..

Journal international de neuroréadaptation

Soumettre le manuscrit arrow_forward arrow_forward ..

Volume 1, Problème 4 (2014)

article de recherche

Improving Memory in Patients with Epilepsy: Considering the Impact of Anti-Epileptic Drugs, Low Mood and/or Surgery on Memory Training Program Outcomes

Zoë Thayer, Cara Wong, Armin Mohamed and Laurie Miller

Aim: To determine whether epilepsy treatments (number of antiepileptic drugs and surgical history) and/or depressed mood would influence the ability to benefit from memory training of outpatients with epilepsy who participated in a group-based, six-week, Memory Training Program. We also investigated the relationships between symptoms of depression, performance on a new objective measure of association memory and subjective memory ratings.
Method: Forty-seven adults with epilepsy and memory complaints completed the training with pre- and posttraining assessments. Scores included (1) number correct on a new Identity Association Memory Test; (2) subjective self-rating of memory function; (3) number of reported strategies used for memory support. Two way (Group x Time) Repeated Measures Analyses of Variance were used to look for differences on the association-learning task. Pearson correlation analyses were used to examine the relationships between number of anti-epileptic drugs, subjective memory ratings, and presence of depression and objective memory scores.
Results: Repeated measures ANOVAs demonstrated that training resulted in significant improvements of the total score on the Association Memory Test regardless of number of antiepileptic drugs (F=6.5,p=.01), surgical status (F=6,p=.02) or mood (F=7.4,p<.01). Although the depressed group rated their memory as lower overall (Group main effect F=4.8,p<.05), both groups showed similar improvements as a result of the training, (Test-time main effect: F=8.0,p<.01). Although depression level was correlated with lower self-ratings of memory (pre: r =-.3, p=.02; post: r=- .3, p=.05, depression scores were not correlated with objective memory performance at either test time.
Conclusion: This study contributes to evidence that memory rehabilitation benefits people with epilepsy. We found significant pre- to post-training improvements on subjective as well as objective measures of association learning. Furthermore, we found that the gains on all three outcome measures were unaffected by higher levels of antiepileptic drugs, previous surgical treatment or depressed mood.

article de recherche

Pharyngeal Stimulation in Head and Neck Cancer Patients with Dysphagia: Functional Outcomes and Transcranial Magnetic Stimulation Motor Evoked Potentials

Carol A Boliek, Jennifer A Harris, Daniel C Sadowski, Teresa Paslawski, Kelvin E Jones, Liu Shi Gan, and Jana M Rieger

Purpose: Head and neck cancer patients often experience swallowing disorders, impacting health and quality of life. This study examined effects of electrical stimulation to the pharynx on swallowing outcomes in post-surgical head and neck cancer patients.
Methods: Swallowing was assessed using video fluoroscopy before, and 30 minutes after, a ten-minute application of electrical stimulation to the pharynx in five patients experiencing moderate-severe dysphagia. Corticopharyngeal motor projections were measured before and after stimulation of the pharynx using transcranial magnetic stimulation of motor cortex and measurements of motor evoked potentials (MEPs) in the striated muscle of the posterior pharyngeal wall.
Results: Short-term changes in swallowing function were observed post-stimulation in: pharyngeal transit time, cricopharyngeal opening duration, total number of swallows, penetration/aspiration score, and duration of contact between the base of tongue and posterior pharyngeal wall. MEPs could not be measured in two participants. In the remaining participants, the MEP measures were not strongly associated with changes in observed swallowing function as has been found for neurogenic dysphagia. Conclusions: These findings indicated that somatosensory input, generated by electrical stimulation of the pharynx, changes swallowing function in head and neck cancer patients. These changes are not strongly correlated with alterations of corticopharyngeal excitability as previously observed in acutely dysphagic stroke patients.

article de recherche

Personality Variables in Prediction of Control over Seizures in Patients with Partial Epilepsies

Vladimir V Kalinin, Anna A Zemlyanaya, Elena V Zheleznova and Lyudmila V Sokolova

