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Kratimenos P, Sanidas G, Simonti G, Byrd C, Gallo V. The shifting landscape of the preterm brain. Neuron 2025:S0896-6273(25)00224-7. [PMID: 40239653 DOI: 10.1016/j.neuron.2025.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2024] [Revised: 02/16/2025] [Accepted: 03/19/2025] [Indexed: 04/18/2025]
Abstract
Preterm birth remains a significant global health concern despite advancements in neonatal care. While survival rates have increased, the long-term neurodevelopmental consequences of preterm birth persist. Notably, the profile of the preterm infant has shifted, with infants at earlier gestational ages surviving and decreased rates of gross structural injury secondary to intracranial hemorrhage. However, these infants are still vulnerable to insults, including hypoxia-ischemia, inflammation, and disrupted in utero development, impinging on critical developmental processes, which can lead to neuronal and oligodendrocyte injury and impaired brain function. Consequently, preterm infants often experience a range of neurodevelopmental disorders, such as cognitive impairment and behavioral problems. Here, we address mechanisms underlying preterm brain injury and explore existing and new investigational therapeutic strategies. We discuss how gestational age influences brain development and how interventions, including pharmacological and non-pharmacological approaches, mitigate the effects of preterm birth complications and improve the long-term outcomes of preterm infants.
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Affiliation(s)
- Panagiotis Kratimenos
- Children's National Research Institute, Washington, DC, USA; George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Georgios Sanidas
- Children's National Research Institute, Washington, DC, USA; George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Gabriele Simonti
- Children's National Research Institute, Washington, DC, USA; George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Chad Byrd
- Children's National Research Institute, Washington, DC, USA; George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Vittorio Gallo
- Seattle Children's Research Institute, Seattle, WA, USA; The University of Washington School of Medicine, Seattle, WA, USA.
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Zhang Q, Qiu Z. Therapeutic effects of repetitive transcranial magnetic stimulation in patients with cerebral palsy: a systematic review and network meta-analysis. Neurol Sci 2024; 45:1953-1967. [PMID: 38117402 DOI: 10.1007/s10072-023-07235-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/28/2023] [Indexed: 12/21/2023]
Abstract
The purpose of this study was to systematically evaluate the efficacy of repetitive transcranial magnetic stimulation in children with cerebral palsy and to compare the differences in efficacy of different treatment parameters. Computer searches of PubMed, Embase, Cochrane Library, Scopus, Web of Science, China Knowledge Network, Wanfang Data Knowledge Service Platform, Vipshop and China Biomedical Literature Database were conducted to collect randomized controlled trials (RCTs) of TMS to improve function in children with cerebral palsy. The search period was from the establishment of the database to April 2023. Two researchers independently screened the literature and extracted data information, and the risk of bias was assessed for the included studies using the Cochrane Systematic Evaluation Manual 5.1.0. Statistical analysis was performed using RevMan 5.4 and Stata software. A total of 18 studies containing 1675 patients with cerebral palsy were included, and r-TMS did not differ significantly from other treatments in improving language function [MD = 2.80, 95% CI (-1.51, 7.11), Z = 1.27, P = 0.20] after treatment. The results of the reticulated meta-analysis showed the best probability ranking of the effect of three different frequencies of r-TMS on motor function scores in children with cerebral palsy: combined LF-rTMS + HF-rTMS (49.8%) > LF-rTMS (45.6%) > HF-rTMS (4.6%) > conventional rehabilitation (0%). Publication bias showed no significant asymmetry in the inverted funnel plot, but the possibility of publication bias could not be excluded. The results of this study showed that r-TMS was not statistically significant in improving language function in children with cerebral palsy compared to conventional treatment. r-TMS was almost unanimously significantly effective in motor function in children with cerebral palsy according to current literature data, and the combined high- and low-frequency transcranial magnetic therapy was better than low-frequency transcranial magnetic therapy.
