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1.
Adv Exp Med Biol ; 1191: 331-346, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002936

RESUMO

Many pharmacological treatments were proved effective in the treatment of panic disorder (PD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD); still many patients do not achieve remission with these treatments. Neurostimulation techniques have been studied as promising alternatives or augmentation treatments to pharmacological and psychological therapies. The most studied neurostimulation method for anxiety disorders, PTSD, and OCD was repetitive transcranial magnetic stimulation (rTMS). This neurostimulation technique had the highest level of evidence for GAD. There were also randomized sham-controlled trials indicating that rTMS may be effective in the treatment of PTSD and OCD, but there were conflicting findings regarding these two disorders. There is indication that rTMS may be effective in the treatment of panic disorder, but the level of evidence is low. Deep brain stimulation (DBS) was most studied for treatment of OCD, but the randomized sham-controlled trials had mixed findings. Preliminary findings indicate that DBS could be affective for PTSD. There is weak evidence indicating that electroconvulsive therapy, transcranial direct current stimulation, vagus nerve stimulation, and trigeminal nerve stimulation could be effective in the treatment of anxiety disorders, PTSD, and OCD. Regarding these disorders, there is no support in the current literature for the use of neurostimulation in clinical practice. Large high-quality studies are warranted.


Assuntos
Transtornos de Ansiedade/terapia , Terapia por Estimulação Elétrica , Eletroconvulsoterapia , Transtorno Obsessivo-Compulsivo/terapia , Transtornos de Estresse Pós-Traumáticos/terapia , Estimulação Transcraniana por Corrente Contínua , Estimulação Magnética Transcraniana , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
World Neurosurg ; 133: 42-48, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31550542

RESUMO

BACKGROUND: Navigated transcranial magnetic stimulation (nTMS) is being used for different purposes in patients with brain tumors. However, the procedure requires a positive electrophysiological response. For patients with negative response in rest conditions, active motor threshold (AMT) may be used. However, sometimes it is difficult to obtain AMT measures owing to inability of the patient to sustain steady muscle contraction. Herein, we describe a simple method by using a hand dynamometer to obtain AMT measures during nTMS session. CASE DESCRIPTION: A woman aged 68 years underwent total removal of a right frontal lobe oligodendroglioma World Health Organization grade II 15 years ago. Cranial magnetic resonance imaging during follow-up revealed local recurrence. In the postoperative period, she developed left upper limb paresis. A postoperative nTMS session was performed for motor electrophysiological evaluation. However, using the standard technique for AMT measurement, the patient was unable to perform sustained muscle contraction as required. A hand dynamometer was used. It allowed sustained muscle contraction for AMT measurement. A counter force for the index finger flexion, the hand support to stabilize hand joints, and a numerical screen serving for both the examiner and the patient as a feedback parameter may explain the success obtained with this simple device. CONCLUSIONS: Although more studies are necessary to validate the method, the hand dynamometer should be considered for patients unable to sustain muscle contraction during AMT measurement.


Assuntos
Lobo Frontal/fisiopatologia , Córtex Motor/fisiopatologia , Contração Muscular/fisiologia , Dinamômetro de Força Muscular , Recidiva Local de Neoplasia/fisiopatologia , Oligodendroglioma/fisiopatologia , Estimulação Magnética Transcraniana/métodos , Idoso , Mapeamento Encefálico , Feminino , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/cirurgia , Humanos , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/cirurgia , Oligodendroglioma/diagnóstico por imagem , Oligodendroglioma/cirurgia
4.
Orv Hetil ; 161(1): 3-10, 2020 Jan.
Artigo em Húngaro | MEDLINE | ID: mdl-31884813

