Review
Neurosciences
Roberto Leiras, Jared M. Cregg, Ole Kiehn
Summary: This review examines recent advances in understanding the brainstem circuits involved in controlling locomotion. The study highlights the importance of delineated command circuits and the need to establish functional connections between these circuits and other brain areas. The unresolved issues regarding the integrated function of locomotor control are also discussed.
ANNUAL REVIEW OF NEUROSCIENCE
(2022)
Article
Neurosciences
Nicole E. Chambers, Michael Coyle, Jordan Sergio, Kathryn Lanza, Carolyn Saito, Brent Topping, Stewart D. Clark, Christopher Bishop
Summary: This study found that cholinergic neurons in the pedunculopontine nucleus (PPN) affect gait parameters related to postural stability, potentially serving as a target for reducing intractable postural instability in patients with Parkinson's disease.
EUROPEAN JOURNAL OF NEUROSCIENCE
(2021)
Article
Biochemistry & Molecular Biology
Manuel J. Ferreira-Pinto, Harsh Kanodia, Antonio Falasconi, Markus Sigrist, Maria S. Esposito, Silvia Arber
Summary: Research has shown the existence of functionally diverse neuronal populations in the mesencephalic locomotor region, with some controlling full-body behavior and others controlling forelimb behavior, stratified by projection target and exhibiting roles in action control beyond locomotion.
Article
Neurosciences
V. S. Witzig, F. Alosaimi, Y. Temel, J. B. Schulz, A. Jahanshahi, S. K. H. Tan
Summary: This study investigated the effects of long-term intermittent bilateral STN-DBS on PPN cholinergic neurons in the MPTP Parkinsonian mouse model. The results showed that STN-DBS improved gait impairments but did not alter the expression or activation of PPN acetylcholine neurons. Therefore, the motor and gait effects of STN-DBS are less likely to be mediated by the STN-PPN connection and PPN cholinergic system.
NEUROSCIENCE LETTERS
(2023)
Review
Clinical Neurology
Dimitri Ryczko
Summary: The mesencephalic locomotor region (MLR) is a crucial area for controlling locomotion in vertebrates, and decreased activity in this region has been associated with locomotor deficits in Parkinson's disease patients. Deep brain stimulation targeting the MLR has shown variable results, and identifying the best cell types to target is still in the early stages. Activation of certain glutamatergic and cholinergic neurons in the MLR has shown promise in improving locomotor function in animal models of Parkinson's disease, while activation of GABAergic neurons should be avoided. The MLR is also considered a potential target for other neurological disorders.
Article
Neurosciences
Guofan Qin, Hutao Xie, Lin Shi, Baotian Zhao, Yifei Gan, Zixiao Yin, Yichen Xu, Xin Zhang, Yaojing Chen, Yin Jiang, Quan Zhang, Jianguo Zhang
Summary: Low frequency STN-DBS improves cognitive function, specifically conflict resolution, in PIGD patients.
FRONTIERS IN NEUROSCIENCE
(2023)
Article
Engineering, Biomedical
Kate McMaster, Michael H. Cole, Daniel Chalkley, Mark W. Creaby
Summary: This study suggests that real-time visual biofeedback can effectively modify specific gait characteristics associated with falls in PD patients, such as reducing mediolateral trunk lean, step length and gait velocity.
JOURNAL OF NEUROENGINEERING AND REHABILITATION
(2022)
Review
Clinical Neurology
Jesco Streumer, Ashok K. Selvaraj, Erkan Kurt, Bastiaan R. Bloem, Rianne A. J. Esselink, Ronald H. M. A. Bartels, Dejan Georgiev, R. Saman Vinke
Summary: Axial disability, including gait disturbances, is common in Parkinson's disease (PD), especially in advanced stages. Epidural spinal cord stimulation (SCS) has been investigated as a treatment option for gait disorders in PD. This review examines the literature on SCS in PD and evaluates its efficacy, optimal stimulation parameters, optimal electrode locations, possible effects of concurrent deep brain stimulation, and possible working mechanisms on gait.
