Motor Stimulation Research Articles

Mitigating Factors in L4 and L5 Medial Branch Motor Stimulation During Radiofrequency Ablation.

Radiofrequency ablation (RFA) is a minimally invasive procedure for facet joint pain. The targets for the procedure are the medial branches of the dorsal spinal nerves which innervate the facet joints. Before RFA, patients undergo diagnostic meal branch blocks to ensure appropriate pain relief and confirm the utility of proceeding to RFA. The success of RFA relies heavily on procedural technique and accurate placement near the medial branch. Motor testing is utilized in the lumbar region to assess the response of the multifidus and ensure proper placement of the RFA probe to prevent inadvertent damage to surrounding spinal anatomy. However, relying on motor responses in this area presents challenges given the frequency of lack of muscle twitching. Factors contributing to limited muscle twitch responses include muscle atrophy, excessive lordosis, facet arthropathy, local anesthetic use before ablation, and previous surgical neurotomy. These complexities highlight the challenges in ensuring precise motor stimulation during RFA. Despite these obstacles, accurate anatomical placement remains crucial. For RFA cases that prove challenging, relying on anatomical placement can be adequate to proceed with the procedure. Bridging knowledge gaps is vital for standardized practices and safer procedures. Further research is necessary to refine techniques, understand patient-specific factors, and enhance the efficacy of RFA in managing chronic lumbar facet joint pain.

Motion-Acuity Test for Visual Field Acuity Measurement with Motion-Defined Shapes.

The standard visual acuity measurements rely on stationary stimuli, either letters (Snellen charts), vertical lines (vernier acuity) or grating charts, processed by those regions of the visual system most sensitive to the stationary stimulation, receiving visual input from the central part of the visual field. Here, an acuity measurement is proposed based on discrimination of simple shapes, that are defined by motion of the dots in the random dot kinematograms (RDK) processed by visual regions sensitive to motion stimulation and receiving input also from the peripheral visual field. In the motion-acuity test, participants are asked to distinguish between a circle and an ellipse, with matching surfaces, built from RDKs, and separated from the background RDK either by coherence, direction, or velocity of dots. The acuity measurement is based on ellipse detection, which with every correct response becomes more circular until reaching the acuity threshold. The motion-acuity test can be presented in negative contrast (black dots on white background) or in positive contrast (white dots on black background). The motion defined shapes are located centrally within 8 visual degrees and are surrounded by RDK background. To test the influence of visual peripheries on centrally measured acuity, a mechanical narrowing of the visual field to 10 degrees is proposed, using opaque goggles with centrally located holes. This easy and replicable narrowing system is suitable for MRI protocols, allowing further investigations of the functions of the peripheral visual input. Here, a simple measurement of shape and motion perception simultaneously is proposed. This straightforward test assesses vision impairments depending on the central and peripheral visual field inputs. The proposedmotion-acuity test advances the capability of standard tests to reveal spare or even strengthened vision functions in patients with injured visual system, that until now remained undetected.

Table tennis players use superior saccadic eye movements to track moving visual targets.

Table tennis players perform visually guided visuomotor responses countlessly. The exposure of the visual system to frequent and long-term motion stimulation has been known to improve perceptual motion detection and discrimination abilities as a learning effect specific to that stimulus, so may also improve visuo-oculomotor performance. We hypothesized and verified that table tennis players have good spatial accuracy of saccades to moving targets. University table tennis players (TT group) and control participants with no striking-sports experience (Control group) wore a virtual reality headset and performed two ball-tracking tasks to track moving and stationary targets in virtual reality. The ball moved from a predetermined position on the opponent's court toward the participant's court. A total of 54 conditions were examined for the moving targets in combinations of three ball trajectories (familiar parabolic, unfamiliar descent, and unfamiliar horizontal), three courses (left, right, and center), and six speeds. All participants primarily used catch-up saccades to track the moving ball. The TT group had lower mean and inter-trial variability in saccade endpoint error compared to the Control group, showing higher spatial accuracy and precision, respectively. It suggests their improvement of the ability to analyze the direction and speed of the ball's movement and predict its trajectory and future destination. The superiority of the spatial accuracy in the TT group was seen in both the right and the left courses for all trajectories but that of precision was for familiar parabolic only. The trajectory dependence of improved saccade precision in the TT group implies the possibility that the motion vision system is trained by the visual stimuli frequently encountered in table tennis. There was no difference between the two groups in the onset time or spatial accuracy of saccades for stationary targets appearing at various positions on the ping-pong table. Table tennis players can obtain high performance (spatial accuracy and precision) of saccades to track moving targets as a result of motion vision ability improved through a vast amount of visual and visuo-ocular experience in their play.

