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Wang YL, Chen CC, Chang CP. Effect of stress on the rehabilitation performance of rats with repetitive mild fluid percussion-induced traumatic brain injuries. Cogn Neurodyn 2024; 18:283-297. [PMID: 38406191 PMCID: PMC10881937 DOI: 10.1007/s11571-023-09961-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 02/21/2023] [Accepted: 03/17/2023] [Indexed: 02/27/2024] Open
Abstract
Animal models of traumatic brain injury (TBI) have shown that impaired motor and cognitive function can be improved by physical exercise. However, not each animal with TBI can be well rehabilitated at the same training intensity due to a high inter-subject variability. Hence, this paper presents a two-stage wheel-based mixed-mode rehabilitation mechanism by which the effect of stress on the rehabilitation performance was investigated. The mixed-mode rehabilitation mechanism consists of a two-week adaptive and a one-week voluntary rehabilitation program as Stages 1 and 2, respectively. In Stage 1, the common over and undertraining problem were completely resolved due to the adaptive design, and rats ran voluntarily over a 30-min duration in Stage 2. The training intensity adapted to the physical condition of all the TBI rats at all times in Stage 1, and then the self-motivated running rats were further rehabilitated under the lowest level of stress in Stage 2. For comparison purposes, another group of rats took a 3-week adaptive rehabilitation program. During the 3-week program, the rehabilitation performance of the rats were assessed using modified neurologic severity score (mNSS) and an 8-arm radial maze. Surprisingly, the group taking the mixed mode program turned out to outperform its counterpart in terms of mNSS. The mixed-mode rehabilitation mechanism was validated as an effective and efficient way to help rats restore motor, neurological and cognitive function after TBI. It was validated that the rehabilitation performance can be optimized under the lowest level of stress.
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Affiliation(s)
- Yu-Lin Wang
- Center of General Education, Southern Taiwan University of Science and Technology, Tainan, 710301 Taiwan
- College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708 Taiwan
- Department of Physical Medicine and Rehabilitation, Chi-Mei Medical Center, Tainan, 710 Taiwan
| | - Chi-Chun Chen
- Department of Electronic Engineering, National Chin-Yi University of Technology, Taichung, 41170 Taiwan
| | - Ching-Ping Chang
- Department of Medical Research, Chi Mei Medical Center, Tainan, 710 Taiwan
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2
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De Las Heras B, Rodrigues L, Cristini J, Moncion K, Ploughman M, Tang A, Fung J, Roig M. Measuring Neuroplasticity in Response to Cardiovascular Exercise in People With Stroke: A Critical Perspective. Neurorehabil Neural Repair 2024:15459683231223513. [PMID: 38291890 DOI: 10.1177/15459683231223513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
BACKGROUND Rehabilitative treatments that promote neuroplasticity are believed to improve recovery after stroke. Animal studies have shown that cardiovascular exercise (CE) promotes neuroplasticity but the effects of this intervention on the human brain and its implications for the functional recovery of patients remain unclear. The use of biomarkers has enabled the assessment of cellular and molecular events that occur in the central nervous system after brain injury. Some of these biomarkers have proven to be particularly valuable for the diagnosis of severity, prognosis of recovery, as well as for measuring the neuroplastic response to different treatments after stroke. OBJECTIVES To provide a critical analysis on the current evidence supporting the use of neurophysiological, neuroimaging, and blood biomarkers to assess the neuroplastic response to CE in individuals poststroke. RESULTS Most biomarkers used are responsive to the effects of acute and chronic CE interventions, but the response appears to be variable and is not consistently associated with functional improvements. Small sample sizes, methodological variability, incomplete information regarding patient's characteristics, inadequate standardization of training parameters, and lack of reporting of associations with functional outcomes preclude the quantification of the neuroplastic effects of CE poststroke using biomarkers. CONCLUSION Consensus on the optimal biomarkers to monitor the neuroplastic response to CE is currently lacking. By addressing critical methodological issues, future studies could advance our understanding of the use of biomarkers to measure the impact of CE on neuroplasticity and functional recovery in patients with stroke.
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Affiliation(s)
- Bernat De Las Heras
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Jewish Rehabilitation Hospital, Laval, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
| | - Lynden Rodrigues
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Jewish Rehabilitation Hospital, Laval, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
| | - Jacopo Cristini
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Jewish Rehabilitation Hospital, Laval, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
| | - Kevin Moncion
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Michelle Ploughman
- Recovery and Performance Laboratory, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Ada Tang
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Joyce Fung
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
| | - Marc Roig
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Jewish Rehabilitation Hospital, Laval, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
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3
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Lee HY, Song SY, Hwang J, Baek A, Baek D, Kim SH, Park JH, Choi S, Pyo S, Cho SR. Very early environmental enrichment protects against apoptosis and improves functional recovery from hypoxic-ischemic brain injury. Front Mol Neurosci 2023; 15:1019173. [PMID: 36824441 PMCID: PMC9942523 DOI: 10.3389/fnmol.2022.1019173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 12/29/2022] [Indexed: 02/10/2023] Open
Abstract
Appropriate rehabilitation of stroke patients at a very early phase results in favorable outcomes. However, the optimal strategy for very early rehabilitation is at present unclear due to the limited knowledge on the effects of very early initiation of rehabilitation based on voluntary exercise (VE). Environmental enrichment (EE) is a therapeutic paradigm for laboratory animals that involves complex combinations of physical, cognitive, and social stimuli, as well as VE. Few studies delineated the effect of EE on apoptosis in very early stroke in an experimental model. Although a minimal benefit of early rehabilitation in stroke models has been claimed in previous studies, these were based on a forced exercise paradigm. The aim of this study is to determine whether very early exposure to EE can effectively regulate Fas/FasL-mediated apoptosis following hypoxic-ischemic (HI) brain injury and improve neurobehavioral function. C57Bl/6 mice were housed for 2 weeks in either cages with EE or standard cages (SC) 3 h or 72 h after HI brain injury. Very early exposure to EE was associated with greater improvement in motor function and cognitive ability, reduced volume of the infarcted area, decreased mitochondria-mediated apoptosis, and decreased oxidative stress. Very early exposure to EE significantly downregulated Fas/FasL-mediated apoptosis, decreased expression of Fas, Fas-associated death domain, cleaved caspase-8/caspase-8, cleaved caspase-3/caspase-3, as well as Bax and Bcl-2, in the cerebral cortex and the hippocampus. Delayed exposure to EE, on the other hand, failed to inhibit the extrinsic pathway of apoptosis. This study demonstrates that very early exposure to EE is a potentially useful therapeutic translation for stroke rehabilitation through effective inhibition of the extrinsic and intrinsic apoptotic pathways.
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Affiliation(s)
- Hoo Young Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea,National Traffic Injury Rehabilitation Hospital, Gyeonggi-do, Republic of Korea,Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Suk-Young Song
- Graduate Program of Biomedical Engineering, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jihye Hwang
- Graduate Program of Biomedical Engineering, Yonsei University College of Medicine, Seoul, Republic of Korea,Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ahreum Baek
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea,Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Dawoon Baek
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea,Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Sung Hoon Kim
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jung Hyun Park
- Yonsei University College of Medicine, Seoul, Republic of Korea,Department of Rehabilitation Medicine, Rehabilitation Institute of Neuromuscular Disease, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sungchul Choi
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Soonil Pyo
- Neuracle Science Co. Ltd., Seoul, Republic of Korea,Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Republic of Korea
| | - Sung-Rae Cho
- Graduate Program of Biomedical Engineering, Yonsei University College of Medicine, Seoul, Republic of Korea,Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea,Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Republic of Korea,Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Republic of Korea,*Correspondence: Sung-Rae Cho, ✉
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So I, Meusel LAC, Sharma B, Monette GA, Colella B, Wheeler AL, Rabin JS, Mikulis DJ, Green REA. Longitudinal Patterns of Functional Connectivity in Moderate-to-Severe Traumatic Brain Injury. J Neurotrauma 2023; 40:665-682. [PMID: 36367163 DOI: 10.1089/neu.2022.0242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Longitudinal neuroimaging studies aid our understanding of recovery mechanisms in moderate-to-severe traumatic brain injury (TBI); however, there is a dearth of longitudinal functional connectivity research. Our aim was to characterize longitudinal functional connectivity patterns in two clinically important brain networks, the frontoparietal network (FPN) and the default mode network (DMN), in moderate-to-severe TBI. This inception cohort study of prospectively collected longitudinal data used resting-state functional magnetic resonance imaging (fMRI) to characterize functional connectivity patterns in the FPN and DMN. Forty adults with moderate-to-severe TBI (mean ± standard deviation [SD]; age = 39.53 ± 16.49 years, education = 13.92 ± 3.20 years, lowest Glasgow Coma Scale score = 6.63 ± 3.24, sex = 70% male) were scanned at approximately 0.5, 1-1.5, and 3+ years post-injury. Seventeen healthy, uninjured participants (mean ± SD; age = 38.91 ± 15.57 years, education = 15.11 ± 2.71 years, sex = 29% male) were scanned at baseline and approximately 11 months afterwards. Group independent component analyses and linear mixed-effects modeling with linear splines that contained a knot at 1.5 years post-injury were employed to investigate longitudinal network changes, and associations with covariates, including age, sex, and injury severity. In patients with TBI, functional connectivity in the right FPN increased from approximately 0.5 to 1.5 years post-injury (unstandardized estimate = 0.19, standard error [SE] = 0.07, p = 0.009), contained a slope change in the opposite direction, from positive to negative at 1.5 years post-injury (estimate = -0.21, SE = 0.11, p = 0.009), and marginally declined afterwards (estimate = -0.10, SE = 0.06, p = 0.079). Functional connectivity in the DMN increased from approximately 0.5 to 1.5 years (estimate = 0.15, SE = 0.05, p = 0.006), contained a slope change in the opposite direction, from positive to negative at 1.5 years post-injury (estimate = -0.19, SE = 0.08, p = 0.021), and was estimated to decline from 1.5 to 3+ years (estimate = -0.04, SE = 0.04, p = 0.303). Similarly, the left FPN increased in functional connectivity from approximately 0.5 to 1.5 years post-injury (estimate = 0.15, SE = 0.05, p = 0.002), contained a slope change in the opposite direction, from positive to negative at 1.5 years post-injury (estimate = -0.18, SE = 0.07, p = 0.008), and was estimated to decline thereafter (estimate = -0.04, SE = 0.03, p = 0.254). At approximately 0.5 years post-injury, patients showed hypoconnectivity compared with healthy, uninjured participants at baseline. Covariates were not significantly associated in any of the models. Findings of early improvement but a tapering and possible decline in connectivity thereafter suggest that compensatory effects are time-limited. These later reductions in connectivity mirror growing evidence of behavioral and structural decline in chronic moderate-to-severe TBI. Targeting such declines represents a novel avenue of research and offers potential for improving clinical outcomes.
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Affiliation(s)
- Isis So
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,KITE Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
| | - Liesel-Ann C Meusel
- KITE Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
| | - Bhanu Sharma
- KITE Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.,Department of Medical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Georges A Monette
- Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
| | - Brenda Colella
- KITE Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
| | - Anne L Wheeler
- Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer S Rabin
- Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - David J Mikulis
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Medical Imaging, Toronto Western Hospital-University Health Network, Toronto, Ontario, Canada
| | - Robin E A Green
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,KITE Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
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5
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Zhang J, Xiao X, Jin Q, Li J, Zhong D, Li Y, Qin Y, Zhang H, Liu X, Xue C, Zheng Z, Jin R. The effect and safety of constraint-induced movement therapy for post-stroke motor dysfunction: a meta-analysis and trial sequential analysis. Front Neurol 2023; 14:1137320. [PMID: 37144004 PMCID: PMC10151521 DOI: 10.3389/fneur.2023.1137320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/13/2023] [Indexed: 05/06/2023] Open
Abstract
Background Due to motor function insufficiency, patients with post-stroke motor dysfunction (PSMD) have limitations in performing an activity, feel restricted during social participation, and feel impaired in their quality of life. Constraint-induced movement therapy (CIMT) is a neurorehabilitation technique, but its effectiveness on PSMD after stroke still remains controversial. Objective This meta-analysis and trial sequential analysis (TSA) aimed to comprehensively evaluate the effect and safety of CIMT for PSMD. Methods Four electronic databases were searched from their inception to 1 January 2023 to identify randomized controlled trials (RCTs) investigating the effectiveness of CIMT for PSMD. Two reviewers independently extracted the data and assessed the risk of bias and reporting quality. The primary outcome was a motor activity log for the amount of use (MAL-AOU) and the quality of movement (MAL-QOM). RevMan 5.4, Statistical Package for Social Sciences (SPSS) 25.0, and STATA 13.0 software were used for statistical analysis. The certainty of the evidence was appraised using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. We also performed the TSA to assess the reliability of the evidence. Results A total of 44 eligible RCTs were included. Our results showed that CIMT combined with conventional rehabilitation (CR) was superior to CR in improving MAL-AOU and MAL-QOM scores. The results of TSA indicated that the above evidence was reliable. Subgroup analysis demonstrated that CIMT (≥6 h per day or duration ≤ 20 days) combined with CR was more effective than CR. Meanwhile, both CIMT and modified CIMT (mCIMT) combined with CR were more efficient than CR at all stages of stroke. No severe CIMT-related adverse events occurred. Conclusion CIMT may be an optional and safe rehabilitation therapy to improve PSMD. However, due to limited studies, the optimal protocol of CIMT for PSMD was undetermined, and more RCTs are required for further exploration. Clinical trial registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=143490, identifier: CRD42019143490.
