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O-2-6-15. Immediate effects of anodal tDCS combined with patterned electrical stimulation on gait performance in patients with stroke
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Abstracts / Clinical Neurophysiology 128 (2017) e171–e177
in response to the stimulation of pyramids on both sides. These results suggest that changes in path between the resected and healthy sides, activation of ventral corticospinal tracts, and propriospinal neurons were involved in the recovery of motor function after cervical cord injury. doi:10.1016/j.clinph.2017.06.007
O-2-6-15. Immediate effects of anodal tDCS combined with patterned electrical stimulation on gait performance in patients with stroke—Tomofumi Yamaguchi, Toshiyuki Fujiwara, Kazuhei Maeda, Tsuyoshi Tatemoto, Shigeo Tanabe, Yoko Takahashi, Katsuhiro Mizuno, Yoshihisa Masakado, Meigen Liu (Keio University, Tokyo, Japan) Anodal transcranial direct current stimulation (tDCS) combined with patterned electrical stimulation (PES) modulates spinal reciprocal inhibition and improves the ankle movement in patients with incomplete spinal cord injury (Yamaguchi et al., 2016). This study aimed to examine the immediate effects of anodal tDCS combined with PES on gait performance in patients with stroke. Twelve patients with subacute stroke participated in this double-masked, sham-controlled cross-over study. They randomly participated in the following sessions on separate days: (1) anodal tDCS + PES; (2) anodal tDCS + sham PES; (3) sham tDCS + PES. The gait speed and surface electromyography (EMG) of tibialis anterior (TA) and soleus (SOL) muscles were measured before and after the intervention. As a result, the gait speed was not changed before and after the stimulation in all interventions. In anodal tDCS + PES condition, the EMG of the TA after the stimulation was significantly greater than that in the swing phase compared with other interventions. Anodal tDCS + PES produced significant improvement in the co-contraction ratio between TA and SOL after the stimulation, while other interventions produced no change. These findings suggest that anodal tDCS + PES could improve walking function in patients with stroke. doi:10.1016/j.clinph.2017.06.008
O2-6-21. Comparison of muscle ultrasound findings between demyelinating neuropathy and axonopathy—Keiichi Hokkoku, Hiroshi Tsukamoto, Yuki Hatanaka, Masahiro Sonoo (Teikyo University School of Medicine, Tokyo, Japan) Denervation causes increased echo intensity (EI) and decreased muscle thickness (MT) on muscle ultrasound (MUS). Chronic inflammatory demyelinating polyneuropathy (CIDP) does not present with denervation unless secondary axonal degeneration occurs. Hence, few MUS changes would occur compared to amyotrophic lateral sclerosis (ALS). The abductor pollicis brevis, abductor digiti minimi, and first dorsal interosseous muscles of 12 patients with CIDP and 13 patients with ALS were examined. There were no significant differences in Medical Research Council scales of each muscle between the CIDP and ALS group. EI and MT were measured quantitatively in every muscle. Raw values were converted into z-scores using the data from 40 normal controls (NCs). There were no significant differences between the CIDP and NC groups regarding EI and MT. The ALS group exhibited significantly higher EI and significantly lower MT than the other two groups (all P < 0.001). Our data suggested that patients with CIDP exhibit few changes on MUS. This finding may help to differentiate CIDP from ALS and predict whether the pathology is demyelination or axonal degeneration. doi:10.1016/j.clinph.2017.06.009
O-2-6-26. Effects of sleep on the epileptiform discharge in benign adult familial myoclonus epilepsy (BAFME)—Takefumi Hitomi, Katsuya Kobayashi, Takeyo Sakurai, Shamima Sultana, Kei Sato, Takeshi Inoue, Akihiro Shimotake, Riki Matsumoto, Ryosuke Takahashi, Akio Ikeda (Kyoto University School of Medicine, Kyoto, Japan) Epileptiform discharges often increase in most epilepsy types. This study sought to clarify the effects of sleep modification on cortical irritability in benign adult familial myoclonus epilepsy (BAFME). We retrospectively reviewed 31 conventional electroencephalographies (EEGs) of 12 BAFME patients and analyzed epileptiform discharges during the awake and sleep periods of 6 EEGs in 5 BAFME patients (5 women, mean age: 49.6 ± 20.3 years). Using conventional EEG analysis, EEG was classified into awake (66.6%) and light sleep stages (Stage I and II) (33.4%). Epileptiform discharges were significantly more frequent during the awake (1.3 ± 1.2/min) period than light sleep stages (0.02 ± 0.04/min) (P < 0.05). Our study showed that epileptiform discharges were consistently reduced during sleep in patients with BAFME, which indicated a reduction in cortical irritability during the sleep period. Unverricht-Lundborg disease, a relatively milder form of progressive myoclonus epilepsy, showed a similar trend, thus BAFME and ULD may share a similar pathological mechanism of cortical irritability in response to a change in vigilance. doi:10.1016/j.clinph.2017.06.010
