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Lee K, Barradas V, Schweighofer N. Self-organizing recruitment of compensatory areas maximizes residual motor performance post-stroke. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.28.601213. [PMID: 39005333 PMCID: PMC11244868 DOI: 10.1101/2024.06.28.601213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Whereas the orderly recruitment of compensatory motor cortical areas after stroke depends on the size of the motor cortex lesion affecting arm and hand movements, the mechanisms underlying this reorganization are unknown. Here, we hypothesized that the recruitment of compensatory areas results from the motor system's goal to optimize performance given the anatomical constraints before and after the lesion. This optimization is achieved through two complementary plastic processes: a homeostatic regulation process, which maximizes information transfer in sensory-motor networks, and a reinforcement learning process, which minimizes movement error and effort. To test this hypothesis, we developed a neuro-musculoskeletal model that controls a 7-muscle planar arm via a cortical network that includes a primary motor cortex and a premotor cortex that directly project to spinal motor neurons, and a contra-lesional primary motor cortex that projects to spinal motor neurons via the reticular formation. Synapses in the cortical areas are updated via reinforcement learning and the activity of spinal motor neurons is adjusted through homeostatic regulation. The model replicated neural, muscular, and behavioral outcomes in both non-lesioned and lesioned brains. With increasing lesion sizes, the model demonstrated systematic recruitment of the remaining primary motor cortex, premotor cortex, and contra-lesional cortex. The premotor cortex acted as a reserve area for fine motor control recovery, while the contra-lesional cortex helped avoid paralysis at the cost of poor joint control. Plasticity in spinal motor neurons enabled force generation after large cortical lesions despite weak corticospinal inputs. Compensatory activity in the premotor and contra-lesional motor cortex was more prominent in the early recovery period, gradually decreasing as the network minimized effort. Thus, the orderly recruitment of compensatory areas following strokes of varying sizes results from biologically plausible local plastic processes that maximize performance, whether the brain is intact or lesioned.
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Affiliation(s)
- Kevin Lee
- Computer Science, University of Southern California, Los Angeles, USA
| | - Victor Barradas
- Institute of Innovative Research, Tokyo Institute of Technology, Yokohama, Japan
| | - Nicolas Schweighofer
- Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, USA
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2
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Suzuki Y, Kiyosawa M, Ishii K. Measurement of Cerebral Glucose Metabolism in the Visual Cortex Predicts the Prognosis of Hemianopia. Neurorehabil Neural Repair 2024; 38:437-446. [PMID: 38659366 DOI: 10.1177/15459683241247536] [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] [Indexed: 04/26/2024]
Abstract
BACKGROUND AND OBJECTIVE Homonymous hemianopia caused by cerebrovascular disease may improve over time. This study investigated whether functional neuroimaging can predict the prognosis of hemianopia due to cerebral infarction. METHODS We studied 19 patients (10 men and 9 women) with homonymous hemianopia and compared them with 34 healthy subjects (20 men and 14 women). Cerebral glucose metabolism was measured by 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), 1 to 6 months after the onset. Bilateral regions of interest (ROIs) were selected from the posterior and, anterior striate cortices, extrastriate cortex, and thalamus. Furthermore, semi-quantitative data on cerebral glucose metabolism were obtained for ROIs and compared with the data obtained for homologous regions in the contralateral hemisphere by calculating the ipsilateral/contralateral (I/C) ratio. RESULTS The I/C ratio for the cerebral glucose metabolism in the posterior striate cortex was high (>0.750) in 8 patients, and the central visual field of these patients improved or showed macular sparing. The I/C ratio for cerebral glucose metabolism in the anterior striate cortex was high (>0.830) in 7 patients, and the peripheral visual field of these patients improved. However, no improvement was observed in 9 patients with a low I/C ratio for cerebral glucose metabolism in both the posterior and anterior striate cortices. CONCLUSION Measurement of cerebral glucose metabolism in the striate cortex is useful for estimating visual field prognosis. Furthermore, FDG-PET is useful in predicting the prognosis of hemianopia.
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Affiliation(s)
- Yukihisa Suzuki
- Department of Ophthalmology, Japan Community Health Care Organization, Mishima General Hospital, Mishima, Japan
- Research Team for Neuroimaging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan
| | | | - Kenji Ishii
- Research Team for Neuroimaging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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3
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Huang L, Yi L, Huang H, Zhan S, Chen R, Yue Z. Corticospinal tract: a new hope for the treatment of post-stroke spasticity. Acta Neurol Belg 2024; 124:25-36. [PMID: 37704780 PMCID: PMC10874326 DOI: 10.1007/s13760-023-02377-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023]
Abstract
Stroke is the third leading cause of death and disability worldwide. Post-stroke spasticity (PSS) is the most common complication of stroke but represents only one of the many manifestations of upper motor neuron syndrome. As an upper motor neuron, the corticospinal tract (CST) is the only direct descending motor pathway that innervates the spinal motor neurons and is closely related to the recovery of limb function in patients with PSS. Therefore, promoting axonal remodeling in the CST may help identify new therapeutic strategies for PSS. In this review, we outline the pathological mechanisms of PSS, specifically their relationship with CST, and therapeutic strategies for axonal regeneration of the CST after stroke. We found it to be closely associated with astroglial scarring produced by astrocyte activation and its secretion of neurotrophic factors, mainly after the onset of cerebral ischemia. We hope that this review offers insight into the relationship between CST and PSS and provides a basis for further studies.
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Affiliation(s)
- Linxing Huang
- College of Acupuncture, Massage and Rehabilitation, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Lizhen Yi
- College of Acupuncture, Massage and Rehabilitation, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Huiyuan Huang
- College of Acupuncture, Massage and Rehabilitation, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Sheng Zhan
- College of Acupuncture, Massage and Rehabilitation, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Ruixue Chen
- College of Acupuncture, Massage and Rehabilitation, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Zenghui Yue
- College of Acupuncture, Massage and Rehabilitation, Hunan University of Chinese Medicine, Changsha, 410208, China.
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4
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De Las Heras B, Rodrigues L, Cristini J, Moncion K, Ploughman M, Tang A, Fung J, Roig M. Measuring Neuroplasticity in Response to Cardiovascular Exercise in People With Stroke: A Critical Perspective. Neurorehabil Neural Repair 2024:15459683231223513. [PMID: 38291890 DOI: 10.1177/15459683231223513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
BACKGROUND Rehabilitative treatments that promote neuroplasticity are believed to improve recovery after stroke. Animal studies have shown that cardiovascular exercise (CE) promotes neuroplasticity but the effects of this intervention on the human brain and its implications for the functional recovery of patients remain unclear. The use of biomarkers has enabled the assessment of cellular and molecular events that occur in the central nervous system after brain injury. Some of these biomarkers have proven to be particularly valuable for the diagnosis of severity, prognosis of recovery, as well as for measuring the neuroplastic response to different treatments after stroke. OBJECTIVES To provide a critical analysis on the current evidence supporting the use of neurophysiological, neuroimaging, and blood biomarkers to assess the neuroplastic response to CE in individuals poststroke. RESULTS Most biomarkers used are responsive to the effects of acute and chronic CE interventions, but the response appears to be variable and is not consistently associated with functional improvements. Small sample sizes, methodological variability, incomplete information regarding patient's characteristics, inadequate standardization of training parameters, and lack of reporting of associations with functional outcomes preclude the quantification of the neuroplastic effects of CE poststroke using biomarkers. CONCLUSION Consensus on the optimal biomarkers to monitor the neuroplastic response to CE is currently lacking. By addressing critical methodological issues, future studies could advance our understanding of the use of biomarkers to measure the impact of CE on neuroplasticity and functional recovery in patients with stroke.
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Affiliation(s)
- Bernat De Las Heras
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Jewish Rehabilitation Hospital, Laval, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
| | - Lynden Rodrigues
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Jewish Rehabilitation Hospital, Laval, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
| | - Jacopo Cristini
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Jewish Rehabilitation Hospital, Laval, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
| | - Kevin Moncion
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Michelle Ploughman
- Recovery and Performance Laboratory, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Ada Tang
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Joyce Fung
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
| | - Marc Roig
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Jewish Rehabilitation Hospital, Laval, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
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5
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Fritsch B, Mayer M, Reis J, Gellner AK. Safety of ipsilesional anodal transcranial direct current stimulation in acute photothrombotic stroke: implications for early neurorehabilitation. Sci Rep 2024; 14:2501. [PMID: 38291061 PMCID: PMC10827716 DOI: 10.1038/s41598-024-51839-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/10/2024] [Indexed: 02/01/2024] Open
Abstract
Early rehabilitation in the acute phase of stroke, that bears unique neuroplastic properties, is the current standard to reduce disability. Anodal transcranial direct current stimulation can augment neurorehabilitation in chronic stroke. Studies in the acute phase are sparse and held back by inconclusive preclinical data pointing towards potential negative interaction of the excitability increasing tDCS modality with stroke-induced glutamate toxicity. In this present study, we aimed to evaluate structural and behavioral safety of anodal tDCS applied in the acute phase of stroke. Photothrombotic stroke including the right primary motor cortex was induced in rats. 24 h after stroke anodal tDCS was applied for 20 min ipsilesionally at one of four different current densities in freely moving animals. Effects on the infarct volume and on stroke induced neuroinflammation were assessed. Behavioral consequences were monitored. Infarct volume and the modified Neurological Severity Score were not affected by anodal tDCS. Pasta handling, a more sensitive task for sensorimotor deficits, and microglia reactivity indicated potentially harmful effects at the highest tDCS current density tested (47.8 A/m2), which is more than 60 times higher than intensities commonly used in humans. Compared to published safety limits of anodal tDCS in healthy rats, recent stroke does not increase the sensitivity of the brain to anodal tDCS, as assessed by lesion size and neuroinflammatory response. Behavioral deficits only occurred at the highest intensity, which was associated with increased neuroinflammation. When safety limits of commonly used clinical tDCS are met, augmentation of early neurorehabilitation after stroke by anodal tDCS appears to be feasible.
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Affiliation(s)
- Brita Fritsch
- Department of Neurology, University Hospital Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany
| | - Marleen Mayer
- Department of Neurology, University Hospital Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany
| | - Janine Reis
- Department of Neurology, University Hospital Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany
| | - Anne-Kathrin Gellner
- Department of Neurology, University Hospital Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany.
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
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Mihailovic JM, Sanganahalli BG, Hyder F, Chitturi J, Elkabes S, Heary RF, Kannurpatti SS. Cross-hemicord spinal fiber reorganization associates with cortical sensory and motor network expansion in the rat model of hemicontusion cervical spinal cord injury. Neurosci Lett 2024; 820:137607. [PMID: 38141752 PMCID: PMC10797561 DOI: 10.1016/j.neulet.2023.137607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/01/2023] [Accepted: 12/17/2023] [Indexed: 12/25/2023]
Abstract
Magnetic resonance imaging plays an important role in characterizing microstructural changes and reorganization after traumatic injuries to the nervous system. In this study, we tested the feasibility of ex-vivo spinal cord diffusion tensor imaging (DTI) in combination with in vivo brain functional MRI to characterize spinal reorganization and its supraspinal association after a hemicontusion cervical spinal cord injury (SCI). DTI parameters (fractional anisotropy [FA], mean diffusion [MD]) and fiber orientation changes related to reorganization in the contused cervical spinal cord were compared to sham specimens. Altered fiber density and fiber directions occurred across the ipsilateral and contralateral hemicords but with only ipsilateral FA and MD changes. The hemicontusion SCI resulted in ipsilateral fiber breaks, voids and vivid fiber reorientations along the injury epicenter. Fiber directional changes below the injury level were primarily inter-hemispheric, indicating prominent below-level cross-hemispheric reorganization. In vivo resting state functional connectivity of the brain from the respective rats before obtaining the spinal cord samples indicated spatial expansion and increased connectivity strength across both the sensory and motor networks after SCI. The consistency of the neuroplastic changes along the neuraxis (both brain and spinal cord) at the single-subject level, indicates that distinctive reorganizational relationships exist between the spinal cord and the brain post-SCI.
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Affiliation(s)
- Jelena M Mihailovic
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 300 Cedar St, New Haven, CT 06520, United States.
| | - Basavaraju G Sanganahalli
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 300 Cedar St, New Haven, CT 06520, United States.
| | - Fahmeed Hyder
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 300 Cedar St, New Haven, CT 06520, United States.
| | - Jyothsna Chitturi
- Department of Radiology, Rutgers Biomedical and Health Sciences-New Jersey Medical School, 30 Bergen Street, Newark, NJ 07103, United States
| | - Stella Elkabes
- Department of Neurosurgery, Rutgers Biomedical and Health Sciences-New Jersey Medical School. 205 South Orange Avenue, Newark, NJ 07103, United States.
| | - Robert F Heary
- Division of Neurosurgery, Hackensack Meridian School of Medicine, Mountainside Medical Center, Montclair, NJ, United States.
| | - Sridhar S Kannurpatti
- Department of Radiology, Rutgers Biomedical and Health Sciences-New Jersey Medical School, 30 Bergen Street, Newark, NJ 07103, United States.
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7
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Tang C, Zhou T, Zhang Y, Yuan R, Zhao X, Yin R, Song P, Liu B, Song R, Chen W, Wang H. Bilateral upper limb robot-assisted rehabilitation improves upper limb motor function in stroke patients: a study based on quantitative EEG. Eur J Med Res 2023; 28:603. [PMID: 38115157 PMCID: PMC10729331 DOI: 10.1186/s40001-023-01565-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/04/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Upper limb dysfunction after stroke seriously affects quality of life. Bilateral training has proven helpful in recovery of upper limb motor function in these patients. However, studies evaluating the effectiveness of bilateral upper limb robot-assisted training on improving motor function and quality of life in stroke patients are lacking. Quantitative electroencephalography (EEG) is non-invasive, simple, and monitors cerebral cortical activity, which can be used to evaluate the effectiveness of interventions. In this study, EEG was used to evaluate the effect of end-drive bilateral upper extremity robot-assisted training on upper extremity functional recovery in stroke patients. METHODS 24 stroke patients with hemiplegia were randomly divided into a conventional training (CT, n = 12) group or a bilateral upper limb robot-assisted training (BRT, n = 12) group. All patients received 60 min of routine rehabilitation treatment including rolling, transferring, sitting, standing, walking, etc., per day, 6 days a week, for three consecutive weeks. The BRT group added 30 min of bilateral upper limb robot-assisted training per day, while the CT group added 30 min of upper limb training (routine occupational therapy) per day, 6 days a week, for 3 weeks. The primary outcome index to evaluate upper limb motor function was the Fugl-Meyer functional score upper limb component (FMA-UE), with the secondary outcome of activities of daily living (ADL), assessed by the modified Barthel index (MBI) score. Quantitative EEG was used to evaluate functional brain connectivity as well as alpha and beta power current source densities of the brain. RESULTS Significant (p < 0.05) within-group differences were found in FMA-UE and MBI scores for both groups after treatment. A between-group comparison indicated the MBI score of the BRT group was significantly different from that of the CT group, whereas the FMA-UE score was not significantly different from that of the CT group after treatment. The differences of FMA-UE and MBI scores before and after treatment in the BRT group were significantly different as compared to the CT group. In addition, beta rhythm power spectrum energy was higher in the BRT group than in the CT group after treatment. Functional connectivity in the BRT group, under alpha and beta rhythms, was significantly increased in both the bilateral frontal and limbic lobes as compared to the CT group. CONCLUSIONS BRT outperformed CT in improving ADL in stroke patients within three months, and BRT facilitates the recovery of upper limb function by enhancing functional connectivity of the bilateral cerebral hemispheres.
