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Takatoshi Hara
Parkwood Institute Research, Parkwood Institute, London, ON N6C 0A7, Canada

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Review
Published: 31 March 2021 in Diagnostics
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In recent years, the potential of non-invasive brain stimulation (NIBS) for therapeutic effects on cognitive functions has been explored for populations with traumatic brain injury (TBI). However, there is no systematic NIBS review of TBI cognitive impairment with a focus on stimulation sites and stimulation parameters. The purpose of this study was to conduct a systematic review examining the effectiveness and safety of NIBS for cognitive impairment after a TBI. This study was prospectively registered with the PROSPERO database of systematic reviews (CRD42020183298). All English articles from the following databases were searched from inception up to 31 December 2020: Pubmed/MEDLINE, Scopus, CINAHL, Embase, PsycINFO and CENTRAL. Randomized and prospective controlled trials, including cross-over studies, were included for analysis. Studies with at least five individuals with TBI, whereby at least five sessions of NIBS were provided and used standardized neuropsychological measurement of cognition, were included. A total of five studies met eligibility criteria. Two studies used repetitive transcranial magnetic stimulation (rTMS) and three studies used transcranial direct current stimulation (tDCS). The pooled sample size was 44 individuals for rTMS and 91 for tDCS. Three of five studies combined cognitive training or additional therapy (computer assisted) with NIBS. Regarding rTMS, target symptoms included attention (n = 2), memory (n = 1), and executive function (n = 2); only one study showing significant improvement compared than control group with respect to attention. In tDCS studies, target symptoms included cognition (n = 2), attention (n = 3), memory (n = 3), working memory (WM) (n = 3), and executive function (n = 1); two of three studies showed significant improvement compared to the control group with respect to attention and memory. The evidence for NIBS effectiveness in rehabilitation of cognitive function in TBI is still in its infancy, more studies are needed. In all studies, dorsolateral prefrontal cortex (DLPFC) was selected as the stimulation site, along with the stimulation pattern promoting the activation of the left DLPFC. In some studies, there was a significant improvement compared to the control group, but neither rTMS nor tDCS had sufficient evidence of effectiveness. To the establishment of evidence we need the evaluation of brain activity at the stimulation site and related areas using neuroimaging on how NIBS acts on the neural network.

ACS Style

Takatoshi Hara; Aturan Shanmugalingam; Amanda McIntyre; Amer Burhan. The Effect of Non-Invasive Brain Stimulation (NIBS) on Executive Functioning, Attention and Memory in Rehabilitation Patients with Traumatic Brain Injury: A Systematic Review. Diagnostics 2021, 11, 627 .

AMA Style

Takatoshi Hara, Aturan Shanmugalingam, Amanda McIntyre, Amer Burhan. The Effect of Non-Invasive Brain Stimulation (NIBS) on Executive Functioning, Attention and Memory in Rehabilitation Patients with Traumatic Brain Injury: A Systematic Review. Diagnostics. 2021; 11 (4):627.

Chicago/Turabian Style

Takatoshi Hara; Aturan Shanmugalingam; Amanda McIntyre; Amer Burhan. 2021. "The Effect of Non-Invasive Brain Stimulation (NIBS) on Executive Functioning, Attention and Memory in Rehabilitation Patients with Traumatic Brain Injury: A Systematic Review." Diagnostics 11, no. 4: 627.

