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Brain Sciences
Special Issues
Innovations in Neurorehabilitation and Neuroplasticity
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Innovations in Neurorehabilitation and Neuroplasticity

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurorehabilitation".

Deadline for manuscript submissions: closed (1 November 2021) | Viewed by 28402

Special Issue Editors

Dr. Michelle Ploughman

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Guest Editor
Recovery and Performance Laboratory, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL A1A 1E5, Canada
Interests: neurorehabilitation; neuroplasticity; physical therapy; stroke; multiple sclerosis
Dr. Arthur Chaves

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Guest Editor
Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL A1A 1E5, Canada
Interests: exercise; aerobic fitness; corticospinal excitability; neuroplasticity; fatigue; stroke; multiple sclerosis

Special Issue Information

Dear Colleagues,

Scientists, health providers, and patients alike are seeking innovative strategies to drive neuroplasticity and recovery in neurological disorders such as stroke, dementia, multiple sclerosis, Parkinson’s disease, and traumatic brain injury. Neuroplasticity is characterized by the ability of synapses, dendrites, and brain networks to modify in response to behavioral interventions such as exercise and task-specific training. Exciting data gleaned from animal models are being translated to clinical practice. Treatments like non-invasive brain stimulation, plasticity-promoting drugs, and robotic-assisted movement, once considered science fiction, are now being investigated in patients.

The aim of this Special Issue is to identify innovative methods to promote and investigate neuroplasticity and recovery in neurological disorders. The scope of this Special Issue encompasses primary research (e.g., case reports, case series, cohorts, trials and preclinical) and research reviews that present the development and testing of rehabilitative treatments aimed at reducing clinical impairment and restoring function of the central nervous system. It also includes research involving neuroimaging and other biomarkers of neuroplasticity that have the potential to map recovery and repair. Research related to the drivers and barriers to rehabilitation-induced neuroplasticity and recovery in neurological disorders is also well-suited to this Special Issue.

Dr. Michelle Ploughman
Dr. Arthur Chaves
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • neuroplasticity
  • rehabilitation
  • exercise
  • sensorimotor
  • cognition
  • stroke
  • multiple sclerosis
  • brain injury
  • Parkinson’s disease
  • spinal cord injury
  • ALS
  • cognitive impairment
  • aging
  • depression
  • dementia
  • neurodegenerative diseases
  • transcranial magnetic stimulation
  • functional magnetic resonance imaging
  • functional near infrared spectroscopy
  • robotics
  • non-invasive brain stimulation
  • EEG
  • PET

Published Papers (6 papers)

