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Rafati Fard A, Mowforth OD, Yuan M, Myrtle S, Lee KS, Banerjee A, Khan M, Kotter MR, Newcombe VFJ, Stamatakis EA, Davies BM. Brain MRI changes in degenerative cervical myelopathy: a systematic review. EBioMedicine 2024; 99:104915. [PMID: 38113760 PMCID: PMC10772405 DOI: 10.1016/j.ebiom.2023.104915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Degenerative cervical myelopathy (DCM) is the most common cause of adult spinal cord dysfunction globally. Associated neurological symptoms and signs have historically been explained by pathobiology within the cervical spine. However, recent advances in imaging have shed light on numerous brain changes in patients with DCM, and it is hypothesised that these changes contribute to DCM pathogenesis. The aetiology, significance, and distribution of these supraspinal changes is currently unknown. The objective was therefore to synthesise all current evidence on brain changes in DCM. METHODS A systematic review was performed. Cross-sectional and longitudinal studies with magnetic resonance imaging on a cohort of patients with DCM were eligible. PRISMA guidelines were followed. MEDLINE and Embase were searched to 28th August 2023. Duplicate title/abstract screening, data extraction and risk of bias assessments were conducted. A qualitative synthesis of the literature is presented as per the Synthesis Without Meta-Analysis (SWiM) reporting guideline. The review was registered with PROSPERO (ID: CRD42022298538). FINDINGS Of the 2014 studies that were screened, 47 studies were identified that used MRI to investigate brain changes in DCM. In total, 1500 patients with DCM were included in the synthesis, with a mean age of 53 years. Brain alterations on MRI were associated with DCM both before and after surgery, particularly within the sensorimotor network, visual network, default mode network, thalamus and cerebellum. Associations were commonly reported between brain MRI alterations and clinical measures, particularly the Japanese orthopaedic association (JOA) score. Risk of bias of included studies was low to moderate. INTERPRETATION The rapidly expanding literature provides mounting evidence for brain changes in DCM. We have identified key structures and pathways that are altered, although there remains uncertainty regarding the directionality and clinical significance of these changes. Future studies with greater sample sizes, more detailed phenotyping and longer follow-up are now needed. FUNDING ODM is supported by an Academic Clinical Fellowship at the University of Cambridge. BMD is supported by an NIHR Clinical Doctoral Fellowship at the University of Cambridge (NIHR300696). VFJN is supported by an NIHR Rosetrees Trust Advanced Fellowship (NIHR302544). This project was supported by an award from the Rosetrees Foundation with the Storygate Trust (A2844).
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Affiliation(s)
- Amir Rafati Fard
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Oliver D Mowforth
- Division of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.
| | - Melissa Yuan
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Samuel Myrtle
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Keng Siang Lee
- Department of Neurosurgery, King's College Hospital, London, UK
| | - Arka Banerjee
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Maaz Khan
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Mark R Kotter
- Division of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Virginia F J Newcombe
- PACE Section, Department of Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Emmanuel A Stamatakis
- PACE Section, Department of Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Benjamin M Davies
- Division of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
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2
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Simpson BK, Rangwani R, Abbasi A, Chung JM, Reed CM, Gulati T. Disturbed laterality of non-rapid eye movement sleep oscillations in post-stroke human sleep: a pilot study. Front Neurol 2023; 14:1243575. [PMID: 38099067 PMCID: PMC10719949 DOI: 10.3389/fneur.2023.1243575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023] Open
Abstract
Sleep is known to promote recovery post-stroke. However, there is a paucity of data profiling sleep oscillations in the post-stroke human brain. Recent rodent work showed that resurgence of physiologic spindles coupled to sleep slow oscillations (SOs) and concomitant decrease in pathological delta (δ) waves is associated with sustained motor performance gains during stroke recovery. The goal of this study was to evaluate bilaterality of non-rapid eye movement (NREM) sleep-oscillations (namely SOs, δ-waves, spindles, and their nesting) in post-stroke patients vs. healthy control subjects. We analyzed NREM-marked electroencephalography (EEG) data in hospitalized stroke-patients (n = 5) and healthy subjects (n = 3). We used a laterality index to evaluate symmetry of NREM oscillations across hemispheres. We found that stroke subjects had pronounced asymmetry in the oscillations, with a predominance of SOs, δ-waves, spindles, and nested spindles in affected hemisphere, when compared to the healthy subjects. Recent preclinical work classified SO-nested spindles as restorative post-stroke and δ-wave-nested spindles as pathological. We found that the ratio of SO-nested spindles laterality index to δ-wave-nested spindles laterality index was lower in stroke subjects. Using linear mixed models (which included random effects of concurrent pharmacologic drugs), we found large and medium effect size for δ-wave nested spindle and SO-nested spindle, respectively. Our results in this pilot study indicate that considering laterality index of NREM oscillations might be a useful metric for assessing recovery post-stroke and that factoring in pharmacologic drugs may be important when targeting sleep modulation for neurorehabilitation post-stroke.
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Affiliation(s)
- Benjamin K. Simpson
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Rohit Rangwani
- Department of Biomedical Sciences, Center for Neural Science and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Bioengineering Graduate Program, Department of Bioengineering, Henry Samueli School of Engineering, University of California, Los Angeles, Los Angeles, CA, United States
| | - Aamir Abbasi
- Department of Biomedical Sciences, Center for Neural Science and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Jeffrey M. Chung
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Chrystal M. Reed
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Tanuj Gulati
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Department of Biomedical Sciences, Center for Neural Science and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Bioengineering Graduate Program, Department of Bioengineering, Henry Samueli School of Engineering, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
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3
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Simpson BK, Rangwani R, Abbasi A, Chung JM, Reed CM, Gulati T. Disturbed laterality of non-rapid eye movement sleep oscillations in post-stroke human sleep: a pilot study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.01.23289359. [PMID: 37205348 PMCID: PMC10187327 DOI: 10.1101/2023.05.01.23289359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Sleep is known to promote recovery post-stroke. However, there is a paucity of data profiling sleep oscillations post-stroke in the human brain. Recent rodent work showed that resurgence of physiologic spindles coupled to sleep slow oscillations(SOs) and concomitant decrease in pathological delta(δ) waves is associated with sustained motor performance gains during stroke recovery. The goal of this study was to evaluate bilaterality of non-rapid eye movement (NREM) sleep-oscillations (namely SOs, δ-waves, spindles and their nesting) in post-stroke patients versus healthy control subjects. We analyzed NREM-marked electroencephalography (EEG) data in hospitalized stroke-patients (n=5) and healthy subjects (n=3) from an open-sourced dataset. We used a laterality index to evaluate symmetry of NREM oscillations across hemispheres. We found that stroke subjects had pronounced asymmetry in the oscillations, with a predominance of SOs, δ-waves, spindles and nested spindles in one hemisphere, when compared to the healthy subjects. Recent preclinical work classified SO-nested spindles as restorative post-stroke and δ-wave-nested spindles as pathological. We found that the ratio of SO-nested spindles laterality index to δ-wave-nested spindles laterality index was lower in stroke subjects. Using linear mixed models (which included random effects of concurrent pharmacologic drugs), we found large and medium effect size for δ-wave nested spindle and SO-nested spindle, respectively. Our results indicate considering laterality index of NREM oscillations might be a useful metric for assessing recovery post-stroke and that factoring in pharmacologic drugs may be important when targeting sleep modulation for neurorehabilitation post-stroke.
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Affiliation(s)
| | - Rohit Rangwani
- Center for Neural Science and Medicine, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA
- Bioengineering Graduate Program, Department of Bioengineering, Henry Samueli School of Engineering, University of California - Los Angeles, Los Angeles, CA
| | - Aamir Abbasi
- Center for Neural Science and Medicine, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Jeffrey M Chung
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Chrystal M Reed
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Tanuj Gulati
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA
- Center for Neural Science and Medicine, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA
- Bioengineering Graduate Program, Department of Bioengineering, Henry Samueli School of Engineering, University of California - Los Angeles, Los Angeles, CA
- Department of Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA
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4
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Assecondi S, Hu R, Kroeker J, Eskes G, Shapiro K. Older adults with lower working memory capacity benefit from transcranial direct current stimulation when combined with working memory training: A preliminary study. Front Aging Neurosci 2022; 14:1009262. [PMID: 36299611 PMCID: PMC9589058 DOI: 10.3389/fnagi.2022.1009262] [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: 08/01/2022] [Accepted: 09/20/2022] [Indexed: 11/27/2022] Open
Abstract
Aging is a very diverse process: successful agers retain most cognitive functioning, while others experience mild to severe cognitive decline. This decline may eventually negatively impact one’s everyday activities. Therefore, scientists must develop approaches to counteract or, at least, slow down the negative change in cognitive performance of aging individuals. Combining cognitive training and transcranial direct current stimulation (tDCS) is a promising approach that capitalizes on the plasticity of brain networks. However, the efficacy of combined methods depends on individual characteristics, such as the cognitive and emotional state of the individual entering the training program. In this report, we explored the effectiveness of working memory training, combined with tDCS to the right dorsolateral prefrontal cortex (DLPFC), to manipulate working memory performance in older individuals. We hypothesized that individuals with lower working memory capacity would benefit the most from the combined regimen. Thirty older adults took part in a 5-day combined regimen. Before and after the training, we evaluated participants’ working memory performance with five working memory tasks. We found that individual characteristics influenced the outcome of combined cognitive training and tDCS regimens, with the intervention selectively benefiting old-old adults with lower working memory capacity. Future work should consider developing individualized treatments by considering individual differences in cognitive profiles.
