Diffuse axonal injury (DAI) following sudden acceleration and deceleration can lead to cognitive function decline. Various treatments have been proposed. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive stimulation technique, is a potential treatment for enhancing neuroplasticity in cases of brain injury. The therapeutic efficacy of rTMS on cognitive function remains unconfirmed. This study investigated the effects of rTMS and the underlying molecular biomechanisms using a rat model of DAI. Sprague–Dawley rats (n = 18) were randomly divided into two groups: one receiving rTMS after DAI and the other without brain stimulation. All rats were subjected to sudden acceleration and deceleration using a DAI modeling machine to induce damage. MRI was performed to confirm the DAI lesion. The experimental group received rTMS at a frequency of 1 Hz over the frontal cortex for 10 min daily for five days. To assess spatial memory, we conducted the Morris water maze (MWM) test one day post-brain damage and one day after the five-day intervention. A video tracking system recorded the escape latency. After post-MWM tests, all rats were euthanized, and their brain tissues, particularly from the hippocampus, were collected for immunohistochemistry and western blot analyses. The escape latency showed no difference on the MWM test after DAI, but a significant difference was observed after rTMS between the two groups. Immunohistochemistry and western blot analyses indicated increased expression of BDNF, VEGF, and MAP2 in the hippocampal brain tissue of the DAI-T group. In conclusion, rTMS improved cognitive function in the DAI rat model. The increased expression of BDNF, VEGF, and MAP2 in the DAI-T group supports the potential use of rTMS in treating cognitive impairments associated with DAI.

Background:Post-stroke gait dysfunction may involve impaired integration of motor commands, somatosensory feedback, and phase-dependent peripheral sensory input during locomotion. Transcutaneous electrical nerve stimulation (TENS) combined with gait training may provide additional sensory input, but the relevance of different temporal stimulation profiles remains unclear.Objective:To evaluate the feasibility, safety, and preliminary clinical signals of continuous and gait-synchronized TENS during gait training in individuals with chronic stroke.Methods:Twenty-four participants with chronic stroke were randomized to continuous stimulation (CS), gait-synchronized stimulation (GS), or sham stimulation during standardized gait training. Participants received 12 intervention sessions over 4 weeks. CS delivered non-phase-specific stimulation, whereas GS delivered stimulation according to stance and swing phases. Outcomes were assessed at baseline, post-intervention, and 8-week follow-up. The primary longitudinal analysis was conducted in the modified intention-to-treat (mITT) population using baseline-adjusted linear mixed-effects models, with false discovery rate correction applied to group × time interaction p-values across estimable outcomes.Results:One participant withdrew before intervention without baseline assessment; therefore, 23 participants were included in the mITT analysis. Intervention adherence was high, with 99% of scheduled sessions completed, and no intervention-related adverse events were reported. Comfortable gait speed showed no significant group × time interaction. Maximal gait speed and Berg Balance Scale showed nominal group × time interaction effects before correction, but these did not remain significant after false discovery rate correction. No robust group × time interaction effects were observed after correction. Exploratory per-protocol analyses were unadjusted for baseline imbalance and were interpreted as supportive only.Conclusions:Continuous and gait-synchronized TENS combined with standardized gait training were feasible and well tolerated in individuals with chronic stroke. The adjusted analysis did not provide robust evidence of differential clinical effects among stimulation-timing groups after correction for multiple outcome testing. Larger, adequately powered trials are needed to determine whether continuous or gait-synchronized TENS provides clinically meaningful benefits during post-stroke gait rehabilitation.Clinical Trial Registration:No: KCT0008481. Registered 17 May, 2023, https://cris.nih.go.kr/cris/search/detailSearch.do?seq=24719&search_page=L.

This study focuses on numerical modeling of thoracic aortic hemodynamics in patients with coarctation, a congenital narrowing of the vessel lumen that impairs blood flow and increases hemodynamic load. The aim of the study was to identify the influence of geometric changes in the aorta on the distribution of velocity, pressure, and shear stress using computational fluid dynamics (CFD) methods. The mathematical model is based on the Navier-Stokes equations for an incompressible non-Newtonian fluid, which describes the rheological properties of blood. Calculations were performed using the finite volume method with an explicit time-dependent scheme for two geometric configurations—normal and pathological. Analysis of the resulting velocity and pressure fields revealed that with coarctation, the maximum velocity increases by approximately 1.6 times, and the pressure difference between the ascending and descending aorta reaches 0.6 kPa. The shear stress distribution revealed localized areas of extreme values that potentially contribute to endothelial dysfunction. This study contributes to the development of personalized blood flow modeling and demonstrates the potential of CFD methods for assessing hemodynamic disturbances in vascular pathologies, which has practical implications for preliminary diagnosis and treatment planning. Keywords: hemodynamics, coarctation of the aorta, computational fluid dynamics, CFD, numerical modeling.