Hemispherics

By Hemispherics

Hemispherics, el podcast de Fisioterapia y Neurorrehabilitación, presentado por Javier Sánchez Aguilar. En este podcast podrán encontrar:

• Reseñas de libros de neurociencia, neurorrehabilitación, fi... more

· Science

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The podcast currently has 75 episodes available.

Hemispherics episodes:

November 22, 2024 #73: Entrevista a Leonardo Boccuni. Prehabilitación en tumores cerebrales y neurorrehabilitación del miembro superior
En esta entrevista, charlo con Leonardo Boccuni, fisioterapeuta italiano que acaba de presentar (noviembre, 2024) su tesis doctoral por la Universidad Autónoma de Barcelona sobre prehabilitación de tumores cerebrales mediante neuromodulación cerebral no invasiva y terapia intensiva, dentro del Proyecto PREHABILITA, del Institut Guttmann (Barcelona, España). Leonardo nos habla sobre este proyecto, su originalidad y complejidad, debido a la confluencia de áreas como la neurocirugía, neuroimagen, neurofisiología, neurorrehabilitación y programación informática. Además, nos cuenta sus aprendizajes en la investigación y práctica clínica sobre la neurorrehabilitación del miembro superior.
Referencias del episodio:
1. Boccuni, L., et al (2018). Is There Full or Proportional Somatosensory Recovery in the Upper Limb After Stroke? Investigating Behavioral Outcome and Neural Correlates. Neurorehabilitation and neural repair, 32(8), 691–700. https://doi.org/10.1177/1545968318787060 (https://pubmed.ncbi.nlm.nih.gov/29991331/).
2. Boccuni, L., et al (2019). Premotor dorsal white matter integrity for the prediction of upper limb motor impairment after stroke. Scientific reports, 9(1), 19712. https://doi.org/10.1038/s41598-019-56334-w (https://pubmed.ncbi.nlm.nih.gov/31873186/).
3. Boccuni, L.,et al (2022). Time to reconcile research findings and clinical practice on upper limb neurorehabilitation. Frontiers in neurology, 13, 939748. https://doi.org/10.3389/fneur.2022.939748 (https://pubmed.ncbi.nlm.nih.gov/35928130/).
4. Boccuni, L., et al (2023). Neuromodulation-induced prehabilitation to leverage neuroplasticity before brain tumor surgery: a single-cohort feasibility trial protocol. Frontiers in neurology, 14, 1243857. https://doi.org/10.3389/fneur.2023.1243857 (https://pubmed.ncbi.nlm.nih.gov/37849833/).
5. Boccuni, L., et al (2024). Exploring the neural basis of non-invasive prehabilitation in brain tumour patients: An fMRI-based case report of language network plasticity. Frontiers in oncology, 14, 1390542. https://doi.org/10.3389/fonc.2024.1390542 (https://pubmed.ncbi.nlm.nih.gov/38826790/).
6. Boccuni, L., et al (2024). Non-invasive prehabilitation to foster widespread fMRI cortical reorganization before brain tumor surgery: lessons from a case series. Journal of neuro-oncology, 170(1), 185–198. https://doi.org/10.1007/s11060-024-04774-4 (https://pubmed.ncbi.nlm.nih.gov/39044115/).
7. Essers, B., Meyer, S., De Bruyn, N., Van Gils, A., Boccuni, L., Tedesco Triccas, L., Peeters, A., Thijs, V., Feys, H., & Verheyden, G. (2019). Mismatch between observed and perceived upper limb function: an eye-catching phenomenon after stroke. Disability and rehabilitation, 41(13), 1545–1551. https://doi.org/10.1080/09638288.2018.1442504 (https://pubmed.ncbi.nlm.nih.gov/29564912/).
8. Salvalaggio, S., Boccuni, L., & Turolla, A. (2023). Patient's assessment and prediction of recovery after stroke: a roadmap for clinicians. Archives of physiotherapy, 13(1), 13. https://doi.org/10.1186/s40945-023-00167-4 (https://pubmed.ncbi.nlm.nih.gov/37337288/).
9. Yilmazer, C., Boccuni, L., Thijs, L., & Verheyden, G. (2019). Effectiveness of somatosensory interventions on somatosensory, motor and functional outcomes in the upper limb post-stroke: A systematic review and meta-analysis. NeuroRehabilitation, 44(4), 459–477. https://doi.org/10.3233/NRE-192687 (https://pubmed.ncbi.nlm.nih.gov/31256086/).
*Tesis doctoral próximamente disponible :)
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1h 41min
November 15, 2024 #72: ¿Existen los Generadores Centrales de Patrones (CPG) de la marcha en humanos?
En el episodio de hoy, tratamos de responder a la pregunta que formulamos, sobre todo matizando la autonomía o no de esos CPGs en la médula humana. Revisamos los principales autores y estudios sobre el tema y ahondamos en la evidencia más actual sobre el sistema de interneuronas que conforman los CPGs y las implicaciones para la neurorrehabilitación (estimulación epidural y terapia intensiva).
Referencias del episodio:
1. Angeli, C. A., Edgerton, V. R., Gerasimenko, Y. P., & Harkema, S. J. (2014). Altering spinal cord excitability enables voluntary movements after chronic complete paralysis in humans. Brain : a journal of neurology, 137(Pt 5), 1394–1409. https://doi.org/10.1093/brain/awu038 (https://pubmed.ncbi.nlm.nih.gov/24713270/).
2. Barkan, C. L., & Zornik, E. (2019). Feedback to the future: motor neuron contributions to central pattern generator function. The Journal of experimental biology, 222(Pt 16), jeb193318. https://doi.org/10.1242/jeb.193318 (https://pmc.ncbi.nlm.nih.gov/articles/PMC6739810/).
3. Brown, T. G. (1911). The Intrinsic Factors in the Act of Progression in the Mammal. Proceedings of the Royal Society of London. Series B, Containing Papers of a Biological Character, 84(572), 308–319. http://www.jstor.org/stable/80647 (https://www.jstor.org/stable/80647).
4. Cherni, Y., Begon, M., Chababe, H., & Moissenet, F. (2017). Use of electromyography to optimize Lokomat® settings for subject-specific gait rehabilitation in post-stroke hemiparetic patients: A proof-of-concept study. Neurophysiologie clinique = Clinical neurophysiology, 47(4), 293–299. https://doi.org/10.1016/j.neucli.2017.01.008 (https://pubmed.ncbi.nlm.nih.gov/28318816/).
