Stroke Rehabilitation Research Articles

Research hotspots and global trends in transcranial magnetic stimulation for stroke neurorestoration: A 30-year bibliometric analysis

BackgroundStroke patients often experience various functional impairments. Transcranial magnetic stimulation (TMS) has emerged as a novel non-invasive brain stimulation technique, and has gained widespread attention over the past 30 years for its application in stroke. The present study used bibliometric and content analysis methods to explore the research hotspots and future trends of TMS in stroke, with an aim to provide benefits for subsequent research. MethodsPublications and reviews related to TMS in stroke from 1992 to 2022 were retrieved from the Web of Science Core Collection database. Data visualization and analysis were performed using CiteSpace, VOSviewer, and Scimago Graphica. ResultsWe included 1666 papers in the analysis and noted an increasing trend in annual publication volume. Collaboration network analysis revealed close cooperation among scholars from these major countries and institutions. Emerging keywords included TMS, stroke, recovery, rehabilitation, rTMS, plasticity, cortex, excitability, upper limb, and tDCS. Keyword citation bursts appeared to be shifting toward clinical applications, including functional connectivity, systematic reviews, double-blind studies, connectivity, injury, and dysphagia. ConclusionOur study indicates substantial growth in TMS publications and citations in stroke rehabilitation since 2006, suggesting a maturing field that is advancing toward more sophisticated treatment protocols. The increasing relevance of TMS in neurological and rehabilitative applications highlights its potential for promoting post-stroke recovery. Emerging keywords such as brain functional connectivity, systematic reviews, and double-blind studies highlight a shift toward clinical applications. The future of TMS in stroke rehabilitation promises continued growth, interdisciplinary approaches, and improved patient outcomes.

Effects of the intermittent theta burst stimulation on gait, balance and lower limbs motor function in stroke: study protocol for a double-blind randomised controlled trial with multimodal neuroimaging assessments

IntroductionApproximately, 50% of stroke survivors experience impaired walking ability 6 months after conventional rehabilitation and standard care. However, compared with upper limb motor function, research on lower limbs rehabilitation through...

Study of Biochemical Predictors of Early Neurological Deterioration in Ischemic Stroke in a Tertiary Care Hospital.

Background and objective Early neurological deterioration (END) following acute ischemic stroke (AIS) poses a significant clinical challenge, often leading to increased disability and mortality. This study aimed to investigate the association between specific biomarkers (lactate dehydrogenase (LDH), ferritin,erythrocyte sedimentation rate (ESR),C-reactive protein (CRP), homocysteine) and the occurrence of END in ischemic stroke patients in a tertiary care hospital. Materials and methods Across-sectional hospital-basedstudy was conducted at Dr. D. Y. Patil Medical College and Hospital, Pune, from July 2022 to April 2024. Patients aged 18 and above with confirmed ischemic stroke were included, while those with hemorrhagic stroke, intracranial tumors, mass effect with midline shift, or extensive cerebral edema were excluded. Upon admission, patients were assessed using the National Institutes of Health Stroke Scale (NIHSS) and monitored daily for seven days. Biomarkers, including LDH, ferritin, ESR, CRP, and homocysteine, were measured, and patients were categorized into those with END and without END. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 20 (Released 2011; IBM Corp., Armonk, New York). Results Out of 100 patients, 12% experienced END. The mean age of patients with END was 53.50 ± 11.20 years, compared to 53.62 ± 11.74 years in those without END (p = 0.790). Males constituted 91.7% of the END group and 73.9% of the non-END group (p = 0.284). A significant association was found between END and alcohol use (41.7% in END vs. 12.5% in non-END, p = 0.010) and tobacco use (41.7% in END vs. 11.4% in non-END, p = 0.010). The mean NIHSS scores were significantly higher in the END group on day 1 (11.58 ± 3.06 vs. 7.69 ± 3.98,p = 0.002) and on day 3 (13.92 ± 3.15 vs. 6.00 ± 3.65, p = 0.001). Biomarker analysis showed a significant difference in the mean vitamin B12 levels between END and non-END groups (93.17 ± 48.58 vs. 183.45 ± 349.33, p = 0.025). Conclusion Our study identified significant predictors of ENDin ischemic stroke patients, including alcohol and tobacco use, higher initial NIHSS scores, and elevated levels of LDH, ferritin, ESR, CRP, and homocysteine, along with low vitamin B12 levels. These findings highlight the importance of routine biochemical assessments and personalized treatment plans in managing AIS, emphasizing lifestyle changes and nutritional support to improve outcomes. Limitations include the single-center design, small sample size, and lack of long-term follow-up data. Future research should validate these findings in larger, multicenter studies and explore their long-term impact on stroke recovery.