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Affiliation(s)
- Sara Assecondi
- Center for Mind/Brain Sciences—CIMeC, University of Trento, Rovereto, Italy
- Visual Experience Laboratory, School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Center for Human Brain Health (CHBH), University of Birmingham, Birmingham, United Kingdom
- *Correspondence: Sara Assecondi, ,
| | - Rong Hu
- Visual Experience Laboratory, School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Department of Neurology, School of Medicine, Guangzhou First People’s Hospital, South China University of Technology, Guangzhou, China
| | - Jacob Kroeker
- Departments of Psychiatry and Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Gail Eskes
- Departments of Psychiatry and Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Kim Shapiro
- Visual Experience Laboratory, School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Center for Human Brain Health (CHBH), University of Birmingham, Birmingham, United Kingdom
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5
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Delli Colli C, Borgi M, Poggini S, Chiarotti F, Cirulli F, Penninx BWJH, Benedetti F, Vai B, Branchi I. Time moderates the interplay between 5-HTTLPR and stress on depression risk: gene x environment interaction as a dynamic process. Transl Psychiatry 2022; 12:274. [PMID: 35821204 PMCID: PMC9276704 DOI: 10.1038/s41398-022-02035-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/13/2022] [Accepted: 06/27/2022] [Indexed: 12/02/2022] Open
Abstract
The serotonin-transporter-linked promoter region (5-HTTLPR) has been widely investigated as contributing to depression vulnerability. Nevertheless, empirical research provides wide contrasting findings regarding its involvement in the etiopathogenesis of the disorder. Our hypothesis was that such discrepancy can be explained considering time as moderating factor. We explored this hypothesis, exploiting a meta analytic approach. We searched PubMed, PsychoINFO, Scopus and EMBASE databases and 1096 studies were identified and screened, resulting in 22 studies to be included in the meta-analyses. The effect of the 5-HTTLPR x stress interaction on depression risk was found to be moderated by the following temporal factors: the duration of stress (i.e. chronic vs. acute) and the time interval between end of stress and assessment of depression (i.e. within 1 year vs. more than 1 year). When stratifying for the duration of stress, the effect of the 5-HTTLPR x stress interaction emerged only in the case of chronic stress, with a significant subgroup difference (p = 0.004). The stratification according to time interval revealed a significant interaction only for intervals within 1 year, though no difference between subgroups was found. The critical role of time interval clearly emerged when considering only chronic stress: a significant effect of the 5-HTTLPR and stress interaction was confirmed exclusively within 1 year and a significant subgroup difference was found (p = 0.01). These results show that the 5-HTTLPR x stress interaction is a dynamic process, producing different effects at different time points, and indirectly confirm that s-allele carriers are both at higher risk and more capable to recover from depression. Overall, these findings expand the current view of the interplay between 5-HTTLPR and stress adding the temporal dimension, that results in a three-way interaction: gene x environment x time.
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Affiliation(s)
- Claudia Delli Colli
- grid.416651.10000 0000 9120 6856Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy ,grid.7841.aPhD program in Pharmacology and Toxicology, Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, Rome, Italy
| | - Marta Borgi
- grid.416651.10000 0000 9120 6856Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Silvia Poggini
- grid.416651.10000 0000 9120 6856Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Flavia Chiarotti
- grid.416651.10000 0000 9120 6856Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Francesca Cirulli
- grid.416651.10000 0000 9120 6856Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Brenda W. J. H. Penninx
- grid.12380.380000 0004 1754 9227Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Francesco Benedetti
- grid.18887.3e0000000417581884Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy ,grid.15496.3f0000 0001 0439 0892Università Vita-Salute San Raffaele, Milan, Italy
| | - Benedetta Vai
- grid.18887.3e0000000417581884Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy ,grid.15496.3f0000 0001 0439 0892Università Vita-Salute San Raffaele, Milan, Italy
| | - Igor Branchi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy.
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6
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Ganesh A, Barber PA. The Cognitive Sequelae of Transient Ischemic Attacks—Recent Insights and Future Directions. J Clin Med 2022; 11:jcm11092637. [PMID: 35566762 PMCID: PMC9104376 DOI: 10.3390/jcm11092637] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 02/05/2023] Open
Abstract
There is now considerable evidence that Transient Ischemic Attack (TIA) carries important sequelae beyond the risk of recurrent stroke, particularly with respect to peri-event and post-event cognitive dysfunction and subsequent cognitive decline. The occurrence of a TIA could provide an important window in understanding the relationship of early mixed vascular-neurodegenerative cognitive decline, and by virtue of their clinical relevance as a “warning” event, TIAs could also furnish the opportunity to act preventatively not only for stroke prevention but also for dementia prevention. In this review, we discuss the current state of the literature regarding the cognitive sequelae associated with TIA, reviewing important challenges in the field. In particular, we discuss definitional and methodological challenges in the study of TIA-related cognitive impairment, confounding factors in the cognitive evaluation of these patients, and provide an overview of the evidence on both transient and long-term cognitive impairment after TIA. We compile recent insights from clinical studies regarding the predictors and mediators of cognitive decline in these patients and highlight important future directions for work in this area.
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Affiliation(s)
- Aravind Ganesh
- Calgary Stroke Program, Departments of Clinical Neurosciences, University of Calgary Cumming School of Medicine, Calgary, AB T2N 4N1, Canada;
- Department of Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, AB T2N 4N1, Canada
- Hotchkiss Brain Institute, University of Calgary Cumming School of Medicine, Calgary, AB T2N 4N1, Canada
| | - Philip A. Barber
- Calgary Stroke Program, Departments of Clinical Neurosciences, University of Calgary Cumming School of Medicine, Calgary, AB T2N 4N1, Canada;
- Department of Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, AB T2N 4N1, Canada
- Hotchkiss Brain Institute, University of Calgary Cumming School of Medicine, Calgary, AB T2N 4N1, Canada
- Department of Radiology, University of Calgary Cumming School of Medicine, Calgary, AB T2N 4N1, Canada
- Correspondence:
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7
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Kujawa K, Żurek A, Gorączko A, Zurek G. Application of High-Tech Solution for Memory Assessment in Patients With Disorders of Consciousness. Front Neurol 2022; 13:841095. [PMID: 35432173 PMCID: PMC9008141 DOI: 10.3389/fneur.2022.841095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Testing cognitive function in patients after severe brain damage is a major clinical challenge. In the absence of both verbal and motor communication, tests commonly used to assess cognitive function are completely or partially undoable for disorders of consciousness patients. The study involved 12 patients with varying degrees of impaired consciousness due to brain damage, with no verbal and motor communication. Memory was assessed in study participants using oculography. Memory tasks were presented in four categories. The total percentage of correctly completed tasks obtained across the group was 39.58%. The most difficult tasks included category C.4 with tasks involving working memory. Regardless of the subjects' level of consciousness, there was no statistically significant difference in the percentage of correct responses obtained in subgroups distinguished by CRS-R score. Eye tracking technology can be successfully used in the assessment of cognitive function, particularly when eye movements are the only channel of communication in individuals after brain damage. We suggest that the cognitive functions of people after brain damage should be further analyzed using eye tracking.
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Affiliation(s)
- Katarzyna Kujawa
- Department of Biostructure, Wroclaw University of Health and Sport Sciences, Wrocław, Poland
- Neurorehabilitation Clinic, Wrocław, Poland
| | - Alina Żurek
- Institute of Psychology, University of Wroclaw, Wrocław, Poland
| | - Agata Gorączko
- Department of Biostructure, Wroclaw University of Health and Sport Sciences, Wrocław, Poland
- Neurorehabilitation Clinic, Wrocław, Poland
| | - Grzegorz Zurek
- Department of Biostructure, Wroclaw University of Health and Sport Sciences, Wrocław, Poland
- *Correspondence: Grzegorz Zurek
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Kim J, Guo L, Hishinuma A, Lemke S, Ramanathan DS, Won SJ, Ganguly K. Recovery of consolidation after sleep following stroke-interaction of slow waves, spindles, and GABA. Cell Rep 2022; 38:110426. [PMID: 35235787 DOI: 10.1016/j.celrep.2022.110426] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/01/2021] [Accepted: 02/01/2022] [Indexed: 12/18/2022] Open
Abstract
Sleep is known to promote recovery after stroke. Yet it remains unclear how stroke affects neural processing during sleep. Using an experimental stroke model in rats along with electrophysiological monitoring of neural firing and sleep microarchitecture, here we show that sleep processing is altered by stroke. We find that the precise coupling of spindles to global slow oscillations (SOs), a phenomenon that is known to be important for memory consolidation, is disrupted by a pathological increase in "isolated" local delta waves. The transition from this pathological to a physiological state-with increased spindle coupling to SO-is associated with sustained performance gains during recovery. Interestingly, post-injury sleep could be pushed toward a physiological state via a pharmacological reduction of tonic γ-aminobutyric acid (GABA). Together, our results suggest that sleep processing after stroke is impaired due to an increase in delta waves and that its restoration can be important for recovery.
