• 한국전문물리치료학회지
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• 제21권4호
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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.

• Archives of Plastic Surgery
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• 제35권5호
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• pp.533-538
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• 2008

Purpose: Sensory changes in the upper limb are complications of a mastectomy with immediate breast reconstruction with the treatment of breast cancer. The purpose of this study is to clarify whether immediate breast reconstruction worsens the sensory changes. Methods: From March 2004 to December 2005, 20 patients who had a mastectomy with immediate breast reconstruction(reconstruction group) were compared with 23 patients who had a mastectomy alone(control group). All patients had stage I or II breast cancer. The sensory changes were assessed in a blind manner by one examiner that used light touch sensation, static two-point discrimination, pain, vibration, hot and cold temperature perception. The sensory changes were identified along the sensory dermatome for diagnosing the damaged nerves. The following factors and their relationship with the sensory changes were analyzed : age, complications, and the mastectomy method. Results: There was no statistical difference in the static two-point discrimination, pain, vibration, hot and cold temperature perception between the two groups. However, the ability to recognize light touch was significantly better(p=0.045) in the reconstruction group than in the control group. The main site of sensory change was the proximal and medial portion of the upper limb in both groups. At these sites, the mean value of Semmes-Weinstein monofilament was $1.01g/mm^2$(reconstruction group 0.82, control group 1.17) and 2-point discrimination was 51.74(converted to perfect score of 100; reconstruction group 42.50, control group 59.78). The total rate of early complications was found to be significantly lower(p=0.006) in the reconstruction group than in the control group. Conclusion: These findings suggest that an immediate breast reconstructive procedure following a mastectomy is as safe as or safer than a mastectomy alone with respect to postoperative sensory changes of the ipsilateral upper limb.

• The Korean Journal of Pain
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• 제10권1호
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• pp.5-10
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• 1997

Background : The Current Perception Threshold (CPT) provides an objective, quantitative gauge of sensory nerve integrity which is obtainable from any cutaneous site. CPT measurement can confirm and quantify or rule out dysfunction of nerve through comparison with established normative values ($Neuval^{TM}$ CPT database). The aim of this study is to compare collected data from Korean adults with $Neuval^{TM}$ CPT database. Method : Normative data from 5 standard test site in face, hand, toe were obtained from 50 healthy adults. Three frequencies(5, 250, 2000 Hz) were stimulated with $Neuromoter^{(R)}$ CPT device. Results : The results of our data were statistically significantly different than Neuval data except in face, but within normal range. Sensory Threshold increased as the frequency of the stimulus changed from 5 Hz to 250 Hz to 2000 Hz., and from face to hand to toe. Conclusion : CPT testing is a valuable neurologic testing modality that is noninvasive and highly reliable for diagnosis and evaluation of sensory nerves where neuropathy is suspected.

• Annals of Clinical Neurophysiology
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• 제10권1호
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• pp.43-47
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• 2008

Background: Acute brachial plexitis is an acute idiopathic inflammatory disease affecting brachial plexus, which is characterized by initial severe pain in shoulder followed by profound weakness of affected arm. This is a retrospective study to evaluate the clinical and electrophysiological profile of acute brachial plexitis. Methods: Sixteen patients with acute brachial plexitis were sampled. The electrodiagnostic studies included motor and sensory nerve conduction studies (NCSs) of the median and ulnar, sensory NCSs of medial and lateral antebrachial cutaneous nerves, and needle electromyography (EMG) of selected muscles of upper extremities and cervical paraspinal muscles. The studies were performed on both sides irrespective of the clinical involvement. Results: In most of our patient, upper trunk was predominantly affected (14 patients, 87.50%). Only two patients showed either predominant lower trunk affection or diffuse affection of brachial plexus. All had an acute pain followed by the development of muscle weakness of shoulder girdle after a variable interval ($7{\pm}8.95$ days). Ten patients (62.50%) had severe disability. In NCSs, the most frequent abnormality was abnormal lateral antebrachial cutaneous sensory nerve action potentials (SNAPs). On needle EMG, all the patients showed abnormal EMG findings in affected muscles. Conclusions: In this study, pain was the presenting feature in all patients, and the territory innervated by upper trunk of the brachial plexus was most frequently involved. The most common NCS abnormality was abnormal SNAP in lateral antebrachial cutaneous nerve. Our findings support that the electrodiagnostic test is useful in localizing the trunk involvement in acute brachial plexitis.

