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1.
Exp Brain Res ; 242(5): 1215-1223, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38526741

RESUMEN

Working memory (WM) can influence selective attention. However, the effect of WM load on postural standing tasks has been poorly understood, even though these tasks require attentional resources. The purpose of this study was to examine whether WM load would impact anticipatory postural adjustments (APAs) during step initiation. Sixteen healthy young adults performed stepping tasks alone or concurrently with a WM task in a dual-task design. The stepping tasks involved volitional stepping movements in response to visual stimuli and comprised of simple and choice reaction time tasks and the Flanker task which consisted of congruent and incongruent (INC) conditions. In the dual-task condition, subjects were required to memorize either one or six digits before each stepping trial. Incorrect weight transfer prior to foot-lift, termed APA errors, reaction time (RT), and foot-lift time were measured from the vertical force data. The results showed that APA error rate was significantly higher when memorizing six-digit than one-digit numerals in the INC condition. In addition, RT and foot-lift time were significantly longer in the INC condition compared to the other stepping conditions, while there was no significant effect of WM load on RT or foot-lift time. These findings suggest that high WM load reduces the cognitive resources needed for selective attention and decision making during step initiation.


Asunto(s)
Anticipación Psicológica , Memoria a Corto Plazo , Equilibrio Postural , Desempeño Psicomotor , Tiempo de Reacción , Humanos , Masculino , Adulto Joven , Femenino , Adulto , Tiempo de Reacción/fisiología , Equilibrio Postural/fisiología , Memoria a Corto Plazo/fisiología , Desempeño Psicomotor/fisiología , Anticipación Psicológica/fisiología , Atención/fisiología , Postura/fisiología
2.
Cereb Cortex ; 33(22): 11157-11169, 2023 11 04.
Artículo en Inglés | MEDLINE | ID: mdl-37757479

RESUMEN

Precision walking (PW) incorporates precise step adjustments into regular walking patterns to navigate challenging surroundings. However, the brain processes involved in PW control, which encompass cortical regions and interregional interactions, are not fully understood. This study aimed to investigate the changes in regional activity and effective connectivity within the frontoparietal network associated with PW. Functional near-infrared spectroscopy data were recorded from adult subjects during treadmill walking tasks, including normal walking (NOR) and PW with visual cues, wherein the intercue distance was either fixed (FIX) or randomly varied (VAR) across steps. The superior parietal lobule (SPL), dorsal premotor area (PMd), supplementary motor area (SMA), and dorsolateral prefrontal cortex (dlPFC) were specifically targeted. The results revealed higher activities in SMA and left PMd, as well as left-to-right SPL connectivity, in VAR than in FIX. Activities in SMA and right dlPFC, along with dlPFC-to-SPL connectivity, were higher in VAR than in NOR. Overall, these findings provide insights into the roles of different brain regions and connectivity patterns within the frontoparietal network in facilitating gait control during PW, providing a useful baseline for further investigations into brain networks involved in locomotion.


Asunto(s)
Mapeo Encefálico , Señales (Psicología) , Adulto , Humanos , Caminata , Encéfalo , Espectroscopía Infrarroja Corta
3.
Somatosens Mot Res ; : 1-11, 2023 Dec 25.
Artículo en Inglés | MEDLINE | ID: mdl-38145411

RESUMEN

PURPOSE: This study aimed to identify the contribution of the common synaptic drives to motor units during obstacle avoidance, using coherence analysis between a-pair electromyography (EMG) signals (EMG-EMG coherence). MATERIALS AND METHODS: Fourteen healthy volunteers walked on a treadmill with and without obstacle avoidance. During obstacle gait, subjects were instructed to step over an obstacle with their right leg while walking that would randomly and unpredictably appear. Surface EMG signals were recorded from the following muscles of the right leg: the proximal and distal ends of tibialis anterior (TAp and TAd), biceps femoris (BF), semitendinosus (ST), lateral gastrocnemius (LG), and medial gastrocnemius (MG). Beta-band (13-30 Hz) EMG-EMG coherence was analysed. RESULTS: Beta-band EMG-EMG coherence of TAp-TAd during swing phase and BF-ST during pre and initial swing phase when stepping over an obstacle were significantly higher compared to normal gait (both p < 0.05). Beta-band EMG-EMG coherence of TAp-TAd, BF-ST, and LG-MG during stance phase were not significantly different between the two gait conditions (all p > 0.05). CONCLUSIONS: The present findings suggest increased common synaptic drives to motor units in ankle dorsiflexor and knee flexor muscles during obstacle avoidance. It also may reflect an increased cortical contribution to modify the gait patterns to avoid an obstacle.

