No abstract available.
Stroke*

The concept of metaplasticity entails a change in the physiological or biochemical state of synapses that alters their ability to generate synaptic plasticity by integrating individual synaptic events. The characteristics of metaplasticity would be the fact that those synaptic changes last in certain period time with association of activity in time, homosynaptically or heterosynaptically. Recently introduced non-invasive brain stimulation enables us to observe the metaplastic changes in vivo, which would give us a insight in developing new effective therapeutic approach based on synaptic plasticity and metaplasticity.
Brain ; Neuronal Plasticity ; Plastics ; Synapses ; Transcranial Magnetic Stimulation

BACKGROUND AND OBJECTIVE: The outcome of asthma treatment has traditionally been assessed by measuring the conventional clinical parameters such as symptoms, expiratory flow rates and needs for medications. But none of them tells us whether the patients are actually able to function properly in their lives. Only assessment of the quality of life (QOL) can reflect the parts of patients lives affected by the disease. However, there is no measure to assess the quality of life of patients with any chronic diseases in Korea yet. We developed the QOL Questionnaire for Korean Asthmatics and evaluated its measurement properties. METHOD: The questionnaire was composed of 18 items in four domains : i.e. activity limitation (6 items), symptoms (5 items), emotional function (3 items) and environmental stimuli (4 items). At our out-patient clinic, 32 adults with moderate to severe persistent bronchial asthma were enrolled. The study design consisted of 4 week unblinded single cohort with visits at 0 and 4 weeks, and the patients were asked to answer the questionnaire by self administration method at the two separate visits. Forced expiratory volume for 1 second (FEV1) and peak expiratory flow rate (PEFR) were recorded at each visit. According to the patients and physicians global assessment, the patients were divided into two groups, i.e. stable and changed (improved). The responsiveness, reproducibility and validity of the questionnaire were evaluated. RESULTS: The total QOL scores at the second visit in the changed group were significantly higher than those at the first visit. The score differences between the two visits in the changed group were higher than in the stable group. In the stable group, the responses to the questionnaire were reproducible. The QOL scores showed good longitudinal correlation with the expiratory flow rates, whereas FEV1 did not correlate with the QOL in cross-sectional analysis. CONCLUSION: The questionnaire proved to be reproducible, responsive and valid in the subjects. It could be recommended for the outcome evaluation of Korean asthmatics.
Adult ; Asthma ; Chronic Disease ; Cohort Studies ; Cross-Sectional Studies ; Forced Expiratory Volume ; Humans ; Korea ; Outpatients ; Peak Expiratory Flow Rate ; Quality of Life* ; Self Administration ; Surveys and Questionnaires

Spatial neglect is a cluster of symptoms characterized by a failure to orient, or react to stimuli located predominantly on the contralesional side. This could be subdivided into personal, peripersonal and extrapersonal neglect in terms of spatial frame of reference. In the perceptual point of view, one can classify into further perceptual and representational neglect. In this review, subtypes of spatial neglect were conceptualized by spatial frame of reference and perception in relationship with their neuroanatomical correlates. Furthermore, its assessment was discussed according to those subtypes.

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive method to produce potent changes in cortical excitability. Therefore, the application of rTMS was recently proposed to promote functional recovery in stroke patients, owing to the induced neuroplasticity. It is important to note that stimulating the brain at a specific site does not only affect the neuronal activity at that site, but the activity throughout the entire neural network. In this review, both local and distant effect of rTMS through related network will be discussed based on previous neuroimaging evidences showing network plasticity. We'd like to extend the discussion to stroke patients, which would be useful for application of rTMS in the clinical rehabilitation field.
Brain ; Functional Neuroimaging ; Humans ; Neuroimaging ; Neuronal Plasticity ; Neurons ; Plastics ; Rehabilitation ; Stroke ; Transcranial Magnetic Stimulation

Diffusion tensor imaging (DTI) has a diagnostic value in cervical myelopathy. The usefulness of diffusion metrics as a potential prognostic biomarker was assessed in this review. Various diffusion metrics, such as fractional anisotropy, mean diffusivity, apparent diffusion coefficient, and radial diffusivity, were significant in correlation with functional recovery after surgery. Changes in diffusion metrics not only at the compression level, but also above and below the compression level were confirmed. However, it was difficult to confirm the results owing to the diversity of studies. Further efforts to make a consensus on spinal cord DTI are needed.
Anisotropy ; Consensus ; Diffusion Tensor Imaging ; Diffusion ; Recovery of Function ; Spinal Cord ; Spinal Cord Diseases

In the rehabilitation, the real executive movement has been considered the main tool for motor recovery and motor learning. Many studies reported that active exercising creates a flow of sensory information which can change neuroplasticity. Recently the numerous studies report that both the imagery and the observation of a movement increase corticospinal excitability of primary motor cortex and activation of M1 area similar to the real execution of the movement. And the studies also report that these central activations occur in a specific manner. Now many people consider the imagery and observation can be a new therapeutic tool in rehabilitation especially for who can not execute a real motion at all due to neurologic deficit. We will review the articles reported the central nerve system changes by the imagery and observation of an action compared with the executive motion. And most of these experimental studies were based on the results of the healthy subjects, we discussed about the limitation of these therapeutic strategies according to the aging process and to the brain dysfunction.

The purpose of this review is to introduce a new mapping technique, the chronometry transcranial magnetic stimulation (TMS), which can be used to delineate detailed time information of specific functioning target network by transiently creating a 'virtual brain lesion', thus disrupting the function of a given cortical target at different time window. Unlike neuroimaging methods such as functional magnetic resonance imaging (fMRI), chronometry TMS provided information about which language area contributes to performance of some specific task, and at what precise moment the contribution is critical. We shall highlight two aspect of chronometry TMS, that is used in language research either for understanding time course of language processing in normal subject or for measuring plastic reorganization of functioning network.
Aphasia ; Brain ; Functional Neuroimaging ; Magnetic Resonance Imaging ; Neuroimaging ; Neuronal Plasticity ; Plastics ; Transcranial Magnetic Stimulation