BACKGROUND

Patients with severe nontraumatic brain injuries often present with disorders of unconsciousness. Immediate neurologic care, neuroprotection, and early neurorehabilitation are core principles for better outcomes. Neurorehabilitation, through both pharmacological and non-pharmacological strategies, aims to enhance neuroplasticity for faster recovery. Amantadine, primarily known as an antiviral and used in Parkinson’s treatment, has shown a potential role for accelerating neuronal recovery and neurorehabilitation.

Available literature on the use of amantadine for nontraumatic brain injury patients is limited. This scoping review aims to identify the potential benefits and limitations of amantadine in neurorehabilitation.

In the literature review, the keywords "Amantadine" AND "Neurorehabilitation" were used to search PubMed, EBSCO, and the Cochrane Library for articles published between January 1, 2003, and August 2024. Inclusion criteria required that articles have clear research objectives, strict subject eligibility criteria, a detailed methodology, and the administration of amantadine for nontraumatic brain injuries. Out of 57 identified articles, only 7 were included in the study.

Its benefits include improving the level of consciousness, accelerating recovery, decreasing mortality, managing delayed post-hypoxic encephalopathy, and improving verbal fluency in nonfluent speech. Its adverse effects and the paucity of available literature recommending amantadine for neurorehabilitation are the possible limitations.

Amantadine accelerates the neurologic recovery of patients with disorders of unconsciousness secondary to nontraumatic brain injuries.

Future studies may conduct meta-analyses, systematic reviews, and randomized controlled trials of amantadine in patients with nontraumatic brain injury to further strengthen its promising role in neurorehabilitation.

With the high incidence of neurological diseases such as stroke and mental illness, rehabilitation treatments for neurological disorders have received widespread attention. Electroencephalography (EEG) technology, despite its excellent temporal resolution, has historically been limited in application due to its insufficient spatial resolution, and is mainly confined to preoperative assessment, intraoperative monitoring, and epilepsy detection. However, traditional constraints of EEG technology are being overcome with the popularization of EEG technology with high-density over 64-lead, the application of innovative analysis techniques and the integration of multimodal techniques, which are significantly broadening its applications in clinical settings. These advancements have not only reinforced the irreplaceable role of EEG technology in neurorehabilitation assessment, but also expanded its therapeutic potential through its combined use with technologies such as transcranial magnetic stimulation, transcranial electrical stimulation and brain-computer interfaces. This article reviewed the applications, advancements, and future prospects of EEG technology in neurorehabilitation assessment and treatment. Advancements in technology and interdisciplinary collaboration are expected to drive new applications and innovations in EEG technology within the neurorehabilitation field, providing patients with more precise and personalized rehabilitation strategies.
Humans ; Electroencephalography/methods* ; Brain-Computer Interfaces ; Neurological Rehabilitation/methods* ; Transcranial Magnetic Stimulation ; Transcranial Direct Current Stimulation ; Nervous System Diseases/diagnosis* ; Epilepsy/diagnosis*

OBJECTIVE: To observe the effect of staged acupuncture on serum irisin level, neurological deficit, balance ability and spasticity in patients with ischemic stroke. METHODS: Sixty patients with ischemic stroke were randomly divided into a staged acupuncture group and a routine acupuncture group, 30 cases in each group; another 30 healthy subjects were selected as a normal group. The patients with ischemic stroke were treated with aspirin (100 mg each time, once a day, changing to 50 mg for prophylactic dose after 4 weeks). The patients in the staged acupuncture group were treated with staged acupuncture (acupoints were selected according to the soft paralysis period, spasticity period and recovery period, sequelae period) and rehabilitation treatment, while the patients in the routine acupuncture group were treated with acupuncture of soft paralysis-period as the staged acupuncture group and rehabilitation treatment. All the treatment was given once a day, 5 times a week, 2 weeks as a course of treatment, and 4 consecutive courses of treatment were provided. Before treatment and at 2 weeks, 4 weeks, 6 weeks and 8 weeks into treatment, the serum irisin level was measured, and the scores of National Institutes of Health stroke scale (NIHSS), Fugl-Meyer assessment scale-balance (FM-B) and comprehensive spasticity scale (CSS) were compared, and the correlation between the serum irisin level and NIHSS and FM-B scores in the two groups was analyzed. RESULTS: Before treatment, the serum irisin levels in the two groups were lower than those in the normal group (P<0.01). Compared before treatment, the serum irisin levels and FM-B scores were increased (P<0.01), and the NIHSS scores were decreased at 2, 4, 6 and 8 weeks into treatment in the two groups (P<0.01). At 4, 6 and 8 weeks into treatment, in the staged acupuncture group, the serum irisin levels and FM-B scores were higher than those in the routine acupuncture group (P<0.01, P<0.05), and the NIHSS scores were lower than those in the routine acupuncture group (P<0.01). After treatment, the CSS scores in the two groups were increased first and then decreased. Compared before treatment, the CSS scores were increased at 2, 4, 6 and 8 weeks into treatment in the two groups (P<0.01). At 4, 6 and 8 weeks into treatment, the CSS scores in the staged acupuncture group were lower than those in the routine acupuncture group (P<0.01). The serum irisin level was negatively correlated with NIHSS score (r =-0.772, P =0.000), and positively correlated with FM-B score (r =0.675, P =0.000). CONCLUSION The severity of neurological deficit and balance ability are related to serum irisin level in patients with ischemic stroke. The staged acupuncture could increase the serum irisin level, improve the neurological function, balance ability and spasticity in patients with ischemic stroke.
Acupuncture Therapy ; Fibronectins ; Humans ; Ischemic Stroke ; Muscle Spasticity ; Neurological Rehabilitation ; Paralysis/complications* ; Stroke/therapy* ; Stroke Rehabilitation ; Treatment Outcome