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Affiliation(s)
- Congzhi Tang
- Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, 210009, China
| | - Ting Zhou
- Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, 210009, China
| | - Yun Zhang
- Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, 210009, China
| | - Runping Yuan
- Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, 210009, China
| | - Xianghu Zhao
- Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, 210009, China
| | - Ruian Yin
- Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, 210009, China
| | - Pengfei Song
- Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, 210009, China
| | - Bo Liu
- Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, 210009, China
| | - Ruyan Song
- Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, 210009, China
| | - Wenli Chen
- Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, 210009, China.
| | - Hongxing Wang
- Department of Rehabilitation Medicine, Zhongda Hospital Southeast University, Nanjing, 210009, China.
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8
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Qi S, Tian M, Rao Y, Sun C, Li X, Qiao J, Huang ZG. Applying transcranial magnetic stimulation to rehabilitation of poststroke lower extremity function and an improvement: Individual-target TMS. WILEY INTERDISCIPLINARY REVIEWS. COGNITIVE SCIENCE 2023; 14:e1636. [PMID: 36437474 DOI: 10.1002/wcs.1636] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/21/2022] [Accepted: 10/26/2022] [Indexed: 11/29/2022]
Abstract
Stroke is the leading cause of disability globally in need of novel and effective methods of rehabilitation. Intermittent theta burst stimulation (iTBS) has been adopted as a Level B recommendation for lower limb spasticity in guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Nonetheless, the methodological differences and deficits of existing work bring about heterogenous results and therefore limit the universal clinical use of rTMS in lower extremity (LE) rehabilitation. The variation of stimulated targets across motor cortex contributes mainly to these heterogeneities. This narrative review includes studies of rTMS on LE motor function rehabilitation in patients after stroke until now. Some analyses of brain imaging and electromagnetic simulation and quantification through computational modeling were also performed. rTMS appears capable of fostering LE motor rehabilitation after stroke, but the actually stimulated targets are considerably bias making it difficult to confirm effectiveness. The main reason for this phenomenon is probably inaccurate targeting of motor cortical leg representation. An underlying updated method is proposed as Individual-Target TMS (IT-TMS) combined with brain imaging. rTMS is a promising validated method for LE function regaining. Future studies should systematically compare the effects of IT-TMS with traditional rTMS using large samples in random clinical trials. This article is categorized under: Neuroscience > Clinical Neuroscience.
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Affiliation(s)
- Shun Qi
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi'an Jiaotong University, The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs, Xi'an, Shaanxi, People's Republic of China.,Shaanxi Brain Modulation and Scientific Research Center, Xi'an, Shaanxi, People's Republic of China
| | - Meng Tian
- National TCM Academic School Inheritance Studio Project-Chang'an Mi Shi Internal Medicine School Inheritance Studio, Xi'an, Shaanxi, People's Republic of China
| | - Yang Rao
- Shaanxi Brain Modulation and Scientific Research Center, Xi'an, Shaanxi, People's Republic of China
| | - Chuanzhu Sun
- Shaanxi Brain Modulation and Scientific Research Center, Xi'an, Shaanxi, People's Republic of China
| | - Xiang Li
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi'an Jiaotong University, The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs, Xi'an, Shaanxi, People's Republic of China.,Shaanxi Brain Modulation and Scientific Research Center, Xi'an, Shaanxi, People's Republic of China
| | - Jin Qiao
- Department of Rehabilitation, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Zi-Gang Huang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi'an Jiaotong University, The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs, Xi'an, Shaanxi, People's Republic of China.,Research Center for Brain-inspired Intelligence, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.,The State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, People's Republic of China
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9
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Mansour S, Giles J, Ang KK, Nair KPS, Phua KS, Arvaneh M. Exploring the ability of stroke survivors in using the contralesional hemisphere to control a brain-computer interface. Sci Rep 2022; 12:16223. [PMID: 36171400 PMCID: PMC9519575 DOI: 10.1038/s41598-022-20345-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/12/2022] [Indexed: 11/09/2022] Open
Abstract
Brain-computer interfaces (BCIs) have recently been shown to be clinically effective as a novel method of stroke rehabilitation. In many BCI-based studies, the activation of the ipsilesional hemisphere was considered a key factor required for motor recovery after stroke. However, emerging evidence suggests that the contralesional hemisphere also plays a role in motor function rehabilitation. The objective of this study is to investigate the effectiveness of the BCI in detecting motor imagery of the affected hand from contralesional hemisphere. We analyzed a large EEG dataset from 136 stroke patients who performed motor imagery of their stroke-impaired hand. BCI features were extracted from channels covering either the ipsilesional, contralesional or bilateral hemisphere, and the offline BCI accuracy was computed using 10 [Formula: see text] 10-fold cross-validations. Our results showed that most stroke patients can operate the BCI using either their contralesional or ipsilesional hemisphere. Those with the ipsilesional BCI accuracy of less than 60% had significantly higher motor impairments than those with the ipsilesional BCI accuracy above 80%. Interestingly, those with the ipsilesional BCI accuracy of less than 60% achieved a significantly higher contralesional BCI accuracy, whereas those with the ipsilesional BCI accuracy more than 80% had significantly poorer contralesional BCI accuracy. This study suggests that contralesional BCI may be a useful approach for those with a high motor impairment who cannot accurately generate signals from ipsilesional hemisphere to effectively operate BCI.
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Affiliation(s)
- Salem Mansour
- Department of Automatic Control and Systems Engineering, University of Sheffield, Mapping Street, Sheffield, S13JD, UK.
| | - Joshua Giles
- Department of Automatic Control and Systems Engineering, University of Sheffield, Mapping Street, Sheffield, S13JD, UK
- Agency for Science Technology and Research, Institute for Infocomm Research, Singapore, Singapore
| | - Kai Keng Ang
- Agency for Science Technology and Research, Institute for Infocomm Research, Singapore, Singapore
- School of Computer Science and Engineering, Nanyang Technological University, Singapore, Singapore
| | - Krishnan P S Nair
- Neurology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust and The University of Sheffield, Sheffield, UK
| | - Kok Soon Phua
- Agency for Science Technology and Research, Institute for Infocomm Research, Singapore, Singapore
| | - Mahnaz Arvaneh
- Department of Automatic Control and Systems Engineering, University of Sheffield, Mapping Street, Sheffield, S13JD, UK
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10
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Wei X, Xia N, Li YA, Gu M, Zhang T, Gao W, Liu Y. Immediate and short-term effects of continuous theta burst transcranial magnetic stimulation over contralesional premotor area on post-stroke spasticity in patients with severe hemiplegia: Study protocol for a randomized controlled trial. Front Neurol 2022; 13:895580. [PMID: 36081877 PMCID: PMC9445437 DOI: 10.3389/fneur.2022.895580] [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: 03/14/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background Post-stroke spasticity is an important complication that greatly affects survivors' functional prognosis and daily activities. Increasing evidence points to aberrant contralesional neuromodulation compensation after brain injury as a possible culprit for increased spasticity in patients with severe stroke. Hyperactivity of the contralesional premotor area (cPMA) was supposed to be highly correlated with this progression. This study aims to demonstrate the immediate and short-term efficacy of continuous theta-burst stimulation (cTBS) targeting cPMA on upper limb spasticity in severe subacute stroke patients. Methods This trial is a single-center, prospective, three-group randomized controlled trial. Forty-five eligible patients will be recruited and randomized into three groups: the sham-cTBS group (sham cTBS targeting contralesional PMA), the cTBS-cM1 group (cTBS targeting contralesional M1), and the cTBS-cPMA group (cTBS targeting contralesional PMA). All subjects will undergo comprehensive rehabilitation and the corresponding cTBS interventions once a day, five times a week for 4 weeks. Clinical scales, neurophysiological examinations, and neuroimaging will be used as evaluation tools in this study. As the primary outcome, clinical performance on muscle spasticity of elbow/wrist flexor/extensors and upper-limb motor function will be evaluated with the modified Ashworth scale and the Fugl-Meyer Assessment of Upper Extremity Scale, respectively. These scale scores will be collected at baseline, after 4 weeks of treatment, and at follow-up. The secondary outcomes were neurophysiological examinations and Neuroimaging. In neurophysiological examinations, motor evoked potentials, startle reflex, and H reflexes will be used to assess the excitability of the subject's motor cortex, reticulospinal pathway, and spinal motor neurons, respectively. Results of them will be recorded before and after the first cTBS treatment, at post-intervention (at 4 weeks), and at follow-up (at 8 weeks). Neuroimaging tests with diffusion tensor imaging for all participants will be evaluated at baseline and after the 4-week treatment. Discussion Based on the latest research progress on post-stroke spasticity, we innovatively propose a new neuromodulation target for improving post-stroke spasticity via cTBS. We expected that cTBS targeting cPMA would have significant immediate and short-term effects on spasticity and related neural pathways. The effect of cTBS-cPMA may be better than that of cTBS via conventional cM1. The results of our study will provide robust support for the application of cTBS neuromodulation in post-stroke spasticity after a severe stroke. Clinical trial registration This trial was registered with chictr.org.cn on June 13, 2022 (protocol version). http://www.chictr.org.cn/showproj.aspx?proj=171759.
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Affiliation(s)
- Xiupan Wei
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- World Health Organization Collaborating Centre for Training and Research in Rehabilitation, Wuhan, China
| | - Nan Xia
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- World Health Organization Collaborating Centre for Training and Research in Rehabilitation, Wuhan, China
| | - Yang-An Li
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- World Health Organization Collaborating Centre for Training and Research in Rehabilitation, Wuhan, China
| | - Minghui Gu
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- World Health Organization Collaborating Centre for Training and Research in Rehabilitation, Wuhan, China
| | - Tongming Zhang
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- World Health Organization Collaborating Centre for Training and Research in Rehabilitation, Wuhan, China
| | - Wei Gao
- Department of Traumatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Wei Gao
| | - Yali Liu
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- World Health Organization Collaborating Centre for Training and Research in Rehabilitation, Wuhan, China
- *Correspondence: Yali Liu
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11
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Calderazzo S, Covert M, Alba DD, Bowley BE, Pessina MA, Rosene DL, Buller B, Medalla M, Moore TL. Neural recovery after cortical injury: Effects of MSC derived extracellular vesicles on motor circuit remodeling in rhesus monkeys. IBRO Neurosci Rep 2022; 13:243-254. [PMID: 36590089 PMCID: PMC9795302 DOI: 10.1016/j.ibneur.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 07/01/2022] [Accepted: 08/07/2022] [Indexed: 01/04/2023] Open
Abstract
Reorganization of motor circuits in the cortex and corticospinal tract are thought to underlie functional recovery after cortical injury, but the mechanisms of neural plasticity that could be therapeutic targets remain unclear. Recent work from our group have shown that systemic treatment with mesenchymal stem cell derived (MSCd) extracellular vesicles (EVs) administered after cortical damage to the primary motor cortex (M1) of rhesus monkeys resulted in a robust recovery of fine motor function and reduced chronic inflammation. Here, we used immunohistochemistry for cfos, an activity-dependent intermediate early gene, to label task-related neurons in the surviving primary motor and premotor cortices, and markers of axonal and synaptic plasticity in the spinal cord. Compared to vehicle, EV treatment was associated with a greater density of cfos+ pyramidal neurons in the deep layers of M1, greater density of cfos+ inhibitory interneurons in premotor areas, and lower density of synapses on MAP2+ lower motor neurons in the cervical spinal cord. These data suggest that the anti-inflammatory effects of EVs may reduce injury-related upper motor neuron damage and hyperexcitability, as well as aberrant compensatory re-organization in the cervical spinal cord to improve motor function.
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Key Words
- CB, Calbindin
- CR, Calretinin
- CSC, Cervical Spinal Cord
- Circuit Remodeling
- Cortical Injury
- DH, Dorsal Horn
- EVs, Extracellular Vesicles
- Extracellular Vesicles
- Ischemia
- LCST, Lateral Corticospinal Tract
- M1, Primary Motor Cortex
- MAP2, Microtubule Associated Protein 2
- MSCd, Mesenchymal Stem Cell derived
- Motor Cortex
- NHP, Non-Human Primate
- PV, Parvalbumin
- Plasticity
- ROS, Reactive Oxygen Species
- SYN, Synaptophysin
- Stem Cell-Based Treatments
- VH, Ventral Horn
- dPMC, dorsal Premotor Cortex
- miRNA, Micro RNA
- periM1, Perilesional Primary Motor Cortex
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Affiliation(s)
| | | | | | | | | | - Douglas L. Rosene
- Anatomy and Neurobiology Dept, BUSM, USA,Center for Systems Neuroscience, BU, USA
| | | | - Maria Medalla
- Anatomy and Neurobiology Dept, BUSM, USA,Center for Systems Neuroscience, BU, USA
| | - Tara L. Moore
- Anatomy and Neurobiology Dept, BUSM, USA,Center for Systems Neuroscience, BU, USA
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12
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Thakkar K, Mariappan R, Prabhu K, Yadav B, Singh G. Comparison of Monitored Anesthesia Care with Propofol Versus Dexmedetomidine for Awake Craniotomy: A Retrospective study. JOURNAL OF NEUROANAESTHESIOLOGY AND CRITICAL CARE 2022. [DOI: 10.1055/s-0042-1748195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
Abstract
Background Anesthetic agents used for awake craniotomy should be safe, short-acting, titratable, and provide an adequate level of sedation and analgesia, along with facilitating adequate neurological assessment during the functional testing. Our study aims to review the efficacy and safety profile, along with the potential for neurophysiological monitoring, of two commonly used anesthetic regimens, i.e., propofol and dexmedetomidine.