Efficacy of a Four-Week Diagonal Pattern Exercise Program on Trunk and Lower Limb Function in Patients With Stroke-Induced Hemiplegia.

Objective The intended effect of this investigation is to quantifythe efficacy of a four-week program of diagonal pattern exercises in managing trunk impairments and improving gait difficulties in hemiplegic stroke subjects. The study aims to measure changes in trunk stability and gait parameters post-intervention, providing insights into the potential therapeutic benefits of these exercises for stroke rehabilitation. Methodology Thisexperimentation approach encompassing before and the follow-up test evaluations was implemented in this investigation. It was conducted at Madha College of Physiotherapy, Chennai, using convenience sampling to recruit 20 stroke subjects meeting specific inclusion criteria. Participants underwent pre-test evaluations for trunk control and gait. They were then divided equally into two groups for a four-week intervention comprising diagonal pattern exercises or single-plane training. Treatment sessions were administered five days per week for 45 minutes each. Posttest evaluations assessed changes in trunk control using the Trunk Impairment Scale (TIS) and gait parameters via the Timed Up and Go (TUG) test. Results Pretest analysis indicated no substantial baseline variations amongthe experimental and control groups, affirming their suitability for comparison. Posttest analysis of intervention at a 5% significance level revealed that the experimental group demonstrated a statistically significant improvement in trunk control, as measured by the TIS and TUG test, compared to the control group. The paired t-testresults showed significant differences in pre- and posttest values within each group, while the unpaired t-test confirmed the superiority of the experimental group's outcomes, with a P-value < 0.05. This improvement is likely due to the effectiveness of the diagonal pattern exercise in enhancing trunk muscle activity and coordination. Conclusions This study concludes that diagonal pattern training is more beneficial for improving trunk musculature control and locomotory ability in chronic cerebrovascular accident subjects. The exercise program's simplicity, minimal risks, and ease of home application after initial therapist supervision make it a promising therapeutic approach.

Bioinformatic Exploration of Circulating microRNAs Related to Functional Outcomes in Patients With Acute Ischemic Stroke: An Exploratory Prospective Study.

Background Although epigenetic modifications have been expected to play an important role in neuroplasticity for stroke recovery, the role of dynamic microRNA (miRNA) regulation related to functional outcomes after ischemic stroke remains unclear. Therefore, the current study performed a comprehensive miRNA expression analysis in serum to identify specifically altered circulating miRNAs associated with different grades of functional outcomes in patients with acute ischemic stroke (AIS). Methods Twelve patients with AIS in the middle cerebral artery region were included in this study. Peripheral blood samples were collected from patients one or two days after hospitalization. Total RNA, including small RNAs, was extracted from 400 µL of serum, and comprehensive miRNA expression analysis was performed to identify specifically altered circulating miRNAs associated with different grades of functional outcomes. Functional outcomes were evaluated three months after stroke onset using the modified Rankin Scale (mRS), classified as favorable (mRS score of 0 or 1) or unfavorable (mRS score of 2 to 5). Differentially expressed miRNAs were analyzed using the DESeq2 package. Target genes of the miRNAs were explored using miRTargetLink 2.0. Results Acute miRNA expression dynamics were characterized by differences in the patients' functional outcomes following ischemic stroke. The favorable outcome group exhibited significantly downregulated miRNAs, including hsa-miR-218-1, hsa-miR-218-2, hsa-miR-320e, hsa-miR-320d-1, hsa-miR-320d-2, hsa-miR-326, and hsa-miR-4429. In addition, 15 miRNAs, including hsa-miR-223, hsa-miR-18a, hsa-miR-411, and hsa-miR-128-1, were significantly upregulated in the favorable outcome group compared to the unfavorable outcome group. Interesting and strong validated networks between miRNAs and their target genes were identified. Conclusion This study identified specifically altered circulating miRNAs in serum associated with varying grades of functional outcomes in AIS patients and explored miRNA-target gene networks that might contribute to these outcomes. Although further studies are needed, this study highlights their potential role as biomarkers for predicting functional outcomes in patients with AIS.