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Affiliation(s)
- Qian Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, Shandong, China.
| | - Zhengang Qiu
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, Shandong, China
- Department of Rehabilitation Medicine, University City Hospital, Shandong University of Traditional Chinese Medicine, Jinan, 250300, Shandong, China
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Sutter EN, Casey CP, Gillick BT. Single-pulse transcranial magnetic stimulation for assessment of motor development in infants with early brain injury. Expert Rev Med Devices 2024; 21:179-186. [PMID: 38166497 PMCID: PMC10947901 DOI: 10.1080/17434440.2023.2299310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/21/2023] [Indexed: 01/04/2024]
Abstract
INTRODUCTION Single-pulse transcranial magnetic stimulation (TMS) has many applications for pediatric clinical populations, including infants with perinatal brain injury. As a noninvasive neuromodulation tool, single-pulse TMS has been used safely in infants and children to assess corticospinal integrity and circuitry patterns. TMS may have important applications in early detection of atypical motor development or cerebral palsy. AREAS COVERED The authors identified and summarized relevant studies incorporating TMS in infants, including findings related to corticospinal development and circuitry, motor cortex localization and mapping, and safety. This special report also describes methodologies and safety considerations related to TMS assessment in infants, and discusses potential applications related to diagnosis of cerebral palsy and early intervention. EXPERT OPINION Single-pulse TMS has demonstrated safety and feasibility in infants with perinatal brain injury and may provide insight into neuromotor development and potential cerebral palsy diagnosis. Additional research in larger sample sizes will more fully evaluate the utility of TMS biomarkers in early diagnosis and intervention. Methodological challenges to performing TMS in infants and technical/equipment limitations require additional consideration and innovation toward clinical implementation. Future research may explore use of noninvasive neuromodulation techniques as an intervention in younger children with perinatal brain injury to improve motor outcomes.
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Affiliation(s)
- Ellen N. Sutter
- Waisman Center, University of Wisconsin-Madison
- Department of Rehabilitation Medicine, University of Minnesota-Twin Cities
| | | | - Bernadette T. Gillick
- Waisman Center, University of Wisconsin-Madison
- Department of Pediatrics, University of Wisconsin-Madison
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Aljuhani T, Coker-Bolt P, Katikaneni L, Ramakrishnan V, Brennan A, George MS, Badran BW, Jenkins D. Use of non-invasive transcutaneous auricular vagus nerve stimulation: neurodevelopmental and sensory follow-up. Front Hum Neurosci 2023; 17:1297325. [PMID: 38021221 PMCID: PMC10666166 DOI: 10.3389/fnhum.2023.1297325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To assess the impact of non-invasive transcutaneous auricular vagal nerve stimulation (taVNS) paired with oral feeding on long-term neurodevelopmental and sensory outcomes. Method We tested 21 of 35 children who as infants were gastrostomy tube (G-tube) candidates and participated in the novel, open-label trial of taVNS paired with oral feeding. To evaluate possible effects on development at 18-months after infant taVNS, we performed the Bayley-III (n = 10) and Sensory Profile (SP-2, n = 12) assessments before the COVID pandemic, and Cognitive Adaptive Test (CAT), Clinical Linguistics and Auditory Milestone (CLAMS), Ages and Stages Questionnaire (ASQ), and Peabody Developmental Motor Scales-2 gross motor tests as possible during and after the pandemic. We compared outcomes for infants who attained full oral feeds during taVNS ('responders') or received G-tubes ('non-responders'). Results At a mean of 19-months, taVNS 'responders' showed significantly better general sensory processing on the SP-2 than 'non-responders'. There were no differences in other test scores, which were similar to published outcomes for infants who required G-tubes. Conclusion This is the first report of neurodevelopmental follow-up in infants who received taVNS-paired feeding. They had similar developmental outcomes as historical control infants failing oral feeds who received G-tubes. Our data suggests that infants who attained full oral feeds had better sensory processing.
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Affiliation(s)
- Turki Aljuhani
- Division of Health Science and Research, Medical University of South Carolina, Charleston, SC, United States
- Department of Occupational Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Patricia Coker-Bolt
- Doctorate of Occupational Therapy Program, Hawai’i Pacific University, Honolulu, HI, United States
| | - Lakshmi Katikaneni
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States
| | - Viswanathan Ramakrishnan
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Alyssa Brennan
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States
| | - Mark S. George
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- Ralph H. Johnson VA Medical Center, Charleston, SC, Unites States
| | - Bashar W. Badran
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Dorothea Jenkins
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States
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Lu YH, Fu Y, Shu J, Yan LY, Shen HJ. Application of cross-migration theory in limb rehabilitation of stroke patients with hemiplegia. World J Clin Cases 2023; 11:4531-4543. [PMID: 37469730 PMCID: PMC10353507 DOI: 10.12998/wjcc.v11.i19.4531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/08/2023] [Accepted: 05/22/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Stroke is a common cause of neurological dysfunction, often resulting in hemiplegia. Thus, rehabilitation of limb function in stroke patients is an important step towards accelerating recovery and improving quality of life.