Review
Published: 03 February 2021 in Diagnostics
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Background: In recent years, the potential of non-invasive brain stimulation (NIBS) for therapeutic effects on cognitive functions has been explored for populations with stroke. There are various NIBS methods depending on the stimulation site and stimulation parameters. However, there is no systematic NIBS review of post-stroke cognitive impairment with a focus on stimulation sites and stimulation parameters. The purpose of this study is to conduct a systematic review and meta-analysis on effectiveness and safety of NIBS for cognitive impairment after a stroke to obtain new insights. This study was prospectively registered with the PROSPERO database of systematic reviews (CRD42020183298). Methods: All English articles from MEDLINE, Scopus, CINAHL, Embase, PsycINFO, and CENTRAL were searched from inception up to 31 December 2020. Randomized and prospective controlled trials were included for the analysis. Studies with at least five individuals post-stroke, whereby at least five sessions of NIBS were provided and using standardized neuropsychological measurement of cognition, were included. We assessed the methodological quality of selected studies as described in the Physiotherapy Evidence Database (PEDro) scoring system. Results: A total of 10 studies met eligibility criteria. Six studies used repetitive transcranial magnetic stimulation (rTMS) and four studies used transcranial direct current stimulation (tDCS). The pooled sample size was 221 and 196 individuals who received rTMS and tDCS respectively. Eight studies combined general rehabilitation, cognitive training, or additional therapy with NIBS. In rTMS studies, target symptoms included global cognition (n = 4), attention (n = 3), memory (n = 4), working memory (WM) (n = 3), and executive function (n = 2). Five studies selected the left dorsolateral prefrontal cortex (DPLFC) as the stimulation target. One rTMS study selected the right DLPFC as the inhibitory stimulation target. Four of six studies showed significant improvement. In tDCS studies, target symptoms included global cognition (n = 2), attention (n = 4), memory (n = 2) and WM (n = 2). Three studies selected the frontal area as the stimulation target. All studies showed significant improvement. In the meta-analysis, rTMS showed a significant effect on attention, memory, WM and global cognition classified by neuropsychological tests. On the other hand, tDCS had no significant effect. Conclusions: In post-stroke patients with deficits in cognitive function, including attention, memory, and WM, NIBS shows promising positive effects. However, this effect is limited, suggesting that further studies are needed with more precision in stimulation sites and stimulation parameters. Future studies using advanced neurophysiological and neuroimaging tools to allow for a network-based approach to treat cognitive symptoms post-stroke with NIBS are warranted.

ACS Style

Takatoshi Hara; Aturan Shanmugalingam; Amanda McIntyre; Amer Burhan. The Effect of Non-Invasive Brain Stimulation (NIBS) on Attention and Memory Function in Stroke Rehabilitation Patients: A Systematic Review and Meta-Analysis. Diagnostics 2021, 11, 227 .

AMA Style

Takatoshi Hara, Aturan Shanmugalingam, Amanda McIntyre, Amer Burhan. The Effect of Non-Invasive Brain Stimulation (NIBS) on Attention and Memory Function in Stroke Rehabilitation Patients: A Systematic Review and Meta-Analysis. Diagnostics. 2021; 11 (2):227.

Chicago/Turabian Style

Takatoshi Hara; Aturan Shanmugalingam; Amanda McIntyre; Amer Burhan. 2021. "The Effect of Non-Invasive Brain Stimulation (NIBS) on Attention and Memory Function in Stroke Rehabilitation Patients: A Systematic Review and Meta-Analysis." Diagnostics 11, no. 2: 227.

Review
Published: 08 March 2020
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BackgroundIn recent years, the potential of non-invasive brain stimulation (NIBS) for therapeutic effects on cognitive functions has been explored for stroke and traumatic brain injury (TBI) populations.MethodsAll English articles from the following sources were searched from inception up to December 31, 2018: PubMed, Scopus, CINAHL, Embase, PsycINFO and CENTRAL. Randomized and prospective controlled trials, including cross-over studies, were included for analysis. Studies with at least five individuals post stroke or TBI, whereby at least five sessions of NIBS were provided and used standardized neuropsychological measurement of cognition, were included.ResultsA total of 17 studies met eligibility criteria which included 546 patients receiving either repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS). Sample sizes ranged 5-25 subjects per group. Seven studies used rTMS and ten studies used tDCS. Target symptoms included global cognition (n=8), memory (n=1), attention (n=1), and unilateral spatial neglect (USN) (n=7). Nine studies combined rehabilitation or additional therapy with NIBS. Six of ten studies showed significant improvement in attention, memory, working memory, and executive function. In the USN study, five of the seven studies had a significant improvement in the intervention group.ConclusionsThe effect of NIBS on executive functions including attention and memory post stroke or TBI yielded mixed results with variable stimulation parameters. A significant, consistent improvement was observed for USN post stroke or TBI. Future studies using advanced neurophysiological and neuroimaging tools to allow network-based approach to NIBS for cognitive symptoms post stroke or TBI are warranted.

