title stringlengths 1 1.19k | keywords stringlengths 0 668 | concept stringlengths 0 909 | paragraph stringlengths 0 61.8k | PMID stringlengths 10 11 |
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Keywords | PMC9840320 | |||
Background | visceral pain | NEONATAL ASPHYXIA, COMPLICATIONS | China's "open childbirth policy" is anticipated to increase the number of women undergoing repeated cesarean section (C-section). C-section has typically been performed under epidural anesthesia due to its safety and controllability [The ability of extracellular vesicles (EVs) to transport specific components of protei... | PMC9840320 |
Methods | PMC9840320 | |||
Study setting | This prospective single-center and randomized clinical trial was approved by the ethical committee of The First Affiliated Hospital of Wenzhou Medical University on 21/09/2021 (Chairperson Pro. Jinglin Xia, NO.KY2021-119) and registered at chictr.org.cn (ChiCTR2100053635) on 26/11/2021. The study was conducted in the F... | PMC9840320 | ||
Patient enrollment | Parturients with singleton, full-term pregnancies, ASA physical status I or II, age 20–40 years, height 150–170 cm, weight 50–80 kg, and body mass index (BMI) less than 35 kg/m | PMC9840320 | ||
Randomization and group allocation | Using a simple randomization procedure (1:1 ratio, | PMC9840320 | ||
Anesthetic procedure | No premedication was administered, and parturients were required to abstain from food and liquid intake for at least 6 h and 2 h before surgery, respectively. Intravenous access was established and nasal oxygenation at a rate of 3 L/min was administered upon entering the operating room. As a preload prior to anesthesia... | PMC9840320 | ||
Vital signs recording | Mean arterial blood pressure (MAP), heart rate (HR), respiration rate (RR), and oxygen saturation (SpO | PMC9840320 | ||
Visceral pain score | Visceral pain, pain | Visceral pain was defined as pain associated with uterine exteriorization and peritoneal traction. The intensity of pain was measured at time points T1-6 using a standard visual analogue scale (VAS) ranging from 0 to 10. | PMC9840320 | |
Evaluation of sedation | drowsiness, irritability, anxiety | The sedation level of the parturient was determined using the Ramsay sedation score system, where level 1 indicates anxiety or irritability; level 2 indicates cooperation, quietness, and well orientation; level 3 indicates drowsiness but responsiveness to instructions; level 4 indicates a rapid response to tapping the ... | PMC9840320 | |
Maternal satisfaction with the anesthetic method | At 24 h postoperatively, maternal satisfaction with the anesthetic method was evaluated using a five-point scale (1 = completely dissatisfied, 2 = dissatisfied, 3 = neutral or undecided, 4 = satisfied, and5 = completely satisfied). | PMC9840320 | ||
Evaluation of Apgar scores and neonatal asphyxia | neurological abnormalities | NEONATAL ASPHYXIA, NEONATAL ASPHYXIA | The neonatal Apgar scores were recorded at 1 min, 5 min, and 10 min after birth, and the occurrence of neonatal asphyxia was documented. Neonatal asphyxia was diagnosed using the following clinical criteria: neurological abnormalities or neonatal resuscitation required at birth, and/or an Apgar score < 7 at 5 min. | PMC9840320 |
Umbilical arterial pH and the isolation of exosomes | UEs | 6 mL of blood samples were obtained from the umbilical artery at 5 min after delivery. One portion of each sample was analyzed for pH. UEs were isolated from another portion of umbilical cord sample using ExoQuick exosome precipitation solution (System Biosciences, Palo Alto, CA, USA), a commercially available kit that... | PMC9840320 | |
Characterization of exosomes using nanoparticle tracking analysis (NTA) | NTA measurements were performed in a flow model using a NanoSight NS300 instrument (Malvern Panalytical, Malvern, United Kingdom) equipped with a 488 nm laser and sCMOS camera module (Malvern Panalytical, Malvern, United Kingdom). Each sample was subjected to NTA at least three times to calculate the mean values. To en... | PMC9840320 | ||
