著者

Ryo Momosaki Shoji Kinoshita Wataru Kakuda Naoki Yamada Masahiro Abo

出版者

徳島大学医学部

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.63, no.3.4, pp.153-158, 2016 (Released:2016-09-17)

参考文献数

26

被引用文献数

8

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The purpose of this study was to review the best available evidence of noninvasive brain stimulation, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) for dysphagia after acquired brain injury. We searched randomized controlled trials that compared noninvasive brain stimulation with control used to improve dysphagia after acquired brain injury. We assessed dysphagia severity rating scales and penetration-aspiration scale as outcomes immediately after intervention. We calculated the pooled estimate of the standardized mean difference (SMD) to combine individual results. We included 8 published studies. Two heterogenous trials of 48 patients showed that rTMS was associated with a significant improvement in the dysphagia severity rating scale score (SMD 2.95). Three homogeneous trials of 88 patients showed a significant effect of rTMS on the penetration-aspiration scale score (SMD 0.77). Two homogeneous trials of 34 patients showed that tDCS was associated with a significant improvement in the dysphagia severity rating scale score (SMD 1.20). The review provided low-quality evidence for the effectiveness of noninvasive brain stimulation in improving dysphagia after acquired brain injury. Further trials of larger sample sizes are needed to determine the most appropriate noninvasive brain stimulation protocol. J. Med. Invest. 63: 153-158, August, 2016

著者

Toshifumi Chino Shoji Kinoshita Masahiro Abo

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.8, pp.20230005, 2023 (Released:2023-03-01)

参考文献数

83

被引用文献数

2

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Recent technological advances in non-invasive brain stimulation (NIBS) have led to the development of therapies for post-stroke upper extremity paralysis. Repetitive transcranial magnetic stimulation (rTMS), a NIBS technique, controls regional activity by non-invasively stimulating selected areas of the cerebral cortex. The therapeutic principle by which rTMS is thought to work is the correction of interhemispheric inhibition imbalances. The guidelines for rTMS for post-stroke upper limb paralysis have graded it as a highly effective treatment, and, based on functional brain imaging and neurophysiological testing, it has been shown to result in progress toward normalization. Our research group has published many reports showing improvement in upper limb function after administration of the NovEl Intervention Using Repetitive TMS and intensive one-to-one therapy (NEURO), demonstrating its safety and efficacy. Based on the findings to date, rTMS should be considered as a treatment strategy based on a functional assessment of the severity of upper extremity paralysis (Fugl-Meyer Assessment), and NEURO should be combined with pharmacotherapy, botulinum treatment, and extracorporeal shockwave therapy to maximize therapeutic effects. In the future, it will be important to establish tailormade treatments in which stimulation frequency and sites are adjusted according to the pathological conditions of interhemispheric imbalance, as revealed by functional brain imaging.

著者

Wataru Kakuda Ryo Momosaki Naoki Yamada Masahiro Abo

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.55, no.23, pp.3515-3519, 2016-12-01 (Released:2016-12-01)

参考文献数

20

被引用文献数

2 11

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Structural and functional abnormalities of the prefrontal cortex seem to correlate with fatigue in patients with chronic fatigue syndrome (CFS). We consecutively applied facilitatory high-frequency repetitive transcranial magnetic stimulation (rTMS) to the dorsolateral prefrontal cortex (DLPFC) of seven CFS patients over three days. Five patients completed the 3-day protocol without any adverse events. For the other two patients, we had to reduce the stimulation intensity in response to mild adverse reactions. In most of the patients, treatment resulted in an improvement of fatigue symptoms. High-frequency rTMS applied over the DLPFC can therefore be a potentially useful therapy for CFS patients.

著者

Go URUMA Keiji HASHIMOTO Masahiro ABO

出版者

日本磁気共鳴医学会

雑誌

Magnetic Resonance in Medical Sciences (ISSN:13473182)

巻号頁・発行日

pp.2014-0104, (Released:2015-02-12)

被引用文献数

5

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Purpose: We developed a new and convenient method that employs voxel-based morphometry (VBM) to evaluate regional reduction in the volume of white matter after diffuse axonal injury (DAI).Methods: We studied 29 patients with moderate cognitive disability after DAI. Each subject underwent 3-dimensional volumetric magnetic resonance (MR) imaging. Images were preprocessed automatically using stand-alone software running on a Windows PC for VBM of volumetric MR imaging utilizing a statistical parametric mapping (SPM) version 8 software engine and an algorithm for diffeomorphic anatomic registration through exponentiated lie algebra (DARTEL). We then computed a Z-score for all coordinates on the white matter, which represented the relative reduction in white matter volume. Finally, we used voxel-based stereotactic extraction estimation (vbSEE) to compute the extent of regional reduction in the volume of white matter (rWMVR) for each region of interest (ROI), defined as the rate of coordinates with Z-scores exceeding 2.0 in the ROI. For each ROI, we used Pearson’s correlation analysis to examine the correlation between the extent of regional volume reduction and patient scores on the Wechsler Adult Intelligence Scale III (WAIS-III).Results: We detected marked rWMVR in several ROIs, including the corpus callosum, and rWMVR correlated significantly with performance IQ and processing speed index in the splenium of the corpus callosum.Conclusions: The results indicate the utility of our applications for the daily clinical evaluation of DAI. That they can be used on a PC and allow acquisition of volumetric data from standard MR images are their advantages.