ABSTRACT
BACKGROUND: Transcranial direct current stimulation (tDCS) has been proven to be able to modulate motor cortical plasticity might have potential as an alternative, adjunctive therapy for Parkinson's disease (PD). However, the efficacy of tDCS in PD is still uncertain. A disease animal model may be useful to clarify the existence of a treatment effect and to explore an effective therapeutic strategy using tDCS protocols. OBJECTIVE: The current study was designed to identify the comprehensive therapeutic effects of tDCS in 6-hydroxydopamine (6-OHDA)-lesioned PD rats. METHODS: Following early and long-term tDCS application (starting 24 h after PD lesion, 300 µA anodal tDCS, 20 min/day, 5 days/week) in awake PD animals for a total of 4 weeks, the effects of tDCS on motor and non-motor behaviors as well as dopaminergic neuron degeneration levels, were identified. RESULTS: We found that the 4-week tDCS intervention significantly alleviated 6-OHDA-induced motor deficits in locomotor activity, akinesia, gait pattern and anxiety-like behavior, but not in apomorphine-induced rotations, recognition memory and depression-like behavior. Immunohistochemically, tyrosine hydroxylase (TH)-positive neurons in the substantia nigra were significantly preserved in the tDCS intervention group. CONCLUSIONS: These results suggest that early and long-term tDCS could exert neuroprotective effects and reduce the aggravation of motor dysfunctions in a 6-OHDA-induced PD rat model. Furthermore, this preclinical model may enhance the promising possibility of the potential use of tDCS and serve as a translational platform to further identify the therapeutic mechanism of tDCS for PD or other neurological disorders.
Subject(s)
Oxidopamine/toxicity , Parkinsonian Disorders/chemically induced , Parkinsonian Disorders/prevention & control , Transcranial Direct Current Stimulation/methods , Animals , Electrodes, Implanted , Gait/drug effects , Gait/physiology , Male , Motor Cortex/drug effects , Motor Cortex/pathology , Parkinsonian Disorders/pathology , Rats , Rats, Wistar , Time Factors , Treatment OutcomeABSTRACT
BACKGROUND: In clinical practice, checkrein deformity is usually found in patients with calf injuries after ankle fracture or distal tibial fracture. The patients with checkrein deformity mainly report distending pain in toe tips, pain when walking or wearing shoes, and gait instability. Previous studies have mainly reported surgical treatments for checkrein deformity, while few studies have reported using comprehensive rehabilitation alone to improve the checkrein deformity. CASE SUMMARY: A 28-year-old woman was admitted to the hospital due to unstable gait caused by pain in the right hallux, for which she was unable to stretch for over three months. The patient had undergone "resection of ameloblastoma at the right mandible, mandibulectomy, and autogenous right fibula grafting". The patient's hallux toe, as well as the second and third toes of the right foot could not be stretched, with pain in all the toes during walking. Based on the medical records of the patient, as well as the results of physical and auxiliary examinations, the main diagnosis was checkrein deformity in the right foot. Since the patient refused surgical treatment, rehabilitation was the only treatment option. At discharge, the patient reported evident improvement in the pain in the toes, gait stability, as well as increased ability to climb up and downstairs. CONCLUSION: Comprehensive rehabilitation therapy could effectively alleviate the manifestations of checkrein deformity and improve the walking ability of the patients.
ABSTRACT
BACKGROUND: To systematically evaluate the therapeutic effect of electrical stimulation (ES) on overactive bladder (OB). METHOD: We retrieved information by searching databases from PubMed, CBM-disc, The Cochrane Library, ScienceDirect (from Elsevier publishers) and Springer publishers up to March 2016. We looked for randomized controlled trials that studied ES in OB treatment with subject headings and keywords using literature searches and manual retrieval. References of included studies were reviewed. Literature was screened independently by two investigators according to inclusion and exclusion criteria. After extracting data and evaluating their quality, meta-analysis was undertaken with RevMan v5.2. RESULTS: Ten randomized controlled trials involving 719 patients were included. Meta-analysis results demonstrated ES to have better effects for improving bladder compliance, reducing residual urine, and decreasing the frequency of enuresis in OB patients compared with the control group. ES elicited significantly better effects for diminishing the maximum detrusor pressure in children than in controls, but there was no significant difference in the maximum detrusor pressure between adults and controls. The therapeutic effect of ES combined with other therapies for increasing the maximum bladder capacity was better compared with other therapies alone. No significant difference was noted between ES alone and other therapies alone. CONCLUSIONS: Based on current evidence, ES has certain effects on OBs. Severe adverse reactions are not observed. ES is safe, efficacious, and worthy of clinical use.