OBJECTIVE: To evaluate the effectiveness of intensive rehabilitation to support recovery of neurological function after brain tumor surgery and assess long-term satisfaction. METHODS: This retrospective study included patients with neurological impairment after brain tumor surgery who underwent intensive rehabilitation therapy between December 2013 and May 2017. To assess effectiveness of rehabilitation, functional outcomes (motor, cognition, and activities of daily living [ADL]) were compared between brain tumor group and a control group enrolling stroke patients who received equivalent rehabilitation during the study period. Long-term satisfaction with rehabilitation was evaluated by surveying family caregivers. RESULTS: This study included 21 patients with benign brain tumor, 14 with malignant brain tumor, and 108 with stroke. Significant and similar improvement in motor, cognition, and ADL function were noted in both the brain tumor group and the stroke group. Malignancy status did not influence the extent of functional improvement. According to medical records and surveys, 9 (69.2%) patients with malignant tumor and 2 (11.8%) with benign tumor had expired by the time of the survey. Most family caregivers confirmed that rehabilitation was effective for functional improvement (>60%), expressing overall satisfaction and stating they would recommend such therapy to patients with similar conditions (approximately 70%). CONCLUSION: Intensive rehabilitation may help promote functional improvement following brain tumor surgery regardless of malignancy compared with stroke patients. Family caregivers expressed overall satisfaction with rehabilitation at long-term follow-up. These findings support the provision of intensive rehabilitation therapy for neurologic function recovery following brain tumor surgery.
Activities of Daily Living ; Brain Neoplasms ; Brain ; Caregivers ; Cognition ; Follow-Up Studies ; Humans ; Medical Records ; Neurological Rehabilitation ; Pilot Projects ; Recovery of Function ; Rehabilitation ; Retrospective Studies ; Stroke ; Treatment Outcome

This study identified the explanatory power of the Korean rehabilitation patient group (KRPG) v1.1 for acquired brain injury (ABI) on medical expenses in the rehabilitation hospitals and the correlation of functional outcomes with the expenses. Here, the design is a retrospective analysis from the claim data of the designated rehabilitation hospitals. Data including KRPG information with functional status and medical expenses were collected from 1 January and 31 August 2018. Reduction of variance (R2) was statistically analyzed for the explanation power of the KRPG. Association between functional status and the medical expenses was carried out using the Spearman's rank order correlation (rho). From the claim data of 365 patients with ABI, the KRPG v1.1 explained 8.6% of variance for the total medical expenses and also explained 9.8% of variance for the rehabilitation therapy costs. Cognitive function and spasticity showed very weak correlation with the total medical expenses (rho = −0.17 and −0.14, respectively). Motor power and performance of activities of daily living were associated weakly (rho = −0.27 and −0.30, respectively). The KRPG and related functional status in ABI reflects the total medical expenses and rehabilitation therapy costs insufficiently in the designated rehabilitation hospitals. Thus, the current KRPG algorithm and variables for ABI may need to be ameliorated in the future.
Activities of Daily Living ; Brain Diseases ; Brain Injuries ; Brain ; Cognition ; Diagnosis-Related Groups ; Fee-for-Service Plans ; Humans ; Muscle Spasticity ; Neurological Rehabilitation ; Rehabilitation ; Retrospective Studies