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Affiliation(s)
- Jiaming Zhang
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xianjun Xiao
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Qizu Jin
- The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan, China
| | - Juan Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Dongling Zhong
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yuxi Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yan Qin
- The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan, China
| | - Hong Zhang
- The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan, China
| | - Xiaobo Liu
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Chen Xue
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zhong Zheng
- Center for Neurobiological Detection, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- *Correspondence: Zhong Zheng
| | - Rongjiang Jin
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- Rongjiang Jin
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Kim CK, Park JS, Kim E, Oh MK, Lee YT, Yoon KJ, Joo KM, Lee K, Park YS. The effects of early exercise in traumatic brain-injured rats with changes in motor ability, brain tissue, and biomarkers. BMB Rep 2022; 55:512-517. [PMID: 36104258 PMCID: PMC9623238 DOI: 10.5483/bmbrep.2022.55.10.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/06/2022] [Accepted: 08/17/2022] [Indexed: 09/19/2023] Open
Abstract
Traumatic brain injury (TBI) is brain damage which is caused by the impact of external mechanical forces. TBI can lead to the temporary or permanent impairment of physical and cognitive abilities, resulting in abnormal behavior. We recently observed that a single session of early exercise in animals with TBI improved their behavioral performance in the absence of other cognitive abnormalities. In the present study, we investigated the therapeutic effects of continuous exercise during the early stages of TBI in rats. We found that continuous low-intensity exercise in early-stage improves the locomotion recovery in the TBI of animal models; however, it does not significantly enhance short-term memory capabilities. Moreover, continuous early exercise not only reduces the protein expression of cerebral damage-related markers, such as Glial Fibrillary Acid Protein (GFAP), Neuron-Specific Enolase (NSE), S100β, Protein Gene Products 9.5 (PGP9.5), and Heat Shock Protein 70 (HSP70), but it also decreases the expression of apoptosis-related protein BAX and cleaved caspase 3. Furthermore, exercise training in animals with TBI decreases the microglia activation and the expression of inflammatory cytokines in the serum, such as CCL20, IL-13, IL-1α, and IL-1β. These findings thus demonstrate that early exercise therapy for TBI may be an effective strategy in improving physiological function, and that serum protein levels are useful biomarkers for the predicition of the effectiveness of early exercise therapy.[BMB Reports 2022; 55(10): 506-511].
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Affiliation(s)
- Chung Kwon Kim
- Biomedical Institute for Convergence at SKKU (BICS), Sungkyunkwan University, Suwon 16419, Korea
- Single Cell Network Research Center, Sungkyunkwan University School of Medicine, Suwon 16149, Korea
- Medical Innovation Technology Inc. (MEDINNO Inc.), Seoul 08517, Korea
| | - Jee Soo Park
- Single Cell Network Research Center, Sungkyunkwan University School of Medicine, Suwon 16149, Korea
- Department of Anatomy and Cell Biology, Sungkyunkwan University School of Medicine, Suwon 16149, Korea
| | - Eunji Kim
- Medical Innovation Technology Inc. (MEDINNO Inc.), Seoul 08517, Korea
| | - Min-Kyun Oh
- Department of Rehabilitation Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University Graduate School of Medicine, Jinju 52727, Korea
| | - Yong-Taek Lee
- Department of Physical & Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea
| | - Kyung Jae Yoon
- Department of Physical & Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea
| | - Kyeung Min Joo
- Biomedical Institute for Convergence at SKKU (BICS), Sungkyunkwan University, Suwon 16419, Korea
- Single Cell Network Research Center, Sungkyunkwan University School of Medicine, Suwon 16149, Korea
- Medical Innovation Technology Inc. (MEDINNO Inc.), Seoul 08517, Korea
- Department of Anatomy and Cell Biology, Sungkyunkwan University School of Medicine, Suwon 16149, Korea
| | - Kyunghoon Lee
- Biomedical Institute for Convergence at SKKU (BICS), Sungkyunkwan University, Suwon 16419, Korea
- Department of Anatomy and Cell Biology, Sungkyunkwan University School of Medicine, Suwon 16149, Korea
| | - Young Sook Park
- Department of Physical & Rehabilitation Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, Korea
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Sayyah M, Seydyousefi M, Moghanlou AE, Metz GAS, Shamsaei N, Faghfoori MH, Faghfoori Z. Activation of BDNF- and VEGF-mediated Neuroprotection by Treadmill Exercise Training in Experimental Stroke. Metab Brain Dis 2022; 37:1843-1853. [PMID: 35596908 DOI: 10.1007/s11011-022-01003-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 04/21/2022] [Indexed: 12/01/2022]
Abstract
Early treatment of ischemic stroke is one of the most effective ways to reduce brains' cell death and promote functional recovery. This study was designed to examine the effect of aerobic exercise on post ischemia/reperfusion injury on concentration and expression of brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF) after inducing a neuronal loss in CA1 region of hippocampus in Male Wistar rats. Three experimental groups including sham(S), ischemia/reperfusion-control (IRC) and ischemia/reperfusion exercise (IRE) were used for this purpose. The rats in the IRE group received a bilateral carotid artery occlusion treatment. They ran for 45 minutes on a treadmill five days per week for eight consecutive weeks. Cresyl violet (Nissl), Hematoxylin (H & E) and Eosin staining procedure were used to determine the extent of damage. A ladder rung walking task was used to assess the functional impairments and recovery after the ischemic lesion. ELISA and immunohistochemistry method were employed to measure BDNF and VEGF protein expressions. The result showed that the brain ischemia/reperfusion condition increased the cell death in hippocampal CA1 neurons and impaired motor performance on the ladder rung task whereas the aerobic exercise program significantly decreased the brain cell's death and improved motor skill performance. It was concluded that ischemic brain lesion decreased the BDNF and VEGF expression. It seems that the aerobic exercise following the ischemia/reperfusion potentially promotes neuroprotective mechanisms and neuronal repair and survival mediated partly by BDNF and other pathways.
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Affiliation(s)
- Mansour Sayyah
- Clinical Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Mehdi Seydyousefi
- Department of Physical Education and Sport Sciences, Bojnourd Branch, Islamic Azad University, Bojnourd, Iran
| | | | - Gerlinde A S Metz
- Canadian Centre for Behavioural Neuroscience, Department of Neuroscience, University of Lethbridge, 4401 University Drive, Lethbridge, Alberta, T1K 3M4, Canada
| | - Nabi Shamsaei
- Department of Physical Education and Sport Sciences, Ilam University, Ilam, Iran
| | - Mohammad Hasan Faghfoori
- Department of Medical Biotechnology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Zeinab Faghfoori
- Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iran.
- Department of Nutrition, School of Nutrition and Food Sciences, Semnan University of Medical Sciences, Semnan, Iran.
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8
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Flores Á, López-Santos D, García-Alías G. When Spinal Neuromodulation Meets Sensorimotor Rehabilitation: Lessons Learned From Animal Models to Regain Manual Dexterity After a Spinal Cord Injury. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:755963. [PMID: 36188826 PMCID: PMC9397786 DOI: 10.3389/fresc.2021.755963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/16/2021] [Indexed: 12/22/2022]
Abstract
Electrical neuromodulation has strongly hit the foundations of spinal cord injury and repair. Clinical and experimental studies have demonstrated the ability to neuromodulate and engage spinal cord circuits to recover volitional motor functions lost after the injury. Although the science and technology behind electrical neuromodulation has attracted much of the attention, it cannot be obviated that electrical stimulation must be applied concomitantly to sensorimotor rehabilitation, and one would be very difficult to understand without the other, as both need to be finely tuned to efficiently execute movements. The present review explores the difficulties faced by experimental and clinical neuroscientists when attempting to neuromodulate and rehabilitate manual dexterity in spinal cord injured subjects. From a translational point of view, we will describe the major rehabilitation interventions employed in animal research to promote recovery of forelimb motor function. On the other hand, we will outline some of the state-of-the-art findings when applying electrical neuromodulation to the spinal cord in animal models and human patients, highlighting how evidences from lumbar stimulation are paving the path to cervical neuromodulation.
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Affiliation(s)
- África Flores
- Department of Cell Biology, Physiology and Immunology, Institute of Neuroscience, Universitat Autònoma de Barcelona and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Bellaterra, Spain
| | - Diego López-Santos
- Department of Cell Biology, Physiology and Immunology, Institute of Neuroscience, Universitat Autònoma de Barcelona and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Bellaterra, Spain
| | - Guillermo García-Alías
- Department of Cell Biology, Physiology and Immunology, Institute of Neuroscience, Universitat Autònoma de Barcelona and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Bellaterra, Spain
- Institut Guttmann de Neurorehabilitació, Badalona, Spain
- *Correspondence: Guillermo García-Alías
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9
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Kerr AL. Contralesional plasticity following constraint-induced movement therapy benefits outcome: contributions of the intact hemisphere to functional recovery. Rev Neurosci 2021; 33:269-283. [PMID: 34761646 DOI: 10.1515/revneuro-2021-0085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/15/2021] [Indexed: 11/15/2022]
Abstract
Stroke is a leading cause of death and disability worldwide. A common, chronic deficit after stroke is upper limb impairment, which can be exacerbated by compensatory use of the nonparetic limb. Resulting in learned nonuse of the paretic limb, compensatory reliance on the nonparetic limb can be discouraged with constraint-induced movement therapy (CIMT). CIMT is a rehabilitative strategy that may promote functional recovery of the paretic limb in both acute and chronic stroke patients through intensive practice of the paretic limb combined with binding, or otherwise preventing activation of, the nonparetic limb during daily living exercises. The neural mechanisms that support CIMT have been described in the lesioned hemisphere, but there is a less thorough understanding of the contralesional changes that support improved functional outcome following CIMT. Using both human and non-human animal studies, the current review explores the role of the contralesional hemisphere in functional recovery of stroke as it relates to CIMT. Current findings point to a need for a better understanding of the functional significance of contralesional changes, which may be determined by lesion size, location, and severity as well stroke chronicity.
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Affiliation(s)
- Abigail L Kerr
- Departments of Psychology and Neuroscience, Illinois Wesleyan University, 1312 Park Street, Bloomington, IL 61701, USA
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10
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Critical Period After Stroke Study (CPASS): A phase II clinical trial testing an optimal time for motor recovery after stroke in humans. Proc Natl Acad Sci U S A 2021; 118:2026676118. [PMID: 34544853 PMCID: PMC8488696 DOI: 10.1073/pnas.2026676118] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2021] [Indexed: 02/06/2023] Open
Abstract
Restoration of postinjury brain function is a signal neuroscience challenge. Animal models of stroke recovery demonstrate time-limited windows of heightened motor recovery, similar to developmental neuroplasticity. However, no equivalent windows have been demonstrated in humans. We report a randomized controlled trial applying essential elements of animal motor training paradigms to humans, to determine the existence of an analogous sensitive period in adults. We found a similar sensitive or optimal period 60 to 90 d after stroke, with lesser effects ≤30 d and no effect 6 mo or later after stroke. These findings prospectively demonstrated the existence of a sensitive period in adult humans. We urge the provision of more intensive motor rehabilitation within 60 to 90 d after stroke onset. Restoration of human brain function after injury is a signal challenge for translational neuroscience. Rodent stroke recovery studies identify an optimal or sensitive period for intensive motor training after stroke: near-full recovery is attained if task-specific motor training occurs during this sensitive window. We extended these findings to adult humans with stroke in a randomized controlled trial applying the essential elements of rodent motor training paradigms to humans. Stroke patients were adaptively randomized to begin 20 extra hours of self-selected, task-specific motor therapy at ≤30 d (acute), 2 to 3 mo (subacute), or ≥6 mo (chronic) after stroke, compared with controls receiving standard motor rehabilitation. Upper extremity (UE) impairment assessed by the Action Research Arm Test (ARAT) was measured at up to five time points. The primary outcome measure was ARAT recovery over 1 y after stroke. By 1 y we found significantly increased UE motor function in the subacute group compared with controls (ARAT difference = +6.87 ± 2.63, P = 0.009). The acute group compared with controls showed smaller but significant improvement (ARAT difference = +5.25 ± 2.59 points, P = 0.043). The chronic group showed no significant improvement compared with controls (ARAT = +2.41 ± 2.25, P = 0.29). Thus task-specific motor intervention was most effective within the first 2 to 3 mo after stroke. The similarity to rodent model treatment outcomes suggests that other rodent findings may be translatable to human brain recovery. These results provide empirical evidence of a sensitive period for motor recovery in humans.
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11
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de Boer A, Storm A, Gomez-Soler M, Smolders S, Rué L, Poppe L, B Pasquale E, Robberecht W, Lemmens R. Environmental enrichment during the chronic phase after experimental stroke promotes functional recovery without synergistic effects of EphA4 targeted therapy. Hum Mol Genet 2021; 29:605-617. [PMID: 31814004 PMCID: PMC7068116 DOI: 10.1093/hmg/ddz288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 11/14/2019] [Accepted: 12/04/2019] [Indexed: 12/31/2022] Open
Abstract
Worldwide, stroke is the main cause of long-term adult disability. After the initial insult, most patients undergo a subacute period with intense plasticity and rapid functional improvements. This period is followed by a chronic phase where recovery reaches a plateau that is only partially modifiable by rehabilitation. After experimental stroke, various subacute rehabilitation paradigms improve recovery. However, in order to reach the best possible outcome, a combination of plasticity-promoting strategies and rehabilitation might be necessary. EphA4 is a negative axonal guidance regulator during development. After experimental stroke, reduced EphA4 levels improve functional outcome with similar beneficial effects upon the inhibition of EphA4 downstream targets. In this study, we assessed the effectiveness of a basic enriched environment in the chronic phase after photothrombotic stroke in mice as well as the therapeutic potential of EphA4 targeted therapy followed by rehabilitation. Our findings show that environmental enrichment in the chronic phase improves functional outcome up to 2 months post-stroke. Although EphA4 levels increase after experimental stroke, subacute EphA4 inhibition followed by environmental enrichment does not further increase recovery. In conclusion, we show that environmental enrichment during the chronic phase of stroke improves functional outcome in mice with no synergistic effects of the used EphA4 targeted therapy.