5. Courtine, G., Gerasimenko, Y., van den Brand, R., Yew, A., Musienko, P., Zhong, H., Song, B., Ao, Y., Ichiyama, R. M., Lavrov, I., Roy, R. R., Sofroniew, M. V., & Edgerton, V. R. (2009). Transformation of nonfunctional spinal circuits into functional states after the loss of brain input. Nature neuroscience, 12(10), 1333–1342. https://doi.org/10.1038/nn.2401 (https://pubmed.ncbi.nlm.nih.gov/19767747/).
6. Dietz V. (2010). Behavior of spinal neurons deprived of supraspinal input. Nature reviews. Neurology, 6(3), 167–174. https://doi.org/10.1038/nrneurol.2009.227 (https://pubmed.ncbi.nlm.nih.gov/20101254/).
7. Dimitrijevic, M. R., Gerasimenko, Y., & Pinter, M. M. (1998). Evidence for a spinal central pattern generator in humans. Annals of the New York Academy of Sciences, 860, 360–376. https://doi.org/10.1111/j.1749-6632.1998.tb09062.x (https://pubmed.ncbi.nlm.nih.gov/9928325/).
8. Dzeladini, F., van den Kieboom, J., & Ijspeert, A. (2014). The contribution of a central pattern generator in a reflex-based neuromuscular model. Frontiers in human neuroscience, 8, 371. https://doi.org/10.3389/fnhum.2014.00371 (https://pmc.ncbi.nlm.nih.gov/articles/PMC4071613/).
9. Gizzi, L., Nielsen, J. F., Felici, F., Moreno, J. C., Pons, J. L., & Farina, D. (2012). Motor modules in robot-aided walking. Journal of neuroengineering and rehabilitation, 9, 76. https://doi.org/10.1186/1743-0003-9-76 (https://pubmed.ncbi.nlm.nih.gov/23043818/).
10. Gosgnach S. (2022). Synaptic connectivity amongst components of the locomotor central pattern generator. Frontiers in neural circuits, 16, 1076766. https://doi.org/10.3389/fncir.2022.1076766 (https://pmc.ncbi.nlm.nih.gov/articles/PMC9730330/).
11. Grillner, S. (1981). Control of Locomotion in Bipeds, Tetrapods, and Fish. Comprehensive Physiology, 1179-1236 (https://onlinelibrary.wiley.com/doi/10.1002/cphy.cp010226).
12. Guertin P. A. (2014). Preclinical evidence supporting the clinical development of central pattern generator-modulating therapies for chronic spinal cord-injured patients. Frontiers in human neuroscience, 8, 272. https://doi.org/10.3389/fnhum.2014.00272 (https://pubmed.ncbi.nlm.nih.gov/24910602/).
13. Harkema, S., Gerasimenko, Y., Hodes, J., Burdick, J., Angeli, C., Chen, Y., Ferreira, C., Willhite, A., Rejc, E., Grossman, R. G., & Edgerton, V. R. (2011). Effect of epidural stimulation of the lumbosacral spinal cord on voluntary movement, standing, and assisted stepping after motor complete paraplegia: a case study. Lancet (London, England), 377(9781), 1938–1947. https://doi.org/10.1016/S0140-6736(11)60547-3 (https://pubmed.ncbi.nlm.nih.gov/21601270/).
14. Kathe, C., Skinnider, M. A., Hutson, T. H., Regazzi, N., Gautier, M., Demesmaeker, R., Komi, S., Ceto, S., James, N. D., Cho, N., Baud, L., Galan, K., Matson, K. J. E., Rowald, A., Kim, K., Wang, R., Minassian, K., Prior, J. O., Asboth, L., Barraud, Q., … Courtine, G. (2022). The neurons that restore walking after paralysis. Nature, 611(7936), 540–547. https://doi.org/10.1038/s41586-022-05385-7 (https://pubmed.ncbi.nlm.nih.gov/36352232/).
15. Minassian, K., Jilge, B., Rattay, F., Pinter, M. M., Binder, H., Gerstenbrand, F., & Dimitrijevic, M. R. (2004). Stepping-like movements in humans with complete spinal cord injury induced by epidural stimulation of the lumbar cord: electromyographic study of compound muscle action potentials. Spinal cord, 42(7), 401–416. https://doi.org/10.1038/sj.sc.3101615 (https://pubmed.ncbi.nlm.nih.gov/15124000/).
16. Minassian, K., Persy, I., Rattay, F., Dimitrijevic, M. R., Hofer, C., & Kern, H. (2007). Posterior root-muscle reflexes elicited by transcutaneous stimulation of the human lumbosacral cord. Muscle & nerve, 35(3), 327–336. https://doi.org/10.1002/mus.20700 (https://pubmed.ncbi.nlm.nih.gov/17117411/).
17. Radhakrishna, M., Steuer, I., Prince, F., Roberts, M., Mongeon, D., Kia, M., Dyck, S., Matte, G., Vaillancourt, M., & Guertin, P. A. (2017). Double-Blind, Placebo-Controlled, Randomized Phase I/IIa Study (Safety and Efficacy) with Buspirone/Levodopa/Carbidopa (SpinalonTM) in Subjects with Complete AIS A or Motor-Complete AIS B Spinal Cord Injury. Current pharmaceutical design, 23(12), 1789–1804. https://doi.org/10.2174/1381612822666161227152200 (https://pubmed.ncbi.nlm.nih.gov/28025945/).
18. Reier, P. J., Howland, D. R., Mitchell, G., Wolpaw, J. R., Hoh, D., & Lane, M. A. (2017). Spinal cord injury: repair, plasticity and rehabilitation. eLS, 1-12 (https://onlinelibrary.wiley.com/doi/abs/10.1002/9780470015902.a0021403.pub2).
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49min
October 19, 2024 #71: El modelo de competición interhemisférica a examen
En el episodio de hoy, describimos el modelo de competición interhemisférica, base de algunas técnicas de estimulación cerebral no invasiva y exponemos las críticas y modelos alternativos en la actualidad para explicar esa relación entre hemisferios cerebrales y la relación con la recuperación motora tras un ictus.
1. Di Pino, G., Pellegrino, G., Assenza, G., Capone, F., Ferreri, F., Formica, D., Ranieri, F., Tombini, M., Ziemann, U., Rothwell, J. C., & Di Lazzaro, V. (2014). Modulation of brain plasticity in stroke: a novel model for neurorehabilitation. Nature reviews. Neurology, 10(10), 597–608. https://doi.org/10.1038/nrneurol.2014.162 (https://pubmed.ncbi.nlm.nih.gov/25201238/).
