Empirical study on the effectiveness of online groups using a mobile health application for middle-aged and older adults to continue exercising.

[Purpose] This study aimed to determine the effects of a mobile health application, and exercise instructions by a physical therapist on exercise frequency, duration, and intensity for middle-aged and older adults. [Participants and Methods] The study included males and females in their 50s to 70s, who provided consent to participate. Thirty-six people who wished to participate in the online group were divided into groups of five or six each, with a physical therapist as group leader. The frequency, intensity, duration of exercise, and group activities were surveyed using questionnaires: before coronavirus disease (COVID-19) (before March 2020, when the novel coronavirus began to spread in Japan), during COVID-19 (after April 2020), after digital versatile disc (DVD) distribution, and after online group initiation (3 weeks after DVD distribution for the control group). [Results] The online group received significantly more frequent instructions by a physiotherapist than the control group. The control group did not show significant changes over time, whereas the online group exercised significantly, more frequently after the intervention. [Conclusion] The online mode and physical therapist intervention resulted in a significant increase in exercise frequency. Exercise advice from professionals and peer presence to continue exercising together were beneficial.

Effects of lower limb segmental muscle vibration on primary motor cortex short-latency intracortical inhibition and spinal excitability in healthy humans.

We examined the effects of lower limb segmental muscle vibration (SMV) on intracortical and spinal excitability in 13 healthy participants (mean age: 34.9 ± 7.8 years, 12 males, 1 female). SMV at 30 Hz was applied to the hamstrings, gastrocnemius, and soleus muscles for 5 min. Paired-pulse transcranial magnetic stimulation protocols were used to investigate motor-evoked potential (MEP)  amplitude, short-interval intracortical inhibition (SICI) and short-interval intracortical facilitation (SICF) from the abductor hallucis muscle (AbdH). These assessments were compared to the results of a control experiment (i.e., non-vibration) in the same participants. F-waves were evaluated from the AbdH on the right (vibration side) and left (non-vibration side) sides, and we calculated the ratio of the F-wave amplitude to the M-response amplitude (F/M ratio). These assessments were obtained before, immediately after, and 10, 20, and 30 min after SMV. For SICI, there was no change immediately after SMV, but there was a decrease over time (before vs. 30 min after, p = 0.021; immediately after vs. 30 min after, p = 0.015). There were no changes in test MEP amplitude, SICF, or the F/M ratio. SMV causes a gradual decrease in SICI over time perhaps owing to long-term potentiation. The present results may have implications for the treatment of spasticity.

Effect of Foot Progression Angle and Lateral Wedge Insole on a Reduction in Knee Adduction Moment.

This study evaluated the effect of foot progression angle on the reduction in knee adduction moment caused by a lateral wedged insole during walking. Twenty healthy, young volunteers walked 10 m at their comfortable velocity wearing a lateral wedged insole or control flat insole in 3 foot progression angle conditions: natural, toe-out, and toe-in. A 3-dimensional rigid link model was used to calculate the external knee adduction moment, the moment arm of ground reaction force to knee joint center, and the reduction ratio of knee adduction moment and moment arm. The result indicated that the toe-out condition and lateral wedged insole decreased the knee adduction moment in the whole stance phase. The reduction ratio of the knee adduction moment and the moment arm exhibited a close relationship. Lateral wedged insoles decreased the knee adduction moment in various foot progression angle conditions due to decrease of the moment arm of the ground reaction force. Moreover, the knee adduction moment during the toe-out gait with lateral wedged insole was the smallest due to the synergistic effect of the lateral wedged insole and foot progression angle. Lateral wedged insoles may be a valid intervention for patients with knee osteoarthritis regardless of the foot progression angle.

The Effects of a Lateral Wedge Insole on Knee and Ankle Joints During Slope Walking.

The purpose of this study was to determine whether a lateral wedge insole reduces the external knee adduction moment during slope walking. Twenty young, healthy subjects participated in this study. Subjects walked up and down a slope using 2 different insoles: a control flat insole and a 7° lateral wedge insole. A three-dimensional motion analysis system and force plate were used to examine the knee adduction moment, the ankle valgus moment, and the moment arm of the ground reaction force to the knee joint center in the frontal plane. The lateral wedge insole significantly decreased the moment arm of the ground reaction force, resulting in a reduction of the knee adduction moment during slope walking, similar to level walking. The reduction ratio of knee adduction moment by the lateral wedge insole during the early stance of up-slope walking was larger than that of level walking. Conversely, the lateral wedge insole increased the ankle valgus moment during slope walking, especially during the early stance phase of up-slope walking. Clinicians should examine the utilization of a lateral wedge insole for knee osteoarthritis patients who perform inclined walking during daily activity, in consideration of the load on the ankle joint.