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Affiliation(s)
- Antina de Boer
- Department of Neurosciences, Experimental Neurology, and Leuven Brain Institute (LBI), KU Leuven-University of Leuven, Leuven 3000, Belgium.,VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven 3000, Belgium
| | - Annet Storm
- Department of Neurosciences, Experimental Neurology, and Leuven Brain Institute (LBI), KU Leuven-University of Leuven, Leuven 3000, Belgium.,VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven 3000, Belgium
| | - Maricel Gomez-Soler
- Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA 92037, USA
| | - Silke Smolders
- Department of Neurosciences, Experimental Neurology, and Leuven Brain Institute (LBI), KU Leuven-University of Leuven, Leuven 3000, Belgium.,VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven 3000, Belgium
| | - Laura Rué
- Department of Neurosciences, Experimental Neurology, and Leuven Brain Institute (LBI), KU Leuven-University of Leuven, Leuven 3000, Belgium.,VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven 3000, Belgium
| | - Lindsay Poppe
- Department of Neurosciences, Experimental Neurology, and Leuven Brain Institute (LBI), KU Leuven-University of Leuven, Leuven 3000, Belgium.,VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven 3000, Belgium
| | - Elena B Pasquale
- Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA 92037, USA
| | - Wim Robberecht
- Department of Neurosciences, Experimental Neurology, and Leuven Brain Institute (LBI), KU Leuven-University of Leuven, Leuven 3000, Belgium.,Department of Neurology, University Hospitals Leuven, Leuven 3000, Belgium
| | - Robin Lemmens
- Department of Neurosciences, Experimental Neurology, and Leuven Brain Institute (LBI), KU Leuven-University of Leuven, Leuven 3000, Belgium.,VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven 3000, Belgium.,Department of Neurology, University Hospitals Leuven, Leuven 3000, Belgium
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Abstract
Stroke is a debilitating disease. Current effective therapies for stroke recovery are limited to neurorehabilitation. Most stroke recovery occurs in a limited and early time window. Many of the mechanisms of spontaneous recovery after stroke parallel mechanisms of normal learning and memory. While various efforts are in place to identify potential drug targets, an emerging approach is to understand biological correlates between learning and stroke recovery. This review assesses parallels between biological changes at the molecular, structural, and functional levels during learning and recovery after stroke, with a focus on drug and cellular targets for therapeutics.
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Affiliation(s)
- Mary Teena Joy
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | - S. Thomas Carmichael
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
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13
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Nemchek V, Haan EM, Kerr AL. Intermittent Skill Training Results in Moderate Improvement in Functional Outcome in a Mouse Model of Ischemic Stroke. Neurorehabil Neural Repair 2020; 35:79-87. [PMID: 33317421 DOI: 10.1177/1545968320975423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Stroke is a leading cause of disability worldwide. Focused training of the impaired limb has been shown to improve its functional outcome in animal models. However, most human stroke survivors exhibit persistent motor deficits, likely due to differences in rehabilitation intensity between experimental (animal) and clinical (human) settings. OBJECTIVE The current study investigated the effect of training intensity on behavioral outcome in a mouse model of stroke. METHODS Mice were trained preoperatively on a skilled reaching task. After training, mice received a unilateral photothrombotic stroke. Postoperatively, animals received either daily rehabilitative training (traditional intensity), intermittent rehabilitative training (every other day), or no rehabilitative training (control). Assessment of the impaired limb occurred after 14 training sessions (14 days for the Traditional group; 28 days for the Intermittent group). RESULTS Assessment of the impaired limb illustrated that traditional, daily training resulted in significantly better performance than no training, while intermittent training offered moderate performance gains. Mice receiving intermittent training performed significantly better than control mice but did not exhibit reaching performance as strong as that of animals trained daily. CONCLUSIONS The intensity of rehabilitation is important for optimal recovery. Although intermediate intensity offers some benefit, it is not intensive enough to mimic the performance gains traditionally observed in animal models. These results suggest that intensive training, which is often unavailable for human stroke survivors, is necessary to achieve an optimal functional outcome. The lower bounds of training intensity for functional benefit still need to be determined.
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Affiliation(s)
| | - Emma M Haan
- Illinois Wesleyan University, Bloomington, IL, USA
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14
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Torres-Espín A, Beaudry E, Fenrich K, Fouad K. Rehabilitative Training in Animal Models of Spinal Cord Injury. J Neurotrauma 2019; 35:1970-1985. [PMID: 30074874 DOI: 10.1089/neu.2018.5906] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Rehabilitative motor training is currently one of the most widely used approaches to promote moderate recovery following injuries of the central nervous system. Such training is generally applied in the clinical setting, whereas it is not standard in preclinical research. This is a concern as it is becoming increasingly apparent that neuroplasticity enhancing treatments require training or some form of activity as a co-therapy to promote functional recovery. Despite the importance of training and the many open questions regarding its mechanistic consequences, its use in preclinical animal models is rather limited. Here we review approaches, findings and challenges when training is applied in animal models of spinal cord injury, and we suggest recommendations to facilitate the integration of training using an appropriate study design, into pre-clinical studies.
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Affiliation(s)
- Abel Torres-Espín
- Faculty of Rehabilitation Medicine and Institute for Neuroscience and Mental Health, University of Alberta , Edmonton, Alberta, Canada
| | - Eric Beaudry
- Faculty of Rehabilitation Medicine and Institute for Neuroscience and Mental Health, University of Alberta , Edmonton, Alberta, Canada
| | | | - Karim Fouad
- Faculty of Rehabilitation Medicine and Institute for Neuroscience and Mental Health, University of Alberta , Edmonton, Alberta, Canada
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15
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Assessment of Somatosensory Reorganization by Functional Magnetic Resonance Imaging After Hand Replantation. Ann Plast Surg 2019; 83:468-474. [PMID: 31524745 DOI: 10.1097/sap.0000000000001946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Amputation of the hand is a rare and extremely intense trauma. Replanting and allografting after this type of injury require a major reorganization of the brain. Brain plasticity, though better known in the context of disorders of the central nervous system, is just as indispensable when the extremities are damaged. MATERIALS AND METHODS A 17-year-old patient underwent replantation of the nondominant hand after transmetaphyseal amputation after traumatic injury. After 18 days in hospital and subsequent treatment in a physical rehabilitation center, the patient attended clinical and radiology follow-up sessions over the next 2 years. RESULTS The management of this patient led to an excellent functional outcome in conjunction with successful social and professional reintegration. Electromyography at 18 months confirmed nerve regrowth. Functional magnetic resonance imaging was done at 2 years to evaluate cerebral plasticity. Motor function, largely dependent on the primary motor area, is aided by the addition of secondary and accessory motor areas for both simple and complex movements. A change in sensory information is stimulation in its own right hemisphere and increases solicitation of the contralateral precentral and postcentral gyrus. CONCLUSIONS There seems to be a real reversible dynamic plasticity under the balance of inhibitory and excitatory influences exerted on the cortical neurons. Any disruption of this balance requires the brain to adapt to the new circumstances to reestablish the hand as a functioning part of the body.
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16
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Dynamic Interaction between Cortico-Brainstem Pathways during Training-Induced Recovery in Stroke Model Rats. J Neurosci 2019; 39:7306-7320. [PMID: 31395620 DOI: 10.1523/jneurosci.0649-19.2019] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/22/2019] [Accepted: 07/31/2019] [Indexed: 11/21/2022] Open
Abstract
Reorganization of residual descending motor circuits underlies poststroke recovery. We previously clarified a causal relationship between the cortico-rubral tract and intensive limb use-induced functional recovery after internal capsule hemorrhage (ICH). However, other descending tracts, such as the cortico-reticular tract, might also be involved in rehabilitation-induced compensation. To investigate whether rehabilitation-induced recovery after ICH involves a shift in the compensatory circuit from the cortico-rubral tract to the cortico-reticular tract, we established loss of function of the cortico-rubral tract or/and cortico-reticular tract using two sets of viral vectors comprising the Tet-on system and designer receptors exclusively activated by the designer drug system. We used an ICH model that destroyed almost 60% of the corticofugal fibers. Anterograde tracing in rehabilitated rats revealed abundant sprouting of axons from the motor cortex in the red nucleus but not in the medullary reticular formation during the early phase of recovery. This primary contribution of the cortico-rubral tract was demonstrated by its selective blockade, whereas selective cortico-reticular tract silencing had little effect. Interestingly, cortico-rubral tract blockade from the start of rehabilitation induced an obvious increase of axon sprouting in the reticular formation with substantial functional recovery. Additional cortico-reticular tract silencing under the cortico-rubral tract blockade significantly worsened the recovered forelimb function. Furthermore, the alternative recruitment of the cortico-reticular tract was gradually induced by intensive limb use under cortico-rubral tract blockade, in which cortico-reticular tract silencing caused an apparent motor deficit. These findings indicate that individual cortico-brainstem pathways have dynamic compensatory potency to support rehabilitative functional recovery after ICH.SIGNIFICANCE STATEMENT This study aimed to clarify the interaction between the cortico-rubral and the cortico-reticular tract during intensive rehabilitation and functional recovery after capsular stroke. Pathway-selective disturbance by two sets of viral vectors revealed that the cortico-rubral tract was involved in rehabilitation-induced recovery of forelimb function from an early phase after internal capsule hemorrhage, but that the cortico-reticular tract was not. The sequential disturbance of both tracts revealed that the cortico-reticular tract was recruited and involved in rehabilitation-induced recovery when the cortico-rubral tract failed to function. Our data demonstrate a dynamic compensatory action of individual cortico-brainstem pathways for recovery through poststroke rehabilitation.
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17
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Nesin SM, Sabitha K, Gupta A, Laxmi T. Constraint Induced Movement Therapy as a Rehabilitative Strategy for Ischemic Stroke—Linking Neural Plasticity with Restoration of Skilled Movements. J Stroke Cerebrovasc Dis 2019; 28:1640-1653. [PMID: 30904472 DOI: 10.1016/j.jstrokecerebrovasdis.2019.02.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 02/12/2019] [Accepted: 02/23/2019] [Indexed: 11/28/2022] Open
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18
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Li C, Zhang B, Tian S, Hu J, Gao B, Liu P, Hua Y, Bao W, Guan Y, Bai Y. Early wheel-running promotes functional recovery by improving mitochondria metabolism in olfactory ensheathing cells after ischemic stroke in rats. Behav Brain Res 2018; 361:32-38. [PMID: 30583029 DOI: 10.1016/j.bbr.2018.12.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/27/2018] [Accepted: 12/20/2018] [Indexed: 01/19/2023]
Abstract
Olfactory ensheathing cells (OECs) has been widely studied in stroke. The present study was aimed at examining the role of wheel-running treatment (WR) on rat olfactory ensheathing cells (rOECs) functions. Thirty adult male Sprague Dawley rats were randomly divided into two groups: the middle cerebral artery occlusion (MCAO) group and WR + MCAO group. Motor behavior was assessed through the footfault test, and the results showed that WR training markedly improved the neurobehavioral outcome. The glucose metabolic status of the brain was assessed with the micro-PET. This training significantly enhanced the glucose uptake of olfactory bulb in the early stage of WR treatment. The function of rOECs mitochondrial was significantly enhanced after 10 days of treatment. Body weight of rats in both of the two groups decreased and then increased slowly following the days. But the growth trend of the WR + MCAO group was no significantly higher than that of the WR group. This training significantly enhanced the glucose uptake, improved the proliferation of rOECs and increased the expression level of cytochrome C (Cyt-c). The mechanism may be associated with the facilitation of mitochondrial function of rOECs cells. Including facilitation of mitochondrial fusion, fission, and accompanying increased quantities of mitochondria. Obtained results indicate that early WR treatment may exert enhanced function on rOECs in vivo and increased mitochondrial amounts, and improved the expression level of Cyt-c after ischemic stroke.
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Affiliation(s)
- Ce Li
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 12 WuLuMuQi Middle Road, Shanghai 200040, China
| | - Bei Zhang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 12 WuLuMuQi Middle Road, Shanghai 200040, China
| | - Shan Tian
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 12 WuLuMuQi Middle Road, Shanghai 200040, China
| | - Jian Hu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 12 WuLuMuQi Middle Road, Shanghai 200040, China
| | - Beiyao Gao
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 12 WuLuMuQi Middle Road, Shanghai 200040, China
| | - Peile Liu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 12 WuLuMuQi Middle Road, Shanghai 200040, China
| | - Yan Hua
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 12 WuLuMuQi Middle Road, Shanghai 200040, China
| | - Weiqi Bao
- Department of PET Center, Huashan Hospital, Fudan University, 518 East Wuzhong Road, Shanghai 200235, China
| | - Yihui Guan
- Department of PET Center, Huashan Hospital, Fudan University, 518 East Wuzhong Road, Shanghai 200235, China
| | - Yulong Bai
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 12 WuLuMuQi Middle Road, Shanghai 200040, China.
