The Experts below are selected from a list of 42435 Experts worldwide ranked by ideXlab platform
Teresa Jacobson Kimberley - One of the best experts on this subject based on the ideXlab platform.
-
focal hand dystonia individualized intervention with repeated application of repetitive transcranial magnetic stimulation
Archives of Physical Medicine and Rehabilitation, 2015Co-Authors: Teresa Jacobson Kimberley, Rebekah Schmidt, Michael R. Borich, James R Carey, Bernadette T GillickAbstract:Abstract Objectives To examine for individual factors that may predict response to inhibitory repetitive transcranial magnetic stimulation (rTMS) in focal hand dystonia (FHD); to present the method for determining optimal stimulation to increase inhibition in a given patient; and to examine individual responses to prolonged intervention. Design Single-subject design to determine optimal parameters to increase inhibition for a given subject and to use the selected parameters once per week for 6 weeks, with 1-week follow-up, to determine response. Setting Clinical research laboratory. Participants A volunteer sample of subjects with FHD (N=2). One participant had transcranial magnetic stimulation responses indicating impaired inhibition, and the other had responses within normative limits. Interventions There were 1200 pulses of 1-Hz rTMS delivered using 4 different stimulation sites/intensity combinations: primary motor cortex at 90% or 110% of resting motor threshold (RMT) and dorsal premotor cortex (PMd) at 90% or 110% of RMT. The parameters producing the greatest within-session increase in cortical silent period (CSP) duration were then used as the intervention. Main Outcome Measures Response variables included handwriting pressure and velocity, Subjective symptom rating, CSP, and short latency intracortical inhibition and facilitation. Results The individual with baseline transcranial magnetic stimulation responses indicating impaired inhibition responded favorably to the repeated intervention, with reduced handwriting force, an increase in the CSP, and Subjective Report of moderate symptom improvement at 1-week follow-up. The individual with normative baseline responses failed to respond to the intervention. In both subjects, 90% of RMT to the PMd produced the greatest lengthening of the CSP and was used as the intervention. Conclusions An individualized understanding of neurophysiological measures can be an indicator of responsiveness to inhibitory rTMS in focal dystonia, with further work needed to determine likely responders versus nonresponders.
-
multiple sessions of low frequency repetitive transcranial magnetic stimulation in focal hand dystonia clinical and physiological effects
Restorative Neurology and Neuroscience, 2013Co-Authors: Teresa Jacobson Kimberley, Michael R. Borich, Sanjeev Arora, Hartwig R SiebnerAbstract:Purpose: The ability of low-frequency repetitive transcranial magnetic stimulation (rTMS) to enhance intracortical inhibition has motivated its use as a potential therapeutic intervention in focal hand dystonia (FHD). In this preliminary investigation, we assessed the physiologic and behavioral effects of multiple sessions of rTMS in FHD. Methods: 12 patients with FHD underwent five daily-sessions of 1 Hz rTMS to contralateral dorsal premotor cortex (dPMC). Patients held a pencil and made movements that did not elicit dystonic symptoms during rTMS. We hypothesized that an active but non-dystonic motor state would increase beneficial effects of rTMS. Five additional patients received sham-rTMS protocol. The area under curve (AUC) of the motor evoked potentials and the cortical silent period (CSP) were measured to assess changes in corticospinal excitability and intracortical inhibition, respectively. Behavioral measures included pen force and velocity during handwriting and Subjective Report. Results: Multiple-session rTMS strengthened intracortical inhibition causing a prolongation of CSP after 3 days of intervention and pen force was reduced at day 1 and 5, leaving other measures unchanged. 68% of patients self-Reported as ‘responders’ at day 5, and 58% at follow-up. Age predicted responders. Conclusions: A strong therapeutic potential of this rTMS paradigm in FHD was not supported but findings warrant further investigation.
Bernadette T Gillick - One of the best experts on this subject based on the ideXlab platform.