2. Brancaccio, A., Tabarelli, D., & Belardinelli, P. (2022). A New Framework to Interpret Individual Inter-Hemispheric Compensatory Communication after Stroke. Journal of personalized medicine, 12(1), 59. https://doi.org/10.3390/jpm12010059 (https://pubmed.ncbi.nlm.nih.gov/35055374/).
3. Lee, H. S., Kim, D. H., Seo, H. G., Im, S., Yoo, Y. J., Kim, N. Y., Lee, J., Kim, D., Park, H. Y., Yoon, M. J., Kim, Y. S., Kim, H., & Chang, W. H. (2024). Efficacy of personalized rTMS to enhance upper limb function in subacute stroke patients: a protocol for a multi-center, randomized controlled study. Frontiers in neurology, 15, 1427142. https://doi.org/10.3389/fneur.2024.1427142 (https://pubmed.ncbi.nlm.nih.gov/39022726/).
4. Xu, J., Branscheidt, M., Schambra, H., Steiner, L., Widmer, M., Diedrichsen, J., Goldsmith, J., Lindquist, M., Kitago, T., Luft, A. R., Krakauer, J. W., Celnik, P. A., & SMARTS Study Group (2019). Rethinking interhemispheric imbalance as a target for stroke neurorehabilitation. Annals of neurology, 85(4), 502–513. https://doi.org/10.1002/ana.25452 (https://pubmed.ncbi.nlm.nih.gov/30805956/).
5. Murase, N., Duque, J., Mazzocchio, R., & Cohen, L. G. (2004). Influence of interhemispheric interactions on motor function in chronic stroke. Annals of neurology, 55(3), 400–409. https://doi.org/10.1002/ana.10848 (https://pubmed.ncbi.nlm.nih.gov/14991818/).
6. Ferbert, A., Priori, A., Rothwell, J. C., Day, B. L., Colebatch, J. G., & Marsden, C. D. (1992). Interhemispheric inhibition of the human motor cortex. The Journal of physiology, 453, 525–546. https://doi.org/10.1113/jphysiol.1992.sp019243 (https://pubmed.ncbi.nlm.nih.gov/1464843/).
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36min
August 05, 2024 #70: Neurocirugía del paciente despierto y el cerebro como metasistema
En el episodio de hoy, os hablo de un libro muy interesante publicado este 2024 titulado “Dime qué sientes. Diario de un neurocirujano. Pacientes despiertos, las 5 dimensiones del cerebro y un cambio de paradigma”. Su autor es el Dr. Jesús Martín-Fernández, un neurocirujano español especializado en cirugía despierta y formado con Hughes Duffau en Montpelier (Francia).
Este libro divulgativo y con tintes autobiográficos defiende la tesis de que tenemos que comprender el cerebro en forma de red, o red de redes, que tienen nodos o puntos clave y que hay ciertas zonas clásicamente sagradas en neurociencia, como el área de Broca, que no existen como tal y que lo importante sobre todo a la hora de la neurocirugía, es respetar los tractos profundos y largos que llevan las grandes funciones cognitivas y motoras. A través de los casos que expone Jesús en el libro, se puede ver cómo van monitorizando al paciente despierto para preservar las funciones cognitivas con diferentes test y con ayuda de inteligencia artificial, todo mientras están quitando un tumor, que en muchas ocasiones, había sido catalogado como ‘inoperable’.
Referencias del episodio:
1. Martín-Fernández, J., Moritz-Gasser, S., Herbet, G., & Duffau, H. (2024). Is intraoperative mapping of music performance mandatory to preserve skills in professional musicians? Awake surgery for lower-grade glioma conducted from a meta-networking perspective. Neurosurgical focus, 56(2), E9. https://doi.org/10.3171/2023.11.FOCUS23702 (https://pubmed.ncbi.nlm.nih.gov/38301246/).
2. Tremblay, P., & Dick, A. S. (2016). Broca and Wernicke are dead, or moving past the classic model of language neurobiology. Brain and language, 162, 60–71. https://doi.org/10.1016/j.bandl.2016.08.004 (https://pubmed.ncbi.nlm.nih.gov/27584714/).
3. Duffau H. (2021). The death of localizationism: The concepts of functional connectome and neuroplasticity deciphered by awake mapping, and their implications for best care of brain-damaged patients. Revue neurologique, 177(9), 1093–1103. https://doi.org/10.1016/j.neurol.2021.07.016 (https://pubmed.ncbi.nlm.nih.gov/34563375/).
4. Duffau H. (2018). The error of Broca: From the traditional localizationist concept to a connectomal anatomy of human brain. Journal of chemical neuroanatomy, 89, 73–81. https://doi.org/10.1016/j.jchemneu.2017.04.003 (https://pubmed.ncbi.nlm.nih.gov/28416459/).
5. Herbet, G., & Duffau, H. (2020). Revisiting the Functional Anatomy of the Human Brain: Toward a Meta-Networking Theory of Cerebral Functions. Physiological reviews, 100(3), 1181–1228. https://doi.org/10.1152/physrev.00033.2019 (https://pubmed.ncbi.nlm.nih.gov/32078778/).
6. Martín-Fernández, J. (2024). Dime qué sientes. Diario de un neurocirujano. Pacientes despiertos, las 5 dimensiones del cerebro y un cambio de paradigma. Ed. Paidós. 1ªed (https://www.amazon.es/Dime-qu%C3%A9-sientes-neurocirujano-dimensiones-ebook/dp/B0CVN4HVCV).
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58min
May 26, 2024 #69: La fatiga en la esclerosis múltiple
En el episodio de hoy, os traigo un tema muy presente en neurorrehabilitación y en las consultas de neurología en relación con la esclerosis múltiple y es nada menos que la fatiga. La fatiga, ese síntoma tan temido desde siempre, tanto por pacientes como por profesionales de la salud, que es uno de los más reportados, con cifras de prevalencia entre 52 y el 90% de los pacientes (Nagaraj et al., 2013).
Indagamos en la fisiopatología de la fatiga para entender mejor este fenómeno, también diferentes formas de ver la fatiga con sus distintas nomenclaturas o términos, vamos a ver cómo se suele evaluar en el entorno clínico y en investigación y finalmente daremos algunas pinceladas de tratamiento neuromodulador.