ACS Style

Takatoshi Hara; Aturan Shanmugalingam; Amanda McIntyre; Amer M. Burhan. A Systematic Review of effect of Non-Invasive Brain Stimulation on Cognition Impairment after a Stroke and Traumatic Brain Injury. 2020, 1 .

AMA Style

Takatoshi Hara, Aturan Shanmugalingam, Amanda McIntyre, Amer M. Burhan. A Systematic Review of effect of Non-Invasive Brain Stimulation on Cognition Impairment after a Stroke and Traumatic Brain Injury. . 2020; ():1.

Chicago/Turabian Style

Takatoshi Hara; Aturan Shanmugalingam; Amanda McIntyre; Amer M. Burhan. 2020. "A Systematic Review of effect of Non-Invasive Brain Stimulation on Cognition Impairment after a Stroke and Traumatic Brain Injury." , no. : 1.

Review
Published: 05 December 2019 in Toxins
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Aim: The purpose of this study was to examine the effectiveness of botulinum toxin A (BoNT-A) therapy combined with rehabilitation on motor function in post-stroke patients. Methods: The following sources up to December 31, 2018, were searched from inception for articles in English: Pubmed, Scopus, CINAHL, Embase, PsycINFO, and CENTRAL. Trials using injections of BoNT-A for upper and lower limb rehabilitation were examined. We excluded studies that were not performed for rehabilitation or were not evaluated for motor function. Results: Twenty-six studies were included. In addition to rehabilitation, nine studies used adjuvant treatment to improve spasticity or improve motor function. In the upper limbs, two of 14 articles indicated that significant improvement in upper limb motor function was observed compared to the control group. In the lower limbs, seven of 14 articles indicated that significant improvement in lower limb motor function was observed compared to the control group. Conclusions: The effect of combined with rehabilitation is limited after stroke, and there is not sufficient evidence, but results suggest that BoNT-A may help to improve motor function. In future studies, the establishment of optimal rehabilitation and evaluation times of BoNT-A treatment will be necessary for improving motor function and spasticity.

ACS Style

Takatoshi Hara; Ryo Momosaki; Masachika Niimi; Naoki Yamada; Hiroyoshi Hara; Masahiro Abo. Botulinum Toxin Therapy Combined with Rehabilitation for Stroke: A Systematic Review of Effect on Motor Function. Toxins 2019, 11, 707 .

AMA Style

Takatoshi Hara, Ryo Momosaki, Masachika Niimi, Naoki Yamada, Hiroyoshi Hara, Masahiro Abo. Botulinum Toxin Therapy Combined with Rehabilitation for Stroke: A Systematic Review of Effect on Motor Function. Toxins. 2019; 11 (12):707.

Chicago/Turabian Style

Takatoshi Hara; Ryo Momosaki; Masachika Niimi; Naoki Yamada; Hiroyoshi Hara; Masahiro Abo. 2019. "Botulinum Toxin Therapy Combined with Rehabilitation for Stroke: A Systematic Review of Effect on Motor Function." Toxins 11, no. 12: 707.

Controlled clinical trial
Published: 31 August 2018 in Toxins
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Objectives: This study is a retrospective investigation of the effects of repetitive botulinum toxin A therapy (BoNT-A) and intensive rehabilitation (IR) on lower limb spasticity in post-stroke patients. Methods: Thirty-five post-stroke patients was included in this study and received BoNT-A for the first time. A 12-day inpatient protocol was with 4 cycles of the treatment protocol. The severity of spasticity, motor function and brace status were evaluated. Results: The modified Ashworth Scale (MAS) score of ankle dorsiflexors, range of motion, walking speed and balancing ability were significantly improved after cycle 1. The improvement of spasticity and motor function was persistent through cycles 2–4. One-third of brace users were able to discontinue the use of a brace. All of these brace users showed a forward gait pattern prior to therapy. Conclusions: Repeated BoNT-A combined with IR improved lower limb spasticity in post-stroke patients. Our results suggest that patients who show the forward gait pattern prior to therapy may be able to discontinue the use of their brace after therapy.

