Akiyoshi Matsugi

• PhD
• Professor at Shijonawate gakuen university

Background Patients with spinocerebellar degeneration (SCD) and multiple system atrophy (MSA) encounter various challenges in daily life due to ataxia and other symptoms. A comprehensive understanding of their diverse needs can improve the effectiveness of rehabilitation interventions. Objective This study aims to identify the daily challenges fac...

Accurate perception of the direction of gravity relies on the integration of multisensory information, particularly from the visual and vestibular systems, within the brain. Although a recent study of patients with cerebellar degeneration suggested a cerebellar role in visuo-vestibular interaction in the perception of gravitational direction, direc...

Background Evidence of the effectiveness of physiotherapy, including muscle strength training, coordination training, aerobic exercise, cycling regimen, balance training, gait training, and activity of daily living training, in patients with degenerative cerebellar ataxia (DCA) was insufficient for clinical decision making. We aimed to explore clin...

This study aimed to investigate whether the cerebellum contributes to contraction-induced facilitation (CIF) of contralateral corticospinal excitability. To this end, repetitive cerebellar transcranial magnetic stimulation (TMS) was used to test whether it modulates CIF. Overall, 20 healthy young individuals participated in the study. Single-pulse...

Background This systematic review and meta‐analysis aimed to assess the effectiveness of non‐invasive brain stimulation (NIBS), including repetitive transcranial magnetic stimulation (rTMS) and transcranial electrical stimulation (tES), as a neurological intervention for degenerative cerebellar ataxia (DCA) based on preregistration (PROSPERO: CRD42...

Tests to detect mild cognitive impairment (MCI) should have high sensitivity and accuracy. Previously, we reported on a cognitive composition test (CCT) that we developed to detect MCI. In this study, we compared gaze behavior parameters, namely, gaze fixation duration and gaze-shift frequency, during the CCT in participants with MCI and healthy co...

This study aimed to evaluate the efficacy and safety of navigation-guided repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex in patients with neuropathic pain in the upper limb. This randomized, blinded, sham-controlled, parallel trial included a rTMS protocol (10-Hz, 2000 pulses/session) consisting of five daily sess...

Movement disorders that stem from neurological conditions such as stroke, cerebral palsy, multiple sclerosis (MS), Parkinson’s disease (PD), and spinocerebellar degeneration (SCD) can significantly impair a person’s activities of daily living (ADL) [...]

This study aimed to investigate abnormalities in inhibitory cortical excitability and motor control during ballistic-targeting movements in individuals with degenerative cerebellar ataxia (DCA). Sixteen participants took part in the study (DCA group [n = 8] and healthy group [n = 8]). The resting motor-threshold and cortical silent period (cSP) wer...

Introduction: To date, the medical and rehabilitation needs of people with degenerative cerebellar ataxia (DCA) are not fully met because no curative treatment has yet been established. Movement disorders such as cerebellar ataxia and balance and gait disturbance are common symptoms of DCA. Recently, non-invasive brain stimulation (NIBS) technique...

Since individuals with cerebellar lesions often exhibit hypotonia, the cerebellum may contribute to the regulation of muscle tone and spinal motoneuron pool excitability. Neurophysiological methods using transcranial magnetic stimulation (TMS) of the cerebellum have been recently proposed for testing the role of the cerebellum in spinal excitabilit...

Mild cognitive impairment (MCI) is the preliminary stage of dementia, which is a serious social problem worldwide. This study aimed to investigate whether the Cognitive Composition Test (CCT) is effective for the early diagnosis of MCI. A total of 104 older adults underwent the Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination...

Background Several medications have been applied to Alzheimer’s dementia patients (AD) but their efficacies have been insufficient. The efficacy and safety of 4 weeks of repetitive transcranial magnetic stimulation (rTMS) in Japanese AD were evaluated in this exploratory clinical trial. Methods Forty-two patients, aged 60–93 years (average, 76.4 y...