4.
BMC Musculoskelet Disord ; 23(1): 768, 2022 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-35953812

RESUMEN

BACKGROUND: Near-falls should be detected to prevent falls related to the earlier ambulation after Total knee arthroplasty (TKA). The quadriceps weakness with femoral nerve block (FNB) has led to a focus on adductor canal block (ACB). We purposed to examine the risk of falls and the earlier ambulation in each continuous infusion nerve block. METHODS: Continuous infusion nerve block (FNB or ACB) was performed until postoperative day (POD) 2 or 3. Pain levels and falls/near-falls with knee-buckling were monitored from POD 1 to POD 3. The score on the manual muscle test, MMT (0 to 5, 5 being normal), of the patients who could ambulate on POD 1, was investigated. RESULTS: A total of 73 TKA cases, 36 FNB and 37 ACB, met the inclusion criteria. No falls were noted. But episodes of near-falls with knee-buckling were witnessed in 14 (39%) cases in the FNB group and in 4 (11%) in the ACB group (p = 0.0068). In the ACB group, 81.1% of patients could ambulate with parallel bars on POD 1, while only 44.4% of FNB patients could do so (p = 0.0019). The quadriceps MMT values in the ACB group was 2.82, significantly higher than 1.97 in the FNB group (p = 0.0035). There were no significant differences in pain as measured with a numerical rating scale (NRS) and rescue analgesia through POD 3. CONCLUSION: ACB was associated with significantly less knee-buckling and earlier ambulation post-TKA, with better quadriceps strength. Our study indicated the incidence of falls and near-falls with continuous infusion nerve blocks, and support the use of ACB to reduce the risk of falls after TKA. It is suggested that a certain number of the patients even with continuous ACB infusion should be considered with the effect of motor branch to prevent falls.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Bloqueo Nervioso , Analgésicos Opioides , Anestésicos Locales , Artroplastia de Reemplazo de Rodilla/efectos adversos , Nervio Femoral , Humanos , Fuerza Muscular , Bloqueo Nervioso/efectos adversos , Dolor Postoperatorio/diagnóstico , Dolor Postoperatorio/etiología , Dolor Postoperatorio/prevención & control , Proyectos Piloto , Estudios Retrospectivos , Caminata
5.
J Neuroeng Rehabil ; 19(1): 129, 2022 11 24.
Artículo en Inglés | MEDLINE | ID: mdl-36424652

RESUMEN

BACKGROUND: Transcranial static magnetic field stimulation (tSMS) using a small and strong neodymium (NdFeB) magnet can temporarily suppress brain functions below the magnet. It is a promising non-invasive brain stimulation modality because of its competitive advantages such as safety, simplicity, and low-cost. However, current tSMS is insufficient to effectively stimulate deep brain areas due to attenuation of the magnetic field with the distance from the magnet. The aim of this study was to develop a brand-new tSMS system for non-invasive deep brain stimulation. METHODS: We designed and fabricated a triple tSMS system with three cylindrical NdFeB magnets placed close to each other. We compared the strength of magnetic field produced by the triple tSMS system with that by the current tSMS. Furthermore, to confirm its function, we stimulated the primary motor area in 17 healthy subjects with the triple tSMS for 20 min and assessed the cortical excitability using the motor evoked potential (MEP) obtained by transcranial magnetic stimulation. RESULTS: Our triple tSMS system produced the magnetic field sufficient for neuromodulation up to 80 mm depth from the magnet surface, which was 30 mm deeper than the current tSMS system. In the stimulation experiment, the triple tSMS significantly reduced the MEP amplitude, demonstrating a successful inhibition of the M1 excitability in healthy subjects. CONCLUSION: Our triple tSMS system has an ability to produce an effective magnetic field in deep areas and to modulate the brain functions. It can be used for non-invasive deep brain stimulation.