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Research

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16 pages, 1179 KiB  
Article
Preliminary Evaluation of the Clinical Benefit of a Novel Visual Rehabilitation Program in Patients Implanted with Trifocal Diffractive Intraocular Lenses: A Blinded Randomized Placebo-Controlled Clinical Trial
by David P. Piñero, Ainhoa Molina-Martin, María L. Ramón, José L. Rincón, Cristian Fernández, Dolores de Fez, Juan F. Arenillas, Luis Leal-Vega, María Begoña Coco-Martín and Miguel J. Maldonado
Brain Sci. 2021, 11(9), 1181; https://doi.org/10.3390/brainsci11091181 - 8 Sep 2021
Cited by 2 | Viewed by 2564
Abstract
The authors of this study evaluated the potential benefit on visual performance of a novel 3 week visual rehabilitation program based on the use of Gabor patches in patients undergoing bilateral cataract surgery with the implantation of two models of trifocal diffractive intraocular [...] Read more.
The authors of this study evaluated the potential benefit on visual performance of a novel 3 week visual rehabilitation program based on the use of Gabor patches in patients undergoing bilateral cataract surgery with the implantation of two models of trifocal diffractive intraocular lens (IOL). A total of 30 patients were randomly assigned to two groups: a study group (15 patients) that used a videogame based on Gabor patches and a placebo group (15 patients) that used a videogame without specific stimuli for improving visual performance. No statistically significant differences between groups were found in distance, intermediate, and near post-training visual acuity (p ≥ 0.15). Significantly better distance contrast sensitivity (CS) was found for the spatial frequencies of 6 (p = 0.02) and 12 cpd (p = 0.01) in the study group. Likewise, significantly better values of near CS were found in the study group compared to the placebo group for the spatial frequency of 1.5 cpd (p = 0.02). In conclusion, a 3 week visual rehabilitation program based on the use of Gabor patches in the immediate postoperative period after the bilateral implantation of trifocal diffractive IOLs seems to be beneficial for improving both distance and near visual performance achieved with the implant. Full article
(This article belongs to the Special Issue Innovations in Neurorehabilitation and Neuroplasticity)
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13 pages, 5954 KiB  
Article
Effect of Immersive Virtual Reality-Based Bilateral Arm Training in Patients with Chronic Stroke
by Yo-Han Song and Hyun-Min Lee
Brain Sci. 2021, 11(8), 1032; https://doi.org/10.3390/brainsci11081032 - 3 Aug 2021
Cited by 9 | Viewed by 2986
Abstract
Virtual reality (VR)-based therapies are widely used in stroke rehabilitation. Although various studies have used VR techniques for bilateral upper limb training, most have been only semi-immersive and have only been performed in an artificial environment. This study developed VR content and protocols [...] Read more.
Virtual reality (VR)-based therapies are widely used in stroke rehabilitation. Although various studies have used VR techniques for bilateral upper limb training, most have been only semi-immersive and have only been performed in an artificial environment. This study developed VR content and protocols based on activities of daily living to provide immersive VR-based bilateral arm training (VRBAT) for upper limb rehabilitation in stroke patients. Twelve patients with chronic stroke were randomized to a VRBAT group or a normal bilateral arm training (NBAT) group and attended 30-min training sessions five times a week for four weeks. At the end of the training, there was a significant difference in upper limb function in both groups (p < 0.05) and in the upper limb function sensory test for proprioception in the NBAT group (p < 0.05). There was no significant between-group difference in upper limb muscle activity after training. The relative alpha and beta power values for electroencephalographic measurements were significantly improved in both groups. These findings indicate that both VRBAT and NBAT are effective interventions for improving upper limb function and electroencephalographic activity in patients with chronic stroke. Full article
(This article belongs to the Special Issue Innovations in Neurorehabilitation and Neuroplasticity)
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35 pages, 4839 KiB  
Article
Probing the Brain–Body Connection Using Transcranial Magnetic Stimulation (TMS): Validating a Promising Tool to Provide Biomarkers of Neuroplasticity and Central Nervous System Function
by Arthur R. Chaves, Nicholas J. Snow, Lynsey R. Alcock and Michelle Ploughman
Brain Sci. 2021, 11(3), 384; https://doi.org/10.3390/brainsci11030384 - 17 Mar 2021
Cited by 16 | Viewed by 7805
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive method used to investigate neurophysiological integrity of the human neuromotor system. We describe in detail, the methodology of a single pulse TMS protocol that was performed in a large cohort of people (n = 110) [...] Read more.
Transcranial magnetic stimulation (TMS) is a non-invasive method used to investigate neurophysiological integrity of the human neuromotor system. We describe in detail, the methodology of a single pulse TMS protocol that was performed in a large cohort of people (n = 110) with multiple sclerosis (MS). The aim was to establish and validate a core-set of TMS variables that predicted typical MS clinical outcomes: walking speed, hand dexterity, fatigue, and cognitive processing speed. We provide a brief and simple methodological pipeline to examine excitatory and inhibitory corticospinal mechanisms in MS that map to clinical status. Delayed and longer ipsilateral silent period (a measure of transcallosal inhibition; the influence of one brain hemisphere’s activity over the other), longer cortical silent period (suggestive of greater corticospinal inhibition via GABA) and higher resting motor threshold (lower corticospinal excitability) most strongly related to clinical outcomes, especially when measured in the hemisphere corresponding to the weaker hand. Greater interhemispheric asymmetry (imbalance between hemispheres) correlated with poorer performance in the greatest number of clinical outcomes. We also show, not surprisingly, that TMS variables related more strongly to motor outcomes than non-motor outcomes. As it was validated in a large sample of patients with varying severities of central nervous system dysfunction, the protocol described herein can be used by investigators and clinicians alike to investigate the role of TMS as a biomarker in MS and other central nervous system disorders. Full article
(This article belongs to the Special Issue Innovations in Neurorehabilitation and Neuroplasticity)
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Review