AIM To investigate whether unilateral strength training in hemiplegic stroke patients could lead to cross-migration, an increase in bilateral muscle strength, and an improvement in lower limb motor function.
METHODS We randomly divided 120 patients with hemiplegic stroke into two groups: Eexperimental and control groups, with 60 patients in each group. Both groups received routine rehabilitation treatment, while the experimental group additionally received ankle dorsiflexion resistance training on the healthy side for 6 wk. We measured the maximum voluntary contract (MVC), changes in surface electromyography (EMG), and the lower limb motor function using the simplified Fugl Meyer Motor Function Assessment Scale (FMA) before and within 1 wk after training.
RESULTS The FMA score in the experimental group improved significantly compared to both their pre-training score and the control group's post-training score (P < 0.05). The integrated EMG of the anterior tibialis muscle and pulmonary intestine muscle in the experimental group were significantly different after training than before (P < 0.05). Furthermore, the MVC of the anterior tibialis muscle on both the healthy and affected sides and the MVC of the pulmonary intestine muscle on both sides showed significant improvement compared with before training and the control group (P < 0.05).
CONCLUSION Our findings suggest that ankle dorsiflexion resistance training on the healthy side in hemiplegic stroke patients can increase strength in the opposite tibialis anterior muscle and antagonist's muscle, indicating a cross-migration phenomenon of strength training. Furthermore, this type of training can also improve lower limb motor function, providing a new exercise method for improving early ankle dorsiflexion dysfunction.
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Affiliation(s)
- Yan-Hong Lu
- Geriatric Rehabilitation Department, Shanghai Jing'an District Shibei Hospital, Shanghai 200040, China
| | - Yi Fu
- Geriatric Rehabilitation Department, Shanghai Jing'an District Shibei Hospital, Shanghai 200040, China
| | - Jin Shu
- Geriatric Rehabilitation Department, Shanghai Jing'an District Shibei Hospital, Shanghai 200040, China
| | - Li-Yan Yan
- Department of Nursing, Shanghai Jing'an District Shibei Hospital, Shanghai 200040, China
| | - Hai-Jian Shen
- Department of Nursing, Shanghai Jing'an District Shibei Hospital, Shanghai 200040, China
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Diaz MJ, Root KT, Beneke A, Penev Y, Lucke-Wold B. Neurostimulation for Traumatic Brain Injury: Emerging Innovation. OBM NEUROBIOLOGY 2023; 07:1-17. [PMID: 36938307 PMCID: PMC10019379 DOI: 10.21926/obm.neurobiol.2301161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Traumatic brain injury (TBI) is a significant source of brain deficit and death among neurosurgical patients, with limited prospects for functional recovery in the cases of moderate-to-severe injury. Until now, the relevant body of literature on TBI intervention has focused on first-line, invasive treatment options (namely craniectomy and hematoma evacuation) with underwhelming focus on non-invasive therapies following surgical stabilization. Recent advances in our understanding of the impaired brain have encouraged deeper investigation of neurostimulation strategies, owed largely to its demonstrated livening of damaged neural circuitry and capacity to stabilize erratic network activity. The objective of the present study is to provide a scoping review of new knowledge in neurostimulation published in the PubMed, Scopus, and Google Scholar databases from inception to November 2022. We critically assess and appraise the available data on primary neurostimulation delivery techniques, with marked emphasis on restorative opportunities for accessory neurostimulation in the interdisciplinary care of moderate-to-severe TBI (msTBI) patients. These data identify two primary future directions: 1) to relate obtained gain-of-function outcomes to hemodynamic and histological changes and 2) to develop a clearer understanding of neurostimulation efficacy, when combined with pharmacologic interventions or other modulatory techniques, for complex brain insult.