ACS Style

Takatoshi Hara; Masahiro Abo; Hiroyoshi Hara; Nobuyuki Sasaki; Naoki Yamada; Masachika Niimi; Yusuke Shimamoto. The Effect of Repeated Botulinum Toxin A Therapy Combined with Intensive Rehabilitation on Lower Limb Spasticity in Post-Stroke Patients. Toxins 2018, 10, 349 .

AMA Style

Takatoshi Hara, Masahiro Abo, Hiroyoshi Hara, Nobuyuki Sasaki, Naoki Yamada, Masachika Niimi, Yusuke Shimamoto. The Effect of Repeated Botulinum Toxin A Therapy Combined with Intensive Rehabilitation on Lower Limb Spasticity in Post-Stroke Patients. Toxins. 2018; 10 (9):349.

Chicago/Turabian Style

Takatoshi Hara; Masahiro Abo; Hiroyoshi Hara; Nobuyuki Sasaki; Naoki Yamada; Masachika Niimi; Yusuke Shimamoto. 2018. "The Effect of Repeated Botulinum Toxin A Therapy Combined with Intensive Rehabilitation on Lower Limb Spasticity in Post-Stroke Patients." Toxins 10, no. 9: 349.

Conference abstract
Published: 13 July 2018 in Annals of Physical and Rehabilitation Medicine
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The purpose of the present study was to investigate retrospectively the relationship between botulinum toxin type A plus multidisciplinary rehabilitation and muscle echo intensity in post-stroke patients with spasticity. The primary aim was to investigate whether the effects of the intervention on the improvement of spasticity depend on muscle echo intensity, and the secondary aim was to investigate whether the motor function of the lower limbs depends on muscle echo intensity. A 12-day inpatient protocol was designed for 102 post-stroke patients with spasticity due to lower limb paralysis. Muscle echo intensity of the triceps surae muscle was measured by ultrasonography, and the patients were categorized into 4 groups based on Heckmatt scale grades (grades I–IV). All 4 groups classified by the Heckmatt scale showed significant pre-to-post-intervention differences in the knee and ankle modified Ashworth scale scores (P < 0.05). Grade I–III patient groups showed a significant improvement in lower limb motor function following intervention. Grade IV patients did not show a significant improvement in lower limb motor function. We observed significant improvements in the modified Ashworth scale scores after botulinum toxin type A and multidisciplinary rehabilitation therapy on post-stroke patients with spasticity. Although patients with lower muscle echo intensity demonstrated improvements in motor function, the improvement was poor in those with higher muscle echo intensity.

ACS Style

T. Hara; A. Masahiro; H. Hiroyoshi; K. Kazushige. Effects of botulinum toxin A therapy and multidisciplinary rehabilitation on lower limb spasticity classified by spastic muscle echo intensity in post-stroke patients. Annals of Physical and Rehabilitation Medicine 2018, 61, e182 .

AMA Style

T. Hara, A. Masahiro, H. Hiroyoshi, K. Kazushige. Effects of botulinum toxin A therapy and multidisciplinary rehabilitation on lower limb spasticity classified by spastic muscle echo intensity in post-stroke patients. Annals of Physical and Rehabilitation Medicine. 2018; 61 ():e182.

Chicago/Turabian Style

T. Hara; A. Masahiro; H. Hiroyoshi; K. Kazushige. 2018. "Effects of botulinum toxin A therapy and multidisciplinary rehabilitation on lower limb spasticity classified by spastic muscle echo intensity in post-stroke patients." Annals of Physical and Rehabilitation Medicine 61, no. : e182.

