• 대한임상전기생리학회지
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• 제11권1호
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• pp.31-38
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• 2013

Purpose : This study was to identify the effect of cognitive reaction following inactive electrode placement when applying anodal transcranial direct current stimulation over the primary motor cortex. Methods : For this study a total of 28 stroke patients participated. Before applying transcranial direct current stimulation, cognitive reaction was measured (P300 of event related potential, cognitive reaction time), and subjects were randomly assigned to two group. Transcranial direct current stimulation was applied to the scalp with an intensity of $0.04mA/cm^2$ for 15 minutes. All subjects were given an anode transcranial direct current stimulation over the primary motor area and inactive electrodes over the deltoid muscle (group I) and supra-orbital area (group II). Cognitive reactions were measured after applying transcranial direct current stimulation. Results : For this study a total of 28 stroke patients participated. Before applying transcranial direct current stimulation, cognitive reaction was measured (P300 of event related potential, cognitive reaction time), and subjects were randomly assigned to two group. Transcranial direct current stimulation was applied to the scalp with an intensity of $0.04mA/cm^2$ for 15 minutes. All subjects were given an anode transcranial direct current stimulation over the primary motor area and inactive electrodes over the deltoid muscle (group I) and supra-orbital area (group II). Cognitive reactions were measured after applying transcranial direct current stimulation. Conclusion : Thus transcranial direct current stimulation on the primary motor area may help cognitive reaction regardless of inactive electrode placement.

• 한국전문물리치료학회지
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• 제12권2호
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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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• 제46권1호
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• pp.1-4
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• 2009

Objective: To report an unsuspected adaptive plasticity of single upper motor neurons and of primary motor cortex found after microsurgical connection of the spinal cord with peripheral nerve via grafts in paraplegics and focussed discussion of the reviewed literature. Methods: The research aimed at making paraplegics walk again, after 20 years of experimental surgery in animals. Amongst other things, animal experiments demonstrated the alteration of the motor endplates receptors from cholinergic to glutamatergic induced by connection with upper motor neurons. The same paradigm was successfully performed in paraplegic humans. The nerve grafts were put into the ventral-lateral spinal tract randomly, with out possibility of choosing the axons coming from different areas of the motor cortex. Results: The patient became able to selectively activate the re-innervated muscles she wanted without concurrent activities of other muscles connected with the same cortical areas. Conclusion: Authors believe that unlike in nerve or tendon transfers, where the whole cortical area corresponding to the transfer changes its function a phenomenon that we call "brain plasticity by areas". in our paradigm due to the direct connection of upper motor neurons with different peripheral nerves and muscles via nerve grafts motor learning occurs based on adaptive neuronal plasticity so that simultaneous contractions of other muscles are prevented. We propose to call it adaptive functional "plasticity by single neurons". We speculate that this phenomenon is due to the simultaneous activation of neurons spread in different cortical areas for a given specific movement, whilst the other neurons of the same areas connected with peripheral nerves of different muscles are not activated at the same time. Why different neurons of the same area fire at different times according to different voluntary demands remains to be discovered. We are committed to solve this enigma hereafter.

• Journal of Acupuncture Research
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• 제25권3호
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• pp.179-187
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• 2008

Objectives & Methods : This study was to investigate effect of low frequency electroacupuncture on NADPH-d positive neurons in the brain cortex of rat with adjuvant induced rheumatoid arthritis. Experimental groups were divided into 6 groups ; Normal, Control, $ST_{36}$, $SP_9$, $ST_{36}+SP_9$ and Non-Acupoint. Normal group, non-arthritic group, was injected normal saline, and the other groups were injected FCA. Each acupoint groups were treated by 2Hz electroacupuncture at each acupoints and NA group was treated by 2Hz electroacupuncture at non-acupoint. Each groups were evaluated by the number of NADPH-d positive neurons in primary somatosensory area(S1), secondary somatosensory area(S2), motor area and caudate putamen by using an image analyzer and a microscope. Results : 1. In S1, the number of NADPH-d positive neuron cells in the $ST_{36}$ group were significantly(p<0.05) increased compared with the control group. 2. In S2, the number of NADPH-d positive neuron cells in all electroacupuncture groups were not significantly changed compared with the control group. 3. In motor area, the number of NADPH-d positive neuron cells in $ST_{36}$ group, $SP_9$ group, NA group were significantly(p<0.05) increased compared with the control group. 4. In Caudate putamen, the number NADPH-d positive neuron cells in all electroacupuncture groups were significantly(p<0.05) decreased compared with the control group. Conclusions : Our result demonstrated that low frequency electroacupuncture on $ST_{36}$ & $SP_9$ normalized expression of NADPH-d positive neurons in the brain cortex of the rheumatoid arthritis model in rats.

