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Kumar DS, Bodt BA, Galloway JC. Real-world environmental enrichment rehabilitation paradigm in people with severe traumatic brain injury: a pilot feasibility study. Brain Inj 2024; 38:742-749. [PMID: 38695288 DOI: 10.1080/02699052.2024.2347551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 04/22/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND The use of Environmental Enrichment (EE) has been widely studied in animal models. However, the application of the same in humans is limited to rehabilitation settings. OBJECTIVE To investigate the feasibility of a community-based EE paradigm in adults with brain injury. METHODS Six individuals diagnosed with traumatic brain injury enrolled in the study. The Go Baby Go Café instrumented with a body weight harness system, provided physical and social enrichment as participants performed functional tasks for 2 hours, three times a week, for 2 months. Feasibility and safety outcomes were recorded throughout sessions. Clinical measures including 10-meter walk, timed up and go, jebsen hand function, 6-minute walk, and trail making tests were obtained pre and post intervention. RESULTS All participants completed the study. The attendance was 100% and adherence was 87%. Positive changes in clinical measures were statistically significant for the timed up and go (p = 0.0175), TUG-cognitive (p = 0.0064), 10-meter walk (p = 0.0428), six-minute walk (p = 0.0196), TMT-A (p = 0.034). Changes in JHFT were not significant (p = 0.0506), with one subject recording values counter to the trend. CONCLUSION The Café was a comprehensive EE-based intervention that was feasible, safe, and has the potential to enhance motor and cognitive function in individuals with brain injury.
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Affiliation(s)
- Devina S Kumar
- Burke Neurological Institute, White Plains, New York, USA
| | | | - James C Galloway
- University of Delaware, Newark, Delaware, USA
- Baylor University, Waco, Texas, USA
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Koloski MF, O'Hearn CM, Frankot M, Giesler LP, Ramanathan DS, Vonder Haar C. Behavioral Interventions Can Improve Brain Injury-Induced Deficits in Behavioral Flexibility and Impulsivity Linked to Impaired Reward-Feedback Beta Oscillations. J Neurotrauma 2024; 41:e1721-e1737. [PMID: 38450560 PMCID: PMC11339556 DOI: 10.1089/neu.2023.0448] [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] [Indexed: 03/08/2024] Open
Abstract
Traumatic brain injury (TBI) affects a large population, resulting in severe cognitive impairments. Although cognitive rehabilitation is an accepted treatment for some deficits, studies in patients are limited in ability to probe physiological and behavioral mechanisms. Therefore, animal models are needed to optimize strategies. Frontal TBI in a rat model results in robust and replicable cognitive deficits, making this an ideal candidate for investigating various behavioral interventions. In this study, we report three distinct frontal TBI experiments assessing behavior well into the chronic post-injury period using male Long-Evans rats. First, we evaluated the impact of frontal injury on local field potentials recorded simultaneously from 12 brain regions during a probabilistic reversal learning (PbR) task. Next, a set of rats were tested on a similar PbR task or an impulsivity task (differential reinforcement of low-rate behavior [DRL]) and half received salient cues associated with reinforcement contingencies to encourage engagement in the target behavior. After intervention on the PbR task, brains were stained for markers of activity. On the DRL task, cue relevance was decoupled from outcomes to determine if beneficial effects persisted on impulsive behavior. TBI decreased the ability to detect reinforced outcomes; this was evident in task performance and reward-feedback signals occurring at beta frequencies in lateral orbitofrontal cortex (OFC) and associated frontostriatal regions. The behavioral intervention improved flexibility and increased OFC activity. Intervention also reduced impulsivity, even after cues were decoupled, which was partially mediated by improvements in timing behavior. The current study established a platform to begin investigating cognitive rehabilitation in rats and identified a strong role for dysfunctional OFC signaling in probabilistic learning after frontal TBI.
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Affiliation(s)
- Miranda F. Koloski
- Mental Health, VA San Diego Medical Center, San Diego, California, USA
- Center of Excellence for Stress and Mental Health, San Diego, California, USA
- Department of Psychiatry, University of California-San Diego, San Diego, California, USA
| | | | - Michelle Frankot
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
- Injury and Recovery Laboratory, Department of Neuroscience, Ohio State University, Columbus, Ohio, USA
| | - Lauren P. Giesler
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Dhakshin S. Ramanathan
- Mental Health, VA San Diego Medical Center, San Diego, California, USA
- Center of Excellence for Stress and Mental Health, San Diego, California, USA
- Department of Psychiatry, University of California-San Diego, San Diego, California, USA
| | - Cole Vonder Haar
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
- Injury and Recovery Laboratory, Department of Neuroscience, Ohio State University, Columbus, Ohio, USA
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Enriched Environment Attenuates Ferroptosis after Cerebral Ischemia/Reperfusion Injury via the HIF-1 α-ACSL4 Pathway. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2023; 2023:5157417. [PMID: 36819784 PMCID: PMC9931469 DOI: 10.1155/2023/5157417] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/02/2022] [Accepted: 11/25/2022] [Indexed: 02/10/2023]
Abstract
Enriched environment (EE) has been proven to be an effective intervention strategy which can improve neurofunctional recovery following cerebral ischemia/reperfusion (I/R) injury. However, it still needs further investigation for the underlying mechanisms. Recently, it has been shown that ferroptosis played an essential role in the pathophysiological development of ischemic stroke (IS). This study is aimed at investigating whether EE plays a neuroprotective role by attenuating ferroptosis after cerebral I/R injury. We used middle cerebral artery occlusion/reperfusion (MCAO/R) to build a model of cerebral I/R injury. To evaluate the effect of EE on neurological recovery, we used the modified neurological severity score (mNSS) and the Morris water maze (MWM). We used the western blot to detect the protein levels of glutathione peroxidase 4 (GPX4), hypoxia-inducible factor-1α (HIF-1α), and acyl-CoA synthetase long-chain family member 4 (ACSL4). We used the quantitative real-time PCR (qRT-PCR) to measure the mRNA levels of ACSL4 and inflammatory cytokines including tumor necrosis factor alpha (TNFα), interleukin-6 (IL-6), and interleukin 1 beta (IL-1β). The occurrence of ferroptosis was detected by TdT-mediated dUTP nick-end labeling (TUNEL) assay, diaminobenzidine- (DAB-) enhanced Perls' staining, iron level assays, and malondialdehyde (MDA) level assays. The results verified that EE enhanced functional recovery and attenuated ferroptosis and neuroinflammation after cerebral I/R injury. EE increased the expression of HIF-1α while inhibited the expression of ACSL4. Our research indicated that EE improved functional recovery after cerebral I/R injury through attenuating ferroptosis, and this might be related to its regulation of the neuroinflammation and HIF-1α-ACSL4 pathway.
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Sihvonen AJ, Soinila S, Särkämö T. Post-stroke enriched auditory environment induces structural connectome plasticity: secondary analysis from a randomized controlled trial. Brain Imaging Behav 2022; 16:1813-1822. [PMID: 35352235 PMCID: PMC9279272 DOI: 10.1007/s11682-022-00661-6] [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] [Accepted: 03/08/2022] [Indexed: 11/30/2022]
Abstract
Post-stroke neuroplasticity and cognitive recovery can be enhanced by multimodal stimulation via environmental enrichment. In this vein, recent studies have shown that enriched sound environment (i.e., listening to music) during the subacute post-stroke stage improves cognitive outcomes compared to standard care. The beneficial effects of post-stroke music listening are further pronounced when listening to music containing singing, which enhances language recovery coupled with structural and functional connectivity changes within the language network. However, outside the language network, virtually nothing is known about the effects of enriched sound environment on the structural connectome of the recovering post-stroke brain. Here, we report secondary outcomes from a single-blind randomized controlled trial (NCT01749709) in patients with ischaemic or haemorrhagic stroke (N = 38) who were randomly assigned to listen to vocal music, instrumental music, or audiobooks during the first 3 post-stroke months. Utilizing the longitudinal diffusion-weighted MRI data of the trial, the present study aimed to determine whether the music listening interventions induce changes on structural white matter connectome compared to the control audiobook intervention. Both vocal and instrumental music groups increased quantitative anisotropy longitudinally in multiple left dorsal and ventral tracts as well as in the corpus callosum, and also in the right hemisphere compared to the audiobook group. Audiobook group did not show increased structural connectivity changes compared to both vocal and instrumental music groups. This study shows that listening to music, either vocal or instrumental promotes wide-spread structural connectivity changes in the post-stroke brain, providing a fertile ground for functional restoration.
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Affiliation(s)
- Aleksi J Sihvonen
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Turku, Finland. .,School of Health and Rehabilitation Sciences, Queensland Aphasia Research Centre and UQ Centre for Clinical Research, The University of Queensland, Brisbane, Australia.
| | - Seppo Soinila
- Neurocenter, Turku University Hospital and Division of Clinical Neurosciences, University of Turku, Turku, Finland
| | - Teppo Särkämö
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Turku, Finland
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5
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Intracellular Signaling. Stroke 2022. [DOI: 10.1016/b978-0-323-69424-7.00006-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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DeBoer SR, Hubbard R, Mersha M, Pinilla Monsalve G, Winter S, Zeiler SR. Enhanced Spontaneous Motor Recovery After Stroke in Mice Treated With Cerebrolysin. Neurorehabil Neural Repair 2021; 35:525-533. [PMID: 33955296 DOI: 10.1177/15459683211000734] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Motor recovery after stroke in humans and in rodent models is time sensitive. Recovery in patients is a result of biological spontaneous recovery via endogenous repair mechanisms and is likely improved by enhancing the synaptic plasticity required for endogenous repair. Cerebrolysin is a polypeptide preparation known to enhance neuroplasticity and may improve recovery in patients. In mice, we tested the hypothesis that Cerebrolysin can act poststroke to enhance both spontaneous and training-associated motor recovery. METHODS Mice were trained to perform a skilled prehension task. We then induced a photothrombotic stroke in the caudal forelimb area, after which we retrained animals on the prehension task in the presence or absence of Cerebrolysin after a 2-day or 8-day delay. Mice received daily intraperitoneal Cerebrolysin or saline injections starting poststroke day 1 or poststroke day 7. RESULTS Prior studies showed that poststroke recovery of prehension can occur if animals receive rehabilitative training during an early sensitive period but is incomplete if rehabilitative training is delayed. In contrast, we show complete recovery of prehension, despite a delay in rehabilitative training, when mice receive daily Cerebrolysin administration starting on poststroke day 1 or on poststroke day 8. When Cerebrolysin is given on poststroke day 1, recovery occurred even in the absence of training. Stroke volumes were similar across groups. CONCLUSIONS Poststroke Cerebrolysin administration leads to recovery of motor function independent of rehabilitative training without a protective effect on stroke volume. This is one of the first demonstrations of training-independent motor recovery in rodent stroke models.