The Effect of Oral Motor Stimulation on the Transition to Full Oral Feeding, Breastfeeding, and Length of Hospital Stay in Preterm Infants.

Objective: To determine the effect of oral motor stimulation (OMS) applied to preterm infants on their sucking and swallowing abilities to establish a successful and safe oral feeding experience. Methods: A pre-post intervention study was conducted between December 2019 and December 2020, which included preterm infants born at <35 weeks of gestational age and admitted to the neonatal intensive care unit. Patients with major congenital abnormalities (including cardiac, facial, and jaw deformities), severe NEC, stage 3-4 IVH were excluded from the study. Patients who received OMS by a speech and language therapist between June 2020 and December 2020 were assigned to Group 1, while patients who received no intervention between December 2019 and May 2020 were assigned to Group 2. The time to achieve full oral feeding (FOF), acquisition of breastfeeding rates at discharge, and the length of hospital stay (LOS) were compared between the groups. Results: A total of 62 patients were included in the study (31 in Group 1 and 31 in Group 2). There were no significant differences in birth weight and demographic data between the groups. The mean time to achieve FOF was found to be significantly shorter in Group 1 (31 ± 23.6 and 46.7 ± 22.3 days, respectively, p = 0.013). The mean LOS was also found to be shortened with a mean duration of 10 days in Group 1, without statistical significance (56.4 ± 35.3 days versus 66.0 ± 42.9 days, respectively, p = 0.34). Acquisition of breastfeeding rates was significantly higher in the intervention group (p < 0.05) Conclusions: OMS accelerates the transition to FOF in preterm infants and increases the rates of acquiring breastfeeding skills at discharge.

Effect of Educational Intervention on Neonatal Nurses Practices Regarding Oral Motor Stimulation on Early Transition from Tube to Oral Feeding in Preterm Infants

Nurses working in neonatal nursery units play a crucial role in assessing the preterm infants feeding readiness cues for initiation of oral feeding and implementing the evidence-based intervention to support the development of feeding skills. Objectives: To assess the effect of educational intervention on neonatal nurses’ practices regarding oral Motor stimulation on early transition from to oral oral feeding in preterm infants. Methods: A quasi-experimental single group study conducted in Children Hospital Lahore from May to July 2023. Pre and post intervention data was collected through the observational checklist from 36 nurses working in Neonatology. Nurses were educated through PowerPoint presentation and direct demonstration on infants. Results: Descriptive statistics showed that Majority of nurses were having diploma in nursing, 4-10 years’ experience and belonged to 31-45 years age category. In inferential statistics Paired sample t-test revealed that the majority of nurses (100%, n=36) had incompetent practices before training which were improved (91.6%, n=33) after educational intervention with significant p-value&lt;0.05. Conclusions: The nurses who received training revealed competent practices so we conclude that educational intervention was effective to improve the nurses’ practices.

Innovative Bamboo Bowling Game to Improve Motor Skills in Early Childhood

The need for educational game tools to stimulate children's gross motor skills is one of the limitations of teachers. This research aims to create an innovative bamboo bowling game to improve children's gross motor skills. The research method uses the ADDIE approach development method. Observation, interviews, and literature collected data. The research subjects consisted of 3 experts in relevant fields. The tool used to analyze research results is a questionnaire. This research was analyzed descriptively and quantitatively using Lawshe's content validation formula, the Content Validity Ratio (CVR). From the results of the expert assessment, the CVR value obtained was 0.99, and the CVI value was 0.99. All media experts gave a CVR value of 0.99. Therefore, Innovative Bamboo Bowling is considered valid. Based on these findings, Innovative Bamboo Bowling is suitable for early childhood learning activities in developing gross motor skills and can have goals that focus on improving children's physical and cognitive skills in a fun and beneficial environment. The implications of this research can be the basis for developing intervention programs or gross motor stimulation activities that are more effective and targeted.