RESUMO

The rapidly evolving field of repetitive transcranial magnetic stimulation as a neuromodulational technique may mean a safe, alternative approach to the management of several mental disorders, especially treatment-resistant major depressive disorder. Our aim is to describe the current role of transcranial magnetic stimulation in research and routine clinical practice, based on the literature and clinical protocols. Since the discovery, that an outer magnetic source can depolarize neurons, both neurology and psychiatry seek the method's possible clinical utility. To date, in the field of psychiatry, the method is only approved in the treatment of major depressive disorder and obsessive-compulsive disorder, but research continues to find application in other mental disorders (schizophrenia, bipolar disorder), too. The next step in the evolution of repetitive transcranial magnetic stimulation is based on magnetic resonance guided, real-time navigation with the help of positioning algorithms. The so-called neuronavigational systems make precise aiming of neuronal circuits responsible for the development of depression, thus increasing the excitability of the left dorsolateral prefrontal cortex and decreasing it on the right hemisphere. The method has few contraindications, and the occurrence of side effects can be minimized by carefully selected patient population. For today, transcranial magnetic stimulation became an evidence-based, effective treatment for some mental disorders, especially treatment-resistant major depressive disorder. It is to be assumed that in the future neuronavigational neuromodulation techniques, including repetitive transcranial magnetic stimulation, will be widely used in the field of psychiatry and neurology. Magnetic stimulation is currently available in a number of centres in Hungary, but the financial approval and the implementation of this neuromodulation method for treating mental disorders in the everyday clinical practice are still in progress. Orv Hetil. 2020; 161(1): 3-10.


Assuntos
Transtorno Depressivo Maior/terapia , Estimulação Magnética Transcraniana/métodos , Transtorno Depressivo Maior/psicologia , Humanos , Hungria , Córtex Pré-Frontal , Estimulação Magnética Transcraniana/efeitos adversos , Resultado do Tratamento
5.
Adv Exp Med Biol ; 1180: 193-199, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31784964

RESUMO

The treatment strategies of depressive disorder include pharmacological treatment, psychotherapy, and physical therapy (electroconvulsive therapy [ECT], transcranial magnetic stimulation [TMS], etc.). The updated CANMAT guidelines recommended the most second-generation antidepressants as first-line treatments for patients with a major depressive disorder (MDD) of moderate or greater severity. Before antidepressant treatment, comprehensive assessment and safety monitoring are necessary. The application of measurement-based care in the diagnosis and treatment of depression would better ensure that enough dosage and response of antidepressant is achieved at each key point, and the final outcome of disease is improved. It is recommended that antidepressant is used with monotherapy in patients with depression. Antidepressants of different types and different mechanisms could be combined to improve the efficacy for patients with treatment-resistant depression (TRD). To prevent the relapse and recurrence of disease, the long-term treatment comprised of acute treatment, consolidation treatment, and maintenance treatment must be considered for all patients.


Assuntos
Transtorno Depressivo Maior/terapia , Antidepressivos/uso terapêutico , Eletroconvulsoterapia , Humanos , Psicoterapia , Estimulação Magnética Transcraniana , Resultado do Tratamento
6.
Adv Exp Med Biol ; 1180: 201-217, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31784965

RESUMO

Despite many advances in pharmacotherapy over the past half centurye, only a fraction of patients with Major Depressive Disorder (MDD) can achieve remission after the first or second trial of pharmacotherapy. Those who failed standard antidepressant treatment are termed as Treatment-Resistant Depression (TRD). Pharmacotherapy for TRD is more viable over past 15 years in part due to advances in clinical trials such as the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) and the US Department of Veterans Affairs Augmentation and Switching Treatments for Improving Depression Outcomes (VAST-D) study. In general, optimizing pharmacotherapy consists of switching to different agents, combination with different antidepressants, or augmentation with different class of psychotropic medications, and the latter is preferred. Augmenting agents with strong evidence include Bupropion, Lithium, Triiodothyronine (T3), Aripiprazole, Brexpiprazole, Quetiapine, and Olanzapine in combination with Fluoxetine. Many works need to be done to further advance this field. These include (1) Establish agreement on a standardized, systematic, and feasible definition of TRD, (2) Establish safety and tolerability beyond acute treatment phase, (3) Establish individual psychosocial and neurobiological marks such as pharmacogenetic variance, and (4) Utilize multi-treatment modules such as combination of psychotherapy and pharmacotherapy in conjunction with brain stimulation therapy such as electroconvulsive therapy, vagus nerve stimulation and transcranial magnetic stimulation; as well as non-traditional therapy such as nutritional supplements, exercise and light therapy.