Original articles
Published: 23 October 2017 in International Journal of Neuroscience
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Objectives: The purpose of the present study was to investigate retrospectively the relationship between botulinum toxin type A plus multidisciplinary rehabilitation and muscle echo intensity in post-stroke patients with spasticity. The primary aim was to investigate whether the effects of the intervention on the improvement of spasticity depend on muscle echo intensity, and the secondary aim was to investigate whether the motor function of the lower limbs depends on muscle echo intensity. Methods: A 12-day inpatient protocol was designed for 102 post-stroke patients with spasticity due to lower limb paralysis. Muscle echo intensity of the triceps surae muscle was measured by ultrasonography, and the patients were categorized into four groups based on Heckmatt scale grades (Grades I–IV). Results: All four groups classified by the Heckmatt scale showed significant pre-to-post-intervention differences in the knee and ankle modified Ashworth scale scores (p < 0.05). Grades I–III patient groups showed a significant improvement in lower limb motor function following intervention. Grade IV patients did not show a significant improvement in lower limb motor function. Conclusions: We observed significant improvements in the modified Ashworth scale scores after botulinum toxin type A and multidisciplinary rehabilitation therapy on post-stroke patients with spasticity. Although patients with lower muscle echo intensity demonstrated improvements in motor function, the improvement was poor in those with higher muscle echo intensity.

ACS Style

Takatoshi Hara; Masahiro Abo; Hiroyoshi Hara; Kazushige Kobayashi; Yusuke Shimamoto; Yamato Shibata; Nobuyuki Sasaki; Naoki Yamada; Masachika Niimi. Effects of botulinum toxin A therapy and multidisciplinary rehabilitation on lower limb spasticity classified by spastic muscle echo intensity in post-stroke patients. International Journal of Neuroscience 2017, 128, 412 -420.

AMA Style

Takatoshi Hara, Masahiro Abo, Hiroyoshi Hara, Kazushige Kobayashi, Yusuke Shimamoto, Yamato Shibata, Nobuyuki Sasaki, Naoki Yamada, Masachika Niimi. Effects of botulinum toxin A therapy and multidisciplinary rehabilitation on lower limb spasticity classified by spastic muscle echo intensity in post-stroke patients. International Journal of Neuroscience. 2017; 128 (5):412-420.

Chicago/Turabian Style

Takatoshi Hara; Masahiro Abo; Hiroyoshi Hara; Kazushige Kobayashi; Yusuke Shimamoto; Yamato Shibata; Nobuyuki Sasaki; Naoki Yamada; Masachika Niimi. 2017. "Effects of botulinum toxin A therapy and multidisciplinary rehabilitation on lower limb spasticity classified by spastic muscle echo intensity in post-stroke patients." International Journal of Neuroscience 128, no. 5: 412-420.

Case reports
Published: 06 September 2017 in NeuroReport
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Repetitive transcranial magnetic stimulation (rTMS) and intensive cognitive rehabilitation (CR) were administered to two patients with cognitive dysfunction following brain injury. The first case was a 67-year-old man who presented with memory dysfunction, attention dysfunction, and decreased insight following diffuse axonal injury. High-frequency rTMS (10 Hz, 2400 pulses/day) targeting the anterior cingulate using a navigation system and CR were administered for 12 days at 1 year from the onset of injury. The patient showed improved neuropsychological performance and activities of daily living. In addition, single photon emission computer tomography with 99mTc-ECD showed improved perfusion in the anterior cingulate gyrus. The second case was a 68-year-old man who presented with dysfunction of memory, attention, and executive function following a cerebral infarction in the middle cerebral artery region within the right hemisphere. This patient received 12 days (except for Sundays) of low-frequency rTMS (1 Hz, 1200 pulses/day) targeting the left dorsolateral prefrontal cortex and the left posterior parietal cortex and CR. Following this intervention, the patient’s neuropsychological performance and activities of daily living improved. Furthermore, single photon emission computer tomography showed changes in perfusion in the rTMS target sites and areas surrounding the targets. We have shown the safety and efficacy of rTMS therapy using a navigation system combined with intensive CR on two patients with cognitive dysfunction following brain injury. In addition, we observed changes in the areas around the rTMS target sites in brain imaging data.