Referencias del episodio:
1. Adibi, I., Sanayei, M., Tabibian, F., Ramezani, N., Pourmohammadi, A., & Azimzadeh, K. (2022). Multiple sclerosis-related fatigue lacks a unified definition: A narrative review. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 27, 24. https://doi.org/10.4103/jrms.jrms_1401_20 (https://pubmed.ncbi.nlm.nih.gov/35419061/).
2. Ayache, S. S., & Chalah, M. A. (2017). Fatigue in multiple sclerosis - Insights into evaluation and management. Neurophysiologie clinique = Clinical neurophysiology, 47(2), 139–171. https://doi.org/10.1016/j.neucli.2017.02.004 (https://pubmed.ncbi.nlm.nih.gov/28416274/).
3. Ayache, S. S., Serratrice, N., Abi Lahoud, G. N., & Chalah, M. A. (2022). Fatigue in Multiple Sclerosis: A Review of the Exploratory and Therapeutic Potential of Non-Invasive Brain Stimulation. Frontiers in neurology, 13, 813965. https://doi.org/10.3389/fneur.2022.813965 (https://pubmed.ncbi.nlm.nih.gov/35572947/).
4. Bhattarai, J. J., Patel, K. S., Dunn, K. M., Brown, A., Opelt, B., & Hughes, A. J. (2023). Sleep disturbance and fatigue in multiple sclerosis: A systematic review and meta-analysis. Multiple sclerosis journal - experimental, translational and clinical, 9(3), 20552173231194352. https://doi.org/10.1177/20552173231194352 (https://pubmed.ncbi.nlm.nih.gov/37641617/).
5. Braley, T. J., & Chervin, R. D. (2010). Fatigue in multiple sclerosis: mechanisms, evaluation, and treatment. Sleep, 33(8), 1061–1067. https://doi.org/10.1093/sleep/33.8.1061 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2910465/).
6. Capone, F., Motolese, F., Falato, E., Rossi, M., & Di Lazzaro, V. (2020). The Potential Role of Neurophysiology in the Management of Multiple Sclerosis-Related Fatigue. Frontiers in neurology, 11, 251. https://doi.org/10.3389/fneur.2020.00251 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7212459/).
7. Chalah, M. A., Riachi, N., Ahdab, R., Créange, A., Lefaucheur, J. P., & Ayache, S. S. (2015). Fatigue in Multiple Sclerosis: Neural Correlates and the Role of Non-Invasive Brain Stimulation. Frontiers in cellular neuroscience, 9, 460. https://doi.org/10.3389/fncel.2015.00460 (https://pubmed.ncbi.nlm.nih.gov/26648845/).
8. Chalah, M. A., Kauv, P., Créange, A., Hodel, J., Lefaucheur, J. P., & Ayache, S. S. (2019). Neurophysiological, radiological and neuropsychological evaluation of fatigue in multiple sclerosis. Multiple sclerosis and related disorders, 28, 145–152. https://doi.org/10.1016/j.msard.2018.12.029 (https://pubmed.ncbi.nlm.nih.gov/30594815/).
9. Dittner, A. J., Wessely, S. C., & Brown, R. G. (2004). The assessment of fatigue: a practical guide for clinicians and researchers. Journal of psychosomatic research, 56(2), 157–170. https://doi.org/10.1016/S0022-3999(03)00371-4 (https://pubmed.ncbi.nlm.nih.gov/15016573/).
10. Dobryakova, E., Genova, H. M., DeLuca, J., & Wylie, G. R. (2015). The dopamine imbalance hypothesis of fatigue in multiple sclerosis and other neurological disorders. Frontiers in neurology, 6, 52. https://doi.org/10.3389/fneur.2015.00052 (https://pubmed.ncbi.nlm.nih.gov/25814977/).
11. Freal, J. E., Kraft, G. H., & Coryell, J. K. (1984). Symptomatic fatigue in multiple sclerosis. Archives of physical medicine and rehabilitation, 65(3), 135–138 (https://pubmed.ncbi.nlm.nih.gov/6703889/).
12. Gaede, G., Tiede, M., Lorenz, I., Brandt, A. U., Pfueller, C., Dörr, J., Bellmann-Strobl, J., Piper, S. K., Roth, Y., Zangen, A., Schippling, S., & Paul, F. (2017). Safety and preliminary efficacy of deep transcranial magnetic stimulation in MS-related fatigue. Neurology(R) neuroimmunology & neuroinflammation, 5(1), e423. https://doi.org/10.1212/NXI.0000000000000423 (https://pubmed.ncbi.nlm.nih.gov/29259998/).
13. Garis, G., Haupts, M., Duning, T., & Hildebrandt, H. (2023). Heart rate variability and fatigue in MS: two parallel pathways representing disseminated inflammatory processes?. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 44(1), 83–98. https://doi.org/10.1007/s10072-022-06385-1 (https://pubmed.ncbi.nlm.nih.gov/36125573/).
14. Hanken, K., Eling, P., & Hildebrandt, H. (2014). The representation of inflammatory signals in the brain - a model for subjective fatigue in multiple sclerosis. Frontiers in neurology, 5, 264. https://doi.org/10.3389/fneur.2014.00264 (https://pubmed.ncbi.nlm.nih.gov/25566171/).
15. Iriarte, J., Subirá, M. L., & Castro, P. (2000). Modalities of fatigue in multiple sclerosis: correlation with clinical and biological factors. Multiple sclerosis (Houndmills, Basingstoke, England), 6(2), 124–130. https://doi.org/10.1177/135245850000600212 (https://pubmed.ncbi.nlm.nih.gov/10773859/).
16. Jaeger, S., Paul, F., Scheel, M., Brandt, A., Heine, J., Pach, D., Witt, C. M., Bellmann-Strobl, J., & Finke, C. (2019). Multiple sclerosis-related fatigue: Altered resting-state functional connectivity of the ventral striatum and dorsolateral prefrontal cortex. Multiple sclerosis (Houndmills, Basingstoke, England), 25(4), 554–564. https://doi.org/10.1177/1352458518758911 (https://pubmed.ncbi.nlm.nih.gov/29464981/).
17. Langeskov-Christensen, M., Heine, M., Kwakkel, G., & Dalgas, U. (2015). Aerobic capacity in persons with multiple sclerosis: a systematic review and meta-analysis. Sports medicine (Auckland, N.Z.), 45(6), 905–923. https://doi.org/10.1007/s40279-015-0307-x (https://pubmed.ncbi.nlm.nih.gov/25739555/).