O3-6-04. Optogenetically induced motor evoked potentials in mice—Fumiaki Yoshida, Edward S. Boyden (Massachusetts Institute of Technology, Cambridge, USA) Optogenetics is a powerful tool that utilizes light to control neurons genetically modified to express light-sensitive ion channels. This innovative technology, which allows for the activation or silencing of neurons on a millisecond time-scale, can be aimed at specific cell types, preventing the manipulation of cells that fall outside a target population. As such, optogenetics has the potential to improve impaired brain networks without side effects commonly associated with alternative strategies (e.g., electrical stimulation). Here, we assessed optogenetically induced motor evoked potentials as a first step in testing the therapeutic potential of this tool. We introduced Chronos, a novel light-sensitive ion channel, into the motor cortex of wild-type mice via viral vector injection. Four weeks later, blue laser light (473 nm) stimulation was delivered to the affected area through the intact skull. Results: Under ketamine (100 mg/kg) and xylazine (10 mg/kg) anesthesia, light-evoked muscle responses were successfully recorded from the triceps brachii and biceps femoris. Optogenetic activation of neurons expressing a novel light-sensitive ion channel effectively induced motor responses in wild-type mice, suggesting this technology may prove useful for neuromodulation therapy. Although future studies are needed, optogenetics may be applied in humans to treat neuropsychiatric diseases. doi:10.1016/j.clinph.2017.06.011
O3-6-21. Time-dependent changes in intraoperative monitoring findings during microvascular decompression for hemifacial spasm—Masafumi Fukuda, Tetsuro Takao, Tetsuya Hiraishi, Yukihiko Fujii (Department of Neurosurgery, Niigata University, Niigata, Japan) We analyzed time-dependent changes in the intraoperative monitoring of abnormal muscle responses (AMRs) and facial motor
Abstracts / Clinical Neurophysiology 128 (2017) e171–e177
in response to the stimulation of pyramids on both sides. These results suggest that changes in path between the resected and healthy sides, activation of ventral corticospinal tracts, and propriospinal neurons were involved in the recovery of motor function after cervical cord injury. doi:10.1016/j.clinph.2017.06.007
O-2-6-15. Immediate effects of anodal tDCS combined with patterned electrical stimulation on gait performance in patients with stroke—Tomofumi Yamaguchi, Toshiyuki Fujiwara, Kazuhei Maeda, Tsuyoshi Tatemoto, Shigeo Tanabe, Yoko Takahashi, Katsuhiro Mizuno, Yoshihisa Masakado, Meigen Liu (Keio University, Tokyo, Japan) Anodal transcranial direct current stimulation (tDCS) combined with patterned electrical stimulation (PES) modulates spinal reciprocal inhibition and improves the ankle movement in patients with incomplete spinal cord injury (Yamaguchi et al., 2016). This study aimed to examine the immediate effects of anodal tDCS combined with PES on gait performance in patients with stroke. Twelve patients with subacute stroke participated in this double-masked, sham-controlled cross-over study. They randomly participated in the following sessions on separate days: (1) anodal tDCS + PES; (2) anodal tDCS + sham PES; (3) sham tDCS + PES. The gait speed and surface electromyography (EMG) of tibialis anterior (TA) and soleus (SOL) muscles were measured before and after the intervention. As a result, the gait speed was not changed before and after the stimulation in all interventions. In anodal tDCS + PES condition, the EMG of the TA after the stimulation was significantly greater than that in the swing phase compared with other interventions. Anodal tDCS + PES produced significant improvement in the co-contraction ratio between TA and SOL after the stimulation, while other interventions produced no change. These findings suggest that anodal tDCS + PES could improve walking function in patients with stroke. doi:10.1016/j.clinph.2017.06.008
