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- All Subjects: Movement Planning
- All Subjects: stroke
- All Subjects: Reticulospinal System
- Creators: Honeycutt, Claire
- Creators: Mcguffin, Brianna Jean
- Member of: Barrett, The Honors College Thesis/Creative Project Collection
Does training in the upper extremity domain with startle translate to the speech domain post-stroke?
The aim of this study was to assess whether exposing individuals who are 6-month post-stroke with an upper extremity motor deficit and some form of speech impairment (aphasia and/or apraxia) to upper extremity training utilizing Startle Adjuvant Rehabilitation Therapy (START) would result in improvement in symptoms of speech impairment. It was hypothesized that while scores on Diadochokinetic Rate (a measure of apraxia) and Repetition (a measure of aphasia) would improve by timepoint with START as compared to the Control group, measures of aphasia including Spontaneous Speech, Auditory Verbal Comprehension, and Naming would not be different in scores by timepoint. Subjects were recruited from two separate ongoing studies consisting of three days of similar upper extremity training on certain functional tasks with and without START and the speech assessments utilized were pulled from the Western Aphasia Battery (Revised) and Apraxia Battery for Adults 2nd Edition. It was found that there were no statistically significant differences by timepoint in either condition for any of the speech assessments. This proof-of-concept study is the first to assess whether the StartReact effect, when applied to the upper extremity domain, will translate into measurable improvements in speech impairment despite the lack of any speech training.
Along with aging, sleep deprivation is correlated with learning deficits. Research has shown that a lack of sleep negatively impacts motor skill learning and consolidation. Since there is a link between sleep and learning, as well as learning and the reticulospinal system, these observations raise the question: does sleep deprivation underlie reticulospinal delays? We hypothesized that sleep deprivation was correlated to a slower startle response, indicating a delayed reticulospinal system. Our objectives were to observe the impact of sleep deprivation on 1) the startle response (characterized by muscle onset latency and percentage of startle responses elicited) and 2) functional performance (to determine whether subjects were sufficiently sleep deprived).
21 young adults participated in two experimental sessions: one control session (8-10 hour time in bed opportunity for at least 3 nights prior) and one sleep deprivation session (0 hour time in bed opportunity for one night prior). The same protocol was conducted during each session. First, subjects were randomly exposed to 15 loud, startling acoustic stimuli of 120 dB. Electromyography (EMG) data measured muscle activity from the left and right sternocleidomastoid (LSCM and RSCM), biceps brachii, and triceps brachii. To assess functional performance, cognitive, balance, and motor tests were also administered. The EMG data were analyzed in MATLAB. A generalized linear mixed model was performed on LSCM and RSCM onset latencies. Paired t-tests were performed on the percentage of startle responses elicited and functional performance metrics. A p-value of less than 0.05 indicated significance.
Thirteen out of 21 participants displayed at least one startle response during their control and sleep deprived sessions and were further analyzed. No differences were found in onset latency (RSCM: control = 75.87 ± 21.94ms, sleep deprived = 82.06 ± 27.47ms; LSCM: control = 79.53 ± 17.85ms, sleep deprived = 78.48 ± 20.75ms) and percentage of startle responses elicited (control = 84.10 ± 15.53%; sleep deprived = 83.59 ± 18.58%) between the two sessions. However, significant differences were observed in reaction time, TUG with Dual time, and average balance time with the right leg up. Our data did not support our hypothesis; no significant differences were seen between subjects’ startle responses during the control and sleep deprived sessions. However, sleep deprivation was indicated with declines were observed in functional performance. Therefore, we concluded that sleep deprivation may not affect the startle response and underlie delays in the reticulospinal system.