Peripheral, but not central, IGF-1 treatment attenuates stroke-induced cognitive impairment in middle-aged female Sprague Dawley rats: The gut as a therapeutic target

Stroke results in immediate sensory or motor disability and increases the risk for long term cognitive-affective impairments. Thus, therapies are urgently needed to improve quality of life for stroke survivors, especially women who are at a greater risk for severe stroke after menopause. Most current research on stroke therapies target the central nervous system; however, stroke also impacts peripheral organ systems. Our studies using acyclic (estrogen-deficient) middle aged female Sprague Dawley rats show that this group not only displays worse outcomes after stroke as compared to adult females, but also has lower levels of the neuroprotective peptide Insulin-like Growth Factor (IGF1) in circulation. Intracerebroventricular (ICV) administration of IGF1 to this group decreases infarct volume and improves sensory motor performance in the acute phase. In this study, we show that, despite this neuroprotection, ICV-IGF1 did not reduce peripheral inflammation or improve post stroke cognitive impairment in the chronic phase. In view of the evidence that stroke induces rapid gut dysfunction, we tested whether systemic delivery of IGF1 (intraperitoneal, IP) would promote gut health and consequently improve long-term behavioral outcomes. Surprisingly, while IP-IGF1, delivered 4 h and 24 h after ischemic stroke, did not reduce infarct volume or acute sensory motor impairment, it significantly attenuated circulating levels of pro-inflammatory cytokines, and attenuated stroke-induced cognitive impairment. In addition, IP-IGF1 treatment reduced gut dysmorphology and gut dysbiosis. Our data support the conclusion that therapeutics targeting peripheral targets are critical for long-term stroke recovery, and that gut repair is a novel therapeutic target to improve brain health in aging females.

Impact of the COVID-19 Pandemic on Acute Stroke Rehabilitation in Japanese Primary Stroke Centers: A Nationwide Cross-Sectional Study Using a Web-Based Questionnaire Survey

Introduction: Acute stroke rehabilitation is crucial for achieving good functional recovery, even during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to clarify the impact of the COVID-19 pandemic on acute stroke rehabilitation and identify which components in the acute stroke rehabilitation provision system were susceptible to the pandemic. Methods: A web-based questionnaire survey was conducted in all primary stroke centers (PSCs) in Japan between February 7 and April 21, 2022. The survey included questions about the current status of acute stroke rehabilitation and the influence of the pandemic. We classified the influences and investigated the relationship between the influence of the pandemic and the provision of rehabilitation. Additionally, we investigated a group of prefectures divided according to the grade of the pandemic. Results: The survey response rate was 67% (639 of 959 PSCs). Among them, 387 PSCs (61%) reported that the COVID-19 pandemic affected acute stroke rehabilitation. In PSCs affected by the pandemic, more rehabilitation-related staff were working, and the proportion of weekend/holiday rehabilitation implementation was higher compared to those unaffected. In PSCs from highly infected prefectures, no significant relationship was observed between the influence of the pandemic and the rehabilitation provision system. Conclusions: PSCs that provide denser acute stroke rehabilitation may be affected to a greater extent by the pandemic. We conclude that stroke hospitals should formulate infection control procedures for acute stroke rehabilitation in advance, depending on the conditions of the region and facility.

Assessing actigraphy performance for daytime sleep detection following stroke: insights from inpatient monitoring in a rehabilitation hospital.

