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首页> 外文学位 >Rehabilitative experience following focal ischemic brain injury: Evidence for bihemispheric neural reorganization and the existence of a critical period for enhanced morphological plasticity and functional recovery.
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Rehabilitative experience following focal ischemic brain injury: Evidence for bihemispheric neural reorganization and the existence of a critical period for enhanced morphological plasticity and functional recovery.

机译：局灶性缺血性脑损伤后的康复经验：双半球神经重组的证据以及增强形态可塑性和功能恢复的关键时期的存在。

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摘要

For most stroke victims, physical rehabilitation is the only treatment option. Several clinical studies have demonstrated the efficacy of rehabilitative therapy to improve sensorimotor function following stroke (Sunderland et al., 1992; Kopp et al., 1999; Kunkel et al., 1999), although the neural mechanisms underlying recovery are poorly understood.; The initial series of experiments utilized serial nuclear magnetic resonance (NMR) imaging to characterize a novel model of middle cerebral artery (MCA) occlusion in the rat. Application of the vasoconstrictive peptide endothelin-1 (ET-1) adjacent to the proximal MCA caused a moderate, but prolonged reduction in cerebral blood flow (CBF) resulting in tissue infarction that subsequently evolved over 48 hours. Importantly, this model of MCA occlusion was found to closely resemble the dynamics observed in clinical stroke.; Rehabilitative therapy provides modest functional improvement after brain injury that is associated with reorganization of cortical neural circuitry in regions adjacent to the infarction (Nudo et al., 1996a). Utilizing the ET-1 model of focal ischemia, Chapter 3 expands on these findings by demonstrating that intensive enriched-rehabilitation of the impaired forelimb provides long-term (3 months) sensorimotor recovery following extensive ischemic injury to both striatum and the cerebral cortex. Improved function was associated with enhanced dendritic growth within the contralateral, undamaged motor cortex, thereby providing a potential morphological substrate for bihemispheric brain activation patterns observed in recovering stroke patients during movement of the affected limb.; Chapter 4 asked specifically whether the observed neuronal remodeling within the undamaged hemisphere contributes to functional recovery of the (ipsilateral) affected forelimb after ischemic brain injury. Lidocaine anesthesia of the undamaged forelimb motor cortex during forelimb reaching of recovering animals reinstated initial motor deficits and abolished reaching ability. Recruitment of the undamaged motor cortex during reaching with the affected limb following focal ischemic injury was dependent on severity of infarction, since only moderate impairment was observed following lidocaine challenge in animals with small infarcts or control animals. The pattern of functional neuronal reorganization after stroke may be dependent on size and distribution of injury.; Finally, Chapter 5 identifies a critical period during which the post-stroke brain is most responsive to rehabilitative intervention. Rehabilitation initiated at either 5 or 14 days after the stroke provided significant functional gains and a marked elevation in neuronal growth that was not observed when the same treatment was delayed for one month. This finding has important (and immediate) implications for rehabilitative practices following stroke.
机译：对于大多数中风患者，身体康复是唯一的治疗选择。一些临床研究表明，康复疗法改善中风后感觉运动功能的功效（Sunderland等，1992； Kopp等，1999； Kunkel等，1999），尽管对恢复的神经机制了解甚少。最初的一系列实验利用串行核磁共振（NMR）成像来表征大鼠中脑中动脉（MCA）阻塞的新型模型。与近端MCA相邻使用血管收缩肽内皮素-1（ET-1）引起脑血流量（CBF）适度但长期减少，从而导致组织梗塞，继而在48小时内演变为脑梗塞。重要的是，发现这种MCA闭塞模型与临床中风中观察到的动力学非常相似。康复治疗可在脑损伤后提供适度的功能改善，这与梗死邻近区域的皮质神经回路的重组有关（Nudo等，1996a）。第三章利用局灶性局部缺血的ET-1模型，通过证实受损前肢的强化强化康复可以在纹状体和大脑皮层广泛缺血性损伤后提供长期（3个月）感觉运动恢复。功能的改善与对侧的，未受损的运动皮层内树突状生长的增强有关，从而为患肢康复的中风患者康复时观察到的双半球脑激活模式提供了潜在的形态学底物。第4章专门询问在未受损的半球内观察到的神经元重塑是否有助于缺血性脑损伤后受影响的前肢（同侧）的功能恢复。在恢复动物的前肢到达过程中，未受损的前肢运动皮层的利多卡因麻醉恢复了最初的运动缺陷并取消了达到能力。在局灶性缺血性损伤后到达患肢期间，未受损的运动皮层的募集取决于梗塞的严重程度，因为在小梗死的动物或对照动物中，利多卡因攻击后仅观察到中度损伤。脑卒中后功能神经元的重组方式可能取决于损伤的大小和分布。最后，第5章确定了卒中后大脑对康复干预最敏感的关键时期。中风后5或14天开始的康复治疗提供了显着的功能增强，并且神经元生长显着升高，而相同的治疗方法延迟一个月没有观察到。这一发现对中风后的康复实践具有重要（直接）的意义。

著录项

  • 作者

    Biernaskie, Jeffrey A.;

  • 作者单位

    Memorial University of Newfoundland (Canada).;

  • 授予单位 Memorial University of Newfoundland (Canada).;
  • 学科 Biology Neuroscience.
  • 学位 Ph.D.
  • 年度 2003
  • 页码 153 p.
  • 总页数 153
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 神经科学;
  • 关键词

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