Matching supplementary motor area-primary motor cortex paired transcranial magnetic stimulation improves motor dysfunction in Parkinson's disease: a single-center, double-blind randomized controlled clinical trial protocol.

Non-invasive neuroregulation techniques have been demonstrated to improve certain motor symptoms in Parkinson's disease (PD). However, the currently employed regulatory techniques primarily concentrate on stimulating single target points, neglecting the functional regulation of networks and circuits. The supplementary motor area (SMA) has a significant value in motor control, and its functionality is often impaired in patients with PD. The matching SMA-primary motor cortex (M1) paired transcranial magnetic stimulation (TMS) treatment protocol, which benefits patients by modulating the sequential and functional connections between the SMA and M1, was elucidated in this study. This was a single-center, double-blind, randomized controlled clinical trial. We recruited 78 subjects and allocated them in a 1:1 ratio by stratified randomization into the paired stimulation (n = 39) and conventional stimulation groups (n = 39). Each patient underwent 3 weeks of matching SMA-M1 paired TMS or sham-paired stimulation. The subjects were evaluated before treatment initiation, 3 weeks into the intervention, and 3 months after the cessation of therapy. The primary outcome measure in this study was the Unified Parkinson's Disease Rating Scale III, and the secondary outcome measures included non-motor functional assessment, quality of life (Parkinson's Disease Questionnaire-39), and objective assessments (electromyography and functional near-infrared spectroscopy). Clinical protocols aimed at single targets using non-invasive neuroregulation techniques often improve only one function. Emphasizing the circuit and network regulation in PD is important for enhancing the effectiveness of TMS rehabilitation. Pairing the regulation of cortical circuits may be a potential treatment method for PD. As a crucial node in motor control, the SMA has direct fiber connections with basal ganglia circuits and complex fiber connections with M1, which are responsible for motor execution. SMA regulation may indirectly regulate the function of basal ganglia circuits. Therefore, the developed cortical pairing stimulation pattern can reshape the control of information flow from the SMA to M1. The novel neuroregulation model designed for this study is based on the circuit mechanisms of PD and previous research results, with a scientific foundation and the potential to be a means of neuroregulation for PD.Clinical trial registration: ClinicalTrials.gov, identifier [ChiCTR2400083325].

Environmental Enrichment for Stroke and Traumatic Brain Injury: Mechanisms and Translational Implications.

Acquired brain injuries, such as ischemic stroke, intracerebral hemorrhage (ICH), and traumatic brain injury (TBI), can cause severe neurologic damage and even death. Unfortunately, currently, there are no effective and safe treatments to reduce the high disability and mortality rates associated with these brain injuries. However, environmental enrichment (EE) is an emerging approach to treating and rehabilitating acquired brain injuries by promoting motor, sensory, and social stimulation. Multiple preclinical studies have shown that EE benefits functional recovery, including improved motor and cognitive function and psychological benefits mediated by complex protective signaling pathways. This article provides an overview of the enriched environment protocols used in animal models of ischemic stroke, ICH, and TBI, as well as relevant clinical studies, with a particular focus on ischemic stroke. Additionally, we explored studies of animals with stroke and TBI exposed to EE alone or in combination with multiple drugs and other rehabilitation modalities. Finally, we discuss the potential clinical applications of EE in future brain rehabilitation therapy and the molecular and cellular changes caused by EE in rodents with stroke or TBI. This article aims to advance preclinical and clinical research on EE rehabilitation therapy for acquired brain injury. © 2024 American Physiological Society. Compr Physiol 14:5291-5323, 2024.