Stroke can result in or exacerbate various sleep disorders. The presence of behaviors such as daytime sleepiness poststroke can indicate underlying sleep disorders which can significantly impact functional recovery and thus require prompt detection and monitoring for improved care. Actigraphy, a quantitative measurement technology, has been primarily validated for nighttime sleep in healthy adults; however, its validity for daytime sleep monitoring is currently unknown. Therefore this study aims to identify the best-performing actigraphy sensor and algorithm for detecting daytime sleep in poststroke individuals. Participants wore Actiwatch Spectrum and ActiGraph wGT3X-BT on their less-affected wrist, while trained observers recorded daytime sleep occurrences and activity levels (active, sedentary, and asleep) during non-therapy times. Algorithms, Actiwatch (Autoscore AMRI) and ActiGraph (Cole-Kripke, Sadeh), were compared with on-site observations and assessed using F2 scores, emphasizing sensitivity to detect daytime sleep. Twenty-seven participants from an inpatient stroke rehabilitation unit contributed 173.5 hours of data. The ActiGraph Cole-Kripke algorithm (minute sleep time = 15 minutes, bedtime = 10 minutes, and wake time = 10 minutes) achieved the highest F2 score (0.59). Notably, when participants were in bed, the ActiGraph Cole-Kripke algorithm continued to outperform Sadeh and Actiwatch AMRI, with an F2 score of 0.69. The study demonstrates both Actiwatch and ActiGraph's ability to detect daytime sleep, particularly during bed rest. ActiGraph (Cole-Kripke) algorithm exhibited a more balanced sleep detection profile and higher F2 scores compared to Actiwatch, offering valuable insights for optimizing daytime sleep monitoring with actigraphy in stroke patients.

Brain-computer interface on wrist training with or without neurofeedback in subacute stroke: a study protocol for a double-blinded, randomized control pilot trial.

After a stroke, damage to the part of the brain that controls movement results in the loss of motor function. Brain-computer interface (BCI)-based stroke rehabilitation involves patients imagining movement without physically moving while the system measures the perceptual-motor rhythm in the motor cortex. Visual feedback through virtual reality and functional electrical stimulation is provided simultaneously. The superiority of real BCI over sham BCI in the subacute phase of stroke remains unclear. Therefore, we aim to compare the effects of real and sham BCI on motor function and brain activity among patients with subacute stroke with weak wrist extensor strength. This is a double-blinded randomized controlled trial. Patients with stroke will be categorized into real BCI and sham BCI groups. The BCI task involves wrist extension for 60 min/day, 5 times/week for 4 weeks. Twenty sessions will be conducted. The evaluation will be conducted four times, as follows: before the intervention, 2 weeks after the start of the intervention, immediately after the intervention, and 4 weeks after the intervention. The assessments include a clinical evaluation, electroencephalography, and electromyography using motor-evoked potentials. Patients will be categorized into two groups, as follows: those who will be receiving neurofeedback and those who will not receive this feedback during the BCI rehabilitation training. We will examine the importance of motor imaging feedback, and the effect of patients' continuous participation in the training rather than their being passive.Clinical Trial Registration: KCT0008589.

Clinical implementation, barriers, and unmet needs of rTMS and neuro-navigation systems in stroke rehabilitation: a nationwide survey in South Korea.

The objective of this study was to determine the implementation, clinical barriers, and unmet needs of repetitive transcranial magnetic stimulation (rTMS) and neuro-navigation systems for stroke rehabilitation. We employed a nationwide survey via Google Forms (web and mobile) consisting of 36 questions across rTMS and neuro-navigation systems, focusing on their implementation, perceptions, and unmet needs in stroke recovery. The survey targeted physiatrists registered in the Korean Society for Neuro-rehabilitation and in rehabilitation hospitals in South Korea. Of 1,129 surveys distributed, 122 responses were analyzed. Most respondents acknowledged the effectiveness of rTMS in treating post-stroke impairments; however, they highlighted significant unmet needs in standardized treatment protocols, guidelines, education, device usability, and insurance coverage. Unmet needs for neuro-navigation were also identified; only 7.4% of respondents currently used such systems, despite acknowledging their potential to enhance treatment accuracy. Seventy percent of respondents identified lack of prescription coverage, time and errors in preparation, and device cost as barriers to clinical adoption of neuro-navigation systems. Despite recognition of the potential of rTMS in stroke rehabilitation, there is a considerable gap between research evidence and clinical practice. Addressing these challenges, establishing standardized protocols, and advancing accessible neuro-navigation systems could significantly enhance the clinical application of rTMS, offering a more personalized, effective treatment modality for stroke recovery.

