Effect of Transcranial Direct Current Stimulation Combined With Virtual Reality Training on Balance in Children With Cerebral Palsy: A Randomized,Controlled, Double-Blind,Clinical Trial

The authors' aim was to investigate the effects of continuous transcranial direct current stimulation (tDCS) combined with virtual reality training on static and functional balance in children with cerebral palsy (CP). Twenty children with CP (6 girls and 14 boys; M age = 7 years 6 months ± 2 years) were randomly allocated to two groups. The experimental group received active tDCS and the control group received sham stimulation during the 10 sessions of virtual reality mobility training protocols. The children were evaluated on 3 occasions (preintervention, postintervention, and 1-month follow-up). Static balance was evaluated using a force plate under 4 conditions: feet on force plate with (a) eyes open and (b) with eyes closed, and feet on foam mat with (c) eyes open and (d) with eyes closed. Functional balance was evaluated using the Pediatric Balance Scale and the Timed Up and Go Test. The analyses demonstrated statistically significant postintervention and follow-up effects favoring the experimental group over the control group with regard to the Pediatric Balance Scale, Timed Up and Go Test, and area of oscillation of the center of pressure when standing on the force plate with eyes open. The present findings suggest that tDCS can potentiate the effects of virtual reality training on static and functional balance among children with CP.     

自体血清对腰背肌损伤修复作用的动物实验研究

研究自体血清局部注射对腰背肌损伤的治疗效果。建立动物模型,分组对照研究。共将实验动物分为四组,通过手术造成小鼠腰背部肌肉损伤。之后,在损伤的局部注射生理盐水,或原浓度的自体血清、二倍浓缩的自体血清、四倍浓缩的自体血清。在术后第2、4、7日分别测得各组小鼠腰背肌肌力,求四组小鼠腰背肌肌力的平均值及标准差,比较组内及组间的差异。最后,对实验结果进行了综合分析和讨论。自体血清局部注射处理的小鼠,肌力恢复更加明显,愈合后肌力明显增强,术后第7日各组肌力平均值具有显著性差异,以生理盐水注射组为对照组,原浓度血清组、二倍浓缩组、四倍浓缩组平均腰背肌力均高于对照组。动物模型验证了自体血清局部注射疗法在腰背肌损伤的动物模型中是有效的,可以促进腰背肌损伤的修复和愈合。     

非肝病治疗药物导致慢性乙型肝炎病毒携带者肝损害现状分析

随着药物种类的增多,药物性肝病的发病率亦增加。由于乙型肝炎病毒携带者肝组织已存在不同程度的损害,比非乙型肝炎病毒感染者更容易发生药物性肝炎。因此,非肝病治疗药物导致慢性乙型肝炎病毒携带者肝损害应引起高度重视。     

Factors Influencing Parental Use of Booster Seats for Their Children

Given that injuries sustained in motor vehicle crashes are the primary health threat to children today and children between the ages of four and eight years are the most susceptible to injury because they are the least likely to be restrained appropriately, the purpose of this study was to examine the factors associated with booster seat use using the Theory of Planned Behavior as a model. Results demonstrated that intention to use booster seats significantly predicted self-reported use of booster seats, and attitudes, but not subjective norms or perceived control, predicted the intention to use booster seats. The present study was an initial attempt to add to a limited body of research in the area of child passenger safety. Further research is needed in order to gain a deeper understanding of the factors associated with booster seat use in order to reduce injury in this vulnerable age group.     

The Impact of Motor Activity and Inactivity on the Brain: Implications for the Prevention and Treatment of Nervous- System Disorders

ABSTRACT— Since Donald Hebb's pioneering observations in the 1940s, much research has focused on the effects of variations in physical activity and environmental complexity on behavioral performance and brain structure. Beneficial effects on brain health have been linked to physical fitness, skilled training, and exposure to complex environments, though in rodents these effects may be negated by sudden changes in social structure. Such manipulations can alleviate the deficits associated with several nervous-system disorders and aging. But how increased activity produces its beneficial effects is still not fully understood. How does unskilled physical activity (e.g., repetitive exercise) compare to training in skilled activities or exposure to complex environments? In injury states, is task-specific training a better rehabilitative strategy than general exercise? How do changes in motor activity affect specific brain regions, and can the intensity and timing of therapeutic movement be adjusted to produce optimal outcomes? Are the beneficial effects of motor enrichment banked over periods of inactivity and can they be called upon with booster training to treat a later neurological disorder? Are there circumstances in which increased activity is harmful? Enrichment of physical activity shows promise as an easy and healthful means for improving or restoring brain function, and questions like these are now being investigated so that the full potential of increased activity may be harnessed.     