O2-6-21. Comparison of muscle ultrasound findings between demyelinating neuropathy and axonopathy—Keiichi Hokkoku, Hiroshi Tsukamoto, Yuki Hatanaka, Masahiro Sonoo (Teikyo University School of Medicine, Tokyo, Japan) Denervation causes increased echo intensity (EI) and decreased muscle thickness (MT) on muscle ultrasound (MUS). Chronic inflammatory demyelinating polyneuropathy (CIDP) does not present with denervation unless secondary axonal degeneration occurs. Hence, few MUS changes would occur compared to amyotrophic lateral sclerosis (ALS). The abductor pollicis brevis, abductor digiti minimi, and first dorsal interosseous muscles of 12 patients with CIDP and 13 patients with ALS were examined. There were no significant differences in Medical Research Council scales of each muscle between the CIDP and ALS group. EI and MT were measured quantitatively in every muscle. Raw values were converted into z-scores using the data from 40 normal controls (NCs). There were no significant differences between the CIDP and NC groups regarding EI and MT. The ALS group exhibited significantly higher EI and significantly lower MT than the other two groups (all P < 0.001). Our data suggested that patients with CIDP exhibit few changes on MUS. This finding may help to differentiate CIDP from ALS and predict whether the pathology is demyelination or axonal degeneration. doi:10.1016/j.clinph.2017.06.009
O-2-6-26. Effects of sleep on the epileptiform discharge in benign adult familial myoclonus epilepsy (BAFME)—Takefumi Hitomi, Katsuya Kobayashi, Takeyo Sakurai, Shamima Sultana, Kei Sato, Takeshi Inoue, Akihiro Shimotake, Riki Matsumoto, Ryosuke Takahashi, Akio Ikeda (Kyoto University School of Medicine, Kyoto, Japan) Epileptiform discharges often increase in most epilepsy types. This study sought to clarify the effects of sleep modification on cortical irritability in benign adult familial myoclonus epilepsy (BAFME). We retrospectively reviewed 31 conventional electroencephalographies (EEGs) of 12 BAFME patients and analyzed epileptiform discharges during the awake and sleep periods of 6 EEGs in 5 BAFME patients (5 women, mean age: 49.6 ± 20.3 years). Using conventional EEG analysis, EEG was classified into awake (66.6%) and light sleep stages (Stage I and II) (33.4%). Epileptiform discharges were significantly more frequent during the awake (1.3 ± 1.2/min) period than light sleep stages (0.02 ± 0.04/min) (P < 0.05). Our study showed that epileptiform discharges were consistently reduced during sleep in patients with BAFME, which indicated a reduction in cortical irritability during the sleep period. Unverricht-Lundborg disease, a relatively milder form of progressive myoclonus epilepsy, showed a similar trend, thus BAFME and ULD may share a similar pathological mechanism of cortical irritability in response to a change in vigilance. doi:10.1016/j.clinph.2017.06.010
O3-6-04. Optogenetically induced motor evoked potentials in mice—Fumiaki Yoshida, Edward S. Boyden (Massachusetts Institute of Technology, Cambridge, USA) Optogenetics is a powerful tool that utilizes light to control neurons genetically modified to express light-sensitive ion channels. This innovative technology, which allows for the activation or silencing of neurons on a millisecond time-scale, can be aimed at specific cell types, preventing the manipulation of cells that fall outside a target population. As such, optogenetics has the potential to improve impaired brain networks without side effects commonly associated with alternative strategies (e.g., electrical stimulation). Here, we assessed optogenetically induced motor evoked potentials as a first step in testing the therapeutic potential of this tool. We introduced Chronos, a novel light-sensitive ion channel, into the motor cortex of wild-type mice via viral vector injection. Four weeks later, blue laser light (473 nm) stimulation was delivered to the affected area through the intact skull. Results: Under ketamine (100 mg/kg) and xylazine (10 mg/kg) anesthesia, light-evoked muscle responses were successfully recorded from the triceps brachii and biceps femoris. Optogenetic activation of neurons expressing a novel light-sensitive ion channel effectively induced motor responses in wild-type mice, suggesting this technology may prove useful for neuromodulation therapy. Although future studies are needed, optogenetics may be applied in humans to treat neuropsychiatric diseases. doi:10.1016/j.clinph.2017.06.011
O3-6-21. Time-dependent changes in intraoperative monitoring findings during microvascular decompression for hemifacial spasm—Masafumi Fukuda, Tetsuro Takao, Tetsuya Hiraishi, Yukihiko Fujii (Department of Neurosurgery, Niigata University, Niigata, Japan) We analyzed time-dependent changes in the intraoperative monitoring of abnormal muscle responses (AMRs) and facial motor