Safety & efficacy of a robotic hip exoskeleton on outpatient stroke rehabilitation

ObjectiveThe objective of this study was to analyze the safety and efficacy of using a robotic hip exoskeleton designed by Samsung Electronics Co., Ltd., Korea, called the Gait Enhancing and Motivating System-Hip (GEMS-H), in assistance mode only with the poststroke population in an outpatient-rehabilitation setting.MethodsForty-one participants with an average age of 60 and average stroke latency of 6.5 years completed this prospective, single arm, interventional, longitudinal study during the COVID-19 pandemic. Significant modifications to the traditional outpatient clinical environment were made to adhere to organizational physical distancing policies as well as guidelines from the Centers for Disease Control. All participants received gait training with the GEMS-H in assistance mode for 18 training sessions over the course of 6–8 weeks. Performance-based and self-reported clinical outcomes were assessed at four time points: baseline, midpoint (after 9 training sessions), post (after 18 training sessions), and 1-month follow up. Daily step count was also collected throughout the duration of the study using an ankle-worn actigraphy device. Additionally, corticomotor excitability was measured at baseline and post for 4 bilateral lower limb muscles using transcranial magnetic stimulation.ResultsBy the end of the training program, the primary outcome, walking speed, improved by 0.13 m/s (p < 0.001). Secondary outcomes of walking endurance, balance, and functional gait also improved as measured by the 6-Minute Walk Test (47 m, p < 0.001), Berg Balance Scale (2.93 points, p < 0.001), and Functional Gait Assessment (1.80 points, p < 0.001). Daily step count significantly improved with and average increase of 1,750 steps per day (p < 0.001). There was a 35% increase in detectable lower limb motor evoked potentials and a significant decrease in the active motor threshold in the medial gastrocnemius (-5.7, p < 0.05) after training with the device.ConclusionsGait training with the GEMS-H exoskeleton showed significant improvements in walking speed, walking endurance, and balance in persons with chronic stroke. Day-to-day activity also improved as evidenced by increased daily step count. Additionally, corticomotor excitability changes suggest that training with this device may help correct interhemispheric imbalance typically seen after stroke.Trial RegistrationThis study is registered with ClinicalTrials.gov (NCT04285060).

ScRNAs reveals high-frequency rTMS-induced pericyte differentiation: Potential implications for vascular regeneration and blood-brain barrier stability in stroke

Stroke is a major cause of adult disability worldwide, often involving disruption of the blood-brain barrier (BBB). Repairing the BBB is crucial for stroke recovery, and pericytes, essential components of the BBB, are potential intervention targets. Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a treatment for functional impairments after stroke, with potential effects on BBB integrity. However, the underlying mechanisms remain unclear. In this study using a transient middle cerebral artery occlusion (tMCAO) rat model, we investigated the impact of rTMS on post-stroke BBB. Through single-cell sequencing (ScRNAs), we observed developmental relationships among pericytes, endothelial cells, and vascular smooth muscle cells, suggesting the differentiation potential of pericytes. A distinct subcluster of pericytes emerged as a potential therapeutic target for stroke. Additionally, our results revealed enhanced cellular communication among these cell types, enriching signaling pathways such as IGF, TNF, NOTCH, and ICAM. Analysis of differentially expressed genes highlighted processes related to stress, differentiation, and development. Notably, rTMS intervention upregulated Reck in vascular smooth muscle cells, implicating its role in the classical Wnt signaling pathway. Overall, our bioinformatics findings suggest that rTMS may modulate BBB permeability and promote vascular regeneration following stroke. This might happen through 20 Hz rTMS promoting pericyte differentiation into vascular smooth muscle cells, upregulating Reck, then activating the classical Wnt signaling pathway, and facilitating vascular regeneration and BBB stability.