Methods After the Ethics Committee approval, a retrospective analysis of 51 patients who underwent awake craniotomy for brain tumor excision over a period of 7 years was done. Those who received monitored anesthesia care (MAC) were divided into two groups, namely, Group P for that received propofol, and Group D that received dexmedetomidine and their hemodynamic profile, perioperative complications, neuromonitoring techniques, and postoperative course was noted from the records.
Results A total of 31 patients were administered MAC with propofol and 20 with dexmedetomidine. The baseline demographic data, duration of surgery, intensive care unit (ICU), and hospital stay were comparable between the two. The hemodynamic profile as assessed by the heart rate and blood pressure was also comparable. The incidence of intraoperative seizures was found to be less in Group P, though. Episodes of transient desaturation were observed more in Group P (9.7%) than in Group D (5%), but none of the patients required conversion to general anesthesia. Direct cortical stimulation was satisfactorily elicited in 80% in Group P and 85% in Group D.
Conclusions MAC with propofol and dexmedetomidine are acceptable techniques with comparable hemodynamic profile, intraoperative and postoperative complications, and potential for neurophysiological monitoring.
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Affiliation(s)
- Keta Thakkar
- Department of Neuroanaesthesia, Christian Medical college, Vellore, Tamil Nadu, India
| | - Ramamani Mariappan
- Department of Neuroanaesthesia, Christian Medical college, Vellore, Tamil Nadu, India
| | - Krishna Prabhu
- Department of Neurosurgery, Christian Medical college, Vellore, Tamil Nadu, India
| | - Bijesh Yadav
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Georgene Singh
- Department of Neuroanaesthesia, Christian Medical college, Vellore, Tamil Nadu, India
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13
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Chen Y, Wang C, Song P, Sun C, Zhang Y, Zhao X, Du J. Alpha rhythm of electroencephalography was modulated differently by three transcranial direct current stimulation protocols in patients with ischemic stroke. Front Hum Neurosci 2022; 16:887849. [PMID: 35911595 PMCID: PMC9334563 DOI: 10.3389/fnhum.2022.887849] [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: 03/02/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
The heterogeneity of transcranial direct current stimulation (tDCS) protocols and clinical profiles may explain variable results in modulating excitability in the motor cortex after stroke. However, the cortical electrical effects induced by different tDCS protocols remain unclear. Here, we aimed to compare rhythm changes in electroencephalography (EEG) induced by three tDCS position protocols and the association between tDCS effects and clinical factors in stroke. Nineteen patients with chronic ischemic stroke underwent four experimental sessions with three tDCS protocols [anodal (atDCS), cathodal (ctDCS), and bilateral (bi-tDCS)] and a sham protocol, according to a single-blind randomized crossover design. Resting-state EEG was acquired before and after each protocol. First, a paired-sample t-test was used to examine the difference in spectral power between pre- and post-stimulation. Then, linear and quadratic regression models were used separately to describe the association between the clinical factors of stroke and changes in spectral power which was significantly different between pre- and post-tDCS. Finally, repeated measures analysis of variance with lesion hemisphere, stimulation protocol, and the location was performed to investigate the effects of tDCS over time. The induced effect of tDCS was mainly reflected in the alpha rhythms. The alpha power was increased by atDCS, especially low-alpha (8–10 Hz), in localized areas of the central and distant areas of the frontal and parietal lobes. Bi-tDCS also affected alpha power but in a smaller area that mainly focused on high-alpha rhythms (10–13 Hz). However, ctDCS and sham had no significant effects on any EEG rhythm. The clinical factors of time since stroke and motor impairment level were related to the change in high-alpha induced by atDCS and bi-tDCS following quadratic regression models. The above-mentioned modulation effect lasted for 20 min without attenuation. In conclusion, our findings provide evidence that the alpha rhythm of EEG is modulated differently by different tDCS protocols and that high alpha is affected by clinical characteristics such as post-stroke time and motor deficits, which is of great significance for understanding the modulation effect of different tDCS protocols on stroke and the guidance of protocols to promote motor recovery following stroke.
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Affiliation(s)
- Yuanyuan Chen
- Tianjin International Joint Research Center for Neural Engineering, Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Chunfang Wang
- Department of Rehabilitation Medicine, Tianjin Union Medical Centre, Rehabilitation Medical Research Center of Tianjin, Tianjin, China
| | - Peiqing Song
- Department of Rehabilitation Medicine, Tianjin Union Medical Centre, Rehabilitation Medical Research Center of Tianjin, Tianjin, China
| | - Changcheng Sun
- Tianjin International Joint Research Center for Neural Engineering, Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- Department of Rehabilitation Medicine, Tianjin Union Medical Centre, Rehabilitation Medical Research Center of Tianjin, Tianjin, China
| | - Ying Zhang
- Department of Rehabilitation Medicine, Tianjin Union Medical Centre, Rehabilitation Medical Research Center of Tianjin, Tianjin, China
- *Correspondence: Ying Zhang,
| | - Xin Zhao
- Tianjin International Joint Research Center for Neural Engineering, Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- Xin Zhao,
| | - Jingang Du
- Department of Rehabilitation Medicine, Tianjin Union Medical Centre, Rehabilitation Medical Research Center of Tianjin, Tianjin, China
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14
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Clarke S, Farron N, Crottaz-Herbette S. Choosing Sides: Impact of Prismatic Adaptation on the Lateralization of the Attentional System. Front Psychol 2022; 13:909686. [PMID: 35814089 PMCID: PMC9260393 DOI: 10.3389/fpsyg.2022.909686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
Seminal studies revealed differences between the effect of adaptation to left- vs. right-deviating prisms (L-PA, R-PA) in normal subjects. Whereas L-PA leads to neglect-like shift in attention, demonstrated in numerous visuo-spatial and cognitive tasks, R-PA has only minor effects in specific aspects of a few tasks. The paucity of R-PA effects in normal subjects contrasts with the striking alleviation of neglect symptoms in patients with right hemispheric lesions. Current evidence from activation studies in normal subjects highlights the contribution of regions involved in visuo-motor control during prism exposure and a reorganization of spatial representations within the ventral attentional network (VAN) after the adaptation. The latter depends on the orientation of prisms used. R-PA leads to enhancement of the ipsilateral visual and auditory space within the left inferior parietal lobule (IPL), switching thus the dominance of VAN from the right to the left hemisphere. L-PA leads to enhancement of the ipsilateral space in right IPL, emphasizing thus the right hemispheric dominance of VAN. Similar reshaping has been demonstrated in patients. We propose here a model, which offers a parsimonious explanation of the effect of L-PA and R-PA both in normal subjects and in patients with hemispheric lesions. The model posits that prismatic adaptation induces instability in the synaptic organization of the visuo-motor system, which spreads to the VAN. The effect is lateralized, depending on the side of prism deviation. Successful pointing with prisms implies reaching into the space contralateral, and not ipsilateral, to the direction of prism deviation. Thus, in the hemisphere contralateral to prism deviation, reach-related neural activity decreases, leading to instability of the synaptic organization, which induces a reshuffling of spatial representations in IPL. Although reshuffled spatial representations in IPL may be functionally relevant, they are most likely less efficient than regular representations and may thus cause partial dysfunction. The former explains, e.g., the alleviation of neglect symptoms after R-PA in patients with right hemispheric lesions, the latter the occurrence of neglect-like symptoms in normal subjects after L-PA. Thus, opting for R- vs. L-PA means choosing the side of major IPL reshuffling, which leads to its partial dysfunction in normal subjects and to recruitment of alternative or enhanced spatial representations in patients with hemispheric lesions.
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15
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Selective plasticity of callosal neurons in the adult contralesional cortex following murine traumatic brain injury. Nat Commun 2022; 13:2659. [PMID: 35551446 PMCID: PMC9098892 DOI: 10.1038/s41467-022-29992-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/11/2022] [Indexed: 11/17/2022] Open
Abstract
Traumatic brain injury (TBI) results in deficits that are often followed by recovery. The contralesional cortex can contribute to this process but how distinct contralesional neurons and circuits respond to injury remains to be determined. To unravel adaptations in the contralesional cortex, we used chronic in vivo two-photon imaging. We observed a general decrease in spine density with concomitant changes in spine dynamics over time. With retrograde co-labeling techniques, we showed that callosal neurons are uniquely affected by and responsive to TBI. To elucidate circuit connectivity, we used monosynaptic rabies tracing, clearing techniques and histology. We demonstrate that contralesional callosal neurons adapt their input circuitry by strengthening ipsilateral connections from pre-connected areas. Finally, functional in vivo two-photon imaging demonstrates that the restoration of pre-synaptic circuitry parallels the restoration of callosal activity patterns. Taken together our study thus delineates how callosal neurons structurally and functionally adapt following a contralateral murine TBI. Which contralesional circuits adapt after traumatic brain injury (TBI) is unclear. Here the authors used in vivo imaging, retrograde labeling, rabies tracing, clearing and functional imaging to demonstrate that callosal neurons selectively adapt after TBI in mice.
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16
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Pirovano I, Mastropietro A, Antonacci Y, Barà C, Guanziroli E, Molteni F, Faes L, Rizzo G. Resting State EEG Directed Functional Connectivity Unveils Changes in Motor Network Organization in Subacute Stroke Patients After Rehabilitation. Front Physiol 2022; 13:862207. [PMID: 35450158 PMCID: PMC9016279 DOI: 10.3389/fphys.2022.862207] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/14/2022] [Indexed: 01/01/2023] Open
Abstract
Brain plasticity and functional reorganization are mechanisms behind functional motor recovery of patients after an ischemic stroke. The study of resting-state motor network functional connectivity by means of EEG proved to be useful in investigating changes occurring in the information flow and find correlation with motor function recovery. In the literature, most studies applying EEG to post-stroke patients investigated the undirected functional connectivity of interacting brain regions. Quite recently, works started to investigate the directionality of the connections and many approaches or features have been proposed, each of them being more suitable to describe different aspects, e.g., direct or indirect information flow between network nodes, the coupling strength or its characteristic oscillation frequency. Each work chose one specific measure, despite in literature there is not an agreed consensus, and the selection of the most appropriate measure is still an open issue. In an attempt to shed light on this methodological aspect, we propose here to combine the information of direct and indirect coupling provided by two frequency-domain measures based on Granger’s causality, i.e., the directed coherence (DC) and the generalized partial directed coherence (gPDC), to investigate the longitudinal changes of resting-state directed connectivity associated with sensorimotor rhythms α and β, occurring in 18 sub-acute ischemic stroke patients who followed a rehabilitation treatment. Our results showed a relevant role of the information flow through the pre-motor regions in the reorganization of the motor network after the rehabilitation in the sub-acute stage. In particular, DC highlighted an increase in intra-hemispheric coupling strength between pre-motor and primary motor areas, especially in ipsi-lesional hemisphere in both α and β frequency bands, whereas gPDC was more sensitive in the detection of those connection whose variation was mostly represented within the population. A decreased causal flow from contra-lesional premotor cortex towards supplementary motor area was detected in both α and β frequency bands and a significant reinforced inter-hemispheric connection from ipsi to contra-lesional pre-motor cortex was observed in β frequency. Interestingly, the connection from contra towards ipsilesional pre-motor area correlated with upper limb motor recovery in α band. The usage of two different measures of directed connectivity allowed a better comprehension of those coupling changes between brain motor regions, either direct or mediated, which mostly were influenced by the rehabilitation, revealing a particular involvement of the pre-motor areas in the cerebral functional reorganization.
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Affiliation(s)
- Ileana Pirovano
- Istituto di Tecnologie Biomediche, Consiglio Nazionale delle Ricerche, Segrate, Italy
| | - Alfonso Mastropietro
- Istituto di Tecnologie Biomediche, Consiglio Nazionale delle Ricerche, Segrate, Italy
- *Correspondence: Alfonso Mastropietro,
| | - Yuri Antonacci
- Dipartimento di Ingegneria, Università di Palermo, Palermo, Italy
| | - Chiara Barà
- Dipartimento di Ingegneria, Università di Palermo, Palermo, Italy
| | | | - Franco Molteni
- Centro Riabilitativo Villa Beretta, Ospedale Valduce, Costa Masnaga, Italy
| | - Luca Faes
- Dipartimento di Ingegneria, Università di Palermo, Palermo, Italy
| | - Giovanna Rizzo
- Istituto di Tecnologie Biomediche, Consiglio Nazionale delle Ricerche, Segrate, Italy
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17
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Tan G, Wang J, Liu J, Sheng Y, Xie Q, Liu H. A framework for quantifying the effects of transcranial magnetic stimulation on motor recovery from hemiparesis: Corticomuscular Network. J Neural Eng 2022; 19. [PMID: 35366651 DOI: 10.1088/1741-2552/ac636b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/01/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Transcranial magnetic stimulation (TMS) is an experimental therapy for promoting motor recovery from hemiparesis. At present, hemiparesis patients' responses to TMS are variable. To maximize its therapeutic potential, we need an approach that relates the electrophysiology of motor recovery and TMS. To this end, we propose Corticomuscular Network (CMN) representing the holistic motor system, including the cortico-cortical pathway, corticospinal tract, and muscle co-activation. METHODS CMN is made up of coherence between pairs of electrode signals and spatial locations of the electrodes. We associated coherence and graph features of CMN with Fugl-Meyer Assessment (FMA) for the upper extremity. Besides, we compared CMN between 8 patients with hemiparesis and 6 healthy controls and contrasted CMN of patients before and after a 1Hz TMS. MAIN RESULTS Corticomuscular coherence (CMC) correlated positively with FMA. The regression model between FMA and CMC between 5 pairs of channels had 0.99 adjusted R^2 and a p-value less than 0.01. Compared to healthy controls, CMN of patients tended to be a small-world network and was more interconnected with higher CMC. CMC between cortex and triceps brachii long head was higher in patients. 15-minute 1Hz TMS protocol induced coherence changes beyond the stimulation side and had a limited impact on CMN parameters that are related to motor recovery. SIGNIFICANCE CMN is a potential clinical approach to quantify rehabilitating progress. It also sheds light on the desirable electrophysiological effects of TMS based on which rehabilitating strategies can be optimized.