ACS Style

Takatoshi Hara; Masahiro Abo; Nobuyuki Sasaki; Naoki Yamada; Masachika Niimi; Mari Kenmoku; Kastuya Kawakami; Reiko Saito. Improvement of higher brain dysfunction after brain injury by repetitive transcranial magnetic stimulation and intensive rehabilitation therapy. NeuroReport 2017, 28, 800 -807.

AMA Style

Takatoshi Hara, Masahiro Abo, Nobuyuki Sasaki, Naoki Yamada, Masachika Niimi, Mari Kenmoku, Kastuya Kawakami, Reiko Saito. Improvement of higher brain dysfunction after brain injury by repetitive transcranial magnetic stimulation and intensive rehabilitation therapy. NeuroReport. 2017; 28 (13):800-807.

Chicago/Turabian Style

Takatoshi Hara; Masahiro Abo; Nobuyuki Sasaki; Naoki Yamada; Masachika Niimi; Mari Kenmoku; Kastuya Kawakami; Reiko Saito. 2017. "Improvement of higher brain dysfunction after brain injury by repetitive transcranial magnetic stimulation and intensive rehabilitation therapy." NeuroReport 28, no. 13: 800-807.

Journal article
Published: 30 June 2017 in Higher Brain Function Research
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非侵襲的脳刺激 (Non-invasive brain stimulation: NBS) は, 頭蓋骨を通して大脳を刺激するために電気的・磁気的な誘導電流を用いる手法で, うつ病・脳卒中など幅広い分野における新たな治療方法として注目を集めている。近年, 高次脳機能障害患者への応用に, その研究フィールドが拡大している。その応用には, (1) 高次脳機能障害を呈するさまざまな疾患, また多彩な症状に, 有効な刺激方法の確立, (2) 安全性・有効性の証明, (3) 患者の社会復帰・社会参加のために反復性経頭蓋磁気刺激療法 (Repetitive Transcranial Magnetic Stimulation: rTMS) と併用する有効な認知リハビリテーションの確立など, いくつかの課題がある。本稿においては, 我々の研究グループでの研究や, 過去の論文より rTMS を用いた手法に関する報告を中心とし, 高次脳機能障害への適応について論じる。

ACS Style

Takatoshi Hara; Masahiro Abo. Application of Transcranial Magnetic Stimulation therapy for higher brain dysfunction. Higher Brain Function Research 2017, 37, 166 -173.

AMA Style

Takatoshi Hara, Masahiro Abo. Application of Transcranial Magnetic Stimulation therapy for higher brain dysfunction. Higher Brain Function Research. 2017; 37 (2):166-173.

Chicago/Turabian Style

Takatoshi Hara; Masahiro Abo. 2017. "Application of Transcranial Magnetic Stimulation therapy for higher brain dysfunction." Higher Brain Function Research 37, no. 2: 166-173.

Randomized controlled trial
Published: 03 June 2017 in European Neurology
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Although repetitive transcranial magnetic stimulation (rTMS) for hemiparesis is beneficial, so far no study has examined the usefulness of rTMS for apathy. Thirteen patients with chronic stroke were assigned randomly to 2 groups: rTMS group (n = 7) and sham stimulation group (n = 6). The patients received 5 sessions of either high-frequency rTMS over the region spanning from the dorsal anterior cingulate cortex (dACC) to medial prefrontal cortex (mPFC) or sham stimulation for 5 days. The severity of apathy was evaluated using the Apathy Scale (AS) and the severity of depression was evaluated using the Quick Inventory of Depressive Symptomatology (QIDS) serially before and after the 5-day protocol. The AS and QIDS scores were significantly improved in the rTMS group, although they were not changed in the sham stimulation group. The degree of change in the AS score was significantly greater in the rTMS group than that in the sham stimulation group. The degree of change in the QIDS score was greater in the rTMS group than that in the sham stimulation group, although the difference was not statistically significant. The application of high frequency rTMS over the dACC and mPFC may be a useful intervention for apathy due to stroke.

ACS Style

Nobuyuki Sasaki; Takatoshi Hara; Naoki Yamada; Masachika Niimi; Wataru Kakuda; Masahiro Abo. The Efficacy of High-Frequency Repetitive Transcranial Magnetic Stimulation for Improving Apathy in Chronic Stroke Patients. European Neurology 2017, 78, 28 -32.