Exosome validation by transmission electron microscopy (TEM) | TEM | The morphology of the exosome was identified using TEM. Briefly, a suspension of freshly isolated exosomes was dropped onto a formvar carbon-coated copper electron microscopy grid (Plano, Wetzlar Germany). The grid was then negatively stained for 1 min with 2% uranyl acetate solution, washed with PBS, and dried at room... | PMC9840320 | |
Exosomal biomarkers measurement | tumor, ABM | TUMOR, LYSIS, SECONDARY | The total protein content of exosomes was extracted using a homemade cell lysis buffer, followed by protein precipitation using a 5 × protein loading buffer (ABM, Vancouver, Canada). After 5 min of heating in a water bath at 100 °C, the mixture was transferred to a polyvinylidene difluoride membrane (Millipore, Burling... | PMC9840320 |
Measurement of other outcomes | ADVERSE EVENTS, RESPIRATORY DEPRESSION | The adverse events that occurred during surgery and PACU stay were documented. Remifentanil infusion was stopped if the parturient developed respiratory depression, defined as SpO | PMC9840320 | |
Statistical analysis | The sample size was calculated using the OpenEpi software version 2.3.1 with the number of UEs as the primary outcome. In our preliminary study of 10 cases (n = 5 in each group), the mean number of UEs was 62 × 10Statistical analysis was performed with SPSS 26.0 software (SPSS Inc, Chicago, IL, USA). The Shapiro–Wilk t... | PMC9840320 | ||
Results | PMC9840320 | |||
The vital signs of the parturients | CAVITY, UTERUS | As demonstrated in Fig. The vital signs of the parturients. T0 = immediately before anesthesia; T1 = skin incision; T2 = peritoneum incision; T3 = neonatal delivery; T4 = placental delivery; T5 = suture of the uterus; T6 = closure of the abdominal cavity; MAP, mean arterial blood pressure; HR, heart rate; SpO | PMC9840320 | |
Discussion | aching, visceral pain, blood loss, Visceral pain, shivering | NEONATAL RESPIRATORY DEPRESSION, BLOOD LOSS, CONTRACTION, ADVERSE EFFECTS, RESPIRATORY DEPRESSION | The primary finding of our present study was that the intravenous administration of remifentanil increased the number of UEs in parturients undergoing repeated C-section under epidural anesthesia. As expected, intravenous remifentanil might be considered as an effective adjunct to epidural ropivacaine for the relief of... | PMC9840320 |
Conclusion | pain | COMPLICATIONS | An intravenous bolus of 0.15 μg/kg followed by a continuous infusion of 0.075 μg/kg/min remifentanil increased the number of UEs in parturients undergoing repeated C-section under epidural anesthesia, effectively reduced visceral pain and improved birth experience of the parturients, without causing significant neonata... | PMC9840320 |
Acknowledgements | The authors wish to thank all the parturients who participated in this study. | PMC9840320 | ||
Authors’ contributions | Liangrong Wang helped with literature search, study design, and manuscript preparation. Juan Li helped with data acquisition, definition of intellectual content and manuscript editing. Xiaodan Yang helped with data acquisition and data analysis. Yicheng Xiong helped with the experimental studies and manuscript editing,... | PMC9840320 | ||
Funding | This study was supported by Wenzhou Municipal Science and Technology Bureau (No.Y20211139), Zhejiang Provincial Natural Science Foundation of China (LQ21H010002) and The Key Project of Scientific Research Fund of National Health Commission (WKJ-ZJ-2131). | PMC9840320 | ||
Availability of data and materials | The datasets generated and analyzed during the current study are available from the corresponding author, on reasonable request. | PMC9840320 | ||
Declarations | PMC9840320 | |||
Ethics approval and consent to participate | Ethical clearance was obtained from the ethical committee of The First Affiliated Hospital of Wenzhou Medical University on 29/09/2021 (Chairperson Pro. Jinglin Xia, NO.KY2021-119) and registered at chictr.org.cn (ChiCTR2100053635) on 26/11/2021. The study was conducted according to the criteria of Declaration of Helsi... | PMC9840320 | ||