Implementasi Buku Skrining dan Stimulasi Motorik kasar Anak Stunting Usia 0-60 Bulan Dalam Peningkatan Pemahaman Isu Stunting Masayarakt di Desa Mancasan

Stunting, a chronic nutritional problem characterized by a child's height below the standard for his or her age, is still a challenge in Indonesia. According to data from the Ministry of Health, the prevalence of stunting in Indonesia in 2021 is 24.4%. In Mancasan Village the prevalence of stunting reached 24%. This figure is quite high, considering that stunting can have a negative impact on children's growth and development, both physically and cognitively. One effort to prevent stunting is to carry out early screening and provide gross motor stimulation. Stunting screening can be done using a screening book and motor stimulation for stunted children aged 0-60 months. This community service is carried out using educational methods, namely lectures and questions and answers. The results of community service show that there has been an increase in community understanding about screening and gross motor stimulation of children aged 0-60 months from 12.9% to 28.6%. It is hoped that this increase in community understanding can reduce the incidence of stunting in Mancasan Village.

Meningkatkan Kemampuan Motorik Halus Melalui Kegiatan Pengolahan Bahan Bekas Pada Anak Usia 5-6 Tahun di TK Aisyiyah Bustanul Athfal Banyuwangi

Fine motor stimulation is an important aspect of early childhood development. If a child has not been able to develop his fine motor skills well, then the child will also experience difficulty in carrying out activities related to hand skills. The aim of this research is to improve fine motor skills through used material processing activities in children aged 5-6 years at the Aisyiyah Bustanul Athfal Kindergarten, Banyuwangi. Specifically, the used material used during the research was waste paper. This type of research is classroom action research. This research was carried out in two cycles and each cycle was held in two meetings. This research was carried out at the Aisyiyah Bustanul Athfal Banyuwangi Kindergarten with research subjects being Group B aged 5-6 years, totaling 16 people. Data collection in this research used observation and documentation techniques. From cycle 1 to cycle II, especially in the "Developing According to Expectations" category which increased from 26.67% to 53.33%. In addition, children who were in the "Undeveloped" category in cycle 1 had reached 0% in cycle 2, showing a positive increase in the fine motor development of group B children aged 5-6 years at the Aisyiyah Bustanul Athfal Banyuwangi Kindergarten. The achievements in cycle 2 were in accordance with the established indicators of success, so that the classroom action research was considered complete and successful in improving children's fine motor skills. Keywords: Fine Motor Skills, Used Materials, ECE

REMIND – a novel “Music‐Movement‐Mind” intervention for the prevention of dementia

AbstractBackgroundLifestyle‐based motor, sensory and cognitive enrichment can target several health risk factors in the older populations by improving psychosocial, cognitive and physical (dys)function1,2. Based on these findings, we developed a novel intervention called REMIND (An Envi r onmental E nrich m ent I ntervention to Preve n t D ementia) for the promotion of healthy aging. REMIND uses dance movement therapy (DMT) and Tango Sistema Dinzel© to integrate enriching activities based on music, movement and mind into a multimodal program.ObjectiveTo present the REMIND program and feasibility check of the telehealth adaptation.MethodsThe intervention was developed and manualized in collaboration with neuropsychologists, neuroscientists and DMT specialists. Several modes of training are employed throughout the program, consisting of the three core components “Music, Movement, and Mind”. These core components are practiced simultaneously using facilitator‐guided exercises, each consisting of motor, sensory, cognitive, emotional, and social stimulations with increasing complexity. As such REMIND enables multimodal enrichment with the goal to improve cognitive and mental health of older adults by activating beneficial brain plasticity. The adaptation of the program into the telehealth setting was assessed qualitatively in four online expert sessions for feasibility.ResultsThe REMIND program is published as an open access manual (doi.org/10.30819/5504) targeting the older population3. Through the simultaneous combination of motor (Movement), sensory (Music), and mental (Mind) stimulations, REMIND promotes enrichment of the body and mind. In the telehealth setting, the multimodal exercises are best practiced via an interactive video‐conference platform, adapted to the needs of older people, using small groups (n = 4‐8) and guidance of a trained facilitator. Break‐out groups, feedback rounds, and joined participation of family members are used to enhance and sustain inter‐personal contact and positive learning experiences in the digital environment. Supplementary on‐site sessions can facilitate social integration and participation.ConclusionThe REMIND program provides a low‐threshold prevention and early intervention tool that is accessible to the target group and health care system. Adaptation to the telehealth setting is cost‐effective, adaptable to individual needs and can be integrated into everyday life. A proof‐of‐concept study will evaluate feasibility and effectiveness of the REMIND program to promote psychosocial, cognitive and physical wellbeing in older adults.