AMA Style

Nobuyuki Sasaki, Takatoshi Hara, Naoki Yamada, Masachika Niimi, Wataru Kakuda, Masahiro Abo. The Efficacy of High-Frequency Repetitive Transcranial Magnetic Stimulation for Improving Apathy in Chronic Stroke Patients. European Neurology. 2017; 78 (1-2):28-32.

Chicago/Turabian Style

Nobuyuki Sasaki; Takatoshi Hara; Naoki Yamada; Masachika Niimi; Wataru Kakuda; Masahiro Abo. 2017. "The Efficacy of High-Frequency Repetitive Transcranial Magnetic Stimulation for Improving Apathy in Chronic Stroke Patients." European Neurology 78, no. 1-2: 28-32.

Clinical trial
Published: 04 February 2017 in European Neurology
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To examine the efficacy of selective repetitive transcranial magnetic stimulation (rTMS) therapy guided by functional near-infrared spectroscopy (fNIRS) combined with intensive speech therapy (iST) on post-stroke patients with aphasia.

ACS Style

Takatoshi Hara; Masahiro Abo; Kiyohito Kakita; Yuko Mori; Nobuyuki Sasaki; Makoto Yoshida. The Effect of Selective Transcranial Magnetic Stimulation with Functional Near-Infrared Spectroscopy and Intensive Speech Therapy on Individuals with Post-Stroke Aphasia. European Neurology 2017, 77, 186 -194.

AMA Style

Takatoshi Hara, Masahiro Abo, Kiyohito Kakita, Yuko Mori, Nobuyuki Sasaki, Makoto Yoshida. The Effect of Selective Transcranial Magnetic Stimulation with Functional Near-Infrared Spectroscopy and Intensive Speech Therapy on Individuals with Post-Stroke Aphasia. European Neurology. 2017; 77 (3):186-194.

Chicago/Turabian Style

Takatoshi Hara; Masahiro Abo; Kiyohito Kakita; Yuko Mori; Nobuyuki Sasaki; Makoto Yoshida. 2017. "The Effect of Selective Transcranial Magnetic Stimulation with Functional Near-Infrared Spectroscopy and Intensive Speech Therapy on Individuals with Post-Stroke Aphasia." European Neurology 77, no. 3: 186-194.

Randomized controlled trial
Published: 09 August 2016 in Acta Neurologica Belgica
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ACS Style

Nobuyuki Sasaki; Masahiro Abo; Takatoshi Hara; Naoki Yamada; Masachika Niimi; Wataru Kakuda. High-frequency rTMS on leg motor area in the early phase of stroke. Acta Neurologica Belgica 2016, 117, 189 -194.

AMA Style

Nobuyuki Sasaki, Masahiro Abo, Takatoshi Hara, Naoki Yamada, Masachika Niimi, Wataru Kakuda. High-frequency rTMS on leg motor area in the early phase of stroke. Acta Neurologica Belgica. 2016; 117 (1):189-194.

Chicago/Turabian Style

Nobuyuki Sasaki; Masahiro Abo; Takatoshi Hara; Naoki Yamada; Masachika Niimi; Wataru Kakuda. 2016. "High-frequency rTMS on leg motor area in the early phase of stroke." Acta Neurologica Belgica 117, no. 1: 189-194.

Original article
Published: 03 June 2016 in International Journal of Neuroscience
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Objectives. The purpose of this study was to examine the effects of combined botulinum toxin type A (BoNT-A) and inpatient multidisciplinary (MD) rehabilitation therapy on the improvement of upper and lower limb function in post-stroke patients. Methods. In this retrospective study, a 12-day inpatient treatment protocol was implemented on 51 post-stroke patients with spasticity. Assessments were performed on the day of admission, at discharge, and at 3 months following discharge. Results. At the time of discharge, all of the evaluated items showed a statistically significant improvement. Only the Functional Reach Test (FRT) showed a statistically significant improvement at 3 months. In subgroup analyses, the slowest walking speed group showed a significantly greater change ratio of the 10 Meter Walk Test relative to the other groups, from the time of admission to discharge. This group showed a greater FRT change ratio than the other groups from the time of admission to the 3-month follow-up. Conclusion. Inpatient combined therapy of simultaneous injections of BoNT-A to the upper and lower limbs and MD may improve motor function.