Asunto(s)
Estimulación Encefálica Profunda , Estimulación Magnética Transcraneal , Humanos , Voluntarios Sanos , Potenciales Evocados Motores , Campos Magnéticos
6.
Neuroimage ; 235: 118022, 2021 07 15.
Artículo en Inglés | MEDLINE | ID: mdl-33836271

RESUMEN

Control of movements using visual information is crucial for many daily activities, and such visuomotor control has been revealed to be supported by alpha and beta cortical oscillations. However, it has been remained to be unclear how midfrontal theta and occipital gamma oscillations, which are associated with high-level cognitive functions, would be involved in this process to facilitate performance. Here we addressed this fundamental open question in healthy young adults by measuring high-density cortical activity during a precision force-matching task. We manipulated the amount of error by changing visual feedback gain (low, medium, and high visual gains) and analyzed event-related spectral perturbations. Increasing the visual feedback gain resulted in a decrease in force error and variability. There was an increase in theta synchronization in the midfrontal area and also in beta desynchronization in the sensorimotor and posterior parietal areas with higher visual feedback gains. Gamma de/synchronization was not evident during the task. In addition, we found a moderation effect of midfrontal theta on the positive relationship between the beta oscillations and force error. Subsequent simple slope analysis indicated that the effect of beta oscillations on force error was weaker when midfrontal theta was high. Our findings suggest that the midfrontal area signals the increased need of cognitive control to refine behavior by modulating the visuomotor processing at theta frequencies.


Asunto(s)
Ritmo beta/fisiología , Lóbulo Frontal/fisiología , Desempeño Psicomotor/fisiología , Ritmo Teta/fisiología , Cognición , Conflicto Psicológico , Electroencefalografía , Retroalimentación Sensorial , Humanos , Adulto Joven
7.
Neuroimage ; 220: 117089, 2020 10 15.
Artículo en Inglés | MEDLINE | ID: mdl-32592849

RESUMEN

Beta-band (15-30 â€‹Hz) corticomuscular and intermuscular coherences are important markers of the corticospinal interaction. The purpose of this study was to investigate whether amount of visual feedback during an isometric pinch grip contraction would influence these coherences in young and elderly adults. Thirty-three healthy young and elderly subjects performed pinch grip force-matching task with right thumb and index finger, while scalp electroencephalogram (EEG) and electromyogram (EMG) from the first dorsal interosseous (FDI) and abductor pollicis brevis (APB) muscles were recorded. The amount of visual feedback was altered by manipulation of visual gain (low and high). Beta-band corticomuscular coherence was computed between EEG over the sensorimotor cortex and EMG from the FDI muscle and between EEG and EMG from the APB muscle (EEG-FDI and EEG-APB coherences). Also, beta-band intermuscular coherence was computed between EMG signals from the FDI and APB muscles (EMG-EMG coherence). Task performance was quantified as standard deviation (SD) of force and mean force error (MFE). EEG-FDI coherence was larger at high than low visual gain in the elderly but not in the young subjects, whereas there was no effect of age or visual gain on EEG-APB coherence. EMG-EMG coherence was smaller at high than low visual gain in the young and elderly subjects. The MFE was smaller at high than low visual gain in the young and elderly subjects, but the SD of force was smaller at high than low visual gain only in the young subjects. These results suggest that the effect of aging on beta-band coherence depends on the amount of visual feedback and further that visual feedback modulates beta-band corticomuscular and intermuscular coherences differently.


