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He LW, Guo XJ, Zhao C, Rao JS. Rehabilitation Training after Spinal Cord Injury Affects Brain Structure and Function: From Mechanisms to Methods. Biomedicines 2023; 12:41. [PMID: 38255148 PMCID: PMC10813763 DOI: 10.3390/biomedicines12010041] [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: 11/01/2023] [Revised: 12/03/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
Spinal cord injury (SCI) is a serious neurological insult that disrupts the ascending and descending neural pathways between the peripheral nerves and the brain, leading to not only functional deficits in the injured area and below the level of the lesion but also morphological, structural, and functional reorganization of the brain. These changes introduce new challenges and uncertainties into the treatment of SCI. Rehabilitation training, a clinical intervention designed to promote functional recovery after spinal cord and brain injuries, has been reported to promote activation and functional reorganization of the cerebral cortex through multiple physiological mechanisms. In this review, we evaluate the potential mechanisms of exercise that affect the brain structure and function, as well as the rehabilitation training process for the brain after SCI. Additionally, we compare and discuss the principles, effects, and future directions of several rehabilitation training methods that facilitate cerebral cortex activation and recovery after SCI. Understanding the regulatory role of rehabilitation training at the supraspinal center is of great significance for clinicians to develop SCI treatment strategies and optimize rehabilitation plans.
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Affiliation(s)
- Le-Wei He
- Beijing Key Laboratory for Biomaterials and Neural Regeneration, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China; (L.-W.H.); (X.-J.G.)
| | - Xiao-Jun Guo
- Beijing Key Laboratory for Biomaterials and Neural Regeneration, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China; (L.-W.H.); (X.-J.G.)
| | - Can Zhao
- Institute of Rehabilitation Engineering, China Rehabilitation Science Institute, Beijing 100068, China
| | - Jia-Sheng Rao
- Beijing Key Laboratory for Biomaterials and Neural Regeneration, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China; (L.-W.H.); (X.-J.G.)
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Chen J, Zhu T, Yu D, Yan B, Zhang Y, Jin J, Yang Z, Zhang B, Hao X, Chen Z, Yan C, Yu J. Moderate Intensity of Treadmill Exercise Rescues TBI-Induced Ferroptosis, Neurodegeneration, and Cognitive Impairments via Suppressing STING Pathway. Mol Neurobiol 2023; 60:4872-4896. [PMID: 37193866 PMCID: PMC10415513 DOI: 10.1007/s12035-023-03379-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/03/2023] [Indexed: 05/18/2023]
Abstract
Traumatic brain injury (TBI) is a universal leading cause of long-term neurological disability and causes a huge burden to an ever-growing population. Moderate intensity of treadmill exercise has been recognized as an efficient intervention to combat TBI-induced motor and cognitive disorders, yet the underlying mechanism is still unclear. Ferroptosis is known to be highly implicated in TBI pathophysiology, and the anti-ferroptosis effects of treadmill exercise have been reported in other neurological diseases except for TBI. In addition to cytokine induction, recent evidence has demonstrated the involvement of the stimulator of interferon genes (STING) pathway in ferroptosis. Therefore, we examined the possibility that treadmill exercise might inhibit TBI-induced ferroptosis via STING pathway. In this study, we first found that a series of ferroptosis-related characteristics, including abnormal iron homeostasis, decreased glutathione peroxidase 4 (Gpx4), and increased lipid peroxidation, were detected at 44 days post TBI, substantiating the involvement of ferroptosis at the chronic stage following TBI. Furthermore, treadmill exercise potently decreased the aforementioned ferroptosis-related changes, suggesting the anti-ferroptosis role of treadmill exercise following TBI. In addition to alleviating neurodegeneration, treadmill exercise effectively reduced anxiety, enhanced spatial memory recovery, and improved social novelty post TBI. Interestingly, STING knockdown also obtained the similar anti-ferroptosis effects after TBI. More importantly, overexpression of STING largely reversed the ferroptosis inactivation caused by treadmill exercise following TBI. To conclude, moderate-intensity treadmill exercise rescues TBI-induced ferroptosis and cognitive deficits at least in part via STING pathway, broadening our understanding of neuroprotective effects induced by treadmill exercise against TBI.
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Affiliation(s)
- Jie Chen
- College of Forensic Medicine, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
- The Key Laboratory of Forensic Medicine (Xi'an Jiaotong University), National Health Commission of China, Xi'an, 710061, Shaanxi, China
- Clinical Experimental Center, Xi'an International Medical Center Hospital, Xi'an, 710100, Shaanxi, China
- Academy of Bio-Evidence Science, The Science and Technology Innovation Port in Western China, Xi'an Jiao Tong University, Xi-Xian New Area, 710115, Shaanxi, China
| | - Tong Zhu
- Clinical Experimental Center, Xi'an International Medical Center Hospital, Xi'an, 710100, Shaanxi, China
| | - Dongyu Yu
- College of Forensic Medicine, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
- The Key Laboratory of Forensic Medicine (Xi'an Jiaotong University), National Health Commission of China, Xi'an, 710061, Shaanxi, China
- Academy of Bio-Evidence Science, The Science and Technology Innovation Port in Western China, Xi'an Jiao Tong University, Xi-Xian New Area, 710115, Shaanxi, China
| | - Bing Yan
- Clinical Experimental Center, Xi'an International Medical Center Hospital, Xi'an, 710100, Shaanxi, China
| | - Yuxiang Zhang
- College of Forensic Medicine, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
- The Key Laboratory of Forensic Medicine (Xi'an Jiaotong University), National Health Commission of China, Xi'an, 710061, Shaanxi, China
- Academy of Bio-Evidence Science, The Science and Technology Innovation Port in Western China, Xi'an Jiao Tong University, Xi-Xian New Area, 710115, Shaanxi, China
| | - Jungong Jin
- Clinical Experimental Center, Xi'an International Medical Center Hospital, Xi'an, 710100, Shaanxi, China
| | - Zhuojin Yang
- College of Forensic Medicine, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
- The Key Laboratory of Forensic Medicine (Xi'an Jiaotong University), National Health Commission of China, Xi'an, 710061, Shaanxi, China
- Academy of Bio-Evidence Science, The Science and Technology Innovation Port in Western China, Xi'an Jiao Tong University, Xi-Xian New Area, 710115, Shaanxi, China
| | - Bao Zhang
- College of Forensic Medicine, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
- The Key Laboratory of Forensic Medicine (Xi'an Jiaotong University), National Health Commission of China, Xi'an, 710061, Shaanxi, China
- Academy of Bio-Evidence Science, The Science and Technology Innovation Port in Western China, Xi'an Jiao Tong University, Xi-Xian New Area, 710115, Shaanxi, China
| | - Xiuli Hao
- College of Forensic Medicine, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
- The Key Laboratory of Forensic Medicine (Xi'an Jiaotong University), National Health Commission of China, Xi'an, 710061, Shaanxi, China
| | - Zhennan Chen
- College of Forensic Medicine, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
- The Key Laboratory of Forensic Medicine (Xi'an Jiaotong University), National Health Commission of China, Xi'an, 710061, Shaanxi, China
- Academy of Bio-Evidence Science, The Science and Technology Innovation Port in Western China, Xi'an Jiao Tong University, Xi-Xian New Area, 710115, Shaanxi, China
| | - Chunxia Yan
- College of Forensic Medicine, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China.
- The Key Laboratory of Forensic Medicine (Xi'an Jiaotong University), National Health Commission of China, Xi'an, 710061, Shaanxi, China.
- Academy of Bio-Evidence Science, The Science and Technology Innovation Port in Western China, Xi'an Jiao Tong University, Xi-Xian New Area, 710115, Shaanxi, China.
| | - Jun Yu
- Clinical Experimental Center, Xi'an International Medical Center Hospital, Xi'an, 710100, Shaanxi, China.
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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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Yazdani M, Chitsaz A, Zolaktaf V, Saadatnia M, Ghasemi M, Nazari F, Chitsaz A, Suzuki K, Nobari H. Can Early Neuromuscular Rehabilitation Protocol Improve Disability after a Hemiparetic Stroke? A Pilot Study. Brain Sci 2022; 12:brainsci12070816. [PMID: 35884625 PMCID: PMC9313239 DOI: 10.3390/brainsci12070816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 04/30/2022] [Accepted: 06/12/2022] [Indexed: 12/04/2022] Open
Abstract
Background: The impairment of limb function and disability are among the most important consequences of stroke. To date, however, little research has been done on the early rehabilitation trial (ERT) after stroke in these patients. The purpose of this study was to evaluate the impact of ERT neuromuscular protocol on motor function soon after hemiparetic stroke. The sample included twelve hemiparetic patients (54.3 ± 15.4 years old) with ischemic stroke (n = 7 control, n = 5 intervention patients). ERT was started as early as possible after stroke and included passive range of motion exercises, resistance training, assisted standing up, and active exercises of the healthy side of the body, in addition to encouraging voluntary contraction of affected limbs as much as possible. The rehabilitation was progressive and took 3 months, 6 days per week, 2–3 hours per session. Fugle-Meyer Assessment (FMA), Box and Blocks test (BBT) and Timed up and go (TUG) assessments were conducted. There was a significantly greater improvement in the intervention group compared to control: FMA lower limbs (p = 0.001), total motor function (p = 0.002), but no significant difference in FMA upper limb between groups (p = 0.51). The analysis of data related to BBT showed no significant differences between the experimental and control groups (p = 0.3). However, TUG test showed significant differences between the experimental and control groups (p = 0.004). The most important finding of this study was to spend enough time in training sessions and provide adequate rest time for each person. Our results showed that ERT was associated with improved motor function but not with the upper limbs. This provides a basis for a definitive trial.