The varying effects of warm-water bathing therapies: partial bathing decreases exercise tolerance to levels similar to full-body bathing.

[Purpose] The purpose of this study was to determine differences in postural sway and tolerance to exercise before and after full-body, forearm, and lower leg bathing in warm-water. [Subjects and Methods] Thirteen healthy, young adult males were subjected to full-body, forearm, and lower leg bathing at 41 °C for 10 minutes. [Results] The 2-point discrimination sense value and total trajectory length significantly decreased after bathing. [Conclusion] In summary, we found that warm-water bathing sharpens plantar sensation, and thus may help to prevent falls in the elderly. Even partial forearm and lower leg bathing increased exercise tolerance to levels similar to full-body bathing.

Hyperthermic effects of hand bathing: benefits of incorporating finger flexion-extension exercise.

[Purpose] The purpose of our study was to compare the effects of hand bathing using plain water and water supplemented with inorganic salt and carbonated gas and to assess the hyperthermic effects of performing finger flexion-extension exercise while bathing in water with carbonated gas and inorganic salt and without water. [Subjects and Methods] Sixteen healthy, young males were subjected to plain water bathing, CO2 bathing, kineto-CO2 bathing, or no bathing. CO2 bathing involved bathing in a solution of artificial bath additives including inorganic salts and carbon dioxide. Partial bathing of the hand was implemented for 20 minutes at 41 °C. The concentration of carbonic gas was set at 33 ppm. In the kineto-CO2 bathing condition, finger flexion-extension exercise was performed at 60 laps per minute in the same solution used in CO2 bathing. The control group engaged in the same exercise as those in the kineto-CO2 bathing group, but without bathing. [Results] A significant increase in deep-body temperature was observed in the CO2 bathing and kineto-CO2 bathing conditions compared with both the plain water bathing and control condition. [Conclusion] Significantly heightened hyperthermic effects were observed when finger flexion-extension exercise was performed during CO2 bathing.

Temperature changes caused by the difference in the distance between the ultrasound transducer and bone during 1†mhz and 3†mhz continuous ultrasound: a phantom study.

[Purpose] This study aimed to use a thermograph to observe temperature changes caused by different distances between an ultrasound transducer and bone during 1 MHz and 3 MHz continuous ultrasound emission on a phantom. [Materials and Methods] We observed the distribution of temperature elevations on a phantom consisting of pig ribs and tissue-mimicking material. One megahertz and 3 MHz ultrasound were delivered at 2.0 W/cm(2) for 5 minutes. To record the temperature changes on the phantom, we took a screenshot of the thermograph with a digital camera every 20 seconds. [Results] With 1 MHz ultrasound at the distances of 2 and 3 cm, the temperature elevation near the bone was higher than that near the transducer. However, with 3 MHz ultrasound, the temperature elevation was higher near the transducer rather than near the bone. At this point, we consider that there is a possibility of heat injury to internal organs in spite of there being no elevation of skin temperature. [Conclusion] When performing ultrasonic therapy, not only should the frequency be taken into consideration, but also the influence of the absorption coefficient and the reflection of the tissue. We visually confirmed the thermal ultrasound effect by thermography. Special attention to the temperature elevation of the internal organs is necessary to avoid injuries.

Effects of edaravone, a free radical scavenger, on photochemically induced cerebral infarction in a rat hemiplegic model.

Edaravone is a free radical scavenger that protects the adjacent cortex during cerebral infarction. We created a hemiparetic model of cerebral thrombosis from a photochemically induced infarction with the photosensitive dye, rose bengal, in rats. We examined the effects of edaravone on recovery in the model. A total of 36 adult Wistar rats were used. The right sensorimotor area was irradiated with green light with a wavelength of 533 nm (10 mm diameter), and the rose bengal was injected intravenously to create an infarction. The edaravone group was injected intraperitoneally with edaravone (3 mg/kg), and the control group was injected with saline. The recovery process of the hemiplegia was evaluated with the 7-step scale of Fenny. The infarcted areas were measured after fixation. The recovery of the paralysis in the edaravone-treated group was significantly earlier than that in the untreated group. Seven days later, both groups were mostly recovered and had scores of 7, and the infarction region was significantly smaller in the edaravone-treated group. Edaravone reduced the infarction area and promoted the functional recovery of hemiparesis from cerebral thrombosis in a rat model. These findings suggest that edaravone treatment would be effective in clinical patients recovering from cerebral infarction.