Comparative Prognostic Value of the National Institutes of Health Stroke Scale (NIHSS) and the Glasgow Coma Scale (GCS) in Supratentorial and Infratentorial Stroke Patients in Western India.

Background Acute coronary syndrome is the most common cause of mortality; cerebral vascular accident ranks second. Stroke is the fourth most common cause of disability worldwide, with nearly 20 million people suffering a stroke every year around the world and an estimated five million dead. Slightly more than 85.5% of stroke-related deaths take place in developing countries. In short, blockage (thrombus or emboli) and decreased blood supply for cerebral tissues lead to a stroke that permanently damages brain tissue. A stroke is clinically defined as rapidly developing clinical symptoms of focal cerebral dysfunction lasting >24 hours or leading to death, as characterized by the World Health Organization (WHO). Objective The present study was designed to compare the efficacy of the National Institutes of Health Stroke Scale (NIHSS) and the Glasgow Coma Scale (GCS) in determining the prognosis of supratentorial and infratentorial stroke. Methods This observational prospective study was performed on over 100 patients admitted to Bharati Hospital, Sangli, whohad cerebrovascular accidents from February 2018 to June 2019. Eligibility criteria were adults more than 18 years of age with clinical and computed tomography/magnet resonance imaging (CT/MRI) evidence consistent with acute stroke. Trauma and concomitant supra- and infratentorial strokes were excluded. GCS and NIH stroke scale scores were measured daily, and scores were noted on the first and last day of hospitalization. Statistical analysis was done using IBM SPSS Statistics for Windows, Version 22 (Released 2013; IBM Corp., Armonk, New York, United States), including mean, standard deviation, paired t-test, and Chi-square test. Results Out of 100 patients, 77% had suffered supratentorial strokes, and thus the other 23% had infratentorial strokes. Alcohol consumption was associated with a higher risk of infratentorial strokes, while smoking was linked to a higher risk of supratentorial strokes. Diabetes and hypertension did not differ statistically between the two groups. Compared to patients with supratentorial strokes, those who suffered from infratentorial strokes had a greater death rate and less favorable recovery results. Patients with supratentorial strokes who recovered completely or partially showed considerable improvements in their GCS scores, but patients with infratentorial strokes showed minimal to no improvement. On the other hand, the NIHSS score significantly improved in patients who achieved both complete or partial recovery and no improvement or mortality in both supratentorial and infratentorial stroke. NIHSS is preferred over GCS because it provides a better insight into morbidity and neurological outcomes of both types of strokes in comparison with GCS, which is more useful in predicting mortalities. Conclusion According to this study, supratentorial strokes were more common, whereas infratentorial strokes had a worse prognosis. Alcohol ingestionand smoking may have an impact on the location of a stroke. Compared to GCS, the NIHSS score provided a more thorough evaluation of stroke recovery, indicating its potential for better patient care.

Learning-to-learn as a metacognitive correlate of functional outcomes after stroke: a cohort study.