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Affiliation(s)
- Mahdi Yazdani
- Faculty of Sport Sciences, University of Isfahan, Isfahan 81746-7344, Iran; (V.Z.); (A.C.)
- Isfahan Neurosciences Research Centre, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan 81839-83434, Iran
- Correspondence: (M.Y.); (K.S.); or (H.N.)
| | - Ahmad Chitsaz
- Isfahan Neurosciences Research Centre, Alzahra Research Institute, Department of Neurology, Isfahan University of Medical Sciences, Isfahan 81839-83434, Iran; (A.C.); (M.S.); (M.G.)
| | - Vahid Zolaktaf
- Faculty of Sport Sciences, University of Isfahan, Isfahan 81746-7344, Iran; (V.Z.); (A.C.)
| | - Mohammad Saadatnia
- Isfahan Neurosciences Research Centre, Alzahra Research Institute, Department of Neurology, Isfahan University of Medical Sciences, Isfahan 81839-83434, Iran; (A.C.); (M.S.); (M.G.)
| | - Majid Ghasemi
- Isfahan Neurosciences Research Centre, Alzahra Research Institute, Department of Neurology, Isfahan University of Medical Sciences, Isfahan 81839-83434, Iran; (A.C.); (M.S.); (M.G.)
| | - Fatemeh Nazari
- Isfahan Neurosciences Research Centre, Department of Adult Health Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan 81839-83434, Iran;
| | - Abbas Chitsaz
- Faculty of Sport Sciences, University of Isfahan, Isfahan 81746-7344, Iran; (V.Z.); (A.C.)
| | - Katsuhiko Suzuki
- Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan
- Correspondence: (M.Y.); (K.S.); or (H.N.)
| | - Hadi Nobari
- Faculty of Sport Sciences, University of Isfahan, Isfahan 81746-7344, Iran; (V.Z.); (A.C.)
- Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
- Department of Motor Performance, Faculty of Physical Education and Mountain Sports, Transilvania University of Brașov, 500068 Brașov, Romania
- Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil 56199-11367, Iran
- Correspondence: (M.Y.); (K.S.); or (H.N.)
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Li F, Geng X, Lee H, Wills M, Ding Y. Neuroprotective Effects of Exercise Postconditioning After Stroke via SIRT1-Mediated Suppression of Endoplasmic Reticulum (ER) Stress. Front Cell Neurosci 2021; 15:598230. [PMID: 33664650 PMCID: PMC7920953 DOI: 10.3389/fncel.2021.598230] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 01/25/2021] [Indexed: 01/13/2023] Open
Abstract
While it is well-known that pre-stroke exercise conditioning reduces the incidence of stroke and the development of comorbidities, it is unclear whether post-stroke exercise conditioning is also neuroprotective. The present study investigated whether exercise postconditioning (PostE) induced neuroprotection and elucidated the involvement of SIRT1 regulation on the ROS/ER stress pathway. Adult rats were subjected to middle cerebral artery occlusion (MCAO) followed by either: (1) resting; (2) mild exercise postconditioning (MPostE); or (3) intense exercise postconditioning (IPostE). PostE was initiated 24 h after reperfusion and performed on a treadmill. At 1 and 3 days thereafter, we determined infarct volumes, neurological defects, brain edema, apoptotic cell death through measuring pro- (BAX and Caspase-3) and anti-apoptotic (Bcl-2) proteins, and ER stress through the measurement of glucose-regulated protein 78 (GRP78), inositol-requiring 1α (IRE1α), protein kinase RNA-like endoplasmic reticulum kinase (PERK), activating transcription factor 6 (ATF6), C/EBP homologous protein (CHOP), Caspase-12, and SIRT1. Proteins were measured by Western blot. ROS production was detected by flow cytometry.Compared to resting rats, both MPostE and IPostE significantly decreased brain infarct volumes and edema, neurological deficits, ROS production, and apoptotic cell death. MPostE further increased Bcl-2 expression and Bcl-2/BAX ratio as well as BAX and Caspase-3 expressions and ROS production (*p < 0.05). Both PostE groups saw decreases in ER stress proteins, while MPostE demonstrated a further reduction in GRP78 (***p < 0.001) and Caspase-12 (*p < 0.05) expressions at 1 day and IRE1α (**p < 0.01) and CHOP (*p < 0.05) expressions at 3 days. Additionally, both PostE groups saw significant increases in SIRT1 expression.In this study, both mild and intense PostE levels induced neuroprotection after stroke through SIRT1 and ROS/ER stress pathway. Additionally, the results may provide a base for our future study regarding the regulation of SIRT1 on the ROS/ER stress pathway in the biochemical processes underlying post-stroke neuroprotection. The results suggest that mild exercise postconditioning might play a similar neuroprotective role as intensive exercise and could be an effective exercise strategy as well.
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Affiliation(s)
- Fengwu Li
- China-America Institute of Neuroscience, Luhe Hospital, Capital Medical University, Beijing, China
| | - Xiaokun Geng
- China-America Institute of Neuroscience, Luhe Hospital, Capital Medical University, Beijing, China.,Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States
| | - Hangil Lee
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States
| | - Melissa Wills
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States
| | - Yuchuan Ding
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States.,Department of Research and Development Center, John D. Dingell VA Medical Center, Detroit, MI, United States
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Pan G, Cheng J, Shen W, Lin Y, Zhu A, Jin L, Xie Q, Zhu M, Liu C, Tu F, Chen X. Intensive treadmill training promotes cognitive recovery after cerebral ischemia-reperfusion in juvenile rats. Behav Brain Res 2020; 401:113085. [PMID: 33358915 DOI: 10.1016/j.bbr.2020.113085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 01/22/2023]
Abstract
Rehabilitation training is routine for children who experience stroke, but its protective mechanism remains unclear. To study the effect of treadmill training intensity on hippocampal synaptic plasticity after cerebral ischemia, a model of middle cerebral artery occlusion (MCAO)/reperfusion was established in young rats to simulate childhood ischemic stroke. The rats were randomly allocated into five groups: sham operation, MCAO, low-intensity exercise and MCAO (5 m/min), medium-intensity exercise and MCAO (10 m/min), and high-intensity exercise and MCAO (15 m/min). Intervention was continued for 14 days, and a series of experimental tests were conducted. After MCAO, the juvenile rats exhibited a series of morphological and functional alterations, including changes in their neurobehavior and cerebral infarct volumes. Compared with control rats, MCAO rats had a longer escape latency and crossed fewer platforms in the water maze test and exhibited decreased hippocampal neuron density and Synapsin I and PSD95 expression. Furthermore, MCAO rats exhibited synapse morphology changes and abnormal serum levels of lactic acid and corticosterone. Treadmill training effectively reduced the neurobehavioral scores and cerebral infarction volumes, with medium-intensity training showing the best effect. Treadmill training shortened the escape latency, increased the number of platform crossings, and improved the spatial cognitive abilities of the rats, with the medium intensity training having the best effect on spatial learning/memory efficiency. Treadmill training increased the neuron density in the hippocampus, with the medium-intensity training resulting in the highest density. Treadmill training had a positive effect on the expression of Synapsin I and PSD95, with the medium-intensity training showing the strongest effect. Treadmill training improved the sub-microstructure synapse morphology, with the medium-intensity training demonstrating the best effect. Treadmill training increased the plasma levels of lactic acid and corticosterone, with the high-intensity training having the most obvious effect. Treadmill training can provide neuroprotection by promoting hippocampal synaptic plasticity, with medium-intensity training showing the most optimal effects.
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Affiliation(s)
- Guoyuan Pan
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuanxi Road, Wenzhou, Zhejiang, China; Tongde Hospital of Zhejiang Province, No. 234, Gucui Road, Hangzhou, Zhejiang, China
| | - Jingyan Cheng
- The Second Hospital Affiliated to Anhui University of Chinese Medicine, No.300, Shouchun Road, Hefei, Anhui, China
| | - Weimin Shen
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuanxi Road, Wenzhou, Zhejiang, China
| | - Yao Lin
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuanxi Road, Wenzhou, Zhejiang, China
| | - Anqi Zhu
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuanxi Road, Wenzhou, Zhejiang, China
| | - Lingqin Jin
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuanxi Road, Wenzhou, Zhejiang, China
| | - Qingfeng Xie
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuanxi Road, Wenzhou, Zhejiang, China
| | - Mingjin Zhu
- Tongde Hospital of Zhejiang Province, No. 234, Gucui Road, Hangzhou, Zhejiang, China
| | - Chan Liu
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuanxi Road, Wenzhou, Zhejiang, China
| | - Fengxia Tu
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuanxi Road, Wenzhou, Zhejiang, China
| | - Xiang Chen
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuanxi Road, Wenzhou, Zhejiang, China.