The physicochemical characteristics and antidepressant-like effects of a polysaccharide-rich fraction from Schisandra chinensis (Turcz.) Baill in behavioral despair mice and olfactory bulbectomy-induced depression-like mice

Ethnopharmacological relevanceThe dried fruit of Schisandra chinensis (Turcz.) Baill (S. chinensis) is widely used in treating central nervous system disorders. Increasing evidence has suggested that alcohol-soluble extracts and lignans from S. chinensis could significantly ameliorate depression-like behaviors in animal models, while there was little research on the potential of alcohol-insoluble polysaccharides as a candidate in the treatment of depression. Aim of the studyOur research was designed to explore both the physicochemical characteristics and antidepressant-like effects of an alcohol-insoluble polysaccharide-rich fraction named SCP from S. chinensis. Simultaneously, the underlying mechanisms were elucidated in the study. Materials and methodsThe physicochemical characteristics were accomplished by colorimetric assays, CE, HPGPC, and FT-IR. Behavioral despair testing accompanied by LAT were processed to promptly assess the antidepressant-like effects of SCP in mice. Then OBX-induced mice were established to explore the impacts of chronic co-treatments with SCP. Furthermore, effects of SCP on the HPA axis, oxidant/antioxidant system, neurotrophic and synaptic factors, and gut microbiota in OBX-induced mice were detected through ELISA and 16S rDNA (V3 + V4 regions) gene sequencing. ResultsSCP is a polysaccharide-rich fraction mainly comprised of xylose, glucose, rhamnose, galactose, mannose, and galacturonic acid in ratios of 0.27, 5.09, 0.24, 1.00, 0.63, and 2.86, of which the MW distribution ranges from 681 to 3232 Da. Acute pre-treatment with SCP (200 mg/kg, i.g.) remarkably reduced mice’s immobility in the FST without motor stimulation. Prolonged pre-treatments effectively enhanced the effects of SCP on the behavioral despair testing in mice. Chronic co-treatments with SCP (50, 200, and 800 mg/kg, i.g.) could ameliorate the slow increase of body weight and behavioral abnormality of OBX-induced mice in systemic behavioral testing. SCP (200 mg/kg) also successfully restored hyperactivity of the HPA axis, oxidative damage in the liver, neurotrophic disturbance and abnormal synaptic plasticity in the hippocampus, and dysregulation of gut microbiota in OBX-induced mice. ConclusionSCP exerts noteworthy antidepressant-like impacts on behavioral despair mice and OBX-induced mice via multiple targets, indicating a potential therapeutic candidate in depression therapy.

Randomised controlled trial to compare the effect of PIOMI (structured) and routine oromotor (unstructured) stimulation in improving readiness for oral feeding in preterm neonates.

Oral motor stimulation interventions improve oral feeding readiness and earlier full oral feeding in preterm neonates. However, using a structured method may improve the transition time to full oral feeds and feeding efficiency with respect to weight gain and exclusive breastfeeding when compared to an unstructured intervention. To compare the effect of Premature Infant Oral Motor Intervention (PIOMI) and routine oromotor stimulation (OMS) on oral feeding readiness. Randomised controlled trial conducted in a neonatal intensive care unit between June-December 2022. Preterm neonates, 29+0-33+6 weeks corrected gestational age, were studied. The intervention group received PIOMI and the control group received OMS. Primary outcome: time to oral feeding readiness by Premature Oral Feeding Readiness Assessment Scale (POFRAS) score ≥30. Secondary outcomes: time to full oral feeds, duration of hospitalisation, weight gain, and exclusive breastfeeding rates. A total of 84 neonates were included and were randomised 42 each in PIOMI and OMS groups. The mean chronological age and time to oral feeding readiness were lower by 4.6 and 2.7 days, respectively, for PIOMI. The transition time to full oral feeds was 2 days lower for PIOMI and the duration of hospitalisation was 8 days lower. The average weight gain was 4.9 g/kg/day more and the exclusive breastfeeding rates at 1 month and 3 months post-discharge were higher by 24.5% and 27%, respectively, for the PIOMI group. The subgroup analysis of study outcomes based on sex and weight for gestational age showed significant weight gain on oral feeds in neonates receiving PIOMI. Similarly, the subgroup analysis based on gestational age favoured the PIOMI group with significantly earlier transition time and weight gain on oral feeds for the neonates >28 weeks of gestational age. The odds of achieving oral feeding readiness by 30 days [OR 1.558 (0.548-4.426)], full oral feeds by 45 days [OR 1.275 (0.449-3.620)], and exclusive breastfeeding at 1 month [OR 6.364 (1.262-32.079)] and 3 months [3.889 (1.186-12.749)] after discharge were higher with PIOMI. PIOMI is a more effective oromotor stimulation method for earlier and improved oral feeding in preterm neonates. https://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=70054&EncHid=34792.72281&modid=1&compid=19','70054det', identifier, CTRI/2022/06/043048.