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Affiliation(s)
- Gansheng Tan
- Washington University in St Louis, 520 S Euclid Ave, St. Louis, MO 63110, St Louis, Missouri, 63130-4899, UNITED STATES
| | - Jixian Wang
- Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, 800 Dongchuan Rd, Shanghai, 200025, CHINA
| | - Jinbiao Liu
- Shanghai Jiao Tong University, 800 Dongchuan Rd, Shanghai, 200240, CHINA
| | - Yixuan Sheng
- Shanghai Jiao Tong University, 800 Dongchuan Rd, Shanghai, 200240, CHINA
| | - Qing Xie
- Ruijin Hospital, 800 Dongchuan Rd, Shanghai, 200025, CHINA
| | - Honghai Liu
- Harbin Institute of Technology Shenzhen, Pingshan 1 Rd, Nanshan, Shenzhen, Guangdong, 518055, CHINA
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18
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Branscheidt M, Ejaz N, Xu J, Widmer M, Harran MD, Cortés JC, Kitago T, Celnik PA, Hernandez-Castillo C, Diedrichsen J, Luft AR, Krakauer JW. No evidence for motor recovery-related cortical connectivity changes after stroke using resting-state fMRI. J Neurophysiol 2021; 127:637-650. [PMID: 34965743 PMCID: PMC8896990 DOI: 10.1152/jn.00148.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
It has been proposed that a form of cortical reorganization (changes in functional connectivity between brain areas) can be assessed with resting-state (rs) fMRI. Here we report a longitudinal data-set collected from 19 patients with subcortical stroke and 11 controls. Patients were imaged up to five times over one year. We found no evidence, using rs-fMRI, for post-stroke cortical connectivity changes despite substantial behavioral recovery. These results could be construed as questioning the value of resting-state imaging. Here we argue instead that they are consistent with other emerging reasons to challenge the idea of motor recovery-related cortical reorganization post-stroke when conceived of as changes in connectivity between cortical areas.
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Affiliation(s)
- Meret Branscheidt
- Brain Physiology and Stimulation Laboratory, Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, United States.,Department of Neurology, University Hospital Zurich, Zürich, Switzerland.,Cereneo Center for Neurology and Rehabilitation, Vitznau, Switzerland
| | - Naveed Ejaz
- Brain and Mind Institute, Western University, London, Ontario, Canada
| | - Jing Xu
- Department of Neuroscience, Johns Hopkins University, Baltimore, MD, United States.,Malone Center for Engineering in Healthcare, Johns Hopkins University, Baltimore, MD, United States
| | - Mario Widmer
- Department of Neurology, University Hospital Zurich, Zürich, Switzerland
| | - Michelle D Harran
- Department of Neuroscience, Johns Hopkins University, Baltimore, MD, United States
| | - Juan Camilo Cortés
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Tomoko Kitago
- Burke Neurological Institute and Weill Cornell Medicine, White Plains, NY, United States
| | - Pablo A Celnik
- Brain Physiology and Stimulation Laboratory, Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, United States
| | | | - Jörn Diedrichsen
- Brain and Mind Institute, Western University, London, Ontario, Canada
| | - Andreas R Luft
- Department of Neurology, University Hospital Zurich, Zürich, Switzerland.,Cereneo Center for Neurology and Rehabilitation, Vitznau, Switzerland
| | - John W Krakauer
- Department of Neuroscience, Johns Hopkins University, Baltimore, MD, United States.,Malone Center for Engineering in Healthcare, Johns Hopkins University, Baltimore, MD, United States.,Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
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19
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Rossi F, Savi F, Prestia A, Mongardi A, Demarchi D, Buccino G. Combining Action Observation Treatment with a Brain-Computer Interface System: Perspectives on Neurorehabilitation. SENSORS 2021; 21:s21248504. [PMID: 34960597 PMCID: PMC8707407 DOI: 10.3390/s21248504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/30/2021] [Accepted: 12/17/2021] [Indexed: 12/04/2022]
Abstract
Action observation treatment (AOT) exploits a neurophysiological mechanism, matching an observed action on the neural substrates where that action is motorically represented. This mechanism is also known as mirror mechanism. In a typical AOT session, one can distinguish an observation phase and an execution phase. During the observation phase, the patient observes a daily action and soon after, during the execution phase, he/she is asked to perform the observed action at the best of his/her ability. Indeed, the execution phase may sometimes be difficult for those patients where motor impairment is severe. Although, in the current practice, the physiotherapist does not intervene on the quality of the execution phase, here, we propose a stimulation system based on neurophysiological parameters. This perspective article focuses on the possibility to combine AOT with a brain–computer interface system (BCI) that stimulates upper limb muscles, thus facilitating the execution of actions during a rehabilitation session. Combining a rehabilitation tool that is well-grounded in neurophysiology with a stimulation system, such as the one proposed, may improve the efficacy of AOT in the treatment of severe neurological patients, including stroke patients, Parkinson’s disease patients, and children with cerebral palsy.
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Affiliation(s)
- Fabio Rossi
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Turin, Italy; (F.R.); (A.P.); (A.M.); (D.D.)
| | - Federica Savi
- Fondazione Don Carlo Gnocchi, Piazzale dei Servi 3, 43100 Parma, Italy;
| | - Andrea Prestia
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Turin, Italy; (F.R.); (A.P.); (A.M.); (D.D.)
| | - Andrea Mongardi
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Turin, Italy; (F.R.); (A.P.); (A.M.); (D.D.)
| | - Danilo Demarchi
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Turin, Italy; (F.R.); (A.P.); (A.M.); (D.D.)
| | - Giovanni Buccino
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, University San Raffaele, Via Olgettina 60, 20132 Milan, Italy
- Correspondence: ; Tel.: +39-02-91751596
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20
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Blackmore M, Batsel E, Tsoulfas P. Widening spinal injury research to consider all supraspinal cell types: Why we must and how we can. Exp Neurol 2021; 346:113862. [PMID: 34520726 PMCID: PMC8805209 DOI: 10.1016/j.expneurol.2021.113862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/19/2021] [Accepted: 09/08/2021] [Indexed: 01/05/2023]
Abstract
The supraspinal connectome consists of dozens of neuronal populations that project axons from the brain to the spinal cord to influence a wide range of motor, autonomic, and sensory functions. The complexity and wide distribution of supraspinal neurons present significant technical challenges, leading most spinal cord injury research to focus on a handful of major pathways such as the corticospinal, rubrospinal, and raphespinal. Much less is known about many additional populations that carry information to modulate or compensate for these main pathways, or which carry pre-autonomic and other information of high value to individuals with spinal injury. A confluence of technical developments, however, now enables a whole-connectome study of spinal cord injury. Improved viral labeling, tissue clearing, and automated registration to 3D atlases can quantify supraspinal neurons throughout the murine brain, offering a practical means to track responses to injury and treatment on an unprecedented scale. Here we discuss the need for expanded connectome-wide analyses in spinal injury research, illustrate the potential by discussing a new web-based resource for brain-wide study of supraspinal neurons, and highlight future prospects for connectome analyses.
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Affiliation(s)
- Murray Blackmore
- Department of Biomedical Sciences, Marquette University, 53201, United States of America.
| | - Elizabeth Batsel
- Department of Biomedical Sciences, Marquette University, 53201, United States of America
| | - Pantelis Tsoulfas
- Department of Neurological Surgery, Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33136, United States of America
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21
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Critical Period After Stroke Study (CPASS): A phase II clinical trial testing an optimal time for motor recovery after stroke in humans. Proc Natl Acad Sci U S A 2021; 118:2026676118. [PMID: 34544853 PMCID: PMC8488696 DOI: 10.1073/pnas.2026676118] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2021] [Indexed: 02/06/2023] Open
Abstract
Restoration of postinjury brain function is a signal neuroscience challenge. Animal models of stroke recovery demonstrate time-limited windows of heightened motor recovery, similar to developmental neuroplasticity. However, no equivalent windows have been demonstrated in humans. We report a randomized controlled trial applying essential elements of animal motor training paradigms to humans, to determine the existence of an analogous sensitive period in adults. We found a similar sensitive or optimal period 60 to 90 d after stroke, with lesser effects ≤30 d and no effect 6 mo or later after stroke. These findings prospectively demonstrated the existence of a sensitive period in adult humans. We urge the provision of more intensive motor rehabilitation within 60 to 90 d after stroke onset. Restoration of human brain function after injury is a signal challenge for translational neuroscience. Rodent stroke recovery studies identify an optimal or sensitive period for intensive motor training after stroke: near-full recovery is attained if task-specific motor training occurs during this sensitive window. We extended these findings to adult humans with stroke in a randomized controlled trial applying the essential elements of rodent motor training paradigms to humans. Stroke patients were adaptively randomized to begin 20 extra hours of self-selected, task-specific motor therapy at ≤30 d (acute), 2 to 3 mo (subacute), or ≥6 mo (chronic) after stroke, compared with controls receiving standard motor rehabilitation. Upper extremity (UE) impairment assessed by the Action Research Arm Test (ARAT) was measured at up to five time points. The primary outcome measure was ARAT recovery over 1 y after stroke. By 1 y we found significantly increased UE motor function in the subacute group compared with controls (ARAT difference = +6.87 ± 2.63, P = 0.009). The acute group compared with controls showed smaller but significant improvement (ARAT difference = +5.25 ± 2.59 points, P = 0.043). The chronic group showed no significant improvement compared with controls (ARAT = +2.41 ± 2.25, P = 0.29). Thus task-specific motor intervention was most effective within the first 2 to 3 mo after stroke. The similarity to rodent model treatment outcomes suggests that other rodent findings may be translatable to human brain recovery. These results provide empirical evidence of a sensitive period for motor recovery in humans.
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Two-Photon Laser Ablation and In Vivo Wide-Field Imaging of Inferior Olive Neurons Revealed the Recovery of Olivocerebellar Circuits in Zebrafish. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168357. [PMID: 34444107 PMCID: PMC8391264 DOI: 10.3390/ijerph18168357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 11/17/2022]
Abstract
The cerebellum, a brain region with a high degree of plasticity, is pivotal in motor control, learning, and cognition. The cerebellar reserve is the capacity of the cerebellum to respond and adapt to various disorders via resilience and reversibility. Although structural and functional recovery has been reported in mammals and has attracted attention regarding treatments for cerebellar dysfunction, such as spinocerebellar degeneration, the regulatory mechanisms of the cerebellar reserve are largely unidentified, particularly at the circuit level. Herein, we established an optical approach using zebrafish, an ideal vertebrate model in optical techniques, neuroscience, and developmental biology. By combining two-photon laser ablation of the inferior olive (IO) and long-term non-invasive imaging of "the whole brain" at a single-cell resolution, we succeeded in visualization of the morphological changes occurring in the IO neuron population and showed at a single-cell level that structural remodeling of the olivocerebellar circuit occurred in a relatively short period. This system, in combination with various functional analyses, represents a novel and powerful approach for uncovering the mechanisms of the cerebellar reserve, and highlights the potential of the zebrafish model to elucidate the organizing principles of neuronal circuits and their homeostasis in health and disease.
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Latchoumane CFV, Betancur MI, Simchick GA, Sun MK, Forghani R, Lenear CE, Ahmed A, Mohankumar R, Balaji N, Mason HD, Archer-Hartmann SA, Azadi P, Holmes PV, Zhao Q, Bellamkonda RV, Karumbaiah L. Engineered glycomaterial implants orchestrate large-scale functional repair of brain tissue chronically after severe traumatic brain injury. SCIENCE ADVANCES 2021; 7:7/10/eabe0207. [PMID: 33674306 PMCID: PMC7935369 DOI: 10.1126/sciadv.abe0207] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 01/21/2021] [Indexed: 05/14/2023]
Abstract
Severe traumatic brain injury (sTBI) survivors experience permanent functional disabilities due to significant volume loss and the brain's poor capacity to regenerate. Chondroitin sulfate glycosaminoglycans (CS-GAGs) are key regulators of growth factor signaling and neural stem cell homeostasis in the brain. However, the efficacy of engineered CS (eCS) matrices in mediating structural and functional recovery chronically after sTBI has not been investigated. We report that neurotrophic factor functionalized acellular eCS matrices implanted into the rat M1 region acutely after sTBI significantly enhanced cellular repair and gross motor function recovery when compared to controls 20 weeks after sTBI. Animals subjected to M2 region injuries followed by eCS matrix implantations demonstrated the significant recovery of "reach-to-grasp" function. This was attributed to enhanced volumetric vascularization, activity-regulated cytoskeleton (Arc) protein expression, and perilesional sensorimotor connectivity. These findings indicate that eCS matrices implanted acutely after sTBI can support complex cellular, vascular, and neuronal circuit repair chronically after sTBI.
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Affiliation(s)
- Charles-Francois V Latchoumane
- Regenerative Bioscience Center, University of Georgia, Athens, GA 30602, USA
- Edgar L. Rhodes Center for ADS, College of Agriculture and Environmental Sciences, University of Georgia, Athens, GA 30602, USA
| | - Martha I Betancur
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, 101 Science Drive, Durham, NC 27705, USA
| | - Gregory A Simchick
- Department of Physics and Astronomy, University of Georgia, Athens, GA 30602, USA
- Bio-Imaging Research Center, University of Georgia, Athens, GA 30602, USA
| | - Min Kyoung Sun
- Regenerative Bioscience Center, University of Georgia, Athens, GA 30602, USA
- Division of Neuroscience, Biomedical & Health Sciences Institute, University of Georgia, Athens, GA 30602, USA
| | - Rameen Forghani
- Regenerative Bioscience Center, University of Georgia, Athens, GA 30602, USA
| | - Christopher E Lenear
- Regenerative Bioscience Center, University of Georgia, Athens, GA 30602, USA
- Edgar L. Rhodes Center for ADS, College of Agriculture and Environmental Sciences, University of Georgia, Athens, GA 30602, USA
| | - Aws Ahmed
- Regenerative Bioscience Center, University of Georgia, Athens, GA 30602, USA
- Edgar L. Rhodes Center for ADS, College of Agriculture and Environmental Sciences, University of Georgia, Athens, GA 30602, USA
| | - Ramya Mohankumar
- Regenerative Bioscience Center, University of Georgia, Athens, GA 30602, USA
| | - Nivedha Balaji
- Regenerative Bioscience Center, University of Georgia, Athens, GA 30602, USA
| | - Hannah D Mason
- Regenerative Bioscience Center, University of Georgia, Athens, GA 30602, USA
| | | | - Parastoo Azadi
- Complex Carbohydrate Research Center, University of Georgia, Athens, GA 30602, USA
| | - Philip V Holmes
- Division of Neuroscience, Biomedical & Health Sciences Institute, University of Georgia, Athens, GA 30602, USA
- Psychology Department, University of Georgia, Athens, GA 30602, USA
| | - Qun Zhao
- Regenerative Bioscience Center, University of Georgia, Athens, GA 30602, USA
- Department of Physics and Astronomy, University of Georgia, Athens, GA 30602, USA
- Bio-Imaging Research Center, University of Georgia, Athens, GA 30602, USA
| | - Ravi V Bellamkonda
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, 101 Science Drive, Durham, NC 27705, USA
| | - Lohitash Karumbaiah
- Regenerative Bioscience Center, University of Georgia, Athens, GA 30602, USA.