The current study has been carried out in order to evaluate the possible relationship between premorbid personality constructs with therapeutic remission and seizures reduction under antiepileptic treatment in patients with partial forms of epilepsy. One hundred and three patients were included into study. There were 33 men and 70 women. The Munich Personality Test and Toronto Alexithymia Scale (TAS-26) have been used for the assessment of premorbid personality in patients. Product moment correlation and multiple forward stepwise regression were used for the analysis of interrelationship between independent variables (personality constructs) and dependent variables of therapeutic remission and percentage in seizures reduction. Obtained results have shown the favorable prognostic significance of Neuroticism, Extraversion, Frustration Tolerance for the percentage of sum of all partial seizures reduction and for sensory partial and motor partial seizures reduction. On the other hand, alexithymia correlated negatively with length of remission and percentage of all seizures reduction.

article de recherche

The Association between Cardiac Autonomic Control System and Motor Performance among Patients Post Stroke: Review of the Literature

Raphaely Beer Noa and Katz-leurer Michal

This paper reviews the evidence regarding the autonomic heart rate regulation system function in relation to motor, activity and functional performance among patients post stroke. The target population included patients of any severity, post event. Databases searched for English language studies from 1990 to 2014 were PubMed, Cochrane Library, the Physiotherapy Evidence Database (PEDro), and the ClinicalTrials.gov. Search terms included ‘stroke’, ‘hemiplegic’, ‘cerebrovascular accident’ and `autonomic nervous system` or `heart rate variability` or `sympathetic` or `para sympathetic` and ‘ motor` or `activity` or `function’. Articles were identified and included if (1) participants were older than 18 years of age, (2) diagnosis of stroke was made (3) autonomic cardiac heart rate regulation system state and response to activity was present by HRV parameters (4) or an association between HRV parameter and motor or function performance was described. Results: Eight studies were identified as eligible for study criteria; among these, five assessed the possible predictive value of the HRV parameters on function performance two or more month later. Two studies assessed the response of heart rate autonomic control system assessed by HRV values to exercise. One study assessed the possible modification effect of heart autonomic system on the influence of aerobic intervention on walking and functional outcomes among patients at the sub-acute phase post stroke. The main results of the current review suggested a relationship between autonomic HR regulation system and motor and functional abilities among patients post stroke. In addition, it seems that cardiac autonomic system response to activity in these patients. However, the extent of the association and further the benefits of autonomic rehabilitation on motor or functional abilities remain to be evaluated.

article de recherche

Structural and Qualitative Analysis of Lamotrigine

T Ramya, GR Ramkumaar and S Gunasekaran

In the present study, the change in the quality of lamotrigine that falls under antiepileptic group at various storage conditions has been studied by FTIR and UV spectroscopic technique. The indications from the result emphasizes that it is essential to store the drugs under the prescribed condition to maintain their quality. The Vibrational spectral analysis also been carried out by employing FTIR, FT-Raman spectroscopy.

article de recherche

Histopathological Changes in Placenta of Rat Induced by Levtricetam

Huda Abdulwadood Omer, Muna Anwer Kutb and Huda Abdulla Kaatabi

Background and objectives: Levetiracetam (LEV) is an established second-generation antiepileptic drug. Its use in women with epilepsy of child-bearing potential is a delicate balance between seizure control and adverse effects to the fetus. This study has been designed to evaluate the histopathological effect of levetiracetam in different doses (Therapeutic dose & ¼ LD50), on the placenta of experimental rats.
Design and Setting: This study is a randomized single blind control trail conducted from January 2009-December2009.Materials and Methods: Placentas were collected for microscopic examination on day 20 of gestation after rat’s scarification.
Results: The placenta showed neither significant reduction in weight nor any overt anomaly compared to control group. Histological examination of the treated groups showed structural changes mainly in the dose of 1/4 LD50. Decidual necrosis, decrease trophospongium area, fibrinoid deposit, necrosis of labyrinth, vascular congestion and hemorrhage were observed. The results suggested that levetiracetam induced dose dependent changes in the structure of placenta.
Conclusions: Therefore, levetiracetam in therapeutic dose can be used safely during pregnancy. However, its safety showed be established in a large scale randomized study with long term follow-up.

Indexé dans

arrow_upward arrow_upward