• The Journal of Korean Physical Therapy
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• 제23권2호
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• pp.85-90
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• 2011

Purpose: The contribution of the supplementary motor area (SMA) to the control of voluntary movement has been revealed. We investigated the changesin the SMA for motor learning of the reaching movement in stroke patient using functional MRI. Methods: The subject was a right-handed 55 year-old woman with left hemiparesis due to an intracerebral hemorrhage. She performed reaching movement during fMRI scanning before and after reaching training in four weeks. The motor assessment scale and surface EMG were used to evaluate the paretic upper limb function and muscle activation. Results: In the fMRI result, contralateral primary sensorimotor cortex (SM1) was activated before and after training. SMA was only activated after training. In addition, muscle activation of the paretic upper limb was similar to that of the unaffected upper limb after training. Conclusion: These findings suggest SMA is related to the execution of a novel movement pattern resulting in motor learning in stroke patients.

• Physical Therapy Rehabilitation Science
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• 제9권4호
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• pp.318-323
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• 2020

Objective: Reacquisition of motor functions following stroke depends on interhemispheric neural connections. The intervention highlighted in the present case is an insight for augmenting motor recovery by stimulating the lesioned area and adjacent areas governing the motor behaviour of an individual. The purpose of this study was to determine the changes in the motor and cognitive outcomes through multi target stimulation of cortical areas by application of multichannel transcranial direct current stimulation (M-tDCS) in a stroke survivor. Design: A case report. Methods: The patient was a participant of a trial registered with the clinical trial registry of India (CTRI/2020/01/022998). The patient was intervened with M-tDCS over the left primary motor cortex i.e. C3 point and left dorsolateral prefrontal cortex i.e. F3 point with 0.5-2 mA intensity for the period of 20 minutes. SaeboFlex-assisted task-oriented training, functional electrical stimulation over the lower extremity (LE) to elicit dorsiflexion at the ankle and eversion of the foot, and conventional physiotherapy rehabilitation including a tailored exercise program were performed. Outcome assessment was done using the Fugl-Meyer assessment scale (FMA) for the upper and lower extremity (UE and LE), Montreal Cognitive Assessment (MOCA), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures. Assessment was taken at Day 0, 15 and 30 post intervention. Results: Improvement was observed in all the outcome measures i.e FMA (UE and LE), MOCA, SSQOL and WGS across the span of 4 weeks. Conclusions: M-tDCS induced improvement in motor functions of the UE and LE, gait parameters and cognitive functions of the patient.

• The Journal of Korean Physical Therapy
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• 제22권2호
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• pp.7-13
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• 2010

Purpose: This study was designed to determine the correlation between faster response time and functional activities of brain regions during cognitive time management. Methods: Twelve healthy subjects participated in this experiment. Subjects performed the serial reaction time task (SRTT), which was designed by the Superlab program, during fMRI scanning. When the 'asterisk' appeared in the 4 partition spaces on the monitor, the subject had to press the correct response button as soon as possible. Results: fMRI results showed activation of the left primary sensorimotor cortex, both premotor areas, the supplementary motor area, posterior parietal cortex and cerebellum. There were significant correlations, from moderate to strong, between faster reaction time and BOLD signal intensity in activated areas. Conclusion: These results suggest that motor skill learning to be needed cognitive time management is associated with greater activation of large scale sensorimotor networks.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2005년도 제30회 춘계학술대회
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• pp.32-34
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• 2005