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Yoon KJ, Kim DY. Immediate Effects of a Single Exercise on Behavior and Memory in the Early Period of Traumatic Brain Injury in Rats. Ann Rehabil Med 2018; 42:643-651. [PMID: 30404413 PMCID: PMC6246858 DOI: 10.5535/arm.2018.42.5.643] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 11/27/2017] [Indexed: 11/25/2022] Open
Abstract
Objective To evaluate the immediate effect of single exercise on physical performance and memory in the early stage of traumatic brain injury (TBI) in rats. Methods Ninety TBI rats were randomly assigned to T0 (sedentary), T10 (treadmill 10 m/min for 30 minutes), or T20 (treadmill 20 m/min for 30 minutes) groups, on day 3 (D3), D7, and D14 after TBI, respectively. Rotarod (RR), Barnes maze (BM), brain magnetic resonance imaging (MRI) and MR spectroscopy were performed immediately before and 6 hours after exercise. Rats were sacrificed for immunohistochemistry with heat shock protein 70 (Hsp70) and glial fibrillary acidic protein (GFAP). Results On D3, the T10 and T20 groups demonstrated significant improvement in RR (p<0.05). On D7, only the T20 group showed significantly enhanced RR (p<0.05). In BM on D3, the T20 group showed significant deterioration compared with the other groups (p<0.05). Lesion volume did not significantly differ among the groups. MR spectroscopy on D3 showed that only the T20 group had significantly increased choline/creatine and 0.9/creatine (p<0.05). In the perilesional area on D3, only T20 had a significantly higher Hsp70 and GFAP than the T0 group. On D7, Hsp70 was significantly higher in the T20 group than in the T0 group (p<0.05). In the ipsilesional hippocampus on D3, the T20 group showed a significantly higher Hsp70 and GFAP than the T0 group (p<0.05). Conclusion A single session of low-intensity exercise in the early period of TBI improves behavioral performance without inducing cognitive deficits. However, high-intensity exercise can exacerbate cognitive function in the early period after TBI. Therefore, the optimal timing of rehabilitation and exercise intensity are crucial in behavior and memory recovery after TBI.
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Affiliation(s)
- Kyung Jae Yoon
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea.,Medical Research Institute, Regenerative and Neuroscience Laboratory, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Dae Yul Kim
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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20
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Langhorne P, Wu O, Rodgers H, Ashburn A, Bernhardt J. A Very Early Rehabilitation Trial after stroke (AVERT): a Phase III, multicentre, randomised controlled trial. Health Technol Assess 2018; 21:1-120. [PMID: 28967376 DOI: 10.3310/hta21540] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Mobilising patients early after stroke [early mobilisation (EM)] is thought to contribute to the beneficial effects of stroke unit care but it is poorly defined and lacks direct evidence of benefit. OBJECTIVES We assessed the effectiveness of frequent higher dose very early mobilisation (VEM) after stroke. DESIGN We conducted a parallel-group, single-blind, prospective randomised controlled trial with blinded end-point assessment using a web-based computer-generated stratified randomisation. SETTING The trial took place in 56 acute stroke units in five countries. PARTICIPANTS We included adult patients with a first or recurrent stroke who met physiological inclusion criteria. INTERVENTIONS Patients received either usual stroke unit care (UC) or UC plus VEM commencing within 24 hours of stroke. MAIN OUTCOME MEASURES The primary outcome was good recovery [modified Rankin scale (mRS) score of 0-2] 3 months after stroke. Secondary outcomes at 3 months were the mRS, time to achieve walking 50 m, serious adverse events, quality of life (QoL) and costs at 12 months. Tertiary outcomes included a dose-response analysis. DATA SOURCES Patients, outcome assessors and investigators involved in the trial were blinded to treatment allocation. RESULTS We recruited 2104 (UK, n = 610; Australasia, n = 1494) patients: 1054 allocated to VEM and 1050 to UC. Intervention protocol targets were achieved. Compared with UC, VEM patients mobilised 4.8 hours [95% confidence interval (CI) 4.1 to 5.7 hours; p < 0.0001] earlier, with an additional three (95% CI 3.0 to 3.5; p < 0.0001) mobilisation sessions per day. Fewer patients in the VEM group (n = 480, 46%) had a favourable outcome than in the UC group (n = 525, 50%) (adjusted odds ratio 0.73, 95% CI 0.59 to 0.90; p = 0.004). Results were consistent between Australasian and UK settings. There were no statistically significant differences in secondary outcomes at 3 months and QoL at 12 months. Dose-response analysis found a consistent pattern of an improved odds of efficacy and safety outcomes in association with increased daily frequency of out-of-bed sessions but a reduced odds with an increased amount of mobilisation (minutes per day). LIMITATIONS UC clinicians started mobilisation earlier each year altering the context of the trial. Other potential confounding factors included staff patient interaction. CONCLUSIONS Patients in the VEM group were mobilised earlier and with a higher dose of therapy than those in the UC group, which was already early. This VEM protocol was associated with reduced odds of favourable outcome at 3 months cautioning against very early high-dose mobilisation. At 12 months, health-related QoL was similar regardless of group. Shorter, more frequent mobilisation early after stroke may be associated with a more favourable outcome. FUTURE WORK These results informed a new trial proposal [A Very Early Rehabilitation Trial - DOSE (AVERT-DOSE)] aiming to determine the optimal frequency and dose of EM. TRIAL REGISTRATION The trial is registered with the Australian New Zealand Clinical Trials Registry number ACTRN12606000185561, Current Controlled Trials ISRCTN98129255 and ISRCTN98129255. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 54. See the NIHR Journals Library website for further project information. Funding was also received from the National Health and Medical Research Council Australia, Singapore Health, Chest Heart and Stroke Scotland, Northern Ireland Chest Heart and Stroke, and the Stroke Association. In addition, National Health and Medical Research Council fellowship funding was provided to Julie Bernhardt (1058635), who also received fellowship funding from the Australia Research Council (0991086) and the National Heart Foundation (G04M1571). The Florey Institute of Neuroscience and Mental Health, which hosted the trial, acknowledges the support received from the Victorian Government via the Operational Infrastructure Support Scheme.
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Affiliation(s)
- Peter Langhorne
- Academic Section of Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Olivia Wu
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Helen Rodgers
- Institute for Ageing and Health, Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - Ann Ashburn
- Rehabilitation Research Unit, Southampton General Hospital, Southampton, UK
| | - Julie Bernhardt
- Stroke Division, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.,University of Melbourne, Parkville, VIC, Australia
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McDonald MW, Hayward KS, Rosbergen ICM, Jeffers MS, Corbett D. Is Environmental Enrichment Ready for Clinical Application in Human Post-stroke Rehabilitation? Front Behav Neurosci 2018; 12:135. [PMID: 30050416 PMCID: PMC6050361 DOI: 10.3389/fnbeh.2018.00135] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 06/14/2018] [Indexed: 11/13/2022] Open
Abstract
Environmental enrichment (EE) has been widely used as a means to enhance brain plasticity mechanisms (e.g., increased dendritic branching, synaptogenesis, etc.) and improve behavioral function in both normal and brain-damaged animals. In spite of the demonstrated efficacy of EE for enhancing brain plasticity, it has largely remained a laboratory phenomenon with little translation to the clinical setting. Impediments to the implementation of enrichment as an intervention for human stroke rehabilitation and a lack of clinical translation can be attributed to a number of factors not limited to: (i) concerns that EE is actually the "normal state" for animals, whereas standard housing is a form of impoverishment; (ii) difficulty in standardizing EE conditions across clinical sites; (iii) the exact mechanisms underlying the beneficial actions of enrichment are largely correlative in nature; (iv) a lack of knowledge concerning what aspects of enrichment (e.g., exercise, socialization, cognitive stimulation) represent the critical or active ingredients for enhancing brain plasticity; and (v) the required "dose" of enrichment is unknown, since most laboratory studies employ continuous periods of enrichment, a condition that most clinicians view as impractical. In this review article, we summarize preclinical stroke recovery studies that have successfully utilized EE to promote functional recovery and highlight the potential underlying mechanisms. Subsequently, we discuss how EE is being applied in a clinical setting and address differences in preclinical and clinical EE work to date. It is argued that the best way forward is through the careful alignment of preclinical and clinical rehabilitation research. A combination of both approaches will allow research to fully address gaps in knowledge and facilitate the implementation of EE to the clinical setting.
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Affiliation(s)
- Matthew W McDonald
- Department of Cellular & Molecular Medicine, University of Ottawa, Ottawa, ON, Canada.,Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada
| | - Kathryn S Hayward
- Stroke Division, Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia.,NHMRC Centre for Research Excellence in Stroke Rehabilitation and Brain Recovery, Heidelberg, VIC, Australia
| | - Ingrid C M Rosbergen
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.,Allied Health Services, Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australia
| | - Matthew S Jeffers
- Department of Cellular & Molecular Medicine, University of Ottawa, Ottawa, ON, Canada.,Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada
| | - Dale Corbett
- Department of Cellular & Molecular Medicine, University of Ottawa, Ottawa, ON, Canada.,Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada
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22
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Jeffers MS, Corbett D. Synergistic Effects of Enriched Environment and Task-Specific Reach Training on Poststroke Recovery of Motor Function. Stroke 2018; 49:1496-1503. [PMID: 29752347 DOI: 10.1161/strokeaha.118.020814] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/09/2018] [Accepted: 04/17/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND PURPOSE Reach training in concert with environmental enrichment provides functional benefits after experimental stroke in rats. The present study extended these findings by assessing whether intensive task-specific reach training or enrichment initiated alone would provide similar functional benefit. Additionally, we investigated whether the 70% recovery rule, or a combined model of initial poststroke impairment, cortical infarct volume, and rehabilitation intensity, could predict recovery in the single-pellet task, as previously found for the Montoya staircase. METHODS Rats were trained on single-pellet reaching before middle cerebral artery occlusion via intracerebral injection of ET-1 (endothelin-1). There were 4 experimental groups: stroke+enrichment, stroke+reaching, stroke+enrichment+reaching, and sham+enrichment+reaching. Reaching rehabilitation utilized a modified Whishaw box that encouraged impaired forelimb reaching for 6 hours per day, 5 days per week, for 4 weeks. All treatment paradigms began 7 days after ischemia with weekly assessment on the single-pellet task during rehabilitation and again 4 weeks after rehabilitation concluded. RESULTS Rats exposed to the combination of enrichment and reaching showed the greatest improvement in pellet retrieval and comparable performance to shams after 3 weeks of treatment, whereas those groups that received a monotherapy remained significantly impaired at all time points. Initial impairment alone did not significantly predict recovery in single-pellet as the 70% rule would suggest; however, a combined model of cortical infarct volume and rehabilitation intensity predicted change in pellet retrieval on the single-pellet task with the same accuracy as previously shown with the staircase, demonstrating the generalizability of this model across reaching tasks. CONCLUSIONS Task-specific reach training and environmental enrichment have synergistic effects in rats that persist long after rehabilitation ends, and this recovery is predicted by infarct volume and rehabilitation intensity.
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Affiliation(s)
- Matthew Strider Jeffers
- From the Department of Cellular and Molecular Medicine, University of Ottawa, Canada (M.S.J., D.C.)
| | - Dale Corbett
- From the Department of Cellular and Molecular Medicine, University of Ottawa, Canada (M.S.J., D.C.) .,Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada (D.C.)
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23
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Mogensen J, Wulf-Andersen C. Home and family in cognitive rehabilitation after brain injury: Implementation of social reserves. NeuroRehabilitation 2017; 41:513-518. [PMID: 29036841 DOI: 10.3233/nre-160007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The focus of the present article is the home and family environment of patients suffering acquired brain injury. In order to obtain the optimal outcome of posttraumatic cognitive rehabilitation it is important (a) to obtain a sufficient intensity of rehabilitative training, (b) to achieve the maximum degree of generalization from formalized training to the daily environment of the patient, and (c) to obtain the best possible utilization of "cognitive reserves" in the form of cognitive abilities and "strategies" acquired pretraumatically. Supplementing the institution-based cognitive training with (potentially computer-based) home-based training these three goals may more easily be met. Home-based training supports a higher intensity of training. Training in the home environment also allows better utilization of cognitive strategies acquired pretraumatically and more direct transfer of training results from formalized training to activities of daily living of the patient.
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Affiliation(s)
- Jesper Mogensen
- The Unit for Cognitive Neuroscience, Department of Psychology, University of Copenhagen, Denmark
| | - Camilla Wulf-Andersen
- Department of Clinical Genetics, Kennedy Center, Copenhagen University Hospital Rigshospitalet, Denmark
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24
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Li F, Geng X, Khan H, Pendy JT, Peng C, Li X, Rafols JA, Ding Y. Exacerbation of Brain Injury by Post-Stroke Exercise Is Contingent Upon Exercise Initiation Timing. Front Cell Neurosci 2017; 11:311. [PMID: 29051728 PMCID: PMC5633611 DOI: 10.3389/fncel.2017.00311] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 09/19/2017] [Indexed: 12/19/2022] Open
Abstract
Accumulating evidence has demonstrated that post-stroke physical rehabilitation may reduce morbidity. The effectiveness of post-stroke exercise, however, appears to be contingent upon exercise initiation. This study assessed the hypothesis that very early exercise exacerbates brain injury, induces reactive oxygen species (ROS) generation, and promotes energy failure. A total of 230 adult male Sprague-Dawley rats were subjected to middle cerebral artery (MCA) occlusion for 2 h, and randomized into eight groups, including two sham injury control groups, three non-exercise and three exercise groups. Exercise was initiated after 6 h, 24 h and 3 days of reperfusion. Twenty-four hours after completion of exercise (and at corresponding time points in non-exercise controls), infarct volumes and apoptotic cell death were examined. Early brain oxidative metabolism was quantified by examining ROS, ATP and NADH levels 0.5 h after completion of exercise. Furthermore, protein expressions of angiogenic growth factors were measured in order to determine whether post-stroke angiogenesis played a role in rehabilitation. As expected, ischemic stroke resulted in brain infarction, apoptotic cell death and ROS generation, and diminished NADH and ATP production. Infarct volumes and apoptotic cell death were enhanced (p < 0.05) by exercise that was initiated after 6 h of reperfusion, but decreased by late exercise (24 h, 3 days). This exacerbated brain injury at 6 h was associated with increased ROS levels (p < 0.05), and decreased (p < 0.05) NADH and ATP levels. In conclusion, very early exercise aggravated brain damage, and early exercise-induced energy failure with ROS generation may underlie the exacerbation of brain injury. These results shed light on the manner in which exercise initiation timing may affect post-stroke rehabilitation.