The effect of anabolic steroid administration on passive stretching-induced expression of mechano-growth factor in skeletal muscle.

BACKGROUND: Stretching of skeletal muscle induces expression of the genes which encode myogenic transcription factors or muscle contractile proteins and results in muscle growth. Anabolic steroids are reported to strengthen muscles. We have previously studied the effects of muscle stretching on gene expression. Here, we studied the effect of a combination of passive stretching and the administration of an anabolic steroid on mRNA expression of a muscle growth factor, insulin-like growth factor-I autocrine variant, or mechano-growth factor (MGF). METHODS: Twelve 8-week-old male Wistar rats were used. Metenolone was administered and passive repetitive dorsiflexion and plantar flexion of the ankle joint performed under deep anesthesia. After 24 h, the gastrocnemius muscles were removed and the mRNA expression of insulin-like growth factor-I autocrine variant was measured using quantitative real-time polymerase chain reaction. RESULTS: Repetitive stretching in combination with metenolone, but not stretching alone, significantly increased MGF mRNA expression. CONCLUSION: Anabolic steroids enhance the effect of passive stretching on MGF expression in skeletal muscle.

Passive repetitive stretching for a short duration within a week increases myogenic regulatory factors and myosin heavy chain mRNA in rats' skeletal muscles.

Stretching is a stimulation of muscle growth. Stretching for hours or days has an effect on muscle hypertrophy. However, differences of continuous stretching and repetitive stretching to affect muscle growth are not well known. To clarify the difference of continuous and repetitive stretching within a short duration, we investigated the gene expression of muscle-related genes on stretched skeletal muscles. We used 8-week-old male Wistar rats (N = 28) for this study. Animals medial gastrocnemius muscle was stretched continuously or repetitively for 15 min daily and 4 times/week under anesthesia. After stretching, muscles were removed and total RNA was extracted. Then, reverse transcriptional quantitative real-time PCR was done to evaluate the mRNA expression of MyoD, myogenin, and embryonic myosin heavy chain (MyHC). Muscles, either stretched continuously or repetitively, increased mRNA expression of MyoD, myogenin, and embryonic MyHC more than unstretched muscles. Notably, repetitive stretching resulted in more substantial effects on embryonic MyHC gene expression than continuous stretching. In conclusion, passive stretching for a short duration within a week is effective in increasing myogenic factor expression, and repetitive stretching had more effects than continuous stretching for skeletal muscle on muscle growth. These findings are applicable in clinical muscle-strengthening therapy.

The utility of bioelectrical impedance analysis to assess nutritional status of patients with severe motor and intellectual disabilities.

OBJECTIVE: We aimed to evaluate the usefulness of the bioelectrical impedance analysis method in the nutritional assessment of patients with severe motor and intellectual disabilities. METHODS: Eighty patients with severe motor and intellectual disabilities were included in the study, and the samples collected were biochemical and body composition data were obtained from regular blood samples and using the bioelectrical impedance analysis method. Nutritional status was scored from the biochemical data, and the subjects were divided into three groups: well-nourished, mildly malnourished, and moderately malnourished. RESULTS: The data that changed significantly with worsening nutritional status were serum albumin, total lymphocyte count, skeletal muscle ratio, phase angle, edema index, and body cell mass normalized by height. There were no significant differences in total lymphocyte count and body cell mass normalized by height between the groups. DISCUSSION: phase angle and edema index, which have been reported to be useful in nutritional assessment, responded sensitively to this nutritional score. Skeletal muscle ratio, which has been reported less frequently, has also been suggested to be useful in the nutritional assessment of severe motor and intellectual disabilities. CONCLUSION: Low skeletal muscle ratio, low phase angle, and high edema index were significantly suggestive of malnutrition in patients with severe motor and intellectual disabilities, and correlated significantly with biochemical data, a conventional nutritional index. Therefore, bioelectrical impedance analysis is a useful method for nutritional assessment in patients with severe motor and intellectual disabilities.