Purpose: To investigate the metabolic changes in the motor and motor association cortices following axonal injury in the internal capsule that was caused by deep intracerebral hematoma. Materials and Methods: Using proton magnetic resonance spectroscopy (1H MRS), the authors studied the primary motor cortices (M-1) and supplementary motor areas (SMA) of 9 hemiparetic patients with documentable hemiparesis of varying severity, and we studied 10 normal volunteers as controls. To measure the M-1 and SMA biochemical changes, 4 separate single volumes of interest (VOIs) were located bilaterally in the affected and unaffected hemisphere (AH and UH). Results: 1H MRS provided a neuronal and axonal viability index by measuring levels of N-acetylaspartate (NAA) and creatine/phosphocreatine (Cr). The M-1/SMA NAA/Cr ratios of the AH and UH in patients, and the AH and normal volunteers were compared. The NAA/Cr ratios of the M-1 and SMA in AH, and the SMA in UH were significantly lower than those of normal volunteers. Conclusion: These 1H MRS findings indicate that axonal injury in the descending motor pathway at the level of internal capsule could induce metabolic changes in the higher centers of the motor pathway.

• 대한임상검사과학회지
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• 제51권2호
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• pp.198-204
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• 2019

여러가지 약물에도 발작의 증세가 조절되지 않는 난치성 뇌전증 환자에서 다양한 치료법들을 시도해 볼 수 있다. 하지만 그 중 수술적인 방법이 필요한 환자에서는 수술 전 검사를 통해 발작부위의 절제부분을 결정한다. 정확한 병변의 측정과 안전한 수술을 위해 뇌 피질에 전극 삽입술을 시행한다. 피질에 삽입된 전극으로 단순히 뇌파만을 기록하는 것이 아니라 다양한 검사를 시도해 그 부위가 갖는 기능을 확인할 수 있고 그런 검사법 중 하나로 유발전위 검사법이 있다. 2015년 1월부터 2018년 12월까지 70명의 환자를 대상으로 측정된 파형의 경향이 의미하는 바를 분석하였다. 뇌 피질에 삽입된 전극에서 기록된 체성감각유발전위는 중심고랑의 주행경로를 찾아 일차운동영역 및 일차감각영역을 피해 수술 할 수 있다. 또한 청각유발전위와 시각유발전위를 이용해 청각피질과 시각피질에서 기능적 피질의 확인과 뇌파검사상 나타난 발작초점부위와의 관계를 비교해 절제부위를 결정하는데 도움을 주고 수술 후에 발생할 수 있는 기능적 장애를 최소화 할 수 있다.

• Investigative Magnetic Resonance Imaging
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• 제26권2호
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• pp.96-103
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• 2022

Purpose: The survival of organisms critically depends on avoidance responses to life-threatening stimuli. Information about dangerous situations needs to be remembered to produce defensive behavior. To investigate underlying brain regions to process information of danger, manganese-enhanced MRI (MEMRI) was used in olfactory fear-conditioned rats. Materials and Methods: Fear conditioning was conducted in male Sprague-Dawley rats. The animals received nasal injections of manganese chloride solution to monitor brain activation for olfactory information processing. Twenty-four hours after manganese injection, rats were exposed to electric foot shocks with odor cue for one hour. Control rats were exposed to the same odor cue without foot shocks. Forty-eight hours after the conditioning, rats were anesthetized and their brains were scanned with 9.4T MRI. Acquired images were processed and statistical analyses were performed using AFNI. Results: Manganese injection enhanced brain areas involved in olfactory information pathways in T1 weighted images. Rats that received foot shocks showed higher brain activation in the central nucleus of the amygdala, septum, primary motor cortex, and preoptic area. In contrast, control rats displayed greater signals in the orbital cortex and nucleus accumbens. Conclusion: Nasal delivery of manganese solution enhanced olfactory signal pathways in rats. Odor cue paired with foot shocks activated amygdala, the central brain region in fear, and related brain circuits. Use of MEMRI in fear conditioning provides a reliable monitoring technique of brain activation for fear learning.