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Affiliation(s)
- Fengwu Li
- Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China
| | - Xiaokun Geng
- Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States
| | - Hajra Khan
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States
| | - John T Pendy
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States
| | - Changya Peng
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States
| | - Xiaorong Li
- Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China
| | - Jose A Rafols
- Department of Anatomy and Cell Biology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Yuchuan Ding
- Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States
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25
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The Effects of Early Exercise on Motor, Sense, and Memory Recovery in Rats With Stroke. Am J Phys Med Rehabil 2017; 96:e36-e43. [PMID: 27977432 DOI: 10.1097/phm.0000000000000670] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Exercise is an effective, inexpensive, home-based, and accessible intervention strategy for stroke treatment, and early exercise after stroke has attracted a great deal of attention in recent years. However, the effects of early exercise on comprehensive functional recovery remain poorly understood. The present study investigated the effect of early exercise on motor, sense, balance, and spatial memory recovery. DESIGN Adult Sprague-Dawley rats were subjected to unilateral middle cerebral artery occlusion (MCAO) and were randomly divided into early exercise group (EE), non-exercise group (NE), and sham group. EE group received 2 weeks of exercise training initiated at 24 hours after operation. The recovery of motor, sense, and balance function was evaluated every 3 days after MCAO. Spatial memory recovery was detected from 21 to 25 days after MCAO. RESULTS The results showed that early exercise significantly promoted the motor and spatial memory recovery with statistical differences. The rats in EE group have a better recovery in sense and balance function, but there is no statistically significant difference about these results. CONCLUSION Our results showed that early moderate exercise can significantly promote motor and spatial memory recovery, but not the sense and balance functions.
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26
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Maynard ME, Barton EA, Robinson CR, Wooden JI, Leasure JL. Sex differences in hippocampal damage, cognitive impairment, and trophic factor expression in an animal model of an alcohol use disorder. Brain Struct Funct 2017; 223:195-210. [PMID: 28752318 DOI: 10.1007/s00429-017-1482-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 07/20/2017] [Indexed: 12/21/2022]
Abstract
Compared to men, women disproportionally experience alcohol-related organ damage, including brain damage, and while men remain more likely to drink and to drink heavily, there is cause for concern because women are beginning to narrow the gender gap in alcohol use disorders. The hippocampus is a brain region that is particularly vulnerable to alcohol damage, due to cell loss and decreased neurogenesis. In the present study, we examined sex differences in hippocampal damage following binge alcohol. Consistent with our prior findings, we found a significant binge-induced decrement in dentate gyrus (DG) granule neurons in the female DG. However, in the present study, we found no significant decrement in granule neurons in the male DG. We show that the decrease in granule neurons in females is associated with both spatial navigation impairments and decreased expression of trophic support molecules. Finally, we show that post-binge exercise is associated with an increase in trophic support and repopulation of the granule neuron layer in the female hippocampus. We conclude that sex differences in alcohol-induced hippocampal damage are due in part to a paucity of trophic support and plasticity-related signaling in females.
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Affiliation(s)
- Mark E Maynard
- Department of Psychology, University of Houston, Houston, TX, 77204-5022, USA.,Department of Neurobiology and Anatomy, University of Texas Health Science Center, PO Box 20708, Houston, TX, 77225-0708, USA
| | - Emily A Barton
- Department of Psychology, University of Houston, Houston, TX, 77204-5022, USA
| | - Caleb R Robinson
- Department of Psychology, University of Houston, Houston, TX, 77204-5022, USA.,Department of Biology, Eastern Nazarene College, 23 E Elm Ave, Shrader Hall 30B, Quincy, MA, 02170, USA
| | - Jessica I Wooden
- Department of Psychology, University of Houston, Houston, TX, 77204-5022, USA
| | - J Leigh Leasure
- Department of Psychology, University of Houston, Houston, TX, 77204-5022, USA. .,Department of Biology and Biochemistry, University of Houston, Houston, TX, 77204-5022, USA.
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27
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Anthony SS, Date I, Yasuhara T. Limiting exercise inhibits neuronal recovery from neurological disorders. Brain Circ 2017; 3:124-129. [PMID: 30276313 PMCID: PMC6057693 DOI: 10.4103/bc.bc_16_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 09/04/2017] [Accepted: 09/05/2017] [Indexed: 12/12/2022] Open
Abstract
Patients who are bedridden often suffer from muscular atrophy due to reduced daily activities and can become depressed. However, patients who undergo physical therapy sometimes demonstrate positive benefits including a reduction of stressful and depressed behavior. Regenerative medicine has seen improvements in two stem cell-based therapies for central nervous system disorders. One therapy is through the transfer of exogenous stem cells. The other therapy is a more natural method and focuses on the increasing endogenous neurogenesis and restoring the neurological impairments. This study overviews how immobilization-induced disuse atrophy affects neurogenesis in rats, specifically hypothesizing that immobilization diminishes circulating trophic factor levels, like vascular endothelial growth factors or brain-derived neurotrophic factor, which in turn limits neurogenesis. This hypothesis requires the classification of the stem cell microenvironment by probing growth factors in addition to other stress-related proteins that correlate with exercise-induced neurogenesis. There is research examining the effects of increased exercise on neurogenesis while limiting exercise, which better demonstrates the pathological states of immobile stroke patients, remains relatively unexplored. To examine the effects of immobilization on neurogenesis quantitative measurements of movements, 5-bromo-2deoxyuridine labeling of proliferative cells, biochemical assays of serum, cerebrospinal fluid and neurological levels of trophic factors, growth factors, and stress-related proteins will indicate levels of neurogenesis. In further research, studies are needed to show how in vivo stimulation, or lack thereof, affects stem cell microenvironments to advance treatment procedures for strengthening neurogenesis in bedridden patients. This paper is a review article. Referred literature in this paper has been listed in the references section. The datasets supporting the conclusions of this article are available online by searching various databases, including PubMed. Some original points in this article come from the laboratory practice in our research center and the authors' experiences.
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Affiliation(s)
- Stefan S Anthony
- Department of Neurosurgery and Brain Repair, Center of Excellence for Aging and Brain Repair, University of South Florida, Tampa, FL 33612, USA
| | - Isao Date
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Takao Yasuhara
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Okayama, Japan
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28
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Tennant KA, Taylor SL, White ER, Brown CE. Optogenetic rewiring of thalamocortical circuits to restore function in the stroke injured brain. Nat Commun 2017. [PMID: 28643802 PMCID: PMC5490053 DOI: 10.1038/ncomms15879] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
To regain sensorimotor functions after stroke, surviving neural circuits must reorganize and form new connections. Although the thalamus is critical for processing and relaying sensory information to the cortex, little is known about how stroke affects the structure and function of these connections, or whether a therapeutic approach targeting these circuits can improve recovery. Here we reveal with in vivo calcium imaging that stroke in somatosensory cortex dampens the excitability of surviving thalamocortical circuits. Given this deficit, we hypothesized that chronic transcranial window optogenetic stimulation of thalamocortical axons could facilitate recovery. Using two-photon imaging, we show that optogenetic stimulation promotes the formation of new and stable thalamocortical synaptic boutons, without impacting axon branch dynamics. Stimulation also enhances the recovery of somatosensory cortical circuit function and forepaw sensorimotor abilities. These results demonstrate that an optogenetic approach can rewire thalamocortical circuits and restore function in the damaged brain. Stroke recovery requires circuit reorganization and therapeutic efforts have focused on rewiring cortical circuits after stroke, but what about thalamic inputs? Here, the authors examine how thalamocortical axons are affected by stroke and use optogenetic stimulation to promote recovery.
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Affiliation(s)
- Kelly A Tennant
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada V8P 5C2
| | - Stephanie L Taylor
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada V8P 5C2
| | - Emily R White
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada V8P 5C2
| | - Craig E Brown
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada V8P 5C2.,Department of Biology, University of Victoria, Victoria, British Columbia, Canada V8P 5C2.,Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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29
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Hylin MJ, Kerr AL, Holden R. Understanding the Mechanisms of Recovery and/or Compensation following Injury. Neural Plast 2017; 2017:7125057. [PMID: 28512585 PMCID: PMC5415868 DOI: 10.1155/2017/7125057] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 02/24/2017] [Accepted: 03/26/2017] [Indexed: 11/30/2022] Open
Abstract
Injury due to stroke and traumatic brain injury result in significant long-term effects upon behavioral functioning. One central question to rehabilitation research is whether the nature of behavioral improvement observed is due to recovery or the development of compensatory mechanisms. The nature of functional improvement can be viewed from the perspective of behavioral changes or changes in neuroanatomical plasticity that follows. Research suggests that these changes correspond to each other in a bidirectional manner. Mechanisms surrounding phenomena like neural plasticity may offer an opportunity to explain how variables such as experience can impact improvement and influence the definition of recovery. What is more, the intensity of the rehabilitative experiences may influence the ability to recover function and support functional improvement of behavior. All of this impacts how researchers, clinicians, and medical professionals utilize rehabilitation.
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Affiliation(s)
- Michael J. Hylin
- Neurotrauma and Rehabilitation Laboratory, Department of Psychology, Southern Illinois University, Carbondale, IL, USA
| | - Abigail L. Kerr
- Department of Psychology, Illinois Wesleyan University, Bloomington, IL, USA
| | - Ryan Holden
- Neurotrauma and Rehabilitation Laboratory, Department of Psychology, Southern Illinois University, Carbondale, IL, USA
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30
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Li F, Pendy JT, Ding JN, Peng C, Li X, Shen J, Wang S, Geng X. Exercise rehabilitation immediately following ischemic stroke exacerbates inflammatory injury. Neurol Res 2017; 39:530-537. [PMID: 28415917 DOI: 10.1080/01616412.2017.1315882] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Fengwu Li
- China–America Institute of Neuroscience, Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China
| | - John T. Pendy
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Jessie N. Ding
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Changya Peng
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Xiaorong Li
- China–America Institute of Neuroscience, Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China
| | - Jiamei Shen
- China–America Institute of Neuroscience, Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Sainan Wang
- China–America Institute of Neuroscience, Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China
| | - Xiaokun Geng
- China–America Institute of Neuroscience, Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
- Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China
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31
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Yagi M, Yasunaga H, Matsui H, Morita K, Fushimi K, Fujimoto M, Koyama T, Fujitani J. Impact of Rehabilitation on Outcomes in Patients With Ischemic Stroke. Stroke 2017; 48:740-746. [DOI: 10.1161/strokeaha.116.015147] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 11/17/2016] [Accepted: 12/07/2016] [Indexed: 01/19/2023]
Abstract
Background and Purpose—
We aimed to examine the concurrent effects of timing and intensity of rehabilitation on improving activities of daily living (ADL) among patients with ischemic stroke.
Methods—
Using the Japanese Diagnosis Procedure Combination inpatient database, we retrospectively analyzed consecutive patients with ischemic stroke at admission who received rehabilitation (n=100 719) from April 2012 to March 2014. Early rehabilitation was defined as that starting within 3 days after admission. The average rehabilitation intensity per day was calculated as the total units of rehabilitation during hospitalization divided by the length of hospital stay. A multivariable logistic regression analysis with multiple imputation and an instrumental variable analysis were performed to examine the association of early and intensive rehabilitation with the proportion of improved ADL score.
Results—
The proportion of improved ADL score was higher in the early and intensive rehabilitation group. The multivariable logistic regression analysis showed that significant improvements in ADL were observed for early rehabilitation (odds ratio: 1.08; 95% confidence interval: 1.04–1.13;
P
<0.01) and intensive rehabilitation of >5.0 U/d (odds ratio: 1.87; 95% confidence interval: 1.69–2.07;
P
<0.01). The instrumental variable analysis showed that an increased proportion of improved ADL was associated with early rehabilitation (risk difference: 2.8%; 95% confidence interval: 2.0–3.4%;
P
<0.001) and intensive rehabilitation (risk difference: 5.6%; 95% confidence interval: 4.6–6.6%;
P
<0.001).
Conclusions—
The present results suggested that early and intensive rehabilitation improved ADL during hospitalization in patients with ischemic stroke.