18. Linnhoff, S., Fiene, M., Heinze, H. J., & Zaehle, T. (2019). Cognitive Fatigue in Multiple Sclerosis: An Objective Approach to Diagnosis and Treatment by Transcranial Electrical Stimulation. Brain sciences, 9(5), 100. https://doi.org/10.3390/brainsci9050100 (https://pubmed.ncbi.nlm.nih.gov/31052593/).
19. Liu, M., Fan, S., Xu, Y., & Cui, L. (2019). Non-invasive brain stimulation for fatigue in multiple sclerosis patients: A systematic review and meta-analysis. Multiple sclerosis and related disorders, 36, 101375. https://doi.org/10.1016/j.msard.2019.08.017 (https://pubmed.ncbi.nlm.nih.gov/31491597/).
20. Loy, B. D., Taylor, R. L., Fling, B. W., & Horak, F. B. (2017). Relationship between perceived fatigue and performance fatigability in people with multiple sclerosis: A systematic review and meta-analysis. Journal of psychosomatic research, 100, 1–7. https://doi.org/10.1016/j.jpsychores.2017.06.017 (https://pubmed.ncbi.nlm.nih.gov/28789787/).
21. Mills, R. J., & Young, C. A. (2008). A medical definition of fatigue in multiple sclerosis. QJM : monthly journal of the Association of Physicians, 101(1), 49–60. https://doi.org/10.1093/qjmed/hcm122 (https://pubmed.ncbi.nlm.nih.gov/18194977/).
22. Nagaraj, K., Taly, A. B., Gupta, A., Prasad, C., & Christopher, R. (2013). Prevalence of fatigue in patients with multiple sclerosis and its effect on the quality of life. Journal of neurosciences in rural practice, 4(3), 278–282. https://doi.org/10.4103/0976-3147.118774 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821412/).
23. Patejdl, R., Penner, I. K., Noack, T. K., & Zettl, U. K. (2016). Multiple sclerosis and fatigue: A review on the contribution of inflammation and immune-mediated neurodegeneration. Autoimmunity reviews, 15(3), 210–220. https://doi.org/10.1016/j.autrev.2015.11.005 (https://pubmed.ncbi.nlm.nih.gov/26589194/).
24. Patejdl, R., & Zettl, U. K. (2022). The pathophysiology of motor fatigue and fatigability in multiple sclerosis. Frontiers in neurology, 13, 891415. https://doi.org/10.3389/fneur.2022.891415 (https://pubmed.ncbi.nlm.nih.gov/35968278/).
25. Torres-Costoso, A., Martínez-Vizcaíno, V., Reina-Gutiérrez, S., Álvarez-Bueno, C., Guzmán-Pavón, M. J., Pozuelo-Carrascosa, D. P., Fernández-Rodríguez, R., Sanchez-López, M., & Cavero-Redondo, I. (2022). Effect of Exercise on Fatigue in Multiple Sclerosis: A Network Meta-analysis Comparing Different Types of Exercise. Archives of physical medicine and rehabilitation, 103(5), 970–987.e18. https://doi.org/10.1016/j.apmr.2021.08.008 (https://pubmed.ncbi.nlm.nih.gov/34509464/).
26. Yang, T. T., Wang, L., Deng, X. Y., & Yu, G. (2017). Pharmacological treatments for fatigue in patients with multiple sclerosis: A systematic review and meta-analysis. Journal of the neurological sciences, 380, 256–261. https://doi.org/10.1016/j.jns.2017.07.042 (https://pubmed.ncbi.nlm.nih.gov/28870581/).
27. Zimek, D., Miklusova, M., & Mares, J. (2023). Overview of the Current Pathophysiology of Fatigue in Multiple Sclerosis, Its Diagnosis and Treatment Options - Review Article. Neuropsychiatric disease and treatment, 19, 2485–2497. https://doi.org/10.2147/NDT.S429862 (https://pubmed.ncbi.nlm.nih.gov/38029042/).
28. Zhou, X., Li, K., Chen, S., Zhou, W., Li, J., Huang, Q., Xu, T., Gao, Z., Wang, D., Zhao, S., & Dong, H. (2022). Clinical application of transcranial magnetic stimulation in multiple sclerosis. Frontiers in immunology, 13, 902658. https://doi.org/10.3389/fimmu.2022.902658 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9483183/).
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1h 13min
March 29, 2024 #68: Cerebelo y ataxia. Neurofisiología y terapéutica
En este episodio, realizo una síntesis de conocimiento y experiencia sobre el cerebelo y la ataxia, desde la anatomía y fisiología, describiendo la ataxia, hasta la evaluación y el tratamiento neurorrehabilitador. El objetivo es hilar el conocimiento anatómico y neurofisiológico con el aprendizaje motor y la plasticidad del cerebelo y tratar de establecer un marco de evaluación y tratamiento de los pacientes atáxicos.
Referencias bibliográficas:
1. Stephan, M. A., et al (2011). Effect of long-term climbing training on cerebellar ataxia: a case series. Rehabilitation research and practice, 2011, 525879. (https://pubmed.ncbi.nlm.nih.gov/22191034/).
2. Aprigliano, F., et al (2019). Effects of repeated waist-pull perturbations on gait stability in subjects with cerebellar ataxia. Journal of neuroengineering and rehabilitation, 16(1), 50. (https://pubmed.ncbi.nlm.nih.gov/30975168/9.
3. Benussi, A.,et al (2017). Long term clinical and neurophysiological effects of cerebellar transcranial direct current stimulation in patients with neurodegenerative ataxia. Brain stimulation, 10(2), 242–250. (https://pubmed.ncbi.nlm.nih.gov/27838276/).
4. Bostan, A. C., & Strick, P. L. (2018). The basal ganglia and the cerebellum: nodes in an integrated network. Nature reviews. Neuroscience, 19(6), 338–350. (https://pubmed.ncbi.nlm.nih.gov/29643480/).
5. Cabaraux, P., et al (2023). Consensus Paper: Ataxic Gait. Cerebellum (London, England), 22(3), 394–430. (https://pubmed.ncbi.nlm.nih.gov/35414041/).
6. D'Angelo E. (2014). The organization of plasticity in the cerebellar cortex: from synapses to control. Progress in brain research, 210, 31–58. (https://pubmed.ncbi.nlm.nih.gov/24916288/).
7. D'Angelo E. (2018). Physiology of the cerebellum. Handbook of clinical neurology, 154, 85–108. (https://pubmed.ncbi.nlm.nih.gov/29903454/).