- Edgar L. Rhodes Center for ADS, College of Agriculture and Environmental Sciences, University of Georgia, Athens, GA 30602, USA
- Division of Neuroscience, Biomedical & Health Sciences Institute, University of Georgia, Athens, GA 30602, USA
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Li Z, Gao H, Zeng P, Jia Y, Kong X, Xu K, Bai R. Secondary Degeneration of White Matter After Focal Sensorimotor Cortical Ischemic Stroke in Rats. Front Neurosci 2021; 14:611696. [PMID: 33536869 PMCID: PMC7848148 DOI: 10.3389/fnins.2020.611696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/14/2020] [Indexed: 12/13/2022] Open
Abstract
Ischemic lesions could lead to secondary degeneration in remote regions of the brain. However, the spatial distribution of secondary degeneration along with its role in functional deficits is not well understood. In this study, we explored the spatial and connectivity properties of white matter (WM) secondary degeneration in a focal unilateral sensorimotor cortical ischemia rat model, using advanced microstructure imaging on a 14 T MRI system. Significant axonal degeneration was observed in the ipsilateral external capsule and even remote regions including the contralesional external capsule and corpus callosum. Further fiber tractography analysis revealed that only fibers having direct axonal connections with the primary lesion exhibited a significant degeneration. These results suggest that focal ischemic lesions may induce remote WM degeneration, but limited to fibers tied to the primary lesion. These “direct” fibers mainly represent perilesional, interhemispheric, and subcortical axonal connections. At last, we found that primary lesion volume might be the determining factor of motor function deficits.
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Affiliation(s)
- Zhaoqing Li
- Interdisciplinary Institute of Neuroscience and Technology, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Biomedical Engineering of Education Ministry, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Huan Gao
- Key Laboratory of Biomedical Engineering of Education Ministry, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China.,Qiushi Academy for Advanced Studies (QAAS), Zhejiang University, Hangzhou, China
| | - Pingmei Zeng
- Department of Chemistry, Zhejiang University, Hangzhou, China
| | - Yinhang Jia
- Interdisciplinary Institute of Neuroscience and Technology, School of Medicine, Zhejiang University, Hangzhou, China.,Department of Physical Medicine and Rehabilitation, The Affiliated Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xueqian Kong
- Department of Chemistry, Zhejiang University, Hangzhou, China
| | - Kedi Xu
- Key Laboratory of Biomedical Engineering of Education Ministry, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China.,Qiushi Academy for Advanced Studies (QAAS), Zhejiang University, Hangzhou, China.,Zhejiang Provincial Key Laboratory of Cardio-Cerebral Vascular Detection Technology and Medicinal Effectiveness Appraisal, Zhejiang University, Hangzhou, China
| | - Ruiliang Bai
- Interdisciplinary Institute of Neuroscience and Technology, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Biomedical Engineering of Education Ministry, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China.,Department of Physical Medicine and Rehabilitation, The Affiliated Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Zhejiang Provincial Key Laboratory of Cardio-Cerebral Vascular Detection Technology and Medicinal Effectiveness Appraisal, Zhejiang University, Hangzhou, China
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25
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Savidan J, Beaud ML, Rouiller EM. Cutaneous Inputs to Dorsal Column Nuclei in Adult Macaque Monkeys Subjected to Unilateral Lesion of the Primary Motor Cortex or of the Cervical Spinal Cord and Treatments Promoting Axonal Growth. Neurosci Insights 2020; 15:2633105520973991. [PMID: 33283186 PMCID: PMC7683840 DOI: 10.1177/2633105520973991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 10/27/2020] [Indexed: 11/17/2022] Open
Abstract
The highly interconnected somatosensory and motor systems are subjected to connectivity changes at close or remote locations following a central nervous system injury. What is the impact of unilateral injury of the primary motor cortex (hand area; MCI) or of the cervical cord (hemisection at C7-C8 level; SCI) on the primary somatosensory (cutaneous) inputs to the dorsal column nuclei (DCN) in adult macaque monkeys? The effects of treatments promoting axonal growth were assessed. In the SCI group (n = 4), 1 monkey received a control antibody and 3 monkeys a combination treatment of anti-Nogo-A antibody and brain-derived neurotrophic factor (BDNF). In the MCI group (n = 4), 2 monkeys were untreated and 2 were treated with the anti-Nogo-A antibody. Using trans-ganglionic transport of cholera toxin B subunit injected in the first 2 fingers and toes on both sides, the areas of axonal terminal fields in the cuneate and gracile nuclei were bilaterally compared. Unilateral SCI at C7-C8 level, encroaching partially on the dorsal funiculus, resulted in an ipsilesional lower extent of the inputs from the toes in the gracile nuclei, not modified by the combined treatment. SCI at C7-C8 level did not affect the bilateral balance of primary inputs to the cuneate nuclei, neither in absence nor in presence of the combined treatment. MCI targeted to the hand area did not impact on the primary inputs to the cuneate nuclei in 2 untreated monkeys. After MCI, the administration of anti-Nogo-A antibody resulted in a slight bilateral asymmetrical extent of cutaneous inputs to the cuneate nuclei, with a larger extent ipsilesionally. Overall, remote effects following MCI or SCI have not been observed at the DCN level, except possibly after MCI and anti-Nogo-A antibody treatment.
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Affiliation(s)
- Julie Savidan
- Faculty of Sciences and Medicine, Fribourg Centre for Cognition, Department of Neurosciences and Movement Sciences, Section of Medicine, University of Fribourg, Fribourg, Switzerland
| | - Marie-Laure Beaud
- Faculty of Sciences and Medicine, Fribourg Centre for Cognition, Department of Neurosciences and Movement Sciences, Section of Medicine, University of Fribourg, Fribourg, Switzerland
| | - Eric M Rouiller
- Faculty of Sciences and Medicine, Fribourg Centre for Cognition, Department of Neurosciences and Movement Sciences, Section of Medicine, University of Fribourg, Fribourg, Switzerland
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Maguire CC, Sieben JM, Lutz N, van der Wijden G, Scheidhauer H, de Bie R. Replacing canes with an elasticated orthotic-garment in chronic stroke patients - The influence on gait and balance. A series of N-of-1 trials. J Bodyw Mov Ther 2020; 24:203-214. [PMID: 33218513 DOI: 10.1016/j.jbmt.2020.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 03/02/2020] [Accepted: 06/07/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the effect of replacing canes with an elasticated orthotic-garment on balance and gait-function in chronic stroke survivors. DESIGN Experimental, N-of-1 series with a replicated, ABC design with randomised phase duration in a home setting. PARTICIPANTS Four cane using chronic stroke survivors (P1-4). INTERVENTIONS Phase A (9-12 weeks) cane-walking "as usual" to establish baseline values; Phase B (9-16 weeks) intervention: orthotic-garment worn throughout the day with maximal cane-use reduction; Phase C (9-10 weeks) participant-determined follow-up: either no walking-aid, orthotic-garment or cane. OUTCOME MEASURES Primary: Functional-Gait-Assessment (FGA), Secondary: Trunk-sway during walking measured as Total-Angle-Area (TAA°2) in frontal and sagittal-planes, both measured weekly. RESULTS Visual and statistical analysis of results showed significant improvements in FGA from phase A to B in all participants. Improvement continued in phase C in P2, stabilized in P1 and P4 and deteriorated in P3. A Minimal-Clinical-Important-Difference of 6 points-change was achieved in P2 & P4. Trunk-sway reduced during walking, indicating increased stability, in two participants from phase A to B and in three participants from A to C but no TAA changes were statistically significant. In phase C participant-selected walking-aids were: P1 cane-usage reduced by 25%, P2 independent-walking with no assistive-device, S3 usual cane-usage, P4 orthotic-garment with reduced cane-usage 2-3 days-a-week, usual cane-usage 4-5 days. CONCLUSIONS Although walking ability is multifactorial these results indicate that the choice of walking-aids can have a specific and clinically relevant impact on gait following stroke. "Hands-free" assistive-devices may be more effective than canes in improving gait-function in some patients. CLINICALTRIALS. GOV ID NCT03642444.
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Affiliation(s)
- Clare C Maguire
- Department of Physiotherapy, Bildungszentrum Gesundheit Basel-Stadt, 4142, Muenchenstein, Switzerland; Caphri School for Public Health and Primary Care Research, Maastricht University, 6200, MD, Maastricht, the Netherlands; Department of Physiotherapy, REHAB, Clinic for Neurorehabilitation and Paraplegiology, Basel, Switzerland; Department of Health, Bern University of Applied Science, Schwarztorstrasse 48, 3007, Bern, Switzerland.
| | - Judith M Sieben
- Caphri School for Public Health and Primary Care Research, Maastricht University, 6200, MD, Maastricht, the Netherlands; Department of Anatomy and Embryology, Maastricht University, 6200, MD, Maastricht, the Netherlands
| | - Nathanael Lutz
- Department of Physiotherapy, Bildungszentrum Gesundheit Basel-Stadt, 4142, Muenchenstein, Switzerland
| | - Gisela van der Wijden
- Department of Physiotherapy, REHAB, Clinic for Neurorehabilitation and Paraplegiology, Basel, Switzerland
| | - Heike Scheidhauer
- Department of Physiotherapy, Bildungszentrum Gesundheit Basel-Stadt, 4142, Muenchenstein, Switzerland
| | - RobertA de Bie
- Caphri School for Public Health and Primary Care Research, Maastricht University, 6200, MD, Maastricht, the Netherlands; Department of Epidemiology, Maastricht University, 6200, MD, Maastricht, the Netherlands
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Slow Waves Promote Sleep-Dependent Plasticity and Functional Recovery after Stroke. J Neurosci 2020; 40:8637-8651. [PMID: 33087472 PMCID: PMC7643301 DOI: 10.1523/jneurosci.0373-20.2020] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 09/15/2020] [Accepted: 09/24/2020] [Indexed: 01/13/2023] Open
Abstract
Functional recovery after stroke is associated with a remapping of neural circuits. This reorganization is often associated with low-frequency, high-amplitude oscillations in the peri-infarct zone in both rodents and humans. These oscillations are reminiscent of sleep slow waves (SW) and suggestive of a role for sleep in brain plasticity that occur during stroke recovery; however, direct evidence is missing. Using a stroke model in male mice, we showed that stroke was followed by a transient increase in NREM sleep accompanied by reduced amplitude and slope of ipsilateral NREM sleep SW. We next used 5 ms optical activation of Channelrhodopsin 2-expressing pyramidal neurons, or 200 ms silencing of Archeorhodopsin T-expressing pyramidal neurons, to generate local cortical UP, or DOWN, states, respectively, both sharing similarities with spontaneous NREM SW in freely moving mice. Importantly, we found that single optogenetically evoked SW (SWopto) in the peri-infarct zone, randomly distributed during sleep, significantly improved fine motor movements of the limb corresponding to the sensorimotor stroke lesion site compared with spontaneous recovery and control conditions, while motor strength remained unchanged. In contrast, SWopto during wakefulness had no effect. Furthermore, chronic SWopto during sleep were associated with local axonal sprouting as revealed by the increase of anatomic presynaptic and postsynaptic markers in the peri-infarct zone and corresponding contralesional areas to cortical circuit reorganization during stroke recovery. These results support a role for sleep SW in cortical circuit plasticity and sensorimotor recovery after stroke and provide a clinically relevant framework for rehabilitation strategies using neuromodulation during sleep. SIGNIFICANCE STATEMENT Brain stroke is one of the leading causes of death and major disabilities in the elderly worldwide. A better understanding of the pathophysiological mechanisms underlying spontaneous brain plasticity after stroke, together with an optimization of rehabilitative strategies, are essential to improve stroke treatments. Here, we investigate the role of optogenetically induced sleep slow waves in an animal model of ischemic stroke and identify sleep as a window for poststroke intervention that promotes neuroplasticity and facilitates sensorimotor recovery.
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Sajid N, Parr T, Gajardo-Vidal A, Price CJ, Friston KJ. Paradoxical lesions, plasticity and active inference. Brain Commun 2020; 2:fcaa164. [PMID: 33376985 PMCID: PMC7750943 DOI: 10.1093/braincomms/fcaa164] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 12/01/2022] Open
Abstract
Paradoxical lesions are secondary brain lesions that ameliorate functional deficits caused by the initial insult. This effect has been explained in several ways; particularly by the reduction of functional inhibition, or by increases in the excitatory-to-inhibitory synaptic balance within perilesional tissue. In this article, we simulate how and when a modification of the excitatory-inhibitory balance triggers the reversal of a functional deficit caused by a primary lesion. For this, we introduce in-silico lesions to an active inference model of auditory word repetition. The first in-silico lesion simulated damage to the extrinsic (between regions) connectivity causing a functional deficit that did not fully resolve over 100 trials of a word repetition task. The second lesion was implemented in the intrinsic (within region) connectivity, compromising the model's ability to rebalance excitatory-inhibitory connections during learning. We found that when the second lesion was mild, there was an increase in experience-dependent plasticity that enhanced performance relative to a single lesion. This paradoxical lesion effect disappeared when the second lesion was more severe because plasticity-related changes were disproportionately amplified in the intrinsic connectivity, relative to lesioned extrinsic connections. Finally, this framework was used to predict the physiological correlates of paradoxical lesions. This formal approach provides new insights into the computational and neurophysiological mechanisms that allow some patients to recover after large or multiple lesions.
