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Following from these observations of ipsilateral pathways are clinical studies that have used rTMS to examine recovery of function following acquired brain lesions (Caramia et al, 2000; Trompetto, Assini, Ducolieri, Marchese, & Abbruzzese, 2000) Trompetto and colleagues (2000) studied recovery following acute stroke by comparing motor responses that had been elicited by TMS when it was applied over the frontal regions of the damaged and nondamaged hemisphere Three subgroups of patients were identi ed The largest subgroup were those with poor recovery of motor function Their responses (motor-evoked potentials) to TMS were absent over both the damaged and undamaged hemispheres The two remaining subgroups had good motor recovery In one, patients had larger MEPs with stimulation of the damaged (ipsilateral) than nondamaged (contralateral) hemisphere Their good recovery possibly related to the unmasking of ipsilateral motor pathways.

In the third recovery group, MEPs were larger in the affected than in nonaffected limb and possibly related to the use of alternate circuits within the damaged hemisphere Such studies point to the.

Table 7.2 Typical water demands for different use categories. (Adapted from information presented by Cole (1998), plus unpublished data held by author.) Category

Boline, P D (1991) Chiropractic treatment and pharmaceutical treatment for muscle contraction headaches: A randomized comparative clinical trial Proceedings from the 1991 Conference on Spinal Manipulation, Arlington, VA; Foundation for Chiropractic Education and Research Bone, M E, Wilkinson, D J, Young, J R, McNeil, J, & Charlton, S (1990) Ginger root A new antiemetic: The effect of ginger root on postoperative nausea and vomiting after major gynaecological surgery Anaesthesia, 45, 669 671 Brooks, D, & Stark, A (1989) The effect of dance/movement therapy on affect: A pilot study American Journal of Dance Therapy, 11, 101 12 1 Bruger, R A, Torres, A R, Warren, R P, Caldwell, V D, & Hughes, B G (1997) Echinacea-induced cytokine production by human macrophages International Journal of Immunopharmacology, 19(7), 371 379 The Burton Goldberg Group (1995) Alternative medicine Fife, WA: Future Medicine Butterweck, V.

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, Wall, A, Lie ander-Wulf, U, Winterhoff, H, & Nahrstedt, A (1997) Effects of the total extract and fractions of hypericum perforatum in animal assays for antidepressant activity Pharmacopsychiatry, 30(Suppl 2), 117 124 Carmack, C L, Boudreaux, E, Amaral-Melendez, M, Brantley, P J, & de Moor, C (1999) Aerobic tness and leisure activity as moderators of the stress-illness relation Annals of Behavioral Medicine, 21, 251 257 Cerrato, P L (1988) Natural tranquilizers RN, 61(12), 61 62 Chambless, D, & Hollon, S D (1998) De ning empirically supported therapies Journal of Consulting and Clinical Psychology, 66, 7 18 Chatterjee, S S, Bhattacharya, S K, Wonnemann, M, Singer, A, & Muller, W E (1998) Hyperforin as a possible antidepressant component of hypericum extracts Life Sciences, 63(6), 499 510 Chen, M L, Lin, L C, Wu, S C.

, & Lin, J G (1999) The effectiveness of acupressure in improving the quality of sleep of institutionalized residents Journals of Gerontology: Series A, Biological Sciences and Medical Sciences, 54, M389 M394 Cohen, S, & Herbert, T B (1996) Health psychology: Psychological factors and physical disease from the perspective of human psychoneuroimmunology Annual Review in Psychology, 47, 113 142 Cooper, M J, & Aygen, M M (1978) Effect of transcendental meditation on serum cholesterol and blood pressure Harefuah, 95(1), 1 2 Cott, J M (1997) In vitro receptor binding and enzyme inhibition by hypericum perforatum extract Pharmacopsychiatry, 30(Suppl 2), 108 12 1 Craft, L L, & Landers, D M (1998) The effect of exercise on clinical depression and depression resulting from mental illness: A meta-analysis Journal of Sport and Exercise Psychology, 20, 339 357..

these four minor symptoms also are de ning criteria for CFS Is it possible that some patients with a primary affective disorder could be misdiagnosed as having CFS Some CFS investigators would not see this as a problem because they believe that high rates of psychiatric comorbidity indicate that CFS is mainly a psychiatric disorder and that distinctions between the two phenomena are super cial and merely a matter of nomenclature However, several CFS symptoms, including prolonged fatigue after physical exertion, night sweats, sore throats, and swollen lymph nodes are not commonly found in depression In addition, while fatigue is the principal feature of CFS, fatigue does not assume equal prominence in depression (Friedberg & Jason, 1998; Komaroff et al, 1996) Also, illness onset with CFS is often sudden, occurring over a few hours or days, whereas primary depression generally shows a more gradual onset.