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Saiote C, Sutter E, Xenopoulos-Oddsson A, Rao R, Georgieff M, Rudser K, Peyton C, Dean D, McAdams RM, Gillick B. Study Protocol: Multimodal Longitudinal Assessment of Infant Brain Organization and Recovery in Perinatal Brain Injury. Pediatr Phys Ther 2022; 34:268-276. [PMID: 35385465 PMCID: PMC9200232 DOI: 10.1097/pep.0000000000000886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Perinatal brain injury is a primary cause of cerebral palsy, a condition resulting in lifelong motor impairment. Infancy is an important period of motor system development, including development of the corticospinal tract (CST), the primary pathway for cortical movement control. The interaction between perinatal stroke recovery, CST organization, and resultant motor outcome in infants is not well understood. METHODS Here, we present a protocol for multimodal longitudinal assessment of brain development and motor function following perinatal brain injury using transcranial magnetic stimulation and magnetic resonance imaging to noninvasively measure CST functional and structural integrity across multiple time points in infants 3 to 24 months of age. We will further assess the association between cortical excitability, integrity, and motor function. DISCUSSION This protocol will identify bioindicators of motor outcome and neuroplasticity and subsequently inform early detection, diagnosis, and intervention strategies for infants with perinatal stroke, brain bleeds, and related diagnoses.
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Affiliation(s)
- Catarina Saiote
- Waisman Center (Drs Saiote, Sutter, Dean, and Gillick), Department of Pediatrics (Drs Dean, McAdams, and Gillick), and Department of Medical Physics (Dr Dean), University of Wisconsin-Madison, Madison, Wisconsin; Department of Rehabilitation Medicine (Dr Sutter and Ms Xenopoulos-Oddsson), Department of Pediatrics (Drs Rao and Georgieff), and Division of Biostatistics (Dr Rudser), University of Minnesota, Minneapolis, Minnesota; Department of Physical Therapy and Human Movement Sciences, Department of Pediatrics (Dr Peyton), Northwestern University, Chicago, Illinois
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Chang D, Singhal NS, Tarapore PE, Auguste KI. Repetitive transcranial magnetic stimulation (rTMS) as therapy in an infant with epilepsia partialis continua. Epilepsy Behav Rep 2022; 18:100511. [PMID: 35198952 PMCID: PMC8850736 DOI: 10.1016/j.ebr.2021.100511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/25/2022] Open
Abstract
rTMS was safely performed in a 10-month old at 10 Hz without apparent adverse effects. rTMS was successfully performed in an infant for refractory epilepsia partialis continua. rTMS may have a treatment role in recurring, refractory epilepsia partialis continua in children. Introduction: We present a case of a 10-month-old girl undergoing repetitive TMS (rTMS) for the treatment of drug-resistant epilepsy. Case report: A 10-month-old girl, later diagnosed with pathogenic POLG1 mutations, presented to our institution with chronic progressive EPC (epilepsia partialis continua) manifesting as a frequent, left-sided, synchronous continuous jerking of the arms and legs. The seizures were drug-resistant to multiple antiseizure medications and epilepsy surgery, responding only to continuous anesthesia. rTMS therapy was attempted to interrupt seizures. Results: rTMS therapy, using an activating protocol to introduce a temporary lesion effect, was used to interrupt persistent, ongoing seizures. Conclusion: rTMS can be safely used to abort seizures in patients as young as 10 months old.
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Affiliation(s)
- Diana Chang
- University of California, San Francisco, School of Medicine, 533 Parnassus Ave, San Francisco, CA 94143, United States
| | - Nilika S. Singhal
- University of California, San Francisco, Department of Neurology, 400 Parnassus Ave 8 Floor, San Francisco, CA 94143, United States
| | - Phiroz E. Tarapore
- University of California, San Francisco, Department of Neurosurgery, 400 Parnassus Ave 8 Floor, San Francisco, CA 94143, United States
| | - Kurtis I. Auguste
- University of California, San Francisco, Department of Neurosurgery, 400 Parnassus Ave 8 Floor, San Francisco, CA 94143, United States
- Corresponding author at: 550 16th Street, 4th floor, Box 0137, San Francisco, CA 94158, United States.