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Affiliation(s)
- Noor Sajid
- Wellcome Centre for Human Neuroimaging, University College London, London WC1N 3AR, UK
| | - Thomas Parr
- Wellcome Centre for Human Neuroimaging, University College London, London WC1N 3AR, UK
| | - Andrea Gajardo-Vidal
- Wellcome Centre for Human Neuroimaging, University College London, London WC1N 3AR, UK
| | - Cathy J Price
- Wellcome Centre for Human Neuroimaging, University College London, London WC1N 3AR, UK
| | - Karl J Friston
- Wellcome Centre for Human Neuroimaging, University College London, London WC1N 3AR, UK
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29
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Efficacy of platelet-rich plasma in the treatment of hemiplegic shoulder pain. Neurol Sci 2020; 42:1977-1986. [PMID: 32990858 DOI: 10.1007/s10072-020-04710-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/04/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The aim of this study was to examine the effects of platelet-rich plasma (PRP) on pain and functional outcomes in patients with hemiplegic shoulder pain. We compared the effects of PRP against saline solution by designing a double blind, randomized, prospective study. DESIGN Forty-four patients with hemiplegia were included in this study. All patients received a total of 3 injections, 1 week apart. The first group received PRP injections while the second group received placebo injections. After 3 months of follow-up, 40 patients completed the trial. Primary outcome measure was movement-induced pain score (VAS), and secondary outcome measures were spontaneous pain score, shoulder passive range of motion (ROM), functional independence measure score, and the amount of paracetamol used. All subjects were evaluated at baseline, 1 week, 1 month, and 3 months after the completion of the last injection. RESULTS Both groups showed an improvement in spontaneous and movement-related pain scores and shoulder passive ROM values on 1st and 3rd month visits (p < 0.05). No significance difference was detected between groups (p > 0.05). Similarly, FIM scores improved significantly in both groups (p < 0.05) but no difference was found between groups. Paracetamol use did not differ significantly between groups. CONCLUSION The PRP injections were found not to be superior to placebo. Improvements in both groups can be attributed to the use of rehabilitation techniques and exercises in all patients. There is still need for further research to show whether PRP is a treatment option in the course of hemiplegic shoulder pain. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03931824.
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Shibata T, Urata A, Kawahara K, Furuya K, Ishikuro K, Hattori N, Kuroda S. Therapeutic Effects of Diagonal-Transcranial Direct Current Stimulation on Functional Recovery in Acute Stroke: A Pilot Study. J Stroke Cerebrovasc Dis 2020; 29:105107. [PMID: 32912556 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/23/2020] [Accepted: 06/26/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Peak neurologic recovery from acute stroke occurs within the first 3 months, and continues at a slower pace for 6 months. OBJECTIVE/HYPOTHESIS The aim of this pilot study is to clarify the safety and feasibility of multiple diagonal-transcranial direct current stimulation (d-tDCS) sessions up to 3 months with electrodes placed diagonally over the lesional dorsolateral prefrontal cortex and contralesional primary motor cortex for upper limb hemiparesis in acute stroke. METHODS Five patients with acute stroke (2 with intracerebral hemorrhage and 3 with cerebral infarction) with upper limb paresis participated. d-tDCS (1 mA, 20 min per day) combined with conventional rehabilitation was given starting 7-21 days after stroke onset. Each session consisted of 10 d-tDCS over 2 weeks and patients received 2 sessions in the acute phase and 2 sessions in the subacute phase for a total 40 treatments. Motor function was assessed using Fugl-Meyer Assessment for upper extremity (FMA-UE) before and after each session, and the period to achieve 70% of maximal potential recovery in FMA-UE was evaluated. RESULTS All 5 patients completed the intervention and showed no adverse effects throughout the protocol. Of these, 3 (60%) achieved 70% predicted scores within 2 months. Regarding therapeutic gains of FMA-UE in each of the 10 sessions in the acute phase, 4 sessions showed great recovery, 3 sessions showed moderate recovery, and 3 sessions showed poor recovery. CONCLUSION These findings suggest that d-tDCS over 3 months may be safe and feasible for acute stroke patients in the acute to subacute phases and have therapeutic potential to promote recovery of upper limb function, although further randomized, double-blind, sham-controlled trial is warranted with larger sample size.
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Affiliation(s)
- Takashi Shibata
- Department of Neurosurgery, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan.
| | - Akio Urata
- Department of Rehabilitation, Toyama Prefectural Rehabilitation Hospital and Support Center for Children with Disabilities, Toyama, Japan.
| | - Kazuyuki Kawahara
- Department of Rehabilitation, Toyama Prefectural Rehabilitation Hospital and Support Center for Children with Disabilities, Toyama, Japan.
| | - Kota Furuya
- Department of Rehabilitation, University of Toyama, Toyama, Japan
| | - Koji Ishikuro
- Department of Rehabilitation, University of Toyama, Toyama, Japan.
| | - Noriaki Hattori
- Department of Rehabilitation, University of Toyama, Toyama, Japan.
| | - Satoshi Kuroda
- Department of Neurosurgery, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan.
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Inhibition of HDAC increases BDNF expression and promotes neuronal rewiring and functional recovery after brain injury. Cell Death Dis 2020; 11:655. [PMID: 32811822 PMCID: PMC7434917 DOI: 10.1038/s41419-020-02897-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 12/17/2022]
Abstract
Brain injury causes serious motor, sensory, and cognitive disabilities. Accumulating evidence has demonstrated that histone deacetylase (HDAC) inhibitors exert neuroprotective effects against various insults to the central nervous system (CNS). In this study, we investigated the effects of the HDAC inhibition on the expression of brain-derived neurotrophic factor (BDNF) and functional recovery after traumatic brain injury (TBI) in mice. Administration of class I HDAC inhibitor increased the number of synaptic boutons in rewiring corticospinal fibers and improved the recovery of motor functions after TBI. Immunohistochemistry results showed that HDAC2 is mainly expressed in the neurons of the mouse spinal cord under normal conditions. After TBI, HDAC2 expression was increased in the spinal cord after 35 days, whereas BDNF expression was decreased after 42 days. Administration of CI-994 increased BDNF expression after TBI. Knockdown of HDAC2 elevated H4K5ac enrichment at the BDNF promoter, which was decreased following TBI. Together, our findings suggest that HDAC inhibition increases expression of neurotrophic factors, and promote neuronal rewiring and functional recovery following TBI.
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Gudmundsson L, Vohryzek J, Fornari E, Clarke S, Hagmann P, Crottaz-Herbette S. A brief exposure to rightward prismatic adaptation changes resting-state network characteristics of the ventral attentional system. PLoS One 2020; 15:e0234382. [PMID: 32584824 PMCID: PMC7316264 DOI: 10.1371/journal.pone.0234382] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 05/26/2020] [Indexed: 12/02/2022] Open
Abstract
A brief session of rightward prismatic adaptation (R-PA) has been shown to alleviate neglect symptoms in patients with right hemispheric damage, very likely by switching hemispheric dominance of the ventral attentional network (VAN) from the right to the left and by changing task-related activity within the dorsal attentional network (DAN). We have investigated this very rapid change in functional organisation with a network approach by comparing resting-state connectivity before and after a brief exposure i) to R-PA (14 normal subjects; experimental condition) or ii) to plain glasses (12 normal subjects; control condition). A whole brain analysis (comprising 129 regions of interest) highlighted R-PA-induced changes within a bilateral, fronto-temporal network, which consisted of 13 nodes and 11 edges; all edges involved one of 4 frontal nodes, which were part of VAN. The analysis of network characteristics within VAN and DAN revealed a R-PA-induced decrease in connectivity strength between nodes and a decrease in local efficiency within VAN but not within DAN. These results indicate that the resting-state connectivity configuration of VAN is modulated by R-PA, possibly by decreasing its modularity.
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Affiliation(s)
- Louis Gudmundsson
- Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), and University of Lausanne, Lausanne, Switzerland
- Neuropsychology and Neurorehabilitation Service, Centre Hospitalier Universitaire Vaudois (CHUV), and University of Lausanne, Lausanne, Switzerland
| | - Jakub Vohryzek
- Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), and University of Lausanne, Lausanne, Switzerland
- Department of Psychiatry, Hedonia Research Group, University of Oxford, Oxford, United Kingdom
| | - Eleonora Fornari
- CIBM (Centre d'Imagerie Biomédicale), Dept. of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), and University of Lausanne, Lausanne, Switzerland
| | - Stephanie Clarke
- Neuropsychology and Neurorehabilitation Service, Centre Hospitalier Universitaire Vaudois (CHUV), and University of Lausanne, Lausanne, Switzerland
| | - Patric Hagmann
- Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), and University of Lausanne, Lausanne, Switzerland
- Signal Processing Lab 5 (LTS5), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Sonia Crottaz-Herbette
- Neuropsychology and Neurorehabilitation Service, Centre Hospitalier Universitaire Vaudois (CHUV), and University of Lausanne, Lausanne, Switzerland
- * E-mail:
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Heredia M, Rodríguez N, Sánchez Robledo V, Criado JM, de la Fuente A, Devesa J, Devesa P, Sánchez Riolobos A. Factors Involved in the Functional Motor Recovery of Rats with Cortical Ablation after GH and Rehabilitation Treatment: Cortical Cell Proliferation and Nestin and Actin Expression in the Striatum and Thalamus. Int J Mol Sci 2019; 20:ijms20225770. [PMID: 31744113 PMCID: PMC6888370 DOI: 10.3390/ijms20225770] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/13/2019] [Accepted: 11/14/2019] [Indexed: 12/15/2022] Open
Abstract
Previously we demonstrated, in rats, that treatment with growth hormone (GH) and rehabilitation, carried out immediately after a motor cortical ablation, significantly improved the motor affectation produced by the lesion and induced the re-expression of nestin in the contralateral motor cortex. Here we analyze cortical proliferation after ablation of the frontal motor cortex and investigate the re-expression of nestin in the contralateral motor cortex and the role of the striatum and thalamus in motor recovery. The rats were subjected to ablation of the frontal motor cortex in the dominant hemisphere or sham-operated and immediately treated with GH or the vehicle (V), for five days. At 1 dpi (days post-injury), all rats received daily injections (for four days) of bromodeoxyuridine and five rats were sacrificed at 5 dpi. The other 15 rats (n = 5/group) underwent rehabilitation and were sacrificed at 25 dpi. GH induced the greatest number of proliferating cells in the perilesional cortex. GH and rehabilitation produced the functional recovery of the motor lesion and increased the expression of nestin in the striatum. In the thalamic ventral nucleus ipsilateral to the lesion, cells positive for nestin and actin were detected, but this was independent on GH. Our data suggest that GH-induced striatal nestin is involved in motor recovery.
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Affiliation(s)
- Margarita Heredia
- Department of Physiology and Pharmacology, Institute of Neurosciences of Castilla and León (INCyL), University of Salamanca, Avenida Alfonso X El Sabio s/n, 37007 Salamanca, Spain; (N.R.); (V.S.R.); (J.M.C.); (A.d.l.F.); (A.S.R.)
- Correspondence: (M.H.); (J.D.); Tel.: +34-9232-9454-0 (M.H); +34-9810-292-8 (J.D.)
| | - Natalia Rodríguez
- Department of Physiology and Pharmacology, Institute of Neurosciences of Castilla and León (INCyL), University of Salamanca, Avenida Alfonso X El Sabio s/n, 37007 Salamanca, Spain; (N.R.); (V.S.R.); (J.M.C.); (A.d.l.F.); (A.S.R.)
| | - Virginia Sánchez Robledo
- Department of Physiology and Pharmacology, Institute of Neurosciences of Castilla and León (INCyL), University of Salamanca, Avenida Alfonso X El Sabio s/n, 37007 Salamanca, Spain; (N.R.); (V.S.R.); (J.M.C.); (A.d.l.F.); (A.S.R.)
| | - José María Criado
- Department of Physiology and Pharmacology, Institute of Neurosciences of Castilla and León (INCyL), University of Salamanca, Avenida Alfonso X El Sabio s/n, 37007 Salamanca, Spain; (N.R.); (V.S.R.); (J.M.C.); (A.d.l.F.); (A.S.R.)
| | - Antonio de la Fuente
- Department of Physiology and Pharmacology, Institute of Neurosciences of Castilla and León (INCyL), University of Salamanca, Avenida Alfonso X El Sabio s/n, 37007 Salamanca, Spain; (N.R.); (V.S.R.); (J.M.C.); (A.d.l.F.); (A.S.R.)
| | - Jesús Devesa
- Scientific Direction, Medical Center Foltra, Travesía de Montouto 24, 15894 Teo, Spain
- Correspondence: (M.H.); (J.D.); Tel.: +34-9232-9454-0 (M.H); +34-9810-292-8 (J.D.)
| | - Pablo Devesa
- Research and Development, Medical Center Foltra, Travesía de Montouto 24, 15894 Teo, Spain;
| | - Adelaida Sánchez Riolobos
- Department of Physiology and Pharmacology, Institute of Neurosciences of Castilla and León (INCyL), University of Salamanca, Avenida Alfonso X El Sabio s/n, 37007 Salamanca, Spain; (N.R.); (V.S.R.); (J.M.C.); (A.d.l.F.); (A.S.R.)
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Gao X, Zhang X, Cui L, Chen R, Zhang C, Xue J, Zhang L, He W, Li J, Wei S, Wei M, Cui H. Ginsenoside Rb1 Promotes Motor Functional Recovery and Axonal Regeneration in Post-stroke Mice through cAMP/PKA/CREB Signaling Pathway. Brain Res Bull 2019; 154:51-60. [PMID: 31715311 DOI: 10.1016/j.brainresbull.2019.10.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 09/29/2019] [Accepted: 10/19/2019] [Indexed: 11/29/2022]
Abstract
The central nervous system (CNS) has a poor self-repairing capability after injury because of the inhibition of axonal regeneration by many myelin-associated inhibitory factors. Therefore, ischemic stroke usually leads to disability. Previous studies reported that Ginsenoside Rb1 (GRb1) plays a role in neuronal protection in acute phase after ischemic stroke, but its efficacy in post-stroke and the underlying mechanism are not clear. Recent evidences demonstrated GRb1 promotes neurotransmitter release through the cAMP-depend protein kinase A (PKA) pathway, which is related to axonal regeneration. The present study aimed to determine whether GRb1 improves long-term motor functional recovery and promotes cortical axon regeneration in post-stroke. Adult male C57BL/6 mice were subjected to distal middle cerebral artery occlusion (dMCAO). GRb1 solution (5 mg/ml) or equal volume of normal saline was injected intraperitoneally for the first time at 24 h after surgery, and then daily injected until day 14. Day 3, 7, 14 and 28 after dMCAO were used as observation time points. Motor functional recovery was assessed with Rota-rod test and grid walking task. The expression of growth-associated protein 43 (GAP43) and biotinylated dextran amine (BDA) was measured to evaluate axonal regeneration. The levels of cyclic AMP (cAMP) and PKA were measured by Elisa, PKAc and phosphorylated cAMP response element protein (pCREB) were determined by western blot. Our results shown that GRb1 treatment improved motor function and increased the expression of GAP43 and BDA in ipsilesional and contralateral cortex. GRb1 significantly elevated cAMP and PKA, increased the protein expression of PKAc and pCREB. However, the effects of GRb1 were eliminated by H89 intervention (a PKA inhibitor). These results suggested that GRb1 improved functional recovery in post-stroke by stimulating axonal regeneration and brain repair. The underlying mechanism might be up-regulating the expression of cAMP/PKA/CREB pathway.