Asunto(s)
Envejecimiento/fisiología , Ritmo beta/fisiología , Retroalimentación Sensorial/fisiología , Corteza Motora/fisiología , Músculo Esquelético/fisiología , Adulto , Anciano , Electroencefalografía , Electromiografía , Humanos , Contracción Isométrica/fisiología , Masculino , Adulto Joven
8.
J Physiol ; 597(13): 3441-3455, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31087329

RESUMEN

KEY POINTS: Neuropathic pain spreads spatially beyond the injured sites, and the mechanism underlying the spread has been attributed to inflammation occurring in the spinal cord. However, the spatial spread of spinal/cortical potentiation induced by conduction block of the peripheral nerves can be observed prior to inflammation. In the present study, we found that spreading potentiation and hypersensitivity acutely induced by unilateral hindpaw ischaemia are nitric oxide (NO)-dependent and that NO is produced by ischaemia and quickly diffuses within the spinal cord. We also found that NO production induced by ischaemia is not observed in the presence of an antagonist for group II metabotropic glutamate receptors (mGluRs) and that neuronal NO synthase-positive dorsal horn neurons express group II mGluRs. These results suggest strongly that NO-mediated spreading potentiation in the spinal cord is one of the trigger mechanisms for neuropathic pain. ABSTRACT: Cortical/spinal responses to hindpaw stimulation are bilaterally potentiated by unilateral hindpaw ischaemia in mice. We tested the hypothesis that hindpaw ischaemia produces nitric oxide (NO), which diffuses in the spinal cord to induce spatially spreading potentiation. Using flavoprotein fluorescence imaging, we confirmed that the spreading potentiation in hindpaw responses was induced during ischaemia in the non-stimulated hindpaw. This spreading potentiation was blocked by spinal application of l-NAME, an inhibitor of NO synthase (NOS). Furthermore, no spreading potentiation was observed in neural NOS (nNOS) knockout mice. Spinal application of an NO donor was enough to induce cortical potentiation and mechanical hypersensitivity. The spatial distribution of NO during unilateral hindpaw ischaemia was visualized using 4-amino-5-methylamino-2',7'-difluorofluorescein (DAF-FM). An increase in fluorescence derived from the complex of DAF-FM with NO was observed on the ischaemic side of the spinal cord. A similar but smaller increase was also observed on the contralateral side. Somatosensory potentiation after hindpaw ischaemia is known to be inhibited by spinal application of LY354740, an agonist of group II metabotropic glutamate receptors (mGluRs). We confirmed that the spinal DAF-FM fluorescence increases during hindpaw ischaemia were not observed in the presence of LY354740. We also confirmed that approximately half of the nNOS-positive neurons in the superficial laminae of the dorsal horn expressed mGluR2 mRNA. These results suggest that disinhibition of mGluR2 produces NO which in turn induces a spreading potentiation in a wide area of the spinal cord. Such spreading, along with the consequent non-specific potentiation in the spinal cord, may trigger neuropathic pain.


Asunto(s)
Isquemia/metabolismo , Neuralgia/metabolismo , Óxido Nítrico/metabolismo , Médula Espinal/metabolismo , Animales , Isquemia/tratamiento farmacológico , Masculino , Ratones , Ratones Endogámicos C57BL , NG-Nitroarginina Metil Éster/farmacología , Neuralgia/tratamiento farmacológico , Óxido Nítrico Sintasa/metabolismo , Óxido Nítrico Sintasa de Tipo I/metabolismo , Dimensión del Dolor/métodos , Receptores de Glutamato Metabotrópico/metabolismo , Médula Espinal/efectos de los fármacos
9.
Exp Brain Res ; 236(5): 1229-1239, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29479634

RESUMEN

To investigate the effects of aging on coordination of plantar flexor muscles during bipedal and unipedal stances, we examined a relationship between the center of pressure sway and electromyographic activity of these muscles, and also the common neural input, using a coherence analysis. Healthy young and elderly adults were asked to perform bipedal and unipedal standing. The electromyograms were recorded unilaterally from the medial and lateral gastrocnemius (MG and LG) and soleus (SL) muscles, and the common input was analyzed for MG-LG, MG-SL, and LG-SL pairs in two frequency bands: a delta band, that is associated with force variability, and a beta band, that could reflect the corticospinal drive. Main results indicated that the MG and SL muscles worked for lateral sway, while the LG muscle worked for medial sway during the unipedal stance. The delta-band coherence for the MG-SL pair and the beta-band coherences for all the pairs were larger during the unipedal than bipedal stance for both groups. The delta-band coherence for the MG-SL pair was larger for the elderly than young adults during the unipedal stance. In addition, the beta-band coherence for the MG-SL pair was larger than the other pairs during the unipedal stance for the elderly. These findings suggest that the oscillatory activity between the MG and SL muscles is strongly involved in the control of unipedal stance, and aging would increase the cortical drive to these muscles to deal with the postural sway that could be affected by forces generated cooperatively by them.


