Abnormal premovement interhemispheric interactions are present in the chronic but not in the acute or subacute post-stroke periods
Bibliographic record
Abstract
activation, leading to functional deficits.Facilitation of the activation of residual cortico-spinal axons could reestablish the missing excitation, restoring voluntary muscle control.We hypothesized that facilitation could be achieved by increasing the excitability of cortical motoneurons in the motor cortex, thereby increasing CST and CBT output.While noninvasive neuromodulation methods have shown promising results in increasing cortical excitability, effects are often moderate and short-lived in patients with severe impairments.Therefore, we proposed that deep brain stimulation (DBS) could be a viable approach to modulate cortical excitability by targeting thalamo-cortical connections in motor thalamus.To test our hypothesis, we aimed to increase muscle activation in the upper limb and face with continuous motor thalamus DBS (mThal-DBS).We observed significantly larger motor evoked potentials (MEPs) in upper limb and orofacial muscles, generated by internal capsule stimulation in nonhuman primates or direct cortical stimulation in intact human patients, with concurrent mThal-DBS.We then tested whether the increase in MEPs with mThal-DBS persisted in patients with CST and CBT lesions and, importantly, whether this increase would produce functional improvements in voluntary motor control.We demonstrated that mThal-DBS enhanced respiratory, phonatory, resonatory, and articulatory control, resulting in clinically significant improvements in speech intelligibility in patients with dysarthria.We also observed a clinical improvement in swallowing function, arm and hand strength, and force control.Here, for the first time, we have shown that mThal-DBS can simultaneously ameliorate dysarthria, dysphagia, and upper-limb paralysis in individuals with cerebral lesions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".