Consent for publication | Not applicable. | PMC9840320 | ||
Competing interests | The authors declare that they have no competing interests. | PMC9840320 | ||
References | PMC9840320 | |||
Introduction | HC, malignant cerebral infarction | In malignant cerebral infarction decompressive hemicraniectomy has demonstrated beneficial effects, but the optimum size of hemicraniectomy is still a matter of debate. Some surgeons prefer a large-sized hemicraniectomy with a diameter of more than 14 cm (HC > 14). We investigated whether this approach is associated wi... | PMC10345046 | |
Methods | DEcompressive, malignant INfarction | COMPLICATIONS | Patients from the DESTINY (DEcompressive Surgery for the Treatment of malignant INfarction of the middle cerebral arterY) registry who received hemicraniectomy were dichotomized according to the hemicraniectomy diameter (HC ≤ 14 cm vs. HC > 14 cm). The primary outcome was modified Rankin scale (mRS) score ≤ 4 after 12 ... | PMC10345046 |
Results | infarct, HC | INFARCT, COMPLICATIONS | Among 130 patients (32.3% female, mean (SD) age 55 (11) years), the mean hemicraniectomy diameter was 13.6 cm. 42 patients (32.3%) had HC > 14. There were no significant differences in the primary outcome and mortality by size of hemicraniectomy. Rate of complications did not differ (HC ≤ 14 27.6% vs. HC > 14 36.6%, p ... | PMC10345046 |
Conclusion | MIDDLE CEREBRAL ARTERY INFARCT | In this post-hoc analysis, large hemicraniectomy was not associated with an improved outcome or lower mortality in unselected patients with malignant middle cerebral artery infarction. Randomized trials should further examine whether individual patients could benefit from a large-sized hemicraniectomy. | PMC10345046 | |
Clinical trial registration information | German Clinical Trials Register (URL: | PMC10345046 | ||
Supplementary Information | The online version contains supplementary material available at 10.1007/s00415-023-11766-3. | PMC10345046 | ||
Keywords | Open Access funding enabled and organized by Projekt DEAL. | PMC10345046 | ||
Introduction | malignant cerebral infarction | BRAIN EDEMA | In malignant cerebral infarction space-occupying brain edema is associated with a mortality of up to 80% despite intensive care treatment [The volume gained by hemicraniectomy directly correlates with the diameter of the bone flap. Current recommendations are based on in vitro models which calculated a minimum diameter... | PMC10345046 |
Methods | stroke, DEcompressive, infratentorial infarction, malignant INfarction, hemispheric syndrome, infarction | STROKE, INFARCTION | Between January 2010 and July 2016 patients with large ischemic infarction were prospectively included into the DEcompressive Surgery for the Treatment of malignant INfarction of the middle cerebral arterY—Registry (DESTINY-R) study in 30 neurological and neurosurgical departments in Germany and Austria.A detailed desc... | PMC10345046 |
Clinical outcome analysis | The primary outcome was defined as the functional status according to the modified Rankin Scale score (mRS) after 12 months. Clinical outcome was dichotomized as mRS 0–4 versus 5 and 6 according to the definition of the pooled analysis of the three European hemicraniectomy RCTs [ | PMC10345046 | ||
Neuroimaging analysis | Neuroradiological parameters were processed centrally and blinded to functional outcome on the basis of CT or MRI scans on admission and after neurosurgery using To simplify the measurement of the hemicraniectomy diameter on postoperative imaging data, the bone flap was considered as an ellipse oriented in sagittal axi... | PMC10345046 | ||
Statistical analysis | Statistics were performed using the SPSS 26 software package (SPSS Inc., Chicago, Illinois, USA). Descriptive analyses were calculated for all variables. Student´s t test, Mann–Whitney U test, or χ | PMC10345046 | ||