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Li F, Geng X, Huber C, Stone C, Ding Y. In Search of a Dose: The Functional and Molecular Effects of Exercise on Post-stroke Rehabilitation in Rats. Front Cell Neurosci 2020; 14:186. [PMID: 32670026 PMCID: PMC7330054 DOI: 10.3389/fncel.2020.00186] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 05/28/2020] [Indexed: 12/11/2022] Open
Abstract
Although physical exercise has been demonstrated to augment recovery of the post-stroke brain, the question of what level of exercise intensity optimizes neurological outcomes of post-stroke rehabilitation remains unsettled. In this study, we aim to clarify the mechanisms underlying the intensity-dependent effect of exercise on neurologic function, and thereby to help direct the clinical application of exercise-based neurorehabilitation. To do this, we used a well-established rat model of ischemic stroke consisting of cerebral ischemia induction through middle cerebral artery occlusion (MCAO). Ischemic rats were subsequently assigned either to a control group entailing post-stroke rest or to one of two exercise groups distinguished by the intensity of their accompanying treadmill regimens. After 24 h of reperfusion, exercise was initiated. Infarct volume, apoptotic cell death, and neurological defects were quantified in all groups at 3 days, and motor and cognitive functions were tracked up to day-28. Additionally, Western blotting was used to assess the influence of our interventions on several proteins related to synaptogenesis and neuroplasticity (growth-associated protein 43, a microtubule-associated protein, postsynaptic density-95, synapsin I, hypoxia-inducible factor-1α, brain-derived neurotrophic factor, nerve growth factor, tyrosine kinase B, and cAMP response element-binding protein). Our results were in equal parts encouraging and surprising. Both mild and intense exercise significantly decreased infarct volume, cell death, and neurological deficits. Motor and cognitive function, as determined using an array of tests such as beam balance, forelimb placing, and the Morris water maze, were also significantly improved by both exercise protocols. Interestingly, while an obvious enhancement of neuroplasticity proteins was shown in both exercise groups, mild exercise rats demonstrated a stronger effect on the expressions of Tau (p < 0.01), brain-derived neurotrophic factor (p < 0.01), and tyrosine kinase B (p < 0.05). These findings contribute to the growing body of literature regarding the positive effects of both mild and intense long-term treadmill exercise on brain injury, functional outcome, and neuroplasticity. Additionally, the results may provide a base for our future study regarding the regulation of HIF-1α on the BDNF/TrkB/CREB pathway in the biochemical processes underlying post-stroke synaptic plasticity.
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Affiliation(s)
- Fengwu Li
- China-America Institute of Neuroscience, Luhe Hospital, Capital Medical University, Beijing, China
| | - Xiaokun Geng
- China-America Institute of Neuroscience, Luhe Hospital, Capital Medical University, Beijing, China.,Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States
| | - Christian Huber
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States
| | - Christopher Stone
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States
| | - Yuchuan Ding
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States.,Department of Research and Development Center, John D. Dingell VA Medical Center, Detroit, MI, United States
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Kim TW, Park SS, Park JY, Park HS. Infusion of Plasma from Exercised Mice Ameliorates Cognitive Dysfunction by Increasing Hippocampal Neuroplasticity and Mitochondrial Functions in 3xTg-AD Mice. Int J Mol Sci 2020; 21:ijms21093291. [PMID: 32384696 PMCID: PMC7247545 DOI: 10.3390/ijms21093291] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/30/2020] [Accepted: 04/30/2020] [Indexed: 12/20/2022] Open
Abstract
Alzheimer’s disease is the most common neurodegenerative brain disease causing dementia. It is characterized by slow onset and gradual worsening of memory and other cognitive functions. Recently, parabiosis and infusion of plasma from young mice have been proposed to have positive effects in aging and Alzheimer’s disease. Therefore, this study examined whether infusion of plasma from exercised mice improved cognitive functions related to the hippocampus in a 3xTg-Alzheimer’s disease (AD) model. We collected plasma from young mice that had exercised for 3 months and injected 100 µL of plasma into the tail vein of 12-month-old 3xTg-AD mice 10 times at 3-day intervals. We then analyzed spatial learning and memory, long-term memory, hippocampal GSK3β/tau proteins, synaptic proteins, mitochondrial function, apoptosis, and neurogenesis. In the hippocampus of 3xTg-AD mice, infusion of plasma from exercised mice improved neuroplasticity and mitochondrial function and suppressed apoptosis, ultimately improving cognitive function. However, there was no improvement in tau hyperphosphorylation. This study showed that plasma from exercised mice could have a protective effect on cognitive dysfunction and neural circuits associated with AD via a tau-independent mechanism involving elevated brain-derived neurotrophic factor due to exercise.
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Affiliation(s)
- Tae-Woon Kim
- Exercise Rehabilitation Research Institute, Department of Exercise & Health Science, Sangmyung University, Seoul 03016, Korea;
- Department of Physiology, College of Medicine, KyungHee University, Seoul 02447, Korea;
| | - Sang-Seo Park
- Department of Physiology, College of Medicine, KyungHee University, Seoul 02447, Korea;
| | - Joon-Young Park
- Department of Kinesiology, College of Public Health and Cardiovascular Research Center, Lewis Katz school of Medicine, Temple University, Philadelphia, PA 19122, USA;
| | - Hye-Sang Park
- Department of Kinesiology, College of Public Health and Cardiovascular Research Center, Lewis Katz school of Medicine, Temple University, Philadelphia, PA 19122, USA;
- Correspondence:
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Baek A, Shin JC, Lee MY, Kim SH, Kim J, Cho SR. Parasympathetic Effect Induces Cell Cycle Activation in Upper Limbs of Paraplegic Patients with Spinal Cord Injury. Int J Mol Sci 2019; 20:ijms20235982. [PMID: 31783707 PMCID: PMC6929129 DOI: 10.3390/ijms20235982] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/21/2019] [Accepted: 11/23/2019] [Indexed: 01/04/2023] Open
Abstract
The present study aimed to investigate gene expression changes related to cell cycle activation in patients with spinal cord injury (SCI) and to further evaluate the difference between the upper and lower limbs of SCI patients. Fibroblasts were obtained from the upper and lower limbs of SCI patients and healthy subjects. To investigate gene expression profiling in the fibroblasts from SCI patients compared to the healthy subjects, RNA-Seq transcriptome analysis was performed. To validate the parasympathetic effects on cell cycle activation, fibroblasts from upper or lower limbs of SCI patients were treated with the anticholinergic agents tiotropium or acetylcholine, and quantitative RT-PCR and Western blot were conducted. Cell proliferation was significantly increased in the upper limbs of SCI patients compared with the lower limbs of SCI patients and healthy subjects. The pathway and genes involved in cell cycle were identified by RNA-Seq transcriptome analysis. Expression of cell-cycle-related genes CCNB1, CCNB2, PLK1, BUB1, and CDC20 were significantly higher in the upper limbs of SCI patients compared with the lower limbs of SCI patients and healthy subjects. When the fibroblasts were treated with tiotropium the upper limbs and acetylcholine in the lower limbs, the expression of cell-cycle-related genes and cell proliferation were significantly modulated. This study provided the insight that cell proliferation and cell cycle activation were observed to be significantly increased in the upper limbs of SCI patients via the parasympathetic effect.
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Affiliation(s)
- Ahreum Baek
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (A.B.); (J.C.S.); (M.-Y.L.)
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
| | - Ji Cheol Shin
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (A.B.); (J.C.S.); (M.-Y.L.)
| | - Min-Young Lee
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (A.B.); (J.C.S.); (M.-Y.L.)
| | - Sung Hoon Kim
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
| | - Jiyong Kim
- Department of Physical Medicine and Rehabilitation, Inje University Ilsanpaik Hospital, 170 Juhwa-ro, Ilsanseo-gu, Goyang 10380, Korea
- Correspondence: (J.K.); (S.-R.C.); Tel.: +82-31-910-7885 (J.K.); +82-2-2228-3715 (S.-R.C.); Fax: +82-31-910-7786 (J.K.); +82-2-363-2795 (S.-R.C.)
| | - Sung-Rae Cho
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (A.B.); (J.C.S.); (M.-Y.L.)
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 03722, Korea
- Yonsei Stem Cell Center, Avison Biomedical Research Center, Yonsei University College of Medicine, Seoul 03722, Korea
- Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul 03722, Korea
- Correspondence: (J.K.); (S.-R.C.); Tel.: +82-31-910-7885 (J.K.); +82-2-2228-3715 (S.-R.C.); Fax: +82-31-910-7786 (J.K.); +82-2-363-2795 (S.-R.C.)
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Guo LY, Lozinski B, Yong VW. Exercise in multiple sclerosis and its models: Focus on the central nervous system outcomes. J Neurosci Res 2019; 98:509-523. [DOI: 10.1002/jnr.24524] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/17/2019] [Accepted: 08/21/2019] [Indexed: 12/30/2022]
Affiliation(s)
- Ling Yi Guo
- Department of Physiology and Pharmacology Western University London Ontario Canada
- Hotchkiss Brain InstituteUniversity of Calgary Calgary Alberta Canada
- Department of Clinical Neurosciences University of Calgary Calgary Alberta Canada
| | - Brian Lozinski
- Hotchkiss Brain InstituteUniversity of Calgary Calgary Alberta Canada
- Department of Clinical Neurosciences University of Calgary Calgary Alberta Canada
| | - Voon Wee Yong
- Hotchkiss Brain InstituteUniversity of Calgary Calgary Alberta Canada
- Department of Clinical Neurosciences University of Calgary Calgary Alberta Canada
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Tamakoshi K, Ishida K, Hayao K, Takahashi H, Tamaki H. Behavioral Effect of Short- and Long-Term Exercise on Motor Functional Recovery after Intracerebral Hemorrhage in Rats. J Stroke Cerebrovasc Dis 2018; 27:3630-3635. [DOI: 10.1016/j.jstrokecerebrovasdis.2018.08.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 08/25/2018] [Indexed: 11/25/2022] Open
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The beneficial role of early exercise training following stroke and possible mechanisms. Life Sci 2018; 198:32-37. [DOI: 10.1016/j.lfs.2018.02.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 02/04/2018] [Accepted: 02/12/2018] [Indexed: 12/21/2022]
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Koh CH, Pronin S, Hughes M. Chondroitinase ABC for neurological recovery after acute brain injury: systematic review and meta-analyses of preclinical studies. Brain Inj 2018; 32:715-729. [PMID: 29436856 DOI: 10.1080/02699052.2018.1438665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Damage to critical brain regions causes deficits in important neurological functions. Chondroitinase ABC (ChABC) has been shown to promote neuroplasticity and may ameliorate neurological deficits caused by disease or trauma. This systematic review identifies and evaluates preclinical studies of ChABC as a treatment for acute brain injury. METHODS Four databases were searched for studies relating to ChABC and brain or brain injuries. Controlled studies in mammals with acute brain injuries treated with ChABC were included in meta-analyses of neurobehavioural outcomes. Means and standard deviations from the fifth day of treatment were extracted, and normalised mean differences were calculated. RESULTS Of 775 identified records, 16 studies administered ChABC after acute brain injury, of which 9 reported neurobehavioural outcomes. The estimated treatment effect on neurological recovery over the duration of included studies was 49.4% (CI: 30.3-68.4% with Hartung-Knapp-Sidik-Jonkman adjustment, p = 0.0002). The mechanisms of action may involve decreasing astroglial scar formation, promoting neuronal sprouting, and selective synaptic strengthening of sprouting neurites and activated neural pathways. CONCLUSIONS The summary of published evidence suggests that ChABC treatment is effective in improving neurological outcomes in preclinical models of acute brain injury. However, more studies are needed for better assessment of the specific translational potential of ChABC. ABBREVIATIONS AVM - Arteriovenous Malformation; ChABC - Chondroitinase ABC; CI - Confidence Interval; CSPG - Chondroitin Sulphate Proteoglycans; HKSJ - Hartung-Knapp-Sidik-Jonkman; MCA - Middle Cerebral Artery; NMD - Normalised Mean Difference; NSPC - Neural Stem/Progenitor Cells; PI - Prediction Interval; SD - Standard Deviation; SMD - Standardised Mean Difference; TBI - Traumatic Brain Injury.