Acute changes in cortical activation during active ankle movement after whole-body vibration for spasticity in hemiplegic legs of stroke patients: a functional near-infrared spectroscopy study.

Background: A recent study revealed that whole-body vibration (WBV) tends to decrease spasticity in stroke-related hemiplegic legs. However, acute changes in cortical activation after WBV are unclear.Objective: To examine whether WBV induces acute changes in sensorimotor cortical activation in patients with stroke-related hemiplegic legs.Methods: Eleven stroke patients (mean age 52.6 [SD 15.4] years; median time after stroke 3 [25th and 75th percentiles; 3 and 10.5, respectively] months) participated in a comparative before-and-after intervention trial. Six healthy adults were also studied. WBV at 30 Hz was applied for 5 min to the hamstrings, gastrocnemius, and soleus muscles. Spasticity was assessed according to the modified Ashworth scale (MAS). Active and passive range of motion (A-ROM and P-ROM, respectively) were also measured. Change in Oxy-Hb concentration in bilateral sensorimotor cortex associated with voluntary ankle dorsiflexion of the affected limb was assessed via functional near-infrared spectroscopy (fNIRS) before and immediately after WBV.Results: MAS score, A-ROM, and P-ROM improved immediately after WBV. In the patients, while there was no significant interaction between effects of region (ipsilesional and contralesional sensorimotor cortex) and the WBV intervention (before and immediately after WBV) (F1,10 = 0.702, p = .422), there was a significant main effect of the WBV intervention (F1,10 = 6.971, p = .025). In the healthy participants, there was no association with the WBV intervention or region.Conclusions: In patients with stroke-related spastic-hemiplegic legs, WBV might result not only in clinical improvement but also in acute increase in sensorimotor cortical activation.

Effect of Functional Electrical Stimulation of the Gluteus Medius during Gait in Patients following a Stroke.

Many stroke patients rely on cane or ankle-foot orthosis during gait rehabilitation. The purpose of this study was to investigate the immediate effect of functional electrical stimulation (FES) to the gluteus medius (GMed) and tibialis anterior (TA) on gait performance in stroke patients, including those who needed assistive devices. Fourteen stroke patients were enrolled in this study (mean poststroke duration: 194.9 ± 189.6 d; mean age: 72.8 ± 10.7 y). Participants walked 14 m at a comfortable velocity with and without FES to the GMed and TA. After an adaptation period, lower-limb motion was measured using magnetic inertial measurement units attached to the pelvis and the lower limb of the affected side. Motion range of angle of the affected thigh and shank segments in the sagittal plane, motion range of the affected hip and knee extension-flexion angle, step time, and stride time were calculated from inertial measurement units during the middle ten walking strides. Gait velocity, cadence, and stride length were also calculated. These gait indicators, both with and without FES, were compared. Gait velocity was significantly faster with FES (p = 0.035). Similarly, stride length and motion range of the shank of the affected side were significantly greater with FES (stride length: p = 0.018; motion range of the shank: p = 0.026). Meanwhile, cadence showed no significant difference (p = 0.238) in gait with or without FES. Similarly, range of motion of the affected hip joint, knee joint, and thigh did not differ significantly depending on FES condition (p = 0.115-0.529). FES to the GMed and TA during gait produced an improvement in gait velocity, stride length, and motion range of the shank. Our results will allow therapists to use FES on stroke patients with varying conditions.

Effect of whole body vibration on spasticity in hemiplegic legs of patients with stroke.

BACKGROUND: Several reports have focused on the effects of whole body vibration (WBV) on spasticity with differing results. Most studies used modified Ashworth scale (MAS) for qualitative measurements, but the effect was small. OBJECTIVE: To investigate the effect of WBV on spasticity in hemiplegic legs of patients with stroke using F-wave parameters. METHODS: Sixteen patients with stroke (mean age, 54.7 ± 13.5 years: time after stroke, 28.0 ± 26.3 months) were enrolled in a comparative before-and-after intervention trial. WBV was applied at 30 Hz (4-8 mm amplitude) for 5 min on the hamstrings, gastrocnemius, and soleus muscles in a sitting position. Spasticity was assessed according to the F-wave parameters, MAS, and active and passive range of motion (A-ROM and P-ROM, respectively). These assessments were obtained before, immediately after, and 20 min after each intervention. RESULTS: The F-wave parameters, MAS score, and P-ROM improved significantly after the WBV and remained below the baseline level, even after 20 min; no such change was noted in the unaffected limb via the F-wave parameters. The WBV also improved volitional movement immediately after intervention, as indicated by the A-ROM. CONCLUSIONS: These results confirmed a significant reduction of motor neuron excitability until 20 min after the WBV, as indicated by F-wave parameters.