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Affiliation(s)
| | | | | | | | - Stefan Winter
- Ever Neuro Pharma GmbH, Unterach, Oberösterreich, Austria
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Deng YH, Dong LL, Zhang YJ, Zhao XM, He HY. Enriched environment boosts the post-stroke recovery of neurological function by promoting autophagy. Neural Regen Res 2021; 16:813-819. [PMID: 33229714 PMCID: PMC8178758 DOI: 10.4103/1673-5374.297084] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/20/2020] [Accepted: 06/06/2020] [Indexed: 12/22/2022] Open
Abstract
Autophagy is crucial for maintaining cellular homeostasis, and can be activated after ischemic stroke. It also participates in nerve injury and repair. The purpose of this study was to investigate whether an enriched environment has neuroprotective effects through affecting autophagy. A Sprague-Dawley rat model of transient ischemic stroke was prepared by occlusion of the middle cerebral artery followed by reperfusion. One week after surgery, these rats were raised in either a standard environment or an enriched environment for 4 successive weeks. The enriched environment increased Beclin-1 expression and the LC3-II/LC3-I ratio in the autophagy/lysosomal pathway in the penumbra of middle cerebral artery-occluded rats. Enriched environment-induced elevations in autophagic activity were mainly observed in neurons. Enriched environment treatment also promoted the fusion of autophagosomes with lysosomes, enhanced the lysosomal activities of lysosomal-associated membrane protein 1, cathepsin B, and cathepsin D, and reduced the expression of ubiquitin and p62. After 4 weeks of enriched environment treatment, neurological deficits and neuronal death caused by middle cerebral artery occlusion/reperfusion were significantly alleviated, and infarct volume was significantly reduced. These findings suggest that neuronal autophagy is likely the neuroprotective mechanism by which an enriched environment promotes recovery from ischemic stroke. This study was approved by the Animal Ethics Committee of the Kunming University of Science and Technology, China (approval No. 5301002013855) on March 1, 2019.
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Affiliation(s)
- Yi-Hao Deng
- Department of Basic Medicine, Medical School, Kunming University of Science and Technology, Kunming, Yunnan Province, China
| | - Ling-Ling Dong
- Department of Basic Medicine, Medical School, Kunming University of Science and Technology, Kunming, Yunnan Province, China
| | - Yong-Jie Zhang
- Department of Basic Medicine, Medical School, Kunming University of Science and Technology, Kunming, Yunnan Province, China
| | - Xiao-Ming Zhao
- Department of Basic Medicine, Medical School, Kunming University of Science and Technology, Kunming, Yunnan Province, China
| | - Hong-Yun He
- Department of Basic Medicine, Medical School, Kunming University of Science and Technology, Kunming, Yunnan Province, China
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Zeiler SR. Should We Care About Early Post-Stroke Rehabilitation? Not Yet, but Soon. Curr Neurol Neurosci Rep 2019; 19:13. [DOI: 10.1007/s11910-019-0927-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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9
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Kondo T, Yoshida S, Nagai H, Takeshita A, Mino M, Morioka H, Nakajima T, Kusakabe KT, Okada T. Transient forebrain ischemia induces impairment in cognitive performance prior to extensive neuronal cell death in Mongolian gerbil ( Meriones unguiculatus). J Vet Sci 2018; 19:505-511. [PMID: 29695143 PMCID: PMC6070588 DOI: 10.4142/jvs.2018.19.4.505] [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: 01/02/2018] [Revised: 03/15/2018] [Accepted: 04/23/2018] [Indexed: 11/20/2022] Open
Abstract
In Mongolian gerbils, bilateral common carotid artery occlusion (BCCAO) for several minutes induces ischemia, due to an incomplete circle of Willis, resulting in delayed neuronal cell death in the Cornet d'Ammon 1 (CA1) region of the hippocampus. Neuronal cell death in the hippocampus and changes in behavior were examined after BCCAO was performed for 5 min in the gerbils. One day after BCCAO, the pyramidal neurons of the CA1 region of the hippocampus showed degenerative changes (clumped chromatin in nuclei). At 5 and 10 days after BCCAO, extensive neuronal cell death was observed in the hippocampal CA1 region. Cognitive performance was evaluated by using the radial maze and passive avoidance tests. In the radial maze test, which examines win-stay performance, the number of errors was significantly higher in ischemic gerbils than in sham-operated gerbils on days 1 and 2 post-operation. In the passive avoidance test, the latency and freezing times were significantly shorter in ischemic gerbils than in sham-operated gerbils on the days 1, 2, and 4-6 post-operation. These results indicate that transient forebrain ischemia impairs cognitive performance, even immediately after the ischemic insult when there are only subtle signs of neuronal cell death.
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Affiliation(s)
- Tomohiro Kondo
- Department of Laboratory Animal Science, Division of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka 598-8531, Japan
| | - Suguru Yoshida
- Department of Laboratory Animal Science, Division of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka 598-8531, Japan
| | - Hiroaki Nagai
- Department of Laboratory Animal Science, Division of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka 598-8531, Japan
| | - Ai Takeshita
- Department of Laboratory Animal Science, Division of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka 598-8531, Japan
| | - Masaki Mino
- Department of Laboratory Animal Science, Division of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka 598-8531, Japan
| | - Hiroshi Morioka
- Department of Laboratory Animal Science, Division of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka 598-8531, Japan
| | - Takayuki Nakajima
- Department of Veterinary Anatomy, Division of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka 598-8531, Japan
| | - Ken Takeshi Kusakabe
- Department of Veterinary Anatomy, Faculty of Common Veterinary Medicine, University of Yamaguchi, Yamaguchi 753-8515, Japan
| | - Toshiya Okada
- Department of Laboratory Animal Science, Division of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka 598-8531, Japan
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Cheng L, Cortese D, Monti MM, Wang F, Riganello F, Arcuri F, Di H, Schnakers C. Do Sensory Stimulation Programs Have an Impact on Consciousness Recovery? Front Neurol 2018; 9:826. [PMID: 30333789 PMCID: PMC6176776 DOI: 10.3389/fneur.2018.00826] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 09/13/2018] [Indexed: 11/13/2022] Open
Abstract
Objectives: Considering sensory stimulation programs (SSP) as a treatment for disorders of consciousness is still debated today. Previous studies investigating its efficacy were affected by various biases among which small sample size and spontaneous recovery. In this study, treatment-related changes were assessed using time-series design in patients with disorders of consciousness (i.e., vegetative state-VS and minimally conscious state-MCS). Methods: A withdrawal design (ABAB) was used. During B phases, patients underwent a SSP (3 days a week, including auditory, visual, tactile, olfactory, and gustatory stimulation). The program was not applied during A phases. To assess behavioral changes, the Coma Recovery Scale-Revised (CRS-R) was administered by an independent rater on a weekly basis, across all phases. Each phase lasted 4 weeks. In a subset of patients, resting state functional magnetic resonance imaging (fMRI) data were collected at the end of each phase. Results: Twenty nine patients (48 ± 19 years old; 15 traumatic; 21 > a year post-injury; 11 VS and 18 MCS) were included in our study. Higher CRS-R total scores (medium effect size) as well as higher arousal and oromotor subscores were observed in the B phases (treatment) as compared to A phases (no treatment), in the MCS group but not in the VS group. In the three patients who underwent fMRI analyses, a modulation of metabolic activity related to treatment was observed in middle frontal gyrus, superior temporal gyrus as well as ventro-anterior thalamic nucleus. Conclusion: Our results suggest that SSP may not be sufficient to restore consciousness. SSP might nevertheless lead to improved behavioral responsiveness in MCS patients. Our results show higher CRS-R total scores when treatment is applied, and more exactly, increased arousal and oromotor functions.
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Affiliation(s)
- Lijuan Cheng
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Daniela Cortese
- Research in Advanced Neurorehabilitation, S. Anna Institute, Crotone, Italy
| | - Martin M. Monti
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Fuyan Wang
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | | | - Francesco Arcuri
- Research in Advanced Neurorehabilitation, S. Anna Institute, Crotone, Italy
| | - Haibo Di
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Caroline Schnakers
- Research Institute, Casa Colina Hospital and Centers for Healthcare, Pomona, CA, United States
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McDonald MW, Hayward KS, Rosbergen ICM, Jeffers MS, Corbett D. Is Environmental Enrichment Ready for Clinical Application in Human Post-stroke Rehabilitation? Front Behav Neurosci 2018; 12:135. [PMID: 30050416 PMCID: PMC6050361 DOI: 10.3389/fnbeh.2018.00135] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 06/14/2018] [Indexed: 11/13/2022] Open
Abstract
Environmental enrichment (EE) has been widely used as a means to enhance brain plasticity mechanisms (e.g., increased dendritic branching, synaptogenesis, etc.) and improve behavioral function in both normal and brain-damaged animals. In spite of the demonstrated efficacy of EE for enhancing brain plasticity, it has largely remained a laboratory phenomenon with little translation to the clinical setting. Impediments to the implementation of enrichment as an intervention for human stroke rehabilitation and a lack of clinical translation can be attributed to a number of factors not limited to: (i) concerns that EE is actually the "normal state" for animals, whereas standard housing is a form of impoverishment; (ii) difficulty in standardizing EE conditions across clinical sites; (iii) the exact mechanisms underlying the beneficial actions of enrichment are largely correlative in nature; (iv) a lack of knowledge concerning what aspects of enrichment (e.g., exercise, socialization, cognitive stimulation) represent the critical or active ingredients for enhancing brain plasticity; and (v) the required "dose" of enrichment is unknown, since most laboratory studies employ continuous periods of enrichment, a condition that most clinicians view as impractical. In this review article, we summarize preclinical stroke recovery studies that have successfully utilized EE to promote functional recovery and highlight the potential underlying mechanisms. Subsequently, we discuss how EE is being applied in a clinical setting and address differences in preclinical and clinical EE work to date. It is argued that the best way forward is through the careful alignment of preclinical and clinical rehabilitation research. A combination of both approaches will allow research to fully address gaps in knowledge and facilitate the implementation of EE to the clinical setting.
