• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.7
• /
• pp.459-466
• /
• 2016

This study examined the effects of robot-assisted therapy on the motor and functional recovery of the lower limbs in 53 subacute stroke patients. Robot-assisted therapy was performed using Lokomat? (Hocoma AG, Zurich, Switzerland) for thirty minutes per day, five times a week for four weeks. The outcome measures used were the Fugl-Meyer assessment, Motricity index(MI), Functional ambulation category(FAC), Berg balance scale(BBS) for gait function and balance ability, 10m walking test, K-Modified Barthel Index(K-MBI) for the activities of daily living and Mini mental state examination (MMSE), and Beck's depression inventory(BDI) for depression. All patients recruited underwent these evaluations before and after the four week robot-assisted therapy. For the evaluation, the somatosensory evoked potentials were used to assess the functional recovery. Robot-assisted therapy on the lower limb after subacute stroke showed improvement in motor strength, gait function, and the activities of daily living. All changes in terms of MI, FAC, BBS, and K-MBI exhibited a statistically significant difference after the four weeks robot-assisted therapy. The somatosensory evoked potential result showed a correlation with the MI and K-MBI. Robot-assisted therapy is believed to facilitate the motor and functional recovery of the lower limb in subacute stroke patients.

• Journal of Magnetics
• /
• v.19 no.1
• /
• pp.28-31
• /
• 2014

The aim of the present study was to examine whether mirror therapy, in conjunction with repetitive transcranial magnetic stimulation (rTMS), can improve the upper extremity function of stroke patient. This study was conducted with 35 subjects, who were diagnosed as a hemiparesis by stroke. The Mirror plus rTMS group was of 12 members who undertook mirror therapy in conjunction with rTMS, the Mirror group was of 11 members who undertook mirror therapy, and the control group was of 12 members who undertook sham therapy. A motor cortex excitability was performed by motor evoked potential, and upper limb function was evaluated by Fugl-Meyer Assessment, and Box and Block Test. Significant difference was shown after the experiment, in comparison of the groups in terms of latency, and as the result of post hoc test, significant difference was shown between the Mirror plus rTMS group and control group, and between the Mirror group and control group, respectively. Significant difference was shown after the experiment in comparison of the groups in amplitude, and as the result of post hoc test, significant difference was shown between the Mirror plus rTMS group and Mirror group, and between the Mirror plus rTMS group and control group. Significant difference was shown after the experiment, in comparison of the groups in FMA and BBT, and as the result of post hoc test, significant difference was shown between the Mirror plus rTMS group and Mirror group, and between the Mirror group and control group. The study showed that mirror therapy in conjunction with rTMS is more effective to improve upper extremity function, than mirror therapy and sham therapy.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.7
• /
• pp.954-958
• /
• 2000

In the removal of small subcortical lesion in the eloquent area like sensory-motor cortex, the prevention of neurologic deficit is important. We present our technique of identification of M-1, S-1 cortex in a case of subcortical granuloma located in sensorymotor cortex. To accurately localize mass, stereotactic craniotomy was planned. At the beginning of procedure, functional MRI of motor cortex was done with stereotactic headframe in place. Next, the stereotactic craniotomy about 4 cm was done under propofol anesthesia for cortical mapping. After reflection of dura, central sulcus was identified with phase-reversal response of intraoperative SEP(somatosensory evoked potential) of contralateral median nerve. Then the patient was awakened, and direct cortical stimulation was done. We observed the muscle contractions of elbow, hand and fingers and the paresthesia over forearm, hand, fingers on the M-1 and S-1 cortex. Through cortical mapping and stereotactic guidance, we concluded that the mass lie immediately posterior to central sulcus, then the mass was carefully removed through small transsulcal approach, opening about 1 cm of rolandic sulcus.

• The Korean Journal of Physiology and Pharmacology
• /
• v.4 no.3
• /
• pp.227-234
• /
• 2000

Many reports suggest that neurotensin (NT) in the gastrointestinal tract may play a possible role as a neurotransmitter, a circulating hormone, or a modulator of motor activity. NT exerts various actions in the intestine; it produces contractile and relaxant responses in intestinal smooth muscle. This study was designed to investigate the effect of NT on motility of antral circular muscle strips in guinea-pig stomach. To assess the role of $Ca^{2+}$ influx in underlying mechanism, slow waves were simultaneously recorded with spontaneous contractions using conventional intracellular microelectrode technique. At the concentration of $10^{-7}$ M, where NT showed maximum response, NT enhanced the magnitude $(863{\pm}198%,\;mean\;SEM,\;n=13)$ and the frequency $(154{\pm}10.3%,\;n=11)$ of spontaneous contractions. NT evoked a slight hyperpolarization of membrane potential, tall and steep slow waves with abortive spikes $(278{\pm}50%,\;n=4).$ These effects were not affected by atropine $(2\;{\mu}M),$ guanethidine $(2\;{\mu}M)$ and tetrodotoxin (0.2μM). NT-induced contractile responses were abolished in $Ca^{2+}-free$ solution and reduced greatly to near abolition by $10\;{\mu}M$ of verapamil or 0.2 mM of $CdCl_2.$ Verapamil attenuated the effects of NT on frequency and amplitude of the slow waves. Taken together, these results indicate that NT enhances contractility in guinea-pig gastric antral circular muscle and $Ca^{2+}$ influx through the voltage-operated $Ca^{2+}$ channel appears to play an important role in the NT-induced contractile mechanism.