Exercise enhanced functional recovery and expression of GDNF after photochemically induced cerebral infarction in the rat.

Exercise has been considered to affect the functional recovery from central nervous damage. Neurotrophic factors have various effects on brain damage. However, the effects of exercise for expression of GDNF on functional recovery with brain damage are not well known. We investigated the difference in functional recovery between non-exercise and beam-walking exercise groups, and the expression of GDNF in both groups after photochemical infarction. Adult male Wistar rats (N = 64) were used. Animals were divided into two groups: non-exercise (N = 35), and beam-walking exercise (N = 29). All rats underwent surgical photochemical infarction. The rats of the beam-walking group were trained every day to walk on a narrow beam after a one-day recovery period and those of the non-exercise group were left to follow a natural course. Animals were evaluated for hind limb function every day using a beam-walking task with an elevated narrow beam. The number of GDNF-like immunoreactive cells in the temporal cortex surrounding the lesion was counted 1, 3, 5, and 7 days after the infarction. Functional recovery of the beam-walking exercise group was significantly earlier than that of the non-exercise group. At 3 days after infarction, the number of GDNF-positive cells in the temporal cortex surrounding the infarction was significantly increased in the beam-walking exercise group compared with that in the non-exercise group. In the exercise group, motor function was remarkably recovered with the increased expression of GDNF-like immunoreactive cells. Our results suggested that a rehabilitative approach increased the expression of GDNF and facilitated functional recovery from cerebral infarction.

Contralateral cortical role on functional recovery in a rat model of hemiplegia.

The role of the contralateral cerebral cortical plasticity in functional recovery after cerebral infarction is controversial. To clarify this role, we made a second contralateral cortical infarction after recovery from the first cerebral infarction. To produce the first infarction, Wistar rats were intravenously injected with Rose Bengal to the sensorimotor area of the right hemisphere of the cerebral cortex under green-light irradiation. Two weeks after the first hemiplegia, a secondary infarction was induced in the left cerebral cortex. Functional recovery was evaluated in a beam-walking test. Hemiplegia observed 1 day after both the first and second infarctions was given a score of 1. At 14 days after the first infarction, the average recovery score (± standard error) was 6.8 ± 0.1. In contrast, functional recovery was slower after the second infarction, reaching an average score of only 3.5 ± 0.5 after 14 days. Therefore, recovery after the contralateral secondary infarction was slower than that from the first, and received a lower recovery score compared to the recovery after the first infarction. These results suggest that the undamaged contralateral cortex plays an important role in motor recovery after hemiplegia caused by cerebral infarction.

Expected for acquisition movement exercise is more effective for functional recovery than simple exercise in a rat model of hemiplegia.

BACKGROUND AND PURPOSE: The use of novel rehabilitative approaches for effecting functional recovery following stroke is controversial. Effects of different but effective rehabilitative interventions in the hemiplegic patient are not clear. We studied the effects of different rehabilitative approaches on functional recovery in the rat photochecmical cerebral infarction model. METHODS: Twenty-four male Wistar rats aged 8 weeks were used. The cranial bone was exposed under deep anesthesia. Rose bengal (20 mg/kg) was injected intravenously, and the sensorimotor area of the cerebral cortex was irradiated transcranially for 20 min with a light beam of 533-nm wavelength. Animals were divided into 3 groups. In the simple-exercise group, treadmill exercise was performed for 20 min every day. In the expected for acquisition movement-training group, beam-walking exercise was done for 20 min daily. The control group was left to recover without additional intervention. Hindlimb function was evaluated with the beam-walking test. RESULTS: Following cerebral infarction, dysfunction of the contralateral extremities was observed. Functional recovery was observed earlier in the expected for acquisition training group than in the other groups. Although rats in the treadmill group recovered more quickly than controls, the beam-walking group had the shortest overall recovery time. CONCLUSIONS: Exercise facilitated functional recovery in the rat hemiplegic model, and expected for acquisition exercise was more effective than simple exercise. These findings are considered to have important implications for the future development of clinical rehabilitation programs.

