unknown cholinomimetic substance(s) contained in that fraction.

• The Korean Journal of Physiology and Pharmacology
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• v.2 no.4
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• pp.493-501
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• 1998

The most significant direct role of estrogen in vivo is its ability to elicit receptor-mediated cellular proliferation in mammalian target tissues. However, the mechanism by which exogenously added estrogen causes the neoplastic transformation of renal cortical cells is yet to be uncovered. The present study was designed to evaluate interaction of $17{\beta}-estradiol\;(E_2)$ with epidermal growth factor (EGF) and insulin-like growth factor-I (IGF-I) on proliferation and $P_i$ uptake in primary cultured rabbit renal proximal tubular cells in phenol red-free, hormonally defined-medium. $[^3H]-thymidine$ incorporation increased markedly by about 133% and 141% more in the presence of $10^{-9}\;and\;10^{-6}\;M\;E_2$, respectively, than that of control. Cell count was 162% and 143% greater in the presence of $10^{-9}\;and\;10^{-6}\;M\;E_2$ , respectively, compared with control. Among all time points examined, there was an increase in $[^3H]-thymidine$ incorporation in the presence of $10^{-9}\;M\;E_2$ at day 9 or 13, respectively. However, $E_2$ ($10^{-9}\;M$) significantly drove up cell count to 160% of that of control at day 13, while it had a slight but statistically insignificant effect at day 9. $E_2-induced$ stimulation of $[^3H]-thymidine$ incorporation was completely reversed by $E_2$ antagonists (progesterone or tamoxifen). $E_2$ ($10^{-9}\;M$) or EGF ($10^{-8}\;M$) significantly stimulated $[^3H]-thymidine$ incorporation by 144% and 154% of control. $E_2$ plus EGF was synergistic on $[^3H]-thymidine$ incorporation (204% of control), while $E_2$ plus IGF-I showed a slight but no significant synergistic effect. Cell number also displayed similar pattern. $E_2$ ($10^{-9}\;M$) significantly stimulated $P_i$ uptake to 134% of control. $E_2$-induced stimulation of $P_i$ uptake was partially reversed by $E_2$ antagonists. EGF or IGF-I ($10^{-8}\;M$) significantly also increased $P_i$ uptake to 132% or 129% of control. $E_2$ plus EGF had synergistic effect on $P_i$ uptake, while $E_2$ plus IGF-I did not. In conclusion, $E_2$ may act not only directly interaction with its receptors but also indirectly as a modulator of EGF in proliferation and $P_i$ uptake of primary cultured rabbit renal proximal tubular cells.