8. França, C., et al (2018). Effects of cerebellar neuromodulation in movement disorders: A systematic review. Brain stimulation, 11(2), 249–260. (https://pubmed.ncbi.nlm.nih.gov/29191439/).
9. Gong, C., et al (2023). Efficacy and safety of noninvasive brain stimulation for patients with cerebellar ataxia: a systematic review and meta-analysis of randomized controlled trials. Journal of neurology, 270(10), 4782–4799. (https://pubmed.ncbi.nlm.nih.gov/37460852/).
10. Gorgas, A. M., et al (2015). Gait changes with balance-based torso-weighting in people with multiple sclerosis. (https://pubmed.ncbi.nlm.nih.gov/24930996/).
11. Ilg, W., et al (2023). Quantitative Gait and Balance Outcomes for Ataxia Trials. Cerebellum 10.1007/s12311-023-01625-2. Advance online publication. (https://pubmed.ncbi.nlm.nih.gov/37955812/).
12. Ilg, W., et al (2009). Intensive coordinative training improves motor performance in degenerative cerebellar disease. Neurology, 73(22), 1823–1830. (https://pubmed.ncbi.nlm.nih.gov/19864636/).
13. Jacobson, G. A. et al (2008). A model of the olivo-cerebellar system as a temporal pattern generator. Trends in neurosciences, 31(12), 617–625. (https://pubmed.ncbi.nlm.nih.gov/18952303/).
14. Kelly, G., & Shanley, J. (2016). Rehabilitation of ataxic gait following cerebellar lesions: Applying theory to practice. Physiotherapy theory and practice, 32(6), 430–437. (https://pubmed.ncbi.nlm.nih.gov/27458875/).
15. Marsden J. F. (2018). Cerebellar ataxia. Handbook of clinical neurology, 159, 261–281. (https://pubmed.ncbi.nlm.nih.gov/30482319/).
16. Morton, S. M., & Bastian, A. J. (2003). Relative contributions of balance and voluntary leg-coordination deficits to cerebellar gait ataxia. Journal of neurophysiology, 89(4), 1844–1856. (https://pubmed.ncbi.nlm.nih.gov/12612041/).
17. Ruggieri, S., et al (2021). A matter of atrophy: differential impact of brain and spine damage on disability worsening in multiple sclerosis. Journal of neurology, 268(12), 4698–4706. (https://pubmed.ncbi.nlm.nih.gov/33942160/).
18. Serrao, M., et al (2017). Use of dynamic movement orthoses to improve gait stability and trunk control in ataxic patients. European journal of physical and rehabilitation medicine, 53(5), 735–743. (https://pubmed.ncbi.nlm.nih.gov/28627859/).
19. Shah, V. V., et al (2021). Gait Variability in Spinocerebellar Ataxia Assessed Using Wearable Inertial Sensors. Movement disorders : official journal of the Movement Disorder Society, 36(12), 2922–2931. (https://pubmed.ncbi.nlm.nih.gov/34424581/).
20. Wang, Y., et al (2023). Effects of transcranial magnetic stimulation on cerebellar ataxia: A systematic review and meta-analysis. Frontiers in neurology, 14, 1049813. (https://pubmed.ncbi.nlm.nih.gov/36779066/).
21. Wright, R. L., et al (2016). Metronome Cueing of Walking Reduces Gait Variability after a Cerebellar Stroke. Frontiers in neurology, 7, 84. (https://pubmed.ncbi.nlm.nih.gov/27313563/).
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1h 57min
January 20, 2024 #67: El núcleo rojo...¿deja de ser motor?
En este episodio, actualizamos la neuroanatomía funcional del núcleo rojo a raíz del último trabajo pre-print de Krimmel (2024): The brainstem’s red nucleus was evolutionarily upgraded to support goal-directed action. Aprovechamos para traer de vuelta la crítica al tracto rubroespinal que hicimos en el #1 de Hemispherics y argumentamos el sentido evolutivo y funcional del núcleo rojo y sus conexiones en el ser humano adulto.
¿Es el núcleo rojo motor? ¿O tiene más función como nodo en una red más amplia de control ejecutivo de la acción? ¡Lo vemos en este episodio!
Referencias del episodio:
1. Habas, C., & Cabanis, E. A. (2006). Cortical projections to the human red nucleus: a diffusion tensor tractography study with a 1.5-T MRI machine. Neuroradiology, 48(10), 755–762. https://doi.org/10.1007/s00234-006-0117-9 (https://pubmed.ncbi.nlm.nih.gov/16937147/).
2. Basile, G. A., Quartu, M., Bertino, S., Serra, M. P., Boi, M., Bramanti, A., Anastasi, G. P., Milardi, D., & Cacciola, A. (2021). Red nucleus structure and function: from anatomy to clinical neurosciences. Brain structure & function, 226(1), 69–91. https://doi.org/10.1007/s00429-020-02171-x (https://pubmed.ncbi.nlm.nih.gov/33180142/).
3. Sung, Y. W., Kiyama, S., Choi, U. S., & Ogawa, S. (2022). Involvement of the intrinsic functional network of the red nucleus in complex behavioral processing. Cerebral cortex communications, 3(3), tgac037. https://doi.org/10.1093/texcom/tgac037 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9491841/).
4. Krimmel, S.R., et al. (2024). The brainstem’s red nucleus was evolutionarily upgraded to support goal-directed action. bioRxiv. Preprint. https://doi.org/10.1101/2023.12.30.573730 (https://www.biorxiv.org/content/10.1101/2023.12.30.573730v1).
5. Gordon, E. M., Chauvin, R. J., Van, A. N., Rajesh, A., Nielsen, A., Newbold, D. J., Lynch, C. J., Seider, N. A., Krimmel, S. R., Scheidter, K. M., Monk, J., Miller, R. L., Metoki, A., Montez, D. F., Zheng, A., Elbau, I., Madison, T., Nishino, T., Myers, M. J., Kaplan, S., … Dosenbach, N. U. F. (2023). A somato-cognitive action network alternates with effector regions in motor cortex. Nature, 617(7960), 351–359. https://doi.org/10.1038/s41586-023-05964-2 (https://pubmed.ncbi.nlm.nih.gov/37076628/).