Meta-learning is a metacognitive function for successful, efficient learning in various tasks. While it is possible that meta-learning is linked to functional recovery in stroke, it has not been investigated in previous clinical research on metacognition. Examine if individual meta-learning ability is associated with functional outcomes. Cohort study. Rehabilitation ward in Fujita Health University Hospital. Twenty-nine hemiparetic people after stroke. The study measured individual sensorimotor adaptation rate, meta-learning (acceleration of adaptation through training), and Functional Independence Measure (FIM) motor effectiveness, an index of functional outcome measuring improvement in proficiency of activity of daily living (ADL). Participants performed visuomotor adaptation training sessions with their less-affected arm. They made arm-reaching movements to hit a target with cursor feedback, which was occasionally rotated with regard to their hand positions, requiring them to change the movement direction accordingly. Initial adaptation rate and meta-learning were quantified from pre- and post-training tests. The relationship between these indices of adaptation ability and FIM motor effectiveness was examined by multiple linear regression analyses. One participant was excluded before data collection in the motor task. In the remaining 28 individuals, the regression analyses revealed that FIM motor effectiveness positively correlated with meta-learning (µ=0.90, P=0.008), which was attenuated by age (µ=-0.015, P=0.005), but not with initial adaptation rate (P=0.08). Control analyses suggested that this observed association between FIM motor effectiveness and meta-learning was not mediated by patients' demographics or stroke characteristics. This study demonstrates that those who can accelerate adaptation through training are likely to improve ADL, suggesting that meta-learning may be linked with functional outcomes in some stroke individuals. Meta-learning may enable the brain to keep (re-)learning motor skills when motor functions change abruptly due to stroke and neural recovery, thereby associated with improvement in ADL. Meta-learning is part of metacognitive functions that is positively associated with functional outcomes.

Paying attention to stroke recovery and carrying forward the advantages of Traditional Chinese Medicine nursing

Paying attention to stroke recovery and carrying forward the advantages of Traditional Chinese Medicine nursing

Dental pulp stem cells regenerate neural tissue in degenerative disorders and stroke rehabilitation: A scope systematic review

BackgroundDental Pulp Stem Cells (DPSCs) possess a remarkable ability for tissue differentiation, making them highly efficient in tissue regeneration and inflammation regulation. This systematic study proposes to find an answer to the question, “Do DPSCs have the ability to regenerate and rehabilitate nerve tissue?" MethodsThis systematic review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, and the principle of non-bias was respected. All the articles from 2014 to 2024 were extracted from the Web of Science, PubMed, and Scopus databases. This study extracted the antigens and pro-inflammatory factors associated with DPSCs' involvement and how they affect the CNS's neural tissue regeneration. ResultsTwo persons of researchers searched the database. After screening the full texts, they included 11 articles in their study. DPSCs control the following antigens: CD73, CD34, CD90, CD105, CD14, CD45, CD19Oct-4, CD73, CD31, CD34CD29CD44. Even though hematopoietic markers did not change much, OCT-4 and CD-73 were increased by DPSCs. DPSC-derived exosomes suppressed the expression of IL-6, IL-1β, TNF-α, and TGF, key mediators of nerve tissue inflammation. Additionally, DPSCs show high Vascular Endothelial Growth Factor (VEGF) expression in mice brain tissue cultures. DPSCs reduce Subarachnoid Hemorrhage (SAH), a condition in which blood collects in the subarachnoid space and causes ischemia. DiscussionDPSCs showed the ability to regenerate nerve tissue and brain ganglia, stimulating angiogenesis by expressing cell markers and controlling growth factors in mice, and high therapeutic potential in neurodegenerative disorders. The present study invites further research in neurological disorders, specifically strokes, to prescribe these stem cells to the human population.

Music therapy with adults in the subacute phase after stroke: A study protocol

Stroke is a highly disabling condition, for which music therapy is regularly used in rehabilitation. One possible mechanism for the effects of music therapy is the motivational aspect of music, for example regarding treatment adherence based on improved mood. In this study, changes in motivation related to Neurologic Music Therapy (NMT) techniques during rehabilitation in the subacute phase after stroke will be investigated. Using a randomised within-subjects cross-over design, the effects of two NMT techniques and related motivational indices will be investigated. Data will be collected at three timepoints: baseline (TP1), after being randomised into groups and receiving NMT or standard care (TP2), and then at a third time point after the cross-over and having received both conditions (TP3). This design allows to counteract order effects, time effects due to spontaneous and/or nonlinear recovery, as well as single-subject comparisons in a relatively heterogeneous sample. Twenty adult participants who have experienced a supratentorial ischaemic or haemorrhagic stroke and are experiencing upper-limb impairments and/or cognitive deficits will be included. Behavioural measures of motor function, cognition, and quality of life will be collected, along with self-reported indices of overall motivation. The study outcomes will have implications for the understanding of the underlying mechanisms of music therapy in stroke recovery, more specifically regarding the relevance of motivational states in neurorehabilitation.