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Affiliation(s)
- Matthew W McDonald
- Department of Cellular & Molecular Medicine, University of Ottawa, Ottawa, ON, Canada.,Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada
| | - Kathryn S Hayward
- Stroke Division, Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia.,NHMRC Centre for Research Excellence in Stroke Rehabilitation and Brain Recovery, Heidelberg, VIC, Australia
| | - Ingrid C M Rosbergen
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.,Allied Health Services, Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australia
| | - Matthew S Jeffers
- Department of Cellular & Molecular Medicine, University of Ottawa, Ottawa, ON, Canada.,Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada
| | - Dale Corbett
- Department of Cellular & Molecular Medicine, University of Ottawa, Ottawa, ON, Canada.,Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada
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12
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Jeffers MS, Corbett D. Synergistic Effects of Enriched Environment and Task-Specific Reach Training on Poststroke Recovery of Motor Function. Stroke 2018; 49:1496-1503. [PMID: 29752347 DOI: 10.1161/strokeaha.118.020814] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/09/2018] [Accepted: 04/17/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND PURPOSE Reach training in concert with environmental enrichment provides functional benefits after experimental stroke in rats. The present study extended these findings by assessing whether intensive task-specific reach training or enrichment initiated alone would provide similar functional benefit. Additionally, we investigated whether the 70% recovery rule, or a combined model of initial poststroke impairment, cortical infarct volume, and rehabilitation intensity, could predict recovery in the single-pellet task, as previously found for the Montoya staircase. METHODS Rats were trained on single-pellet reaching before middle cerebral artery occlusion via intracerebral injection of ET-1 (endothelin-1). There were 4 experimental groups: stroke+enrichment, stroke+reaching, stroke+enrichment+reaching, and sham+enrichment+reaching. Reaching rehabilitation utilized a modified Whishaw box that encouraged impaired forelimb reaching for 6 hours per day, 5 days per week, for 4 weeks. All treatment paradigms began 7 days after ischemia with weekly assessment on the single-pellet task during rehabilitation and again 4 weeks after rehabilitation concluded. RESULTS Rats exposed to the combination of enrichment and reaching showed the greatest improvement in pellet retrieval and comparable performance to shams after 3 weeks of treatment, whereas those groups that received a monotherapy remained significantly impaired at all time points. Initial impairment alone did not significantly predict recovery in single-pellet as the 70% rule would suggest; however, a combined model of cortical infarct volume and rehabilitation intensity predicted change in pellet retrieval on the single-pellet task with the same accuracy as previously shown with the staircase, demonstrating the generalizability of this model across reaching tasks. CONCLUSIONS Task-specific reach training and environmental enrichment have synergistic effects in rats that persist long after rehabilitation ends, and this recovery is predicted by infarct volume and rehabilitation intensity.
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Affiliation(s)
- Matthew Strider Jeffers
- From the Department of Cellular and Molecular Medicine, University of Ottawa, Canada (M.S.J., D.C.)
| | - Dale Corbett
- From the Department of Cellular and Molecular Medicine, University of Ottawa, Canada (M.S.J., D.C.) .,Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada (D.C.)
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13
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Wiersma AM, Fouad K, Winship IR. Enhancing Spinal Plasticity Amplifies the Benefits of Rehabilitative Training and Improves Recovery from Stroke. J Neurosci 2017; 37:10983-10997. [PMID: 29025926 PMCID: PMC6596489 DOI: 10.1523/jneurosci.0770-17.2017] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 09/15/2017] [Accepted: 10/01/2017] [Indexed: 12/15/2022] Open
Abstract
The limited recovery that occurs following stroke happens almost entirely in the first weeks postinjury. Moreover, the efficacy of rehabilitative training is limited beyond this narrow time frame. Sprouting of spared corticospinal tract axons in the contralesional spinal cord makes a significant contribution to sensorimotor recovery, but this structural plasticity is also limited to the first few weeks after stroke. Here, we tested the hypothesis that inducing plasticity in the spinal cord during chronic stroke could improve recovery from persistent sensorimotor impairment. We potentiated spinal plasticity during chronic stroke, weeks after the initial ischemic injury, in male Sprague-Dawley rats via intraspinal injections of chondroitinase ABC. Our data show that chondroitinase injections into the contralesional gray matter of the cervical spinal cord administered 28 d after stroke induced significant sprouting of corticospinal axons originating in the peri-infarct cortex. Chondroitinase ABC injection during chronic stroke without additional training resulted in moderate improvements of sensorimotor deficits. Importantly, this therapy dramatically potentiated the efficacy of rehabilitative training delivered during chronic stroke in a skilled forelimb reaching task. These novel data suggest that spinal therapy during chronic stroke can amplify the benefits of delayed rehabilitative training with the potential to reduce permanent disability in stroke survivors.SIGNIFICANCE STATEMENT The brain and spinal cord undergo adaptive rewiring ("plasticity") following stroke. This plasticity allows for partial functional recovery from stroke induced sensorimotor impairments. However, the plasticity that underlies recovery occurs predominantly in the first weeks following stroke, and most stroke survivors are left with permanent disability even after rehabilitation. Using animal models, our data show that removal of plasticity-inhibiting signals in the spinal cord (via intraspinal injections of the enzyme chondroitinase ABC) augments rewiring of circuits connecting the brain to the spinal cord, even weeks after stroke. Moreover, this plasticity can be harnessed by rehabilitative training to significantly promote sensorimotor recovery. Thus, intraspinal therapy may augment rehabilitative training and improve recovery even in individuals living with chronic disability due to stroke.
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Affiliation(s)
| | - Karim Fouad
- Neuroscience and Mental Health Institute
- Faculty of Rehabilitation Medicine, and
| | - Ian R Winship
- Neuroscience and Mental Health Institute,
- Neurochemical Research Unit, Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta T6G 2G3, Canada
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Long-term effects of enriched environment following neonatal hypoxia-ischemia on behavior, BDNF and synaptophysin levels in rat hippocampus: Effect of combined treatment with G-CSF. Brain Res 2017; 1667:55-67. [DOI: 10.1016/j.brainres.2017.05.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Revised: 04/13/2017] [Accepted: 05/01/2017] [Indexed: 12/12/2022]
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15
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Reuter B, Gumbinger C, Sauer T, Wiethölter H, Bruder I, Diehm C, Ringleb PA, Hacke W, Hennerici MG, Kern R. Access, timing and frequency of very early stroke rehabilitation - insights from the Baden-Wuerttemberg stroke registry. BMC Neurol 2016; 16:222. [PMID: 27852229 PMCID: PMC5112693 DOI: 10.1186/s12883-016-0744-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 11/08/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND While the precise timing and intensity of very early rehabilitation (VER) after stroke onset is still under discussion, its beneficial effect on functional disability is generally accepted. The recently published randomized controlled AVERT trial indicated that patients with severe stroke might be more susceptible to harmful side effects of VER, which we hypothesized is contrary to current clinical practice. We analyzed the Baden-Wuerttemberg stroke registry to gain insight into the application of VER in acute ischemic stroke (IS) and intracerebral hemorrhage (ICH) in clinical practice. METHODS 99,753 IS patients and 8824 patients with ICH hospitalized from January 2008 to December 2012 were analyzed. Data on the access to physical therapy (PT), occupational therapy (OT), and speech therapy (ST), the time from admission to first contact with a therapist and the average number of therapy sessions during the first 7 days of admission are reported. Multiple logistic regression models adjusted for patient and treatment characteristics were carried out to investigate the influence of VER on clinical outcome. RESULTS PT was applied in 90/87% (IS/ICH), OT in 63/57%, and ST in 70/65% of the study population. Therapy was mostly initiated within 24 h (PT 87/82%) or 48 h after admission (OT 91/89% and ST 93/90%). Percentages of patients under therapy and also the average number of therapy sessions were highest in those with a discharge modified Rankin Scale score of 2 to 5 and lowest in patients with complete recovery or death during hospitalization. The outcome analyses were fundamentally hindered due to biases by individual decision making regarding the application and frequency of VER. CONCLUSIONS While most patients had access to PT we noticed an undersupply of OT and ST. Only little differences were observed between patients with IS and ICH. The staff decisions for treatment seem to reflect attempts to optimize resources. Patients with either excellent or very unfavorable prognosis were less frequently assigned to VER and, if treated, received a lower average number of therapy sessions. On the contrary, severely disabled patients received VER at high frequency, although potentially harmful according to recent indications from the randomized controlled AVERT trial.
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Affiliation(s)
- Björn Reuter
- Department of Neurology and Neurophysiology, University Hospital Freiburg, Breisacher Straße 64, 79106 Freiburg, Germany
| | - Christoph Gumbinger
- Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | - Tamara Sauer
- Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany
| | - Horst Wiethölter
- formerly affiliated to Department of Neurology, Bürgerhospital, Stuttgart, Germany
| | - Ingo Bruder
- Office for Quality Assurance in Hospitals (GeQiK), Baden-Wuerttembergische Hospital Association, Stuttgart, Germany
| | - Curt Diehm
- Department of Internal/Vascular Medicine, Max-Grundig-Klinik, Bühl, Germany
| | - Peter A. Ringleb
- Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | - Werner Hacke
- Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | - Michael G. Hennerici
- Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany
| | - Rolf Kern
- Department of Neurology, Klinikum Kempten-Oberallgaeu, Kempten, Germany
| | - and Stroke Working Group of Baden-Wuerttemberg
- Department of Neurology and Neurophysiology, University Hospital Freiburg, Breisacher Straße 64, 79106 Freiburg, Germany
- Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
- Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany
- formerly affiliated to Department of Neurology, Bürgerhospital, Stuttgart, Germany
- Office for Quality Assurance in Hospitals (GeQiK), Baden-Wuerttembergische Hospital Association, Stuttgart, Germany
- Department of Internal/Vascular Medicine, Max-Grundig-Klinik, Bühl, Germany
- Department of Neurology, Klinikum Kempten-Oberallgaeu, Kempten, Germany
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16
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Pendharkar AV, Levy SL, Ho AL, Sussman ES, Cheng MY, Steinberg GK. Optogenetic modulation in stroke recovery. Neurosurg Focus 2016; 40:E6. [DOI: 10.3171/2016.2.focus163] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Stroke is one of the leading contributors to morbidity, mortality, and health care costs in the United States. Although several preclinical strategies have shown promise in the laboratory, few have succeeded in the clinical setting. Optogenetics represents a promising molecular tool, which enables highly specific circuit-level neuromodulation. Here, the conceptual background and preclinical body of evidence for optogenetics are reviewed, and translational considerations in stroke recovery are discussed.