Assuntos
Transtorno Depressivo Maior/terapia , Antidepressivos/uso terapêutico , Quimioterapia Combinada , Eletroconvulsoterapia , Humanos , Psicoterapia , Estimulação Magnética Transcraniana , Resultado do Tratamento
7.
Artigo em Russo | MEDLINE | ID: mdl-31793539

RESUMO

AIM: To assess diagnostic and therapeutic values of transcranial magnetic stimulation (TMS) in patients with writer's cramp (WC). MATERIAL AND METHODS: Twelve right-handed patients with WC were enrolled in the study. All patients underwent low-frequency repetitive TMS (rTMS) over the premotor cortex of the hemisphere contralateral to the affected hand. The clinical efficacy was assessed using the Writer's Cramp Rating Scale (WCRS) and the Medical Outcomes Study-Short Form (MOS-SF-36). Before and after the last rTMS session, motor mapping of abductor pollicis brevis muscle (APB) was performed using navigated TMS (nTMS). Localization, area, and amplitude-weighted area of the APB muscle cortical representations were compared with the healthy controls. The dynamics of the mentioned above parameters after the rTMS course was assessed. RESULTS: Ten sessions of low-frequency rTMS over premotor cortex reduced the severity of WC clinical symptoms, with a duration of effect of at least 1 month (p<0.05). There was no significant difference between the area and the weighted area of cortical muscle representations between patients and healthy controls or in patients before and after rTMS. When assessing the localization of cortical muscle representations, two trends were noted: in 4 patients, the localization remained stable, with a shift in the center of gravity of less than 4 mm; in the other 8 patients, a shift in the center of gravity of more than 5 mm was noted. No significant correlations between the stability of the cortical muscle representations (the magnitude of the shift in the center of gravity) and the improvement on the WCRS scale were found. CONCLUSION: The low-frequency rTMS over the premotor cortex of the hemisphere contralateral to the affected hand can be used as an adjuvant therapy for WC. The TMS-motor mapping study did not show its diagnostic value.


Assuntos
Distúrbios Distônicos , Córtex Motor , Estimulação Magnética Transcraniana , Distúrbios Distônicos/terapia , Mãos , Humanos , Músculo Esquelético
8.
Artigo em Russo | MEDLINE | ID: mdl-31793548

RESUMO

According to rough estimates, at least one third of the population in developed countries suffers, to varying degrees, from certain forms of primary headache, the modern pharmacotherapy of which is not always effective and has a number of limitations. The non-pharmacological treatment of headache can be an alternative to the prescription of pharmacological agents and the only possible assistance option for patients developing drug-resistant cephalalgias. This review describes various methods of electrical neuromodulation that are used for the management of primary headaches. The authors provide information on current stages in implementation of implantable and non-invasive equipment into clinical practice, which makes possible electrical stimulations of peripheral nerves and of the sphenopalatine ganglion, as well as allows transcranial magnetic stimulation. Also the appearance and usage of portable electrical devices available on the world market are described, and mechanisms that can underlie anticephalgic action of neuromodulation therapy are discussed. Special attention is paid to the methods that are applied for electrostimulation of the vagus nerve and occipital nerves.


Assuntos
Terapia por Estimulação Elétrica , Cefaleia , Estimulação Magnética Transcraniana , Cefaleia/terapia , Humanos , Nervos Periféricos , Nervo Vago
9.
Artigo em Russo | MEDLINE | ID: mdl-31880760

RESUMO

BACKGROUND: Parkinson's disease is a neurodegenerative disease manifested by a whole group of motor, cognitive, affective, and other disorders. Many of them cannot be controlled by modern pharmacotherapy in full measure. New treatments, including nondrug ones, are needed. OBJECTIVE: To evaluate the impact of rhythmic transcranial magnetic stimulation on motor, cognitive, and affective disorders in Parkinson's disease. MATERIAL AND METHODS: The investigation enrolled 55 patients with Stage III Parkinson's disease according to the Hoehn and Yahr scale. The patients were randomly divided into 2 groups: a study group (n=35) and a control one (n=20). The groups were matched for age, disease type and duration, and symptom severity. The basic therapy for Parkinson's disease included Levodopa in combination with dopamine receptor agonists and monoamine oxidase B inhibitors. All the patients in the study group underwent a cycle of therapeutic transcranial magnetic stimulation. Both patient groups underwent clinical and neurological examinations and tests using various scales. All the patients were followed up for 6 months. RESULTS: The patients who had undergone a cycle of magnetic stimulation showed a significant improvement in motor functions. There was a decrease in the total MDS-UPDRS-III scores by an average of 6.4 (p<0.05) and that in the GABS scores by 5.9 (p<0.05). CONCLUSION: Rhythmic transcranial magnetic stimulation can be considered as an additional treatment for Parkinson's disease. No significant side effects were noted during and after stimulation.


