Objectives: To determine the effectiveness of computer-assisted cognitive rehabilitation and compare the patterns of cognitive function recovery occurring in both traumatic brain injury (TBI) and stroke. Methods: A total of 62 patients were finally enrolled, consisting of 30 with TBI and 32 with stroke. The patients received 30 sessions of computer-assisted cognitive rehabilitation (Comcog) five times per week. Each session lasted for 30 min. Before and immediately after cognitive rehabilitation, all patients were evaluated by computerized neuropsychological test (CNT), Mini-Mental State Examination (MMSE), and modified Barthel index (MBI). Results: We analyzed the differences between pre- and post-cognitive rehabilitation in each TBI and stroke group. Significant differences were observed in MMSE, MBI, and some CNT contents, including digit span forward, verbal learning, verbal learning delayed recall, visual span forward, visual span backward, visual learning, trail making test A and B, and intelligence quotient (IQ) in the TBI group (p < 0.05). In the stroke group, in addition to significant differences that appeared in the TBI group, additional significant differences in the digit span backward, visual learning delayed recall, auditory continuous performance test (CPT), visual CPT, and card sorting test. We compared the difference values at pre- and post-cognitive rehabilitation for cognitive recovery between the TBI and stroke groups. All contents, except the digital span forward, visual learning, word-color test, and MMSE, had greater mean values in the stroke group; and thus, statistically significant higher values were observed in the visual span forward and card sorting test (p < 0.05). Conclusion: Most evaluation results showed improvement and the evaluation between the TBI and stroke groups also showed significant differences in cognitive functions in addition to more CNT contents, which significantly change in the stroke group. The stroke group showed a high difference value in most CNT contents. Therefore, those with stroke in the focal brain region tend to have better cognitive function recovery after a computer-assisted cognitive rehabilitation than those with TBI, which could cause diffuse brain damage and post-injury inflammation.
Acute lymphocytic leukemia is one of the most common cancers in children. Multi-drug chemotherapy is used for treatment, and the representative drug is vincristine. Although various side effects may occur due to vincristine, the association with peripheral neuropathy is high compared to that of other drugs. This study focused on children under the age of 18 years of age with ALL who received chemotherapy containing vincristine. We retrospectively analyzed the results of a nerve conduction study and a cumulative dose of vincristine in 30 children diagnosed with peripheral neuropathy. The average cumulative dose until diagnosis of vincristine-induced peripheral neuropathy was 14.99 ± 1.21 mg/m2, and motor nerves were predominantly involved. Additionally, a marked decrease in average amplitude was also observed in motor nerves. In addition, when the relationship between the incidence of peripheral neuropathy and the cumulative dose was analyzed through the survival curve, about 50% of children developed peripheral neuropathy at a dose of 15.5 ± 1.77 mg/m2. Based on the electrophysiological characteristics of pediatric vincristine-induced peripheral neuropathy, as well as the relationship between the incidence rate and the cumulative dose, it is possible to observe more closely the vincristine-induced peripheral neuropathy occurrence in children with ALL at an appropriate time.
Rationale: Cortical deafness is a rare auditory dysfunction caused by damage to brain auditory networks. The aim was to report alterations of functional connectivity in intrinsic auditory, motor, and sensory networks in a cortical deafness patient. Patient concerns: A 41-year-old woman suffered a right putaminal hemorrhage. Eight years earlier, she had suffered a left putaminal hemorrhage and had minimal sequelae. She had quadriparesis, imbalance, hypoesthesia, and complete hearing loss. Diagnoses: She was diagnosed with cortical deafness. After 6 months, resting-state functional magnetic resonance imaging (rs-fMRI) and diffuse tensor imaging (DTI) were performed. DTI revealed that the acoustic radiation was disrupted while the corticospinal tract and somatosensory track were intact using deterministic tracking methods. Furthermore, the patient showed decreased functional connectivity between auditory and sensorimotor networks. Interventions: The patient underwent in-patient stroke rehabilitation therapy for 2 months. Outcomes: Gait function and ability for activities of daily living were improved. However, complete hearing impairment persisted in 6 months after bilateral putaminal hemorrhagic stroke. Lessons: Our case report seems to suggest that functional alterations of spontaneous neuronal activity in auditory and sensorimotor networks are related to motor and sensory impairments in a patient with cortical deafness.
Background: Rhabdomyolysis is a clinical symptom caused by the rapid release of intracellular components such as myoglobin, lactate dehydrogenase, and creatine kinase into the blood circulation. It is commonly caused by muscular injury including compartment syndrome, infection, drugs, etc. Although it rarely occurs during surgery, the incidence may increase if risk factors such as long operation time, improper posture, and condition of being overweight exist. Case Presentation: A 46-year-old male patient complained of pain and weakness in the right hip area and several abnormal findings were observed in the blood sample, reflecting muscle injury and decreased renal function after prolonged urological surgery. He was confirmed as having rhabdomyolysis, which was caused by compartment syndrome of the right gluteal muscle. After the diagnosis, conservative cares were performed in the acute phase and rehabilitation treatments were performed in the chronic phase. After conservative treatment and rehabilitation, blood sample values returned to almost normal ranges and both level of pain and muscle strength were significantly improved. In addition, about 25 days after discharge, he almost recovered to pre-operative condition. Conclusion: Careful attention is required to prevent intraoperative compartment syndrome. It also suggests that not only medical treatment but also early patient-specific rehabilitation is important in patients with rhabdomyolysis after prolonged surgery.
Introduction: Cognitive dysfunction reduces patients' quality of life and social participation with traumatic brain injury (TBI). Computerized cognitive rehabilitation is increasingly being used for cognitive therapy in TBI patients. The purpose of this study was to investigate the influence of age on the effect of computerized cognitive rehabilitation in cognitive dysfunction after TBI.Material and methods: A total of 34 patients with cognitive dysfunction after TBI were enrolled. Participants performed 30 sessions of computerized cognitive rehabilitation (Comcog) for 6 weeks. A cognitive evaluation was performed before and after treatment with Mini-Mental State Examination (MMSE) and Computerized Neurophyschologic Test (CNT).Results: There were no cognitive tests that differed between the young group and the old group at baseline. However, after computerized cognitive rehabilitation, the young group showed significant improvement compared to the old group in verbal memory, visual memory, attention, and visuo-motor coordination tests. The young group showed improvement in MMSE, verbal and visual memory, and visuo-motor coordination tests after computerized cognitive rehabilitation. In contrast, the old group showed significant improvement only in MMSE and visual learning test, one of the visual memory tests. Conclusion:Our findings demonstrate that age may be an important factor related to the effect of computer cognitive rehabilitation on cognitive dysfunction after TBI. Methodologically more ordered studies with larger sample sizes are needed in the future.
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