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9
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Valkama AM, Rytky SO, Olsén PM. Bilateral Motor Responses to Transcranial Magnetic Stimulation in Preterm Children at 9 Years of Age. Neuropediatrics 2021; 52:268-273. [PMID: 33706405 DOI: 10.1055/s-0041-1726127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This study was aimed to evaluate motor tracts integrity in nondisabled preterm-born (PT) children at 9 years of age. METHODS Overall, 18 PT and 13 term-born (T) children without motor disability were assessed by transcranial magnetic stimulation (TMS). Motor-evoked potentials (MEPs) were measured bilaterally from the abductor pollicis brevis (APB) and the tibialis anterior (TA) muscles. Muscle responses could be stimulated from all patients. RESULTS Overall, 83.3 and 23.1% of PT and T children, respectively, had mild clumsiness (p = 0.001). One PT and three T children had immediate bilateral responses in the upper extremities. Seven PT children had delayed ipsilateral APB responses after left and ten after right TMS. Three controls had delayed ipsilateral responses. Ipsilateral lower extremity responses were seen in one PT after right and two PT children and one T child after left TMS. The results did not correlate to groups, genders, clumsiness, or handedness. CONCLUSION Children of PT and T may have bilateral motor responses after TMS at 9 years of age. Ipsilateral conduction emerges immediately or more often slightly delayed and more frequently in upper than in lower extremities. SIGNIFICANCE Bilateral motor conduction reflects developmental and neurophysiological variability in children at 9 years of age. MEPs can be used as a measure of corticospinal tract integrity in PT children.
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Affiliation(s)
- A Marita Valkama
- Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland.,PEDEGO Research Center, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu, Oulu, Finland
| | - Seppo O Rytky
- Department of Clinical Neurophysiology, Oulu University Hospital, Oulu, Finland
| | - Päivi M Olsén
- Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland.,PEDEGO Research Center, University of Oulu, Oulu, Finland
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O'Leary GH, Jenkins DD, Coker-Bolt P, George MS, Kautz S, Bikson M, Gillick BT, Badran BW. From adults to pediatrics: A review noninvasive brain stimulation (NIBS) to facilitate recovery from brain injury. PROGRESS IN BRAIN RESEARCH 2021; 264:287-322. [PMID: 34167660 DOI: 10.1016/bs.pbr.2021.01.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Stroke is a major problem worldwide that impacts over 100 million adults and children annually. Rehabilitation therapy is the current standard of care to restore functional impairments post-stroke, however its effects are limited and many patients suffer persisting functional impairments and life-long disability. Noninvasive Brain Stimulation (NIBS) has emerged as a potential rehabilitation treatment option in both adults and children with brain injury. In the last decade, Transcranial Magnetic Stimulation (TMS), Transcranial Direct Current Stimulation (tDCS) and Transcutaneous Auricular Vagus Nerve Stimulation (taVNS) have been investigated to improve motor recovery in adults post-stroke. These promising adult findings using NIBS, however, have yet to be widely translated to the area of pediatrics. The limited studies exploring NIBS in children have demonstrated safety, feasibility, and utility of stimulation-augmented rehabilitation. This chapter will describe the mechanism of NIBS therapy (cortical excitability, neuroplasticity) that underlies its use in stroke and motor function and how TMS, tDCS, and taVNS are applied in adult stroke treatment paradigms. We will then discuss the current state of NIBS in early pediatric brain injury and will provide insight regarding practical considerations and future applications of NIBS in pediatrics to make this promising treatment option a viable therapy in children.
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Affiliation(s)
- Georgia H O'Leary
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Dorothea D Jenkins
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States
| | - Patricia Coker-Bolt
- Division of Occupational Therapy, College of Health Professions, Medical University of South Carolina, Charleston, SC, United States
| | - Mark S George
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States; Ralph H. Johnson VA Medical Center, Charleston, SC, United States
| | - Steve Kautz
- Ralph H. Johnson VA Medical Center, Charleston, SC, United States; Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC, United States
| | - Marom Bikson
- Department of Biomedical Engineering, City College of New York, New York, NY, United States
| | - Bernadette T Gillick
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, United States
| | - Bashar W Badran
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.