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Affiliation(s)
- Maiko Yagi
- From the Department of Rehabilitation, St Marianna University School of Medicine, Toyoko Hospital, Kanagawa, Japan (M.Y.); Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Japan (H.Y., H.M., K.M.); Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Japan (K.F.); Department of Rehabilitation, National Center for Global Health and Medicine, Tokyo, Japan (M.F., J.F.); and Department of
| | - Hideo Yasunaga
- From the Department of Rehabilitation, St Marianna University School of Medicine, Toyoko Hospital, Kanagawa, Japan (M.Y.); Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Japan (H.Y., H.M., K.M.); Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Japan (K.F.); Department of Rehabilitation, National Center for Global Health and Medicine, Tokyo, Japan (M.F., J.F.); and Department of
| | - Hiroki Matsui
- From the Department of Rehabilitation, St Marianna University School of Medicine, Toyoko Hospital, Kanagawa, Japan (M.Y.); Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Japan (H.Y., H.M., K.M.); Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Japan (K.F.); Department of Rehabilitation, National Center for Global Health and Medicine, Tokyo, Japan (M.F., J.F.); and Department of
| | - Kojiro Morita
- From the Department of Rehabilitation, St Marianna University School of Medicine, Toyoko Hospital, Kanagawa, Japan (M.Y.); Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Japan (H.Y., H.M., K.M.); Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Japan (K.F.); Department of Rehabilitation, National Center for Global Health and Medicine, Tokyo, Japan (M.F., J.F.); and Department of
| | - Kiyohide Fushimi
- From the Department of Rehabilitation, St Marianna University School of Medicine, Toyoko Hospital, Kanagawa, Japan (M.Y.); Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Japan (H.Y., H.M., K.M.); Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Japan (K.F.); Department of Rehabilitation, National Center for Global Health and Medicine, Tokyo, Japan (M.F., J.F.); and Department of
| | - Masashi Fujimoto
- From the Department of Rehabilitation, St Marianna University School of Medicine, Toyoko Hospital, Kanagawa, Japan (M.Y.); Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Japan (H.Y., H.M., K.M.); Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Japan (K.F.); Department of Rehabilitation, National Center for Global Health and Medicine, Tokyo, Japan (M.F., J.F.); and Department of
| | - Teruyuki Koyama
- From the Department of Rehabilitation, St Marianna University School of Medicine, Toyoko Hospital, Kanagawa, Japan (M.Y.); Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Japan (H.Y., H.M., K.M.); Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Japan (K.F.); Department of Rehabilitation, National Center for Global Health and Medicine, Tokyo, Japan (M.F., J.F.); and Department of
| | - Junko Fujitani
- From the Department of Rehabilitation, St Marianna University School of Medicine, Toyoko Hospital, Kanagawa, Japan (M.Y.); Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Japan (H.Y., H.M., K.M.); Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Japan (K.F.); Department of Rehabilitation, National Center for Global Health and Medicine, Tokyo, Japan (M.F., J.F.); and Department of
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32
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Haefeli J, Ferguson AR, Bingham D, Orr A, Won SJ, Lam TI, Shi J, Hawley S, Liu J, Swanson RA, Massa SM. A data-driven approach for evaluating multi-modal therapy in traumatic brain injury. Sci Rep 2017; 7:42474. [PMID: 28205533 PMCID: PMC5311970 DOI: 10.1038/srep42474] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 01/11/2017] [Indexed: 01/22/2023] Open
Abstract
Combination therapies targeting multiple recovery mechanisms have the potential for additive or synergistic effects, but experimental design and analyses of multimodal therapeutic trials are challenging. To address this problem, we developed a data-driven approach to integrate and analyze raw source data from separate pre-clinical studies and evaluated interactions between four treatments following traumatic brain injury. Histologic and behavioral outcomes were measured in 202 rats treated with combinations of an anti-inflammatory agent (minocycline), a neurotrophic agent (LM11A-31), and physical therapy consisting of assisted exercise with or without botulinum toxin-induced limb constraint. Data was curated and analyzed in a linked workflow involving non-linear principal component analysis followed by hypothesis testing with a linear mixed model. Results revealed significant benefits of the neurotrophic agent LM11A-31 on learning and memory outcomes after traumatic brain injury. In addition, modulations of LM11A-31 effects by co-administration of minocycline and by the type of physical therapy applied reached statistical significance. These results suggest a combinatorial effect of drug and physical therapy interventions that was not evident by univariate analysis. The study designs and analytic techniques applied here form a structured, unbiased, internally validated workflow that may be applied to other combinatorial studies, both in animals and humans.
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Affiliation(s)
- Jenny Haefeli
- Brain and Spinal Injury Center (BASIC), Department of Neurological Surgery, University of California, San Francisco, CA, United States
| | - Adam R. Ferguson
- Brain and Spinal Injury Center (BASIC), Department of Neurological Surgery, University of California, San Francisco, CA, United States
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Deborah Bingham
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Adrienne Orr
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Seok Joon Won
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, CA, United States
| | - Tina I. Lam
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, CA, United States
| | - Jian Shi
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, CA, United States
| | - Sarah Hawley
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Jialing Liu
- Brain and Spinal Injury Center (BASIC), Department of Neurological Surgery, University of California, San Francisco, CA, United States
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Raymond A. Swanson
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, CA, United States
| | - Stephen M. Massa
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, CA, United States
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33
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Li F, Shi W, Zhao EY, Geng X, Li X, Peng C, Shen J, Wang S, Ding Y. Enhanced apoptosis from early physical exercise rehabilitation following ischemic stroke. J Neurosci Res 2016; 95:1017-1024. [PMID: 27571707 DOI: 10.1002/jnr.23890] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 06/30/2016] [Accepted: 07/26/2016] [Indexed: 01/28/2023]
Abstract
The effectiveness of the rehabilitative benefits of physical exercise appears to be contingent upon when the exercise is initiated after stroke. The present study assessed the hypothesis that very early exercise increases the extent of apoptotic cell death via increased expression of proapoptotic proteins in a rat stroke model. Adult male Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO) for 2 hr using an intraluminal filament and assigned to four nonexercise and three exercise groups. Exercise on a Rota-Rod was initiated for 30 min at 6 hr (considered very early), at 24 hr (early), and at 3 days (relatively late) after reperfusion. At 24 hr after exercise, apoptotic cell death was determined. At 3 and 24 hr after exercise, the expression of pro- and antiapoptotic proteins was evaluated through Western blotting. As expected, ischemic stroke significantly increased the levels of apoptotic cell death. Compared with the stroke group without exercise, apoptotic cell death was further increased (P < 0.05) at 6 hr but not at 24 hr or 3 days with exercise. This exacerbated cell injury was associated with increased expression of proapoptotic proteins (BAX and caspase-3). The expression of Bcl-2, an antiapoptotic protein, was not affected by exercise. In ischemic stroke, apoptotic cell death was enhanced by very early exercise in association with increased expression of proapoptotic proteins. These results shed light on the time-sensitive effect of exercise in poststroke rehabilitation. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Fengwu Li
- China-America Institute of Neuroscience, Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Wei Shi
- Department of General Surgery, Luhe Hospital, Capital Medical University, Beijing, China
| | - Ethan Y Zhao
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan
| | - Xiaokun Geng
- China-America Institute of Neuroscience, Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan.,Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China
| | - Xiaorong Li
- China-America Institute of Neuroscience, Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Changya Peng
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan
| | - Jiamei Shen
- China-America Institute of Neuroscience, Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan
| | - Sainan Wang
- China-America Institute of Neuroscience, Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Yuchuan Ding
- China-America Institute of Neuroscience, Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan
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Shen J, Huber M, Zhao EY, Peng C, Li F, Li X, Geng X, Ding Y. Early rehabilitation aggravates brain damage after stroke via enhanced activation of nicotinamide adenine dinucleotide phosphate oxidase (NOX). Brain Res 2016; 1648:266-276. [PMID: 27495986 DOI: 10.1016/j.brainres.2016.08.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 08/01/2016] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Although physical exercise has emerged as a potential therapeutic modality for functional deficits following ischemic stroke, the extent of this effect appears to be contingent upon the time of exercise initiation. In the present study, we assessed how exercise timing affected brain damage through hyperglycolysis-associated NADPH oxidase (NOX) activation. METHODS Using an intraluminal filament, adult male Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO) for 2h and assigned to one non-exercise and three exercise groups. Exercise on Rota-rod was initiated for 30min at 6h (considered very early), at 24h (early), and at day 3 (relatively late) after reperfusion. Lactate production was measured 30min after exercise completion, and NOX activity and protein expression of NOX subunits (p47(phox), gp91(phox), p22(phox) and p67(phox)) and glucose transporter 1 and 3 (Glut-1 and -3) were measured at 3 and 24h after exercise. Apoptotic cell death was determined at 24h after exercise. RESULTS Lactate production and Glut-1 and Glut-3 expression were increased after very early exercise (6h), but not after late exercise (3 days), suggesting hyperglycolysis. NOX activity was increased with the initiation of exercise at 6h (P<0.05), but not 24h or 3 days, following stroke. Early (6 and 24h), but not late (3 days), post-stroke exercise was associated with increased (P<0.05) expression of the NOX protein subunit p47(phox), gp91(phox)and p67(phox). This may have led to the enhanced apoptosis observed after early exercise in ischemic rats. CONCLUSION Hyperglycolysis and NOX activation was associated with an elevation in apoptotic cell death after very early exercise, and the detrimental effect of exercise on stroke recovery began to decrease when exercise was initiated 24h after reperfusion.
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Affiliation(s)
- Jiamei Shen
- China-America Institute of Neuroscience, Beijing Luhe Hospital, Capital Medical University, China; Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Mitchell Huber
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ethan Y Zhao
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Changya Peng
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Fengwu Li
- China-America Institute of Neuroscience, Beijing Luhe Hospital, Capital Medical University, China
| | - Xiaorong Li
- China-America Institute of Neuroscience, Beijing Luhe Hospital, Capital Medical University, China
| | - Xiaokun Geng
- China-America Institute of Neuroscience, Beijing Luhe Hospital, Capital Medical University, China; Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA.
| | - Yuchuan Ding
- China-America Institute of Neuroscience, Beijing Luhe Hospital, Capital Medical University, China; Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA.
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35
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Lippert T, Watson N, Ji X, Yasuhara T, Date I, Kaneko Y, Tajiri N, Borlongan CV. Detrimental effects of physical inactivity on neurogenesis. Brain Circ 2016; 2:80-85. [PMID: 30276277 PMCID: PMC6126252 DOI: 10.4103/2394-8108.186278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 02/25/2016] [Accepted: 03/04/2016] [Indexed: 01/01/2023] Open
Abstract
Patients diagnosed with neurological disorders exhibit a variety of physical and psychiatric symptoms, including muscle atrophy, general immobility, and depression. Patients who participate in physical rehabilitation at times show unexpected clinical improvement, which includes diminished depression and other stress-related behaviors. Regenerative medicine has advanced two major stem cell-based therapies for central nervous system (CNS) disorders, transplantation of exogenous stem cells, and enhancing the endogenous neurogenesis. The latter therapy utilizes a natural method of re-innervating the injured brain, which may mend neurological impairments. In this study, we examine how inactivity-induced atrophy, using the hindlimb suspension model, alters neurogenesis in rats. The hypothesis is that inactivity inhibits neurogenesis by decreasing circulation growth or trophic factors, such as vascular endothelial growth or neurotrophic factors. The restriction modifies neurogenesis and stem cell differentiation in the CNS, the stem cell microenvironment is examined by the trophic and growth factors, including stress-related proteins. Despite growing evidence revealing the benefits of “increased” exercise on neurogenesis, the opposing theory involving “physical inactivity,” which simulates pathological states, continues to be neglected. This novel theory will allow us to explore the effects on neurogenesis by an intransigent stem cell microenvironment likely generated by inactivity. 5-bromo-2-deoxyuridine labeling of proliferative cells, biochemical assays of serum, cerebrospinal fluid, and brain levels of trophic factors, growth factors, and stress-related proteins are suggested identifiers of neurogenesis, while evaluation of spontaneous movements will give insight into the psychomotor effects of inactivity. Investigations devised to show how in vivo stimulation, or lack thereof, affects the stem cell microenvironment are necessary to establish treatment methods to boost neurogenesis in bedridden patients.
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Affiliation(s)
- Trenton Lippert
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA
| | - Nate Watson
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA
| | - Xunming Ji
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Takao Yasuhara
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Isao Date
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yuji Kaneko
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA
| | - Naoki Tajiri
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA
| | - Cesar V Borlongan
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA
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Bittner GD, Schallert T, Peduzzi JD. Degeneration, Trophic Interactions, and Repair of Severed Axons: A Reconsideration of Some Common Assumptions. Neuroscientist 2016. [DOI: 10.1177/107385840000600207] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We suggest that several interrelated properties of severed axons (degeneration, trophic dependencies, initial repair, and eventual repair) differ in important ways from commonly held assumptions about those properties. Specifically, (1) axotomy does not necessarily produce rapid degeneration of distal axonal segments because (2) the trophic maintenance of nerve axons does not necessarily depend entirely on proteins transported from the perikaryon—but instead axonal proteins can be trophically maintained by slowing their degradation and/or by acquiring new proteins via axonal synthesis or transfer from adjacent cells (e.g., glia). (3) The initial repair of severed distal or proximal segments occurs by barriers (seals) formed amid accumulations of vesicles and/or myelin delaminations induced by calcium influx at cut axonal ends—rather than by collapse and fusion of cut axolemmal leaflets. (4) The eventual repair of severed mammalian CNS axons does not necessarily have to occur by neuritic outgrowths, which slowly extend from cut proximal ends to possibly reestablish lost functions weeks to years after axotomy—but instead complete repair can be induced within minutes by polyethylene glycol to rejoin (fuse) the cut ends of surviving proximal and distal stumps. Strategies to repair CNS lesions based on fusion techniques combined with rehabilitative training and induced axonal outgrowth may soon provide therapies that can at least partially restore lost CNS functions.
