Therapeutic Effect of Erythropoietin on Alzheimer's Disease by Activating the Serotonin Pathway.

Alzheimer's disease (AD) is a neurodegenerative disease characterized by memory impairment in patients. Erythropoietin (EPO) has been reported to stimulate neurogenesis. This study was conducted to determine the regenerative effects of EPO in an AD model and to assess its underlying mechanism. Recombinant human EPO was intraperitoneally administered to AD mice induced by intracerebroventricular Aß oligomer injection. Behavioral assessments with novel object recognition test and passive avoidance task showed improvement in memory function of the EPO-treated AD mice compared to that of the saline-treated AD mice (p < 0.0001). An in vivo protein assay for the hippocampus and cortex tissue indicated that EPO treatment modulated neurotransmitters, including dopamine, serotonin, and adrenaline. EPO treatment also restored the activity of serotonin receptors, including 5-HT4R, 5-HT7R, and 5-HT1aR (p < 0.01), at mRNA levels. Furthermore, EPO seemed to exert an anti-inflammatory influence by downregulating TLR4 at mRNA and protein levels (p < 0.05). Finally, an immunohistochemical assay revealed increments of Nestin(+) and NeuN(+) neuronal cells in the CA3 region in the EPO-treated AD mice compared to those in the saline-treated AD mice. The conclusion is that EPO administration might be therapeutic for AD by activating the serotonergic pathway, anti-inflammatory action, and neurogenic characteristics.

The relationship between rotator cuff tear and four acromion types: cross-sectional study based on shoulder magnetic resonance imaging in 227 patients.

BACKGROUND: Rotator cuff tear (RCT) has been believed to be related to specific types of the acromion. However, most of the studies were performed on a small number of patients with surgical findings not considering the severity of RCT. PURPOSE: To analyze the relationship between age, gender, the side of the shoulder, the acromion type, and the severity of RCT using shoulder magnetic resonance arthrography (MRA). MATERIAL AND METHODS: A total of 277 shoulder MRA findings were analyzed by a radiologist specializing in the musculoskeletal system. The relationship between variables (age, gender, side of the shoulder, and acromion type) and the injury of the supraspinatus (no rupture, partial rupture, full rupture, complete rupture) was confirmed. The partial tear of the supraspinatus tendon was divided into bursal and articular side tear in order to investigate the damage caused by the anatomical difference of the acromion. We also confirmed the differences between single supraspinatus injury and multiple RCTs. RESULTS: The severity of supraspinatus tear and multiple RCTs were statistically significant with the old age and the right side of the shoulder, but not with a specific acromion type. In supraspinatus partial tear, there was no statistical difference between bursal and articular side tears. CONCLUSION: Our study revealed that the age at which degeneration could occur also was associated with multiple RCTs and is considered to be the most important factor in RCT, not anatomical structures such as acromion type.

Effects of pelvic compression belts on the kinematics and kinetics of the lower extremities during sit-to-stand maneuvers.

[Purpose] To investigate the effects of a pelvic compression belt (PCB) and chair height on the kinematics and kinetics of the lower extremity during sit-to-stand (STS) maneuvers in healthy people. [Subjects and Methods] Twenty-two people participated in this study. They were required to perform STS maneuvers under four conditions. Hip joint moment and angular displacement of the hip, knee, and ankle were measured. A PCB was also applied below the anterior superior iliac spine. [Results] The angular displacement of the ankle joint increased while performing STS maneuvers from a normal chair with a PCB in phase 1, and decreased during phase 2 when performing STS maneuvers from a high chair. The overall angular displacement in phase 3 was decreased while rising from a chair with a PCB and rising from a high chair. When performed STS maneuvers from a high chair, the angular displacement of the hip, knee, and ankle joint decreased considerably in phase 3. This decreased lower extremity motion in phase 3 indicated that participants required less momentum to complete the maneuver. [Conclusion] The results of this study suggest that a PCB might be appropriate for patients with pelvic girdle pain and lower back pain related to pregnancy.

Accuracy of water displacement hand volumetry using an ethanol and water mixture.