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Affiliation(s)
- Jaekyung Kim
- Neurology and Rehabilitation Service, San Francisco Veterans Affairs Medical Center, 1700 Owens Street, San Francisco, CA 94158, USA; Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Ling Guo
- Neurology and Rehabilitation Service, San Francisco Veterans Affairs Medical Center, 1700 Owens Street, San Francisco, CA 94158, USA; Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - April Hishinuma
- Neurology and Rehabilitation Service, San Francisco Veterans Affairs Medical Center, 1700 Owens Street, San Francisco, CA 94158, USA; Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Stefan Lemke
- Neurology and Rehabilitation Service, San Francisco Veterans Affairs Medical Center, 1700 Owens Street, San Francisco, CA 94158, USA; Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Dhakshin S Ramanathan
- Neurology and Rehabilitation Service, San Francisco Veterans Affairs Medical Center, 1700 Owens Street, San Francisco, CA 94158, USA; Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Seok Joon Won
- Neurology and Rehabilitation Service, San Francisco Veterans Affairs Medical Center, 1700 Owens Street, San Francisco, CA 94158, USA; Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA.
| | - Karunesh Ganguly
- Neurology and Rehabilitation Service, San Francisco Veterans Affairs Medical Center, 1700 Owens Street, San Francisco, CA 94158, USA; Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA.
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9
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Pastorino R, Loreti C, Giovannini S, Ricciardi W, Padua L, Boccia S. Challenges of Prevention for a Sustainable Personalized Medicine. J Pers Med 2021; 11:jpm11040311. [PMID: 33923579 PMCID: PMC8073054 DOI: 10.3390/jpm11040311] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/09/2021] [Accepted: 04/14/2021] [Indexed: 02/07/2023] Open
Abstract
The development and implementation of the approaches of personalized medicine for disease prevention are still at infancy, although preventive activities in healthcare represent a key pillar to guarantee health system sustainability. There is an increasing interest in finding informative markers that indicate the disease risk before the manifestation of the disease (primary prevention) or for early disease detection (secondary prevention). Recently, the systematic collection and study of clinical phenotypes and biomarkers consented to the advance of Rehabilomics in tertiary prevention. It consents to identify relevant molecular and physiological factors that can be linked to plasticity, treatment response, and natural recovery. Implementation of these approaches would open avenues to identify people at high risk and enable new preventive lifestyle interventions or early treatments targeted to their individual genomic profile, personalizing prevention and rehabilitation. The integration of personalized medicine into prevention may benefit citizens, patients, healthcare professionals, healthcare authorities, and industry, and ultimately will seek to contribute to better health and quality of life for Europe’s citizens.
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Affiliation(s)
- Roberta Pastorino
- Department of Woman and Child Health and Public Health—Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.P.); (S.B.)
| | - Claudia Loreti
- Dipartimento di Scienze dell’Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (S.G.); (L.P.)
- Correspondence:
| | - Silvia Giovannini
- Dipartimento di Scienze dell’Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (S.G.); (L.P.)
| | - Walter Ricciardi
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Luca Padua
- Dipartimento di Scienze dell’Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (S.G.); (L.P.)
- Dipartimento di Scienze Geriatriche e Ortopediche, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Stefania Boccia
- Department of Woman and Child Health and Public Health—Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.P.); (S.B.)
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
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10
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Oh HM, Kim TW, Park HY, Kim Y, Park GY, Im S. Role of rs6265 BDNF polymorphisms and post-stroke dysphagia recovery-A prospective cohort study. Neurogastroenterol Motil 2021; 33:e13953. [PMID: 32776402 DOI: 10.1111/nmo.13953] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/29/2020] [Accepted: 07/02/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Previous studies suggest that specific genes may predispose some to increased risk of dysphagia in the geriatric population, but whether these genes may affect swallowing recovery after a stroke is unknown. This study investigated whether single-nucleotide polymorphisms (SNP) of the brain-derived neurotrophic factor (BDNF), catechol-O-methyl transferase, apolipoprotein E, interleukin-1 receptor antagonist, and dopamine, which have been linked to swallowing, could adversely affect the prognosis of post-stroke dysphagia. METHODS In this study, 218 subjects with confirmed post-stroke dysphagia were enrolled. The primary endpoint was failed recovery from nil per mouth (NPM) status with the first 3 months post-stroke. KEY RESULTS The Val/Val group from the rs6265, BDNF, showed higher score changes on the Functional Oral Intake Scale at 1 month. The proportion of patients with recovery from NPM status within the first 1 month was 60.8% in the Val/Val group, which was statistically higher than those in the Met allele groups (38.1%, P = .017). At 3 months, the BDNF rs6265 showed significant group differences in Modified Barium Swallow Impairment Profile© score changes with the Val/Val allele leading to greater improvement. However, no single SNP was associated with increased risk of poor recovery with persistence of NPM at 3 months post-stroke. CONCLUSIONS AND INFERENCES Those with the dominant Val/Val phenotype of BDNF manifested with faster and greater improvement than the Met-phenotypes. Based on our results, the BDNF Val allele may play a positive role with faster score improvement and rapid recovery from NPM than the Met allele. Clinical Trials gov: NCT03577444 (https://clinicaltrials.gov/ct2/show/study/NCT03577444).
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Affiliation(s)
- Hyun Mi Oh
- Department of Rehabilitation Medicine, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Gyeonggi-do, Republic of Korea.,Department of Rehabilitation Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Tae-Woo Kim
- Department of Rehabilitation Medicine, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Gyeonggi-do, Republic of Korea.,Department of Rehabilitation Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Hae-Yeon Park
- Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Youngkook Kim
- Department of Rehabilitation Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Geun-Young Park
- Department of Rehabilitation Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sun Im
- Department of Rehabilitation Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Vorobyeva EV, Ermakov PN, Borokhovski EF, Kovsh EM, Stoletniy AS. Association between categorization of emotionally-charged and neutral visual scenes and parameters of event-related potentials in carriers of COMT, HTR2A, BDNF gene polymorphisms. F1000Res 2020; 9:446. [PMID: 32983417 PMCID: PMC7495216 DOI: 10.12688/f1000research.22503.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2020] [Indexed: 03/30/2024] Open
Abstract
Background: This study aimed to discover the association between parameters of event-related potentials (ERPs) and categorization of images of visual scenes, both emotionally-charged and neutral, in carriers of polymorphisms of the COMT, HTR2A, BDNF genes. Methods: Electroencephalogram (EEG) and ERPs were recorded at 128 leads, with two ear referents. Images of different visual scenes were presented to the study participants sequentially on a monitor screen. The participants' task was to examine these images and indicate what emotions (negative, neutral or positive) they elicit. Comparison of event-related potentials was carried out using unpaired Student t-test in EEGLAB toolbox. Results: COMT. A stronger reaction, as reflected in the amplitude of the ERPs, in participants with the recessive homozygous Met/Met genotype was observed on latency around 200 ms to the stimuli, assessed as positive. Carriers of dominant homozygous Val/Val genotype had higher amplitude of 200 ms peak when assessed scene images as either neutral or negative in comparison to other genotypes. Participant with the Val/Met heterozygous genotype had higher amplitude of ERP that Met/Met group on same latency when assessed stimuli as negative. HTR2A . Significant increase in negativity in the parietal-occipital regions revealed in the range of 350-420 ms in participants with the recessive homozygous A/A genotype when choosing any type of assessment, compared to carriers of the heterozygous genotype A/G and the dominant homozygous G/G genotype. BDNF. Participants with Val/Val genotype categorized the visual images more thoroughly, as reflected in greater activation of the parietal-occipital zones and higher amplitude on ERP peak on 190 ms (negative assessment) and 160 ms (neutral assessment) then Val/Met carriers. Conclusions: The COMT, HTR2A, BDNF gene polymorphisms are associated with the process of categorizing emotionally charged and neutral visual scenes, and this relationship is reflected in the ERP parameters.
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Affiliation(s)
- Elena V. Vorobyeva
- Department of Psychophysiology and Clinical Psychology, Academy of Psychology and Education Sciences of Southern Federal University, Rostov-on-Don, 344006, Russian Federation
| | - Pavel N. Ermakov
- Department of Psychophysiology and Clinical Psychology, Academy of Psychology and Education Sciences of Southern Federal University, Rostov-on-Don, 344006, Russian Federation
| | - Evgenij F. Borokhovski
- Department of Education, Centre for the Study of Learning and Performance of Concordia University, Montreal, H3H 2S2, Canada
| | - Ekaterina M. Kovsh
- Department of Psychophysiology and Clinical Psychology, Academy of Psychology and Education Sciences of Southern Federal University, Rostov-on-Don, 344006, Russian Federation
| | - Alexander S. Stoletniy
- Department of Psychophysiology and Clinical Psychology, Academy of Psychology and Education Sciences of Southern Federal University, Rostov-on-Don, 344006, Russian Federation
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12
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Vorobyeva EV, Ermakov PN, Borokhovski EF, Kovsh EM, Stoletniy AS. Association between categorization of emotionally-charged and neutral visual scenes and parameters of event-related potentials in carriers of different COMT, HTR2A, BDNF gene genotypes. F1000Res 2020; 9:446. [PMID: 32983417 PMCID: PMC7495216 DOI: 10.12688/f1000research.22503.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/18/2020] [Indexed: 11/24/2022] Open
Abstract
Background: This study aimed to discover the association between parameters of event-related potentials (ERPs) and categorization of images of visual scenes, both emotionally-charged and neutral, in carriers of different genotypes of the COMT, HTR2A, BDNF genes. Methods: Electroencephalogram (EEG) and ERPs were recorded at 128 leads, with two ear referents. Images of different visual scenes were presented to the study participants sequentially on a monitor screen. The participants' task was to examine these images and indicate what emotions (negative, neutral or positive) they elicit. Comparison of event-related potentials was carried out using unpaired Student t-test in EEGLAB toolbox. Results: COMT. A stronger reaction, as reflected in the amplitude of the ERPs, in participants with the recessive homozygous Met/Met genotype was observed on latency around 200 ms to the stimuli, assessed as positive. Carriers of dominant homozygous Val/Val genotype had higher amplitude of 200 ms peak when assessed scene images as either neutral or negative in comparison to other genotypes. Participant with the Val/Met heterozygous genotype had higher amplitude of ERP that Met/Met group on same latency when assessed stimuli as negative. HTR2A . Significant increase in negativity in the parietal-occipital regions revealed in the range of 350-420 ms in participants with the recessive homozygous A/A genotype when choosing any type of assessment, compared to carriers of the heterozygous genotype A/G and the dominant homozygous G/G genotype. BDNF. Participants with Val/Val genotype categorized the visual images more thoroughly, as reflected in greater activation of the parietal-occipital zones and higher amplitude on ERP peak on 190 ms (negative assessment) and 160 ms (neutral assessment) then Val/Met carriers. Conclusions: The COMT, HTR2A, BDNF gene different genotypes are associated with the process of categorizing emotionally charged and neutral visual scenes, and this relationship is reflected in the ERP parameters.