• Journal of Korean Neurosurgical Society
• /
• v.64 no.2
• /
• pp.282-288
• /
• 2021

Objective : Electrooculography (EOG) records eyeball movements as changes in the potential difference between the negatively charged retina and the positively charged cornea. We aimed to investigate whether reliable EOG waveforms can be evoked by electrical stimulation of the oculomotor and abducens nerves during skull base surgery. Methods : We retrospectively reviewed the records of 18 patients who had undergone a skull base tumor surgery using EOG (11 craniotomies and seven endonasal endoscopic surgeries). Stimulation was performed at 5 Hz with a stimulus duration of 200 μs and an intensity of 0.1-5 mA using a concentric bipolar probe. Recording electrodes were placed on the upper (active) and lower (reference) eyelids, and on the outer corners of both eyes; the active electrode was placed on the contralateral side. Results : Reproducibly triggered EOG waveforms were observed in all cases. Electrical stimulation of cranial nerves (CNs) III and VI elicited positive waveforms and negative waveforms, respectively, in the horizontal recording. The median latencies were 3.1 and 0.5 ms for craniotomies and endonasal endoscopic surgeries, respectively (p=0.007). Additionally, the median amplitudes were 33.7 and 46.4 μV for craniotomies and endonasal endoscopic surgeries, respectively (p=0.40). Conclusion : This study showed reliably triggered EOG waveforms with stimulation of CNs III and VI during skull base surgery. The latency was different according to the point of stimulation and thus predictable. As EOG is noninvasive and relatively easy to perform, it can be used to identify the ocular motor nerves during surgeries as an alternative of electromyography.

• Clinical Pain
• /
• v.18 no.1
• /
• pp.1-7
• /
• 2019

Objective: To investigate the cortical disinhibition in diabetic patients with neuropathic pain and without pain. In addition, we assessed the cortical disinhibition and pain relief after repetitive transcranial magnetic stimulation (rTMS). Method: We recruited diabetic patients with neuropathic pain (n = 15) and without pain (n = 15). We compared the TMS parameters such as motor evoked potential (MEP) amplitude, cortical silent period (CSP), intracortical inhibition (ICI %) and intracortical facilitation (ICF %) between two groups. Moreover, we evaluated the changes of pain and TMS parameters after five consecutive high frequency (10 Hz) rTMS sessions in diabetic patients with neuropathic pain. The neuropathic pain intensity (visual analog scale) and TMS parameters were assessed on pre-rTMS, post-rTMS 1day, and post-rTMS 5 day. Results: The comparison of the CSP, ICI % revealed significant differences between two groups (p<0.01). After rTMS sessions, the decrease in pain intensity across the three time points revealed a pattern of significant differences (p<0.01). The change of CSP and ICI % across the three test points revealed a pattern of significant differences (p<0.01). The ICI % revealed immediate increase after first rTMS application and significant increase after five rTMS application (p<0.01) in diabetic patients with neuropathic pain. The MEP amplitude and ICF % did not reveal any significant changes. Conclusion: Our findings demonstrate that cortical inhibition was decreased in diabetic patients with neuropathic pain compared with patients without pain. Furthermore, we also identified that five daily rTMS sessions restored the defective intracortical inhibition which related to improvement of neuropathic pain in diabetic patients.

• Journal of the Korean Institute of Intelligent Systems
• /
• v.22 no.4
• /
• pp.429-434
• /
• 2012

This paper presents a technology for manipulating external devices by Brain Computer Interface (BCI) system. Recently, BCI based rehabilitation and assistance system for disabled people, such as patient of Spinal Cord Injury (SCI), general paralysis, and so on, is attracting tremendous interest. Especially, electroencephalogram (EEG) signal is used to organize the BCI system by analyzing the signals, such as evoked potential. The general findings of neurophysiology support an availability of the EEG-based BCI system. We concentrate on the event-related synchronization of motor imagery EEG signal, which have an affinity with an intention for moving control of external device. To analyze the brain activity, short-time Fourier transform and particle swarm optimization are used to optimal feature selection from the preprocessed EEG signals. In our experiment, we can verify that the power spectral density correspond to range mu-rhythm(${\mu}8$~12Hz) have maximum amplitude among the raw signals and most of particles are concentrated in the corresponding region. Result shows accuracy of subject left hand 40% and right hand 38%.