BACKGROUND: The traditional water displacement method for measuring limb volume is improved by adding ethanol to water. METHODS: Four solutions were tested (pure water, 0.5% ethanol, 3% ethanol, and 6% ethanol) to determine the most accurate method when measuring the volume of a known object. RESULTS: The 3% and 6% ethanol solutions significantly reduced (P < 0.001) the mean standard deviation of 10 measurements of a known sphere (390.1 +/- 0.25 mi) from 2.27 ml with pure water to 0.9 ml using the 3% alcohol solution and to 0.6 using 6% ethanol solution (the mean coefficients of variation were reduced from 0.59% for water to 0.22% for 3% ethanol and 0.16% for 6% ethanol). The spheres' volume measured with pure water, 0.5% ethanol solution, 3% ethanol solution, and 6% ethanol solution was 383.2 +/- 2.27 ml, 384.4 +/- 1.9 ml, 389.4 +/- 0.9 ml, and 390.2 +/- 0.6 ml, respectively. Using the 3% and 6% ethanol solutions to measure hand volume blindly in 10 volunteers significantly reduced the mean coefficient of variation for hand volumetry from 0.91% for water to 0.52% for the 3% ethanol solution (P < 0.05) and to 0.46% for the 6% ethanol solution (P < 0.05). The mean standard deviation from all 10 subjects decreased from 4.2 ml for water to 2.3 ml for 3% ethanol solution and 2.1 ml for the 6% solution. DISCUSSION: These findings document that the accuracy and reproducibility of hand volume measurements are improved by small additions of ethanol, most likely by reducing surface tension of water.

Effects of fermented pepper powder on body fat accumulation in mice fed a high-fat diet.

We investigated the effects of non-pungent pepper powder fermented by Bacillus licheniformis SK1230 on the fat accumulation in mice. Four weeks of feeding a high-fat diet with fermented pepper powder resulted in a significantly decreased hepatic total-lipid level and increased serum HDL-cholesterol, and tended to lower the fat weight. These results suggest that fermented pepper powder inhibited fat accumulation and improved lipid metabolism in mice fed the high-fat diet.

Design and application of a field sensing system for ground anchors in slopes.

In a ground anchor system, cables or tendons connected to a bearing plate are used for stabilization of slopes. Then, the stability of a slope is dependent on maintaining the tension levels in the cables. So far, no research on a strain-based field sensing system for ground anchors has been reported. Therefore, in this study, a practical monitoring system for long-term sensing of tension levels in tendons for anchor-reinforced slopes is proposed. The system for anchor-reinforced slopes is composed of: (1) load cells based on vibrating wire strain gauges (VWSGs), (2) wireless sensor nodes which receive and process the signals from load cells and then transmit the result to a master node through local area communication, (3) master nodes which transmit the data sent from sensor nodes to the server through mobile communication, and (4) a server located at the base station. The system was applied to field sensing of ground anchors in the 62 m-long and 26 m-high slope at the side of the highway. Based on the long-term monitoring, the safety of the anchor-reinforced slope can be secured by the timely applications of re-tensioning processes in tendons.

A wireless laser displacement sensor node for structural health monitoring.

This study describes a wireless laser displacement sensor node that measures displacement as a representative damage index for structural health monitoring (SHM). The proposed measurement system consists of a laser displacement sensor (LDS) and a customized wireless sensor node. Wireless communication is enabled by a sensor node that consists of a sensor module, a code division multiple access (CDMA) communication module, a processor, and a power module. An LDS with a long measurement distance is chosen to increase field applicability. For a wireless sensor node driven by a battery, we use a power control module with a low-power processor, which facilitates switching between the sleep and active modes, thus maximizing the power consumption efficiency during non-measurement and non-transfer periods. The CDMA mode is also used to overcome the limitation of communication distance, which is a challenge for wireless sensor networks and wireless communication. To evaluate the reliability and field applicability of the proposed wireless displacement measurement system, the system is tested onsite to obtain the required vertical displacement measurements during the construction of mega-trusses and an edge truss, which are the primary structural members in a large-scale irregular building currently under construction. The measurement values confirm the validity of the proposed wireless displacement measurement system and its potential for use in safety evaluations of structural elements.