Comparison of uni- and multimodal motion stimulation on visual neglect: A proof-of-concept study

Spatial neglect is characterized by the failure to attend stimuli presented in the contralesional space. Typically, the visual modality is more severely impaired than the auditory one. This dissociation offers the possibility of cross-modal interactions, whereby auditory stimuli may have beneficial effects on the visual modality. A new auditory motion stimulation method with music dynamically moving from the right to the left hemispace has recently been shown to improve visual neglect. The aim of the present study was twofold: a) to compare the effects of unimodal auditory against visual motion stimulation, i.e., smooth pursuit training, which is an established therapeutical approach in neglect therapy and b) to explore whether a combination of auditory + visual motion stimulation, i.e., multimodal motion stimulation, would be more effective than unimodal auditory or visual motion stimulation. 28 patients with left-sided neglect due to a first-ever, right-hemispheric subacute stroke were included. Patients either received auditory, visual, or multimodal motion stimulation. The between-group effect of each motion stimulation condition as well as a control group without motion stimulation was investigated by means of a one-way ANOVA with the patient’s visual exploration behaviour as an outcome variable. Our results showed that unimodal auditory motion stimulation is equally effective as unimodal visual motion stimulation: both interventions significantly improved neglect compared to the control group. Multimodal motion stimulation also significantly improved neglect, however, did not show greater improvement than unimodal auditory or visual motion stimulation alone. Besides the established visual motion stimulation, this proof-of-concept study suggests that auditory motion stimulation seems to be an alternative promising therapeutic approach to improve visual attention in neglect patients. Multimodal motion stimulation does not lead to any additional therapeutic gain. In neurorehabilitation, the implementation of either auditory or visual motion stimulation seems therefore reasonable.

Feasibility and usability of a virtual-reality-based sensorimotor activation apparatus for carpal tunnel syndrome patients.

This study aimed to assess the usability of a virtual reality-assisted sensorimotor activation (VRSMA) apparatus for individual digit rehabilitation. The study had two main objectives: Firstly, to collect preliminary data on the expectations and preferences of patients with carpal tunnel syndrome (CTS) regarding virtual reality (VR) and an apparatus-assisted therapy for their affected digits. Secondly, to evaluate the usability of the VRSMA apparatus that was developed. The VRSMA system consists of an apparatus that provides sensory and motor stimulation via a vibratory motor and pressure sensor attached to a button, and a virtual reality-based visual cue provided by texts overlaid on top of a 3D model of a hand. The study involved 10 CTS patients who completed five blocks of VRSMA with their affected hand, with each block corresponding to the five digits. The patients were asked to complete a user expectations questionnaire before experiencing the VRSMA, and a user evaluation questionnaire after completing the VRSMA. Expectations for VRSMA were obtained from the questionnaire results using a House of Quality (HoQ) analysis. In the survey for expectations, participants rated certain attributes as important for a rehabilitation device for CTS, with mean ratings above 4 for attributes such as ease of use, ease of understanding, motivation, and improvement of hand function based on clinical evidence. The level of immersion and an interesting rehabilitation regime received lower ratings, with mean ratings above 3.5. The survey evaluating VRSMA showed that the current prototype was overall satisfactory with a mean rating of 3.9 out of 5. Based on the HoQ matrix, the highest priority for development of the VRSMA was to enhance device comfort and usage time. This was followed by the need to perform more clinical studies to provide evidence of the efficacy of the VRSMA. Other technical characteristics, such as VRSMA content and device reliability, had lower priority scores. The current study presents a potential for an individual digit sensorimotor rehabilitation device that is well-liked by CTS patients.