We investigated whether vermal cerebellar low-frequency repetitive transcranial magnetic stimulation (crTMS) affects motor learning of visually guided postural tracking training (VTT) using foot center of pressure (COP) as well as the stability and sensory contribution of upright standing. Twenty-one healthy volunteers participated (10 in the sham-...

This study aimed to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) of the cerebellum on changes in motor performance during a series of repetitive ballistic-targeting tasks. Twenty-two healthy young adults (n = 12 in the active-rTMS group and n = 10 in the sham rTMS group) participated in this study. The participants...

Purpose The purpose of this study was to investigate whether information on extraocular muscle proprioception without visual information affects postural control. Methods Thirty-five healthy young volunteers participated in the study. Postural control outcomes included the center of pressure (CoP) for static standing, the total length of the sway...

We investigated whether noisy galvanic vestibular stimulation (nGVS) modulates the vestibulo-ocular reflex (VOR) and whether this effect is correlated with the effect of nGVS on body sway. Thirty healthy young adults participated. The video head impulse test (vHIT) was used to estimate the ratio of eye motion velocity/head motion velocity to VOR-ga...

Introduction: Pain relief from repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (M1) is particularly poor in patients with leg pain. The optimal parameters for relieving leg pain remain poorly understood. The purpose of this study was to explore the optimal stimulation parameters of M1-rTMS for patients with leg pa...

This study aims to investigate the effects of nerve gliding exercise following carpal tunnel release surgery (NGE-CTRS) and the probing factors affecting the effect of NGE-CTRS on hand function. A total of 86 patients after CTRS participated. Grip strength (grip-s), pinch strength (pinch-s), Semmes-Weinstein monofilament test (SWMT), two-point disc...

Repeated high-impact ground forces can lead to injury and decreased performance. While increasing flexor hallucis longus (FHL) muscle activity is known to increase stiffness and elasticity, it is unknown if this also decreases ground reaction forces by shock absorption during landing. This study aimed to determine whether increasing FHL muscle acti...

Objective Noisy galvanic vestibular stimulation (nGVS) is often used to improve postural stability in disorders, such as neurorehabilitation montage. For the safe use of nGVS, we investigated whether arterial pressure (AP) and heart rate vary during static supine and slow whole-body tilt with random nGVS (0.4 mA, 0.1–640 Hz, gaussian distribution)...

The aim of this study was to determine the abnormal hand and mouth behavior before actual swallowing for eating in elderly people with high risk of aspiration pneumonia. Ten elderly people with a diagnosis of aspiration pneumonia (EAP), 15 healthy elderly (HE) people, and 21 young adults (YA) were enrolled. The feeding time and the timing of the ma...

Rehabilitation is an important treatment for spinocerebellar ataxia (SCA). The lack of improvement in ataxia, deficit of motor learning, and unstable balance causes disability for activities of daily living and restricts participation in social activities, further resulting in a disturbance of the restoration of quality of life. This narrative revi...

Objective: This study aimed to investigate whether galvanic vestibular stimulation with stochastic noise (nGVS) modulates the body sway and muscle activity of the lower limbs, depending on visual and somatosensory information from the foot using rubber-foam. Methods: Seventeen healthy young adults participated in the study. Each subject maintained...

Background The cerebellum strongly contributes to vestibulospinal function, and the modulation of vestibulospinal function is important for rehabilitation. As transcranial magnetic stimulation (TMS) and electrical stimulation may induce functional changes in neural systems, we investigated whether cerebellar repetitive TMS (crTMS) and noisy galvani...

This study aimed to investigate whether cerebellar transcranial magnetic stimulation (C-TMS) affected the cortical silent period (cSP) induced by TMS over the primary motor cortex (M1) and the effect of interstimulus interval (ISI) on cerebellar conditioning and TMS to the left M1 (M1-TMS). Fourteen healthy adult participants were instructed to con...