Field monitoring of column shortenings in a high-rise building during construction.

The automatic monitoring of shortenings of vertical members in high-rise buildings under construction is a challenging issue in the high-rise building construction field. In this study, a practical system for monitoring column shortening in a high-rise building under construction is presented. The proposed monitoring system comprises the following components: (1) a wireless sensing system and (2) the corresponding monitoring software. The wireless sensing system comprises the sensors and energy-efficient wireless sensing units (sensor nodes, master nodes, and repeater nodes), which automate the processes for measuring the strains of vertical members and transmitting the measured data to the remote server. The monitoring software enables construction administrators to monitor real-time data collected by the server via an Internet connection. The proposed monitoring system is applied to actual 66-floor and 72-floor high-rise buildings under construction. The system enables automatic and real-time measurements of the shortening of vertical members, which can result in more precise construction.

Distribution of Embryonic Stem Cell-Derived Mesenchymal Stem Cells after Intravenous Infusion in Hypoxic-Ischemic Encephalopathy.

Systemic administration of mesenchymal stem cells (MSCs) has been reported to improve neurological function in brain damage, including hypoxic-ischemic encephalopathy (HIE), though the action mechanisms have not been fully elucidated. In this study, the cells were tracked live using a Pearl Trilogy Small Animal fluorescence imaging system after human embryonic stem Cell-Derived MSCs (ES-MSCs) infusion for an HIE mouse model. ES-MSC-treated HIE mice showed neurobehavioral improvement. In vivo imaging showed similar sequential migration of ES-MSCs from lungs, liver, and spleen within 7 days in both HIE and normal mice with the exception of lungs, where there was higher entrapment in the HIE 1 h after infusion. In addition, ex vivo experiments confirmed time-dependent infiltration of ES-MSCs into the organs, with similar findings in vivo, although lungs and brain revealed small differences. ES-MSCs seemed to remain in the brain only in the case of HIE on day 14 after the cell infusion. The homing effect in the host brain was confirmed with immunofluorescence staining, which showed that grafted cells remained in the brain tissue at the lesion area with neurorestorative findings. Further research should be carried out to elucidate the role of each host organ's therapeutic effects when stem cells are systemically introduced.

Development and application of rTMS device to murine model.

Repetitive transcranial magnetic stimulation (rTMS) is attracting attention as a new treatment technique for brain lesions, and many animal studies showing its effects have been reported. However, the findings of animal application researches cannot directly represent the effects of rTMS in human, mainly due to size difference and mechanistic characteristics of rTMS. Therefore, the authors purposed to develop a mouse rTMS to simulate clinical application and to confirm. Firstly, a virtual head model was created according to magnetic resonance images of murine head. Then, simulations of rTMS stimulation with different coils were performed on the murine head phantom, and an rTMS device for mice was fabricated based on the optimal voltage conditions. Lastly, strengths of magnetic fields generated by the two rTMS devices, for human (conventional clinical use) and mouse (newly fabricated), were measured in air and on mouse head and compared. Resultantly, the magnetic field intensity generated by coil of mouse was lower than human's (p < 0.01), and no differences were found between the predicted simulation values and the measured intensity in vivo (p > 0.05). Further in vivo researches using miniaturized rTMS devices for murine head should be followed to be more meaningful for human.

Identification of Sympetrum depressiusculum Sélys, 1841 in South Korea (Odonata: Libellulidae) According to Morphology and Genetic Markers.

In South Korea, both Sympetrum depressiusculum Sélys, 1841 (Odonata: Libellulidae), which is distributed throughout Europe and from Russia to the Korean Peninsula, and Sympetrum frequens Sélys, 1883, which is endemic to Japan, are recorded. However, the identity of South Korean populations and the validity of listing the two species have not yet been settled. In this study, we collected seventy-four individuals of Sympetrum species from South Korea (five localities), Russia, The Netherlands, and Japan. These samples were examined for morphology and sequenced for partial COI, 16S rRNA, and a nuclear internal spacer (ITS) region, after which these molecular data were combined with available public data from Russia, Japan, and The Netherlands. Major morphological characters that have been used to distinguish the two species and phylogenetic, network, and structure analyses all consistently suggest that South Korean populations form a single species. Consequently, it could be valid to treat South Korean populations as one species, S. depressiusculum, by applying the senior name. Nevertheless, the validity of maintaining each as an independent species in other countries may need additional study considering that our samples were focused more on South Korea and limited for Europe, Russia, and Japan.