Immoral behaviour following brain damage: A review

Despite the apparent sociability of human kind, immoral behaviour is ever present in society. The term ‘immoral behaviour’ represents a complex array of conduct, ranging from insensitivity to topics of conversation through to violent assault and murder. To better understand the neuroscience of immoral behaviour, this review investigates two clinical populations that commonly present with changes in moral behaviour – behavioural-variant frontotemporal dementia and acquired brain injuries. Based on evidence from these groups, it is argued that rather than a single underlying cause, immoral behaviour can result from three distinct types of cognitive failure: (1) problems understanding others; (2) difficulties controlling behaviour; or (3) deficits in the capacity to make appropriate emotional contributions. Each of these failures is associated with damage to different brain regions. A more nuanced approach to the neuroscience of immoral behaviour has important implications for our understanding of immoral behaviour in a wide range of clinical groups, as well as human society more broadly.     

Evaluating anxiety and depression symptoms in children and adolescents with prior mild traumatic brain injury: Agreement between methods and respondents

Psychological functioning can be adversely impacted after a mild traumatic brain injury (mTBI) and may be a potential target for intervention. Despite the use of symptom ratings or structured diagnostic interview to assess long-term anxiety and depression symptoms in children and adolescents post-injury, no known studies have considered the agreement between different assessment methods and between respondents. The objectives of this study were to investigate the agreement between symptom ratings and structured diagnostic interview and between children and parents’ symptom reporting. Participants (N = 33; 9–18 years old) were recruited from the Emergency Department and assessed on average 22.8 months (SD = 5.6) after their mTBI. Anxiety and depression symptoms were evaluated via subscales of a questionnaire (Behavior Assessment System for Children) and parts of a computerized structured diagnostic interview (generalized anxiety disorder and major depressive episode; Diagnostic Interview Schedule for Children – C-DISC-IV) administered individually to children and their parents. Results showed that the inter-method agreement to identify high levels of anxiety and depression was moderate to perfect in children while it was lower in parents. Although a similar percentage of participants with elevated anxiety or depression were identified by both children and parents, the agreement between youth and parents was variable, ranging from poor to good for anxiety and poor to moderate for depression. These results highlight the importance of collecting youth and parents’ reports of anxiety and depression symptoms and considering potential discrepancies between informants’ answers.     

Processing speed in children treated for brain tumors: effects of radiation therapy and age

The current study examined processing speed in children two years post-treatment for brain tumors (BT) with radiation therapy (RT) compared to those treated with without RT. Participants included 59 children (4–17 years) with BT assessed as part of the Brain Radiation Investigative Study Consortium (BRISC). Processing speed was assessed at two time points: Time1 (3–9 months post-surgery) for 26 children who received whole brain or focal RT (RT group) and 33 treated without RT (no-RT group), and again two years later (Time2) for 42 participants (17 RT, 25 no-RT). Linear mixed effects (LME) regression analyses examined differences in cognitive and motor speed between groups and across visits, with age at Time1 (age1) treated as a moderating variable, and sex and primary tumor size as covariates. No effects for treatment group or visit were found for motor speed (Pegboard) or mean reaction time (Attention Network Task). On the Wechsler Processing Speed Index (PSI), the no-RT group performed better than the RT group, with a group-by-age interaction such that across visits, the difference between the no-RT and RT groups was larger among children who were older at initial treatment (≥10 years) than among those who were younger (<10 years). Cumulative brain injury earlier in life (tumor, surgery, plus RT) may result in greater impact on more complex tasks of cognitive efficiency. Children receiving RT showed reduced processing speed over time, with a larger group difference among those who were over 10 years at treatment.     

An Intensive Outpatient Program for Veterans With Posttraumatic Stress Disorder and Traumatic Brain Injury

Post-9/11 service members may return from military service with a complicated set of symptoms and conditions, such as posttraumatic stress disorder (PTSD), depression, substance misuse, and traumatic brain injury (TBI), that interfere with reintegration and impair functioning. Although evidence-based treatments that facilitate recovery exist, their successful delivery at a sufficient dose is limited. Barriers to accessing treatment combined with challenges compiling a comprehensive treatment team further delay delivery of effective evidence-based care for PTSD, TBI, and co-occurring mental health conditions. This paper describes the development of a comprehensive, multidisciplinary, 2-week intensive day program for post-9/11 veterans with complex mental health concerns. The treatment program combines skill building groups, family education, and integrative health approaches with evidence-based individual PTSD or TBI care. Initial results from the first 132 participants were notable for a 97% completion rate, as well as statistically significant and clinically meaningful reductions in PTSD, neurobehavioral, and depression symptom severity for the 107 veterans who completed the PTSD track and the 21 who completed the TBI track. These data suggest the intensive program approach is an effective, well-tolerated model of treatment for post-9/11 veterans with PTSD and/or TBI. Future controlled studies should examine the effectiveness of this intensive model compared to standard evidence-based therapy delivery, as well as longitudinal outcomes.