-
focal hand dystonia individualized intervention with repeated application of repetitive transcranial magnetic stimulation
Archives of Physical Medicine and Rehabilitation, 2015Co-Authors: Teresa Jacobson Kimberley, Rebekah Schmidt, Michael R. Borich, James R Carey, Bernadette T GillickAbstract:Abstract Objectives To examine for individual factors that may predict response to inhibitory repetitive transcranial magnetic stimulation (rTMS) in focal hand dystonia (FHD); to present the method for determining optimal stimulation to increase inhibition in a given patient; and to examine individual responses to prolonged intervention. Design Single-subject design to determine optimal parameters to increase inhibition for a given subject and to use the selected parameters once per week for 6 weeks, with 1-week follow-up, to determine response. Setting Clinical research laboratory. Participants A volunteer sample of subjects with FHD (N=2). One participant had transcranial magnetic stimulation responses indicating impaired inhibition, and the other had responses within normative limits. Interventions There were 1200 pulses of 1-Hz rTMS delivered using 4 different stimulation sites/intensity combinations: primary motor cortex at 90% or 110% of resting motor threshold (RMT) and dorsal premotor cortex (PMd) at 90% or 110% of RMT. The parameters producing the greatest within-session increase in cortical silent period (CSP) duration were then used as the intervention. Main Outcome Measures Response variables included handwriting pressure and velocity, Subjective symptom rating, CSP, and short latency intracortical inhibition and facilitation. Results The individual with baseline transcranial magnetic stimulation responses indicating impaired inhibition responded favorably to the repeated intervention, with reduced handwriting force, an increase in the CSP, and Subjective Report of moderate symptom improvement at 1-week follow-up. The individual with normative baseline responses failed to respond to the intervention. In both subjects, 90% of RMT to the PMd produced the greatest lengthening of the CSP and was used as the intervention. Conclusions An individualized understanding of neurophysiological measures can be an indicator of responsiveness to inhibitory rTMS in focal dystonia, with further work needed to determine likely responders versus nonresponders.
Michael R. Borich - One of the best experts on this subject based on the ideXlab platform.
-
focal hand dystonia individualized intervention with repeated application of repetitive transcranial magnetic stimulation
Archives of Physical Medicine and Rehabilitation, 2015Co-Authors: Teresa Jacobson Kimberley, Rebekah Schmidt, Michael R. Borich, James R Carey, Bernadette T GillickAbstract:Abstract Objectives To examine for individual factors that may predict response to inhibitory repetitive transcranial magnetic stimulation (rTMS) in focal hand dystonia (FHD); to present the method for determining optimal stimulation to increase inhibition in a given patient; and to examine individual responses to prolonged intervention. Design Single-subject design to determine optimal parameters to increase inhibition for a given subject and to use the selected parameters once per week for 6 weeks, with 1-week follow-up, to determine response. Setting Clinical research laboratory. Participants A volunteer sample of subjects with FHD (N=2). One participant had transcranial magnetic stimulation responses indicating impaired inhibition, and the other had responses within normative limits. Interventions There were 1200 pulses of 1-Hz rTMS delivered using 4 different stimulation sites/intensity combinations: primary motor cortex at 90% or 110% of resting motor threshold (RMT) and dorsal premotor cortex (PMd) at 90% or 110% of RMT. The parameters producing the greatest within-session increase in cortical silent period (CSP) duration were then used as the intervention. Main Outcome Measures Response variables included handwriting pressure and velocity, Subjective symptom rating, CSP, and short latency intracortical inhibition and facilitation. Results The individual with baseline transcranial magnetic stimulation responses indicating impaired inhibition responded favorably to the repeated intervention, with reduced handwriting force, an increase in the CSP, and Subjective Report of moderate symptom improvement at 1-week follow-up. The individual with normative baseline responses failed to respond to the intervention. In both subjects, 90% of RMT to the PMd produced the greatest lengthening of the CSP and was used as the intervention. Conclusions An individualized understanding of neurophysiological measures can be an indicator of responsiveness to inhibitory rTMS in focal dystonia, with further work needed to determine likely responders versus nonresponders.
-
multiple sessions of low frequency repetitive transcranial magnetic stimulation in focal hand dystonia clinical and physiological effects
Restorative Neurology and Neuroscience, 2013Co-Authors: Teresa Jacobson Kimberley, Michael R. Borich, Sanjeev Arora, Hartwig R SiebnerAbstract:Purpose: The ability of low-frequency repetitive transcranial magnetic stimulation (rTMS) to enhance intracortical inhibition has motivated its use as a potential therapeutic intervention in focal hand dystonia (FHD). In this preliminary investigation, we assessed the physiologic and behavioral effects of multiple sessions of rTMS in FHD. Methods: 12 patients with FHD underwent five daily-sessions of 1 Hz rTMS to contralateral dorsal premotor cortex (dPMC). Patients held a pencil and made movements that did not elicit dystonic symptoms during rTMS. We hypothesized that an active but non-dystonic motor state would increase beneficial effects of rTMS. Five additional patients received sham-rTMS protocol. The area under curve (AUC) of the motor evoked potentials and the cortical silent period (CSP) were measured to assess changes in corticospinal excitability and intracortical inhibition, respectively. Behavioral measures included pen force and velocity during handwriting and Subjective Report. Results: Multiple-session rTMS strengthened intracortical inhibition causing a prolongation of CSP after 3 days of intervention and pen force was reduced at day 1 and 5, leaving other measures unchanged. 68% of patients self-Reported as ‘responders’ at day 5, and 58% at follow-up. Age predicted responders. Conclusions: A strong therapeutic potential of this rTMS paradigm in FHD was not supported but findings warrant further investigation.