• 대한한의학회지
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• 제31권1호
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• pp.93-111
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• 2010

Objectives: The present study was performed to evaluate the potential effects of Bupleuri radix (SH) on regenerative activities in the peripheral sciatic nerve after crushing injury in rats. Methods: Axonal regeneration after crush injury in rats was analyzed by immunofluorescence staining using anti-NF-200 antibody and retrograde tracing of DiI-axons. Changes in protein levels in the sciatic nerve axons and DRG tissue were analyzed by Western blot analysis and immunofluorescence staining. Effects of SH extract treatment on neurite outgrowth was examined by immunofluorescence staining for cultured DRG neurons. Results: Major findings on the effects of SH extract treatment on axonal regeneration are summarized as follows. 1. SH-mediated enhancement in axonal regeneration was identified by immuno- fluorescence straining of NF-200 protein and retrograde tracing of DiI-labeled axons. 2. Axonal GAP-43 protein levels were upregulated by SH not only in the injured axons but also in the DRG sensory neurons corresponding to sciatic sensory axons. 3. Phospho-Erk1/2 protein levels were increased in both injured axonal area and DRG sensory neurons by SH. Phospho-Erk1/2 was also found in non-neuronal cells in the injured axons. 4. SH elevated levels of Cdc2 protein produced in Schwann cells in the distal portions of injured sciatic nerves. 5. The neurite outgrowth of DRG sensory neurons in culture was augmented by SH, and these changes were positively associated with GAP-43 production levels in the DRG neurons. Conclusions: These data suggest that SH extract improves the regenerative responses of injured peripheral neurons, and thus may be useful for understanding molecular basis for the development of therapeutic strategies.

• Clinical and Experimental Pediatrics
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• 제51권12호
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• pp.1350-1354
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• 2008

척수성 근위축증은 상염색체 열성으로 유전되며 사지 및 몸통 근위부와 원위부의 광범위한 근력약화를 특징으로 한다. 5번 염색체 장완(5q11.2-13.3)에 위치한 survival motor neuron (SMN) 유전자의 결손이 그 원인이다. 척수성 근위축증은 순수하게 운동신경만 침범하는 것으로 알려져 있다. 분자유전학적 방법으로 유전자의 결손을 증명하므로써 진단할 수 있다. 저자들은 아주 이른 영아시기부터 심한 근긴장도 저하와 잦은 폐흡인을 보였고, 분자 유전학적 검사로 척수성 근위축증을 진단한 2명의 환아에서 신경전도 검사상 광범위한 감각신경을 침범한 경우를 경험하여 보고하는 바이다. 본 증례는 감각 신경을 침범한 척수성 근위축증에 대해 국내에서는 첫번째 보고로 생각한다.

• 농촌의학ㆍ지역보건
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• 제24권1호
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• pp.1-11
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• 1999

본 연구는 농약에 직업적으로 폭로되고 있는 농부들의 말초신경 기능을 평가하고자 농약살포 남성 농민 34명을 대상으로, 1998년 5월부터 1999년 2월에 걸쳐 실시하였다. 연구내용으로는 말초신경병변을 평가하기 위한 방법으로 현재 가장 많이 사용되고 있는 신경전도 검사를 우세 상하지의 청중신경, 척골신경, 비골신경, 후경골신경, 비복신경 대해 각 구간별로 나누어 실시하였다. 조사결과 조사대상자들은 평균 60세로서 농약살포 경력은 평균 33년이었다. 농사 유형은 주로 논, 밭, 고추 농사를 경작하고 있었으며 년간 평균 약 35일간 농약을 살포하였고 1일 살포시간은 약 9시간이었다. 또한 농약 중독 관련 증상을 경험한 적이 약 82%이상에서 보고되었다. 신경전도 검사상 조사원 모든 신정에서의 값이 정상범위에는 포함되었지만, 일부구간(척골감각 신경의 wrist-elbow, 후경골신경의 terminal latency)을 제외하고는 모두 참고치의 평균값보다 유의하게 낮은 것으로 나타났다. 또한 상대적 고폭로군과 저폭로군 간의 신경전도 검사치 비교에 의하면 정중감각 및 운동, 비골신경의 일부 구간 값이 고폭로군에서 높은 것을 제외하고는 유의한 차이를 발견할 수 없었다. 이것은 고폭로군의 연령이 저폭로군보다 유의하게 낮기 때문으로 판단되며, 조사 대상자들의 값이 참고치 평균보다 떨어진 것도 연령이 높음으로 인한 것임을 연령군별 비교에 의해 확인할 수 있었다. 따라서 향후 농약 폭로로 인한 미세한 말초신경 기의 이상여부를 조기에 파악하기 위해서는 감각역치 검사등 다론 신경학적 검사들을 함께 실시하는 것이 바람직하다고 판단되었다.