Objective To investigate whether gaze stabilization exercises (GSEs) improve eye and head movements and whether low-frequency cerebellar repetitive transcranial magnetic stimulation (rTMS) inhibits GSE trainability. Methods 25 healthy adults (real rTMS, n = 12; sham rTMS, n = 13) were recruited. Real or sham rTMS was performed for 15 min (1 Hz, 90...

Objective: Repetitive transcranial magnetic stimulation over the primary motor cortex has been shown to provide an analgesic effect on refractory neuropathic pain. It is thought that the primary motor cortex may be involved in pain–related cognitive processing. In this study, navigation–guided transcranial magnetic stimulation (TMS) was applied to...

Cerebellar transcranial magnetic stimulation (C-TMS) facilitates the ipsilateral soleus H-reflex, which reflects the excitability of the spinal motoneuron pool. This study aimed to investigate whether this facilitation of the spinal motoneuron pool excitability by C-TMS is affected by cerebellar transcranial direct current stimulation (ctDCS) in a...

Purpose: The contribution of gamma-aminobutyric acidergic inhibitory neural circuits in the primary motor cortex, as estimated by the cortical silent period, during weak and strong force output has not been defined. The aim of this study was to investigate whether cortical silent period is modulated with change from weak to strong force control. Ma...

[Purpose] The purpose of this study was to investigate the effect of an intervention to improve electromechanical delay (EMD) of the gluteus medius (GM) for Duchenne gait. [Participant] A woman in her 40s participated in this study 9 months after rotational acetabular osteotomy. This patient exhibited Duchenne gait, despite a grade of more than 4 i...

Modulation of the soleus H-reflex following galvanic vestibular stimulation (GVS) has been used to evaluate vestibulospinal tract function. It is not known whether this modulation is because of vestibular stimulation and/or cutaneous stimulation, and the suitable stimulating intensity of GVS for the modulation is not established. We investigated th...

Purpose: The present study aimed to investigate whether spinal reflex excitability is influenced by the site of cerebellar transcranial magnetic stimulation (C-TMS). Materials and methods: Fourteen healthy volunteers (mean age: 24.6 ± 6.6 years [11 men]) participated. Participants lay on a bed in the prone position, with both ankle joints fixed to...

The aim of study was to investigate cerebellar brain inhibition (CBI) is affected by imaginary muscle contraction (Contract-I) and relaxation (Relax-I) using paired pulse paradigm with transcranial magnetic stimulation (TMS) in healthy human. Participants performed tonic actual contraction and relaxation of right first dorsal interosseous (FDI) mus...

We investigated whether transcranial magnetic stimulation (TMS)-induced cortical silent period (cSP), which reflects activation of the GABAergic inhibitory neural circuit in the primary motor cortex (M1), was modulated with dependency on actual output force and corticospinal excitability. Eleven healthy participants were asked to control the force...

We reported that cerebellar transcranial magnetic stimulation (TMS) facilitates spinal reflex in healthy humans. The aim of this study was to investigate whether the “cerebellar” spinal facilitation (CSpF) appears in patients with spinocerebellar ataxia (SCA) with atrophy in the cerebellar cortex and dentate nucleus (DN). Two patients with SCA (one...

Transcranial magnetic stimulation (TMS) over the cerebellum facilitates the spinal reflex in healthy humans. The aim of this study was to investigate whether such cerebellar spinal facilitation (CSpF) appears in patients with spinocerebellar ataxia (SCA) presenting with atrophy in the cerebellar gray matter and dentate nucleus. One patient with SCA...

Background: The aim of this study was to investigate whether vibration that is applied to the lateral muscles of the neck induces the illusion that the body is swaying and compensatory body sway during sit-to-stand movements.

The purpose of this study was to investigate cerebellar brain inhibition (CBI) of the contralateral primary motor cortex (M1) during imaginary muscle contraction (Contract-I) and relaxation (Relax-I) using transcranial magnetic stimulation (TMS). Twenty-nine healthy adults completed two experiments. Motor evoked potentials (MEPs) in the right first...