A new non-human primate model of photochemically induced cerebral infarction.

BACKGROUND AND PURPOSE: Rat models of photochemically induced cerebral infarction have been readily studied, but to date there are no reports of transcranial photochemically induced infarctions in the marmoset. In this report, we used this non-human primate as a model of cerebral thrombosis and observed the recovery process. METHODS: Five common marmosets were used. Cerebral ischemia was produced via intravascular thrombosis induced by an intravenous injection of Rose Bengal and irradiation with green light. After inducing cerebral infarction, we observed the behavior of marmosets via a continuous video recording. We evaluated maximum speed, mean speed, and distance traveled in 1 min. In addition, we evaluated scores for feeding behavior, upper limb grip, and lower limb grip. We confirmed the infarct area after cerebral infarction using 2,3,5-triphenyltetrazolium chloride staining in a separate marmoset. RESULTS: We found functional decreases 2 days after creating the cerebral infarction in all measurements. Total distance traveled, average speed, upper limb score, and feeding behavior score did not recover to pre-infarction levels within 28 days. Maximum speed in 1 min and lower limb score recovered 28 days after infarction as compared to pre-infarction levels. We confirmed the infarct area of 11.4 mm × 6.8 mm as stained with 2,3,5-triphenyltetrazolium chloride. CONCLUSION: We were able to create a primate photothrombosis-induced cerebral infarction model using marmosets and observe functional recovery. We suggest that this is a useful model for basic research of cerebral infarction.

Effect of menthol on detrusor smooth-muscle contraction and the micturition reflex in rats.

OBJECTIVES: To investigate the effects of menthol, an activator of the temperature-sensitive transient receptor potential family member TRPM8, on detrusor smooth-muscle contraction and the micturition reflex in rats. METHODS: We evaluated the effect of intravesical infusion of 1 or 3 mM menthol by cystometry in conscious female Sprague-Dawley rats. Some of the animals were pretreated with 125 mg/kg capsaicin subcutaneously 4 days earlier. The parameters measured were voided volume (VV), residual volume (RV), volume threshold for inducing micturition (VT), voiding efficiency (VE), micturition pressure (MP), and pressure threshold for inducing micturition (PT). Strips of detrusor muscle were mounted in organ baths to study the effect of menthol on the contractile response to 0.01 mM carbachol. RESULTS: Intravesical infusion of 3 mM menthol reduced VV by 20%, VT by 19%, and PT by 31%. RV, VE, and MP were unaltered. Capsaicin pretreatment had no effect on baseline cystometric parameters, and 3 mM menthol caused similar reductions in VV (24%), VT (22%), and PT (30%), while having no effect on RV, VE, and MP. Menthol at 0.1, 0.3, and 1 mM inhibited carbachol-induced contractions by 10.7%, 36.7%, and 97.3%, respectively. CONCLUSIONS: Our results demonstrated that intravesical infusion of menthol facilitated the micturition reflex, and capsaicin pretreatment had no effect on this response. Menthol inhibited carbachol-induced contraction of the detrusor smooth muscle. This suggests that intravesically infused menthol cannot relax detrusor muscle, and acts on capsaicin-resistant afferents (probably through TRPM8 in urothelium or sensory nerve endings) to facilitate the micturition reflex.

Functional recovery and expression of GDNF seen in photochemically induced cerebral infarction.

Glial cell line-derived neurotrophic factor (GDNF) is a potent neurotrophic factor involved in the survival and proliferation of neurons. However, there have been few reports examining the relationship between GDNF and functional recovery after cerebral infarction. The authors investigated the change in the expression of GDNF proteins during functional recovery in rats following photochemically induced cerebral infarctions. Functional recovery for the first 14 days after the infarction was evaluated using a beam-walking test. The number of GDNF-like immunoreactive cells around the infarction were counted at various times (24 h, 72 h, 7 days, and 14 days) post-infarction. Immunohistochemical analysis of brain sections showed that the expression of GDNF-like immunoreactive cells was significantly increased in the temporal cortex until 7 days on the side ipsilateral to the infarction, and had decreased by 14 days. Likewise, the functional recovery of paralysis was substantial until 7 days post-infarction, after which the improvement was mild. Therefore, the expression of GDNF protein might have some relationship with the functional recovery of paralysis. There are great hopes that GDNF could be used as a therapeutic agent for cerebral infarction.