The important role of community organizations in stroke recovery and reintegration

The important role of community organizations in stroke recovery and reintegration

A Comprehensive Review on Brain–Computer Interface (BCI)-Based Machine and Deep Learning Algorithms for Stroke Rehabilitation

This literature review explores the pivotal role of brain–computer interface (BCI) technology, coupled with electroencephalogram (EEG) technology, in advancing rehabilitation for individuals with damaged muscles and motor systems. This study provides a comprehensive overview of recent developments in BCI and motor control for rehabilitation, emphasizing the integration of user-friendly technological support and robotic prosthetics powered by brain activity. This review critically examines the latest strides in BCI technology and its application in motor skill recovery. Special attention is given to prevalent EEG devices adaptable for BCI-driven rehabilitation. The study surveys significant contributions in the realm of machine learning-based and deep learning-based rehabilitation evaluation. The integration of BCI with EEG technology demonstrates promising outcomes for enhancing motor skills in rehabilitation. The study identifies key EEG devices suitable for BCI applications, discusses advancements in machine learning approaches for rehabilitation assessment, and highlights the emergence of novel robotic prosthetics powered by brain activity. Furthermore, it showcases successful case studies illustrating the practical implementation of BCI-driven rehabilitation techniques and their positive impact on diverse patient populations. This review serves as a cornerstone for informed decision-making in the field of BCI technology for rehabilitation. The results highlight BCI’s diverse advantages, enhancing motor control and robotic integration. The findings highlight the potential of BCI in reshaping rehabilitation practices and offer insights and recommendations for future research directions. This study contributes significantly to the ongoing transformation of BCI technology, particularly through the utilization of EEG equipment, providing a roadmap for researchers in this dynamic domain.

Technology Use for Home-Based Stroke Rehabilitation in Switzerland From the Perspectives of Persons Living With Stroke, Informal Caregivers, and Therapists: Qualitative Interview and Focus Group Study.

Stroke is a leading cause for long-term disability, requiring both inpatient and outpatient rehabilitation and self-training in the home environment. Technology-based tools are gradually gaining acceptance as additional and suitable options for extending the rehabilitation process. While the experiences of persons living with stroke, therapists, and informal caregivers with respect to technology use have already been investigated in other countries, this topic is underexplored in the Swiss context. We aimed to explore the experiences and needs of persons living with stroke, informal caregivers, and therapists in using technology-based tools in a home environment for stroke rehabilitation in Switzerland. This study followed a qualitative descriptive methodology, including semistructured interviews and focus group discussions. We applied a deductive template analysis alongside the accessibility, adaptability, accountability, and engagement framework to analyze the qualitative data sets for technology-assisted solutions for poststroke rehabilitation. We collected the experiences and needs of persons living with stroke (7/23, 30%), informal caregivers (4/23, 17%), and therapists (occupational and physical therapists; 12/23, 52%). The 4 categories we used to organize the analysis and results were accessibility to quality rehabilitation, adaptability to patient differences, accountability or compliance with rehabilitation, and engagement with rehabilitation. Persons living with stroke stated that they use various tools within their rehabilitation process depending on their specific needs. They felt that there is a plethora of tools available but sometimes felt overwhelmed with the selection process. Informal caregivers indicated that they generally felt underserved and insufficiently informed throughout the rehabilitation process. They reported that they use technology-based tools to support their relatives affected by stroke in becoming more independent. Therapists appreciate the numerous possible applications of technology-based tools in rehabilitation. At the same time, however, they express dissatisfaction with the lack of clarity in Switzerland regarding cost coverage, recommendations, and training opportunities. Persons living with stroke, informal caregivers, and therapists in Switzerland reported varied and unique experiences and needs with the use of technology-based tools in outpatient stroke rehabilitation. Written recommendations, the assumption of financial costs, and the provision of information and education could foster increased confidence in the use of technology-based tools for patients and therapists.