Asunto(s)
Envejecimiento/fisiología , Músculo Esquelético/fisiología , Postura/fisiología , Anciano , Electromiografía , Femenino , Humanos , Masculino , Equilibrio Postural/fisiología , Adulto Joven
11.
J Anesth ; 32(5): 781-785, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-30206690

RESUMEN

Opioid-related postoperative nausea and vomiting should not occur following remifentanil administration because of its relatively short time to elimination. However, studies have indicated that the incidence of postoperative nausea and vomiting associated with remifentanil is similar to that with other opioids. Hence, we aimed to determine whether intraoperative remifentanil itself is associated with postoperative nausea and vomiting when postoperative pain is managed without opioid use. In this prospective pilot study, 150 patients who underwent unilateral upper limb surgery under general anesthesia with brachial plexus block were included. Patients in the remifentanil and control groups received 0.5 µg/kg/min remifentanil and saline, respectively. Postoperative pain was managed using a brachial plexus block, non-steroidal anti-inflammatory drugs, and acetaminophen. The presence of postoperative nausea and vomiting within the first 24 h after anesthesia was assessed by an evaluator blinded to patient allocation. Eight patients were excluded from the final analysis, resulting in 72 and 70 patients in the remifentanil and control groups, respectively. Postoperative nausea and vomiting within 24 h after surgery occurred in 11 and 9 patients in the remifentanil and control groups, respectively. These data suggest that remifentanil use only minimally affects the incidence of postoperative nausea and vomiting under sevoflurane anesthesia. UMIN Clinical Trials Registry identification number: UMIN000016110.


Asunto(s)
Analgésicos Opioides/administración & dosificación , Dolor Postoperatorio/tratamiento farmacológico , Náusea y Vómito Posoperatorios/epidemiología , Remifentanilo/administración & dosificación , Adulto , Anciano , Anestesia General/métodos , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Estudios Prospectivos
12.
Br J Clin Pharmacol ; 83(10): 2205-2213, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28548279

RESUMEN

AIM: The kinetics of propofol are influenced by cardiac output. The aim of this study was to examine changes in blood propofol concentrations during phaeochromocytoma surgery using target-controlled infusion (TCI) anaesthesia with propofol. METHODS: This is a prospective observational study. Ten patients with phaeochromocytoma who underwent unilateral adrenalectomy were included. Cardiac output was measured using an arterial pressure-based cardiac output analysis method. The target blood propofol concentrations were adjusted to maintain an approximate bispectral index (BIS) value of 40 before initiating surgery. The settings remained constant during surgery. Blood samples for propofol concentrations were collected from the radial artery at seven time points: two before tumour manipulation (T1, 2), two during tumour manipulation (T3, 4), and three after tumour vein ligation (T4-7). BIS values, the arterial pressure cardiac index (APCI) and haemodynamic parameters were measured at the same time points as the blood samples. The prop-ratio was calculated by dividing blood propofol concentrations by target concentrations of TCI. RESULTS: APCI increased during tumour manipulation and after tumour vein ligation. The prop-ratio was reduced significantly by approximately 40% and showed a significant negative correlation with APCI. BIS values increased significantly and showed a significant negative correlation with the prop-ratio. CONCLUSION: The increased APCI during tumour manipulation and after tumour vein ligation was associated with markedly reduced blood propofol concentrations. These results reveal that significant decreases in the anaesthetic effect may be observed in patients undergoing phaeochromocytoma surgery even if TCI anaesthesia is used with propofol.