Michael M Myers - One of the best experts on this subject based on the ideXlab platform.
-
Subjective and objective measures of parent child relationship dysfunction child separation distress and joint attention
Psychiatry MMC, 2010Co-Authors: Daniel S Schechter, Erica Willheim, Claudia Hinojosa, Kimberly Scholfieldkleinman, Blake J Turner, Jaime Mccaw, Charles H Zeanah, Michael M MyersAbstract:The literature suggests an adverse impact of maternal stress related to interpersonal violence on parent-child interaction. The current study investigated associations between a mother's self-Reported parent-child relationship dysfunction and what she does in response to her child's cues. It also examined whether maternal perception of parent-child dysfunctional interaction and child behavior when stressed by separation, along with maternal behavior in response to child distress, predicted impaired joint attention (JA) during play. Participant mothers (n = 74) and their children ages 12–48 months were recruited from community pediatrics clinics and completed two videotaped visits. After correlations, multiple linear regression was applied to find the best model fit that would predict outcomes of interest. We found that both maternal Subjective Report of self-Reported parent-child relationship dysfunction and observed child separation distress together predicted atypical maternal behavior. Self-Reported pa...
-
Subjective and objective measures of parent child relationship dysfunction child separation distress and joint attention
Psychiatry MMC, 2010Co-Authors: Daniel S Schechter, Erica Willheim, Claudia Hinojosa, Kimberly Scholfieldkleinman, Blake J Turner, Jaime Mccaw, Charles H Zeanah, Michael M MyersAbstract:The literature suggests an adverse impact of maternal stress related to interpersonal violence on parent-child interaction. The current study investigated associations between a mother's self-Reported parent-child relationship dysfunction and what she does in response to her child's cues. It also examined whether maternal perception of parent-child dysfunctional interaction and child behavior when stressed by separation, along with maternal behavior in response to child distress, predicted impaired joint attention (JA) during play. Participant mothers (n = 74) and their children ages 12-48 months were recruited from community pediatrics clinics and completed two videotaped visits. After correlations, multiple linear regression was applied to find the best model fit that would predict outcomes of interest. We found that both maternal Subjective Report of self-Reported parent-child relationship dysfunction and observed child separation distress together predicted atypical maternal behavior. Self-Reported parent-child relationship dysfunction, observed atypical maternal behavior, and child separation distress combined significantly predicted less time spent in joint attention during play. Maternal posttraumatic stress predicted less maternal availability after separation stress. Clinicians should thus carefully assess and listen to parents' communication of disturbances in their relationship with their young child. Left untreated, parent-child relationship dysfunction may well lead to impairment in learning and social-emotional development.
Hartwig R Siebner - One of the best experts on this subject based on the ideXlab platform.
-
multiple sessions of low frequency repetitive transcranial magnetic stimulation in focal hand dystonia clinical and physiological effects
Restorative Neurology and Neuroscience, 2013Co-Authors: Teresa Jacobson Kimberley, Michael R. Borich, Sanjeev Arora, Hartwig R SiebnerAbstract:Purpose: The ability of low-frequency repetitive transcranial magnetic stimulation (rTMS) to enhance intracortical inhibition has motivated its use as a potential therapeutic intervention in focal hand dystonia (FHD). In this preliminary investigation, we assessed the physiologic and behavioral effects of multiple sessions of rTMS in FHD. Methods: 12 patients with FHD underwent five daily-sessions of 1 Hz rTMS to contralateral dorsal premotor cortex (dPMC). Patients held a pencil and made movements that did not elicit dystonic symptoms during rTMS. We hypothesized that an active but non-dystonic motor state would increase beneficial effects of rTMS. Five additional patients received sham-rTMS protocol. The area under curve (AUC) of the motor evoked potentials and the cortical silent period (CSP) were measured to assess changes in corticospinal excitability and intracortical inhibition, respectively. Behavioral measures included pen force and velocity during handwriting and Subjective Report. Results: Multiple-session rTMS strengthened intracortical inhibition causing a prolongation of CSP after 3 days of intervention and pen force was reduced at day 1 and 5, leaving other measures unchanged. 68% of patients self-Reported as ‘responders’ at day 5, and 58% at follow-up. Age predicted responders. Conclusions: A strong therapeutic potential of this rTMS paradigm in FHD was not supported but findings warrant further investigation.