Lack of a region-specific brain stimulation modality having both spatial specificity and depth penetration has limited clinicians to explore novel non-pharmacological treatment options in neurorehabilitation. Focused ultrasound (FUS) has shown excitatory and suppressive modulatory effects on neural tissues in both central and peripheral nervous systems by transcranially delivering low-intensity highly focused acoustic pressure waves to region-specific neural structures in a completely non-invasive fashion. This emerging technique, with exquisite spatial selectively and depth penetration, is considered as a new mode of brain stimulation that may significantly improve existing brain stimulation modalities. This review aims to provide the perspectives of FUS-mediated brain stimulation in neurorehabilitation, along with potential pitfalls and cautions that need to be taken into consideration. When combined with the intravascular introduction of microbubble-based ultrasound contrast agents, the technique adds therapeutic potentials in delivering drug/genes/cells across the blood-brain barrier, which may open new opportunities for neurorehabilitation. Efforts are being made to construct FUS devices appropriate for routine clinical use, to investigate its fundamental mechanisms, and to optimize the sonication parameters. Repeated administration of the technique for inducing neuroplasticity, including the assessment of long-term safety, is warranted to reveal its utility in neurorehabilitation.
Acoustics ; Blood-Brain Barrier ; Brain* ; Contrast Media ; Neurological Rehabilitation* ; Neuronal Plasticity ; Peripheral Nervous System ; Sensitivity and Specificity ; Sonication ; Ultrasonography*

Cerebral blood volume (CBV) is a hemodynamic correlate of oxygen metabolism and changes due to neuronal activity. CBV alteration may precede other hemodynamic correlates and provide an early indication of hemodynamic impairment. CBV can be easily quantified using magnetic resonance imaging (MRI); moreover, CBV MRI has a strong point of high resolution compared to other neuroimaging modalities. The early and accurate assessments of cerebral metabolism and the brain map with the high resolution of CBV MRI enable advanced neurorehabilitation examinations in a neuroimaging study.
Blood Volume* ; Brain ; Hemodynamics ; Magnetic Resonance Imaging* ; Metabolism ; Neuroimaging ; Neurological Rehabilitation ; Neurons ; Oxygen

Virtual reality (VR) therapy has many benefits to promote neurological and functional recovery in the field of neurorehabilitation after brain injury. VR-assisted neurorehabilitation can be applied in motor, sensori-motor, cognitive, activities of daily living (ADL), and telerehabilitation. Recent reports found that VR therapy appears to be a safe intervention that is effective at improving arm function and ADL function following stroke. Greater improvements were seen at a higher VR therapeutic dose. There has been insufficient evidence that VR therapy improved lower extremity gait speed, balance, and cognitive function after brain injury. As a result, the number of commercially available devices have increased and large-scale controlled trials have reported positive effects recently. Interface devices, various feedback methods, and the advancement of augmented reality technology are quickly developing, therefore, the potential value of VR therapy in neurorehabilitation will be high and its clinical application will be diversified.
Activities of Daily Living ; Arm ; Brain Injuries ; Cognition ; Gait ; Lower Extremity ; Neurological Rehabilitation* ; Rehabilitation ; Stroke ; Telerehabilitation

No abstract available.
Brain* ; Neurological Rehabilitation*

A novel robotic mirror therapy system was recently developed to provide proprioceptive stimulus to the hemiplegic arm during a mirror therapy. Validation of the robotic mirror therapy system was performed to confirm its synchronicity prior to the clinical study. The mean error angle range between the intact arm and the robot was 1.97 to 4.59 degrees. A 56-year-old male who had right middle cerebral artery infarction 11 months ago received the robotic mirror therapy for ten 30-minute sessions during 2 weeks. Clinical evaluation and functional magnetic resonance imaging (fMRI) studies were performed before and after the intervention. At the follow-up evaluation, the thumb finding test score improved from 2 to 1 for eye level and from 3 to 1 for overhead level. The Albert's test score on the left side improved from 6 to 11. Improvements were sustained at 2-month follow-up. The fMRI during the passive motion revealed a considerable increase in brain activity at the lower part of the right superior parietal lobule, suggesting the possibility of proprioception enhancement. The robotic mirror therapy system may serve as a useful treatment method for patients with supratentorial stroke to facilitate recovery of proprioceptive deficit and hemineglect.
Arm ; Brain ; Clinical Study ; Exoskeleton Device ; Follow-Up Studies ; Hemiplegia ; Humans ; Infarction, Middle Cerebral Artery ; Magnetic Resonance Imaging ; Male ; Methods ; Middle Aged ; Neurological Rehabilitation ; Parietal Lobe ; Pilot Projects* ; Proprioception* ; Stroke ; Thumb ; Upper Extremity*