Clinical Practice Guideline for Stroke Rehabilitation in Korea-Part 1: Rehabilitation for Motor Function (2022).

This clinical practice guideline (CPG) is the fourth edition of the Korean guideline for stroke rehabilitation, which was last updated in 2016. The development approach has been changed from a consensus-based approach to an evidence-based approach using the Grading of Recommendations Assessment Development and Evaluation (GRADE) method. This change ensures that the guidelines are based on the latest and strongest evidence available. The aim is to provide the most accurate and effective guidance to stroke rehabilitation teams, and to improve the outcomes for stroke patients in Korea. Fifty-five specialists in stroke rehabilitation and one CPG development methodology expert participated in this development. The scope of the previous clinical guidelines was very extensive, making it difficult to revise at once. Therefore, it was decided that the scope of this revised CPG would be limited to Part 1: Rehabilitation for Motor Function. The key questions were selected by considering the preferences of the target population and referring to foreign guidelines for stroke rehabilitation, and the recommendations were completed through systematic literature review and the GRADE method. The draft recommendations, which were agreed upon through an official consensus process, were refined after evaluation by a public hearing and external expert evaluation.

Synthesis and photophysical properties of an Eu(II)-complex/PS blend: role of Ag nanoparticles in surface-enhanced luminescence.

A novel Eu(II) complex with 2-ethylhexyl hydrogen 2-ethylhexyl phosphonate (EHHEHP or PC88A) was synthesized and blended with polystyrene polymer (PS). Both an independent complex and the Eu(II)/PS blend excited by near-UV light produced blue luminescence, arising from the 5d→ 4f transitions of Eu(II). Time-dependent density functional theory (TD-DFT) calculations on electronic structures of the complex molecule indicated that the absorbing and emitting center was associated with the (2)A(d(z(2))) state under the C(2) crystal field. We also synthesized silver nanoparticles (Ag NPs) with an average particle size of 4.48 nm (σ = 0.91 nm) using EHHEHP as a stabilizer. The effects of Ag NPs as a colloidal suspension and an interfacial layer on the luminescence intensity of the blend were investigated as functions of the concentration of Ag NPs and the thickness of the Ag NP layer, respectively. The critical concentration of the colloidal Ag NPs and the critical thickness of the interfacial Ag NP layer were ∼355 ppm and ∼0.16 µm, respectively. Under critical conditions, the Ag NPs increased the luminescence intensity by 4.4 times as a colloidal suspension in CH(2)Cl(2) and 2.2 times as an interfacial-layer state.

Effect of Comorbidities on the Infection Rate and Severity of COVID-19: Nationwide Cohort Study With Propensity Score Matching.