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Affiliation(s)
- George D. Bittner
- School of Biological Sciences (Neurobiology Section) and Institute of Neuroscience, The University of Texas at Austin, Austin, Texas
| | - Timothy Schallert
- School of Biological Sciences (Neurobiology Section) and Institute of Neuroscience, Department of Pyschology, The University of Texas at Austin, Austin, Texas
| | - Jean D. Peduzzi
- School of Optometry, Department of Physiological Optics, Injury Control and Vision Science Research Centers, University of Alabama at Birmingham, Birmingham, Alabama
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Bernhardt J, Churilov L, Ellery F, Collier J, Chamberlain J, Langhorne P, Lindley RI, Moodie M, Dewey H, Thrift AG, Donnan G. Prespecified dose-response analysis for A Very Early Rehabilitation Trial (AVERT). Neurology 2016; 86:2138-45. [PMID: 26888985 PMCID: PMC4898313 DOI: 10.1212/wnl.0000000000002459] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 01/12/2016] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Our prespecified dose-response analyses of A Very Early Rehabilitation Trial (AVERT) aim to provide practical guidance for clinicians on the timing, frequency, and amount of mobilization following acute stroke. METHODS Eligible patients were aged ≥18 years, had confirmed first (or recurrent) stroke, and were admitted to a stroke unit within 24 hours of stroke onset. Patients were randomized to receive very early and frequent mobilization, commencing within 24 hours, or usual care. We used regression analyses and Classification and Regression Trees (CART) to investigate the effect of timing and dose of mobilization on efficacy and safety outcomes, irrespective of assigned treatment group. RESULTS A total of 2,104 patients were enrolled, of whom 2,083 (99.0%) were followed up at 3 months. We found a consistent pattern of improved odds of favorable outcome in efficacy and safety outcomes with increased daily frequency of out-of-bed sessions (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.09 to 1.18, p < 0.001), keeping time to first mobilization and mobilization amount constant. Increased amount (minutes per day) of mobilization reduced the odds of a good outcome (OR 0.94, 95% CI 0.91 to 0.97, p < 0.001). Session frequency was the most important variable in the CART analysis, after prognostic variables age and baseline stroke severity. CONCLUSION These data suggest that shorter, more frequent mobilization early after acute stroke is associated with greater odds of favorable outcome at 3 months when controlling for age and stroke severity. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that shorter, more frequent early mobilization improves the chance of regaining independence after stroke.
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Affiliation(s)
- Julie Bernhardt
- From The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia.
| | - Leonid Churilov
- From The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia
| | - Fiona Ellery
- From The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia
| | - Janice Collier
- From The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia
| | - Jan Chamberlain
- From The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia
| | - Peter Langhorne
- From The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia
| | - Richard I Lindley
- From The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia
| | - Marj Moodie
- From The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia
| | - Helen Dewey
- From The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia
| | - Amanda G Thrift
- From The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia
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The interplay between neuropathology and activity based rehabilitation after traumatic brain injury. Brain Res 2016; 1640:152-163. [DOI: 10.1016/j.brainres.2016.01.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 01/08/2016] [Accepted: 01/09/2016] [Indexed: 02/07/2023]
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Nishioka R, Sugimoto K, Aono H, Mise A, Choudhury ME, Miyanishi K, Islam A, Fujita T, Takeda H, Takahashi H, Yano H, Tanaka J. Treadmill exercise ameliorates ischemia-induced brain edema while suppressing Na⁺/H⁺ exchanger 1 expression. Exp Neurol 2015; 277:150-161. [PMID: 26724742 DOI: 10.1016/j.expneurol.2015.12.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/15/2015] [Accepted: 12/22/2015] [Indexed: 01/23/2023]
Abstract
Exercise may be one of the most effective and sound therapies for stroke; however, the mechanisms underlying the curative effects remain unclear. In this study, the effects of forced treadmill exercise with electric shock on ischemic brain edema were investigated. Wistar rats were subjected to transient (90 min) middle cerebral artery occlusion (tMCAO). Eighty nine rats with substantially large ischemic lesions were evaluated using magnetic resonance imaging (MRI) and were randomly assigned to exercise and non-exercise groups. The rats were forced to run at 4-6m/s for 10 min/day on days 2, 3 and 4. Brain edema was measured on day 5 by MRI, histochemical staining of brain sections and tissue water content determination (n=7, each experiment). Motor function in some rats was examined on day 30 (n=6). Exercise reduced brain edema (P<0.05-0.001, varied by the methods) and ameliorated motor function (P<0.05). The anti-glucocorticoid mifepristone or the anti-mineralocorticoid spironolactone abolished these effects, but orally administered corticosterone mimicked the ameliorating effects of exercise. Exercise prevented the ischemia-induced expression of mRNA encoding aquaporin 4 (AQP4) and Na(+)/H(+) exchangers (NHEs) (n=5 or 7, P<0.01). Microglia and NG2 glia expressed NHE1 in the peri-ischemic region of rat brains and also in mixed glial cultures. Corticosterone at ~10nM reduced NHE1 and AQP4 expression in mixed glial and pure microglial cultures. Dexamethasone and aldosterone at 10nM did not significantly alter NHE1 and AQP4 expression. Exposure to a NHE inhibitor caused shrinkage of microglial cells. These results suggest that the stressful short-period and slow-paced treadmill exercise suppressed NHE1 and AQP4 expression resulting in the amelioration of brain edema at least partly via the moderate increase in plasma corticosterone levels.
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Affiliation(s)
- Ryutaro Nishioka
- Department of Molecular and Cellular Physiology, Graduate School of Medicine, Ehime University, Japan
| | - Kana Sugimoto
- Department of Legal Medicine, Graduate School of Medicine/Faculty of Medicine, Osaka University, Japan
| | - Hitomi Aono
- Department of Molecular and Cellular Physiology, Graduate School of Medicine, Ehime University, Japan
| | - Ayano Mise
- Department of Molecular and Cellular Physiology, Graduate School of Medicine, Ehime University, Japan
| | - Mohammed E Choudhury
- Department of Molecular and Cellular Physiology, Graduate School of Medicine, Ehime University, Japan
| | - Kazuya Miyanishi
- Department of Molecular and Cellular Physiology, Graduate School of Medicine, Ehime University, Japan
| | - Afsana Islam
- Department of Molecular and Cellular Physiology, Graduate School of Medicine, Ehime University, Japan
| | - Takahiro Fujita
- Department of Molecular and Cellular Physiology, Graduate School of Medicine, Ehime University, Japan
| | - Haruna Takeda
- Department of Molecular and Cellular Physiology, Graduate School of Medicine, Ehime University, Japan
| | - Hisaaki Takahashi
- Center for Advanced Research and Education, Asahikawa Medical University, Japan
| | - Hajime Yano
- Department of Molecular and Cellular Physiology, Graduate School of Medicine, Ehime University, Japan
| | - Junya Tanaka
- Department of Molecular and Cellular Physiology, Graduate School of Medicine, Ehime University, Japan.
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Combs HL, Jones TA, Kozlowski DA, Adkins DL. Combinatorial Motor Training Results in Functional Reorganization of Remaining Motor Cortex after Controlled Cortical Impact in Rats. J Neurotrauma 2015; 33:741-7. [PMID: 26421759 DOI: 10.1089/neu.2015.4136] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Cortical reorganization subsequent to post-stroke motor rehabilitative training (RT) has been extensively examined in animal models and humans. However, similar studies focused on the effects of motor training after traumatic brain injury (TBI) are lacking. We previously reported that after a moderate/severe TBI in adult male rats, functional improvements in forelimb use were accomplished only with a combination of skilled forelimb reach training and aerobic exercise, with or without nonimpaired forelimb constraint. Thus, the current study was designed to examine the relationship between functional motor cortical map reorganization after experimental TBI and the behavioral improvements resulting from this combinatorial rehabilitative regime. Adult male rats were trained to proficiency on a skilled reaching task, received a unilateral controlled cortical impact (CCI) over the forelimb area of the caudal motor cortex (CMC). Three days post-CCI, animals began RT (n = 13) or no rehabilitative training (NoRT) control procedures (n = 13). The RT group participated in daily skilled reach training, voluntary aerobic exercise, and nonimpaired forelimb constraint. This RT regimen significantly improved impaired forelimb reaching success and normalized reaching strategies, consistent with previous findings. RT also enlarged the area of motor cortical wrist representation, derived by intracortical microstimulation, compared to NoRT. These findings indicate that sufficient RT can greatly improve motor function and improve the functional integrity of remaining motor cortex after a moderate/severe CCI. When compared with findings from stroke models, these findings also suggest that more intense RT may be needed to improve motor function and remodel the injured cortex after TBI.
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Affiliation(s)
- Hannah L Combs
- 1 Department of Psychology, University of Texas at Austin , Austin, Texas
| | - Theresa A Jones
- 1 Department of Psychology, University of Texas at Austin , Austin, Texas.,2 Institute for Neuroscience, University of Texas at Austin , Austin, Texas
| | | | - DeAnna L Adkins
- 4 Department of Neuroscience, Department of Health Sciences and Research, and Center for Biomedical Imaging, Medical University of South Carolina , Charleston, South Carolina
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Luft AR, Kesselring J. Critique of A Very Early Rehabilitation Trial (AVERT). Stroke 2015; 47:291-2. [PMID: 26658440 DOI: 10.1161/strokeaha.115.010483] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 10/30/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Andreas R Luft
- From the Division of Vascular Neurology and Rehabilitation, Department of Neurology, University of Zurich, Zurich, Switzerland (A.R.L.); Cereneo Center for Neurology and Rehabilitation, Vitznau, Switzerland (A.R.L.); and Kliniken Valens, Valens, Switzerland (J.K.).
| | - Jürg Kesselring
- From the Division of Vascular Neurology and Rehabilitation, Department of Neurology, University of Zurich, Zurich, Switzerland (A.R.L.); Cereneo Center for Neurology and Rehabilitation, Vitznau, Switzerland (A.R.L.); and Kliniken Valens, Valens, Switzerland (J.K.)
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42
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Gram MG, Wogensen E, Wörtwein G, Mogensen J, Malá H. Delayed restraint procedure enhances cognitive recovery of spatial function after fimbria-fornix transection. Restor Neurol Neurosci 2015; 34:1-17. [PMID: 26518669 DOI: 10.3233/rnn-140396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To i) evaluate the effect of a restraint procedure (7 days, 2 h/day) on place learning after fimbria-fornix transection (FF), ii) investigate effects of early vs. late administration of restraint, and iii) establish effects of the restraint procedure on expression of brain derived neurotrophic factor (BDNF) in prefrontal cortex and hippocampus. METHODS Fifty rats subjected to FF or sham surgery and divided into groups exposed to restraint immediately (early restraint) or 21 days (late restraint) after surgery were trained to acquire an allocentric place learning task. In parallel, 29 animals were subjected to FF or sham surgery and an identical restraint procedure in order to measure concentrations of BDNF and corticosterone. RESULTS The performance of the sham operated rats was positively affected by the late restraint. In FF-lesioned animals, the late restraint significantly improved task performance compared to the lesioned group with no restraint, while the early restraint was associated with a negative impact on task acquisition. Biochemical analysis after restraint procedure revealed a lesion-induced upregulation of BDNF in FF animals. CONCLUSIONS The improved task performance of lesioned animals suggests a therapeutic effect of this manipulation, independent of BDNF. This effect is sensitive to the temporal administration of treatment.
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Affiliation(s)
- Marie Gajhede Gram
- The Unit for Cognitive Neuroscience, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Elise Wogensen
- The Unit for Cognitive Neuroscience, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Gitta Wörtwein
- Laboratory of Neuropsychiatry, Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Mogensen
- The Unit for Cognitive Neuroscience, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Hana Malá
- The Unit for Cognitive Neuroscience, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Bondi CO, Semple BD, Noble-Haeusslein LJ, Osier ND, Carlson SW, Dixon CE, Giza CC, Kline AE. Found in translation: Understanding the biology and behavior of experimental traumatic brain injury. Neurosci Biobehav Rev 2015; 58:123-46. [PMID: 25496906 PMCID: PMC4465064 DOI: 10.1016/j.neubiorev.2014.12.004] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 10/26/2014] [Accepted: 12/02/2014] [Indexed: 12/14/2022]
Abstract
The aim of this review is to discuss in greater detail the topics covered in the recent symposium entitled "Traumatic brain injury: laboratory and clinical perspectives," presented at the 2014 International Behavioral Neuroscience Society annual meeting. Herein, we review contemporary laboratory models of traumatic brain injury (TBI) including common assays for sensorimotor and cognitive behavior. New modalities to evaluate social behavior after injury to the developing brain, as well as the attentional set-shifting test (AST) as a measure of executive function in TBI, will be highlighted. Environmental enrichment (EE) will be discussed as a preclinical model of neurorehabilitation, and finally, an evidence-based approach to sports-related concussion will be considered. The review consists predominantly of published data, but some discussion of ongoing or future directions is provided.
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Affiliation(s)
- Corina O Bondi
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States
| | - Bridgette D Semple
- Neurological Surgery and the Graduate Program in Physical Medicine & Rehabilitation Science, University of California, San Francisco, San Francisco, CA, United States; Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia
| | - Linda J Noble-Haeusslein
- Neurological Surgery and the Graduate Program in Physical Medicine & Rehabilitation Science, University of California, San Francisco, San Francisco, CA, United States
| | - Nicole D Osier
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Shaun W Carlson
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - C Edward Dixon
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States; Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, United States
| | - Christopher C Giza
- Pediatric Neurology and Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States; UCLA Brain Injury Research Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Anthony E Kline
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States; Psychology, University of Pittsburgh, Pittsburgh, PA, United States; Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
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44
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Neuroprotection of Early Locomotor Exercise Poststroke: Evidence From Animal Studies. Can J Neurol Sci 2015; 42:213-20. [PMID: 26041314 DOI: 10.1017/cjn.2015.39] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Early locomotor exercise after stroke has attracted a great deal of attention in clinical and animal research in recent years. A series of animal studies showed that early locomotor exercise poststroke could protect against ischemic brain injury and improve functional outcomes through the promotion of angiogenesis, inhibition of acute inflammatory response and neuron apoptosis, and protection of the blood-brain barrier. However, to date, the clinical application of early locomotor exercise poststroke was limited because some clinicians have little confidence in its effectiveness. Here we review the current progress of early locomotor exercise poststroke in animal models. We hope that a comprehensive awareness of the early locomotor exercise poststroke may help to implement early locomotor exercise more appropriately in treatment for ischemic stroke.