Discussion | herniation, malignant infarction, osmotherapy, deaths, infarct | MUSCLE RELAXATION, INFARCT, MIDDLE CEREBRAL ARTERY INFARCT, COMPLICATIONS | Despite early prophylactic hemicraniectomy almost 20% of patients who suffer a malignant middle cerebral artery infarction still die. Most deaths occur early and are due to herniation which raises the question if some patients might benefit from a larger hemicraniectomy or if a larger hemicraniectomy in general could b... | PMC10345046 |
Supplementary Information | Below is the link to the electronic supplementary material.Supplementary file1 (DOCX 32 KB) | PMC10345046 | ||
Acknowledgements | The authors thank Victoria Rücker, PhD (Institute of Clinical Epidemiology and Biometry, University Würzburg) for her support in data analysis. | PMC10345046 | ||
Author contributions | EJ, TG | EJ and HN conceived, designed and supervised the study. H-PM and JK analyzed radiologic data. Analyses of clinical data were performed by DL and HN. The first draft of the manuscript was written by DL and all authors commented on previous versions of the manuscript. Data collection was performed by NH, GT, DM, TG, KEW,... | PMC10345046 | |
Funding | Open Access funding enabled and organized by Projekt DEAL. The authors report no targeted funding. | PMC10345046 | ||
Data availability | Original data are available and will be shared by request from a qualified investigator. | PMC10345046 | ||
Declarations | PMC10345046 | |||
Conflicts of interest | Edema, Stroke | EDEMA, STROKE, BRAIN INFARCTION | D. Lehrieder, H.P. Müller, J. Kassubek, G. Thomalla, D. Michalski, T. Gattringer, K.E. Wartenberg, J. Schultze-Amberger, H. Huttner, J.B. Kuramatsu, S. Wunderlich, H.H. Steiner, K. Weissenborn, S. Heck, H. Schneider, C. Dohmen, J. Woitzik and H. Neugebauer report no disclosures relevant to the manuscript; N. Hecht is B... | PMC10345046 |
Ethical approval | FRANKLIN | The trial was registered in the German Registry for Clinical Studies (DRKS00000624). The ethics committee of the Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin (EA4/108/09) and the local ethics committees of all participating centers approved this registry. Written informed consent was obtained from all... | PMC10345046 | |
References | PMC10345046 | |||
Objective | CMDs | DISORDERS | Edited by: Yuka Kotozaki, Iwate Medical University, JapanReviewed by: José Ignacio Ramírez Manent,Balearic Islands Health Research Institute (IdISBa), Spain;Alicia Salamanca-Sanabria, Singapore Institute for Clinical Sciences (A*STAR), SingaporeTo prevent the exacerbation of mental health burdens, a growing body of res... | PMC10824847 |
Methods | Anxiety | DISORDER | A total of 106 participants with Patient Health Questionnaire-9 total score < 10 and Generalized Anxiety Disorder 7-Item Scale <8 were randomly assigned to either the Lifestyle Hub intervention group (LH, | PMC10824847 |
Results | depressive, insomnia, anxiety | The linear mixed effect model based on the intention-to-treat principle indicated that Lifestyle Hub significantly improved overall mental health, depressive symptoms, anxiety symptoms, stress, insomnia severity, overall health-promoting behaviors, dietary quality, and stress management compared to the WL group at imme... | PMC10824847 | |
Introduction | CMDs, anxiety, Common mental disorders, CMD, depressive, depression | Common mental disorders (CMDs), such as depression and anxiety, are significant public health concerns worldwide. Recent studies indicated that the prevalence of depression and anxiety among the general population ranged between 32% and 38% across the globe (Considering the sound evidentiary support for the relationshi... | PMC10824847 | |
Methods | PMC10824847 | |||
Study design | MAY | To assess the efficacy of Lifestyle Hub in improving mental health, a two-arm RCT was conducted between February and May 2020. A total of 106 eligible participants were randomly assigned to either the intervention group receiving the 8-week smartphone-delivered multicomponent LM intervention (Lifestyle Hub; LH) or the ... | PMC10824847 | |
