ニューロリハビリテーションの国際ジャーナル

As we cannot stop disease progression of neurodegenerative diseases, we have to consider neurodegenerative diseases as life-threatening illnesses and the objects of palliative care. Neurodegenerative disease patients and their families usually did not have much information about their diseases and often could not choose their treatment and care options on their own. Before applying the principles of palliative care to the patients and their families, we had to give appropriate information about their disease to them. But there were few educational interventions for neurodegenerative disease patients and their families and also few studies investigating the knowledge of them. Moreover all but one was the educational interventions for demented patients. All reports about the educational interventions for neurodegenerative diseases showed that the simple educational interventions might not reduce the burdens on the families, and moreover one report for extrapyramidal diseases and cerebellar degenerations showed that the simple educational interventions could not change the course of natural degradation of the diseases and might produce depressive reaction to the patients. In order to reduce the burdens of the families we have to support the families with physically, and in order to encourage the patients to accept their disease we have to control their depression and approach to them with the principles of palliative care.

Following painful stimuli and injuries, activated microglia and astrocytes contribute to the facilitation of pain signaling via glia-neuronal signaling pathway. The purpose of this mini-review is to compare recent progress of the last 5 years on microglia and astrocyte control of pain, especially sex differences in pathological pain.

Introduction: Various therapies have been utilized to improve cardiometabolic health after spinal cord injury (SCI), including Functional Electrical Stimulation (FES) cycling. Typically, FES is used in SCI cases resulting from the Upper Motor Neuron Injury (UMN-SCI). However, it has been reported that FES may improve muscle torque and functional mobility in individuals with Lower Motor Neuron Injuries (LMN-SCI) but potential effects on cardiometabolic health have not been studied before. Thus, this study examined the cardiometabolic health response to FES cycling combined with nutritional counseling in two individuals with chronic SCI; one person with LMN-SCI and one with UMN-SCI.
Case Presentation: Body composition, vascular stiffness, and glucose deposition were assessed before and after participation in the FES cycling and nutritional counseling program. Despite the decrease in the body mass in the case of LMN-SCI but not UMN-SCI, the fat mass-to-lean mass ratio in the lower limbs and trunk increased +4% and +8% respectively, in the former and decreased -10% and -8% respectively in the latter. Both subjects decreased markers of central vascular stiffness (AIx@75, reflection magnitude) as well as the blood glucose and HbA1c levels, however, the changes were greater in the case of UMN-SCI.
Discussion: This dual case study provides only a partial support for the use of FES cycling alone or in combination with nutritional counseling for improving cardio metabolic health in LMN-SCI, however modest decreases in glucose and vascular stiffness warrant further investigations.