Neurol Neurochir Pol
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Neurol Neurochir Pol · Nov 2010
Review[Influence of transcranial direct current stimulation on cognitive functioning of patients with brain injury].
Clinical consequences of brain injuries are not simply the result of the initial insult, but also reflect dynamic changes of activity in disrupted neural networks, some of which might be maladaptive. Transcranial direct current stimulation (tDCS), which delivers weak polarizing direct currents to the cortex, is used to modulate cortical excitability. The nature of neuromodulation depends on the stimulation polarity: anodal stimulation increases cortical excitability while cathodal stimulation reduces it. ⋯ In most paradigms tested, excitability-enhancing anodal tDCS proved beneficial to learning and memory processes, attention, and linguistic skills. In this context, tDCS appears to be a promising method to improve cognitive functions in patients with various neurological disorders, including stroke and neurodegenerative diseases. Exposure to brain polarization may help in specific and selective enhancement of adaptive patterns of activity, suppression of non-adaptive activation patterns, and balancing interhemispheric interactions.
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Neurol Neurochir Pol · Sep 2009
Review[Transcranial magnetic stimulation in the therapy of selected post-stroke cognitive deficits: aphasia and visuospatial hemineglect].
Over the last several years functional neuroimaging studies and neurophysiological investigations have provided greater insight into the mechanisms underlying neuroplasticity and recovery after stroke. Various techniques became available for the non-invasive modulation of human brain activity and allowed better rehabilitation programmes to be designed. One of these new techniques is transcranial magnetic stimulation (TMS). ⋯ A growing number of studies consider rTMS as a potential therapeutic technique in neurological disorders. This method can be used as a complementary treatment to conventional therapy based on training of disturbed functions. In this review, we cite studies indicating that sessions of rTMS could improve some of the cognitive symptoms after stroke.
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Neurol Neurochir Pol · Mar 2009
Review[Deep brain stimulation in the surgical management of Tourette syndrome].
Tourette syndrome (TS) is a neuropsychiatric disorder characterized by the presence of vocal and motor tics. Besides tics, patients with TS exhibit a variety of behavioural symptoms, particularly deficit-hyperactivity disorder and obsessive-compulsive disorder. Behavioural therapy is applied in patients with mild forms of TS but it has not been proven to be effective in the long-term follow-up. ⋯ Only a limited number of adult patients require long-term medication. Only those patients who were most severely disabled by tics and concomitant obsessive-compulsive disorder were treated in the past by neuroablative neurosurgical procedures. Nowadays, deep brain stimulation is applied in patients with severe forms of TS because of its safety, adjustability, and efficacy.
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Neurol Neurochir Pol · May 2008
Review Case ReportsNeuroendoscopic third ventriculostomy in the management of noncommunicating hydrocephalus secondary to giant basilar artery bifurcation aneurysm - case report and review of literature.
Recently neuroendoscopic third ventriculostomy has become a well-established procedure for the treatment of noncommunicating hydrocephalus. However, morphological changes of the third ventricular floor can make endoscopic fenestration technically difficult, and increase the risk of injury to the basilar artery and perforators. The risk is especially high in patients with basilar artery bifurcation aneurysms, in whom aneurysm exclusion should precede treatment of hydrocephalus. ⋯ We report upon a case of obstructive hydrocephalus produced by a non-ruptured partially thrombosed giant basilar artery bifurcation aneurysm, in which definitive treatment was considered impossible, successfully treated with neuroendoscopic third ventriculostomy. To the authors' knowledge this is the first reported case of its kind. The authors conclude that in similar cases neuroendoscopic ventriculostomy is worth trying if anatomical landmarks are identifiable.
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The pathogenesis of migraine aura, like migraine, remains unclear. The probable cause of migraine aura may be cortical spreading depression (CSD) and cerebral hypoperfusion. ⋯ The focal symptoms during migraine aura may be due to transient constriction of a cerebral artery and headache can result from a sterile inflammatory reaction around the walls of dilated cranial vessels. The development of aura makes a vascular origin a remote possibility, while a primary disturbance of cortical neuron function, probably CSD and activation of the trigeminovascular system, is a more reasonable explanation.