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42min
December 27, 2023 #66: Krakauer y el problema de la reorganización cortical
En este episodio, resumo un artículo reciente (2023) de John Krakauer y Tamar Makin sobre la reorganización cortical. Es un artículo crítica a este concepto tan famoso y vanagloriado en neurociencia y se aportan datos que apoyan esta crítica mencionando estudios clásicos en animales y humanos. Estudios sobre ceguera congénita, experimentos en gatos y hurones, amputados y reorganización tras un ictus. Krakauer propone su definición y criterios de reorganización cortical y en base a eso refuta los estudios que afirman la reorganización.
Referencias del episodio:
1. Makin, T. R., & Krakauer, J. W. (2023). Against cortical reorganisation. eLife, 12, e84716. https://doi.org/10.7554/eLife.84716 (https://pubmed.ncbi.nlm.nih.gov/37986628/).
2. Kilgard, M. P., & Merzenich, M. M. (1998). Cortical map reorganization enabled by nucleus basalis activity. Science (New York, N.Y.), 279(5357), 1714–1718. https://doi.org/10.1126/science.279.5357.1714 (https://pubmed.ncbi.nlm.nih.gov/9497289/).
3. Pascual-Leone, A., & Torres, F. (1993). Plasticity of the sensorimotor cortex representation of the reading finger in Braille readers. Brain : a journal of neurology, 116 ( Pt 1), 39–52. https://doi.org/10.1093/brain/116.1.39 (https://pubmed.ncbi.nlm.nih.gov/8453464/).
4. Nudo R. J. (2007). Postinfarct cortical plasticity and behavioral recovery. Stroke, 38(2 Suppl), 840–845. https://doi.org/10.1161/01.STR.0000247943.12887.d2 (https://pubmed.ncbi.nlm.nih.gov/17261749/).
5. Ramachandran, V. S., Stewart, M., & Rogers-Ramachandran, D. C. (1992). Perceptual correlates of massive cortical reorganization. Neuroreport, 3(7), 583–586. https://doi.org/10.1097/00001756-199207000-00009 (https://pubmed.ncbi.nlm.nih.gov/1421112/).
6. Wiesel, T. N., & Hubel, D. H. (1963). Single-cell responses in striate cortex of kittens deprived of vision in one eye. Journal of neurophysiology, 26, 1003–1017. https://doi.org/10.1152/jn.1963.26.6.1003 (https://pubmed.ncbi.nlm.nih.gov/14084161/).
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1h 22min
December 09, 2023 #65: Santiago Ramón y Cajal. Neuronas de la voluntad
Este es un episodio muy especial, en el que resumo la biografía de Cajal y sus principales descubrimientos en neurociencia, además de hablar de su contexto y principales discípulos. Es un episodio homenaje a una figura muy poco reconocida en España para la relevancia que tiene en la neurociencia moderna. Cajal ganó el Premio Nobel en Fisiología y Medicina en 1906, compartido con Camillo Golgi, en reconocimiento a su “teoría neuronal” y a su investigación sobre histología del sistema nervioso del humano y los vertebrados. Obtuvo innumerables galardones, como la Medalla Helmholtz en 1905, Premio Nacional de Moscú en 1900 y Doctor Honoris Causa en muchas universidades.
Referencias del episodio:
1. Cánovas Sánchez F. (2021). Cajal. Alianza Editorial.
2. Swanson W. Larry & Newman Eric (2017). The Beautiful Brain: The Drawings of Santiago Ramon y Cajal. Abrams.
3.de Castro F. (2019). Cajal and the Spanish Neurological School: Neuroscience Would Have Been a Different Story Without Them. Frontiers in cellular neuroscience, 13, 187. https://doi.org/10.3389/fncel.2019.00187 (https://pubmed.ncbi.nlm.nih.gov/31178695/).
4. Alonso Peña Jose Ramón & De Carlos Segovia Juan Andrés (2018). Cajal: un grito por la ciencia. Next Door Publishers S.L.
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1h 5min
October 21, 2023 #64: Vibración focal en neurorrehabilitación adulta (+entrevista Serafín Ortigueira)
En este episodio, hablo sobre vibración focal en neurorrehabilitación del adulto, apoyándome posteriormente en la charla con el fisioterapeuta Serafín Ortigueira, quien tiene amplia experiencia con esta técnica. Describo brevemente la vibración focal, sus mecanismos de acción y algunas de las aplicaciones clínicas actuales, sobre todo en pacientes con ictus y lesión medular.
La vibración focal es una técnica sencilla de aplicar, pero tiene mecanismos que deben ser comprendidos para aplicarla con toda su riqueza y posibilidades que brinda, ya sea para el tratamiento de la espasticidad, mejora del control motor o o incluso aspectos coaduyaventes a nivel visceral o respiratorio.
Referencias del episodio:
1. Shinohara M. (2005). Effects of prolonged vibration on motor unit activity and motor performance. Medicine and science in sports and exercise, 37(12), 2120–2125. https://doi.org/10.1249/01.mss.0000178106.68569.7e (https://pubmed.ncbi.nlm.nih.gov/16331139/).
2. Khalifeloo, M., Naghdi, S., Ansari, N. N., Akbari, M., Jalaie, S., Jannat, D., & Hasson, S. (2018). A study on the immediate effects of plantar vibration on balance dysfunction in patients with stroke. Journal of exercise rehabilitation, 14(2), 259–266. https://doi.org/10.12965/jer.1836044.022 (https://pubmed.ncbi.nlm.nih.gov/29740561/).
3. Karimi-AhmadAbadi, A., Naghdi, S., Ansari, N. N., Fakhari, Z., & Khalifeloo, M. (2018). A clinical single blind study to investigate the immediate effects of plantar vibration on balance in patients after stroke. Journal of bodywork and movement therapies, 22(2), 242–246. https://doi.org/10.1016/j.jbmt.2017.04.013 (https://pubmed.ncbi.nlm.nih.gov/29861214/).
4. Celletti, C., Suppa, A., Bianchini, E., Lakin, S., Toscano, M., La Torre, G., Di Piero, V., & Camerota, F. (2020). Promoting post-stroke recovery through focal or whole body vibration: criticisms and prospects from a narrative review. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 41(1), 11–24. https://doi.org/10.1007/s10072-019-04047-3 (https://pubmed.ncbi.nlm.nih.gov/31468237/).
5. Paoloni, M., Mangone, M., Scettri, P., Procaccianti, R., Cometa, A., & Santilli, V. (2010). Segmental muscle vibration improves walking in chronic stroke patients with foot drop: a randomized controlled trial. Neurorehabilitation and neural repair, 24(3), 254–262. https://doi.org/10.1177/1545968309349940 (https://pubmed.ncbi.nlm.nih.gov/19855076/).