Eligibility criteria | depressive symptoms | Participants were eligible if they (1) were Hong Kong residents; (2) aged 18 years or older; (3) were able to read Chinese and type in Chinese or English; (4) had an internet-enabled mobile device (iOS or Android operating system); and (5) were willing to provide informed consent and comply with the trial protocol. Par... | PMC10824847 | |
Recruitment and study procedure | anxiety, depressive symptoms | Participants were recruited via the university mass mailing system, social networking websites (i.e., Facebook and Instagram), and print media. Prospective participants were required to complete a set of online questionnaires for screening purposes, which included (1) the PHQ-9 measuring depressive symptoms and current... | PMC10824847 | |
The LH intervention group | breathing exerciseExplain | SESSION | The detailed intervention content has been published elsewhere (Overview of the intervention structure and content of Lifestyle Hub.Overview of Introduction to lifestyle medicineA brief assessment of physical activityIntroduction to low-intensity exercise with demonstration videosExplain the association between physica... | PMC10824847 |
The WL control group | Participants allocated to the WL control group were advised to maintain their usual lifestyle routines and were given access to Lifestyle Hub upon the completion of the immediate post-intervention assessment at Week 9. | PMC10824847 | ||
Outcome measures | anxiety, Functional disability, insomnia, Insomnia, depressive symptoms, Depression | SHEEHAN, SECONDARY | Self-report outcome measures were collected at baseline (Week 0), immediate post-intervention (Week 9), and 1-month post-intervention (LH only; Week 13). The primary outcome was overall mental health conditions as assessed by the Chinese version of Depression Anxiety Stress Scales-21 (DASS-21) (The secondary outcomes i... | PMC10824847 |
Statistical analysis | Sample size estimation was conducted using G*Power 3 (The R version 4.1.2 ( | PMC10824847 | ||
Results | PMC10824847 | |||
Participant characteristics | In sum, 546 prospective participants completed the online screening for eligibility, of which 348 were excluded due to a variety of reasons (CONSORT flow diagram.Baseline characteristics.Data were presented as mean ( | PMC10824847 | ||
Intervention dropout | The study attrition rates (i.e., the number of dropouts throughout the entire study period) of the LH and WL groups were 20.8% ( | PMC10824847 | ||
Intervention usage | At Week 9, the 44 LH participants who completed the immediate post-intervention assessment had a mean Lifestyle Hub utilization of 11 days ( | PMC10824847 | ||
Intervention acceptability | The paired-samples | PMC10824847 | ||
Discussion | depression, insomnia, anxiety, depressive symptoms | RECRUITMENT | This RCT examined the efficacy and acceptability of a smartphone-delivered multicomponent LM intervention, Lifestyle Hub, for improving mental health among a nonclinical population of Chinese adults. The results indicated that Lifestyle Hub had small to moderate effects (The findings regarding the improvement in depres... | PMC10824847 |
Data availability statement | The datasets presented in this article are not readily available because the data underlying this article will be shared on reasonable request to the corresponding author. Requests to access the datasets should be directed to FY-YH, | PMC10824847 | ||
Ethics statement | The studies involving humans were approved by Survey and Behavioral Research Ethics Committee, The Chinese University of Hong Kong. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study. | PMC10824847 | ||
Author contributions | VWW and FY-YH designed the study protocol, developed the intervention, performed the data analysis, and contributed to the writing of the manuscript. JTT and N-KS assisted in developing the intervention and data collection and contributed to the writing of the manuscript. CN and JS verified the intervention content and... | PMC10824847 | ||