Assuntos
Doença de Parkinson/terapia , Estimulação Magnética Transcraniana , Humanos , Doença de Parkinson/fisiopatologia , Resultado do Tratamento
10.
Adv Exp Med Biol ; 1192: 545-564, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31705513

RESUMO

Recently, noninvasive brain stimulation (NIBS) methodologies, including TMS and tDCS, have been considered as efficacious, safe, and innovative treatments and alternatives to conventional therapies for some psychiatric disorders. Developing evidence suggests that applying rTMS and tDCS over the cognitive control network (CCN), particularly the dorsolateral prefrontal cortex (DLPFC), may improve core symptoms in various psychiatric disorders via direct impact on the cognitive control processes involved in emotion regulation. Therefore, neuromodulation of brain regions involved in the cognitive control of emotion by NIBS approaches could contribute to a paradigm shift in psychiatry. The available evidence suggests that development of effective treatment alternatives to enhance cognition is critical for patients with psychiatric disorders. The purpose of this chapter is to review the cognition-enhancing properties of tDCS and TMS and the impact of these treatments on cognitive control processes, especially those related to emotion regulation in psychiatric disorders.


Assuntos
Cognição/fisiologia , Terapia por Estimulação Elétrica/métodos , Emoções/fisiologia , Córtex Pré-Frontal/fisiopatologia , Estimulação Transcraniana por Corrente Contínua/métodos , Estimulação Magnética Transcraniana/métodos , Humanos
11.
Medicine (Baltimore) ; 98(46): e17929, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725646

RESUMO

BACKGROUND: Upper limb dysfunction is one of common sequelae of stroke which limits daily activities and decreases quality of life of patients, as well as increasing caregiving burden on families. Theta burst stimulation (TBS) is considered to be a beneficial therapy for post-stroke patients with upper limb motor dysfunction, but there is a lack of a high quality evidence. We aim to investigate the effectiveness and safety of TBS for upper limb motor dysfunction in patients with stroke. METHODS: The following databases will be searched: PubMed, EMBASE, The Cochrane Library, Web of Science, China Biology Medicine (CBM), China National Knowledge infrastructure (CNKI), Technology Periodical Database (VIP) and WanFang Data from the inception to October 2019. All relevant randomized controlled trials (RCTs) using TBS to treat poststroke patients with upper limb motor dysfunction will be included. The primary outcome is Upper Limb Fugl-Meyer Assessment (UL-FMA). Secondary outcomes will include Action Research Arm Test (ARAT), Box and Block Test (BBT), Wolf Motor Function Test (WMFT), Motor Assessment Scale (MAS), Nine Hole Peg Test (NHPT), Grip strength and other scales evaluating the upper limb motor function. Adverse effects will also be evaluated. Two reviewers will screen studies, extract data and assess the risk of bias of included studies independently. Data analysis will be conducted using Review Manager software (RevMan, version 5.3.5) and R software (version 3.6.1). RESULTS: Our SR will be conducted according to AMSTAR 2.0 and reported in compliance with PRISMA. The findings of this SR will be disseminated through peer-reviewed publications or conference presentations. CONCLUSION: Our study will provide evidence for the effectiveness and safety of theta burst stimulation for upper limb motor dysfunction in patients with stroke. ETHICS AND DISSEMINATION: This systematic review (SR) does not require formal ethical approval since no privacy health information will be included. The findings of this SR will be disseminated through peer-reviewed publications or conference presentations. PROSPERO REGISTRATION NUMBER: CRD42019142462.


Assuntos
Paralisia/reabilitação , Reabilitação do Acidente Vascular Cerebral/métodos , Estimulação Magnética Transcraniana/métodos , Extremidade Superior/fisiopatologia , Força da Mão , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Reabilitação do Acidente Vascular Cerebral/efeitos adversos , Estimulação Magnética Transcraniana/efeitos adversos , Extremidade Superior/fisiologia
12.
Medicine (Baltimore) ; 98(45): e17874, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702655