PARKINSONISM & RELATED DISORDERS
(2023)
Article
Neurosciences
Rene Molina, Chris J. Hass, Stephanie Cernera, Kristen Sowalsky, Abigail C. Schmitt, Jaimie A. Roper, Daniel Martinez-Ramirez, Enrico Opri, Christopher W. Hess, Robert S. Eisinger, Kelly D. Foote, Aysegul Gunduz, Michael S. Okun
Summary: This study investigated the feasibility and effectiveness of PPN CL-DBS in treating medication-refractory FoG, showing high recruitment feasibility but suboptimal safety and heterogeneous clinical outcomes.
FRONTIERS IN HUMAN NEUROSCIENCE
(2021)
Article
Clinical Neurology
Ashley L. B. Raghu, Tariq Parker, Amir P. Divanbeighi Zand, Stephen Payne, Jesper Andersson, John Stein, Tipu Z. Aziz, Alexander L. Green
Summary: Deep brain stimulation targeting the pedunculopontine nucleus shows promise for treating Parkinsonian gait and balance dysfunction, with clinical outcomes correlated with structural connectivity between the stimulating electrodes and specific brain regions. Lower cortical thickness in certain areas is associated with greater pre-operative symptom severity.
JOURNAL OF NEURAL TRANSMISSION
(2021)
Article
Anatomy & Morphology
S. Petryszyn, L. Saidi, D. Gagnon, A. Parent, M. Parent
Summary: The study investigated the changes in morphology and distribution of striatal interneurons expressing calretinin in a mouse model of Parkinson's disease. It found that medium-sized calretinin-positive interneurons are specifically targeted by dopamine denervation, while small and intensely immunoreactive calretinin-positive cells remain unaffected. These results suggest that the expression of calretinin may play a protective role against altered corticostriatal transmission in Parkinson's disease.
BRAIN STRUCTURE & FUNCTION
(2021)
Article
Multidisciplinary Sciences
Debora Masini, Ole Kiehn
Summary: The study demonstrates that cell-type specific stimulation of brainstem neurons can restore severe locomotor deficit in mouse models of parkinsonism, suggesting a potential target for neuromodulatory restoration of locomotor function in Parkinson's disease.
NATURE COMMUNICATIONS
(2022)
Article
Clinical Neurology
Yun Su Hwang, Sungyang Jo, Seung Hyun Lee, Nayoung Kim, Mi-Sun Kim, Sang Ryong Jeon, Sun Ju Chung
Summary: This study investigated the long-term motor outcomes in PD patients undergoing GPi-DBS. The results showed improvement in tremor, LID, and motor fluctuation up to 5 years after surgery, but worsening of PIGD symptoms. Preoperative levodopa response was associated with long-term benefits on UPDRS scores.
JOURNAL OF THE NEUROLOGICAL SCIENCES
(2023)
Article
Clinical Neurology
Arnaldo Fim Neto, Julia Baldi de Luccas, Bruno Leonardo Bianqueti, Luiz Ricardo da Silva, Tiago Paggi Almeida, Andre Kazuo Takahata, Manoel Jacobsen Teixeira, Eberval Gadelha Figueiredo, Slawomir J. Nasuto, Maria Sheila Guimaraes Rocha, Diogo Coutinho Soriano, Fabio Godinho
Summary: This study investigated the dynamics of subthalamic nucleus local field potentials (STN-LFP) in Parkinson's disease patients and found differences in low-frequency beta bursts between tremor-dominant and postural instability and gait disorder phenotypes. These differences were correlated with motor symptoms.
CLINICAL NEUROPHYSIOLOGY
(2022)
Article
Rehabilitation
Paula T. Bezerra, Lorenna M. Santiago, Isaira A. Silva, Aline A. Souza, Camila L. Pegado, Clecia M. Damascena, Tatiana S. Ribeiro, Ana R. Lindquist
Summary: Combining action observation, motor imagery, and gait training did not show greater effectiveness than isolated gait training for balance and freezing of gait in individuals with Parkinson's disease. However, motor imagery training can moderate the effects of action observation and enhance motor learning when used together.
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
(2022)
Article
Medicine, Research & Experimental
David J. Clark, Sudeshna A. Chatterjee, Jared W. Skinner, Paige E. Lysne, Chanoan Sumonthee, Samuel S. Wu, Ronald A. Cohen, Dorian K. Rose, Adam J. Woods
Summary: This pilot study examined the feasibility, safety, and preliminary efficacy of combining frontal lobe tDCS with complex walking rehabilitation for improving walking and executive function. Results showed high completion rates, low tDCS side effects, and improvements in walking performance for all groups, with the Sham/Typical group exhibiting the greatest gains. The study suggests that combining tDCS with walking rehabilitation may lead to potential improvements in executive function and justifies further larger clinical trials to explore these benefits.