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Livingston-Thomas J, Nelson P, Karthikeyan S, Antonescu S, Jeffers MS, Marzolini S, Corbett D. Exercise and Environmental Enrichment as Enablers of Task-Specific Neuroplasticity and Stroke Recovery. Neurotherapeutics 2016; 13:395-402. [PMID: 26868018 PMCID: PMC4824016 DOI: 10.1007/s13311-016-0423-9] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Improved stroke care has resulted in greater survival, but >50% of patients have chronic disabilities and 33% are institutionalized. While stroke rehabilitation is helpful, recovery is limited and the most significant gains occur in the first 2-3 months. Stroke triggers an early wave of gene and protein changes, many of which are potentially beneficial for recovery. It is likely that these molecular changes are what subserve spontaneous recovery. Two interventions, aerobic exercise and environmental enrichment, have pleiotropic actions that influence many of the same molecular changes associated with stroke injury and subsequent spontaneous recovery. Enrichment paradigms have been used for decades in adult and neonatal animal models of brain injury and are now being adapted for use in the clinic. Aerobic exercise enhances motor recovery and helps reduce depression after stroke. While exercise attenuates many of the signs associated with normal aging (e.g., hippocampal atrophy), its ability to reverse cognitive impairments subsequent to stroke is less evident. It may be that stroke, like other diseases such as cancer, needs to use multimodal treatments that augment complimentary neurorestorative processes.
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Affiliation(s)
- Jessica Livingston-Thomas
- Canadian Partnership for Stroke Recovery, University of Ottawa, Ottawa, ON, Canada
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Paul Nelson
- Canadian Partnership for Stroke Recovery, University of Ottawa, Ottawa, ON, Canada
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Sudhir Karthikeyan
- Canadian Partnership for Stroke Recovery, University of Ottawa, Ottawa, ON, Canada
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Sabina Antonescu
- Canadian Partnership for Stroke Recovery, University of Ottawa, Ottawa, ON, Canada
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Matthew Strider Jeffers
- Canadian Partnership for Stroke Recovery, University of Ottawa, Ottawa, ON, Canada
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Susan Marzolini
- Canadian Partnership for Stroke Recovery, University of Ottawa, Ottawa, ON, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Dale Corbett
- Canadian Partnership for Stroke Recovery, University of Ottawa, Ottawa, ON, Canada.
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
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18
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Schnakers C, Magee WL, Harris B. Sensory Stimulation and Music Therapy Programs for Treating Disorders of Consciousness. Front Psychol 2016; 7:297. [PMID: 27014119 PMCID: PMC4780279 DOI: 10.3389/fpsyg.2016.00297] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 02/16/2016] [Indexed: 11/23/2022] Open
Affiliation(s)
- Caroline Schnakers
- Department of Neurosurgery, University of California, Los Angeles Los Angeles, CA, USA
| | - Wendy L Magee
- Music Therapy Program, Boyer College of Music and Dance, Temple University Philadelphia, PA, USA
| | - Brian Harris
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital Boston, MA, USA
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19
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Assessing cognitive function following medial prefrontal stroke in the rat. Behav Brain Res 2015; 294:102-10. [DOI: 10.1016/j.bbr.2015.07.053] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 07/22/2015] [Accepted: 07/27/2015] [Indexed: 01/01/2023]
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20
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Ng KL, Gibson EM, Hubbard R, Yang J, Caffo B, O'Brien RJ, Krakauer JW, Zeiler SR. Fluoxetine Maintains a State of Heightened Responsiveness to Motor Training Early After Stroke in a Mouse Model. Stroke 2015; 46:2951-60. [PMID: 26294676 PMCID: PMC4934654 DOI: 10.1161/strokeaha.115.010471] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 07/16/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND PURPOSE Data from both humans and animal models suggest that most recovery from motor impairment after stroke occurs in a sensitive period that lasts only weeks and is mediated, in part, by an increased responsiveness to training. Here, we used a mouse model of focal cortical stroke to test 2 hypotheses. First, we investigated whether responsiveness to training decreases over time after stroke. Second, we tested whether fluoxetine, which can influence synaptic plasticity and stroke recovery, can prolong the period over which large training-related gains can be elicited after stroke. METHODS Mice were trained to perform a skilled prehension task to an asymptotic level of performance after which they underwent stroke induction in the caudal forelimb area. The mice were then retrained after a 1- or 7-day delay with and without fluoxetine. RESULTS Recovery of prehension after a caudal forelimb area stroke was complete if training was initiated 1 day after stroke but incomplete if it was delayed by 7 days. In contrast, if fluoxetine was administered at 24 hours after stroke, then complete recovery of prehension was observed even with the 7-day training delay. Fluoxetine seemed to mediate its beneficial effect by reducing inhibitory interneuron expression in intact premotor cortex rather than through effects on infarct volume or cell death. CONCLUSIONS There is a gradient of diminishing responsiveness to motor training over the first week after stroke. Fluoxetine can overcome this gradient and maintain maximal levels of responsiveness to training even 7 days after stroke.
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Affiliation(s)
- Kwan L Ng
- From the Departments of Neurology (K.L.N., E.M.G., R.H., J.W.K., S.R.Z.) and Neuroscience (J.W.K.), Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.Y., B.C.); and Department of Neurology, Duke University, Durham, NC (R.J.O.)
| | - Ellen M Gibson
- From the Departments of Neurology (K.L.N., E.M.G., R.H., J.W.K., S.R.Z.) and Neuroscience (J.W.K.), Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.Y., B.C.); and Department of Neurology, Duke University, Durham, NC (R.J.O.)
| | - Robert Hubbard
- From the Departments of Neurology (K.L.N., E.M.G., R.H., J.W.K., S.R.Z.) and Neuroscience (J.W.K.), Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.Y., B.C.); and Department of Neurology, Duke University, Durham, NC (R.J.O.)
| | - Juemin Yang
- From the Departments of Neurology (K.L.N., E.M.G., R.H., J.W.K., S.R.Z.) and Neuroscience (J.W.K.), Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.Y., B.C.); and Department of Neurology, Duke University, Durham, NC (R.J.O.)
| | - Brian Caffo
- From the Departments of Neurology (K.L.N., E.M.G., R.H., J.W.K., S.R.Z.) and Neuroscience (J.W.K.), Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.Y., B.C.); and Department of Neurology, Duke University, Durham, NC (R.J.O.)
| | - Richard J O'Brien
- From the Departments of Neurology (K.L.N., E.M.G., R.H., J.W.K., S.R.Z.) and Neuroscience (J.W.K.), Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.Y., B.C.); and Department of Neurology, Duke University, Durham, NC (R.J.O.)
| | - John W Krakauer
- From the Departments of Neurology (K.L.N., E.M.G., R.H., J.W.K., S.R.Z.) and Neuroscience (J.W.K.), Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.Y., B.C.); and Department of Neurology, Duke University, Durham, NC (R.J.O.)
| | - Steven R Zeiler
- From the Departments of Neurology (K.L.N., E.M.G., R.H., J.W.K., S.R.Z.) and Neuroscience (J.W.K.), Johns Hopkins University, Baltimore, MD; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.Y., B.C.); and Department of Neurology, Duke University, Durham, NC (R.J.O.).
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21
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Corbett D, Jeffers M, Nguemeni C, Gomez-Smith M, Livingston-Thomas J. Lost in translation: rethinking approaches to stroke recovery. PROGRESS IN BRAIN RESEARCH 2015; 218:413-34. [PMID: 25890148 DOI: 10.1016/bs.pbr.2014.12.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Stroke is the second leading cause of death and the preeminent cause of neurological disability. Attempts to limit brain injury after ischemic stroke with clot-dissolving drugs have met with great success but their use remains limited due to a narrow therapeutic time window and concern over serious side effects. Unfortunately, the neuroprotective strategy failed in clinical trials. A more promising approach is to promote recovery of function in people affected by stroke. Following stroke, there is a heightened critical period of plasticity that appears to be receptive to exogenous interventions (e.g., delivery of growth factors) designed to enhance neuroplasticity processes important for recovery. An emerging concept is that combinational therapies appear much more effective than single interventions in improving stroke recovery. One of the most promising interventions, with clinical feasibility, is enriched rehabilitation, a combination of environmental enrichment and task-specific therapy.
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Affiliation(s)
- Dale Corbett
- Heart & Stroke Foundation Canadian Partnership for Stroke Recovery and Department of Cellular & Molecular Medicine, University of Ottawa, Ottawa, Canada.
| | - Matthew Jeffers
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Canadian Partnership for Stroke Recovery, University of Ottawa, Ottawa, Ontario, Canada
| | - Carine Nguemeni
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Canadian Partnership for Stroke Recovery, University of Ottawa, Ottawa, Ontario, Canada
| | - Mariana Gomez-Smith
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Canadian Partnership for Stroke Recovery, University of Ottawa, Ottawa, Ontario, Canada
| | - Jessica Livingston-Thomas
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Canadian Partnership for Stroke Recovery, University of Ottawa, Ottawa, Ontario, Canada
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22
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Abstract
Social isolation has been recognized as a major risk factor for morbidity and mortality in humans for more than a quarter century. The brain is the key organ of social connections and processes, however, and the same objective social relationship can be experienced as caring and protective or as exploitive and isolating. We review evidence that the perception of social isolation (i.e., loneliness) impacts brain and behavior and is a risk factor for broad-based morbidity and mortality. However, the causal role of loneliness on neural mechanisms and mortality is difficult to test conclusively in humans. Mechanistic animal studies provide a lens through which to evaluate the neurological effects of a member of a social species living chronically on the social perimeter. Experimental studies show that social isolation produces significant changes in brain structures and processes in adult social animals. These effects are not uniform across the brain or across species but instead are most evident in brain regions that reflect differences in the functional demands of solitary versus social living for a particular species. The human and animal literatures have developed independently, however, and significant gaps also exist. The current review underscores the importance of integrating human and animal research to delineate the mechanisms through which social relationships impact the brain, health, and well-being.