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Affiliation(s)
- Elena V. Vorobyeva
- Department of Psychophysiology and Clinical Psychology, Academy of Psychology and Education Sciences of Southern Federal University, Rostov-on-Don, 344006, Russian Federation
| | - Pavel N. Ermakov
- Department of Psychophysiology and Clinical Psychology, Academy of Psychology and Education Sciences of Southern Federal University, Rostov-on-Don, 344006, Russian Federation
| | - Evgenij F. Borokhovski
- Department of Education, Centre for the Study of Learning and Performance of Concordia University, Montreal, H3H 2S2, Canada
| | - Ekaterina M. Kovsh
- Department of Psychophysiology and Clinical Psychology, Academy of Psychology and Education Sciences of Southern Federal University, Rostov-on-Don, 344006, Russian Federation
| | - Alexander S. Stoletniy
- Department of Psychophysiology and Clinical Psychology, Academy of Psychology and Education Sciences of Southern Federal University, Rostov-on-Don, 344006, Russian Federation
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13
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Maltese PE, Michelini S, Baronio M, Bertelli M. Molecular foundations of chiropractic therapy. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:93-102. [PMID: 31577263 PMCID: PMC7233649 DOI: 10.23750/abm.v90i10-s.8768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 08/06/2019] [Indexed: 11/23/2022]
Abstract
Background and aim: Alternative medicine is a broad term used to encompass different therapies, including chiropractic. Chiropractic was called “a science of healing without drugs” by its founder, David Daniel Palmer. It is based on the idea that the body has a powerful self-healing ability and that there is a relationship between body structure and function that affects health. In particular, chiropractic assumes that the nervous system controls the human body through nerves branching from the vertebral column and spinal cord. Researchers do not fully understand how chiropractic therapies affect pain, but chiropractic is widely used today to treat chronic pain, such as back pain. Different studies with animal models have demonstrated that chiropractic therapies mediate neuroplasticity, specifically through modulation of neurotrophins. No studies have yet been published on interaction between neurotrophin gene polymorphisms and chiropractic treatment. Methods: We searched PubMed with the following keywords: chiropractic, neuroplasticity, neurotrophin gene polymorphism for a panorama of on the molecular mechanisms of chiropractic therapy. Results: From the material collected, we identified a set of genes and some functional polymorphisms that could be correlated with better response to chiropractic therapy. Conclusions: Further association studies will be necessary to confirm hypotheses of a correlation between single nucleotide polymorphisms in specific genes and better response to chiropractic therapy. (www.actabiomedica.it)
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Abstract
BACKGROUND AND PURPOSE In many neurologic diagnoses, significant interindividual variability exists in the outcomes of rehabilitation. One factor that may impact response to rehabilitation interventions is genetic variation. Genetic variation refers to the presence of differences in the DNA sequence among individuals in a population. Genetic polymorphisms are variations that occur relatively commonly and, while not disease-causing, can impact the function of biological systems. The purpose of this article is to describe genetic polymorphisms that may impact neuroplasticity, motor learning, and recovery after stroke. SUMMARY OF KEY POINTS Genetic polymorphisms for brain-derived neurotrophic factor (BDNF), dopamine, and apolipoprotein E have been shown to impact neuroplasticity and motor learning. Rehabilitation interventions that rely on the molecular and cellular pathways of these factors may be impacted by the presence of the polymorphism. For example, it has been hypothesized that individuals with the BDNF polymorphism may show a decreased response to neuroplasticity-based interventions, decreased rate of learning, and overall less recovery after stroke. However, research to date has been limited and additional work is needed to fully understand the role of genetic variation in learning and recovery. RECOMMENDATIONS FOR CLINICAL PRACTICE Genetic polymorphisms should be considered as possible predictors or covariates in studies that investigate neuroplasticity, motor learning, or motor recovery after stroke. Future predictive models of stroke recovery will likely include a combination of genetic factors and other traditional factors (eg, age, lesion type, corticospinal tract integrity) to determine an individual's expected response to a specific rehabilitation intervention.
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15
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Alawieh A, Zhao J, Feng W. Factors affecting post-stroke motor recovery: Implications on neurotherapy after brain injury. Behav Brain Res 2018; 340:94-101. [PMID: 27531500 PMCID: PMC5305670 DOI: 10.1016/j.bbr.2016.08.029] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 07/27/2016] [Accepted: 08/12/2016] [Indexed: 02/05/2023]
Abstract
Neurological disorders are a major cause of chronic disability globally among which stroke is a leading cause of chronic disability. The advances in the medical management of stroke patients over the past decade have significantly reduced mortality, but at the same time increased numbers of disabled survivors. Unfortunately, this reduction in mortality was not paralleled by satisfactory therapeutics and rehabilitation strategies that can improve functional recovery of patients. Motor recovery after brain injury is a complex, dynamic, and multifactorial process in which an interplay among genetic, pathophysiologic, sociodemographic and therapeutic factors determines the overall recovery trajectory. Although stroke recovery is the most well-studied form of post-injury neuronal recovery, a thorough understanding of the pathophysiology and determinants affecting stroke recovery is still lacking. Understanding the different variables affecting brain recovery after stroke will not only provide an opportunity to develop therapeutic interventions but also allow for developing personalized platforms for patient stratification and prognosis. We aim to provide a narrative review of major determinants for post-stroke recovery and their implications in other forms of brain injury.
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Affiliation(s)
- Ali Alawieh
- Medical Scientist Training Program, Medical University of South Carolina, Charleston, SC, 29425, USA
| | - Jing Zhao
- Minhang District Central Hospital, Fudan University, Shanghai, 201199, China
| | - Wuwei Feng
- Department of Neurology, MUSC Stroke Center, Medical University of South Carolina, Charleston, SC, 29425, USA; Department of Health Science and Research, The Center of Rehabilitation Science in Neurological Conditions, College of Health Professions, Medical University of South Carolina, Charleston, SC, 29425, USA.
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16
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French MA, Morton SM, Pohlig RT, Reisman DS. The relationship between BDNF Val66Met polymorphism and functional mobility in chronic stroke survivors. Top Stroke Rehabil 2018; 25:276-280. [PMID: 29480080 DOI: 10.1080/10749357.2018.1437938] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background A single nucleotide polymorphism, Val66Met, in the Brain Derived Neurotrophic Factor (BDNF) gene has been studied for its role in recovery following stroke. Despite this work, the role of BDNF genotype on long-term recovery is unclear. Additionally, no study has examined its impact on functional mobility. As a result, the purpose of this study was to examine the relationship between BDNF genotype and functional mobility in chronic stroke survivors by first accounting for factors related to the Val66Met polymorphism and post-stroke recovery. Methods Participants 6 months post-stroke completed the Fugl-Meyer Lower Extremity Assessment (FMLE), Yesavage Geriatric Depression Scale (YGDS), 10 meter walk test (SSWS), and BDNF genotype testing. A regression model was used to determine if including genotype (Val or Met) and the genotype's interactions with age, gender, and depression increased the model's fit in predicting functional mobility, as measured by SSWS, after accounting for physical impairment (FMLE) and personal information (age, gender, and YGDS). Results Sixty-three subjects, twenty-two percent of whom had at least one Met allele, were included. Impairment and personal information significantly predicted SSWS (R2 = 0.268, p < 0.001 and ΔR2 = 0.158, p = 0.002, respectively). The addition of genotype and genotype's interactions did not significantly increase the variance accounted for in SSWS (ΔR2 = 0.012, p = 0.27, and ΔR2 = 0.006, p = 0.723, respectively). Conclusions Our results suggest that the Val66Met polymorphism does not predict long-term, functional mobility following stroke. This difference may be due to differences in model variables or a reduced impact of the polymorphism as recovery progresses.