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Affiliation(s)
- Chan Hee Koh
- a Edinburgh Medical School , University of Edinburgh , Edinburgh , United Kingdom
| | - Savva Pronin
- a Edinburgh Medical School , University of Edinburgh , Edinburgh , United Kingdom
| | - Mark Hughes
- b Translational Neurosurgery Unit , Centre for Clinical Brain Sciences, University of Edinburgh , Edinburgh , United Kingdom
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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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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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Effect of Physical and Social Components of Enriched Environment on Astrocytes Proliferation in Rats After Cerebral Ischemia/Reperfusion Injury. Neurochem Res 2017; 42:1308-1316. [DOI: 10.1007/s11064-016-2172-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 12/26/2016] [Accepted: 12/29/2016] [Indexed: 12/27/2022]
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17
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Yelnik AP, Quintaine V, Andriantsifanetra C, Wannepain M, Reiner P, Marnef H, Evrard M, Meseguer E, Devailly JP, Lozano M, Lamy C, Colle F, Vicaut E. AMOBES (Active Mobility Very Early After Stroke): A Randomized Controlled Trial. Stroke 2016; 48:400-405. [PMID: 28008092 DOI: 10.1161/strokeaha.116.014803] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 11/08/2016] [Accepted: 11/15/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Intensive physical therapy (PT) facilitates motor recovery when provided during a subacute stage after stroke. The efficiency of very early intensive PT has been less investigated. We aimed to investigate whether intensive PT conducted within the first 2 weeks could aid recovery of motor control. METHODS This multicentre randomized controlled trial compared soft PT (20-min/d apart from respiratory needs) and intensive PT (idem+45 minutes of intensive exercises/day) initiated within the first 72 hours after a first hemispheric stroke. The primary outcome was change in motor control between day (D) 90 and D0 assessed by the Fugl-Meyer score. Main secondary outcomes were number of days to walking 10 m unassisted, balance, autonomy, quality of life, and unexpected medical events. All analyses were by intent to treat. RESULTS We could analyze data for 103 of the 104 included patients (51 control and 52 experimental group; 64 males; median age overall 67 [interquartile range 59-77], 67 right hemispheric lesions, 80 ischemic lesions, National Institutes of Health Stroke Scale score ≥8 for 82%). Fugl-Meyer score increased over time (P<0.0001), with no significant effect of treatment (P=0.29) or interaction between treatment and time (P=0.40). The median change in score between D90 and D0 was 27.5 (12-40) and 22.0 (12-56) for control and experimental groups (P=0.69). Similar results were found for the secondary criteria. CONCLUSIONS Very early after stroke, intensive exercises may not be efficient in improving motor control. This conclusion may apply to mainly severe stroke. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01520636.
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Affiliation(s)
- Alain P Yelnik
- From the PRM Department, GH Lariboisière F. Widal, AP-HP, Paris Diderot University, UMR8257, Paris, France (A.P.Y., V.Q., C.A., M.W., H.M., M.E.); Neurological Department GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (P.R.); Department of Neurology and Stroke Centre (E.M.) and PRM Department (J.P.D., M.L.), GH Paris Nord Val de Seine, AP-HP, Paris Diderot University, Paris, France; Neurological Department (C.L.) and PRM Department (F.C.), Sainte Anne Hospital, Paris Descartes University, Paris, France; and Clinical Research Unit GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (E.V.).
| | - Victorine Quintaine
- From the PRM Department, GH Lariboisière F. Widal, AP-HP, Paris Diderot University, UMR8257, Paris, France (A.P.Y., V.Q., C.A., M.W., H.M., M.E.); Neurological Department GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (P.R.); Department of Neurology and Stroke Centre (E.M.) and PRM Department (J.P.D., M.L.), GH Paris Nord Val de Seine, AP-HP, Paris Diderot University, Paris, France; Neurological Department (C.L.) and PRM Department (F.C.), Sainte Anne Hospital, Paris Descartes University, Paris, France; and Clinical Research Unit GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (E.V.)
| | - Cedric Andriantsifanetra
- From the PRM Department, GH Lariboisière F. Widal, AP-HP, Paris Diderot University, UMR8257, Paris, France (A.P.Y., V.Q., C.A., M.W., H.M., M.E.); Neurological Department GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (P.R.); Department of Neurology and Stroke Centre (E.M.) and PRM Department (J.P.D., M.L.), GH Paris Nord Val de Seine, AP-HP, Paris Diderot University, Paris, France; Neurological Department (C.L.) and PRM Department (F.C.), Sainte Anne Hospital, Paris Descartes University, Paris, France; and Clinical Research Unit GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (E.V.)
| | - Marie Wannepain
- From the PRM Department, GH Lariboisière F. Widal, AP-HP, Paris Diderot University, UMR8257, Paris, France (A.P.Y., V.Q., C.A., M.W., H.M., M.E.); Neurological Department GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (P.R.); Department of Neurology and Stroke Centre (E.M.) and PRM Department (J.P.D., M.L.), GH Paris Nord Val de Seine, AP-HP, Paris Diderot University, Paris, France; Neurological Department (C.L.) and PRM Department (F.C.), Sainte Anne Hospital, Paris Descartes University, Paris, France; and Clinical Research Unit GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (E.V.)
| | - Peggy Reiner
- From the PRM Department, GH Lariboisière F. Widal, AP-HP, Paris Diderot University, UMR8257, Paris, France (A.P.Y., V.Q., C.A., M.W., H.M., M.E.); Neurological Department GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (P.R.); Department of Neurology and Stroke Centre (E.M.) and PRM Department (J.P.D., M.L.), GH Paris Nord Val de Seine, AP-HP, Paris Diderot University, Paris, France; Neurological Department (C.L.) and PRM Department (F.C.), Sainte Anne Hospital, Paris Descartes University, Paris, France; and Clinical Research Unit GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (E.V.)
| | - Hélène Marnef
- From the PRM Department, GH Lariboisière F. Widal, AP-HP, Paris Diderot University, UMR8257, Paris, France (A.P.Y., V.Q., C.A., M.W., H.M., M.E.); Neurological Department GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (P.R.); Department of Neurology and Stroke Centre (E.M.) and PRM Department (J.P.D., M.L.), GH Paris Nord Val de Seine, AP-HP, Paris Diderot University, Paris, France; Neurological Department (C.L.) and PRM Department (F.C.), Sainte Anne Hospital, Paris Descartes University, Paris, France; and Clinical Research Unit GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (E.V.)
| | - Mathilde Evrard
- From the PRM Department, GH Lariboisière F. Widal, AP-HP, Paris Diderot University, UMR8257, Paris, France (A.P.Y., V.Q., C.A., M.W., H.M., M.E.); Neurological Department GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (P.R.); Department of Neurology and Stroke Centre (E.M.) and PRM Department (J.P.D., M.L.), GH Paris Nord Val de Seine, AP-HP, Paris Diderot University, Paris, France; Neurological Department (C.L.) and PRM Department (F.C.), Sainte Anne Hospital, Paris Descartes University, Paris, France; and Clinical Research Unit GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (E.V.)
| | - Elena Meseguer
- From the PRM Department, GH Lariboisière F. Widal, AP-HP, Paris Diderot University, UMR8257, Paris, France (A.P.Y., V.Q., C.A., M.W., H.M., M.E.); Neurological Department GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (P.R.); Department of Neurology and Stroke Centre (E.M.) and PRM Department (J.P.D., M.L.), GH Paris Nord Val de Seine, AP-HP, Paris Diderot University, Paris, France; Neurological Department (C.L.) and PRM Department (F.C.), Sainte Anne Hospital, Paris Descartes University, Paris, France; and Clinical Research Unit GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (E.V.)
| | - Jean Pascal Devailly
- From the PRM Department, GH Lariboisière F. Widal, AP-HP, Paris Diderot University, UMR8257, Paris, France (A.P.Y., V.Q., C.A., M.W., H.M., M.E.); Neurological Department GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (P.R.); Department of Neurology and Stroke Centre (E.M.) and PRM Department (J.P.D., M.L.), GH Paris Nord Val de Seine, AP-HP, Paris Diderot University, Paris, France; Neurological Department (C.L.) and PRM Department (F.C.), Sainte Anne Hospital, Paris Descartes University, Paris, France; and Clinical Research Unit GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (E.V.)