[Purpose] The aim of this study was to investigate whether gaze stabilization exercise derives sensory reweighting of vestibular for upright postural control. [Subjects and Methods] Twenty-three healthy volunteers participated in this study. The center of pressure of the total trajectory length was measured before (pre), immediately after (post), a...

[Purpose] We aimed to investigate the effects of core stability training (CST) on ataxia and balance disturbance. [Subjects and Methods] A man in his fifties who was at 3 years past the onset of pontine hemorrhage and had severe cerebellar and afferent ataxias, and balance and gait disorders was included in this study. In the first 4 weeks (phase A...

Ataxia, the incoordination and balance dysfunction in movements without muscle weakness, causes gait and postural disturbance in patients with stroke, multiple sclerosis, and degeneration in the cerebellum. The aim of this article was to provide a narrative review of the previous reports on physical therapy for mainly cerebellar ataxia offering var...

The aim of this study was to investigate whether transcranial static magnetic field stimulation (tSMS) delivered using a compact cylindrical NdFeB magnet over the cerebellum modulates the excitability of the cerebellum and contralateral primary motor cortex, as measured using cerebellar brain inhibition (CBI), motor evoked potentials (MEPs), and re...

Gaze-stabilization exercise (GSE) is often conducted in vestibular rehabilitation, but its effect on vestibular function in postural control is not clear. We investigated whether GSE affects vestibular function during static upright standing and vestibulospinal reflex (VSR) in healthy young adults. First, the center of pressure of the total traject...

[Purpose] We report the treatment course of a patient who showed a delay in regaining pre-injury levels of physical function and activities of daily living (ADL) due to disuse syndrome caused by bed rest after a vertebral fracture. [Subjects and Methods] A male in his 70s sustained an L2 vertebral fracture with no clear mechanism of the injury. Aft...

Purpose: The aim of this study was to assess the role of the sub score of the home care score for the prediction of advisability of home care and to assess whether the it is useful for prediction when it is difficult to draw a high-precision prediction using the functional independence measure. Methods: In total, 148 subjects living at their home o...

[Purpose] Post-stroke astasia is an inability to stand without external support despite having sufficient muscle strength. However, the dysfunction underlying astasia is unclear. We tested the hypothesis that astasia is the result of an abnormal bias in vertical perception, especially subjective postural vertical (SPV), mediated by somatosensory in...

[Purpose] This study investigated whether it is possible to predict return to home at discharge from a rehabilitation hospital in Japan using the home care score of patients with cerebrovascular or osteoarticular disease and low activities of daily living at admission. [Subjects and Methods] The home care score and functional independent measuremen...

[Purpose] This study was designed to examine the effect of plantar sensory input training on balance control and gait function of a patient with stroke, who had abnormal sensory integration, especially abnormal sensory re-weighting. [Subject] The patient was a woman with right hemiplegia at 1 month post-stroke. Her postural stability was affected b...

Purpose . The aim of this study was to assess whether the home care score (HCS), which was developed by the Ministry of Health and Welfare in Japan in 1992, is useful for the prediction of advisability of home care. Methods . Subjects living at home and in assisted-living facilities were analyzed. Binominal logistic regression analyses, using age,...

[Purpose] This case report describes a treatment course for catastrophizing and allodynia-like symptoms occurring after cardiosurgery. [Subject] A female in her seventies, who showed inflammatory reaction around the operative wound of median sternotomy and exaggerated pain with shoulder movement four months after surgery, was treated. The subject a...

[Purpose] We investigated the effect of rhythmic ankle movement on the contralateral soleus H-reflex. The H-reflex was evoked from the right soleus muscle. [Subjects and Methods] Healthy humans rhythmically moved the left ankle (movement condition) or held the left ankle stationary (stationary condition) at one of three positions corresponding to t...