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Affiliation(s)
- Stephanie Cacioppo
- High Performance Electrical NeuroImaging (HPEN) Laboratory of the Center for Cognitive and Social Neuroscience, and Department of Psychiatry and Behavioral Neuroscience, University of Chicago
| | - John P Capitanio
- California National Primate Research Center and Department of Psychology, University of California-Davis
| | - John T Cacioppo
- High Performance Electrical NeuroImaging (HPEN) Laboratory of the Center for Cognitive and Social Neuroscience, and Department of Psychiatry and Behavioral Neuroscience, University of Chicago
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23
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Langdon KD, Granter-Button S, Harley CW, Moody-Corbett F, Peeling J, Corbett D. A cognitive rehabilitation paradigm effective in male rats lacks efficacy in female rats. J Cereb Blood Flow Metab 2014; 34:1673-80. [PMID: 25052554 PMCID: PMC4269728 DOI: 10.1038/jcbfm.2014.132] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 05/30/2014] [Accepted: 06/24/2014] [Indexed: 12/18/2022]
Abstract
Cognitive dysfunction, as a consequence of dementia, is a significant cause of morbidity lacking efficacious treatment. Females comprise at least half of this demographic but have been vastly underrepresented in preclinical studies. The current study addressed this gap by assessing the protective efficacy of physical exercise and cognitive activity on learning and memory outcomes in a rat model of vascular dementia. Forty ovariectomized Sprague-Dawley rats (∼6 months old) were exposed to either a diet high in saturated fats and refined sugars or standard laboratory chow and underwent either chronic bilateral carotid occlusion or Sham surgery. Learning and memory abilities were evaluated using standard cognitive outcomes over the ensuing 6 months, followed by histologic analyses of hippocampal CA1 neurons. In Experiment 1, we confirmed hypoperfusion-induced cognitive dysfunction using a 2 × 2 (Surgery × Diet) experimental design, without alterations in hippocampal architecture. In Experiment 2, hypoperfused animals were either exposed to alternating days of physical (wheel running) and cognitive activity (modified Hebb-Williams maze) or sedentary housing. In contrast to males, this combination rehabilitation paradigm did not improve cognition or histopathologic outcomes in hypoperfused animals. These findings, highlighting differences between female and male animals, show the necessity of including both sexes in preclinical experimentation.
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Affiliation(s)
- Kristopher D Langdon
- 1] Division of BioMedical Sciences, Memorial University, St John's, Newfoundland and Labrador, Canada [2] Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada
| | - Shirley Granter-Button
- Division of BioMedical Sciences, Memorial University, St John's, Newfoundland and Labrador, Canada
| | - Carolyn W Harley
- Department of Psychology, Memorial University, St John's, Newfoundland and Labrador, Canada
| | - Frances Moody-Corbett
- Division of BioMedical Sciences, Memorial University, St John's, Newfoundland and Labrador, Canada
| | - James Peeling
- 1] Department of Radiology, University of Manitoba, Winnipeg, Manitoba, Canada [2] Department of Chemistry, University of Winnipeg, Winnipeg, Manitoba, Canada
| | - Dale Corbett
- 1] Division of BioMedical Sciences, Memorial University, St John's, Newfoundland and Labrador, Canada [2] Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada [3] Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada [4] Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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24
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Effects of enriched environment on hippocampal neuronal cell death and neurogenesis in rat global ischemia. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 812:203-208. [PMID: 24729234 DOI: 10.1007/978-1-4939-0620-8_27] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Enriched environments reportedly show neuroprotective effects. Here, we evaluated the effect of an enriched environment prior to cerebral ischemia on neuronal cell death and neurogenesis in rats. Male SD rats were housed under standard conditions (SC) or in an enriched environment (EE), then subjected to global ischemia. The Y-maze test and novel object cognition test were used to evaluate cognitive function before and after ischemia. At 7 days post-ischemia, we evaluated hippocampal neuronal cell death with Fluoro-Jade B staining and neurogenesis with BrdU staining. Phosphorylated cAMP response element-binding protein (phospho-CREB) was also evaluated immunohistochemically. The EE + ischemia group showed a significant decrease of cell death post-ischemia compared with the SC + ischemia group. There was no difference in neurogenesis post-ischemia between SC + ischemia and EE + ischemia. The EE + ischemia group showed a significant increase of performance before and after ischemia compared with the SC + ischemia group. Phospho-CREB-positive cells were significantly increased post-ischemia in EE + ischemia compared with SC + ischemia. EE suppressed hippocampal cell death due to global ischemia. Additionally, enhancement of cognitive function before and after ischemia and prevention of cognitive impairment associated with ischemia were observed compared with the controls (rats housed in SC without ischemia). The CREB pathway may play an important role in protection of cognitive ability.
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25
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de Mendonça LIZ. Transcranial brain stimulation (TMS and tDCS) for post-stroke aphasia rehabilitation: Controversies. Dement Neuropsychol 2014; 8:207-215. [PMID: 29213905 PMCID: PMC5619396 DOI: 10.1590/s1980-57642014dn83000003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Transcranial brain stimulation (TS) techniques have been investigated for use in
the rehabilitation of post-stroke aphasia. According to previous reports,
functional recovery by the left hemisphere improves recovery from aphasia, when
compared with right hemisphere participation. TS has been applied to stimulate
the activity of the left hemisphere or to inhibit homotopic areas in the right
hemisphere. Various factors can interfere with the brain's response to TS,
including the size and location of the lesion, the time elapsed since the causal
event, and individual differences in the hemispheric language dominance pattern.
The following questions are discussed in the present article: [a] Is inhibition of the right hemisphere truly beneficial?; [b] Is the transference of the language network to the left
hemisphere truly desirable in all patients?; [c] Is the use of TS during the post-stroke subacute phase truly
appropriate? Different patterns of neuroplasticity must occur in
post-stroke aphasia.
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26
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Allred RP, Kim SY, Jones TA. Use it and/or lose it-experience effects on brain remodeling across time after stroke. Front Hum Neurosci 2014; 8:379. [PMID: 25018715 PMCID: PMC4072969 DOI: 10.3389/fnhum.2014.00379] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 05/14/2014] [Indexed: 01/29/2023] Open
Abstract
The process of brain remodeling after stroke is time- and neural activity-dependent, and the latter makes it inherently sensitive to behavioral experiences. This generally supports targeting early dynamic periods of post-stroke neural remodeling with rehabilitative training (RT). However, the specific neural events that optimize RT effects are unclear and, as such, cannot be precisely targeted. Here we review evidence for, potential mechanisms of, and ongoing knowledge gaps surrounding time-sensitivities in RT efficacy, with a focus on findings from animal models of upper extremity RT. The reorganization of neural connectivity after stroke is a complex multiphasic process interacting with glial and vascular changes. Behavioral manipulations can impact numerous elements of this process to affect function. RT efficacy varies both with onset time and its timing relative to the development of compensatory strategies with the less-affected (nonparetic) hand. Earlier RT may not only capitalize on a dynamic period of brain remodeling but also counter a tendency for compensatory strategies to stamp-in suboptimal reorganization patterns. However, there is considerable variability across injuries and individuals in brain remodeling responses, and some early behavioral manipulations worsen function. The optimal timing of RT may remain unpredictable without clarification of the cellular events underlying time-sensitivities in its effects.
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Affiliation(s)
- Rachel P Allred
- Department of Psychology and Institute for Neuroscience, University of Texas at Austin Austin, TX, USA
| | - Soo Young Kim
- Department of Integrative Biology, University of California Berkeley Berkeley, CA, USA
| | - Theresa A Jones
- Department of Psychology and Institute for Neuroscience, University of Texas at Austin Austin, TX, USA
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Wahl AS, Schwab ME. Finding an optimal rehabilitation paradigm after stroke: enhancing fiber growth and training of the brain at the right moment. Front Hum Neurosci 2014; 8:381. [PMID: 25018717 PMCID: PMC4072965 DOI: 10.3389/fnhum.2014.00381] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 05/14/2014] [Indexed: 12/11/2022] Open
Abstract
After stroke the central nervous system reveals a spectrum of intrinsic capacities to react as a highly dynamic system which can change the properties of its circuits, form new contacts, erase others, and remap related cortical and spinal cord regions. This plasticity can lead to a surprising degree of spontaneous recovery. It includes the activation of neuronal molecular mechanisms of growth and of extrinsic growth promoting factors and guidance signals in the tissue. Rehabilitative training and pharmacological interventions may modify and boost these neuronal processes, but almost nothing is known on the optimal timing of the different processes and therapeutic interventions and on their detailed interactions. Finding optimal rehabilitation paradigms requires an optimal orchestration of the internal processes of re-organization and the therapeutic interventions in accordance with defined plastic time windows. In this review we summarize the mechanisms of spontaneous plasticity after stroke and experimental interventions to enhance growth and plasticity, with an emphasis on anti-Nogo-A immunotherapy. We highlight critical time windows of growth and of rehabilitative training and consider different approaches of combinatorial rehabilitative schedules. Finally, we discuss potential future strategies for designing repair and rehabilitation paradigms by introducing a “3 step model”: determination of the metabolic and plastic status of the brain, pharmacological enhancement of its plastic mechanisms, and stabilization of newly formed functional connections by rehabilitative training.
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Affiliation(s)
- Anna-Sophia Wahl
- Brain Research Institute, University of Zurich Zurich, Switzerland ; Department of Health, Sciences and Technology, ETH Zurich Zurich, Switzerland
| | - Martin E Schwab
- Brain Research Institute, University of Zurich Zurich, Switzerland ; Department of Health, Sciences and Technology, ETH Zurich Zurich, Switzerland
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28
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Schmidt A, Wellmann J, Schilling M, Strecker JK, Sommer C, Schäbitz WR, Diederich K, Minnerup J. Meta-analysis of the Efficacy of Different Training Strategies in Animal Models of Ischemic Stroke. Stroke 2014; 45:239-47. [DOI: 10.1161/strokeaha.113.002048] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Antje Schmidt
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Jürgen Wellmann
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Matthias Schilling
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Jan-Kolja Strecker
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Clemens Sommer
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Wolf-Rüdiger Schäbitz
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Kai Diederich
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
| | - Jens Minnerup
- From the Department of Neurology (A.S., M.S., J.-K.S., K.D., J.M.) and Institute of Epidemiology and Social Medicine (J.W.), University of Münster, Münster, Germany; Department of Neuropathology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (C.S.); and Department of Neurology, Bethel-EvKB, Bielefeld, Germany (W.-R.S.)