BACKGROUND: A vaccine against COVID-19 has been developed; however, COVID-19 transmission continues. Although there have been many studies of comorbidities that have important roles in COVID-19, some studies have reported contradictory results. OBJECTIVE: This study was conducted using real-world data from COVID-19 patients in South Korea and aimed to investigate the impact of patient demographics and comorbidities on the infection rate and severity of COVID-19. METHODS: Data were derived from a nationwide South Korean COVID-19 cohort study with propensity score (PS) matching. We included infected individuals who were COVID-19-positive between January 1, 2020, and May 30, 2020, and PS-matched uninfected controls. PS matching was performed to balance the baseline characteristics of each comorbidity and to adjust for potential confounders, such as age, sex, Charlson Comorbidity Index, medication, and other comorbidities, that were matched with binary variables. The outcomes were the confirmed comorbidities affecting the infection rate and severity of COVID-19. The endpoints were COVID-19 positivity and severe clinical outcomes of COVID-19 (such as tracheostomy, continuous renal replacement therapy, intensive care unit admission, ventilator use, cardiopulmonary resuscitation, and death). RESULTS: The COVID-19 cohort with PS matching included 8070 individuals with positive COVID-19 test results and 8070 matched controls. The proportions of patients in the severe group were higher for individuals 60 years or older (severe clinical outcomes for those 60 years or older, 16.52%; severe clinical outcomes for those of other ages, 2.12%), those insured with Medicaid (Medicaid, 10.81%; other insurance, 5.61%), and those with disabilities (with disabilities, 18.26%; without disabilities, 5.07%). The COVID-19 infection rate was high for patients with pulmonary disease (odds ratio [OR] 1.88; 95% CI 1.70-2.03), dementia (OR 1.75; 95% CI 1.40-2.20), gastrointestinal disease (OR 1.74; 95% CI 1.62-1.88), stroke (OR 1.67; 95% CI 1.23-2.27), hepatobiliary disease (OR 1.31; 95% CI 1.19-1.44), diabetes mellitus (OR 1.28; 95% CI 1.16-1.43), and cardiovascular disease (OR 1.20; 95% CI 1.07-1.35). In contrast, it was lower for individuals with hyperlipidemia (OR 0.73; 95% CI 0.67-0.80), autoimmune disease (OR 0.73; 95% CI 0.60-0.89), and cancer (OR 0.73; 95% CI 0.62-0.86). The severity of COVID-19 was high for individuals with kidney disease (OR 5.59; 95% CI 2.48-12.63), hypertension (OR 2.92; 95% CI 1.91-4.47), dementia (OR 2.92; 95% CI 1.91-4.47), cancer (OR 1.84; 95% CI 1.15-2.94), pulmonary disease (OR 1.72; 95% CI 1.35-2.19), cardiovascular disease (OR 1.54; 95% CI 1.17-2.04), diabetes mellitus (OR 1.43; 95% CI 1.09-1.87), and psychotic disorders (OR 1.29; 95% CI 1.01-6.52). However, it was low for those with hyperlipidemia (OR 0.78; 95% CI 0.60-1.00). CONCLUSIONS: Upon PS matching considering the use of statins, it was concluded that people with hyperlipidemia could have lower infection rates and disease severity of COVID-19.

Effect of Cognition Recovery by Repetitive Transcranial Magnetic Stimulation on Ipsilesional Dorsolateral Prefrontal Cortex in Subacute Stroke Patients.

OBJECTIVE: To demonstrate the efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) over the ipsilesional dorsolateral prefrontal cortex (DLPFC) on neurological recovery in patients with subacute phase stroke. METHODS: Patients with supratentorial hemispheric stroke who were hospitalized for intensive rehabilitation in the subacute phase were enrolled for this retrospective analysis. Two groups of patients were selected: the rTMS group who received high-frequency (20 Hz) rTMS ≥ 5 times over the ipsilesional DLPFC, and a control group who did not receive any rTMS. The patients were further divided into groups with right- or left-side brain lesions. Functional measurements for cognitive ability, mood, speech, and activities of daily living, which were assessed at baseline and at the 1-month follow-up as a routine clinical practice, were used for analyses. RESULTS: Among 270 patients with available clinical data, 133 (women, 51; age, 61.0 ± 13.8 years) met the inclusion criteria and were enrolled for analysis. There were no differences in demographic data and functional scores at baseline between the rTMS (n = 49) and control (n = 84) groups. The rTMS group showed a higher gain in the mini-mental status examination (MMSE) total score and subscores of all domains, forward digit span, and FIM-cognition than the control group (P < 0.05). Among the patients with left hemispheric lesions (n = 57), the rTMS group showed better outcomes in cognition and depression through scores of total and "attention and concentration" subscores of MMSE, FIM-cognition, and the geriatric depression scale (P < 0.05). Among the patients with right hemispheric lesions (n = 76), the rTMS group showed better outcomes in cognition through the MMSE total score and subscores of "attention and concentration," "registration," and "recall," and scores of both forward and backward digit spans (P < 0.05). CONCLUSION: High-frequency rTMS over the ipsilesional DLPFC has beneficial effects on the recovery of cognition on both sides as well as mood in patients with left-sided hemispheric lesions.

