Objective: Intermittent theta burst stimulation (iTBS) is a special form of repetitive transcranial magnetic stimulation (rTMS), which effectively increases cortical excitability and has been widely used as a neural modulation approach in stroke rehabilitation. As effects of iTBS are typically investigated by motor evoked potentials, how iTBS influences functional brain network following stroke remains unclear. Resting-state electroencephalography (EEG) has been suggested to be a sensitive measure for evaluating effects of rTMS on brain functional activity and network. Here, we used resting-state EEG to investigate the effects of iTBS on functional brain network in stroke survivors.Methods: We studied thirty stroke survivors (age: 63.1 ± 12.1 years; chronicity: 4.0 ± 3.8 months; UE FMA: 26.6 ± 19.4/66) with upper limb motor dysfunction. Stroke survivors were randomly divided into two groups receiving either Active or Sham iTBS over the ipsilesional primary motor cortex. Resting-state EEG was recorded at baseline and immediately after iTBS to assess the effects of iTBS on functional brain network.Results: Delta and theta bands interhemispheric functional connectivity were significantly increased after Active iTBS (P = 0.038 and 0.011, respectively), but were not significantly changed after Sham iTBS (P = 0.327 and 0.342, respectively). Delta and beta bands global efficiency were also significantly increased after Active iTBS (P = 0.013 and 0.0003, respectively), but not after Sham iTBS (P = 0.586 and 0.954, respectively).Conclusion: This is the first study that used EEG to investigate the acute neuroplastic changes after iTBS following stroke. Our findings for the first time provide evidence that iTBS modulates brain network functioning in stroke survivors. Acute increase in interhemispheric functional connectivity and global efficiency after iTBS suggest that iTBS has the potential to normalize brain network functioning following stroke, which can be utilized in stroke rehabilitation.
Chronic osteomyelitis is a painful and serious disease normally caused by infected surgical prostheses or infected fractures. Currently, antibioticloaded cements are extensively used as the treatment in clinical practice. However, the quick emergence of antibiotic-resistant bacteria has resulted in a formidable challenge in treating chronic osteomyelitis, such as the chronic osteomyelitis caused by methicillin-resistant Staphylococcus aureus (MRSA). Aiming to address MRSA-infected chronic osteomyelitis, an antibacterial peptide polymer doped polymethylmethacrylate bone cement pellets (PMMA@polymer) is prepared. The peptide polymer is designed as the synthetic mimic of host defense peptide and enables PMMA@polymer to have notable advantages, including complete release of antibacterial agent from PMMA, potent and robust activity against MRSA even after autoclave and enzymatic treatment, and low susceptibility to antibacterial resistance. PMMA@polymer showed potent in vitro activities against MRSA, superior in vivo therapeutic efficacy in a rabbit chronic osteomyelitis model, and low toxicity during the treatment. These advantages and the easy preparation of PMMA@polymer altogether suggest the great potential of PMMA@polymer as an effective treatment of MRSA-infected chronic osteomyelitis. This study opens new avenues in developing antibacterial biomaterials for the treatment of chronic orthopedic infections, frequently caused by drug-resistant bacteria.
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