RESUMO

BACKGROUND: Stepping in place (SIP) is a useful locomotor training intervention. The purpose of this study was to investigate the effects of single auditory-cued SIP training on cortical excitability, rhythmic movements and walking ability in patients with Parkinson's disease(PD). METHODS: Cross-over randomized control trial. Each participant completed two interventions with at least one-week washout period in between: (1) SIP with concurrent auditory cues (AC condition) and (2) SIP without auditory cues (NC condition). RESULTS: In the primary outcome, the cortical silent period (CSP) duration increased (P = .005), whereas short intracortical inhibition (SICI) decreased after training (P = .001). Freezers demonstrated enhanced inhibition in the resting motor threshold and CSP duration. SICI and intracortical facilitation were modulated in both groups under the AC condition. In the secondary outcomes, the stepping variability decreased significantly (AC: P = .033; NC: P = .009), whereas walking cadence increased after training (AC: P = .019; NC: P = .0023). CONCLUSIONS: Auditory-cued SIP training improved the lower-limb movement variability and modulated the cortical excitability in patients with PD. Freezers may benefit more from this training than nonfreezers.


Assuntos
Estimulação Acústica/métodos , Sinais (Psicologia) , Transtornos Neurológicos da Marcha/terapia , Estimulação Magnética Transcraniana/métodos , Idoso , Estudos Cross-Over , Potenciais Evocados Auditivos/fisiologia , Transtornos Neurológicos da Marcha/etiologia , Humanos , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Desempenho Físico Funcional , Modalidades de Fisioterapia , Caminhada/fisiologia
14.
Zhen Ci Yan Jiu ; 44(10): 757-61, 2019 Oct 25.
Artigo em Chinês | MEDLINE | ID: mdl-31657167

RESUMO

OBJECTIVE: To investigate the clinical effect of acupuncture combined with repetitive transcranial magnetic stimulation in the treatment of children with spastic cerebral palsy with spleen-kidney deficiency, as well as its effect in improving cerebral hemodynamics. METHODS: A total of 220 children with spastic cerebral palsy were divided into observation group and control group using a random number table, with 110 children in each group. The children in the control group were given rehabilitation training and repetitive transcranial magnetic stimulation, and those in the observation group were given acupuncture in addition to the treatment in the control group. Acupuncture was performed at Zusanli (ST36), Xuanzhong (GB39), Sanyinjiao (SP6), Pishu (BL20), Shenshu (BL23), Qihai (CV6), Quchi (LI11), Neiguan (PC6), Hegu (LI4) and Tianshu (ST25) once every other day, three times a week for 3 consecutive months. The two groups were compared in terms of Gross Motor Function Measure (GMFM), Fine Motor Function Measure (FMFM), comprehensive function score for children with cerebral palsy, clinical outcome, and related cerebral hemodynamic parameters (mean blood flow velocity [Vm], systolic peak velocity [Vs], and resistance index [RI] of the cerebral artery). RESULTS: After treatment, both groups had significant increases in the scores of GMFM, FMFM and comprehensive function (cognitive function, speech function, motor ability, self-care, and social adaptability,P<0.01), and the observation group had significantly better improvements in the scores of GMFM (domains A, B and C), FMFM (domains B, C, D and E), and comprehensive function than those of the control group (P<0.01). The therapeutic effect of the observation group (93/110, 84.55%)was superior to that of the control group (80/110, 72.73%, P<0.05). The observation group had significantly higher Vs and Vm and a significantly lower RI than the control group (P<0.01). CONCLUSION: In the treatment of children with spasmodic cerebral palsy with spleen-kidney deficiency, acupuncture combined with repeated transcranial magnetic stimulation can significantly improve their motor function, comprehensive function, and clinical outcome, which may be associated with the regulation of cerebral hemodynamics.


Assuntos
Terapia por Acupuntura , Paralisia Cerebral , Criança , Hemodinâmica , Humanos , Baço , Estimulação Magnética Transcraniana
15.
Rev Med Suisse ; 15(665): 1737-1739, 2019 Oct 02.
Artigo em Francês | MEDLINE | ID: mdl-31580016

RESUMO

The Mal de Débarquement Syndrome (MdDS) is characterized by a persistent (> 1 month) sensation of self-motion, most of the time initially motion-triggered (i.e. boat, car, airplane travel). The symptoms are markedly diminished during a new exposure to passive motion. Female are more often affected. The vestibular functional assessment and cerebral imaging are normal. Chronic fatigue, headache, hypersensitivity to visual stimuli are other classical features of MdDS. The impact of MdDS on quality of life is significant. Maladaptation of the vestibulo-ocular reflex, abnormal functional connectivity as well as gonadal hormones imbalance are possible causes of the MdDS. Exposure to optokinetic stimulations, and transcranial magnetic stimulations open therapeutic perspectives.