Therapeutic Effect of Repetitive Transcranial Magnetic Stimulation for Post-stroke Vascular Cognitive Impairment: A Prospective Pilot Study.

Objective: Post-stroke cognitive impairment (PSCI) is resistant to treatment. Recent studies have widely applied repetitive transcranial magnetic stimulation (rTMS) to treat various brain dysfunctions, such as post-stroke syndromes. Nonetheless, a protocol for PSCI has not been established. Therefore, this study is aimed to evaluate the therapeutic effect of our high-frequency rTMS protocol for PSCI during the chronic phase of stroke. Methods: In this prospective study, ten patients with PSCI were enrolled and received high-frequency rTMS on the ipsilesional dorsolateral prefrontal cortex (DLPFC) for 10 sessions (5 days per week for 2 weeks). Cognitive and affective abilities were assessed at baseline and 2 and 14 weeks after rTMS initiation. To investigate the therapeutic mechanism of rTMS, the mRNA levels of pro-inflammatory cytokines (interleukin (IL)-6, IL-1ß, transforming growth factor beta [TGF-ß], and tumor necrosis factor alpha [TNF-α]) in peripheral blood samples were quantified using reverse transcription polymerase chain reaction, and cognitive functional magnetic resonance imaging (fMRI) was conducted at baseline and 14 weeks in two randomly selected patients after rTMS treatment. Results: The scores of several cognitive evaluations, i.e., the Intelligence Quotient (IQ) of Wechsler Adult Intelligence Scale, auditory verbal learning test (AVLT), and complex figure copy test (CFT), were increased after completion of the rTMS session. After 3 months, these improvements were sustained, and scores on the Mini-Mental Status Examination and Montreal Cognitive Assessment (MoCA) were also increased (p < 0.05). While the Geriatric Depression Scale (GeDS) did not show change among all patients, those with moderate-to-severe depression showed amelioration of the score, with marginal significance. Expression of pro-inflammatory cytokines was decreased immediately after the ten treatment sessions, among which, IL-1ß remained at a lower level after 3 months. Furthermore, strong correlations between the decrease in IL-6 and increments in AVLT (r = 0.928) and CFT (r = 0.886) were found immediately after the rTMS treatment (p < 0.05). Follow-up fMRI revealed significant activation in several brain regions, such as the medial frontal lobe, hippocampus, and angular area. Conclusions: High-frequency rTMS on the ipsilesional DLPFC may exert immediate efficacy on cognition with the anti-inflammatory response and changes in brain network in PSCI, lasting at least 3 months.

The assessment of usability of pain medical device by physiatrists and physiotherapists: A Delphi survey.

ABSTRACT: When developing a new medical device, it is essential to assess the usability of such a device through various stakeholders.This study assessed the usability of pain medical devices through a Delphi survey administered to physiatrists and physiotherapists.A Delphi survey was conducted on the problems and improvements in hardware and software for a panel consisting of 10 physiatrists and 10 physiotherapists. A total of 3 rounds of surveys were conducted, and the third round of survey was confirmed through a Likert scale (1 = strongly agree to 5 = strongly disagree).The 2 groups generally had a common perception of the problems and improvements in pain medical devices. However, the physiatrist group mostly identified problems such as linking patient information, whereas the physiotherapist group deemed hardware problems such as device weight or connection cables as being more important (mean [standard deviation]; physiatrist, hardware 2.90 [0.93], software 2.28 [0.91] / physiotherapist, hardware 3.04 [0.84], software 3.03 [1.13]).To date, analysis has not been conducted by dividing the focus of various stakeholders using pain medical devices. The difference in view of the usability of these 2 stakeholder groups should be considered when improving the hardware or software of pain medical devices in the future. Further research is warranted to investigate other stakeholders such as patients and device developers to improve the devices.

Therapeutic efficacy of repetitive transcranial magnetic stimulation in an animal model of Alzheimer's disease.