| | - Monica Lozano
- From the PRM Department, GH Lariboisière F. Widal, AP-HP, Paris Diderot University, UMR8257, Paris, France (A.P.Y., V.Q., C.A., M.W., H.M., M.E.); Neurological Department GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (P.R.); Department of Neurology and Stroke Centre (E.M.) and PRM Department (J.P.D., M.L.), GH Paris Nord Val de Seine, AP-HP, Paris Diderot University, Paris, France; Neurological Department (C.L.) and PRM Department (F.C.), Sainte Anne Hospital, Paris Descartes University, Paris, France; and Clinical Research Unit GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (E.V.)
| | - Catherine Lamy
- From the PRM Department, GH Lariboisière F. Widal, AP-HP, Paris Diderot University, UMR8257, Paris, France (A.P.Y., V.Q., C.A., M.W., H.M., M.E.); Neurological Department GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (P.R.); Department of Neurology and Stroke Centre (E.M.) and PRM Department (J.P.D., M.L.), GH Paris Nord Val de Seine, AP-HP, Paris Diderot University, Paris, France; Neurological Department (C.L.) and PRM Department (F.C.), Sainte Anne Hospital, Paris Descartes University, Paris, France; and Clinical Research Unit GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (E.V.)
| | - Florence Colle
- From the PRM Department, GH Lariboisière F. Widal, AP-HP, Paris Diderot University, UMR8257, Paris, France (A.P.Y., V.Q., C.A., M.W., H.M., M.E.); Neurological Department GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (P.R.); Department of Neurology and Stroke Centre (E.M.) and PRM Department (J.P.D., M.L.), GH Paris Nord Val de Seine, AP-HP, Paris Diderot University, Paris, France; Neurological Department (C.L.) and PRM Department (F.C.), Sainte Anne Hospital, Paris Descartes University, Paris, France; and Clinical Research Unit GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (E.V.)
| | - Eric Vicaut
- From the PRM Department, GH Lariboisière F. Widal, AP-HP, Paris Diderot University, UMR8257, Paris, France (A.P.Y., V.Q., C.A., M.W., H.M., M.E.); Neurological Department GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (P.R.); Department of Neurology and Stroke Centre (E.M.) and PRM Department (J.P.D., M.L.), GH Paris Nord Val de Seine, AP-HP, Paris Diderot University, Paris, France; Neurological Department (C.L.) and PRM Department (F.C.), Sainte Anne Hospital, Paris Descartes University, Paris, France; and Clinical Research Unit GH Lariboisière F. Widal, AP-HP, Paris Diderot University, Paris, France (E.V.)
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Himi N, Takahashi H, Okabe N, Nakamura E, Shiromoto T, Narita K, Koga T, Miyamoto O. Exercise in the Early Stage after Stroke Enhances Hippocampal Brain-Derived Neurotrophic Factor Expression and Memory Function Recovery. J Stroke Cerebrovasc Dis 2016; 25:2987-2994. [PMID: 27639585 DOI: 10.1016/j.jstrokecerebrovasdis.2016.08.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 07/13/2016] [Accepted: 08/11/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Exercise in the early stage after stroke onset has been shown to facilitate the recovery from physical dysfunction. However, the mechanism of recovery has not been clarified. In this study, the effect of exercise on spatial memory function recovery in the early stage was shown, and the mechanism of recovery was discussed using a rat model of brain embolism. METHODS Intra-arterial microsphere (MS) injection induced small emboli in the rat brain. Treadmill exercise was started at 24 hours (early group) or 8 days (late group) after MS injection. The non-exercise (NE) and sham-operated groups were included as controls. Memory function was evaluated by the Morris water maze test, and hippocampal levels of brain-derived neurotrophic factor (BDNF) were measured by enzyme-linked immunosorbent assays. To further investigate the effect of BDNF on memory function, BDNF was continuously infused into the hippocampus via implantable osmotic pumps in the early or late stage after stroke. RESULTS Memory function significantly improved only in the early group compared with the late and the NE groups, although hippocampal BDNF concentrations were temporarily elevated after exercise in both the early and the late groups. Rats infused with BDNF in the early stage exhibited significant memory function recovery; however, rats that received BDNF infusion in the late stage showed no improvement. CONCLUSION Exercise elevates hippocampal BDNF levels in the early stage after cerebral embolism, and this event facilitates memory function recovery.
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Affiliation(s)
- Naoyuki Himi
- Second Department of Physiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Hisashi Takahashi
- Department of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan
| | - Naohiko Okabe
- Second Department of Physiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Emi Nakamura
- Second Department of Physiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Takashi Shiromoto
- Department of Stroke, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Kazuhiko Narita
- Second Department of Physiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Tomoshige Koga
- Department of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan
| | - Osamu Miyamoto
- Second Department of Physiology, Kawasaki Medical School, Kurashiki, Okayama, Japan.
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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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Otsuka S, Sakakima H, Sumizono M, Takada S, Terashi T, Yoshida Y. The neuroprotective effects of preconditioning exercise on brain damage and neurotrophic factors after focal brain ischemia in rats. Behav Brain Res 2016; 303:9-18. [DOI: 10.1016/j.bbr.2016.01.049] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 01/18/2016] [Accepted: 01/20/2016] [Indexed: 01/07/2023]
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Abstract
Over recent decades, experimental and clinical stroke studies have identified a number of neurorestorative treatments that stimulate neural plasticity and promote functional recovery. In contrast to the acute stroke treatments thrombolysis and endovascular thrombectomy, neurorestorative treatments are still effective when initiated days after stroke onset, which makes them applicable to virtually all stroke patients. In this article, selected physical, pharmacological and cell-based neurorestorative therapies are discussed, with special emphasis on interventions that have already been transferred from the laboratory to the clinical setting. We explain molecular and structural processes that promote neural plasticity, discuss potential limitations of neurorestorative treatments, and offer a speculative viewpoint on how neurorestorative treatments will evolve.
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Affiliation(s)
- Antje Schmidt
- a Department of Neurology , University of Münster , Münster , Germany
| | - Jens Minnerup
- a Department of Neurology , University of Münster , Münster , Germany
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Zhang Y, Cao RY, Jia X, Li Q, Qiao L, Yan G, Yang J. Treadmill exercise promotes neuroprotection against cerebral ischemia-reperfusion injury via downregulation of pro-inflammatory mediators. Neuropsychiatr Dis Treat 2016; 12:3161-3173. [PMID: 28003752 PMCID: PMC5161395 DOI: 10.2147/ndt.s121779] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Stroke is one of the major causes of morbidity and mortality worldwide, which is associated with serious physical deficits that affect daily living and quality of life and produces immense public health and economic burdens. Both clinical and experimental data suggest that early physical training after ischemic brain injury may reduce the extent of motor dysfunction. However, the exact mechanisms have not been fully elucidated. The aim of this study was to investigate the effects of aerobic exercise on neuroprotection and understand the underlying mechanisms. MATERIALS AND METHODS Middle cerebral artery occlusion (MCAO) was conducted to establish a rat model of cerebral ischemia-reperfusion injury to mimic ischemic stroke. Experimental animals were divided into the following three groups: sham (n=34), MCAO (n=39), and MCAO plus treadmill exercise (n=28). The effects of aerobic exercise intervention on ischemic brain injury were evaluated using functional scoring, histological analysis, and Bio-Plex Protein Assays. RESULTS Early aerobic exercise intervention was found to improve motor function, prevent death of neuronal cells, and suppress the activation of microglial cells and astrocytes. Furthermore, it was observed that aerobic exercise downregulated the expression of the cytokine interleukin-1β and the chemokine monocyte chemotactic protein-1 after transient MCAO in experimental rats. CONCLUSION This study demonstrates that treadmill exercise rehabilitation promotes neuroprotection against cerebral ischemia-reperfusion injury via the downregulation of proinflammatory mediators.
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Affiliation(s)
| | - Richard Y Cao
- Laboratory of Immunology, Shanghai Xuhui Central Hospital, Shanghai Clinical Research Center, Chinese Academy of Sciences
| | - Xinling Jia
- School of Life sciences, Shanghai University
| | - Qing Li
- Department of Rehabilitation
| | | | - Guofeng Yan
- School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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Park K, Lee S, Hong Y, Park S, Choi J, Chang KT, Kim JH, Hong Y. Therapeutic physical exercise in neural injury: friend or foe? J Phys Ther Sci 2015; 27:3933-5. [PMID: 26834383 PMCID: PMC4713822 DOI: 10.1589/jpts.27.3933] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 09/01/2015] [Indexed: 01/29/2023] Open
Abstract
[Purpose] The intensity of therapeutic physical exercise is complex and sometimes
controversial in patients with neural injuries. This review assessed whether therapeutic
physical exercise is beneficial according to the intensity of the physical exercise.
[Methods] The authors identified clinically or scientifically relevant articles from
PubMed that met the inclusion criteria. [Results] Exercise training can improve body
strength and lead to the physiological adaptation of skeletal muscles and the nervous
system after neural injuries. Furthermore, neurophysiological and neuropathological
studies show differences in the beneficial effects of forced therapeutic exercise in
patients with severe or mild neural injuries. Forced exercise alters the distribution of
muscle fiber types in patients with neural injuries. Based on several animal studies,
forced exercise may promote functional recovery following cerebral ischemia via signaling
molecules in ischemic brain regions. [Conclusions] This review describes several types of
therapeutic forced exercise and the controversy regarding the therapeutic effects in
experimental animals versus humans with neural injuries. This review also provides a
therapeutic strategy for physical therapists that grades the intensity of forced exercise
according to the level of neural injury.