Abbreviations | Anxiety, CMD, Insomnia, Health-Promoting Behaviors, Depression Anxiety Stress Scales-21 | SHEEHAN, DISORDER | CMD, Common Mental Disorder; CEQ, Credibility-Expectancy Questionnaire; DASS-21, Depression Anxiety Stress Scales-21; GAD-7, Generalized Anxiety Disorder 7-Item Scale; HPBs, Health-Promoting Behaviors; HRQOL, Health-Related Quality of Life; ISI, Insomnia Severity Index; LMM, Linear Mixed-Effects Model; LM, Lifestyle Me... | PMC10824847 |
Conflict of interest | CN had served as a consultant for Lundbeck, Grunbiotics, Servier, Janssen-Cilag, Wyeth, and Eli Lilly, received research grant support from Wyeth and Lundbeck, and speaker honoraria from Servier, Lundbeck, Bristol-Myers Squibb, Organon, Eli Lilly, GlaxoSmithKline, Janssen-Cilag, Astra-Zenaca, Wyeth, and Pfizer, none re... | PMC10824847 | ||
Publisher’s note | All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or ... | PMC10824847 | ||
References | PMC10824847 | |||
Subject terms | stroke | STROKE, CORTEX | Upregulation of neuroplasticity might help maximize stroke recovery. One intervention that appears worthy of investigation is aerobic exercise. This study aimed to determine whether a single bout of moderate intensity aerobic exercise can enhance neuroplasticity in people with stroke. Participants were randomly assigne... | PMC10475034 |
Introduction | stroke, disabilityA, Stroke | STROKE, STROKE | Stroke remains a leading global cause of adult disabilityA topical question in stroke recovery is whether it is possible to re-open, or prolong, the spontaneous period of enhanced neuroplasticity seen after stroke. Ability to do so might lead to greater recovery. A mouse model of stroke has provided some evidence to su... | PMC10475034 |
Methods | PMC10475034 | |||
Participants | stroke, seizures, seizure | STROKE, RECRUITMENT, NEUROLOGICAL DISEASE | People who had experienced stroke at least three months prior, were community ambulators, medically stable and over the age of 18 years were invited to participate. Recruitment occurred via advertisement in a university health clinic and distributing information to willing volunteers in a research database. Exclusion c... | PMC10475034 |
Study design and protocol | A single-blinded, randomized, parallel group, controlled study was conducted to explore physiological effects of cardiovascular exercise on the brain. Participants were allocated to either the intervention or control group following consent using a random number generator. Allocation was concealed prior to enrolment, w... | PMC10475034 | ||
Baseline assessment | stroke | STROKE | Participant demographics and clinical characteristics including age, sex, time since stroke, levels of physical activity and resting motor threshold (RMT) were obtained. Prior physical activity was assessed using the International Physical Activity Questionnaire—Short Form (IPAQ-SF) | PMC10475034 |
Electromyography (EMG) | SKIN | Surface EMG was used to record MEPs from the first dorsal interosseous (FDI) muscle of the non-paretic hand, with adhesive disposable EMG electrodes positioned in a belly-tendon montage (22 × 34 mm, FIAB, Florence, Italy). Skin overlying the FDI muscle was cleaned using an alcohol wipe prior to electrode application. A... | PMC10475034 | |
Stimulation | CORTEX | Stimulation was delivered using a Neuro-MS/D rTMS device (Neurosoft Ltd. Ivanova, Russia) that was connected to an oil cooled figure eight coil (wing diameter 70 mm). Single pulses were delivered every five seconds to the contralesional motor cortex region. The coil was held tangentially to the scalp with the handle po... | PMC10475034 | |
iTBS | iTBS was delivered following the control or intervention. The standard 600 pulses iTBS paradigm was used, consisting of three low intensity, high frequency pulses (50 Hz), applied every 200 ms for two seconds, then repeated every 10 s for a total of 190 seconds | PMC10475034 | ||
Cardiovascular exercise | Participants allocated to the intervention (exercise) group completed 20 min of moderate intensity continuous aerobic exercise on a Monark RT2 recumbent exercise bike. Participants were monitored to ensure they stayed within 60–80% of maximum heart rate which was calculated using the formula: 208–(0.7 × age) | PMC10475034 | ||