Previous studies on repetitive transcranial magnetic stimulation (rTMS) suggested potential neurorestorative properties in Alzheimer's disease (AD). This study aimed to investigate therapeutic effects of rTMS on an AD mouse model at high and low frequencies. The subject mice were allocated into the AD model group (AD induced by intracerebroventricular amyloid beta 42 oligomer [Aß42] injection) and the saline-injected control group. Each group was subdivided according to rTMS treatment: high frequency (20 Hz), low frequency (1 Hz), and not rTMS-treated. Behavioural assessments with Y-maze test and novel object recognition task were performed; the results indicated cognition recovery by both the frequencies of rTMS after treatment in the AD model (Ps < 0.01). Tendency of further effects by high frequency compared to low frequency rTMS was also shown in Y-maze test. Neurotransmitter assay showed increment in dopamine concentration and upregulation of dopamine-receptor 4 (DR4) by rTMS in AD mice with higher response by high frequency stimulation (Ps < 0.05). Only high-frequency rTMS induced an elevation of brain-derived neurotrophic factor (BDNF) levels and enhanced the expression of Nestin and NeuN in the brain tissue (Ps < 0.05). Under in vitro conditions, Aß42 incubated mouse hippocampal cell showed an increase in dopamine levels and BDNF by application of high-frequency rTMS treatment. In conclusion, rTMS might have a potential therapeutic effect on AD, and it seems to be related with dopaminergic activation. High frequency of stimulation seems to induce higher efficacy than that induced by low frequency, with elevated expressions of DR4 gene and neurogenic proteins.

Changes in muscle architecture on ultrasound in patients early after stroke.

BACKGROUND: Early muscle changes are believed to occur in patients with stroke. However, there are insufficient data on the changes in muscle mass and architecture of these patients. OBJECTIVES: This study investigates differences in ultrasound-derived muscle architecture parameters of the hemiplegic upper and lower limbs in patients with subacute stroke. METHODS: This is a prospective observational study, which recruited 40 adult patients who had experienced a first ever unilateral stroke (ischemic or hemorrhagic), with a duration of < 1 month post stroke. The brachialis, vastus lateralis and medial gastrocnemius on both the hemiplegic and normal side were evaluated via ultrasound. We recorded clinical variables including Motricity Index, Modified Ashworth Scale (MAS) and Functional Independence Measure (FIM)-walk. RESULTS: We found reduced mean muscle thickness (p < 0.001) and increased echo intensity (p < 0.001) in the brachialis muscle, increased echo intensity (p = 0.002) in the vastus lateralis muscle, and reduced muscle thickness (p < 0.001) with increased echo intensity (p < 0.001) in the medial gastrocnemius muscle compared to the normal side. There were no significant correlations between ultrasound findings and Motricity Index. CONCLUSIONS: We report changes in ultrasound-derived muscle architecture in the hemiplegic limbs of patients with subacute stroke, with consistent findings of decreased muscle mass and increased echo intensity.

Relationship Between Line Bisection Test Time and Hemispatial Neglect Prognosis in Patients With Stroke: A Prospective Pilot Study.

OBJECTIVE: To determine the relationship between line bisection test (LBT) performance time and prognosis of hemispatial neglect (HSN) in stroke patients. METHODS: Data on stroke patients with HSN were prospectively collected. After patient recruitment and eligibility screening, the LBT, Motor-Free Visual Perception Test 3rd edition, and Korean version of Mini-Mental State Examination were performed at the time of admission and 4 weeks thereafter. The LBT performance time was also measured. All patients received conventional rehabilitation for 4 weeks. Based on the improvements in their LBT grades, the patients were divided into improved and non-improved groups. The evaluation results of the two groups were compared using Mann-Whitney U-tests and logistic regression was performed to predict the independence of each outcome. RESULTS: In total, 26 stroke patients with HSN were included, with 13 patients in each group. Significant differences were observed in the baseline LBT performance times between the improved and non-improved groups (p<0.05). Logistic regression analysis revealed associations between HSN prognosis, and baseline LBT performance time (odds ratio=0.95; 95% confidence interval, 0.90-1.00; p<0.05) and baseline Motor-Free Visual Perception Test 3rd edition (odds ratio=1.20; 95% confidence interval, 1.01-1.43; p<0.05). CONCLUSION: A significant relationship was observed between the baseline LBT performance time and HSN prognosis.