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21 pages, 1329 KiB  
Review
Effects of Exercise Training on Neurotrophic Factors and Subsequent Neuroprotection in Persons with Multiple Sclerosis—A Systematic Review and Meta-Analysis
by Mette D. Diechmann, Evan Campbell, Elaine Coulter, Lorna Paul, Ulrik Dalgas and Lars G. Hvid
Brain Sci. 2021, 11(11), 1499; https://doi.org/10.3390/brainsci11111499 - 12 Nov 2021
Cited by 20 | Viewed by 3910
Abstract
Background: Evidence indicates that exercise holds the potential to counteract neurodegeneration experienced by persons with multiple sclerosis (pwMS), which is in part believed to be mediated through increases in neurotrophic factors. There is a need to summarize the existing evidence on exercise-induced effects [...] Read more.
Background: Evidence indicates that exercise holds the potential to counteract neurodegeneration experienced by persons with multiple sclerosis (pwMS), which is in part believed to be mediated through increases in neurotrophic factors. There is a need to summarize the existing evidence on exercise-induced effects on neurotrophic factors alongside neuroprotection in pwMS. Aim: To (1) systematically review the evidence on acute (one session) and/or chronic (several sessions) exercise-induced changes in neurotrophic factors in pwMS and (2) investigate the potential translational link between exercise-induced changes in neurotrophic factors and neuroprotection. Methods: Five databases (Medline, Scopus, Web of Science, Embase, Sport Discus) were searched for randomized controlled trials (RCT) examining the effects of exercise (all modalities included) on neurotrophic factors as well as measures of neuroprotection if reported. The quality of the study designs and the exercise interventions were assessed by use of the validated tool TESTEX. Results: From N = 337 identified studies, N = 14 RCTs were included. While only N = 2 of the identified studies reported on the acute changes in neurotrophic factors, all N = 14 RCTs reported on the chronic effects, with N = 9 studies revealing between-group differences in favor of exercise. This was most prominent for brain-derived neurotrophic factor (BDNF), with between-group differences in favor of exercise being observed in N = 6 out of N = 12 studies. Meta-analyses were applicable for three out of 10 different identified neurotrophic factors and revealed that exercise can improve the chronic levels of BDNF (delta changes; N = 9, ES = 0.78 (0.27; 1.28), p = 0.003, heterogeneity between studies) and potentially also ciliary neurotrophic factor (CNTF) (N = 3, ES = 0.24 (−0.07; 0.54), p = 0.13, no heterogeneity between studies) but not nerve growth factor (NGF) (N = 4, ES = 0.28 (−0.55; 1.11), p = 0.51, heterogeneity between studies). Indicators of neuroprotection (e.g., with direct measures of brain structure assessed by MRI) were assessed in N = 3 of the identified studies only, with N = 2 partly supporting and thus indicating a potential translational link between increases in neurotrophic factors and neuroprotection. Conclusion: The present study reveals that exercise can elicit improvements in chronic levels of BDNF in pwMS, whereas the effects of exercise on chronic levels of other neurotrophic factors and on acute levels of neurotrophic factors in general, along with a potential translational link (i.e., with exercise-induced improvements in neurotropic factors being associated with or even mediating neuroprotection), are sparse and inconclusive. There is a need for more high-quality studies that assess neurotrophic factors (applying comparable methods of blood handling and analysis) concomitantly with neuroprotective outcome measures. Review Registration: PROSPERO (ID: CRD42020177353). Full article
(This article belongs to the Special Issue Innovations in Neurorehabilitation and Neuroplasticity)
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17 pages, 365 KiB  
Review
A Systematic Review of Neurofeedback for the Management of Motor Symptoms in Parkinson’s Disease
by Krithika Anil, Stephen D. Hall, Sara Demain, Jennifer A. Freeman, Giorgio Ganis and Jonathan Marsden
Brain Sci. 2021, 11(10), 1292; https://doi.org/10.3390/brainsci11101292 - 29 Sep 2021
Cited by 8 | Viewed by 5345
Abstract
Background: Neurofeedback has been proposed as a treatment for Parkinson’s disease (PD) motor symptoms by changing the neural network activity directly linked with movement. However, the effectiveness of neurofeedback as a treatment for PD motor symptoms is unclear. Aim: To systematically review the [...] Read more.
Background: Neurofeedback has been proposed as a treatment for Parkinson’s disease (PD) motor symptoms by changing the neural network activity directly linked with movement. However, the effectiveness of neurofeedback as a treatment for PD motor symptoms is unclear. Aim: To systematically review the literature to identify the effects of neurofeedback in people with idiopathic PD; as defined by measurement of brain activity; motor function; and performance. Design: A systematic review. Included Sources and Articles: PubMed; MEDLINE; Cinhal; PsychoInfo; Prospero; Cochrane; ClinicalTrials.gov; EMBASE; Web of Science; PEDro; OpenGrey; Conference Paper Index; Google Scholar; and eThos; searched using the Population-Intervention-Comparison-Outcome (PICO) framework. Primary studies with the following designs were included: randomized controlled trials (RCTs), non-RCTs; quasi-experimental; pre/post