Motor cortex repetitive transcranial magnetic stimulation in major depressive disorder - A preliminary randomized controlled clinical trial

BackgroundRepetitive transcranial magnetic stimulation (rTMS) at left dorsolateral prefrontal cortex (lDLPFC) is commonly used in major depressive disorder (MDD), even though its therapeutic efficacy is limited. Given that many MDD patients show psychomotor retardation, we aim to examine whether the left motor cortex (lMC) as a novel rTMS target would provide effective and well-tolerated treatment as being comparable to lDLPFC-rTMS. MethodsIn this prospective double-blind randomized single-center study, 131 MDD patients were randomly assigned to the lDLPFC or lMC group and were treated with 10 Hz rTMS (90 % motor threshold) applied twice daily for 4000 pulses continuously over five days. The primary endpoint was the Hamilton Depression Scale (HAMD) total score change after treatment. ResultsAfter the five-day rTMS treatment, there was no significant difference in both HAMD reduction rate (lDLPFC 59.3 % ± 20.4 %, lMC 51.3 % ± 26.3 %, P = 0.10) and adverse effects (P = 0.79) between 48 (73.8 %) lMC subjects and 51 (77.3 %) lDLPFC subjects. Furthermore, the lMC study group showed stable HAMD scores at follow-up compared to their endpoint scores (P = 0.08). LimitationsSham-control group was not included and the sample size was small. Therefore, our results should be seen as exploratory and preliminary. ConclusionsThe preliminary good therapeutic response, comparability, and tolerability of lMC-rTMS suggest lMC a potential and more easily accessible rTMS target. Together, our findings raise the possibility of symptom-specific rTMS in motor cortex (psychomotor retardation) or lDLPFC (cognitive deficits). This warrants larger clinical trials of rTMS in MDD with symptom-specific stimulation targets.

A wireless, solar-powered, optoelectronic system for spatial restriction-free long-term optogenetic neuromodulations.

Numerous wireless optogenetic systems have been reported for practical tether-free optogenetics in freely moving animals. However, most devices rely on battery-powered or coil-powered systems requiring periodic battery replacement or bulky, high-cost charging equipment with delicate antenna design. This leads to spatiotemporal constraints, such as limited experimental duration due to battery life or animals' restricted movement within specific areas to maintain wireless power transmission. In this study, we present a wireless, solar-powered, flexible optoelectronic device for neuromodulation of the complete freely behaving subject. This device provides chronic operation without battery replacement or other external settings including impedance matching technique and radio frequency generators. Our device uses high-efficiency, thin InGaP/GaAs tandem flexible photovoltaics to harvest energy from various light sources, which powers Bluetooth system to facilitate long-term, on-demand use. Observation of sustained locomotion behaviors for a month in mice via secondary motor cortex area stimulation demonstrates the notable capabilities of our device, highlighting its potential for space-free neuromodulating applications.

The effects of environmental enrichment on voluntary physical activity and muscle mass gain in growing rats.

Introduction: Environmental enrichment (EE) for rodents involves housing conditions that facilitate enhanced sensory, cognitive, and motor stimulation relative to standard housing conditions. A recent study suggested that EE induces muscle hypertrophy. However, it remains unclear whether muscle hypertrophy in EE is associated with voluntary physical activity, and the characteristics of muscle adaptation to EE remain unclarified. Therefore, this study investigated whether muscle adaptation to EE is associated with voluntary physical activity, and assessed the changes in the muscle fiber-type distribution and fiber-type-specific cross-sectional area in response to EE. Methods: Wistar rats (6weeks of age) were randomly assigned to either the standard environment group (n = 10) or the EE group (n = 10). The voluntary physical activity of rats housed in EE conditions was measured using a recently developed three-axis accelerometer. After exposure to the standard or enriched environment for 30days, the tibialis anterior, extensor digitorum longus, soleus, plantaris, and gastrocnemius muscles were removed and weighed. Immunohistochemistry analysis was performed on the surface (anterior) and deep (posterior) areas of the tibialis anterior and soleus muscles. Results and discussion: The EE group showed increased voluntary physical activity during the dark period compared with the standard environment group (p = 0.005). EE induced muscle mass gain in the soleus muscle (p = 0.002) and increased the slow-twitch muscle fiber cross-sectional area of the soleus muscle (p = 0.025). EE also increased the distribution of high-oxidative type IIa fibers of the surface area (p = 0.001) and type I fibers of the deep area (p = 0.037) of the tibialis anterior muscle. These findings suggest that EE is an effective approach to induce slow-twitch muscle fiber hypertrophy through increased daily voluntary physical activity.