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Affiliation(s)
- Margaret A French
- a Department of Physical Therapy, College of Health Sciences , University of Delaware , Newark , DE , USA.,b Biomechanics and Movement Science Program, College of Health Sciences , University of Delaware , Newark , DE , USA
| | - Susanne M Morton
- a Department of Physical Therapy, College of Health Sciences , University of Delaware , Newark , DE , USA.,b Biomechanics and Movement Science Program, College of Health Sciences , University of Delaware , Newark , DE , USA
| | - Ryan T Pohlig
- c Biostatistics Core Facility, College of Health Sciences , University of Delaware , Newark , DE , USA
| | - Darcy S Reisman
- a Department of Physical Therapy, College of Health Sciences , University of Delaware , Newark , DE , USA.,b Biomechanics and Movement Science Program, College of Health Sciences , University of Delaware , Newark , DE , USA
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17
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De Marco M, Meneghello F, Pilosio C, Rigon J, Venneri A. Up-regulation of DMN Connectivity in Mild Cognitive Impairment Via Network-based Cognitive Training. Curr Alzheimer Res 2018; 15:578-589. [PMID: 29231140 PMCID: PMC5898032 DOI: 10.2174/1567205015666171212103323] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 10/30/2017] [Accepted: 11/09/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Previous work designed a network-based protocol of cognitive training. This programme exploits a mechanism of induced task-oriented co-activation of multiple regions that are part of the default mode network (DMN), to induce functional rewiring and increased functional connectivity within this network. OBJECTIVE In this study, the programme was administered to patients with a diagnosis of mild cognitive impairment to test its effects in a clinical sample. METHOD Twenty-three patients with mild cognitive impairment (mean age: 73.74 years, standard deviation 5.13, female/male ratio 13/10) allocated to the experimental condition, underwent one month of computerised training, while fourteen patients (mean age: 73.14 years, standard deviation 6.16, female/ male ratio 7/7) assigned to the control condition underwent a regime of intense social engagement. Patients were in the prodromal stage of Alzheimer's disease (AD) as confirmed by clinical follow ups for at least two years. The DMN was computed at baseline and retest, together with other, control patterns of connectivity, grey matter maps and neuropsychological profiles. RESULTS A condition-by-timepoint interaction indicating increased connectivity triggered by the programme was found in left parietal DMN regions. No decreases as well as no changes in the other networks or morphology were found. Although between-condition cognitive changes did not reach statistical significance, they correlated positively with changes in DMN connectivity in the left parietal region, supporting the hypothesis that parietal changes were beneficial. CONCLUSION This programme of cognitive training up-regulates a pattern of connectivity which is pathologically down-regulated in AD. We argue that, when cognitive interventions are conceptualised as tools to induce co-activation repeatedly, they can lead to clinically relevant improvements in brain functioning, and can be of aid in support of pharmacological and other interventions in the earliest stages of AD.
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Affiliation(s)
- Matteo De Marco
- Department of Neuroscience, University of Sheffield, Sheffield, United Kingdom
| | | | | | - Jessica Rigon
- IRCCS Fondazione Ospedale San Camillo, Venice Lido, Italy
| | - Annalena Venneri
- Department of Neuroscience, University of Sheffield, Sheffield, United Kingdom
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18
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Thunshelle C, Hamblin MR. Transcranial Low-Level Laser (Light) Therapy for Brain Injury. Photomed Laser Surg 2017; 34:587-598. [PMID: 28001759 DOI: 10.1089/pho.2015.4051] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Low-level laser therapy (LLLT) or photobiomodulation (PBM) is a possible treatment for brain injury, including traumatic brain injury (TBI). METHODS We review the fundamental mechanisms at the cellular and molecular level and the effects on the brain are discussed. There are several contributing processes that have been proposed to lead to the beneficial effects of PBM in treating TBI such as stimulation of neurogenesis, a decrease in inflammation, and neuroprotection. Both animal and clinical trials for ischemic stroke are outlined. A number of articles have shown how transcranial LLLT (tLLLT) is effective at increasing memory, learning, and the overall neurological performance in rodent models with TBI. RESULTS Our laboratory has conducted three different studies on the effects of tLLLT on mice with TBI. The first studied pulsed against continuous laser irradiation, finding that 10 Hz pulsed was the best. The second compared four different wavelengths, discovering only 660 and 810 nm to have any effectiveness, whereas 732 and 980 nm did not. The third looked at varying regimens of daily laser treatments (1, 3, and 14 days) and found that 14 laser applications was excessive. We also review several studies of the effects of tLLLT on neuroprogenitor cells, brain-derived neurotrophic factor and synaptogenesis, immediate early response knockout mice, and tLLLT in combination therapy with metabolic inhibitors. CONCLUSIONS Finally, some clinical studies in TBI patients are covered.
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Affiliation(s)
- Connor Thunshelle
- 1 Harvard College , Cambridge, Massachusetts.,2 Wellman Center for Photomedicine , Massachusetts General Hospital, Boston, Massachusetts
| | - Michael R Hamblin
- 2 Wellman Center for Photomedicine , Massachusetts General Hospital, Boston, Massachusetts.,3 Department of Dermatology, Harvard Medical School , Boston, Massachusetts.,4 Harvard-MIT Division of Health Sciences and Technology , Cambridge, Massachusetts
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Essa H, Vasant DH, Raginis-Zborowska A, Payton A, Michou E, Hamdy S. The BDNF polymorphism Val66Met may be predictive of swallowing improvement post pharyngeal electrical stimulation in dysphagic stroke patients. Neurogastroenterol Motil 2017; 29. [PMID: 28317287 DOI: 10.1111/nmo.13062] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 02/14/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND The aim of this study was to explore the effect of brain-derived neurotrophic factor (BDNF) polymorphism rs6265 (Val66Met) in both "natural" and treatment induced recovery of swallowing after dysphagic stroke. METHODS Sixteen dysphagic stroke patients that completed a single-blind randomized sham controlled trial of pharyngeal electrical stimulation (PES) within 6 weeks of their stroke (N=38), were genotyped for the BDNF SNP Val66Met (rs6265) from saliva samples. These patients received active or sham PES according to randomized allocation. PES was delivered at a set frequency (5 Hz), intensity (75% of maximal tolerated), and duration (10 minutes) once a day for three consecutive days. Clinical measurements were taken from patients at baseline, 2 weeks and 3 months post entering the study. Changes in swallowing ability based on the dysphagia severity rating scale (DSRS) were compared between active and sham groups and associated with BDNF SNP status. KEY RESULTS In the active stimulation group, patients with the Met BDNF allele demonstrated significantly greater improvements in DSRS at 3 months compared to patients homozygous for the Val allele (P=.009). By comparison, there were no significant associations at the 2 week stage in either the active or sham group, or at 3 month in the sham group. Functional scores including the Barthel Index and modified Rankin scale were also unaffected by BDNF status. CONCLUSIONS & INFERENCES Our findings suggest an association between BDNF and stimulation induced swallowing recovery. Further work will be required to validate these observations and demonstrate clinical utility in patients.
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Affiliation(s)
- H Essa
- University of Manchester, Division of Diabetes, Endocrinology and Gastroenterology, Gastrointestinal Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - D H Vasant
- University of Manchester, Division of Diabetes, Endocrinology and Gastroenterology, Gastrointestinal Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - A Raginis-Zborowska
- University of Manchester, Division of Diabetes, Endocrinology and Gastroenterology, Gastrointestinal Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - A Payton
- University of Manchester, Division of Diabetes, Endocrinology and Gastroenterology, Gastrointestinal Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.,School of Health Sciences, Division of Human Communication, Development & Hearing, The University of Manchester, Manchester, UK
| | - E Michou
- University of Manchester, Division of Diabetes, Endocrinology and Gastroenterology, Gastrointestinal Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - S Hamdy
- University of Manchester, Division of Diabetes, Endocrinology and Gastroenterology, Gastrointestinal Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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Juth V, Holman EA, Chan MK, Cramer SC. Genetics as a molecular window into recovery, its treatment, and stress responses after stroke. J Investig Med 2016; 64:983-8. [PMID: 27045100 PMCID: PMC4942179 DOI: 10.1136/jim-2016-000126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2016] [Indexed: 01/13/2023]
Abstract
Stroke remains a major source of adult disability in the USA and worldwide. Most patients show some recovery during the weeks to months following a stroke, but this is generally incomplete. An emerging branch of therapeutics targets the processes underlying this behavioral recovery from stroke toward the goal of reducing long-term disability. A key factor hampering these efforts is the very large degree of variability between stroke survivors. Available data suggest that genetic differences could explain an important fraction of the differences between subjects. The current review considers this from several angles, including genetic differences in relation to drugs that promote recovery. Genetic factors related to physiological and psychological stress responses may also be critically important to understanding recovery after stroke and its treatment. The studies reviewed provide insights into recovery and suggest directions for further research to improve clinical decision-making in this setting. Genetic differences between patients might be used to help clinical trials select specific patient subgroups, on a biological basis, in order to sharpen the precision with which new treatments are evaluated. Pharmacogenomic factors might also provide insights into inter-subject differences in treatment side effects for pharmacological prescriptions, and behavioral interventions, and others. These efforts must be conducted with the strictest ethical standards given the highly sensitive nature of genetic data. Understanding the effect of selected genetic measures could improve a clinician's ability to predict the risk and efficacy of a restorative therapy and to make maximally informed decisions, and in so doing, facilitate individual patient care.