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Livingston-Thomas JM, McGuire EP, Doucette TA, Tasker RA. Voluntary forced use of the impaired limb following stroke facilitates functional recovery in the rat. Behav Brain Res 2013; 261:210-9. [PMID: 24388978 DOI: 10.1016/j.bbr.2013.12.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 11/29/2013] [Accepted: 12/11/2013] [Indexed: 12/22/2022]
Abstract
Constraint induced movement therapy (CIMT), which forces use of the impaired arm following stroke, improves functional recovery. The mechanisms underlying recovery are not well understood, necessitating further investigation into how rehabilitation may affect neuroplasticity using animal models. Animal motivation and stress make modelling CIMT in animals challenging. We have shown that following focal ischemia, voluntary forced use therapy using pet activity balls could engage the impaired forelimb and result in a modest acceleration in recovery. In this study, we investigated the effects of a more intensive appetitively motivated regimen that included task specific reaching exercises. Adult male Sprague Dawley rats were subjected to focal unilateral stroke using intracerebral injections of endothelin-1 or sham surgery. Three days later, stroke animals were assigned to daily rehabilitation or control therapy. Rehabilitation consisted of 30 min of generalized movement sessions in activity balls, followed by 30 min of voluntary task-specific movement using reaching boxes. Rats were tested weekly to measure forelimb deficit and recovery. After 30 days, animals were euthanized and tissue was examined for infarct volume, brain derived neurotrophic factor expression, and the presence of new neurons using doublecortin immunohistochemistry. Rehabilitation resulted in a significant acceleration of forelimb recovery in several tests, and a significant increase in the number of doublecortin-expressing cells. Furthermore, while the proportion of cells expressing BDNF in the peri-infarct region did not change, there was a shift in the cellular origin of expressed BDNF, resulting in significantly more non-neuronal, non-astrocytic BDNF, presumed to be of microglial origin.
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Affiliation(s)
- Jessica M Livingston-Thomas
- Departments of Biomedical Sciences, University of Prince Edward Island, 550 University Avenue, Charlottetown, PEI, C1A4P3, Canada
| | - Emily P McGuire
- Departments of Biomedical Sciences, University of Prince Edward Island, 550 University Avenue, Charlottetown, PEI, C1A4P3, Canada
| | - Tracy A Doucette
- Departments of Biology, University of Prince Edward Island, 550 University Avenue, Charlottetown, PEI, C1A4P3, Canada
| | - R Andrew Tasker
- Departments of Biomedical Sciences, University of Prince Edward Island, 550 University Avenue, Charlottetown, PEI, C1A4P3, Canada.
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Gender-dependent effects of enriched environment and social isolation in ischemic retinal lesion in adult rats. Int J Mol Sci 2013; 14:16111-23. [PMID: 23921682 PMCID: PMC3759902 DOI: 10.3390/ijms140816111] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 07/10/2013] [Accepted: 07/17/2013] [Indexed: 12/17/2022] Open
Abstract
Exposure to an enriched environment has been shown to have many positive effects on brain structure and function. Numerous studies have proven that enriched environment can reduce the lesion induced by toxic and traumatic injuries. Impoverished environment, on the other hand, can have deleterious effects on the outcome of neuronal injuries. We have previously shown that enriched conditions have protective effects in retinal injury in newborn rats. It is well-known that the efficacy of neuroprotective strategies can depend on age and gender. The aim of the present study, therefore, was to examine the effects of environmental enrichment and social isolation in retinal ischemia. We used bilateral common carotid artery occlusion to induce retinal hypoperfusion in adult Wistar rats of both genders. Groups were housed in standard, enriched or impoverished conditions. Impoverished environment was induced by social isolation. Retinas were processed for histological analysis after two weeks of survival. In the present study, we show that (1) enriched environment has protective effects in adult ischemic retinal lesion, while (2) impoverished environment further increases the degree of ischemic injury, and (3) that these environmental effects are gender-dependent: females are less responsive to the positive effects of environmental enrichment and more vulnerable to retinal ischemia in social isolation. In summary, our present study shows that the effects of both positive and negative environmental stimuli are gender-dependent in ischemic retinal lesions.
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31
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Noninvasive strategies to promote functional recovery after stroke. Neural Plast 2013; 2013:854597. [PMID: 23864962 PMCID: PMC3707231 DOI: 10.1155/2013/854597] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 06/02/2013] [Indexed: 01/17/2023] Open
Abstract
Stroke is a common and disabling global health-care problem, which is the third most common cause of death and one of the main causes of acquired adult disability in many countries. Rehabilitation interventions are a major component of patient care. In the last few years, brain stimulation, mirror therapy, action observation, or mental practice with motor imagery has emerged as interesting options as add-on interventions to standard physical therapies. The neural bases for poststroke recovery rely on the concept of plasticity, namely, the ability of central nervous system cells to modify their structure and function in response to external stimuli. In this review, we will discuss recent noninvasive strategies employed to enhance functional recovery in stroke patients and we will provide an overview of neural plastic events associated with rehabilitation in preclinical models of stroke.
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Xie H, Wu Y, Jia J, Liu G, Zhang F, Zhang Q, Yu K, Hu Y, Bai Y, Hu R. Enriched environment preconditioning induced brain ischemic tolerance without reducing infarct volume and edema: the possible role of enrichment-related physical activity increase. Brain Res 2013; 1508:63-72. [PMID: 23501217 DOI: 10.1016/j.brainres.2013.02.052] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Revised: 02/26/2013] [Accepted: 02/27/2013] [Indexed: 01/09/2023]
Abstract
External stimuli, including environmental enrichment (EE) and physical activity, have been shown to significantly facilitate recovery from brain injury. However, whether EE can be used as a preconditioning method to induce cerebral ischemic tolerance has never been investigated. Furthermore, whether, and to what extent, such environmental stimuli regulate physical activity to promote neuroprotection is largely unclear. To examine the neuroprotective effects of pre-ischemic EE (PIEE) and to investigate the relationship between these effects and EE-induced physical activity, we tested neurobehavioral and morphological recovery of rats following transient focal cerebral ischemia. Our study showed that PIEE improved the recovery of motor function, spatial learning and memory without reduction in brain edema or infarct volume. We also found that PIEE robustly increased the level of physical activity of rats that positively correlated with the extent of neurobehavioral recovery. Our results suggest that PIEE may induce brain ischemic tolerance through, at least partially, increasing physical activity.
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Affiliation(s)
- Hongyu Xie
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, WuLuMuQi Middle Road 12, Shanghai 200040, China
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33
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Sex and rearing condition modify the effects of perinatal lead exposure on learning and memory. Neurotoxicology 2012; 33:985-95. [PMID: 22542453 DOI: 10.1016/j.neuro.2012.04.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Revised: 04/01/2012] [Accepted: 04/12/2012] [Indexed: 11/20/2022]
Abstract
Developmental lead (Pb) exposure is associated with cognitive impairments in humans and rodents alike. In particular, impaired spatial learning and memory, as assessed using the Morris water maze (MWM), has been noted in developmentally Pb-exposed rats. Although sex and rearing environment can influence MWM performance in normal animals, the interactions of sex and rearing environment on the impact of developmental Pb exposure on hippocampal-dependent processes has not been well characterized. The present study examined the effects of perinatal exposure (i.e., gestation through weaning) to different levels of Pb (250, 750 and 1500 ppm Pb acetate in food) in males and females raised in a non-enriched environment (standard cage with 3 animals and no toys) or an enriched environment (large cage containing a variety of toys that were changed twice weekly). Testing in the MWM began at postnatal day 55. Behavioral outcomes were influenced by sex and rearing environment, with complex interactions with Pb exposure. In non-Pb exposed control animals, beneficial effects of environmental enrichment on spatial learning and memory were observed in males and females, with greater effects in females. Pb exposure in females mitigated at least some of the benefits of enrichment on learning, particularly at the lowest and highest exposure levels. In males, enrichment conferred a modest learning advantage and for the most part, Pb exposure did not affect this. However, in males with the highest Pb exposure, enrichment did help to overcome detrimental effects of Pb on learning. In females, any potential benefit to reference memory contributed by enrichment was muted by exposure to Pb and for the most part, this was not reproduced in males. Thus, there are complex interactions between sex, environment, and Pb exposure on spatial learning and memory. Environmental manipulation is a potential risk modifier of developmental Pb exposure and interacts with other factors including sex and amount of Pb exposure to affect the functional influences of Pb on the brain.
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Krakauer JW, Carmichael ST, Corbett D, Wittenberg GF. Getting neurorehabilitation right: what can be learned from animal models? Neurorehabil Neural Repair 2012; 26:923-31. [PMID: 22466792 DOI: 10.1177/1545968312440745] [Citation(s) in RCA: 371] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Animal models suggest that a month of heightened plasticity occurs in the brain after stroke, accompanied by most of the recovery from impairment. This period of peri-infarct and remote plasticity is associated with changes in excitatory/inhibitory balance and the spatial extent and activation of cortical maps and structural remodeling. The best time for experience and training to improve outcome is unclear. In animal models, very early (<5 days from onset) and intense training may lead to increased histological damage. Conversely, late rehabilitation (>30 days) is much less effective both in terms of outcome and morphological changes associated with plasticity. In clinical practice, rehabilitation after disabling stroke involves a relatively brief period of inpatient therapy that does not come close to matching intensity levels investigated in animal models and includes the training of compensatory strategies that have minimal impact on impairment. Current rehabilitation treatments have a disappointingly modest effect on impairment early or late after stroke. Translation from animal models will require the following: (1) substantial increases in the intensity and dosage of treatments offered in the first month after stroke with an emphasis on impairment; (2) combinational approaches such as noninvasive brain stimulation with robotics, based on current understanding of motor learning and brain plasticity; and (3) research that emphasizes mechanistic phase II studies over premature phase III clinical trials.
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Affiliation(s)
- John W Krakauer
- Johns Hopkins University School of Medicine and Johns Hopkins University, Baltimore, MD, USA
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35
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Zai L, Ferrari C, Dice C, Subbaiah S, Havton LA, Coppola G, Geschwind D, Irwin N, Huebner E, Strittmatter SM, Benowitz LI. Inosine augments the effects of a Nogo receptor blocker and of environmental enrichment to restore skilled forelimb use after stroke. J Neurosci 2011; 31:5977-88. [PMID: 21508223 PMCID: PMC3101108 DOI: 10.1523/jneurosci.4498-10.2011] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Revised: 02/17/2011] [Accepted: 02/19/2011] [Indexed: 01/28/2023] Open
Abstract
Stroke is the leading cause of disability in much of the world, with few treatment options available. Following unilateral stroke in rats, inosine, a naturally occurring purine nucleoside, stimulates the growth of projections from the undamaged hemisphere into denervated areas of the spinal cord and improves skilled use of the impaired forelimb. Inosine augments neurons' intrinsic growth potential by activating Mst3b, a component of the signal transduction pathway through which trophic factors regulate axon outgrowth. The present study investigated whether inosine would complement the effects of treatments that promote plasticity through other mechanisms. Following unilateral stroke in the rat forelimb motor area, inosine combined with NEP1-40, a Nogo receptor antagonist, doubled the number of axon branches extending from neurons in the intact hemisphere into the denervated side of the spinal cord compared with either treatment alone, and restored rats' level of skilled reaching using the impaired forepaw to preoperative levels. Similar functional improvements were seen when inosine was combined with environmental enrichment (EE). The latter effect was associated with changes in gene expression in layer 5 pyramidal neurons of the undamaged cortex well beyond those seen with inosine or EE alone. Inosine is now in clinical trials for other indications, making it an attractive candidate for the treatment of stroke patients.
