The 15-day in-patient protocol of low-frequency rTMS/OT is potentially suitable for reducing spasticity as well as improving motor function on the affected upper limb after stroke.
SUMMARYWe have prepared and characterized monoclonal antibodies against five major structural proteins, i.e. the HA, P, NP, F and M proteins, of measles virus. At least three non-overlapping antigenic sites were delineated on the HA protein, three on the P, four on the NP, four on the F and five on the M proteins by competitive binding assays. Antigenic sites on the HA and F proteins roughly represented functional domains defined by serological tests. The reactivity of monoclonal antibodies with various measles virus strains including those from subacute sclerosing panencephalitis (SSPE) and other members of the morbillivirus family was studied by immunofluorescence. A monoclonal antibody or set of monoclonal antibodies to each of the antigenic sites showed a characteristic pattern of cross-reactivity with heterologous strains. The HA and NP proteins were antigenically the most variable, followed by the F and M proteins, while the P protein was relatively stable. None of the 14 anti-M monoclonal antibodies reacted with non-virus-producing SSPE cells, strongly suggesting the absence of M protein in these cells.
The purpose of the study was to determine the safety and feasibility of a 15-day protocol of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with intensive occupational therapy (OT) on motor function and spasticity in hemiparetic upper limbs in poststroke patients.Fifteen poststroke patients (age at study entry 55 ± 17years, time after stroke 57± 55 months) with upper limb hemiparesis categorized as Brunnstrom stages 3–5 forhand–fingers were recruited. They were considered to have reached a plateau state at study entry, based on the lack of any increase in Fugl–Meyer Assessment (FMA) Score inthe last 3 months. During the 15-day hospitalization, each patient received 22 sessions of rTMS with 1 Hz applied to the contralesional cerebral hemisphere, followed by intensive OT (one-to-one training including shaping techniques and self training). Upper limb motor function was evaluated by FMA and Wolf Motor Function Test at admission and discharge. The spasticity of finger flexors,wrist flexors and elbow flexors in the affected upper limb was also evaluated with Modified Ashworth Scale. The15-day protocol was well tolerated by all patients. Atdischarge, the FMA Score was increased in all 15 patients(17–57 to 18–61 points). Shortening of performance time on Wolf Motor Function Test was noted in 12 patients(44–1584 to 39–1485 s). The Modified Ashworth ScaleScore for some flexor muscles decreased in 12 patients.In conclusion, our 15-day protocol of low-frequency rTMS combined with intensive OT seems feasible not only for improving motor function, but also for reducing spasticity in the affected upper limb in post stroke hemiparetic patients.
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