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Dromerick AW, Edwardson MA, Edwards DF, Giannetti ML, Barth J, Brady KP, Chan E, Tan MT, Tamboli I, Chia R, Orquiza M, Padilla RM, Cheema AK, Mapstone ME, Fiandaca MS, Federoff HJ, Newport EL. Critical periods after stroke study: translating animal stroke recovery experiments into a clinical trial. Front Hum Neurosci 2015; 9:231. [PMID: 25972803 PMCID: PMC4413691 DOI: 10.3389/fnhum.2015.00231] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 04/10/2015] [Indexed: 12/20/2022] Open
Abstract
Introduction: Seven hundred ninety-five thousand Americans will have a stroke this year, and half will have a chronic hemiparesis. Substantial animal literature suggests that the mammalian brain has much potential to recover from acute injury using mechanisms of neuroplasticity, and that these mechanisms can be accessed using training paradigms and neurotransmitter manipulation. However, most of these findings have not been tested or confirmed in the rehabilitation setting, in large part because of the challenges in translating a conceptually straightforward laboratory experiment into a meaningful and rigorous clinical trial in humans. Through presentation of methods for a Phase II trial, we discuss these issues and describe our approach. Methods: In rodents there is compelling evidence for timing effects in rehabilitation; motor training delivered at certain times after stroke may be more effective than the same training delivered earlier or later, suggesting that there is a critical or sensitive period for strongest rehabilitation training effects. If analogous critical/sensitive periods can be identified after human stroke, then existing clinical resources can be better utilized to promote recovery. The Critical Periods after Stroke Study (CPASS) is a phase II randomized, controlled trial designed to explore whether such a sensitive period exists. We will randomize 64 persons to receive an additional 20 h of upper extremity therapy either immediately upon rehab admission, 2–3 months after stroke onset, 6 months after onset, or to an observation-only control group. The primary outcome measure will be the Action Research Arm Test (ARAT) at 1 year. Blood will be drawn at up to 3 time points for later biomarker studies. Conclusion: CPASS is an example of the translation of rodent motor recovery experiments into the clinical setting; data obtained from this single site randomized controlled trial will be used to finalize the design of a Phase III trial.
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Affiliation(s)
- Alexander W Dromerick
- Department of Rehabilitation Medicine, Center for Brain Plasticity and Recovery, Georgetown University and MedStar National Rehabilitation Hospital Washington, DC, USA ; Department of Neurology, Georgetown University Washington, DC, USA
| | - Matthew A Edwardson
- Department of Rehabilitation Medicine, Center for Brain Plasticity and Recovery, Georgetown University and MedStar National Rehabilitation Hospital Washington, DC, USA ; Department of Neurology, Georgetown University Washington, DC, USA
| | - Dorothy F Edwards
- Department of Kinesiology and Occupational Therapy, University of Wisconsin Madison, WI, USA
| | - Margot L Giannetti
- Department of Rehabilitation Medicine, Center for Brain Plasticity and Recovery, Georgetown University and MedStar National Rehabilitation Hospital Washington, DC, USA
| | - Jessica Barth
- Department of Rehabilitation Medicine, Center for Brain Plasticity and Recovery, Georgetown University and MedStar National Rehabilitation Hospital Washington, DC, USA
| | - Kathaleen P Brady
- Department of Rehabilitation Medicine, Center for Brain Plasticity and Recovery, Georgetown University and MedStar National Rehabilitation Hospital Washington, DC, USA
| | - Evan Chan
- Department of Rehabilitation Medicine, Center for Brain Plasticity and Recovery, Georgetown University and MedStar National Rehabilitation Hospital Washington, DC, USA
| | - Ming T Tan
- Department of Biostatistics, Georgetown University Washington, DC, USA
| | - Irfan Tamboli
- Department of Neuroscience, Georgetown University Washington, DC, USA
| | - Ruth Chia
- Department of Neuroscience, Georgetown University Washington, DC, USA
| | - Michael Orquiza
- Department of Neuroscience, Georgetown University Washington, DC, USA
| | - Robert M Padilla
- Department of Neuroscience, Georgetown University Washington, DC, USA
| | - Amrita K Cheema
- Departments of Oncology and Biochemistry, Georgetown University Washington, DC, USA
| | - Mark E Mapstone
- Department of Neurology, University of Rochester Rochester, NY, USA
| | - Massimo S Fiandaca
- Department of Neurology, Georgetown University Washington, DC, USA ; Department of Neuroscience, Georgetown University Washington, DC, USA
| | - Howard J Federoff
- Department of Neurology, Georgetown University Washington, DC, USA ; Department of Neuroscience, Georgetown University Washington, DC, USA
| | - Elissa L Newport
- Department of Rehabilitation Medicine, Center for Brain Plasticity and Recovery, Georgetown University and MedStar National Rehabilitation Hospital Washington, DC, USA ; Department of Neurology, Georgetown University Washington, DC, USA
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Semple BD, Lee S, Sadjadi R, Fritz N, Carlson J, Griep C, Ho V, Jang P, Lamb A, Popolizio B, Saini S, Bazarian JJ, Prins ML, Ferriero DM, Basso DM, Noble-Haeusslein LJ. Repetitive concussions in adolescent athletes - translating clinical and experimental research into perspectives on rehabilitation strategies. Front Neurol 2015; 6:69. [PMID: 25883586 PMCID: PMC4382966 DOI: 10.3389/fneur.2015.00069] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 03/13/2015] [Indexed: 12/23/2022] Open
Abstract
Sports-related concussions are particularly common during adolescence, a time when even mild brain injuries may disrupt ongoing brain maturation and result in long-term complications. A recent focus on the consequences of repetitive concussions among professional athletes has prompted the development of several new experimental models in rodents, as well as the revision of guidelines for best management of sports concussions. Here, we consider the utility of rodent models to understand the functional consequences and pathobiology of concussions in the developing brain, identifying the unique behavioral and pathological signatures of concussive brain injuries. The impact of repetitive concussions on behavioral consequences and injury progression is also addressed. In particular, we focus on the epidemiological, clinical, and experimental evidence underlying current recommendations for physical and cognitive rest after concussion, and highlight key areas in which further research is needed. Lastly, we consider how best to promote recovery after injury, recognizing that optimally timed, activity-based rehabilitative strategies may hold promise for the adolescent athlete who has sustained single or repetitive concussions. The purpose of this review is to inform the clinical research community as it strives to develop and optimize evidence-based guidelines for the concussed adolescent, in terms of both acute and long-term management.
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Affiliation(s)
- Bridgette D. Semple
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Sangmi Lee
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Raha Sadjadi
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Nora Fritz
- Kennedy Krieger Institute, John Hopkins University, Baltimore, MD, USA
| | - Jaclyn Carlson
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Carrie Griep
- San Francisco State University Graduate Program in Physical Therapy, University of California San Francisco, San Francisco, CA, USA
| | - Vanessa Ho
- San Francisco State University Graduate Program in Physical Therapy, University of California San Francisco, San Francisco, CA, USA
| | - Patrice Jang
- San Francisco State University Graduate Program in Physical Therapy, University of California San Francisco, San Francisco, CA, USA
| | - Annick Lamb
- San Francisco State University Graduate Program in Physical Therapy, University of California San Francisco, San Francisco, CA, USA
| | - Beth Popolizio
- San Francisco State University Graduate Program in Physical Therapy, University of California San Francisco, San Francisco, CA, USA
| | - Sonia Saini
- San Francisco State University Graduate Program in Physical Therapy, University of California San Francisco, San Francisco, CA, USA
| | - Jeffrey J. Bazarian
- School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY, USA
| | - Mayumi L. Prins
- Department of Neurosurgery, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, USA
| | - Donna M. Ferriero
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - D. Michele Basso
- School of Health and Rehabilitation Sciences, Ohio State University, Columbus, OH, USA
| | - Linda J. Noble-Haeusslein
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- Department of Physical Therapy and Rehabilitation Sciences, University of California San Francisco, San Francisco, CA, USA
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Watson N, Ji X, Yasuhara T, Date I, Kaneko Y, Tajiri N, Borlongan CV. No pain, no gain: lack of exercise obstructs neurogenesis. Cell Transplant 2015; 24:591-7. [PMID: 25806858 DOI: 10.3727/096368915x687723] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Bedridden patients develop atrophied muscles, their daily activities greatly reduced, and some display a depressive mood. Patients who are able to receive physical rehabilitation sometimes show surprising clinical improvements, including reduced depression and attenuation of other stress-related behaviors. Regenerative medicine has advanced two major stem cell-based therapies for CNS disorders, namely, transplantation of exogenous stem cells and amplification of endogenous neurogenesis. The latter strategy embraces a natural way of reinnervating the damaged brain and correcting the neurological impairments. In this study, we discussed how immobilization-induced disuse atrophy, using the hindlimb suspension model, affects neurogenesis in rats. The overarching hypothesis is that immobilization suppresses neurogenesis by reducing the circulating growth or trophic factors, such as vascular endothelial growth factor or brain-derived neurotrophic factor. That immobilization alters neurogenesis and stem cell differentiation in the CNS requires characterization of the stem cell microenvironment by examining the trophic and growth factors, as well as stress-related proteins that have been implicated in exercise-induced neurogenesis. Although accumulating evidence has revealed the contribution of "increased" exercise on neurogenesis, the reverse paradigm involving "lack of exercise," which mimics pathological states (e.g., stroke patients are often immobile), remains underexplored. This novel paradigm will enable us to examine the effects on neurogenesis by a nonpermissive stem cell microenvironment likely produced by lack of exercise. BrdU labeling of proliferative cells, biochemical assays of serum, cerebrospinal fluid and brain levels of trophic factors, growth factors, and stress-related proteins are proposed as indices of neurogenesis, while quantitative measurements of spontaneous movements will reveal psychomotor components of immobilization. Studies designed to reveal how in vivo stimulation, or lack thereof, alters the stem cell microenvironment are needed to begin to develop treatment strategies for enhancing neurogenesis in bedridden patients.
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Affiliation(s)
- Nate Watson
- Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, FL, USA
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Teasell R, Bitensky J, Salter K, Bayona NA. The Role of Timing and Intensity of Rehabilitation Therapies. Top Stroke Rehabil 2015; 12:46-57. [PMID: 16110427 DOI: 10.1310/etdp-6dr4-d617-vmvf] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In both animal and clinical studies, motor rehabilitation and training increase cortical representation and improve recovery, whereas lack of training decreases cortical representation for particular motor functions. In animals, delays in providing rehabilitation reduce the impact of therapy with a worsening in motor outcomes and a corresponding reduction in cortical reorganization. In clinical studies, there is an association between earlier admission to rehabilitation and better outcomes that correlates with animal work both in terms of functional gains from chronic stroke deficits and cortical reorganization. There is a likely relationship between therapy intensity and improvements in functional outcomes. Clinically, greater intensity of stroke rehabilitation has been associated with improved outcomes.
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Affiliation(s)
- Robert Teasell
- Department of Physical Medicine and Rehabilitation, St. Joseph's Health Care and the University of Western Ontario, London, Ontario, Canada
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O'Bryant AJ, Adkins DL, Sitko AA, Combs HL, Nordquist SK, Jones TA. Enduring Poststroke Motor Functional Improvements by a Well-Timed Combination of Motor Rehabilitative Training and Cortical Stimulation in Rats. Neurorehabil Neural Repair 2014; 30:143-54. [PMID: 25527486 DOI: 10.1177/1545968314562112] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND In animal stroke models, peri-infarct cortical stimulation (CS) combined with rehabilitative reach training (RT) enhances motor functional outcome and cortical reorganization, compared with RT alone. It was unknown whether the effects of CS + RT (a) persist long after treatment, (b) can be enhanced by forcing greater use of the paretic limb, and (C) vary with treatment onset time. OBJECTIVE To test the endurance, time sensitivity, and the potential for augmentation by forced forelimb use of CS + RT treatment effects following ischemic stroke. METHODS Adult rats that were proficient in skilled reaching received unilateral ischemic motor cortical lesions. RT was delivered for 3 weeks alone or concurrently with 100-Hz cathodal epidural CS, delivered at 50% of movement thresholds. In study 1, this treatment was initiated at 14 days postinfarct, with some subgroups receiving an overlapping period of continuous constraint of the nonparetic forelimb to force use of the paretic limb. The function of the paretic limb was assessed weekly for 9 to 10 months posttreatment. In study 2, rats underwent CS, RT, and the combination during the chronic postinfarct period. RESULTS Early onset CS + RT resulted in greater functional improvements than RT alone. The CS-related gains persisted for 9 to 10 months posttreatment and were not significantly influenced by forced use of the paretic limb. When treatment onset was delayed until 3 months post-infarct, RT alone improved function, but CS + RT was no more effective than RT alone. CONCLUSION CS can enhance the persistence, as well as the magnitude of RT-driven functional improvements, but its effectiveness in doing so may vary with time postinfarct.
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50
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Interplay between intra- and interhemispheric remodeling of neural networks as a substrate of functional recovery after stroke: Adaptive versus maladaptive reorganization. Neuroscience 2014; 283:178-201. [DOI: 10.1016/j.neuroscience.2014.06.066] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 06/27/2014] [Accepted: 06/27/2014] [Indexed: 11/18/2022]
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