• Biomolecules & Therapeutics
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• 제3권4호
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• pp.256-259
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• 1995

Antinociceptive and desensitizing effects of systemically administered capsaicinoids (capsaicin and KR25018) were investigated in guinea pig. Nociceptive sensitivity to chemical stimulus was examined to test sensory function, and the content of substance P-like immunorractivity (SP-LI) in bronchi was determined as a peripheral marker of capsaicin-sensitive primary afferent neurons. Guinea pigs were pretreated s.c. with several doses of capsaicin (1,2.5,5, 10 mg/kg) or KR25018 (1, 2.5, 5, 10 mg/kg) one week prior to the experiments. Frequency of eye wiping was significantly decreased by capsaicin and KR25018 in a pretreatment dosedependent manner. In capsaicin- or KR25018-pretreated guinea pigs, there was a significant loss of SP-LI in bronchial tissue extracts. In summary, a newly synthesized capsaicin analogue H725018 exhibited antinociceptive effect against chemical stimulus in guinea pig, with comparable potency to capsaicin. This desensitizing activity of capsaicin or KR25018 might be related to the loss of SP-LI in peripheral afferent nerves.

• Annals of Clinical Neurophysiology
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• 제6권2호
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• pp.98-102
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• 2004

Background: Carpal tunnel syndrome (CTS) is a common condition characterized by entrapment neuropathy of the median nerves. Clinical manifestations are the most important findings for diagnosis and assessment of therapeutic effects. But, objective indicators, such as electrophysiological findings, are also valuable supplementary tools. This study investigated the relationship between clinical grading and sensory nerve conduction velocity (SNCV) of median proper palmar digital nerve (MPPDN) in CTS patients. Method: This study was done on 90 upper limbs of 53 patients with CTS (men: 6, women: 47, age: 26~69 years, mean age; 52 years). Each SNCV of MPPDN was recorded with bar electrode using antidromic method. Each SNCV was compared with clinical grading of CTS. The clinical grades of CTS were designated as follows; group 1 is mild symptoms, 2 is moderate symptoms, and 3 is severe and longstanding symptoms. Result: In thumb, the SNCV of MPPDN was not different significantly between 3 groups (p=0.817). In the index finger, the SNCV was the fastest in the group 1, but faster in group 3 than in group 2 (p=0.001). In the middle and ring fingers, SNCV was decreased in higher clinical grading groups (middle finger: p=0.015, ring finger: p=0.044). Conclusion: SNCV of MPPDN of middle and ring finger correlated with the clinical grading of CTS. SNCV of index finger was the fastest in group 1. But SNCV of thumb did not correlate with the clinical grading of CTS.

• Annals of Clinical Neurophysiology
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• 제10권2호
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• pp.101-103
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• 2008

Many neurologists, particularly whose subspecialty is in peripheral neurology, may agree that patients with peripheral neuropathy often complain of the "restless legs" symptoms. These symptoms seem to share the typical features of the so-called "restless legs syndrome (RLS)", i.e., unpleasant sensations in the leg/feet, worsening in the evening or at night, and the partial relief of the positive sensory symptoms by the movements such as walking, shaking or rubbing. In fact, a higher incidence of RLS was reported among the neuropathic patients, and peripheral neuropathy was found to be more prevalent in patients with RLS than in general population. Moreover, RLS share many risk factors with peripheral neuropathy such as diabetes, uremia, amyloidosis and cryoglobulinemia, which suggests that peripheral neuropathy may play a pathophysiologic role in the development of RLS.