Article
Orthopedics
David W. Russ, Shinichi Amano, Timothy D. Law, James S. Thomas, Brian C. Clark
Summary: This study examined the association and discriminative properties of TE muscle function with Sorensen Test-TTF in individuals with recurrent LBP. The results showed that individuals at risk of subsequent LBP episodes had higher perceived disability and fat mass/TE strength ratios than those not at risk.
JOURNAL OF BACK AND MUSCULOSKELETAL REHABILITATION
(2021)
Article
Neurosciences
Rene Molina, Chris J. Hass, Stephanie Cernera, Kristen Sowalsky, Abigail C. Schmitt, Jaimie A. Roper, Daniel Martinez-Ramirez, Enrico Opri, Christopher W. Hess, Robert S. Eisinger, Kelly D. Foote, Aysegul Gunduz, Michael S. Okun
Summary: This study investigated the feasibility and effectiveness of PPN CL-DBS in treating medication-refractory FoG, showing high recruitment feasibility but suboptimal safety and heterogeneous clinical outcomes.
FRONTIERS IN HUMAN NEUROSCIENCE
(2021)
Article
Clinical Neurology
Anat Mirelman, Mor Ben Or Frank, Michal Melamed, Lena Granovsky, Alice Nieuwboer, Lynn Rochester, Silvia Del Din, Laura Avanzino, Elisa Pelosin, Bastiaan R. Bloem, Ugo Della Croce, Andrea Cereatti, Paolo Bonato, Richard Camicioli, Theresa Ellis, Jamie L. Hamilton, Chris J. Hass, Quincy J. Almeida, Maidan Inbal, Avner Thaler, Julia Shirvan, Jesse M. Cedarbaum, Nir Giladi, Jeffrey M. Hausdorff
Summary: This study utilized wearable sensors to record gait and mobility measures in PD patients and healthy controls, and applied machine-learning algorithms to distinguish between different stages of PD severity. The findings suggest that gait and mobility measures can reflect distinct PD stages with high discriminatory values.
MOVEMENT DISORDERS
(2021)
Article
Neurosciences
Kyoung Shin Park, Chris J. Hass, Christopher M. Janelle
Summary: The study showed that familiar music cues improved stride amplitude and enjoyment while reducing stride-to-stride variability in individuals with PD. On the other hand, unfamiliar music cues increased gait velocity and familiarity, but did not enhance enjoyment or decrease cognitive demand.
Article
Biophysics
Noah L. Pieper, Sidney T. Baudendistel, Chris J. Hass, Gabriela B. Diaz, Rebecca L. Krupenevich, Jason R. Franz
Summary: Older adults consume more metabolic energy during walking than younger individuals, possibly due to a redistribution of leg muscle demand. Modulating propulsive forces in younger adults affects metabolic and joint power costs, with increased hip joint power having a significant impact on metabolic energy expenditure.
JOURNAL OF BIOMECHANICS
(2021)
Article
Neurosciences
Jared W. Skinner, Hyo Keun Lee, Chris J. Hass
Summary: Individuals with Essential Tremor (ET) exhibit slower gait velocity, smaller propulsive and braking forces, and worse stability scores during gait termination compared to individuals with Parkinson's Disease (PD) and Healthy Older Adults (HOA). PD patients fall between ET and HOA in terms of approach velocity, forces generated, and postural stability.
Article
Clinical Neurology
Grace K. Kellaher, Sidney T. Baudendistel, Ryan T. Roemmich, Matthew J. Terza, Chris J. Hass
Summary: Individuals with Parkinson's disease demonstrated impaired interlimb coordination, particularly between the more affected arm and legs, during backward walking compared to healthy controls. This may contribute to difficulties in walking for those with Parkinson's disease, highlighting the importance of understanding and addressing coordination deficits in rehabilitation strategies.
PARKINSONISM & RELATED DISORDERS
(2022)
Article
Psychology, Experimental
Amanda E. Stone, Adam C. Hockman, Jaimie A. Roper, Chris J. Hass
Summary: This study investigated the effects of visual information on locomotor adaptation and retention by comparing incremental levels of visual occlusion. The results showed that participants with complete visual occlusion displayed less consistency in their walking pattern compared to those with lower visual field occlusion. However, varying levels of visual occlusion did not significantly affect locomotor adaptation or retention.