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Affiliation(s)
- Xuan Gao
- Department of Neurology, Second Hospital of Hebei Medical University, 215 Hepingxi Road, Shijiazhuang, Hebei, 050000, PR China
| | - Xiangjian Zhang
- Department of Neurology, Second Hospital of Hebei Medical University, 215 Hepingxi Road, Shijiazhuang, Hebei, 050000, PR China; Hebei Key Laboratory of Vascular Homeostasis and Hebei Collaborative Innovation Center for Cardio-cerebrovascular Disease, 215 Hepingxi Road, Shijiazhuang, Hebei, 050000, PR China.
| | - Lili Cui
- Department of Neurology, Second Hospital of Hebei Medical University, 215 Hepingxi Road, Shijiazhuang, Hebei, 050000, PR China; Hebei Key Laboratory of Vascular Homeostasis and Hebei Collaborative Innovation Center for Cardio-cerebrovascular Disease, 215 Hepingxi Road, Shijiazhuang, Hebei, 050000, PR China
| | - Rong Chen
- Department of Neurology, Second Hospital of Hebei Medical University, 215 Hepingxi Road, Shijiazhuang, Hebei, 050000, PR China; Hebei Key Laboratory of Vascular Homeostasis and Hebei Collaborative Innovation Center for Cardio-cerebrovascular Disease, 215 Hepingxi Road, Shijiazhuang, Hebei, 050000, PR China
| | - Cong Zhang
- Department of Neurology, Second Hospital of Hebei Medical University, 215 Hepingxi Road, Shijiazhuang, Hebei, 050000, PR China
| | - Jing Xue
- Department of Neurology, Second Hospital of Hebei Medical University, 215 Hepingxi Road, Shijiazhuang, Hebei, 050000, PR China
| | - Lan Zhang
- Department of Neurology, Second Hospital of Hebei Medical University, 215 Hepingxi Road, Shijiazhuang, Hebei, 050000, PR China
| | - Weiliang He
- Department of Neurology, Second Hospital of Hebei Medical University, 215 Hepingxi Road, Shijiazhuang, Hebei, 050000, PR China
| | - Jiamin Li
- Department of Neurology, Second Hospital of Hebei Medical University, 215 Hepingxi Road, Shijiazhuang, Hebei, 050000, PR China
| | - Shanshan Wei
- Department of Neurology, Second Hospital of Hebei Medical University, 215 Hepingxi Road, Shijiazhuang, Hebei, 050000, PR China
| | - Mengmeng Wei
- Department of Neurology, Second Hospital of Hebei Medical University, 215 Hepingxi Road, Shijiazhuang, Hebei, 050000, PR China
| | - Hemei Cui
- Department of Neurology, Second Hospital of Hebei Medical University, 215 Hepingxi Road, Shijiazhuang, Hebei, 050000, PR China
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35
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Oby ER, Golub MD, Hennig JA, Degenhart AD, Tyler-Kabara EC, Yu BM, Chase SM, Batista AP. New neural activity patterns emerge with long-term learning. Proc Natl Acad Sci U S A 2019; 116:15210-15215. [PMID: 31182595 PMCID: PMC6660765 DOI: 10.1073/pnas.1820296116] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Learning has been associated with changes in the brain at every level of organization. However, it remains difficult to establish a causal link between specific changes in the brain and new behavioral abilities. We establish that new neural activity patterns emerge with learning. We demonstrate that these new neural activity patterns cause the new behavior. Thus, the formation of new patterns of neural population activity can underlie the learning of new skills.
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Affiliation(s)
- Emily R Oby
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213
- Center for the Neural Basis of Cognition, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, PA 15213
- University of Pittsburgh Brain Institute, Pittsburgh, PA 15213
- Systems Neuroscience Center, University of Pittsburgh, Pittsburgh, PA 15213
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
| | - Matthew D Golub
- Center for the Neural Basis of Cognition, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, PA 15213
- Department of Electrical and Computer Engineering, Carnegie Mellon University, Pittsburgh, PA 15213
- Department of Electrical Engineering, Stanford University, Stanford, CA 94305
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA 94305
| | - Jay A Hennig
- Center for the Neural Basis of Cognition, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, PA 15213
- Carnegie Mellon Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA 15213
- Machine Learning Department, Carnegie Mellon University, Pittsburgh, PA 15213
| | - Alan D Degenhart
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213
- Center for the Neural Basis of Cognition, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, PA 15213
- University of Pittsburgh Brain Institute, Pittsburgh, PA 15213
- Systems Neuroscience Center, University of Pittsburgh, Pittsburgh, PA 15213
| | - Elizabeth C Tyler-Kabara
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15213
| | - Byron M Yu
- Center for the Neural Basis of Cognition, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, PA 15213
- Department of Electrical and Computer Engineering, Carnegie Mellon University, Pittsburgh, PA 15213
- Carnegie Mellon Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA 15213
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213
| | - Steven M Chase
- Center for the Neural Basis of Cognition, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, PA 15213
- Carnegie Mellon Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA 15213
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213
| | - Aaron P Batista
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213;
- Center for the Neural Basis of Cognition, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, PA 15213
- University of Pittsburgh Brain Institute, Pittsburgh, PA 15213
- Systems Neuroscience Center, University of Pittsburgh, Pittsburgh, PA 15213
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36
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Simon-Martinez C, Jaspers E, Alaerts K, Ortibus E, Balsters J, Mailleux L, Blommaert J, Sleurs C, Klingels K, Amant F, Uyttebroeck A, Wenderoth N, Feys H. Influence of the corticospinal tract wiring pattern on sensorimotor functional connectivity and clinical correlates of upper limb function in unilateral cerebral palsy. Sci Rep 2019; 9:8230. [PMID: 31160679 PMCID: PMC6547689 DOI: 10.1038/s41598-019-44728-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 05/21/2019] [Indexed: 12/02/2022] Open
Abstract
In children with unilateral cerebral palsy (uCP), the corticospinal tract (CST)-wiring patterns may differ (contralateral, ipsilateral or bilateral), partially determining motor deficits. However, the impact of such CST-wiring on functional connectivity remains unknown. Here, we explored resting-state sensorimotor functional connectivity in 26 uCP with periventricular white matter lesions (mean age (standard deviation): 12.87 m (±4.5), CST wiring: 9 contralateral, 9 ipsilateral, 6 bilateral) compared to 60 healthy controls (mean age (standard deviation): 14.54 (±4.8)), and between CST-wiring patterns. Functional connectivity from each M1 to three bilateral sensorimotor regions of interest (primary sensory cortex, dorsal and ventral premotor cortex) and the supplementary motor area was compared between groups (controls vs. uCP; and controls vs. each CST-wiring group). Seed-to-voxel analyses from bilateral M1 were compared between groups. Additionally, relations with upper limb motor deficits were explored. Aberrant sensorimotor functional connectivity seemed to be CST-dependent rather than specific from all the uCP population: in the dominant hemisphere, the contralateral CST group showed increased connectivity between M1 and premotor cortices, whereas the bilateral CST group showed higher connectivity between M1 and somatosensory association areas. These results suggest that functional connectivity of the sensorimotor network is CST-wiring-dependent, although the impact on upper limb function remains unclear.
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Affiliation(s)
| | - Ellen Jaspers
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH, Zurich, Switzerland
| | - Kaat Alaerts
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | - Els Ortibus
- KU Leuven Department of Development and Regeneration, Leuven, Belgium
| | - Joshua Balsters
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH, Zurich, Switzerland.,Department of Psychology, Royal Holloway University of London, Egham, United Kingdom
| | - Lisa Mailleux
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | | | | | - Katrijn Klingels
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.,Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Frédéric Amant
- KU Leuven Department of Oncology, Leuven, Belgium.,Centre for Gynaecologic Oncology, Antoni van Leeuwenhoek, Amsterdam, Netherlands.,Centre for Gynaecologic Oncology, Amsterdam University Medical Centres, Amsterdam, Netherlands
| | | | - Nicole Wenderoth
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH, Zurich, Switzerland
| | - Hilde Feys
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
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37
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Nesin SM, Sabitha K, Gupta A, Laxmi T. Constraint Induced Movement Therapy as a Rehabilitative Strategy for Ischemic Stroke—Linking Neural Plasticity with Restoration of Skilled Movements. J Stroke Cerebrovasc Dis 2019; 28:1640-1653. [PMID: 30904472 DOI: 10.1016/j.jstrokecerebrovasdis.2019.02.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 02/12/2019] [Accepted: 02/23/2019] [Indexed: 11/28/2022] Open
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38
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Lotze M, Ladda AM, Stephan KM. Cerebral plasticity as the basis for upper limb recovery following brain damage. Neurosci Biobehav Rev 2019; 99:49-58. [DOI: 10.1016/j.neubiorev.2019.01.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/28/2019] [Accepted: 01/29/2019] [Indexed: 01/05/2023]
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39
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Engineer ND, Kimberley TJ, Prudente CN, Dawson J, Tarver WB, Hays SA. Targeted Vagus Nerve Stimulation for Rehabilitation After Stroke. Front Neurosci 2019; 13:280. [PMID: 30983963 PMCID: PMC6449801 DOI: 10.3389/fnins.2019.00280] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 03/08/2019] [Indexed: 01/14/2023] Open
Abstract
Stroke is a leading cause of disability worldwide, and in approximately 60% of individuals, upper limb deficits persist 6 months after stroke. These deficits adversely affect the functional use of the upper limb and restrict participation in day to day activities. An important goal of stroke rehabilitation is to improve the quality of life by enhancing functional independence and participation in activities. Since upper limb deficits are one of the best predictors of quality of life after stroke, effective interventions targeting these deficits may represent a means to improve quality of life. An increased understanding of the neurobiological processes underlying stroke recovery has led to the development of targeted approaches to improve motor deficits. One such targeted strategy uses brief bursts of Vagus Nerve Stimulation (VNS) paired with rehabilitation to enhance plasticity and support recovery of upper limb function after chronic stroke. Stimulation of the vagus nerve triggers release of plasticity promoting neuromodulators, such as acetylcholine and norepinephrine, throughout the cortex. Timed engagement of neuromodulators concurrent with motor training drives task-specific plasticity in the motor cortex to improve function and provides the basis for paired VNS therapy. A number of studies in preclinical models of ischemic stroke demonstrated that VNS paired with rehabilitative training significantly improved the recovery of forelimb motor function compared to rehabilitative training without VNS. The improvements were associated with synaptic reorganization of cortical motor networks and recruitment of residual motor neurons controlling the impaired forelimb, demonstrating the putative neurobiological mechanisms underlying recovery of motor function. These preclinical studies provided the basis for conducting two multi-site, randomized controlled pilot trials in individuals with moderate to severe upper limb weakness after chronic ischemic stroke. In both studies, VNS paired with rehabilitation improved motor deficits compared to rehabilitation alone. The trials provided support for a 120-patient pivotal study designed to evaluate the efficacy of paired VNS therapy in individuals with chronic ischemic stroke. This manuscript will discuss the neurobiological rationale for VNS therapy, provide an in-depth discussion of both animal and human studies of VNS therapy for stroke, and outline the challenges and opportunities for the future use of VNS therapy.
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Affiliation(s)
| | - Teresa J. Kimberley
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, United States
| | | | - Jesse Dawson
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, Queen Elizabeth University Hospital, University of Glasgow, Glasgow, United Kingdom
| | | | - Seth A. Hays
- Texas Biomedical Device Center, The University of Texas at Dallas, Richardson, TX, United States
- Department of Bioengineering, The University of Texas at Dallas, Richardson, TX, United States
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40
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Delayed treatment of α5 GABAA receptor inverse agonist improves functional recovery by enhancing neurogenesis after cerebral ischemia-reperfusion injury in rat MCAO model. Sci Rep 2019; 9:2287. [PMID: 30783142 PMCID: PMC6381084 DOI: 10.1038/s41598-019-38750-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 12/18/2018] [Indexed: 11/08/2022] Open
Abstract
Development of effective therapeutics and treatment strategy to promote recovery after cerebral ischemia-reperfusion injury necessitates further understandings of the complex pathophysiology of ischemic stroke. Given that α5-GABAAR inhibition has been shown to be involved in functional recovery after stroke, the present study was designed to evaluate the effects of treatment timing of α5 GABAAR inhibition on post-middle cerebral artery occlusion (MCAO) functional recovery. To this end, we examined the effects of L655,708 (α5 GABAAR inverse agonist) treatment at 3 or 7 days post-ischemia on apoptosis and neurogenesis in the peri-infarct region, brain infarction size, as well as modified neurological severity score (mNSS) and rotarod test time in rats. Consistent with previous reports, we found that when the treatment of L655,708 was initiated at post-MCAO day 3, it did not alter the functional recovery in rats. However, when the treatment of L655,708 was initiated at post-MCAO day 7, it demonstrated beneficial effects on functional recovery in rats. Interestingly, this phenomenon was not associated with altered brain infarction size nor with changes in brain cell apoptosis. However, we found that delayed treatment of L655,708 at post-MCAO day 7 significantly increased neurogenesis in peri-infarct zone in rats. These results suggested that removing α5 GABAAR-mediated tonic inhibition after cerebral ischemia-reperfusion injury may be an effective therapeutic strategy for promoting functional recovery from stroke.
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41
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Lie ME, Gowing EK, Johansen NB, Dalby NO, Thiesen L, Wellendorph P, Clarkson AN. GAT3 selective substrate l-isoserine upregulates GAT3 expression and increases functional recovery after a focal ischemic stroke in mice. J Cereb Blood Flow Metab 2019; 39:74-88. [PMID: 29160736 PMCID: PMC6311676 DOI: 10.1177/0271678x17744123] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Ischemic stroke triggers an elevation in tonic GABA inhibition that impairs the ability of the brain to form new structural and functional cortical circuits required for recovery. This stroke-induced increase in tonic inhibition is caused by impaired GABA uptake via the glial GABA transporter GAT3, highlighting GAT3 as a novel target in stroke recovery. Using a photothrombotic stroke mouse model, we show that GAT3 protein levels are decreased in peri-infarct tissue from 6 h to 42 days post-stroke. Prior studies have shown that GAT substrates can increase GAT surface expression. Therefore, we aimed to assess whether the GAT3 substrate, L-isoserine, could increase post-stroke functional recovery. L-Isoserine (38 µM or 380 µM) administered directly into the infarct from day 5 to 32 post-stroke, significantly increased motor performance in the grid-walking and cylinder tasks in a concentration-dependent manner, without affecting infarct volumes. Additionally, L-isoserine induced a lasting increase in GAT3 expression in peri-infarct regions accompanied by a small decrease in GFAP expression. This study is the first to show that a GAT3 substrate can increase GAT3 expression and functional recovery after focal ischemic stroke following a delayed long-term treatment. We propose that enhancing GAT3-mediated uptake dampens tonic inhibition and promotes functional recovery after stroke.