Assuntos
Enjoo devido ao Movimento/fisiopatologia , Doença Relacionada a Viagens , Feminino , Humanos , Enjoo devido ao Movimento/etiologia , Enjoo devido ao Movimento/terapia , Qualidade de Vida , Estimulação Magnética Transcraniana , Viagem
17.
Nat Commun ; 10(1): 4287, 2019 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-31537795

RESUMO

Performance anxiety can profoundly affect motor performance, even in experts such as professional athletes and musicians. Previously, the neural mechanisms underlying anxiety-induced performance deterioration have predominantly been investigated for individual one-shot actions. Sports and music, however, are characterized by action sequences, where many individual actions are assembled to develop a performance. Here, utilizing a novel differential sequential motor learning paradigm, we first show that performance at the junctions between pre-learnt action sequences is particularly prone to anxiety. Next, utilizing functional magnetic resonance imaging (fMRI), we reveal that performance deterioration at the junctions is parametrically correlated with activity in the dorsal anterior cingulate cortex (dACC). Finally, we show that 1 Hz repetitive transcranial magnetic stimulation of the dACC attenuates the performance deterioration at the junctions. These results demonstrate causality between dACC activity and impairment of sequential motor performance due to anxiety, and suggest new intervention techniques against the deterioration.


Assuntos
Giro do Cíngulo/fisiologia , Ansiedade de Desempenho/fisiopatologia , Ansiedade de Desempenho/terapia , Desempenho Psicomotor/fisiologia , Estimulação Magnética Transcraniana/métodos , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Ansiedade de Desempenho/psicologia , Inquéritos e Questionários
18.
Nervenarzt ; 90(10): 1005-1012, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31538210

RESUMO

Functional recovery of stroke-related deficits is mainly achieved through neural reorganization. Neurorehabilitative approaches, therefore, aim at supporting positive processes while suppressing maladaptive neuronal processes. This review summarizes the main findings of studies using non-invasive and invasive brain stimulation with respect to the benefits of the treatment for motor deficits after stroke. In addition, the article discusses possible approaches to enhance the effectiveness of neuromodulatory approaches and thus improve the outcome of patients.


Assuntos
Transtornos Motores , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Estimulação Magnética Transcraniana , Humanos , Córtex Motor/patologia , Transtornos Motores/etiologia , Plasticidade Neuronal , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/complicações , Reabilitação do Acidente Vascular Cerebral/métodos
19.
Phys Ther Sport ; 40: 143-152, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31546134

RESUMO

OBJECTIVE: The increase in voluntary force of an untrained limb (i.e. Cross-education) after unilateral resistance training (RT) is believed to be a consequence of cortical adaptations. However, studies measuring neurophysiological adaptations with transcranial magnetic stimulation (TMS) found inconsistent results. One unexamined factor contributing to the conflicting data is the variation in the type and intensity of muscle contractions, fatigue, and the strategies of pacing the movement. Therefore, the purpose was to analyse how those unilateral RT variables affect the adaptations in ipsilateral M1 (iM1) and cross-education. METHODS: We performed a systematic literature review, with the following search terms with Boolean conjunctions: "Transcranial magnetic stimulation" AND "Ipsilateral cortex" AND "Resistance training". RESULTS: The 11 acute and 12 chronic studies included partially support the idea of increased cortical excitability and reduced intracortical inhibition in iM1, but the inconsistency between studies was high. CONCLUSIONS: Differences in type and intensity of contraction, fatigue, and strategies of pacing the movement contributed to the inconsistencies. The tentative conclusion is that high intensity eccentric or externally paced contractions are effective to increase iM1 excitability but cross-education can occur in the absence of such changes. Thus, the mechanism of the cross-education examined with TMS remains unclear.


Assuntos
Excitabilidade Cortical , Córtex Motor/fisiologia , Contração Muscular , Treinamento de Resistência , Estimulação Magnética Transcraniana , Adaptação Fisiológica , Eletromiografia , Humanos , Músculo Esquelético/fisiologia
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