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Affiliation(s)
- Vanessa Juth
- Program in Nursing Science, UC Irvine, Irvine, California, USA
| | - E Alison Holman
- Program in Nursing Science, UC Irvine, Irvine, California, USA
| | - Michelle K Chan
- Program in Nursing Science, UC Irvine, Irvine, California, USA
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21
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Nimmons D, Pendleton N, Payton A, Ollier W, Horan M, Wilkinson J, Hamdy S. A novel association between COMT and BDNF gene polymorphisms and likelihood of symptomatic dysphagia in older people. Neurogastroenterol Motil 2015; 27:1223-31. [PMID: 26073434 DOI: 10.1111/nmo.12609] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 05/05/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND Catechol-O-methyl transferase (COMT) and brain-derived neurotrophic factor (BDNF) are neuro-modulatory proteins that have been demonstrated to affect cortical plasticity, which in turn has been shown to affect age-related changes and neuronal functioning in humans. Here, we tested the hypothesis that single nucleotide polymorphisms (SNP) within COMT and BDNF genes are associated with dysphagia in older adults. METHODS A total of 800 community-dwelling older individuals were sent the Sydney Oropharyngeal Dysphagia Questionnaire to identify swallowing difficulties. DNA from this population was available for study and used to genotype 18 COMT and 12 BDNF polymorphisms. Logistic regression statistical models were used to identify potential associations between dysphagia and the genotypes. KEY RESULTS A total of 638 individuals completed the questionnaire, giving an 80% response rate. Of these, 538 were genotyped for COMT and BDNF polymorphisms. Age was found to predict dysphagia (p = 0.018, OR = 1.08, CI = 1.01-1.14). The COMT polymorphism rs165599 and the BDNF polymorphism rs10835211 were found to predict dysphagia and have an interactive effect (p = 0.028), which varied according to the carrier status of the other. In the case of SNP rs10835211, the effect of heterozygosity was protective or harmful dependent on the respective status of rs165599. CONCLUSIONS & INFERENCES These results suggest that certain interactions between plasticity genes contribute to the development of dysphagia with increasing age. This highlights a possible role for genetic factors in future monitoring and treating individuals affected by dysphagia.
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Affiliation(s)
- D Nimmons
- Centre for Gastrointestinal Sciences, Institute of Inflammation and Repair, University of Manchester, Manchester, UK.,Salford Royal NHS Foundation Trust, Salford, UK
| | - N Pendleton
- Salford Royal NHS Foundation Trust, Salford, UK.,Centre for Clinical and Cognitive Neuroscience, Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - A Payton
- Salford Royal NHS Foundation Trust, Salford, UK.,Centre for Integrated Genomic Medical Research, UK
| | - W Ollier
- Salford Royal NHS Foundation Trust, Salford, UK.,Centre for Integrated Genomic Medical Research, UK
| | - M Horan
- Manchester Medical School, University of Manchester, Manchester, UK
| | - J Wilkinson
- Salford Royal NHS Foundation Trust, Salford, UK
| | - S Hamdy
- Centre for Gastrointestinal Sciences, Institute of Inflammation and Repair, University of Manchester, Manchester, UK.,Salford Royal NHS Foundation Trust, Salford, UK
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Linking genes to neurological clinical practice: the genomic basis for neurorehabilitation. J Neurol Phys Ther 2015; 39:52-61. [PMID: 25415554 DOI: 10.1097/npt.0000000000000066] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Large-scale genomics projects such as the Human Genome Project and the International HapMap Project promise significant advances in the ability to diagnose and treat many conditions, including those with a neurological basis. A major focus of research has emerged in the neurological sciences to elucidate the molecular and genetic basis of various neurological diseases. Indeed, genetic factors are implicated in susceptibility for many neurological disorders, with family history studies providing strong evidence of familial risk for conditions such as stroke, Parkinson's, Alzheimer's, and Huntington's diseases. Heritability studies also suggest a strong genetic contribution to the risk for neurological diseases. Genome-wide association studies are also uncovering novel genetic variants associated with neurological disorders. Whole-genome and exome sequencing are likely to provide novel insights into the genetic basis of neurological disorders. Genetic factors are similarly associated with clinical phenotypes such as symptom severity and progression as well as response to treatment. Specifically, disease progression and functional restoration depend, in part, on the capacity for neural plasticity within residual neural tissues. Furthermore, such plasticity may be influenced in part by the presence of polymorphisms in several genes known to orchestrate neural plasticity including brain-derived neurotrophic factor (BDNF) and Apolipoprotein E. (APOE). It is important for neurorehabilitation therapist practicing in the "genomic era" to be aware of the potential influence of genetic factors during clinical encounters, as advances in molecular sciences are revealing information of critical relevance to the clinical rehabilitation management of individuals with neurological conditions. Video Abstract available (See Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A88) for more insights from the authors.
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Cherry-Allen KM, Gidday JM, Lee JM, Hershey T, Lang CE. Remote limb ischemic conditioning enhances motor learning in healthy humans. J Neurophysiol 2015; 113:3708-19. [PMID: 25867743 DOI: 10.1152/jn.01028.2014] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 03/27/2015] [Indexed: 12/19/2022] Open
Abstract
Brief bouts of sublethal ischemia have been shown to protect exposed tissue (ischemic conditioning) and tissues at remote sites (remote ischemic conditioning) against subsequent ischemic challenges. Given that the mechanisms of this protective phenomenon are multifactorial and epigenetic, we postulated that remote limb ischemic conditioning (RLIC) might enhance mechanisms responsible for neural plasticity, and thereby facilitate learning. Specifically, we hypothesized that conditioning of the nervous system with RLIC, achieved through brief repetitive limb ischemia prior to training, would facilitate the neurophysiological processes of learning, thus making training more effective and more long-lasting. Eighteen healthy adults participated in this study; nine were randomly allocated to RLIC and nine to sham conditioning. All subjects underwent seven consecutive weekday sessions and 2-wk and 4-wk follow-up sessions. We found that RLIC resulted in significantly greater motor learning and longer retention of motor performance gains in healthy adults. Changes in motor performance do not appear to be due to a generalized increase in muscle activation or muscle strength and were not associated with changes in serum brain-derived neurotrophic factor (BDNF) concentration. Of note, RLIC did not enhance cognitive learning on a hippocampus-dependent task. While future research is needed to establish optimal conditioning and training parameters, this inexpensive, clinically feasible paradigm might ultimately be implemented to enhance motor learning in individuals undergoing neuromuscular rehabilitation for brain injury and other pathological conditions.
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Affiliation(s)
- Kendra M Cherry-Allen
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri
| | - Jeff M Gidday
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri; Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri; Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri
| | - Jin-Moo Lee
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Tamara Hershey
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri; Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri; Department of Radiology, Washington University School of Medicine, St. Louis, Missouri; and
| | - Catherine E Lang
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri; Department of Neurology, Washington University School of Medicine, St. Louis, Missouri; Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri
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Lamb YN, McKay NS, Thompson CS, Hamm JP, Waldie KE, Kirk IJ. Brain-derived neurotrophic factor Val66Met polymorphism, human memory, and synaptic neuroplasticity. WILEY INTERDISCIPLINARY REVIEWS. COGNITIVE SCIENCE 2014; 6:97-108. [PMID: 26263066 DOI: 10.1002/wcs.1334] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 10/20/2014] [Accepted: 11/07/2014] [Indexed: 11/09/2022]
Abstract
Some people have much better memory than others, and there is compelling evidence that a considerable proportion of this variation in memory ability is genetically inherited. A form of synaptic plasticity known as long-term potentiation (LTP) is the principal candidate mechanism underlying memory formation in neural circuits, and it might be expected, therefore, that a genetic influence on the degree of LTP might in turn influence memory abilities. Of the genetic variations thought to significantly influence mnemonic ability in humans, the most likely to have its effect via LTP is a single nucleotide polymorphism affecting brain-derived neurotrophic factor [BDNF (Val66Met)]. However, although it is likely that BDNF influences memory via a modulation of acute plasticity (i.e., LTP), BDNF also has considerable influence on structural development of neural systems. Thus, the influence of BDNF (Val66Met) on mnemonic performance via influences of brain structure as well as function must also be considered. In this brief review, we will describe the phenomenon of LTP and its study in non-human animals. We will discuss the relatively recent attempts to translate this work to studies in humans. We will describe how this has enabled investigation of the effect of the BDNF polymorphism on LTP, on brain structure, and on memory performance.