Control condition | Those allocated to the control group were seated in a quiet room and watched a documentary of the same duration (20 min) on a television. The documentary was interesting, but not overstimulating. It was ensured participants did not move around but stayed awake and engaged in a sedentary position. | PMC10475034 | ||
MRI acquisition and analysis | BLIND | Anatomical MRI was available for a subset of participants (n = 26). Images were acquired with a Siemens 3 T MAGNETOM Skyra scanner (Siemens, Erlangen, Germany) with a 64-channel head coil. The scan protocol was: T1-weighted image MPRAGE (voxel 1 mm x 1 mm x 1 mm, repetition time (TR) = 2300 ms, echo time (TE) = 2.98 ms... | PMC10475034 | |
Data analysis | All statistical analyses were completed using SPSS (IBM Corp., Released 2020, IBM SPSS Statistics for Windows, Version 27.0, Armonk, NY, USA). Significance level was set at | PMC10475034 | ||
Results | PMC10475034 | |||
Participant demographics and clinical characteristics | stroke | STROKE | There were no adverse outcomes reported and all participants completed the study. A total of 33 stroke survivors participated, with 16 randomized to exercise and 17 randomized to the control group. MRI data was available for a subset of 26 participants (11 in exercise and 15 in control). No differences in patient demog... | PMC10475034 |
Effect of exercise on iTBS response | stroke, Stroke | STROKE, STROKE | Linear mixed model analyses revealed a significant effect of Group (FResults for test of fixed effects.df, degrees of freedom; RMT, resting motor threshold; IPAQ-SF, International Physical Activity Questionnaire Short Form.Bold indicates statistical significance.Effect of exercise on iTBS response. X-axis shows time th... | PMC10475034 |
Discussion | stroke | ADVERSE EVENTS, STROKE | This study aimed to investigate whether moderate intensity aerobic exercise could enhance neuroplasticity in people with stroke. Our measure of neuroplasticity was the change in MEP amplitude after administering iTBS. We observed a stronger iTBS response for people allocated to the exercise group, compared to those in ... | PMC10475034 |
Exercise can increase neuroplasticity | stroke | STROKE, CORTEX | That iTBS response was greater in the exercise group might indicate increased potential for neuroplasticity after moderate intensity exercise. There is evidence that iTBS can induce an effect that resembles long-term potentiation in the human cortex. Pharmacological studies found that administration of NMDA receptor an... | PMC10475034 |
Time since stroke and effects of exercise on neuroplasticity | stroke, human stroke, post-stroke | STROKE | A noteworthy finding from this study was the possible role of time post-stroke on neuroplasticity following aerobic exercise. While this outcome should be interpreted cautiously, given it was exploratory, and the sub-group analysis was performed on a small sample, it remains possible that chronicity might influence eff... | PMC10475034 |
Alternative explanations | Although the exercise group did exhibit a stronger response to iTBS, it is noteworthy that there was no iTBS facilitation of MEPs in the control group. This was not unexpected. Nonresponse to iTBS is commonly reported in the literature | PMC10475034 | ||
Clinical implications | stroke | STROKE | Persistent disability after stroke is an unresolved problem. While much recovery happens in the weeks to months following stroke, likely underpinned by a spontaneous upregulation in neuroplasticity | PMC10475034 |
Limitations and future directions | Findings from this study should be considered with respect to several limitations. First, consistent with the pilot nature of this work, the sample size was relatively small. Future studies should seek to replicate these findings in a larger patient group. Second, there are many factors known to affect response to brai... | PMC10475034 |
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