Modeling of cerebellar transcranial electrical stimulation effects on hand tremor in Parkinson’s disease

IntroductionParkinson’s disease (PD) is a neurodegenerative disorder with different motor and neurocognitive symptoms. Tremor is a well-known symptom of this disease. Increasing evidence suggested that the cerebellum may substantially contribute to tremors as a clinical symptom of PD. However, the theoretical foundations behind these observations are not yet fully understood.MethodsIn this study, a computational model is proposed to consider the role of the cerebellum and to show the effectiveness of cerebellar transcranial alternating current stimulation (tACS) on the rest tremor in participants with PD. The proposed model consists of the cortex, cerebellum, spinal circuit-muscular system (SC-MS), and basal ganglia blocks as the most critical parts of the brain, which are involved in generating rest tremors. The cortex, cerebellum, and SC-MS blocks were modeled using Van der Pol oscillators that interacted through synchronization procedures. Basal ganglia are considered as a regulator of the coupling weights defined between oscillators. In order to evaluate the global behavior of the model, we applied tACS on the cerebellum of fifteen PD patients for 15 min at each patient’s peak frequency of their rest tremors. A tri-axial accelerometer recorded rest tremors before, during, and after the tACS.Results and DiscussionThe simulation of the model provides a suggestion for the possible role of the cerebellum on rest tremors and how cerebellar tACS can affect these tremors. Results of human experiments also showed that the online and offline effects of cerebellar tACS could lead to the reduction of rest tremors significantly by about %76 and %68, respectively. Our findings suggest that the cerebellar tACS could serve as a reliable, therapeutic technique to suppress the PD tremor

Comparison of therapeutic effects of two type of cock-up splint carpal tunnel syndrome

Background and Objective: Carpal Tunnel Syndrome is the most common compression neuropathy which can cause mild, moderate and sever disability in patiens hands. The first standard treatment is to use Cock-up splint. This study was done to compare therapeutic effects of long (With MP Joint restriction) and short (without mp Joint restriction) Cock-up splint patients with Carpal Tunnel Syndrome. Materials and Methods: In this clinical trail study was done on 23 patients with mild and moderate Carpal Tunnel Syndrome in Shafa Yahyayian Hospital, Tehran, Iran. The diagnosis of Carpal Tunnel Syndrome in patients confirmed with electrodiagnostic method. In this study 23 Patients was treated with long & short cock-up splint in two groups. Group A (12 Patients) was treated by long Splint and group B (11) Patients was treated by short Splint for 4 weeks. Patients was evaluated by Semmes –Wein stein monofilaments, Two Point discrimination, Visual analog Scale (VAS), pinch and Grip Strength. Results: Both types of splints appear to be effective in decreasing CTS symptoms but long Splint more beneficial than Short splint. The results of SWMS, 2PD, Pinch & grip Strength in group A had higher significant difference than group B. (P<0.05). Two groups did not have significant difference in results of severity of pain according to VAS. Conclusion: This study revealed that long Cock-up Splint in comparision with short Cock-up splint demonestrate high efficasy in improving the signs of Carpal Tunnel Syndrome

Evaluation of Acupuncture in the Treatment of Restless Legs Syndrome: A Randomized Controlled Trial

The aim of this study was to examine the additive effect of medical acupuncture on controlling the symptoms of restless legs syndrome (RLS). A total of 46 randomly allocated patients diagnosed with RLS were assigned to receive either 10 sessions of acupuncture plus gabapentin (300 mg/d), or gabapentin (300 mg/d) alone (23 patients in each group) over 4 weeks in a single-blind study. The symptoms of patients were assessed by the Visual Analogue Scale (VAS), the International Restless Legs Syndrome Rating Scale (IRLSRS), and the Pittsburgh Sleep Quality Index (PSQI) at baseline, just after the therapeutic course and 8 weeks later. For all outcome measures, there was a significant time-group interaction, showing that the behavior of groups differed regarding changes in VAS, IRLSRS, and PSQI in favor of the experimental group. After therapeutic course termination and in 8 weeks follow up, VAS and IRLSRS had a significant improvement in both the experimental group and the control group, but PSQI improved significantly just in the experimental group. Based on the findings of the present study, acupuncture plus a low dose of gabapentin (300 mg/d) is clinically useful in the treatment of RLS during 8 weeks follow up, and also has an additive therapeutic effect over gabapentin alone in patients with RLS

Dry Needling for Arthrogenic Muscle Inhibition of Quadriceps Femoris in Patients after Reconstruction of Anterior Cruciate Ligament: a Protocol for a Randomized Controlled Trial

Background : Dry needling (DN) is recommended as a therapeutic modality for various neuromusculoskeletal disorders. No study has been performed on the impact of DN on arthrogenic muscle inhibition (AMI) after anterior cruciate ligament reconstruction (ACLR). This study protocol is aimed to investigate the impacts of DN on AMI of quadriceps femoris, corticomotor, and spinal reflex excitability in patients with ACLR. Methods : A double-blind, between-subject, randomized, controlled trial will be conducted to measure changes in AMI after DN. Twenty-four subjects with ACLR will be recruited to receive a DN or a sham DN, providing that they met the inclusion criteria. Three sessions of DN on the quadriceps femoris will be applied during a one-week period. The primary outcome measures are the active motor threshold, motor evoked potential, and Hmax - Mmax ratio. The secondary outcomes are the International Knee Documentation Committee subjective knee form questionnaire score and maximum quadriceps isometric torque. Data will be collected at baseline, immediately after the first session, after the third session, and at the one-month follow-up visit. Discussion: The results of this study will provide preliminary evidence regarding the effects of DN on AMI of quadriceps femoris in patients with ACLR