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Affiliation(s)
- Yvette N Lamb
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Nicole S McKay
- School of Psychology, University of Auckland, Auckland, New Zealand
| | | | - Jeffrey P Hamm
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Karen E Waldie
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Ian J Kirk
- School of Psychology, University of Auckland, Auckland, New Zealand
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25
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Apolipoprotein E ε4 Allele Modulates the Immediate Impact of Acute Exercise on Prefrontal Function. Behav Genet 2014; 45:106-16. [DOI: 10.1007/s10519-014-9675-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 09/05/2014] [Indexed: 01/29/2023]
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Barton B, Treister A, Humphrey M, Abedi G, Cramer SC, Brewer AA. Paradoxical visuomotor adaptation to reversed visual input is predicted by BDNF Val66Met polymorphism. J Vis 2014; 14:14.9.4. [PMID: 25104829 DOI: 10.1167/14.9.4] [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] [Indexed: 11/24/2022] Open
Abstract
Brain-derived neurotrophic factor (BDNF) is the most abundant neurotrophin in the brain, influencing neural development, plasticity, and repair (Chen et al., 2004; Thoenen, 1995). The BDNF gene contains a single-nucleotide polymorphism (SNP) called Val(66)Met. The Met allele interferes with intracellular BDNF-trafficking, decreases activity-dependent BDNF secretion, and consequently is often associated with a shift from plasticity to stability in neural circuits (Egan et al., 2003). We investigated the behavioral consequences of the presence of the Met allele by comparing how 40 heterozygous subjects with the Val/Met genotype and 35 homozygous subjects with the Val/Val genotype performed on visuomotor tasks (reaching and navigation) under two conditions: normal vision and completely left-right reversed vision. As expected, subjects did not differ in their short-term ability to learn the tasks with normal vision (p = 0.58). Intuitively, it would be expected that homozygous Val/Val subjects with a propensity for greater BDNF-induced activity-dependent plasticity would learn new tasks more quickly than heterozygous Val/Met subjects with decreased BDNF secretion (Gilbert, Li, & Piech, 2009). However, we found the opposite here. When short-term mechanisms of visuomotor adaptation were engaged to compensate for the misalignment of visual and somatomotor information created by the left-right reversal of vision, heterozygous Val/Met subjects learned significantly more quickly than their homozygous Val/Val counterparts (p = 0.027). Our results demonstrate the paradoxical finding that the presence of the Met allele, which is thought to promote cortical stability, here improves immediate visuomotor adaptation to left-right-reversed visual input.
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Affiliation(s)
- Brian Barton
- Department of Cognitive Sciences, University of California, Irvine, CA, USA
| | - Andrew Treister
- Department of Neurology, University of California, Irvine, CA, USA
| | - Melanie Humphrey
- Department of Cognitive Sciences, University of California, Irvine, CA, USA
| | - Garen Abedi
- Department of Neurology, University of California, Irvine, CA, USA
| | - Steven C Cramer
- Departments of Anatomy and Neurobiology and Neurology, University of California, Irvine, CA, USA
| | - Alyssa A Brewer
- Department of Cognitive Sciences, University of California, Irvine, CA, USA
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Saux G, Demey I, Rojas G, Feldberg C. Cognitive rehabilitation therapy after acquired brain injury in Argentina: Psychosocial outcomes in connection with the time elapsed before treatment initiation. Brain Inj 2014; 28:1447-54. [DOI: 10.3109/02699052.2014.919528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Pearson-Fuhrhop KM, Cramer SC. Pharmacogenetics of neural injury recovery. Pharmacogenomics 2014; 14:1635-43. [PMID: 24088134 DOI: 10.2217/pgs.13.152] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Relatively few pharmacological agents are part of routine care for neural injury, although several are used or under consideration in acute stroke, chronic stroke, traumatic brain injury and secondary stroke prevention. Tissue plasminogen activator is approved for the treatment of acute ischemic stroke, and genetic variants may impact the efficacy and safety of this drug. In the chronic phase of stroke, several drugs such as L-dopa, fluoxetine and donepezil are under investigation for enhancing rehabilitation therapy, with varying levels of evidence. One potential reason for the mixed efficacy displayed by these drugs may be the influence of genetic factors that were not considered in prior studies. An understanding of the genetics impacting the efficacy of dopaminergic, serotonergic and cholinergic drugs may allow clinicians to target these potential therapies to those patients most likely to benefit. In the setting of stroke prevention, which is directly linked to neural injury recovery, the most highly studied pharmacogenomic interactions pertain to clopidogrel and warfarin. Incorporating pharmacogenomics into neural injury recovery has the potential to maximize the benefit of several current and potential pharmacological therapies and to refine the choice of pharmacological agent that may be used to enhance benefits from rehabilitation therapy.
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Affiliation(s)
- Kristin M Pearson-Fuhrhop
- Department of Anatomy & Neurobiology, University of California, Irvine, 200 S Manchester Avenue, Suite 206, Orange, CA 92868, USA
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Kim WS, Lim JY, Shin JH, Park HK, Tan SA, Park KU, Paik NJ. Effect of the presence of brain-derived neurotrophic factor val(66)met polymorphism on the recovery in patients with acute subcortical stroke. Ann Rehabil Med 2013; 37:311-9. [PMID: 23869328 PMCID: PMC3713287 DOI: 10.5535/arm.2013.37.3.311] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 12/24/2012] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To investigate the effect of brain-derived neurotrophic factor (BDNF) Val(66)Met polymorphism on the recovery after subcortical stroke, using the modified Rankin Scale (mRS). METHODS Subcortical stroke patients with copies of BDNF Val(66)Met polymorphism (n=7) were compared to their controls (n=7) without a copy of BDNF Val(66)Met polymorphism after matching for initial severity, location and type of stroke. The mRS scores at 1 and 3 months after discharge from the neurorehabilitation unit were compared between the groups. RESULTS A repeated measures ANOVA for mRS revealed significant interaction between time and group (F(2, 24) =37.2, p<0.001) and a significant effect of time (F(2, 24)=10.8, p<0.001), thereby reflecting significant differences between the Met allele (+) group and the Met allele (-) group. There was a significant difference in mRS scores at 3 months post-discharge between the two groups (p=0.01) although no difference was evident in mRS scores at 1 month post-discharge between the two groups. There were significant improvements between mRS scores on admission and mRS scores at 1 month post-discharge (p=0.02), and between mRS scores at 1 month post-discharge and mRS scores at 3 months post-discharge (p=0.004) in the Met allele (-) group. CONCLUSION BDNF Val(66)Met polymorphism may be associated with worse functional outcome in Korean patients with subcortical stroke. Therefore, BDNF Val(66)Met polymorphism should be considered as an important prognostic factor for recovery and responses to rehabilitation therapies after stroke in Korean patients. There is a need for developing different rehabilitation strategies for the population with BDNF Val(66)Met polymorphism. Further studies assessing different outcomes for various functional domains of stroke recovery are needed to clarify the role of BDNF Val(66)Met polymorphism.
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Affiliation(s)
- Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Sharma N, Classen J, Cohen LG. Neural plasticity and its contribution to functional recovery. HANDBOOK OF CLINICAL NEUROLOGY 2013; 110:3-12. [PMID: 23312626 DOI: 10.1016/b978-0-444-52901-5.00001-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
In this chapter we address the phenomena of neural plasticity, operationally defined as the ability of the central nervous system to adapt in response to changes in the environment or lesions. At the cellular level, we discuss basic changes in membrane excitability, synaptic plasticity as well as structural changes in dendritic and axonal anatomy that support behavioral expressions of plasticity and functional recovery. We consider the different levels at which these changes can occur and possible links with modification of cognitive strategies, recruitment of new/different neural networks, or changes in strength of such connections or specific brain areas in charge of carrying out a particular task (i.e., movement, language, vision, hearing). The study of neuroplasticity has wide-reaching implications for understanding reorganization of action and cognition in the healthy and lesioned brain.
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Affiliation(s)
- Nikhil Sharma
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
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31
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Huang YY, Gupta A, Vecchio D, Bil de Arce VJ, Huang SF, Xuan W, Hamblin MR. Transcranial low level laser (light) therapy for traumatic brain injury. JOURNAL OF BIOPHOTONICS 2012; 5:827-37. [PMID: 22807422 PMCID: PMC5379852 DOI: 10.1002/jbio.201200077] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 06/12/2012] [Accepted: 06/13/2012] [Indexed: 05/08/2023]
Abstract
We review the use of transcranial low-level laser (light) therapy (LLLT) as a possible treatment for traumatic-brain injury (TBI). The basic mechanisms of LLLT at the cellular and molecular level and its effects on the brain are outlined. Many interacting processes may contribute to the beneficial effects in TBI including neuroprotection, reduction of inflammation and stimulation of neurogenesis. Animal studies and clinical trials of transcranial-LLLT for ischemic stroke are summarized. Several laboratories have shown that LLLT is effective in increasing neurological performance and memory and learning in mouse models of TBI. There have been case report papers that show beneficial effects of transcranial-LLLT in a total of three patients with chronic TBI. Our laboratory has conducted three studies on LLLT and TBI in mice. One looked at pulsed-vs-continuous wave laser-irradiation and found 10 Hz to be superior. The second looked at four different laser-wavelengths (660, 730, 810, and 980 nm); only 660 and 810 nm were effective. The last looked at different treatment repetition regimens (1, 3 and 14-daily laser-treatments).