Asunto(s)
Neoplasias de las Glándulas Suprarrenales/cirugía , Adrenalectomía/efectos adversos , Anestésicos Intravenosos/farmacocinética , Feocromocitoma/cirugía , Propofol/farmacocinética , Adrenalectomía/métodos , Adulto , Anciano , Anestesia/métodos , Anestésicos Intravenosos/sangre , Presión Arterial , Gasto Cardíaco , Electroencefalografía , Femenino , Hemodinámica , Humanos , Masculino , Persona de Mediana Edad , Propofol/sangre , Estudios Prospectivos
13.
Eur J Appl Physiol ; 117(12): 2409-2423, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29027033

RESUMEN

PURPOSE: The study aim was to compare the influence of an auditory stimulus (AS) on anticipatory postural adjustments (APAs) between young and older adults during a choice step reaction. METHODS: Sixteen young and 19 older adults stepped forward in response to a visual imperative stimulus of an arrow. We used a choice reaction time (CRT) task and a Simon task which consisted of congruent and incongruent conditions. The direction of the presented arrow and its spatial location matched in the congruent condition while they did not in the incongruent condition. The AS was presented randomly and simultaneously with the visual stimulus. Incorrect weight shifts before lifting off the foot, termed APA errors, stepping errors, temporal parameters, and APA amplitudes were analyzed. RESULTS: The APA error rate was higher in trials with than without AS in all task conditions for the older group, while this increase occurred only in the incongruent condition for the young group. The stepping error rate was also increased in the presence of AS in the incongruent condition for the older group. Reaction times were faster with AS in both groups. The APA amplitude of erroneous APA trials became larger with AS in the incongruent condition for both groups, and this effect appeared greater for the older group. CONCLUSIONS: The effect of AS on APAs is larger in the elderly during a choice step reaction. In the presence of incongruent visual information, this effect becomes even greater, potentially inducing not only APA errors but also stepping errors.


Asunto(s)
Envejecimiento/fisiología , Percepción Auditiva , Equilibrio Postural , Tiempo de Reacción , Caminata , Anciano , Anticipación Psicológica , Conducta de Elección , Femenino , Humanos , Masculino , Percepción Visual , Adulto Joven
14.
Exp Brain Res ; 234(11): 3355-3365, 2016 11.
Artículo en Inglés | MEDLINE | ID: mdl-27443854

RESUMEN

Choice reaction requires response conflict resolution, and the resolution processes that occur during a choice stepping reaction task undertaken in a standing position, which requires maintenance of balance, may be different to those processes occurring during a choice reaction task performed in a seated position. The study purpose was to investigate the resolution processes during a choice stepping reaction task at the cortical level using electroencephalography and compare the results with a control task involving ankle dorsiflexion responses. Twelve young adults either stepped forward or dorsiflexed the ankle in response to a visual imperative stimulus presented on a computer screen. We used the Simon task and examined the error-related negativity (ERN) that follows an incorrect response and the correct-response negativity (CRN) that follows a correct response. Error was defined as an incorrect initial weight transfer for the stepping task and as an incorrect initial tibialis anterior activation for the control task. Results revealed that ERN and CRN amplitudes were similar in size for the stepping task, whereas the amplitude of ERN was larger than that of CRN for the control task. The ERN amplitude was also larger in the stepping task than the control task. These observations suggest that a choice stepping reaction task involves a strategy emphasizing post-response conflict and general performance monitoring of actual and required responses and also requires greater cognitive load than a choice dorsiflexion reaction. The response conflict resolution processes appear to be different for stepping tasks and reaction tasks performed in a seated position.


Asunto(s)
Conducta de Elección/fisiología , Conflicto Psicológico , Potenciales Evocados/fisiología , Desempeño Psicomotor/fisiología , Tiempo de Reacción/fisiología , Adulto , Análisis de Varianza , Electroencefalografía , Electromiografía , Femenino , Humanos , Masculino , Estimulación Luminosa , Postura , Adulto Joven
15.
J Anesth ; 30(2): 317-9, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26661449

RESUMEN

We describe a case in which an anatomic diagnosis was useful for diagnosing and estimating the cause of femoral nerve palsy following gynecologic surgery. A 49-year-old female received general and epidural anesthesia for radical ovarian cancer surgery. Although injection pain was noted in the left medial shin with 1 % mepivacaine administered as a test dose, the catheter was left indwelling because it improved her symptoms. The surgery, which lasted 195 min, was performed in the lithotomy position, and a self-retained retractor was used to gain a good surgical field. Postoperatively, the patient complained of difficulty in stretching her knee joint and left lower limb paresthesia that did not improve after stopping continuous epidural administration. A spinal cord injury related to epidural anesthesia was suspected because the sites of sensory impairment and epidural injection pain were the same; however, the patient had greater weakness of the quadriceps muscle than the iliopsoas, and no other muscle weakness was observed. These findings and previous reports suggest that her femoral nerve palsy was caused by compression of the inguinal ligament from the self-retaining retractor and lithotomy position. Twenty months after surgery, her muscle strength had fully recovered.