Previously, we reported that cerebellar transcranial magnetic stimulation (C-TMS) facilitates spinal motoneuronal excitability in resting humans. In this study, we aimed to characterize the descending pathway that is responsible for the C-TMS-associated cerebellar spinal facilitation. We evaluated the effect of C-TMS on ipsilateral soleus Ia presyn...

We investigated whether cerebellar transcranial magnetic stimulation (C-TMS) facilitates the excitability of the ipsilateral soleus motoneuron pool in resting humans, and whether the facilitation is modulated by a task that promotes cerebellar activity. A test tibial nerve stimulus evoking the H-reflex from the right soleus muscle was delivered bef...

[Purpose]: We examined the effect of exercise therapy, aiming to improve the ability to form internal rhythm, on the rhythmic tapping and freezing of gait (FOG) of a Parkinson’s disease patient. [Subject] One Parkinson’s disease patient who had difficulty in sustaining rhythmic tapping, and in controlling FOG with external visual or auditory cues....

[Purpose] The purpose of this study was to confirm the accuracy of a revised method for predicting the Functional Independence Measure (FIM) at discharge when stroke patients are first admitted to a rehabilitation hospital. [Subjects and Methods] The predictive equation with logarithmic trend line was calculated based on the total score of the FIM...

It has been well established that fear increases corticospinal excitability in the hand muscles. Postural threat, a kind of fear, may have a unique effect on corticospinal excitability in the trunk flexor muscles during the upright stance on high ground. We investigated whether postural threat modulates corticospinal excitability in the trunk flexo...

[Purpose] In this study, human body movement when lifting loads of different weights was recorded, and the characteristics were investigated. [Subjects] The subjects were 13 healthy males. [Method] Human body movement when lifting loads was recorded using a three-dimensional motion analyzer. There were 3 types of load: no-load, 10 kg, and 15 kg. [R...

[Purpose] The purpose of the present study was to investigate the effect of trumpet and marching euphonium performance posture on the trunk and lower limb musculoskeletal system. [Subjects] The subjects were 10 female university students. [Methods] Subjects maintained a resting position, a trumpet performance posture, and a marching euphonium perfo...

Abstract The purpose of this study was to investigate the effect of eye movement on the control of arm movement to a target. Healthy humans flexed the elbow to a stationary target in response to a start tone. Simultaneously, the subject moved the eyes to the target (saccade eye movement), visually tracked a laser point moving with the arm (smooth p...

We investigated the effect of advance information about the sequence of a to-be-signaled motor response on corticospinal excitability during the foreperiod in healthy humans. Advance information about the sequence of a to-be-signaled motor response was provided by a precue signal 600 ms before a response signal during a warned choice reaction task....

We investigated whether long latency motor response induced by transcranial magnetic stimulation over the cerebellum (C-TMS) preferentially appears during a continuous visually guided manual tracking task, and whether it originates in a concomitantly evoked neck twitch. C-TMS or magnetic stimulation over the neck (N-MS) was delivered during one of...

The purpose of this study was to investigate whether right index finger movement during visually guided manual tracking task is fluctuated by transcranial magnetic stimulation (TMS) specifically over the cerebellum and is differently fluctuated by TMS over different sites of the cerebellum. TMS was delivered over the left, middle, or right cerebell...

Previous studies showed that transcranial magnetic stimulation (TMS) to the cerebellum evokes a long latency motor response in the soleus muscle during a postural task. The cerebellum is activated not only during postural tasks but also during motor tasks for which eye-hand coordination is required. The purpose of this study was to investigate whet...

The purpose of this study was to investigate whether premovement facilitation of corticospinal excitability before sequential movement was different from that before simple movement. Each of 7 participants who performed choice reaction tasks with the right hand pressed a force transducer with the index finger in response to a start cue or pressed t...

The purpose of this study was to investigate whether totally blind humans rely on muscle sense for guiding goal-directed movement more than do blindfolded normally sighted humans. Twelve totally blind humans and 12 blindfolded normally sighted humans performed goal-directed movement. The subjects rapidly extended the elbow to a target angle in resp...