Yoon-Ghil Park

Functional recovery following traumatic vs non-traumatic brain injury: a case-controlled study.

Primary objective: To explore differences in rate of recovery and functional outcome in case-matched patients with traumatic (TBI) vs non-traumatic brain injury (non-TBI) during inpatient rehabilitation and 1 year post-insult. Research design: Retrospective comparison study and case-controlled design. Methods and procedures: Demographic data, severity of injury, functional outcome measures and outcomes at 1 year follow-up were collected on 573 patients (404 TBI; 169 non-TBI) admitted to a multidisciplinary neurorehabilitation programme. After general cohort comparisons, 86 TBI and 86 non-TBI patients were matched on age, severity of injury and functional outcome scores. Main outcomes and results: In the general cohort analyses, TBI patients demonstrated better outcomes at discharge as indicated by lower Disability Rating Scale (DRS) scores and higher gain and efficiency scores on both motor and cognitive sub-scales of the Functional Independence Measure (FIM). After matching patients, TBI patients showed greater functional improvement throughout their rehabilitation stay. Outcomes at 1 year follow-up were mixed; TBI patients showed better outcomes compared to non-TBI patients on DRS scores; however, FIM scores were not significantly different. Conclusions: Results from the present study support the hypothesis that TBI patients achieve greater functional improvements compared to non-TBI patients when matched according to injury and demographic characteristics.

Anterior pituitary dysfunction in moderate-to-severe chronic traumatic brain injury patients and the influence on functional outcome

Objective: The objective of this study is to determine the prevalence of anterior pituitary dysfunction in moderate-to-severe chronic traumatic brain injury (TBI) patients. The investigation of a relationship between pituitary hormonal status and body mass index (BMI) in TBI patients by observing changes in BMI was conducted as well as an assessment of whether there is a difference in functional outcome related to anterior pituitary dysfunction in TBI patients. Methods: Forty-five TBI patients and 30 normal controls underwent a series of standard endocrine tests for anterior pituitary hormone function. It was studied whether changes in BMI correlated with anterior pituitary hormone levels. This study also compared changes in mini-mental state examination (K-MMSE) and functional independence measure (FIM) scores between patients in the hormone-sufficient and -deficient groups. Results: Anterior pituitary dysfunction was found in 31.1% of TBI patients. Changes in BMI statistically correlated with IGF-1 and basal cortisol levels. A meaningful difference was found between the hormone-sufficient and -deficient groups in light of the K-MMSE and FIM score gains. Conclusions: These findings strongly suggest that patients who suffer head trauma should be routinely tested for anterior pituitary hormone deficiency.

Effects of constraint-induced movement therapy on neurogenesis and functional recovery after early hypoxic-ischemic injury in mice

Aimu2002 Constraint‐induced movement therapy (CIMT) has emerged as a promising therapeutic strategy for improving affected upper limb function in children with hemiplegic cerebral palsy (CP). However, little is known about the changes in the brain that are induced by CIMT. This study was designed to investigate these changes and behavioural performance after CIMT intervention in mice with neonatal hypoxic‐ischemic brain injury.

P35.18 Sympathetic skin response at big toe in diabetic polyneuropathy

Objectives: The aim of this study was to determine whether the sympathetic skin response (SSR) recorded from the big toe is more effective than standard SSR recorded from the sole for the detection of sudomotor fiber dysfunction in diabetic neuropathy. Methods: We recorded big toe SSR (SSRBT) and plantar SSR (SSRP) in 23 diabetic patients and 30 age-matched normal controls. For SSRP, surface electrodes were attached to the sole (G1) and dorsum of foot (G2) and for SSRBT, surface electrodes were attached to the toe-tip (distal phalanx, G1) and to the dorsum of the proximal phalanx of the big toe (G2). Peak to peak SSR amplitudes were measured and the response with largest amplitudes were selected. A deep inspiration was used as stimulus. Results: With regard to controls, SSRP amplitude was not reduced. In contrast, SSRBT amplitude was reduced in patient group (p<0.0001). In 5 patients, SSRBT was not recordable while SSRP still persisted. Conclusion: Our results suggest that SSRBT is more effective test than SSRP in detecting distal sudomotor failure in patients with diabetic neuropathy.

P32.4 Establishment of turns-amplitude cloud of normal adolescents

Correlations were found between the hemiparetic side parameter values and time after stroke onset and hemiparetic severity. Conclusion: Collateral reinnervation occurs after ischaemic stroke and results in the increase of the total electrical size of the active motor unit and in abnormal motor unit organization. Our data confirm the controversial concept about lower motor neuron injury with stroke.