6. Moggio, L., de Sire, A., Marotta, N., Demeco, A., & Ammendolia, A. (2022). Vibration therapy role in neurological diseases rehabilitation: an umbrella review of systematic reviews. Disability and rehabilitation, 44(20), 5741–5749. https://doi.org/10.1080/09638288.2021.1946175 (https://pubmed.ncbi.nlm.nih.gov/34225557/).
7. Rosenkranz, K., & Rothwell, J. C. (2003). Differential effect of muscle vibration on intracortical inhibitory circuits in humans. The Journal of physiology, 551(Pt 2), 649–660. https://doi.org/10.1113/jphysiol.2003.043752 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2343209/).
8. Binder, C., Kaya, A. E., & Liepert, J. (2009). Vibration prolongs the cortical silent period in an antagonistic muscle. Muscle & nerve, 39(6), 776–780. https://doi.org/10.1002/mus.21240 (https://pubmed.ncbi.nlm.nih.gov/19334048/).
9. Bertasi, V., Bertolasi, L., Frasson, E., & Priori, A. (2000). The excitability of human cortical inhibitory circuits responsible for the muscle silent period after transcranial brain stimulation. Experimental brain research, 132(3), 384–389. https://doi.org/10.1007/s002210000352 (https://pubmed.ncbi.nlm.nih.gov/10883387/).
10. Mortaza, N., Abou-Setta, A. M., Zarychanski, R., Loewen, H., Rabbani, R., & Glazebrook, C. M. (2019). Upper limb tendon/muscle vibration in persons with subacute and chronic stroke: a systematic review and meta-analysis. European journal of physical and rehabilitation medicine, 55(5), 558–569. https://doi.org/10.23736/S1973-9087.19.05605-3 (https://pubmed.ncbi.nlm.nih.gov/30868835/).
11. Avvantaggiato, C., Casale, R., Cinone, N., Facciorusso, S., Turitto, A., Stuppiello, L., Picelli, A., Ranieri, M., Intiso, D., Fiore, P., Ciritella, C., & Santamato, A. (2021). Localized muscle vibration in the treatment of motor impairment and spasticity in post-stroke patients: a systematic review. European journal of physical and rehabilitation medicine, 57(1), 44–60. https://doi.org/10.23736/S1973-9087.20.06390-X (https://pubmed.ncbi.nlm.nih.gov/33111513/).
12. Murillo, N., Valls-Sole, J., Vidal, J., Opisso, E., Medina, J., & Kumru, H. (2014). Focal vibration in neurorehabilitation. European journal of physical and rehabilitation medicine, 50(2), 231–242 (https://pubmed.ncbi.nlm.nih.gov/24842220/).
13. Li, W., Luo, F., Xu, Q., Liu, A., Mo, L., Li, C., & Ji, L. (2022). Brain oscillatory activity correlates with the relief of post-stroke spasticity following focal vibration. Journal of integrative neuroscience, 21(3), 96. https://doi.org/10.31083/j.jin2103096 (https://pubmed.ncbi.nlm.nih.gov/35633177/).
14. Murillo, N., Kumru, H., Vidal-Samso, J., Benito, J., Medina, J., Navarro, X., & Valls-Sole, J. (2011). Decrease of spasticity with muscle vibration in patients with spinal cord injury. Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 122(6), 1183–1189. https://doi.org/10.1016/j.clinph.2010.11.012 (https://pubmed.ncbi.nlm.nih.gov/21172739/).
15. Murillo, N. (2011). Neuromodulación de la espasticidad en pacientes con lesión medular mediante vibración y estimulación magnética transcraneal (http://hdl.handle.net/10803/3840).
16. Wang, H., Chandrashekhar, R., Rippetoe, J., & Ghazi, M. (2020). Focal Muscle Vibration for Stroke Rehabilitation: A Review of Vibration Parameters and Protocols. Applied Sciences, 10(22), 8270. MDPI AG. Retrieved from http://dx.doi.org/10.3390/app10228270 (https://www.mdpi.com/2076-3417/10/22/8270).
17. Filippi, G. M., Rodio, A., Fattorini, L., Faralli, M., Ricci, G., & Pettorossi, V. E. (2023). Plastic changes induced by muscle focal vibration: A possible mechanism for long-term motor improvements. Frontiers in neuroscience, 17, 1112232. https://doi.org/10.3389/fnins.2023.1112232 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9992721/).
18. Hagbarth, K. E., & Eklund, G. (1969). The muscle vibrator--a useful tool in neurological therapeutic work. Scandinavian journal of rehabilitation medicine, 1(1), 26–34 (https://pubmed.ncbi.nlm.nih.gov/5406721/).
19. Zapatillas Nushu (https://magnes.ch/solutions/nushu/).
20. Sadeghi, M., & Sawatzky, B. (2014). Effects of vibration on spasticity in individuals with spinal cord injury: a scoping systematic review. American journal of physical medicine & rehabilitation, 93(11), 995–1007. https://doi.org/10.1097/PHM.0000000000000098 (https://pubmed.ncbi.nlm.nih.gov/24743464/).
21. DeForest, B. A., Bohorquez, J., & Perez, M. A. (2020). Vibration attenuates spasm-like activity in humans with spinal cord injury. The Journal of physiology, 598(13), 2703–2717. https://doi.org/10.1113/JP279478 (https://pubmed.ncbi.nlm.nih.gov/32298483/).
22. Calabrò, R. S., Naro, A., Russo, M., Milardi, D., Leo, A., Filoni, S., Trinchera, A., & Bramanti, P. (2017). Is two better than one? Muscle vibration plus robotic rehabilitation to improve upper limb spasticity and function: A pilot randomized controlled trial. PloS one, 12(10), e0185936. https://doi.org/10.1371/journal.pone.0185936 (https://pubmed.ncbi.nlm.nih.gov/28973024/).
23. Chen, Y. L., Jiang, L. J., Cheng, Y. Y., Chen, C., Hu, J., Zhang, A. J., Hua, Y., & Bai, Y. L. (2023). Focal vibration of the plantarflexor and dorsiflexor muscles improves poststroke spasticity: a randomized single-blind controlled trial. Annals of physical and rehabilitation medicine, 66(3), 101670. https://doi.org/10.1016/j.rehab.2022.101670 (https://pubmed.ncbi.nlm.nih.gov/35940478/).
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1h 42min

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