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Affiliation(s)
- Kanghui Park
- Ubiquitous Healthcare and Anti-aging Research Center (u-HARC), Inje University, Republic of Korea; Department of Physical Therapy, Dong-Ju College, Republic of Korea
| | - Seunghoon Lee
- Ubiquitous Healthcare and Anti-aging Research Center (u-HARC), Inje University, Republic of Korea; Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Republic of Korea; Biohealth Products Research Center (BPRC), Inje University, Republic of Korea
| | - Yunkyung Hong
- Ubiquitous Healthcare and Anti-aging Research Center (u-HARC), Inje University, Republic of Korea; Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Republic of Korea; Biohealth Products Research Center (BPRC), Inje University, Republic of Korea
| | - Sookyoung Park
- Ubiquitous Healthcare and Anti-aging Research Center (u-HARC), Inje University, Republic of Korea; Department of Physical Therapy, College of Natural Sciences, Kyungnam University, Republic of Korea
| | - Jeonghyun Choi
- Ubiquitous Healthcare and Anti-aging Research Center (u-HARC), Inje University, Republic of Korea; Biohealth Products Research Center (BPRC), Inje University, Republic of Korea; Department of Physical Therapy, Graduate School of Inje University, Gimhae, Republic of Korea, Republic of Korea
| | - Kyu-Tae Chang
- National Primate Research Center (NPRC), Korea Research Institute of Bioscience and Biotechnology (KRIBB), Republic of Korea
| | - Joo-Heon Kim
- Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University, Republic of Korea
| | - Yonggeun Hong
- Ubiquitous Healthcare and Anti-aging Research Center (u-HARC), Inje University, Republic of Korea; Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Republic of Korea; Biohealth Products Research Center (BPRC), Inje University, Republic of Korea; Department of Physical Therapy, Graduate School of Inje University, Gimhae, Republic of Korea, Republic of Korea
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The Effects of Exercise on Cognitive Recovery after Acquired Brain Injury in Animal Models: A Systematic Review. Neural Plast 2015; 2015:830871. [PMID: 26509085 PMCID: PMC4609870 DOI: 10.1155/2015/830871] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 06/09/2015] [Indexed: 12/15/2022] Open
Abstract
The objective of the present paper is to review the current status of exercise as a tool to promote cognitive rehabilitation after acquired brain injury (ABI) in animal model-based research. Searches were conducted on the PubMed, Scopus, and psycINFO databases in February 2014. Search strings used were: exercise (and) animal model (or) rodent (or) rat (and) traumatic brain injury (or) cerebral ischemia (or) brain irradiation. Studies were selected if they were (1) in English, (2) used adult animals subjected to acquired brain injury, (3) used exercise as an intervention tool after inflicted injury, (4) used exercise paradigms demanding movement of all extremities, (5) had exercise intervention effects that could be distinguished from other potential intervention effects, and (6) contained at least one measure of cognitive and/or emotional function. Out of 2308 hits, 22 publications fulfilled the criteria. The studies were examined relative to cognitive effects associated with three themes: exercise type (forced or voluntary), timing of exercise (early or late), and dose-related factors (intensity, duration, etc.). The studies indicate that exercise in many cases can promote cognitive recovery after brain injury. However, the optimal parameters to ensure cognitive rehabilitation efficacy still elude us, due to considerable methodological variations between studies.
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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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Abstract
Background:The current study explored the effects of treadmill exercise intensity on functional recovery and hippocampal phospho-NR2B (p-NR2B) expression in cerebral ischemic rats, induced by permanent middle cerebral artery occlusion (MCAO) surgery.Method:Adult male Sprague-Dawley rats were randomly divided into four groups, including sham, no exercise (NE), low intensity training (LIT, v = 15 m/min), and moderate intensity training groups (MIT, v = 20 m/min). At different time points, the hippocampal expressions of p-NR2B and total NR2B were examined. In addition, neurological deficit score (NDS), body weight, and 2,3,5-triphenyltetrazolium chloride (TTC) staining were used to evaluate brain infarct volume as assessments of post-stroke functional recovery. In order to investigate the effect of exercise on survival, the mortality rate was also recorded.Results:The results showed that treadmill exercise significantly decreased hippocampal expression of p-NR2B but didn't change the total NR2B, compared to the NE group on the 3rd, 7th, and 14th days following MCAO surgery. The effect on changes in p-NR2B levels, body weight, and brain infarct volume were more significant in the LIT compared to the MIT group.Discussion and Conclusion:The current findings demonstrate that physical exercise can produce neuroprotective effects, in part by down-regulating p-NR2B expression. Furthermore, the appropriate intensity of physical exercise is critical for post-stroke rehabilitation.
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Lovatel GA, Bertoldi K, Elsnerb VR, Piazza FV, Basso CG, Moysés FDS, Worm PV, Netto CA, Marcuzzo S, Siqueira IR. Long-term effects of pre and post-ischemic exercise following global cerebral ischemia on astrocyte and microglia functions in hippocampus from Wistar rats. Brain Res 2014; 1587:119-26. [PMID: 25192647 DOI: 10.1016/j.brainres.2014.08.068] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 07/23/2014] [Accepted: 08/25/2014] [Indexed: 02/07/2023]
Abstract
Persistent effects of pre- and postischemic exercise on glial cells activation after global cerebral ischemia remains poorly understood. Here, we investigated the effect of both pre and postischemic treadmill exercise protocols (20min/day during 2 weeks) on glial cells immunostaining in the hippocampus of Wistar rats submitted to global ischemia. A synergistic effect between ischemia and postischemic exercise on the astrocytic area was demonstrated. Postischemic exercise partially reversed the ischemia-induced increase on the area occupied by microglia, without any effect of pre-ischemic protocol. In conclusion, postischemic exercise distinctly modulates astrocyte and microglia immunostaining in the hippocampal dentate gyrus following global cerebral ischemia in Wistar rats.
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Affiliation(s)
- Gisele Agustini Lovatel
- Universidade Federal de Santa Catarina, Curso de Fisioterapia, Rua Pedro João Pereira, 150 Mato Alto, EP 88900-000 Araranguá, SC, Brazil; Universidade Federal do Rio Grande do Sul, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil
| | - Karine Bertoldi
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Instituto de Ciências Básicas da Saúde, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil
| | - Viviane Rostirola Elsnerb
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Instituto de Ciências Básicas da Saúde, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil; Programa de Pós Graduação em Biociências e Reabilitação do Centro Universitário Metodista do IPA, Brazil
| | - Francele Valente Piazza
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil
| | - Carla Giovana Basso
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Instituto de Ciências Básicas da Saúde, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil
| | - Felipe Dos Santos Moysés
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Instituto de Ciências Básicas da Saúde, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil
| | - Paulo Valdeci Worm
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Instituto de Ciências Básicas da Saúde, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil
| | - Carlos Alexandre Netto
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Instituto de Ciências Básicas da Saúde, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil
| | - Simone Marcuzzo
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil
| | - Ionara Rodrigues Siqueira
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Instituto de Ciências Básicas da Saúde, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Rua Sarmento Leite, 500, CEP 90050-170 Porto Alegre, RS, Brazil.
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Austin MW, Ploughman M, Glynn L, Corbett D. Aerobic exercise effects on neuroprotection and brain repair following stroke: a systematic review and perspective. Neurosci Res 2014; 87:8-15. [PMID: 24997243 DOI: 10.1016/j.neures.2014.06.007] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 05/04/2014] [Accepted: 06/24/2014] [Indexed: 01/02/2023]
Abstract
Aerobic exercise (AE) enhances neuroplasticity and improves functional outcome in animal models of stroke, however the optimal parameters (days post-stroke, intensity, mode, and duration) to influence brain repair processes are not known. We searched PubMed, CINAHL, PsychInfo, the Cochrane Library, and the Central Register of Controlled Clinical Trials, using predefined criteria, including all years up to July 2013 (English language only). Clinical studies were included if participants had experienced an ischemic or hemorrhagic stroke. We included animal studies that utilized any method of global or focal ischemic stroke or intracerebral hemorrhage. Any intervention utilizing AE-based activity with the intention of improving cardiorespiratory fitness was included. Of the 4250 titles returned, 47 studies (all in animal models) met criteria and measured the effects of exercise on brain repair parameters (lesion volume, oxidative damage, inflammation and cell death, neurogenesis, angiogenesis and markers of stress). Our synthesized findings show that early-initiated (24-48h post-stroke) moderate forced exercise (10m/min, 5-7 days per week for about 30min) reduced lesion volume and protected perilesional tissue against oxidative damage and inflammation at least for the short term (4 weeks). The applicability and translation of experimental exercise paradigms to clinical trials are discussed.
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Affiliation(s)
- Mark W Austin
- Recovery and Performance Laboratory, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Michelle Ploughman
- Recovery and Performance Laboratory, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.
| | - Lindsay Glynn
- Health Sciences Library, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Dale Corbett
- Canadian Partnership for Stroke Recovery and Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Zheng HQ, Zhang LY, Luo J, Li LL, Li M, Zhang Q, Hu XQ. Physical exercise promotes recovery of neurological function after ischemic stroke in rats. Int J Mol Sci 2014; 15:10974-88. [PMID: 24945308 PMCID: PMC4100192 DOI: 10.3390/ijms150610974] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 06/12/2014] [Accepted: 06/13/2014] [Indexed: 01/05/2023] Open
Abstract
Although physical exercise is an effective strategy for treatment of ischemic stroke, the underlying protective mechanisms are still not well understood. It has been recently demonstrated that neural progenitor cells play a vital role in the recovery of neurological function (NF) through differentiation into mature neurons. In the current study, we observed that physical exercise significantly reduced the infarct size and improved damaged neural functional recovery after an ischemic stroke. Furthermore, we found that the treatment not only exhibited a significant increase in the number of neural progenitor cells and neurons but also decreased the apoptotic cells in the peri-infarct region, compared to a control in the absence of exercise. Importantly, the insulin-like growth factor-1 (IGF-1)/Akt signaling pathway was dramatically activated in the peri-infarct region of rats after physical exercise training. Therefore, our findings suggest that physical exercise directly influences the NF recovery process by increasing neural progenitor cell count via activation of the IGF-1/Akt signaling pathway.