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Kowalski JL, Hickey M, Rao R, Georgieff MK, Chen M, Gillick BT. Safety of single-pulse TMS in two infants with implanted patent ductus arteriosus closure devices. Brain Stimul 2020; 13:861-862. [PMID: 32289718 DOI: 10.1016/j.brs.2020.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 03/01/2020] [Indexed: 10/24/2022] Open
Affiliation(s)
- Jesse L Kowalski
- Department of Rehabilitation Medicine, University of Minnesota, 420 Delaware Street SE, MMC 388, Minneapolis, MN, 55455, United States
| | - Marie Hickey
- Department of Pediatrics, University of Minnesota, 2450 Riverside Avenue, 6th Floor, East Building, Delivery Code 8952A, Minneapolis, MN, 55454, United States
| | - Raghavendra Rao
- Department of Pediatrics, University of Minnesota, 2450 Riverside Avenue, 6th Floor, East Building, Delivery Code 8952A, Minneapolis, MN, 55454, United States
| | - Michael K Georgieff
- Department of Pediatrics, University of Minnesota, 2450 Riverside Avenue, 6th Floor, East Building, Delivery Code 8952A, Minneapolis, MN, 55454, United States
| | - Mo Chen
- Department of Psychiatry, University of Minnesota, 2312 S. 6th St. Floor 2, Suite F-275, Minneapolis, MN, 55454, United States
| | - Bernadette T Gillick
- Department of Rehabilitation Medicine, University of Minnesota, 420 Delaware Street SE, MMC 388, Minneapolis, MN, 55455, United States.
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12
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Kowalski JL, Nemanich ST, Nawshin T, Chen M, Peyton C, Zorn E, Hickey M, Rao R, Georgieff M, Rudser K, Gillick BT. Motor Evoked Potentials as Potential Biomarkers of Early Atypical Corticospinal Tract Development in Infants with Perinatal Stroke. J Clin Med 2019; 8:jcm8081208. [PMID: 31412592 PMCID: PMC6723226 DOI: 10.3390/jcm8081208] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/31/2019] [Accepted: 08/09/2019] [Indexed: 11/16/2022] Open
Abstract
Diagnosis of cerebral palsy (CP) after perinatal stroke is often delayed beyond infancy, a period of rapid neuromotor development with heightened potential for rehabilitation. This study sought to assess whether the presence or absence of motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) could be an early biomarker of atypical development within the first year of life. In 10 infants with perinatal stroke, motor outcome was assessed with a standardized movement assessment. Single-pulse TMS was utilized to assess presence of MEPs. Younger infants (3-6 months CA, n = 5, 4/5 (80%)) were more likely to present with an MEP from the more-affected hemisphere (MAH) compared to older infants (7-12 months CA, n = 5, 0/5, (0%)) (p = 0.048). Atypical movement was demonstrated in the majority of infants with an absent MEP from the MAH (5/6, 83%) compared to those with a present MEP (1/4, 25%) (p = 0.191). We found that age influences the ability to elicit an MEP from the MAH, and motor outcome may be related to MAH MEP absence. Assessment of MEPs in conjunction with current practice of neuroimaging and motor assessments could promote early detection and intervention in infants at risk of CP.
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Affiliation(s)
- Jesse L Kowalski
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN 55455, USA
| | - Samuel T Nemanich
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN 55455, USA
| | - Tanjila Nawshin
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN 55455, USA
| | - Mo Chen
- Department of Psychiatry, University of Minnesota, Minneapolis, MN 55455, USA
| | - Colleen Peyton
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL 60611, USA
| | - Elizabeth Zorn
- Division of Neonatology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN 55455, USA
| | - Marie Hickey
- Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Raghavendra Rao
- Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Michael Georgieff
- Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Kyle Rudser
- Division of Biostatistics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Bernadette T Gillick
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN 55455, USA.
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13
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Heathcock JC, Lockman JJ. Infant and Child Development: Innovations and Foundations for Rehabilitation. Phys Ther 2019; 99:643-646. [PMID: 31155659 DOI: 10.1093/ptj/pzz067] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 04/07/2019] [Indexed: 11/13/2022]
Affiliation(s)
- Jill C Heathcock
- The Ohio State University, Columbus, Ohio. Dr Heathcock is a PTJ Editorial Board member
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