studies; and case studies. Results: This review included 11 studies out of 6197 studies that were identified from the literature search. Neuroimaging methods used were fMRI; scalp EEG; surface brain EEG; and deep brain EEG; where 10–15 Hz and the supplementary motor area were the most commonly targeted signatures for EEG and fMRI, respectively. Success rates for changing one’s brain activity ranged from 47% to 100%; however, both sample sizes and success criteria differed considerably between studies. While six studies included a clinical outcome; a lack of consistent assessments prevented a reliable conclusion on neurofeedback’s effectiveness. Narratively, fMRI neurofeedback has the greatest potential to improve PD motor symptoms. Two main limitations were found in the studies that contributed to the lack of a confident conclusion: (1) insufficient clinical information and perspectives (e.g., no reporting of adverse events), and (2) limitations in numerical data reporting (e.g., lack of explicit statistics) that prevented a meta-analysis. Conclusions: While fMRI neurofeedback was narratively the most effective treatment; the omission of clinical outcome measures in studies using other neurofeedback approaches limits comparison. Therefore, no single neurofeedback type can currently be identified as an optimal treatment for PD motor symptoms. This systematic review highlights the need to improve the inclusion of clinical information and more robust reporting of numerical data in future work. Neurofeedback appears to hold great potential as a treatment for PD motor symptoms. However, this field is still in its infancy and needs high quality RCTs to establish its effectiveness. Review Registration: PROSPERO (ID: CRD42020191097) Full article
(This article belongs to the Special Issue Innovations in Neurorehabilitation and Neuroplasticity)
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16 pages, 459 KiB  
Systematic Review
Upper Limb Robotic Rehabilitation for Patients with Cervical Spinal Cord Injury: A Comprehensive Review
by Giovanni Morone, Alessandro de Sire, Alex Martino Cinnera, Matteo Paci, Luca Perrero, Marco Invernizzi, Lorenzo Lippi, Michela Agostini, Irene Aprile, Emanuela Casanova, Dario Marino, Giuseppe La Rosa, Federica Bressi, Silvia Sterzi, Daniele Giansanti, Alberto Battistini, Sandra Miccinilli, Serena Filoni, Monica Sicari, Salvatore Petrozzino, Claudio Marcello Solaro, Stefano Gargano, Paolo Benanti, Paolo Boldrini, Donatella Bonaiuti, Enrico Castelli, Francesco Draicchio, Vincenzo Falabella, Silvia Galeri, Francesca Gimigliano, Mauro Grigioni, Stefano Mazzoleni, Stefano Mazzon, Franco Molteni, Maurizio Petrarca, Alessandro Picelli, Marialuisa Gandolfi, Federico Posteraro, Michele Senatore, Giuseppe Turchetti and Sofia Straudiadd Show full author list remove Hide full author list
Brain Sci. 2021, 11(12), 1630; https://doi.org/10.3390/brainsci11121630 - 10 Dec 2021
Cited by 17 | Viewed by 4229
Abstract
The upper extremities limitation represents one of the essential functional impairments in patients with cervical spinal cord injury. Electromechanics assisted devices and robots are increasingly used in neurorehabilitation to help functional improvement in patients with neurological diseases. This review aimed to systematically report [...] Read more.
The upper extremities limitation represents one of the essential functional impairments in patients with cervical spinal cord injury. Electromechanics assisted devices and robots are increasingly used in neurorehabilitation to help functional improvement in patients with neurological diseases. This review aimed to systematically report the evidence-based, state-of-art on clinical applications and robotic-assisted arm training (RAT) in motor and functional recovery in subjects affected by cervical spinal cord injury. The present study has been carried out within the framework of the Italian Consensus Conference on “Rehabilitation assisted by robotic and electromechanical devices for persons with disability of neurological origin” (CICERONE). PubMed/MEDLINE, Cochrane Library, and Physiotherapy Evidence Database (PEDro) databases were systematically searched from inception to September 2021. The 10-item PEDro scale assessed the study quality for the RCT and the AMSTAR-2 for the systematic review. Two different authors rated the studies included in this review. If consensus was not achieved after discussion, a third reviewer was interrogated. The five-item Oxford CEBM scale was used to rate the level of evidence. A total of 11 studies were included. The selected studies were: two systematic reviews, two RCTs, one parallel-group controlled trial, one longitudinal intervention study and five case series. One RCT was scored as a high-quality study, while the systematic review was of low quality. RAT was reported as feasible and safe. Initial positive effects of RAT were found for arm function and quality of movement in addition to conventional therapy. The high clinical heterogeneity of treatment programs and the variety of robot devices could severely affect the generalizability of the study results. Therefore, future studies are warranted to standardize the type of intervention and evaluate the role of robotic-assisted training in subjects affected by cervical spinal cord injury. Full article
(This article belongs to the Special Issue Innovations in Neurorehabilitation and Neuroplasticity)
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