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Affiliation(s)
- Ying-Ying Huang
- Wellman Center for Photomedicine, Massachusetts General Hospital, BAR414, 40 Blossom Street, Boston, MA 02114, USA
- Department of Dermatology, Harvard Medical School, Boston, MA 02115, USA
- Aesthetic and Plastic Center of Guangxi Medical University, Nanning, China
| | - Asheesh Gupta
- Wellman Center for Photomedicine, Massachusetts General Hospital, BAR414, 40 Blossom Street, Boston, MA 02114, USA
- Department of Dermatology, Harvard Medical School, Boston, MA 02115, USA
- Defence Institute of Physiology and Allied Sciences, Timarpur, Delhi-110 054, India
| | - Daniela Vecchio
- Wellman Center for Photomedicine, Massachusetts General Hospital, BAR414, 40 Blossom Street, Boston, MA 02114, USA
- Department of Dermatology, Harvard Medical School, Boston, MA 02115, USA
| | - Vida J. Bil de Arce
- Wellman Center for Photomedicine, Massachusetts General Hospital, BAR414, 40 Blossom Street, Boston, MA 02114, USA
| | - Shih-Fong Huang
- Wellman Center for Photomedicine, Massachusetts General Hospital, BAR414, 40 Blossom Street, Boston, MA 02114, USA
- Department of Dermatology, Harvard Medical School, Boston, MA 02115, USA
- Taipei Veterans General Hospital, Beitou District, Taipei City, Taiwan 112
| | - Weijun Xuan
- Wellman Center for Photomedicine, Massachusetts General Hospital, BAR414, 40 Blossom Street, Boston, MA 02114, USA
- Department of Dermatology, Harvard Medical School, Boston, MA 02115, USA
- Department of Otolaryngology, Traditional Chinese Medical University of Guangxi, Nanning, China
| | - Michael R. Hamblin
- Department of Dermatology, Harvard Medical School, Boston, MA 02115, USA
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA 02139, USA
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Cirillo J, Hughes J, Ridding M, Thomas PQ, Semmler JG. Differential modulation of motor cortex excitability in BDNF Met allele carriers following experimentally induced and use-dependent plasticity. Eur J Neurosci 2012; 36:2640-9. [PMID: 22694150 DOI: 10.1111/j.1460-9568.2012.08177.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to investigate how healthy young subjects with one of three variants of the brain-derived neurotrophic factor (BDNF) gene modulate motor cortex excitability following experimentally induced and use-dependent plasticity interventions. Electromyographic recordings were obtained from the right first dorsal interosseous (FDI) muscle of 12 Val/Val, ten Val/Met and seven Met/Met genotypes (aged 18-39 years). Transcranial magnetic stimulation of the left hemisphere was used to assess changes in FDI motor-evoked potentials (MEPs) following three separate interventions involving paired associative stimulation, a simple ballistic task and complex visuomotor tracking task using the index finger. Val/Val subjects increased FDI MEPs following all interventions (≥ 25%, P < 0.01), whereas the Met allele carriers only showed increased MEPs after the simple motor task (≥ 26%, P < 0.01). In contrast to the simple motor task, there was no significant change in MEPs for the Val/Met subjects (7%, P = 0.50) and a reduction in MEPs for the Met/Met group (-38%, P < 0.01) following the complex motor task. Despite these differences in use-dependent plasticity, the performance of both motor tasks was not different between BDNF genotypes. We conclude that modulation of motor cortex excitability is strongly influenced by the BDNF polymorphism, with the greatest differences observed for the complex motor task. We also found unique motor cortex plasticity in the rarest form of the BDNF polymorphism (Met/Met subjects), which may have implications for functional recovery after disease or injury to the nervous system in these individuals.
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Affiliation(s)
- John Cirillo
- Discipline of Physiology, School of Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
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Thomas AG, Dennis A, Bandettini PA, Johansen-Berg H. The effects of aerobic activity on brain structure. Front Psychol 2012; 3:86. [PMID: 22470361 PMCID: PMC3311131 DOI: 10.3389/fpsyg.2012.00086] [Citation(s) in RCA: 163] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 03/05/2012] [Indexed: 01/13/2023] Open
Abstract
Aerobic activity is a powerful stimulus for improving mental health and for generating structural changes in the brain. We review the literature documenting these structural changes and explore exactly where in the brain these changes occur as well as the underlying substrates of the changes including neural, glial, and vasculature components. Aerobic activity has been shown to produce different types of changes in the brain. The presence of novel experiences or learning is an especially important component in how these changes are manifest. We also discuss the distinct time courses of structural brain changes with both aerobic activity and learning as well as how these effects might differ in diseased and elderly groups.
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Affiliation(s)
- Adam G Thomas
- Functional MRI Facility, NIMH, NIH, DHHS Bethesda, MD, USA
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Pascual-Leone A, Freitas C, Oberman L, Horvath JC, Halko M, Eldaief M, Bashir S, Vernet M, Shafi M, Westover B, Vahabzadeh-Hagh AM, Rotenberg A. Characterizing brain cortical plasticity and network dynamics across the age-span in health and disease with TMS-EEG and TMS-fMRI. Brain Topogr 2011; 24:302-15. [PMID: 21842407 PMCID: PMC3374641 DOI: 10.1007/s10548-011-0196-8] [Citation(s) in RCA: 209] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 07/27/2011] [Indexed: 01/21/2023]
Abstract
Brain plasticity can be conceptualized as nature's invention to overcome limitations of the genome and adapt to a rapidly changing environment. As such, plasticity is an intrinsic property of the brain across the lifespan. However, mechanisms of plasticity may vary with age. The combination of transcranial magnetic stimulation (TMS) with electroencephalography (EEG) or functional magnetic resonance imaging (fMRI) enables clinicians and researchers to directly study local and network cortical plasticity, in humans in vivo, and characterize their changes across the age-span. Parallel, translational studies in animals can provide mechanistic insights. Here, we argue that, for each individual, the efficiency of neuronal plasticity declines throughout the age-span and may do so more or less prominently depending on variable 'starting-points' and different 'slopes of change' defined by genetic, biological, and environmental factors. Furthermore, aberrant, excessive, insufficient, or mistimed plasticity may represent the proximal pathogenic cause of neurodevelopmental and neurodegenerative disorders such as autism spectrum disorders or Alzheimer's disease.
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Affiliation(s)
- Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA.
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36
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Cramer SC, Sur M, Dobkin BH, O'Brien C, Sanger TD, Trojanowski JQ, Rumsey JM, Hicks R, Cameron J, Chen D, Chen WG, Cohen LG, deCharms C, Duffy CJ, Eden GF, Fetz EE, Filart R, Freund M, Grant SJ, Haber S, Kalivas PW, Kolb B, Kramer AF, Lynch M, Mayberg HS, McQuillen PS, Nitkin R, Pascual-Leone A, Reuter-Lorenz P, Schiff N, Sharma A, Shekim L, Stryker M, Sullivan EV, Vinogradov S. Harnessing neuroplasticity for clinical applications. Brain 2011; 134:1591-609. [PMID: 21482550 PMCID: PMC3102236 DOI: 10.1093/brain/awr039] [Citation(s) in RCA: 604] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Neuroplasticity can be defined as the ability of the nervous system to respond to intrinsic or extrinsic stimuli by reorganizing its structure, function and connections. Major advances in the understanding of neuroplasticity have to date yielded few established interventions. To advance the translation of neuroplasticity research towards clinical applications, the National Institutes of Health Blueprint for Neuroscience Research sponsored a workshop in 2009. Basic and clinical researchers in disciplines from central nervous system injury/stroke, mental/addictive disorders, paediatric/developmental disorders and neurodegeneration/ageing identified cardinal examples of neuroplasticity, underlying mechanisms, therapeutic implications and common denominators. Promising therapies that may enhance training-induced cognitive and motor learning, such as brain stimulation and neuropharmacological interventions, were identified, along with questions of how best to use this body of information to reduce human disability. Improved understanding of adaptive mechanisms at every level, from molecules to synapses, to networks, to behaviour, can be gained from iterative collaborations between basic and clinical researchers. Lessons can be gleaned from studying fields related to plasticity, such as development, critical periods, learning and response to disease. Improved means of assessing neuroplasticity in humans, including biomarkers for predicting and monitoring treatment response, are needed. Neuroplasticity occurs with many variations, in many forms, and in many contexts. However, common themes in plasticity that emerge across diverse central nervous system conditions include experience dependence, time sensitivity and the importance of motivation and attention. Integration of information across disciplines should enhance opportunities for the translation of neuroplasticity and circuit retraining research into effective clinical therapies.
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Affiliation(s)
- Steven C Cramer
- Department of Neurology, UC Irvine Medical Centre, 101 The City Drive South, Bldg 53, Rm 203, Orange, CA 92868-4280, USA.
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Plowman EK, Kleim JA. Motor cortex reorganization across the lifespan. JOURNAL OF COMMUNICATION DISORDERS 2010; 43:286-294. [PMID: 20478572 DOI: 10.1016/j.jcomdis.2010.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Revised: 12/03/2009] [Accepted: 12/03/2009] [Indexed: 05/29/2023]
Abstract
UNLABELLED The brain is a highly dynamic structure with the capacity for profound structural and functional change. Such neural plasticity has been well characterized within motor cortex and is believed to represent one of the neural mechanisms for acquiring and modifying motor behaviors. A number of behavioral and neural signals have been identified that modulate motor cortex plasticity throughout the lifespan in both the intact and damaged brain. Specific signals discussed in this review include: motor learning in the intact brain, motor relearning in the damaged brain, cortical stimulation, stage of development and genotype. Clinicians are encouraged to harness these signals in the development and implementation of treatment so as to maximally drive neural plasticity and functional improvements in speech, language and swallowing. LEARNING OUTCOMES Readers will be able to: (1) describe a set of behavioral and neural signals that modulate motor cortex plasticity in the intact and damaged brain; (2) describe the influence of stage of development on plasticity and functional outcomes; and (3) identify a known genotype that alters the capacity for motor learning and brain plasticity.
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Affiliation(s)
- Emily K Plowman
- Department of Neuroscience, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville, FL, USA
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