強制把握へのBTXと電気刺激下RFEの併用: Improvement and Neuroplasticity after Combined Rehabilitation..
把握反射と強い痙縮に苦しむ左片麻痺例(10年前の発症)はボツリヌス治療と2週間の持続的電気刺激下の促通反復療法と物品操作訓練によって、左上肢機能が改善した。ピンチ中の脳血流はボツリヌス治療後の持続的電気刺激下では障害半球のsensorimotor cortexと medial frontal cortex に集約した。
Arima M, et al: Improvement and Neuroplasticity after Combined Rehabilitation to Forced Grasping.
Case Reports in Neurological Medicine 2017: 1-7, 2017
We report the case of a 17-year-old man who had suffered cerebral infarction 10 years previously. Forced grasping of the hemiparetic left upper limb was improved after Botulinum toxin injection. In addition, repetitive facilitative exercise and object-related training were performed under low-amplitude continuous neuromuscular electrical stimulation. Since this 2-week treatment improved upper limb function, we compared brain activities, as measured by near-infrared spectroscopy during finger pinching, before and after the combined treatment. Brain activities in the ipsilesional sensorimotor cortex (SMC) and medial frontal cortex (MFC) during pinching under electrical stimulation after treatment were greater than those before. The results suggest that training under electrical stimulation after Botulinum toxin treatment may modulate the activities of the ipsilesional SMC and MFC and lead to functional improvement of the affected upper limb with forced grasping.