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Affiliation(s)
- Hai-Qing Zheng
- Department of Rehabilitation Medicine Science, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
| | - Li-Ying Zhang
- Department of Rehabilitation Medicine Science, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
| | - Jing Luo
- Department of Rehabilitation Medicine Science, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
| | - Li-Li Li
- Department of Rehabilitation Medicine Science, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
| | - Menglin Li
- Department of Rehabilitation Medicine Science, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
| | - Qingjie Zhang
- Department of Rehabilitation Medicine Science, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
| | - Xi-Quan Hu
- Department of Rehabilitation Medicine Science, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
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Pin-Barre C, Laurin J, Felix MS, Pertici V, Kober F, Marqueste T, Matarazzo V, Muscatelli-Bossy F, Temprado JJ, Brisswalter J, Decherchi P. Acute neuromuscular adaptation at the spinal level following middle cerebral artery occlusion-reperfusion in the rat. PLoS One 2014; 9:e89953. [PMID: 24587147 PMCID: PMC3938604 DOI: 10.1371/journal.pone.0089953] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 01/24/2014] [Indexed: 11/18/2022] Open
Abstract
The purpose of the study was to highlight the acute motor reflex adaptation and to deepen functional deficits following a middle cerebral artery occlusion-reperfusion (MCAO-r). Thirty-six Sprague-Dawley rats were included in this study. The middle cerebral artery occlusion (MCAO; 120 min) was performed on 16 rats studied at 1 and 7 days, respectively (MCAO-D1 and MCAO-D7, n = 8 for each group). The other animals were divided into 3 groups: SHAM-D1 (n = 6), SHAM-D7 (n = 6) and Control (n = 8). Rats performed 4 behavioral tests (the elevated body swing test, the beam balance test, the ladder-climbing test and the forelimb grip force) before the surgery and daily after MCAO-r. H-reflex on triceps brachii was measured before and after isometric exercise. Infarction size and cerebral edema were respectively assessed by histological (Cresyl violet) and MRI measurements at the same time points than H-reflex recordings. Animals with cerebral ischemia showed persistent functional deficits during the first week post-MCAO-r. H-reflex was not decreased in response to isometric exercise one day after the cerebral ischemia contrary to the other groups. The motor reflex regulation was recovered 7 days post-MCAO-r. This result reflects an acute sensorimotor adaptation at the spinal level after MCAO-r.
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Affiliation(s)
- Caroline Pin-Barre
- Aix-Marseille Université, Centre National de la Recherche Scientifique, Institut des Sciences du Mouvement, Faculté des Sciences du Sport, Marseille, France
- Université de Nice Sophia-Antipolis et Université du Sud Toulon-Var, Motricité Humaine Éducation Sport Santé, Nice, France
| | - Jérôme Laurin
- Aix-Marseille Université, Centre National de la Recherche Scientifique, Institut des Sciences du Mouvement, Faculté des Sciences du Sport, Marseille, France
- * E-mail:
| | - Marie-Solenne Felix
- Aix-Marseille Université, Centre National de la Recherche Scientifique, Institut des Sciences du Mouvement, Faculté des Sciences du Sport, Marseille, France
| | - Vincent Pertici
- Aix-Marseille Université, Centre National de la Recherche Scientifique, Institut des Sciences du Mouvement, Faculté des Sciences du Sport, Marseille, France
| | - Frank Kober
- Aix-Marseille Université, Centre National de la Recherche Scientifique, Centre de Résonance Magnétique Biologique et Médicale, Faculté de Médecine Timone, Marseille, France
| | - Tanguy Marqueste
- Aix-Marseille Université, Centre National de la Recherche Scientifique, Institut des Sciences du Mouvement, Faculté des Sciences du Sport, Marseille, France
| | - Valery Matarazzo
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale, Institut de Neurobiologie de la Méditerranée, Marseille, France
| | - Françoise Muscatelli-Bossy
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale, Institut de Neurobiologie de la Méditerranée, Marseille, France
| | - Jean-Jacques Temprado
- Aix-Marseille Université, Centre National de la Recherche Scientifique, Institut des Sciences du Mouvement, Faculté des Sciences du Sport, Marseille, France
| | - Jeanick Brisswalter
- Université de Nice Sophia-Antipolis et Université du Sud Toulon-Var, Motricité Humaine Éducation Sport Santé, Nice, France
| | - Patrick Decherchi
- Aix-Marseille Université, Centre National de la Recherche Scientifique, Institut des Sciences du Mouvement, Faculté des Sciences du Sport, Marseille, France
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Schmidt A, Wellmann J, Schilling M, Strecker JK, Sommer C, Schäbitz WR, Diederich K, Minnerup J. Meta-analysis of the Efficacy of Different Training Strategies in Animal Models of Ischemic Stroke. Stroke 2014; 45:239-47. [DOI: 10.1161/strokeaha.113.002048] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Antje Schmidt
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Jürgen Wellmann
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Matthias Schilling
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Jan-Kolja Strecker
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Clemens Sommer
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Wolf-Rüdiger Schäbitz
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Kai Diederich
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Jens Minnerup
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
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Sohn MK, Song HJ, Jee S. Plasticity Associated Changes in Neurophysiological Tests Following Non Invasive Brain Stimulation in Stroke Rat Model. ACTA ACUST UNITED AC 2014. [DOI: 10.14253/kjcn.2014.16.2.62] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Min Kyun Sohn
- Department of Rehabilitation Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hee-Jung Song
- Department of Neurology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Sungju Jee
- Department of Rehabilitation Medicine, Chungnam National University School of Medicine, Daejeon, Korea
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Zhang Y, Zhang P, Shen X, Tian S, Wu Y, Zhu Y, Jia J, Wu J, Hu Y. Early exercise protects the blood-brain barrier from ischemic brain injury via the regulation of MMP-9 and occludin in rats. Int J Mol Sci 2013; 14:11096-112. [PMID: 23708107 PMCID: PMC3709721 DOI: 10.3390/ijms140611096] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 05/05/2013] [Accepted: 05/16/2013] [Indexed: 01/18/2023] Open
Abstract
Early exercise within 24 h after stroke can reduce neurological deficits after ischemic brain injury. However, the mechanisms underlying this neuroprotection remain poorly understood. Ischemic brain injury disrupts the blood-brain barrier (BBB) and then triggers a cascade of events, leading to secondary brain injury and poor long-term outcomes. This study verified the hypothesis that early exercise protected the BBB after ischemia. Adult rats were randomly assigned to sham, early exercise (EE) or non-exercise (NE) groups. The EE and NE groups were subjected to ischemia induced by middle cerebral artery occlusion (MCAO). The EE group ran on a treadmill beginning 24 h after ischemia, 30 min per day for three days. After three-days’ exercise, EB extravasation and electron microscopy were used to evaluate the integrity of the BBB. Neurological deficits, cerebral infarct volume and the expression of MMP-9, the tissue inhibitors of metalloproteinase-1 (TIMP-1), and occludin were determined. The data indicated that early exercise significantly inhibited the ischemia-induced reduction of occludin, and an increase in MMP-9 promoted TIMP-1 expression (p < 0.01), attenuated the BBB disruption (p < 0.05) and neurological deficits (p < 0.01) and diminished the infarct volume (p < 0.01). Our results suggest that the neuroprotection conferred by early exercise was likely achieved by improving the function of the BBB via the regulation of MMP-9 and occludin.
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Affiliation(s)
- Yuling Zhang
- Department of Rehabilitation of Huashan Hospital, Fudan University, Shanghai 200040, China; E-Mails: (Y.Z.); (P.Z.); (X.S.); (S.T.); (Y.W.); (Y.Z.); (J.J.); (J.W.)
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai 200032, China
| | - Pengyue Zhang
- Department of Rehabilitation of Huashan Hospital, Fudan University, Shanghai 200040, China; E-Mails: (Y.Z.); (P.Z.); (X.S.); (S.T.); (Y.W.); (Y.Z.); (J.J.); (J.W.)
| | - Xiafeng Shen
- Department of Rehabilitation of Huashan Hospital, Fudan University, Shanghai 200040, China; E-Mails: (Y.Z.); (P.Z.); (X.S.); (S.T.); (Y.W.); (Y.Z.); (J.J.); (J.W.)
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai 200032, China
| | - Shan Tian
- Department of Rehabilitation of Huashan Hospital, Fudan University, Shanghai 200040, China; E-Mails: (Y.Z.); (P.Z.); (X.S.); (S.T.); (Y.W.); (Y.Z.); (J.J.); (J.W.)
| | - Yi Wu
- Department of Rehabilitation of Huashan Hospital, Fudan University, Shanghai 200040, China; E-Mails: (Y.Z.); (P.Z.); (X.S.); (S.T.); (Y.W.); (Y.Z.); (J.J.); (J.W.)
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai 200032, China
| | - Yulian Zhu
- Department of Rehabilitation of Huashan Hospital, Fudan University, Shanghai 200040, China; E-Mails: (Y.Z.); (P.Z.); (X.S.); (S.T.); (Y.W.); (Y.Z.); (J.J.); (J.W.)
| | - Jie Jia
- Department of Rehabilitation of Huashan Hospital, Fudan University, Shanghai 200040, China; E-Mails: (Y.Z.); (P.Z.); (X.S.); (S.T.); (Y.W.); (Y.Z.); (J.J.); (J.W.)