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Affiliation(s)
- Maria Ek Lie
- 1 Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.,2 Department of Anatomy, Brain Health Research Centre and Brain Research New Zealand, University of Otago, Dunedin, New Zealand
| | - Emma K Gowing
- 2 Department of Anatomy, Brain Health Research Centre and Brain Research New Zealand, University of Otago, Dunedin, New Zealand
| | - Nina B Johansen
- 1 Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Nils Ole Dalby
- 1 Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Louise Thiesen
- 1 Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Petrine Wellendorph
- 1 Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Andrew N Clarkson
- 2 Department of Anatomy, Brain Health Research Centre and Brain Research New Zealand, University of Otago, Dunedin, New Zealand.,3 Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
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42
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Shan Y, Wang YS, Zhang M, Rong DD, Zhao ZL, Cao YX, Wang PP, Deng ZZ, Ma QF, Li KC, Zuo XN, Lu J. Homotopic Connectivity in Early Pontine Infarction Predicts Late Motor Recovery. Front Neurol 2018; 9:907. [PMID: 30429821 PMCID: PMC6220368 DOI: 10.3389/fneur.2018.00907] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 10/08/2018] [Indexed: 11/13/2022] Open
Abstract
Connectivity-based methods are essential to explore brain reorganization after a stroke and to provide meaningful predictors for late motor recovery. We aim to investigate the homotopic connectivity alterations during a 180-day follow-up of patients with pontine infarction to find an early biomarker for late motor recovery prediction. In our study, resting-state functional MRI was performed in 15 patients (11 males, 4 females, age: 57.87 ± 6.50) with unilateral pontine infarction and impaired motor function during a period of 6 months (7, 14, 30, 90, and 180 days after stroke onset). Clinical neurological assessments were performed using the Fugl–Meyer scale (FM).15 matched healthy volunteers were also recruited. Whole-brain functional homotopy in each individual scan was measured by voxel-mirrored homotopic connectivity (VMHC) values. Group-level analysis was performed between stroke patients and normal controls. A Pearson correlation was performed to evaluate correlations between early VMHC and the subsequent 4 visits for behavioral measures during day 14 to day 180. We found in early stroke (within 7 days after onset), decreased VMHC was detected in the bilateral precentral and postcentral gyrus and precuneus/posterior cingulate cortex (PCC), while increased VMHC was found in the hippocampus/amygdala and frontal pole (P < 0.01). During follow-up, VMHC in the precentral and postcentral gyrus increased to the normal level from day 90, while VMHC in the precuneus/PCC presented decreased intensity during all time points (P < 0.05). The hippocampus/amygdala and frontal pole presented a higher level of VMHC during all time points (P < 0.05). Negative correlation was found between early VMHC in the hippocampus/amygdala with FM on day 14 (r = −0.59, p = 0.021), day 30 (r = −0.643, p = 0.01), day 90 (r = −0.693, p = 0.004), and day 180 (r = −0.668, p = 0.007). Furthermore, early VMHC in the frontal pole was negatively correlated with FM scores on day 30 (r = −0.662, p = 0.013), day 90 (r = −0.606, p = 0.017), and day 180 (r = −0.552, p = 0.033). Our study demonstrated the potential utility of early homotopic connectivity for prediction of late motor recovery in pontine infarction.
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Affiliation(s)
- Yi Shan
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Yin-Shan Wang
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.,Key Laboratory of Behavioral Science, Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Miao Zhang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Dong-Dong Rong
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Zhi-Lian Zhao
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Yan-Xiang Cao
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Pei-Pei Wang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Zheng-Zheng Deng
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.,Key Laboratory of Behavioral Science, Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Qing-Feng Ma
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Kun-Cheng Li
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Xi-Nian Zuo
- Key Laboratory of Behavioral Science, Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jie Lu
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China.,Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
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Aberrances of Cortex Excitability and Connectivity Underlying Motor Deficit in Acute Stroke. Neural Plast 2018; 2018:1318093. [PMID: 30420876 PMCID: PMC6215555 DOI: 10.1155/2018/1318093] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 06/19/2018] [Indexed: 12/23/2022] Open
Abstract
Purpose This study was aimed at evaluating the motor cortical excitability and connectivity underlying the neural mechanism of motor deficit in acute stroke by the combination of functional magnetic resonance imaging (fMRI) and electrophysiological measures. Methods Twenty-five patients with motor deficit after acute ischemic stroke were involved. General linear model and dynamic causal model analyses were applied to fMRI data for detecting motor-related activation and effective connectivity of the motor cortices. Motor cortical excitability was determined as a resting motor threshold (RMT) of motor evoked potential detected by transcranial magnetic stimulation (TMS). fMRI results were correlated with cortical excitability and upper extremity Fugl-Meyer assessment scores, respectively. Results Greater fMRI activation likelihood and motor cortical excitability in the ipsilesional primary motor area (M1) region were associated with better motor performance. During hand movements, the inhibitory connectivity from the contralesional to the ipsilesional M1 was correlated with the degree of motor impairment. Furthermore, ipsilesional motor cortex excitability was correlated with an enhancement of promoting connectivity in ipsilesional M1 or a reduction of interhemispheric inhibition in contralesional M1. Conclusions The study suggested that a dysfunction of the ipsilesional M1 and abnormal interhemispheric interactions might underlie the motor disability in acute ischemic stroke. Modifying the excitability of the motor cortex and correcting the abnormal motor network connectivity associated with the motor deficit might be the therapeutic target in early neurorehabilitation for stroke patients.
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Zhao C, Könönen M, Vanninen R, Pitkänen K, Hiekkala S, Jolkkonen J. Translating experimental evidence to finding novel ways to promote motor recovery in stroke patients – a review. Restor Neurol Neurosci 2018; 36:519-533. [PMID: 29889087 DOI: 10.3233/rnn-180814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
| | | | | | - Kauko Pitkänen
- Brain Research and Rehabilitation Center Neuron, Kuopio, Finland
| | - Sinikka Hiekkala
- Finnish Association of People with Physical Disabilities, Helsinki, Finland
| | - Jukka Jolkkonen
- Institute of Clinical Medicine – Neurology, University of Eastern Finland, Kuopio, Finland
- NeuroCenter, Kuopio University Hospital, Kuopio, Finland
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Action Observation Treatment Improves Upper Limb Motor Functions in Children with Cerebral Palsy: A Combined Clinical and Brain Imaging Study. Neural Plast 2018; 2018:4843985. [PMID: 30123250 PMCID: PMC6079352 DOI: 10.1155/2018/4843985] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 03/27/2018] [Accepted: 04/26/2018] [Indexed: 01/26/2023] Open
Abstract
The aim of the present study was to assess the role of action observation treatment (AOT) in the rehabilitation of upper limb motor functions in children with cerebral palsy. We carried out a two-group, parallel randomized controlled trial. Eighteen children (aged 5–11 yr) entered the study: 11 were treated children, and 7 served as controls. Outcome measures were scores on two functional scales: Melbourne Assessment of Unilateral Upper Limb Function Scale (MUUL) and the Assisting Hand Assessment (AHA). We collected functional scores before treatment (T1), at the end of treatment (T2), and at two months of follow-up (T3). As compared to controls, treated children improved significantly in both scales at T2 and this improvement persisted at T3. AOT has therefore the potential to become a routine rehabilitation practice in children with CP. Twelve out of 18 enrolled children also underwent a functional magnetic resonance study at T1 and T2. As compared to controls, at T2, treated children showed stronger activation in a parieto-premotor circuit for hand-object interactions. These findings support the notion that AOT contributes to reorganize brain circuits subserving the impaired function rather than activating supplementary or vicariating ones.
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46
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Bu L, Huo C, Xu G, Liu Y, Li Z, Fan Y, Li J. Alteration in Brain Functional and Effective Connectivity in Subjects With Hypertension. Front Physiol 2018; 9:669. [PMID: 29904355 PMCID: PMC5990593 DOI: 10.3389/fphys.2018.00669] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 05/14/2018] [Indexed: 12/20/2022] Open
Abstract
To reveal the physiological mechanism of the cognitive decline in subjects with hypertension, the functional connectivity (FC) was assessed by using the wavelet phase coherence (WPCO), and effective connectivity (EC) was assessed by using the coupling strength (CS) of near-infrared spectroscopy (NIRS) signals. NIRS signals were continuously recorded from the prefrontal cortex, sensorimotor cortex, and occipital lobes of 13 hypertensive patients (hypertension group, 70 ± 6.5 years old) and 16 elderly healthy subjects (control group, 71 ± 5.5 years old) in resting and standing periods. WPCO and CS were calculated in four frequency intervals: I, 0.6–2; II, 0.145–0.6; III, 0.052–0.145; and IV, 0.021–0.052 Hz. CS quantifies coupling amplitude. In comparison with the control group, the hypertension group showed significantly decreased (p < 0.05) WPCO and CS in intervals III and IV and in the resting and standing states. WPCO and CS were significantly decreased in the resting state compared with those in the standing state in the hypertension group (p < 0.05). Decreased WPCO and CS indicated a reduced network interaction, suggesting disturbed neurovascular coupling in subjects with hypertension. Compared with the control group, the hypertension group showed significantly lower Mini-Mental State Examination (MMSE) (p = 0.028) and Montreal Cognitive Assessment (MoCA) scores (p = 0.011). In the hypertension group, correlation analysis showed that WPCO and CS were significantly positively correlated with MMSE and MoCA scores, respectively. These findings may provide evidence of impaired cognitive function in hypertension and can enhance the understanding on neurovascular coupling.
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Affiliation(s)
- Lingguo Bu
- Key Laboratory of High Efficiency and Clean Mechanical Manufacture, School of Mechanical Engineering, Shandong University, Jinan, China
| | - Congcong Huo
- Key Laboratory of High Efficiency and Clean Mechanical Manufacture, School of Mechanical Engineering, Shandong University, Jinan, China
| | - Gongcheng Xu
- Key Laboratory of High Efficiency and Clean Mechanical Manufacture, School of Mechanical Engineering, Shandong University, Jinan, China
| | - Ying Liu
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - Zengyong Li
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China.,Key Laboratory of Rehabilitation Aids Technology and System of the Ministry of Civil Affairs, Beijing, China
| | - Yubo Fan
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China.,Key Laboratory of Rehabilitation Aids Technology and System of the Ministry of Civil Affairs, Beijing, China
| | - Jianfeng Li
- Key Laboratory of High Efficiency and Clean Mechanical Manufacture, School of Mechanical Engineering, Shandong University, Jinan, China
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Laterality of Poststroke Cortical Motor Activity during Action Observation Is Related to Hemispheric Dominance. Neural Plast 2018; 2018:3524960. [PMID: 29997648 PMCID: PMC5994588 DOI: 10.1155/2018/3524960] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 04/05/2018] [Accepted: 04/19/2018] [Indexed: 11/26/2022] Open
Abstract
Background Increased activity in the lesioned hemisphere has been related to improved poststroke motor recovery. However, the role of the dominant hemisphere—and its relationship to activity in the lesioned hemisphere—has not been widely explored. Objective Here, we examined whether the dominant hemisphere drives the lateralization of brain activity after stroke and whether this changes based on if the lesioned hemisphere is the dominant hemisphere or not. Methods We used fMRI to compare cortical motor activity in the action observation network (AON), motor-related regions that are active both during the observation and execution of an action, in 36 left hemisphere dominant individuals. Twelve individuals had nondominant, right hemisphere stroke, twelve had dominant, left-hemisphere stroke, and twelve were healthy age-matched controls. We previously found that individuals with left dominant stroke show greater ipsilesional activity during action observation. Here, we examined if individuals with nondominant, right hemisphere stroke also showed greater lateralized activity in the ipsilesional, right hemisphere or in the dominant, left hemisphere and compared these results with those of individuals with dominant, left hemisphere stroke. Results We found that individuals with right hemisphere stroke showed greater activity in the dominant, left hemisphere, rather than the ipsilesional, right hemisphere. This left-lateralized pattern matched that of individuals with left, dominant hemisphere stroke, and both stroke groups differed from the age-matched control group. Conclusions These findings suggest that action observation is lateralized to the dominant, rather than ipsilesional, hemisphere, which may reflect an interaction between the lesioned hemisphere and the dominant hemisphere in driving lateralization of brain activity after stroke. Hemispheric dominance and laterality should be carefully considered when characterizing poststroke neural activity.
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48
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Abe H, Jitsuki S, Nakajima W, Murata Y, Jitsuki-Takahashi A, Katsuno Y, Tada H, Sano A, Suyama K, Mochizuki N, Komori T, Masuyama H, Okuda T, Goshima Y, Higo N, Takahashi T. CRMP2-binding compound, edonerpic maleate, accelerates motor function recovery from brain damage. Science 2018; 360:50-57. [DOI: 10.1126/science.aao2300] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 02/01/2018] [Indexed: 12/25/2022]
Abstract
Brain damage such as stroke is a devastating neurological condition that may severely compromise patient quality of life. No effective medication-mediated intervention to accelerate rehabilitation has been established. We found that a small compound, edonerpic maleate, facilitated experience-driven synaptic glutamate AMPA (α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic-acid) receptor delivery and resulted in the acceleration of motor function recovery after motor cortex cryoinjury in mice in a training-dependent manner through cortical reorganization. Edonerpic bound to collapsin-response-mediator-protein 2 (CRMP2) and failed to augment recovery in CRMP2-deficient mice. Edonerpic maleate enhanced motor function recovery from internal capsule hemorrhage in nonhuman primates. Thus, edonerpic maleate, a neural plasticity enhancer, could be a clinically potent small compound with which to accelerate rehabilitation after brain damage.
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49
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Modulation of Post-Stroke Plasticity and Regeneration by Stem Cell Therapy and Exogenic Factors. CELLULAR AND MOLECULAR APPROACHES TO REGENERATION AND REPAIR 2018. [DOI: 10.1007/978-3-319-66679-2_7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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50
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Baron JC. Mapping neuronal density in peri-infarct cortex with PET. Hum Brain Mapp 2017; 38:5822-5824. [PMID: 28731596 DOI: 10.1002/hbm.23733] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 07/05/2017] [Accepted: 07/10/2017] [Indexed: 11/11/2022] Open
Affiliation(s)
- Jean-Claude Baron
- Department of Neurology, Hopital Sainte-Anne, Inserm U894, Paris Descartes University, France.,Department of Clinical Neurosciences, Stroke Research Group, University of Cambridge, United Kingdom
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