Asunto(s)
Nervio Femoral/lesiones , Neuropatía Femoral/etiología , Procedimientos Quirúrgicos Ginecológicos/efectos adversos , Anestesia Epidural/efectos adversos , Femenino , Humanos , Articulación de la Rodilla/patología , Pierna , Mepivacaína/administración & dosificación , Persona de Mediana Edad , Periodo Posoperatorio
16.
J Neurophysiol ; 114(1): 419-26, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25925321

RESUMEN

When multiple sensory modalities are simultaneously presented, reaction time can be reduced while interference enlarges. The purpose of this research was to examine the effects of task-irrelevant acoustic accessory stimuli simultaneously presented with visual imperative stimuli on executive function during stepping. Executive functions were assessed by analyzing temporal events and errors in the initial weight transfer of the postural responses prior to a step (anticipatory postural adjustment errors). Eleven healthy young adults stepped forward in response to a visual stimulus. We applied a choice reaction time task and the Simon task, which consisted of congruent and incongruent conditions. Accessory stimuli were randomly presented with the visual stimuli. Compared with trials without accessory stimuli, the anticipatory postural adjustment error rates were higher in trials with accessory stimuli in the incongruent condition and the reaction times were shorter in trials with accessory stimuli in all the task conditions. Analyses after division of trials according to whether anticipatory postural adjustment error occurred or not revealed that the reaction times of trials with anticipatory postural adjustment errors were reduced more than those of trials without anticipatory postural adjustment errors in the incongruent condition. These results suggest that accessory stimuli modulate the initial motor programming of stepping by lowering decision threshold and exclusively under spatial incompatibility facilitate automatic response activation. The present findings advance the knowledge of intersensory judgment processes during stepping and may aid in the development of intervention and evaluation tools for individuals at risk of falls.


Asunto(s)
Anticipación Psicológica , Función Ejecutiva , Actividad Motora , Postura , Percepción Visual , Anticipación Psicológica/fisiología , Fenómenos Biomecánicos , Conducta de Elección , Señales (Psicología) , Femenino , Humanos , Juicio , Masculino , Actividad Motora/fisiología , Estimulación Luminosa , Postura/fisiología , Psicofísica , Tiempo de Reacción , Adulto Joven
17.
Masui ; 64(10): 1072-5, 2015 Oct.
Artículo en Japonés | MEDLINE | ID: mdl-26742413

RESUMEN

A patient with medication resistant schizophrenia underwent modified electroconvulsive therapy (12 sessions). Propofol was chosen as a hypnotic agent and the adjustment of its dose and stimulus intensity was attempted. However, despite using propofol of a dose minimally required for hypnosis, adequate seizures could not be induced even with the maximum stimulation. Assuming that propofol was preventing the induction of seizures, it was decided to reduce its dose and at the same time to combine it with remifentanil 100 µg starting from the fifth session. This allowed to reach the seizure adequacy during the next and the four subsequent sessions. Although from the tenth session on, adequate seizures could no longer be induced (possibly due to the development of resistance to propofol), the patient's symptoms showed improvement after completion of all 12 sessions.