ACS Style

Takatoshi Hara; Masahiro Abo; Hiroyoshi Hara; Kazushige Kobayashi; Yusuke Shimamoto; Yuta Samizo; Nobuyuki Sasaki; Naoki Yamada; Masachika Niimi. Effects of botulinum toxin A therapy and multidisciplinary rehabilitation on upper and lower limb spasticity in post-stroke patients. International Journal of Neuroscience 2016, 127, 469 -478.

AMA Style

Takatoshi Hara, Masahiro Abo, Hiroyoshi Hara, Kazushige Kobayashi, Yusuke Shimamoto, Yuta Samizo, Nobuyuki Sasaki, Naoki Yamada, Masachika Niimi. Effects of botulinum toxin A therapy and multidisciplinary rehabilitation on upper and lower limb spasticity in post-stroke patients. International Journal of Neuroscience. 2016; 127 (6):469-478.

Chicago/Turabian Style

Takatoshi Hara; Masahiro Abo; Hiroyoshi Hara; Kazushige Kobayashi; Yusuke Shimamoto; Yuta Samizo; Nobuyuki Sasaki; Naoki Yamada; Masachika Niimi. 2016. "Effects of botulinum toxin A therapy and multidisciplinary rehabilitation on upper and lower limb spasticity in post-stroke patients." International Journal of Neuroscience 127, no. 6: 469-478.

Research article
Published: 01 January 2016 in Neural Regeneration Research
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Low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) to the contralesional hemisphere and intensive occupational therapy (iOT) have been shown to contribute to a significant improvement in upper limb hemiparesis in patients with chronic stroke. However, the effect of the combined intervention program of LF-rTMS and iOT on cognitive function is unknown. We retrospectively investigated whether the combined treatment influence patient's Trail-Making Test part B (TMT-B) performance, which is a group of easy and inexpensive neuropsychological tests that evaluate several cognitive functions. Twenty-five patients received 11 sessions of LF-rTMS to the contralesional hemisphere and 2 sessions of iOT per day over 15 successive days. Patients with right- and left-sided hemiparesis demonstrated significant improvements in upper limb motor function following the combined intervention program. Only patients with right-sided hemiparesis exhibited improved TMT-B performance following the combined intervention program, and there was a significant negative correlation between Fugl-Meyer Assessment scale total score change and TMT-B performance. The results indicate the possibility that LF-rTMS to the contralesional hemisphere combined with iOT improves the upper limb motor function and cognitive function of patients with right-sided hemiparesis. However, further studies are necessary to elucidate the mechanism of improved cognitive function.

ACS Style

Takatoshi Hara; Masahiro Abo; Kiyohito Kakita; Takeshi Masuda; Ryunosuke Yamazaki. Does a combined intervention program of repetitive transcranial magnetic stimulation and intensive occupational therapy affect cognitive function in patients with post-stroke upper limb hemiparesis? Neural Regeneration Research 2016, 11, 1932 -1939.

AMA Style

Takatoshi Hara, Masahiro Abo, Kiyohito Kakita, Takeshi Masuda, Ryunosuke Yamazaki. Does a combined intervention program of repetitive transcranial magnetic stimulation and intensive occupational therapy affect cognitive function in patients with post-stroke upper limb hemiparesis? Neural Regeneration Research. 2016; 11 (12):1932-1939.

Chicago/Turabian Style

Takatoshi Hara; Masahiro Abo; Kiyohito Kakita; Takeshi Masuda; Ryunosuke Yamazaki. 2016. "Does a combined intervention program of repetitive transcranial magnetic stimulation and intensive occupational therapy affect cognitive function in patients with post-stroke upper limb hemiparesis?" Neural Regeneration Research 11, no. 12: 1932-1939.