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Article in Chinese | WPRIM | ID: wpr-746034


Objective To explore the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on activity in the intact motor cortex controlling the suprahyoid muscles and thus on dysphagia after an unilateral stroke.Methods Forty patients suffering dysphagia more than two weeks after a unilateral cerebral stroke were randomly divided into an experimental group and a control group,each of 20.Both groups were given traditional swallowing rehabilitation training,while the experimental group was additionally provided with 5 Hz rTMS for two weeks.Before and after the treatment,all of the patients were characterized using X-ray fluoroscopy,video fluoroscopic swallowing study (VFSS) and surface electromyography,and their swallowing was evaluated using a standardized swallowing assessment (SSA) and a penetration-aspiration scale (PAS).Results After the treatment,significant improvement was observed in both groups in the average swallowing time and in the maximum amplitude of sEMG,as well as the average SSA,PAS and VFSS scores (P<0.05).The average values in the experimental group were in all cases significantly better than the control group's averages (P<0.05).Conclusion Applying rTMS at 5 Hz to the motor cortex of the contralateral hemisphere controlling the suprahyoid muscles can effectively improve unilateral-hemisphere dysphagia after stroke.

Article in Chinese | WPRIM | ID: wpr-469218


Objective To explore the effect of computer-aided cognitive training on cognitive function and auditory event-related potential P300 in patients with vascular cognitive impairment no dementia (VCIND).Methods Sixty VCIND patients were randomly divided into two groups namely a training group and a control group,each of 30.Both groups were given routine drug treatment and the traditional rehabilitation training.At the same time,the training group was additionally given 40min computer-aided cognitive training once a day,six times a week,lasing 4 weeks.Before and after four weeks of treatment,the cognitive function,the ability of daily life (ADL) and P300 of the two groups were assessed using mini-mental state examination(MMSE),the Montreal cognitive assessment (MoCA),Barthel Index (BI) and Motor evoked potential instrument respectively.Results Before treatment,no significant difference was found in the average MoCA,MMSE and BI scores of the two groups.After treatment,improvement was observed in the total MoCA scores (22.40 ± 4.38),as well as the average score,of visual space and executive function (3.27 ± 0.58),attention (4.30 ± 1.60),language (2.67 ± 0.48),delayed memory (3.67±0.80),MMSE (22.03 ±3.55) and BI (82.17±11.28) in the training group compared with the control group.Before treatment,there was no significant difference in the P300 latency and amplitude between the two groups.After treatment,however,the P300 latency of the training group decreased to(352.1 ± 30.68) ms,significently lower than the control group [(356.45 ± 40.30) ms] and that before treatment.Meanwhile,the amplitude rose to(8.65 ± 1.18)μV,significantly higher than the control group [(8.65 ± 1.18) μV] and that before treatment.Conclusion Computer-aided cognitive training can effectively improve the cognitive function of patients with VCIND and promote their ADL.

Article in Chinese | WPRIM | ID: wpr-469209


Objective To observe the clinical therapeutic effects of neuromuscular electric stimulation (NMES) on patients with swallowing disorders after stroke and to assess the value of surface electromyography (sEMG).Methods Forty stroke survivors with swallowing disorders were divided into a treatment group (20 cases) and a control group (20 cases) using a random number table.All of the patients were given routine medication and conventional swallowing training lasting 2 weeks,on the basis of which the patients in the treatment group were also given electrical stimulation.The seriousness of their swallowing disorders was evaluated and surface electromyographs were recorded for both groups before and after the 2 weeks of treatment.Results After treatment,the average dysphagia rating in the treatment group was significantly higher than before treatment,and significantly higher than that of the control group.sEMG of the suprahyoid muscles showed that the swallowing duration of both groups had significantly improved,but the values of the treatment group were significantly better than those of the control group.Conclusions NMES plus conventional swallowing training can significantly improve swallowing function for patients with swallowing disorders after stroke.sEMG can be regarded as an effective method for assessing swallowing disorders.

Article in Chinese | WPRIM | ID: wpr-447113


Objective To investigate any correlation between cognition and auditory event-related potential (ERP) after traumatic brain injury (TBI),and to explore the diagnostic value of the P300 ERP for TBI patients.Methods Thirty TBI patients and 28 healthy subjects were recruited.Their P300 auditory event-related potentials were measured and the Montreal cognitive assessment (MoCA) was administered.Results The TBI patients' total MoCA scores and their scores on most of the sub-item components were significantly lower than those of the control subjects,though their naming and speech showed no significant difference.The TBI patients had abnormal P300 responses.Their N1,P2,N2 and P3 latencies were significantly longer and their P2 and P3 amplitudes were significantly lower than those of the control group.Stepwise regression and multivariate analysis showed that the P300 latency was significantly associated with delayed memory,impaired visual spatial executive functioning and total MoCA score.Conclusion P300 can be used as a quantitative electrophysiological index for detecting cognitive impairment in patients with TBI.

Article in Chinese | WPRIM | ID: wpr-428692


Objective To observe the changes of cognition and auditory event-related potential P300 on vascular cognitive impairment-no dementia (VCIND) patients before and after cognitive rehabilitation training,then further to explore the application value of P300 in early diagnosis of vascular cognitive impairment (VCI). MethodsA total of 57 patients with VCIND were randomly assigned to the treatment group ( n =30) and the control group ( n =27),and 30 healthy volunteers without cognitive deficits were recruited as normal group.Each patient was examined with auditory-P300 and scored with mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) scale.The measurement indicators were analyzed and evaluated with the factors of education,age and so on. ResultsThe P300 latency in VCIND group was longer,and the amplitude lower than those in normal group before treatment (P<0.05 ),the latency lengthening was more significant than the lowering of the amplitude ( P<0.01 ).The cognitive assessment scale scores of MMSE,MoCA and ADL (Barther index,BI) in VCIND group were lower than those in normal group (P<0.05),while no significant difference was revealed between the VCIND and normal groups with regard to naming and speech( P > 0.05 ).A highly positive correlation between age and P300 latency as well as a significantly negative correlation between years of education and P300 latency were demonstrated( P<0.05 ).After cognitive rehabilitation therapy the P300 latency in VCIND group was shortened,the amplitude increased (P<0.05 ),scores of the items of cognitive scale raised(P<0.05 ) and the change of each indicator was more statistically significant in treatment group(P<0.05). ConclusionP300 could objectively reflect early cognitive dysfunction in VCIND patients.Early cognitive training could effectively promote cognitive function of VCI patients.

Article in Chinese | WPRIM | ID: wpr-380562


Objective To explore possible mechanisms of the cross-over observed in stroke patients comple-ting a line bisection test. Methods Twenty-five stroke patients with left neglect and twenty normal subjects were studied.In the ordinary line bisection test,there are two papers presenting 20 mm and 100 mm lines respectively.On each paper,three lines with the same length are presented at the left,middle and right of the paper.In the line im-age test,the two papers are the same as in line bisection test,but here subjects are asked to set endpoints of each re-al line. Results Replicating earlier findings,length cross-over was observed in the patients with neglect.In the hline image test,those patients neglected lines on both sides but with a much larger proportion on the left.The patientsunderestimated long lines as in previous studies,but they also underestimated very short lines in contrast to earlier findings. Conclusion Foveal neglect sparing may explain these observations.For very short lines,the left end of the line falls into foveal vision and the left part of the line was not neglected.As a result,the crossover effect of line length occurs.