Asunto(s)
Terapia Electroconvulsiva , Piperidinas/administración & dosificación , Propofol/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad , Remifentanilo , Convulsiones
18.
Masui ; 63(8): 866-71, 2014 Aug.
Artículo en Japonés | MEDLINE | ID: mdl-25199319

RESUMEN

BACKGROUND: There is an increasing number of patients scheduled for abdominal aortic aneurysm resection in whom epidural anesthesia cannot be performed because of concomitant antiplatelet/anticoagulant therapy. Instead of epidural anesthesia for postoperative analgesia in such patients it is possible to use repeated bilateral subcostal transversus abdominis plane (TAP) blocks. METHODS: Four patients receiving antiplatelet/anticoagulant therapy for abdominal aortic aneurysm resection under general anesthesia were studied. After the completion of surgery and before emergence from anesthesia 18-gauge intravenous catheters were inserted bilaterally into subcostal TAP and 100 ml (50 ml on each side) of 0.2% lidocaine with 1/500,000 epinephrine were injected via the catheters twice daily until the second postoperative day. Pain intensity was assessed using a 0-10 numerical rating scale at rest and during movement, before and after each block. RESULTS: Numerical pain ratings at rest and during movement decreased after each block, and good analgesia was obtained. No complications such as nausea, vomiting or infection were observed in the postoperative period. CONCLUSIONS: These findings suggest that repeated bilateral subcostal TAP blocks with 0.2% lidocaine performed via 18-gauge intravenous catheters provide good postoperative analgesia after abdominal aortic aneurysm resection.


Asunto(s)
Músculos Abdominales/inervación , Analgesia/métodos , Anestésicos Locales/administración & dosificación , Aneurisma de la Aorta Abdominal/cirugía , Lidocaína/administración & dosificación , Bloqueo Nervioso/métodos , Dolor Postoperatorio/tratamiento farmacológico , Dispositivos de Acceso Vascular , Anciano , Epinefrina/administración & dosificación , Humanos , Masculino , Cuidados Posoperatorios , Resultado del Tratamiento
19.
Masui ; 62(6): 665-9, 2013 Jun.
Artículo en Japonés | MEDLINE | ID: mdl-23814987

RESUMEN

BACKGROUND: We performed a retrospective study of the efficacy and safety of spinal anesthesia with 0.1 mg morphine in the postoperative course of elderly patients with femoral neck fracture. METHODS: Sixty patients with ages averaging 84 years participated in this study. Surgery was performed under spinal anesthesia. Patients were assigned to either a group receiving of 0.1 mg morphine added to isobaric bupivacaine (Group M) or a group receiving of isobaric bupivacaine alone (Group B). The frequency of analgesic use and the occurrence of adverse side effects during the first 48 hours after surgery were compared between the two groups. RESULTS: In the first 24 hours, the patients in Group M needed significantly less analgesics compared to Group B. The incidence of adverse side effects did not differ significantly between the groups, although nausea had a tendency to increase in Group M. One patient in Group M showed a mild decrease in oxygen saturation. CONCLUSIONS: The spinal administration of 0.1 mg morphine had beneficial effects and was safe in the postoperative period of elderly patients with femoral neck fracture provided that sufficient observation was given.


Asunto(s)
Anestesia Raquidea , Fracturas del Cuello Femoral/cirugía , Morfina/administración & dosificación , Anciano de 80 o más Años , Analgésicos/administración & dosificación , Anestesia Raquidea/efectos adversos , Bupivacaína/administración & dosificación , Femenino , Humanos , Masculino , Morfina/efectos adversos , Dolor Postoperatorio/prevención & control
20.
Neurosci Lett ; 797: 137079, 2023 02 16.
Artículo en Inglés | MEDLINE | ID: mdl-36657634

RESUMEN

In animal models, oscillations of local field potentials are entrained by nasal respiration at the frequency of breathing cycle in olfactory brain regions, such as the olfactory bulb and piriform cortex, as well as in the other brain regions. Studies in humans also confirmed these respiration-entrained oscillations in several brain regions using intracranial electroencephalogram (EEG). Here we extend these findings by analyzing coherence between cortical activity and respiration using high-density scalp EEG in twenty-seven healthy human subjects. Results indicated the occurrence of significant coherence between scalp EEG and respiration signals, although the number and locations of electrodes showing significant coherence were different among subjects. These findings suggest that scalp EEG can detect respiration-entrained oscillations. It remained to be determined whether these oscillations are volume conducted from the olfactory brain regions or reflect the local cortical activity.


Asunto(s)
Encéfalo , Cuero Cabelludo , Animales , Humanos , Electroencefalografía/métodos , Respiración , Bulbo Olfatorio
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