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai 200032, China
| | - Junfa Wu
- Department of Rehabilitation of Huashan Hospital, Fudan University, Shanghai 200040, China; E-Mails: (Y.Z.); (P.Z.); (X.S.); (S.T.); (Y.W.); (Y.Z.); (J.J.); (J.W.)
| | - Yongshan Hu
- Department of Rehabilitation of Huashan Hospital, Fudan University, Shanghai 200040, China; E-Mails: (Y.Z.); (P.Z.); (X.S.); (S.T.); (Y.W.); (Y.Z.); (J.J.); (J.W.)
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai 200032, China
- Author to whom correspondence should be addressed; E-Mail: ; Tel./Fax: +86-21-5288-7820
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35
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Zhang P, Zhang Y, Zhang J, Wu Y, Jia J, Wu J, Hu Y. Early Exercise Protects against Cerebral Ischemic Injury through Inhibiting Neuron Apoptosis in Cortex in Rats. Int J Mol Sci 2013; 14:6074-89. [PMID: 23502470 PMCID: PMC3634421 DOI: 10.3390/ijms14036074] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 02/03/2013] [Accepted: 02/28/2013] [Indexed: 12/31/2022] Open
Abstract
Early exercise is an effective strategy for stroke treatment, but the underlying mechanism remains poorly understood. Apoptosis plays a critical role after stroke. However, it is unclear whether early exercise inhibits apoptosis after stroke. The present study investigated the effect of early exercise on apoptosis induced by ischemia. Adult SD rats were subjected to transient focal cerebral ischemia by middle cerebral artery occlusion model (MCAO) and were randomly divided into early exercise group, non-exercise group and sham group. Early exercise group received forced treadmill training initiated at 24 h after operation. Fourteen days later, the cell apoptosis were detected by TdT-mediated dUTP-biotin nick-end labeling (TUNEL) and Fluoro-Jade-B staining (F-J-B). Caspase-3, cleaved caspase-3 and Bcl-2 were determined by western blotting. Cerebral infarct volume and motor function were evaluated by cresyl violet staining and foot fault test respectively. The results showed that early exercise decreased the number of apoptotic cells (118.74 ± 6.15 vs. 169.65 ± 8.47, p < 0.05, n = 5), inhibited the expression of caspase-3 and cleaved caspase-3 (p < 0.05, n = 5), and increased the expression of Bcl-2 (p < 0.05, n = 5). These data were consistent with reduced infarct volume and improved motor function. These results suggested that early exercise could provide neuroprotection through inhibiting neuron apoptosis.
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Affiliation(s)
- Pengyue Zhang
- Medical Faculty, Kunming University of Science and Technology, Kunming 650500, China; E-Mail: (J.Z.)
- Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai 200040, China; E-Mails: (Y.Z.); (Y.W.); (J.J.); (J.W.)
| | - Yuling Zhang
- Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai 200040, China; E-Mails: (Y.Z.); (Y.W.); (J.J.); (J.W.)
| | - Jie Zhang
- Medical Faculty, Kunming University of Science and Technology, Kunming 650500, China; E-Mail: (J.Z.)
- Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, Genetic Diagnosis Center, the First People’s Hospital of Yunnan Province, Kunming 650032, China
| | - Yi Wu
- Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai 200040, China; E-Mails: (Y.Z.); (Y.W.); (J.J.); (J.W.)
- The Yonghe Branch of Huashan Hospital, Fudan University, Shanghai 200436, China
| | - Jie Jia
- Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai 200040, China; E-Mails: (Y.Z.); (Y.W.); (J.J.); (J.W.)
| | - Junfa Wu
- Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai 200040, China; E-Mails: (Y.Z.); (Y.W.); (J.J.); (J.W.)
| | - Yongshan Hu
- Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai 200040, China; E-Mails: (Y.Z.); (Y.W.); (J.J.); (J.W.)
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Krafft PR, Bailey EL, Lekic T, Rolland WB, Altay O, Tang J, Wardlaw JM, Zhang JH, Sudlow CLM. Etiology of stroke and choice of models. Int J Stroke 2012; 7:398-406. [PMID: 22712741 DOI: 10.1111/j.1747-4949.2012.00838.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Animal models of stroke contribute to the development of better stroke prevention and treatment through studies investigating the pathophysiology of different stroke subtypes and by testing promising treatments before trials in humans. There are two broad types of animal models: those in which stroke is induced through artificial means, modeling the consequences of a vascular insult but not the vascular pathology itself; and those in which strokes occur spontaneously. Most animal models of stroke are in rodents due to cost, ethical considerations, availability of standardized neurobehavioral assessments, and ease of physiological monitoring. While there are similarities in cerebrovascular anatomy and pathophysiology between rodents and humans, there are also important differences, including brain size, length and structure of perforating arteries, and gray to white matter ratio, which is substantially lower in humans. The wide range of rodent models of stroke includes models of global and focal ischemia, and of intracerebral and sub-arachnoid hemorrhage. The most widely studied model of spontaneous stroke is the spontaneously hypertensive stroke-prone rat, in which the predominant lesions are small subcortical infarcts resulting from a vascular pathology similar to human cerebral small vessel disease. Important limitations of animal models of stroke - they generally model only certain aspects of the disease and do not reflect the heterogeneity in severity, pathology and comorbidities of human stroke - and key methodological issues (especially the need for adequate sample size, randomization, and blinding in treatment trials) must be carefully considered for the successful translation of pathophysiological concepts and therapeutics from bench to bedside.
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Affiliation(s)
- Paul R Krafft
- Department of Physiology, School of Medicine, Loma Linda University, Loma Linda, CA, USA
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37
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Mourouzis I, Mantzouratou P, Galanopoulos G, Kostakou E, Roukounakis N, Kokkinos AD, Cokkinos DV, Pantos C. Dose-dependent effects of thyroid hormone on post-ischemic cardiac performance: potential involvement of Akt and ERK signalings. Mol Cell Biochem 2011; 363:235-43. [PMID: 22134702 DOI: 10.1007/s11010-011-1175-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 11/24/2011] [Indexed: 12/16/2022]
Abstract
The present study explored the effects of thyroid hormone (TH) treatment on post-ischemic cardiac function and potential implicated mechanisms. Acute myocardial infarction (AMI) was induced in mice by coronary artery ligation while sham-operated animals served as controls. This procedure resulted in a marked depression of cardiac function and significant reduction in TH levels in plasma. TH was given at a dose aiming to normalize T3 levels in plasma [AMI-TH (A)] and also at higher doses. The group of animals treated with the highest dose of TH, which displayed significantly increased mortality rate was included in the study [AMI-TH (B)]. In AMI-TH (A) mice, TH significantly improved left ventricular (LV) ejection fraction (EF%), [27.9% (1.4) in AMI versus 38.0 (3.1) in AMI-TH (A), P < 0.05], and favorably remodeled LV chamber while α-MHC was the dominant isoform expressed. In AMI-TH (B) mice, TH treatment resulted in increased mortality as compared to untreated mice (73% vs 47%, P < 0.05), while the favorable effect of TH was not evident in the survived animals. At the molecular level, TH, at the replacement dose, modestly increased p-Akt levels in the myocardium without any change in p-ERK levels. On the contrary, TH at the higher dose resulted in further increase in p-Akt along with an increase in p-ERK levels. In conclusion, TH appears to have a dose-dependent bimodal effect on post-ischemic cardiac performance and this effect may, at least in part, be mediated by a distinct pattern of activation of Akt and ERK signaling.
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Affiliation(s)
- Iordanis Mourouzis
- Department of Pharmacology, University of Athens, 75 Mikras Asias Ave, 11527 Goudi, Athens, Greece
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Yoon KJ, Lee YT, Han TR. Mechanism of functional recovery after repetitive transcranial magnetic stimulation (rTMS) in the subacute cerebral ischemic rat model: neural plasticity or anti-apoptosis? Exp Brain Res 2011; 214:549-56. [PMID: 21904929 DOI: 10.1007/s00221-011-2853-2] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2011] [Accepted: 08/26/2011] [Indexed: 01/08/2023]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) has been studied increasingly in recent years to determine whether it has a therapeutic benefit on recovery after stroke. However, the underlying mechanisms of rTMS in stroke recovery remain unclear. Here, we evaluated the effect of rTMS on functional recovery and its underlying mechanism by assessing proteins associated with neural plasticity and anti-apoptosis in the peri-lesional area using a subacute cerebral ischemic rat model. Twenty cerebral ischemic rats were randomly assigned to the rTMS or the sham group at post-op day 4. A total of 3,500 impulses with 10 Hz frequency were applied to ipsilesional cortex over a 2-week period. Functional outcome was measured before (post-op day 4) and after rTMS (post-op day 18). The rTMS group showed more functional improvement on the beam balance test and had stronger Bcl-2 and weaker Bax expression on immunohistochemistry compared with the sham group. The expression of NMDA and MAP-2 showed no significant difference between the two groups. These results suggest that rTMS in subacute cerebral ischemia has a therapeutic effect on functional recovery and is associated with an anti-apoptotic mechanism in the peri-ischemic area rather than with neural plasticity.
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Affiliation(s)
- Kyung Jae Yoon
- Department of Rehabilitation Medicine, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, #108, Pyung-dong, Jongno-gu, Seoul 110-746, South Korea
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39
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Affiliation(s)
- Dae-Yul Kim
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College Medicine, Korea
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40
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Karelina K, Norman GJ, Zhang N, DeVries AC. Social contact influences histological and behavioral outcomes following cerebral ischemia. Exp Neurol 2009; 220:276-82. [DOI: 10.1016/j.expneurol.2009.08.022] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Revised: 08/05/2009] [Accepted: 08/25/2009] [Indexed: 11/26/2022]
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