PERCEPTUAL AND MOTOR SKILLS
(2021)
Article
Substance Abuse
Kimberly S. Fasczewski, Sara M. Powell, Nolasco R. Stevens, Jared W. Skinner
Summary: This study examined the relationship between perceptions of masculinity and body image to eating disorder risk in male collegiate wrestlers. The results suggest that the masculine traits exemplified by the sport of wrestling may negatively impact body image and encourage maladaptive eating and/or weight-control behaviors, increasing the risk of eating disorders.
PERFORMANCE ENHANCEMENT & HEALTH
(2022)
Article
Geriatrics & Gerontology
Ania L. Lipat, David J. Clark, Chris J. Hass, Yenisel Cruz-Almeida
Summary: This study identified and characterized three different gait clusters (Normal Gait, Shuffle Gait, and Unsteady Gait) within the older adult chronic pain population. The Shuffle Gait cluster exhibited reduced gray matter volume in certain brain regions and higher pain severity compared to other clusters, highlighting the importance of considering gait subgroups in future studies on pain, mobility, and aging.
EXPERIMENTAL GERONTOLOGY
(2022)
Article
Biophysics
Francesca E. Wade, Grace K. Kellaher, Sarah Pesquera, Sidney T. Baudendistel, Arkaprava Roy, David J. Clark, Rachael D. Seidler, Daniel P. Ferris, Todd M. Manini, Chris J. Hass
Summary: The ability to adapt walking speed is crucial for independent mobility, and this ability diminishes with age. This study examined the biomechanical parameters during transitions from preferred walking speed to slower or faster walking in older and younger adults. The findings showed distinct changes in step length, hip flexion, and dorsiflexion during the transition, as well as altered timing of peak joint angles in older adults. This study provides important insights into the kinematics of walking speed transitions in different age groups.
JOURNAL OF BIOMECHANICS
(2022)
Article
Multidisciplinary Sciences
Ryan J. Downey, Natalie Richer, Rohan Gupta, Chang Liu, Erika M. Pliner, Arkaprava Roy, Jungyun Hwang, David J. Clark, Chris J. Hass, Todd M. Manini, Rachael D. Seidler, Daniel P. Ferris
Summary: This study investigated the effects of altering terrain unevenness on gait kinematics, and found that increasing terrain unevenness led to greater stride-to-stride variability and reduced perceived stability in participants.
Review
Physiology
Seaver O. Wait, Nisha Charkoudian, Jared W. Skinner, Caroline J. Smith
Summary: Increasing numbers of lowlanders are traveling to high altitudes for various reasons, resulting in increased interest in the physiological responses to multistressor environments. The effects of hypoxia on the body during exercise, as well as the interactions with heat, cold, and altitude, are not well understood. There is a lack of data on integrated responses and sex differences, and further research is needed to understand the impact on performance, occupation, and health outcomes.
AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY, INTEGRATIVE AND COMPARATIVE PHYSIOLOGY
(2023)
Article
Geriatrics & Gerontology
Hope E. Gamwell, Seaver O. Wait, Jackson T. Royster, Brody L. Ritch, Sarah C. Powell, Jared W. Skinner
Summary: This study aimed to investigate the relationship between variations in the normal gait cycle and parameters of reduced functionality in older adults. The results showed that older adults had poorer ankle muscle function, higher force variability, and deficits in walking parameters, which may be associated with age-related deterioration in central motor control. Participation in physical activity was identified as a means to maintain gait quality and independence.
GERONTOLOGY AND GERIATRIC MEDICINE
(2022)
Article
Rehabilitation
Gang Liu, Bradley Chi
Summary: This article provides a comprehensive review of the technological advances in the diagnosis and treatment of patients with a disorder of consciousness over the past 10 years. While these advances show promise, there is limited high-quality evidence supporting their widespread clinical adoption.
PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA
(2024)
Article
Rehabilitation
Amy Shapiro-Rosenbaum, Michelle P. Jaffe
Summary: Caregivers of persons with DoC experience high levels of perceived burden, which is associated with adverse physical, emotional, psychosocial, and financial outcomes and is directly tied to expressed needs for information and support. Providing individualized education and training at each phase of recovery can enhance effective communication between providers and caregivers, helping to increase caregiver proficiency in managing their loved one's care while also helping to mitigate the challenges associated with perceived burden. This may subsequently increase the rate of community discharge among persons with DoC, potentially translating to a reduction in the long-term costs of care for this population.
PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA
(2024)
Article
Rehabilitation
Jean E. Woo, Abana Azariah, Eboni A. Reed, Nicholas Gut
PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA
(2024)
Article
Rehabilitation
Katherine O'Brien, Bei Zhang, Elizabeth Anderl, Sunil Kothari
Summary: Behavioral assessment is essential in the clinical evaluation of disorders of consciousness, and it should be supplemented by qualitative behavioral observations and individualized quantitative assessments. Therapy disciplines, staff, and family members all play important roles in this process.
PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA
(2024)
Article
Rehabilitation
Mary E. Russell, Cindy B. Ivanhoe, Eboni A. Reed
Summary: Acquired brain injury, especially severe brain injury, is a chronic medical condition that lacks research studies on postacute care and long-term outcomes. There is a need for standardized admission criteria, diagnostic tools, and prognostic protocols. Furthermore, healthcare systems should consider personalized factors and different perspectives on meaningful recovery and quality of life.
PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA
(2024)
Article
Rehabilitation
Brooke Murtaugh, Susan Fager, Tabatha Sorenson
PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA
(2024)
Article
Rehabilitation
Amanda Appel, Eric Spier
Summary: This article discusses the importance of the emergence of consciousness in brain-injured patients and presents a framework for evaluating and tailoring treatment of sleep and pain. Although more research is needed, validated tools are currently available for assessing consciousness, pain, and sleep.
PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA
(2024)
Article
Rehabilitation
Kristen A. Harris, Yi Zhou, Stacey Jou, Brian D. Greenwald
PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA
(2024)
Article
Rehabilitation
Ruth Tangonan, Christos Lazaridis
Summary: Acute disorders of consciousness refer to impairments in arousal and awareness that occur within 28 days of an initial injury, which can be caused by various insults. Thorough evaluations, including assessments of consciousness level, brainstem reflexes, and motor responses, are important. Laboratory tests, imaging, and electrophysiology testing are needed for the evaluation of acute disorders of consciousness. Prognostication in this phase should be done cautiously, with open and frequent communication with families, considering the significant multidimensional uncertainty.
PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA
(2024)
Editorial Material
Rehabilitation
Sunil Kothari, Bei Zhang
PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA
(2024)
Article
Rehabilitation
Michael H. Marino
PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA
(2024)
Article
Rehabilitation
Linda B. Xu, Stephen Hampton, David Fischer
Summary: Neuroimaging in DoC has evolved to characterize complex brain networks and may have significant implications for understanding the natural history of DoC and optimizing long-term management.
PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA
(2024)
Article
Rehabilitation
David B. Arciniegas, Lindsey J. Gurin, Bei Zhang
Summary: Understanding the neuroanatomy of wakefulness and awareness is crucial for clinicians dealing with disorders of consciousness. Wakefulness is supported by brainstem-forebrain-diencephalic systems, while awareness is a result of integrated activity within and between wakefulness systems and cortical areas. Disruptions in these neural systems can inform the clinical presentation and treatment options for disorders of consciousness.
PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA
(2024)
Article
Rehabilitation
Katherine Golden, Yelena G. Bodien, Joseph T. Giacino
Summary: This article discusses the classification associated with the four major disorders of consciousness (DoC): coma, vegetative state or unresponsive wakefulness syndrome, minimally conscious state, and post-traumatic confusional state. The history of each disorder are briefly reviewed and operational definitions and diagnostic criteria are provided. The article heavily relies on recently released practice guidelines and identifies knowledge gaps and discusses future directions to advance DoC research and practice.
PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA
(2024)
Article
Rehabilitation
Beth S. Slomine, Stacy J. Suskauer
Summary: Research on children with disorders of consciousness (DoC) lags behind adult literature, and there is a lack of rigorous evaluation of assessment tools for this population. However, recent developments show promise in improving assessment for young children and those without overt command following. Early signs of consciousness are associated with better long-term outcomes. Although large clinical trials are lacking, programmatic data provide valuable information for standards of care and treatment options for children with DoC.
PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA
(2024)