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Affiliation(s)
- Laila Zai
- Laboratories for Neuroscience Research in Neurosurgery and
- F. M. Kirby Neurobiology Center, Children's Hospital, Boston, Massachusetts 02115
- Department of Surgery, Harvard Medical School, Boston, Massachusetts 02115
| | | | - Carlie Dice
- Laboratories for Neuroscience Research in Neurosurgery and
| | - Sathish Subbaiah
- Laboratories for Neuroscience Research in Neurosurgery and
- Department of Surgery, Harvard Medical School, Boston, Massachusetts 02115
| | | | - Giovanni Coppola
- Department of Neurology and
- Neurogenetics Program, University of California, Los Angeles, Los Angeles, California 90095, and
| | - Daniel Geschwind
- Department of Neurology and
- Neurogenetics Program, University of California, Los Angeles, Los Angeles, California 90095, and
| | - Nina Irwin
- Laboratories for Neuroscience Research in Neurosurgery and
- F. M. Kirby Neurobiology Center, Children's Hospital, Boston, Massachusetts 02115
- Department of Surgery, Harvard Medical School, Boston, Massachusetts 02115
| | - Eric Huebner
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut 06520
| | | | - Larry I. Benowitz
- Laboratories for Neuroscience Research in Neurosurgery and
- F. M. Kirby Neurobiology Center, Children's Hospital, Boston, Massachusetts 02115
- Program in Neuroscience and
- Department of Surgery, Harvard Medical School, Boston, Massachusetts 02115
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36
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Milot MR, Plamondon H. Changes in HPA reactivity and noradrenergic functions regulate spatial memory impairments at delayed time intervals following cerebral ischemia. Horm Behav 2011; 59:594-604. [PMID: 21376725 DOI: 10.1016/j.yhbeh.2011.02.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Revised: 02/23/2011] [Accepted: 02/25/2011] [Indexed: 11/24/2022]
Abstract
This study investigates the association of ischemia-induced spatial memory impairment to alterations of the HPA axis and noradrenergic activation post insult. Experiment 1 characterized the effects of 10 min forebrain ischemia on corticosterone (CORT) secretion following ischemia and in response to spatial memory assessment in the Barnes maze, as well as the impact of pre-ischemia treatment with the glucocorticoid inhibitor metyrapone (175 mg/kg; s.c.). The results showed that cerebral ischemia represents a significant physiological stressor that upregulated CORT secretion 1, 24 and 72 h post-ischemia but not at 7 days. In response to testing in the Barnes maze ischemic animals showed elevated CORT secretion simultaneously with spatial memory deficits. The single dose of metyrapone attenuated the ischemia-induced adrenocortical hyper-responsiveness and subsequent memory deficits despite not providing neuroprotection in the hippocampal CA1 pyramidal cells. To complement these findings, we examined whether norepinephrine which provides positive feedback to the HPA axis and is upregulated following brain ischemia could influence memory performance at delayed intervals after ischemia. Experiment 2 demonstrated that pre-testing administration of the alpha2-adrenoceptor agonist clonidine (.04 mg/kg, s.c.) attenuated ischemia-induced working memory impairments in a radial maze while opposite effects were obtained with the antagonist yohimbine (.3 mg/kg, s.c.). Post-testing administration of clonidine produced spatial reference memory impairments in ischemic rats. The findings from the current study demonstrate increased sensitization and responsiveness of systems regulating stress hormones at long intervals post ischemia. Importantly, we demonstrate that these effects contribute to post ischemic cognitive impairments which can be attenuated pharmacologically even in the presence of hippocampal degeneration at time of testing.
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37
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Small SL, Buccino G, Solodkin A. The mirror neuron system and treatment of stroke. Dev Psychobiol 2010; 54:293-310. [PMID: 22415917 DOI: 10.1002/dev.20504] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Accepted: 09/14/2010] [Indexed: 11/10/2022]
Affiliation(s)
- Steven L Small
- Department of Neurology, The University of Chicago, 5841 S. Maryland Ave., MC-2030, Chicago, IL 60637, USA.
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38
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Wang X, Han W, Du X, Zhu C, Carlsson Y, Mallard C, Jacotot E, Hagberg H. Neuroprotective Effect of Bax-Inhibiting Peptide on Neonatal Brain Injury. Stroke 2010; 41:2050-5. [DOI: 10.1161/strokeaha.110.589051] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Xiaoyang Wang
- From the Perinatal Center (X.W., W.H., X.D., Y.C., C.M., E.J., H.H.), Department of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; the Department of Pediatrics (X.W., W.H., X.D., C.Z.), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China; the Center for Brain Repair and Rehabilitation (C.Z.), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; the Perinatal Center (Y.C., H.H.), Department of
| | - Wei Han
- From the Perinatal Center (X.W., W.H., X.D., Y.C., C.M., E.J., H.H.), Department of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; the Department of Pediatrics (X.W., W.H., X.D., C.Z.), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China; the Center for Brain Repair and Rehabilitation (C.Z.), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; the Perinatal Center (Y.C., H.H.), Department of
| | - Xiaonan Du
- From the Perinatal Center (X.W., W.H., X.D., Y.C., C.M., E.J., H.H.), Department of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; the Department of Pediatrics (X.W., W.H., X.D., C.Z.), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China; the Center for Brain Repair and Rehabilitation (C.Z.), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; the Perinatal Center (Y.C., H.H.), Department of
| | - Changlian Zhu
- From the Perinatal Center (X.W., W.H., X.D., Y.C., C.M., E.J., H.H.), Department of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; the Department of Pediatrics (X.W., W.H., X.D., C.Z.), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China; the Center for Brain Repair and Rehabilitation (C.Z.), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; the Perinatal Center (Y.C., H.H.), Department of
| | - Ylva Carlsson
- From the Perinatal Center (X.W., W.H., X.D., Y.C., C.M., E.J., H.H.), Department of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; the Department of Pediatrics (X.W., W.H., X.D., C.Z.), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China; the Center for Brain Repair and Rehabilitation (C.Z.), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; the Perinatal Center (Y.C., H.H.), Department of
| | - Carina Mallard
- From the Perinatal Center (X.W., W.H., X.D., Y.C., C.M., E.J., H.H.), Department of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; the Department of Pediatrics (X.W., W.H., X.D., C.Z.), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China; the Center for Brain Repair and Rehabilitation (C.Z.), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; the Perinatal Center (Y.C., H.H.), Department of
| | - Etienne Jacotot
- From the Perinatal Center (X.W., W.H., X.D., Y.C., C.M., E.J., H.H.), Department of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; the Department of Pediatrics (X.W., W.H., X.D., C.Z.), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China; the Center for Brain Repair and Rehabilitation (C.Z.), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; the Perinatal Center (Y.C., H.H.), Department of
| | - Henrik Hagberg
- From the Perinatal Center (X.W., W.H., X.D., Y.C., C.M., E.J., H.H.), Department of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; the Department of Pediatrics (X.W., W.H., X.D., C.Z.), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China; the Center for Brain Repair and Rehabilitation (C.Z.), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; the Perinatal Center (Y.C., H.H.), Department of
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McEwen B, Paterson P. Caloric restriction provided after global ischemia does not reduce hippocampal cornu ammonis injury or improve functional recovery. Neuroscience 2010; 166:263-70. [DOI: 10.1016/j.neuroscience.2009.11.076] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Revised: 11/15/2009] [Accepted: 11/28/2009] [Indexed: 10/20/2022]
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40
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Carmichael ST. Translating the frontiers of brain repair to treatments: starting not to break the rules. Neurobiol Dis 2009; 37:237-42. [PMID: 19770043 DOI: 10.1016/j.nbd.2009.09.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2009] [Accepted: 09/13/2009] [Indexed: 01/12/2023] Open
Abstract
The field of neural repair in stroke has identified cellular systems of reorganization and possible molecular mechanisms. Conceptual barriers now limit the generation of clinically useful agents. First, it is not clear what the causal mechanisms of neural repair are in stroke. Second, adequate delivery systems for neural repair drugs need to be determined for candidate molecules. Third, ad hoc applications of existing pharmacological agents that enhance attention, mood or arousal to stroke have failed. New approaches that specifically harness the molecular systems of learning and memory provide a new avenue for stroke repair drugs. Fourth, combinatorial treatments for neural repair need to be considered for clinical therapies. Finally, neural repair therapies have as a goal altering brain connections, cognitive maps and active neural networks. These actions may trigger a unique set of "neural repair side effects" that need to be considered in planning clinical trials.
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Affiliation(s)
- S Thomas Carmichael
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
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41
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Goldstein LB. Stroke recovery and rehabilitation. HANDBOOK OF CLINICAL NEUROLOGY 2009; 94:1327-1337. [PMID: 18793903 DOI: 10.1016/s0072-9752(08)94066-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Larry B Goldstein
- Duke Center for Cerebrovascular Disease and Durham VA Medical Center, Durham, NC 27710, USA.
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42
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Langdon KD, Granter-Button S, Corbett D. Persistent behavioral impairments and neuroinflammation following global ischemia in the rat. Eur J Neurosci 2008; 28:2310-8. [PMID: 19019197 DOI: 10.1111/j.1460-9568.2008.06513.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Cognitive deficits associated with cardiac arrest have been well documented; however, the corresponding deficits in animal models of global ischemia have not been comprehensively assessed, particularly after long-term, clinically relevant survival times. We exposed male Sprague-Dawley rats to 10 min of bilateral carotid artery occlusion + systemic hypotension (40-45 mmHg) or sham surgery, and used histopathological assessments for short-term survival animals (16 days) and both behavioral and histopathological assessments for long-term survival animals (270 days). Analyses revealed significant long-term deficits in ischemic animals' learning, memory (T-maze, radial arm maze), working memory (radial arm maze), and reference memory (Morris water maze, radial arm maze) abilities that were not associated with a general cognitive decline. Histological results showed significant increases in glial fibrillary acidic protein, neuron glia 2, OX-42 and ED-1 staining, as well as significant decreases in microtubule-associated protein 2 staining and cornu ammonis area 1 (CA1) cell counts 16 days post-ischemia. The pattern at 270 days was similar, but notably there was a persistent elevation of ED-1 staining, suggesting recent cell death as well as significant atrophy of CA1. Whereas previous work has primarily reported transient changes in behavior after global ischemia, this study describes disturbances in several different functional domains following CA1 cell loss at clinically relevant survival times. Moreover, the histopathological outcome is suggestive of a spontaneous repopulation of CA1, but this was not sufficient to offset the behavioral impairments arising from the ischemic insult.