Expect the Unexpected!! – Transient Cranial Nerve Palsies after Radiofrequency Ablation of Gasserian Ganglion for Trigeminal Neuralgia

Trigeminal neuralgia is the most common type of craniofacial neuralgia, characterized by paroxysmal lancinating electric shock-like pain confined to the somatosensory distribution of the trigeminal nerve. Fluoroscopy-guided Radiofrequency Ablation of Gasserian Ganglion (RFA-GG) is the commonly performed minimally invasive pain intervention in these patients. Various complications such as masseter weakness, corneal anesthesia, dysesthesia, anesthesia dolorosa, keratitis, and cranial nerve deficits have been reported during the procedure. We present the case of a 58-year-old male diagnosed with left-sided trigeminal neuralgia involving mandibular division of trigeminal nerve (V3 division) with a Numerical Rating Scale of 9/10 at the time of presentation. As the patient was unresponsive to medical management, RFA of the V3 division of GG was performed with acceptable sensory and motor stimulation. Postablation, 1 ml of 1.0% Lidocaine injection with 2 mg injection dexamethasone was given. After the procedure, the patient complained of dizziness, left-sided hearing loss, and double vision on looking toward the left side. On examination, deviation of the angle of the mouth toward the right side, reduced blink reflex on the left side, and incomplete closure of the left eyelid were observed. Vitals were stable and there was no respiratory discomfort. The patient was reassured and monitored in the recovery room. Signs and symptoms were transient and the patient recovered completely after 45 min. Clinical findings were suggestive of the involvement of three cranial nerves: the abducens nerve, the facial nerve, and the vestibulocochlear nerve. Spillage of local anesthetic solution into adjacent cranial nerves surrounding the GG might be the causative mechanism for transient cranial nerve palsies in this case.

Motor development in premature infants: Study protocol for an interdisciplinary hospital-home intervention.

Deviations occur in the neuropsychomotor development of premature infants; early interventions minimize delay motor. This study aimed to determine the effect of an interdisciplinary hospital-home intervention addressing motor development adaptation in premature infants in Colombia in comparison with traditional interventions. This study was based on a parallel design, with two groups, namely, experimental and control. The experimental group, hospital-home intervention (HHI) performed in two settings (i.e., hospital neonatal care units and homes), and the control group, traditional intervention, (TI) performed in institutions for premature infants. The sample will be composed of 130 randomly-allocated infants, 65 in the experimental group (HHI) and 65 in the control group (TI) of moderate to late preterm infants (gestational age between 34 and 37 weeks), weighing more than or equal to 1.800 g, who are hemodynamically stable and reside in the cities of Tunja and Bogotá-Colombia recruited between 2021 and 2022. For the pre- and post-intervention assessments, the TIMPSI and the CapDMP are the instruments used to assess motor development and the degree of parents' or caregivers' knowledge about motor development. The HHI is composed of 10 intervention strategies based on stimulation of motor development, performed twice a day for 10 min for two months, in combination with calls to a mobile device, using software (Baby Motor Skills) and an instant messaging system (WhatsApp). This hospital-home intervention program proposes an approach focused on the motor development of premature infants, based on sensory and motor stimulation strategies, in addition to follow-up performed at home with the use of a mobile application that improves the motor development of premature infants. Register Clinical Trial: NCT04563364. The HHI provides the opportunity to determine whether the individualized four-week from admission to follow up at home with parent training will improve the motor skills of premature infants.