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Affiliation(s)
- Kristopher D Langdon
- Division of BioMedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St John's, NF, Canada
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Roberge MC, Messier C, Staines WA, Plamondon H. Food restriction induces long-lasting recovery of spatial memory deficits following global ischemia in delayed matching and non-matching-to-sample radial arm maze tasks. Neuroscience 2008; 156:11-29. [PMID: 18672030 DOI: 10.1016/j.neuroscience.2008.05.062] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2007] [Revised: 05/30/2008] [Accepted: 05/30/2008] [Indexed: 12/29/2022]
Abstract
Food restriction has been shown to be beneficial for a number of brain processes. In the current study, we characterized the impact of food restriction on hippocampal damage 70 days following ischemia. We assessed memory and cognitive flexibility of ad libitum fed (AL) and food-restricted (FR) animals using complex delayed non-matching- and matching-to-sample tasks in the radial arm maze. Our findings demonstrate that food restriction led to significant improvement of ischemia-induced memory impairments. FR ischemic animals rapidly reached comparable performance as both AL and FR sham animals in delayed-non-matching (win-shift) and matching (win-stay) radial arm maze tasks. They also made considerably fewer microchoices in the retention trials than AL ischemic animals. In contrast, AL ischemic rats showed persistent spatial memory impairments in the same paradigms. Assessment of basal and stress-induced corticosterone (CORT) secretion revealed no significant differences in baseline levels in AL and FR rats prior to or following global ischemia. However, FR animals showed a more pronounced attenuation of CORT secretion 45 min following restraint. Both FR and AL ischemic rats had comparable cell loss within CA1 and CA3 subfields of Ammon's horn (CA1 and CA3) at 70 days following reperfusion, although a trend toward increased CA3 cell survival was observed in FR ischemic rats. The functional sparing in the FR ischemic animals in the face of equivalent hippocampal cell loss suggests that food restriction somehow enhanced the efficacy of remaining hippocampal or extrahippocampal neurons following ischemia. In the current study, this phenomenon was not associated with diet- and or ischemia-related alterations of vesicular glutamate transporter 1 expression in various hippocampal regions although lower vesicular GABA transporter immunostaining was present in the CA1 stratum oriens and the CA3 stratum radiatum in FR sham and ischemic rats.
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Affiliation(s)
- M-C Roberge
- University of Ottawa, School of Psychology, 11, Marie Curie, Vanier Building Room 204, Ottawa, ON, Canada K1N 9A4
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Early enriched housing results in partial recovery of memory deficits in female, but not in male, rats after neonatal hypoxia–ischemia. Brain Res 2008; 1218:257-66. [DOI: 10.1016/j.brainres.2008.04.010] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2007] [Revised: 04/03/2008] [Accepted: 04/06/2008] [Indexed: 11/22/2022]
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Abstract
Ischemic brain damage can be prevented or at least significantly reduced when there is a preceding brief ischemic period that does not exceed the threshold for tissue damage--a phenomenon termed "ischemic preconditioning" (ischemic PC). Experimental PC in rodents is now considered to be a model for transient ischemic attacks in humans, and there is increasing hope for translating the knowledge of underlying mechanisms in the animal models into the clinic to enhance endogenous neuroprotective mechanisms in patients with stroke. However, although PC was originally defined as a subtoxic stimulus without any morphologic damage, there is a growing body of evidence from studies using sensitive techniques that postischemic structural alterations of brain tissue manifest not only after ischemia with prior PC but also after the PC stimulus itself. Furthermore, it has become evident over time that the primary shortcomings of many experimental studies on PC are the short observation intervals. The few studies with extended postischemic survival periods done to date provide clear evidence of considerable structural changes and even cell death, which may only be postponed by PC. Therefore, further studies are needed to elucidate structural long-term changes after PC and to validate the persistence of the neuroprotective effects.
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Cerebral ischemic preconditioning induces lasting effects on CA1 neuronal survival, prevents memory impairments but not ischemia-induced hyperactivity. Behav Brain Res 2008; 189:145-51. [DOI: 10.1016/j.bbr.2007.12.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2007] [Revised: 12/20/2007] [Accepted: 12/26/2007] [Indexed: 01/19/2023]
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Allred RP, Jones TA. Experience--a double edged sword for restorative neural plasticity after brain damage. FUTURE NEUROLOGY 2008; 3:189-198. [PMID: 19718283 DOI: 10.2217/14796708.3.2.189] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
During the time period following damage, the brain undergoes widespread reorganizational processes. Manipulations of behavioral experience can be potent therapeutic interventions for shaping this reorganization and enhancing long-term functional outcome. Recovery of function is a major concern for survivors of central nervous system damage and management of post-injury rehabilitation is increasingly becoming a topic of chief importance. Animal research, the focus of this review, suggests that, in the absence of behavioral manipulations, the brain is unlikely to realize its full potential for supporting function. However, experiences also have the capacity to be maladaptive for brain and behavioral function. From a treatment perspective, it may be unwise to adopt the canon of "first, do no harm" because maladaptive experiences include behaviors that individuals learn to do on their own. A better understanding of how behavioral experience interacts with brain reorganization could result in rehabilitative therapies, individually tailored and optimized for functional outcome.
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Affiliation(s)
- Rachel P Allred
- Psychology Department, University of Texas at Austin, Austin, TX 78712, USA
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Raymer AM, Beeson P, Holland A, Kendall D, Maher LM, Martin N, Murray L, Rose M, Thompson CK, Turkstra L, Altmann L, Boyle M, Conway T, Hula W, Kearns K, Rapp B, Simmons-Mackie N, Gonzalez Rothi LJ. Translational research in aphasia: from neuroscience to neurorehabilitation. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2008; 51:S259-S275. [PMID: 18230850 DOI: 10.1044/1092-4388(2008/020)] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
PURPOSE In this article, the authors encapsulate discussions of the Language Work Group that took place as part of the Workshop in Plasticity/NeuroRehabilitation Research at the University of Florida in April 2005. METHOD In this narrative review, they define neuroplasticity and review studies that demonstrate neural changes associated with aphasia recovery and treatment. The authors then summarize basic science evidence from animals, human cognition, and computational neuroscience that is relevant to aphasia treatment research. They then turn to the aphasia treatment literature in which evidence exists to support several of the neuroscience principles. CONCLUSION Despite the extant aphasia treatment literature, many questions remain regarding how neuroscience principles can be manipulated to maximize aphasia recovery and treatment. They propose a framework, incorporating some of these principles, that may serve as a potential roadmap for future investigations of aphasia treatment and recovery. In addition to translational investigations from basic to clinical science, the authors propose several areas in which translation can occur from clinical to basic science to contribute to the fundamental knowledge base of neurorehabilitation. This article is intended to reinvigorate interest in delineating the factors influencing successful recovery from aphasia through basic, translational, and clinical research.
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Affiliation(s)
- Anastasia M Raymer
- 110 Child Study Center, Old Dominion University, Norfolk, VA 23529-0136, USA.
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Prosser-Loose EJ, Saucier DM, Paterson PG. Can a reward-based behavioural test be used to investigate the effect of protein-energy malnutrition on hippocampal function? Nutr Neurosci 2008; 10:145-50. [PMID: 18019396 DOI: 10.1080/10284150701523168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Our laboratory is investigating the effects of protein-energy malnutrition (PEM) on cognitive outcome following global ischemia. Here, we investigated whether PEM independently impairs working memory in the T-maze and if the associated food reward reverses PEM. Gerbils were fed 12.5% (control diet) or 2% protein. A loss of body weight (20.1%) in the 2% protein group and decreased food intake and serum albumin concentration compared to controls (17.5% and 18.2%, respectively) indicated that PEM was achieved. Based on T-maze criterion frequently used in ischemia studies, no difference was observed in the mean (+/- SEM) number of trials required (control 5.2 +/- 0.7; PEM 4.9 +/- 0.4; p = 0.758) or the number of animals reaching criterion (control 10/12; PEM 12/12; p = 0.140). Using more stringent criterion, PEM animals required fewer trials (control 7.3 +/- 0.7; PEM 5.4 +/- 0.4; p = 0.035), and more reached criterion (control 8/12; PEM 12/12; p = 0.028). PEM may increase motivation to obtain a food reward.
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Affiliation(s)
- Erin J Prosser-Loose
- College of Pharmacy and Nutrition, University of Saskatchewan, 110 Science Place, Saskatoon, Sask., Canada
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Dhanushkodi A, Shetty AK. Is exposure to enriched environment beneficial for functional post-lesional recovery in temporal lobe epilepsy? Neurosci Biobehav Rev 2007; 32:657-74. [PMID: 18178250 DOI: 10.1016/j.neubiorev.2007.10.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2007] [Revised: 09/24/2007] [Accepted: 10/29/2007] [Indexed: 01/19/2023]
Abstract
Exposure to enriched environment has been shown to induce robust neuronal plasticity in both intact and injured adult central nervous system, including up-regulation of multiple neurotrophic factors, enhanced neurogenesis in the dentate gyrus of the hippocampus, and improved spatial learning and memory function. Neuronal plasticity, though mostly adaptive and abnormal, also occurs during certain neurodegenerative conditions such as the temporal lobe epilepsy (TLE). The TLE is characterized by hippocampal neurodegeneration, aberrant mossy fiber sprouting, spontaneous recurrent motor seizures, cognitive deficits, and abnormally enhanced neurogenesis during the early phase and dramatically declined neurogenesis during the chronic phase of the disease. As environmental enrichment has been found to be beneficial for treating animal models of Alzheimer's, Parkinson's, and Huntington's diseases, there is considerable interest in determining the efficacy of this strategy for preventing or treating chronic TLE after the initial precipitating brain injury. This review first discusses the proof of principle behind the potential application of the environmental enrichment strategy for preventing or treating TLE after brain injury. The subsequent chapters confer the portrayed beneficial effects of enrichment for functional post-lesional recovery in TLE and the possible complications which may arise from housing epilepsy-prone or epileptic rats in enriched environmental conditions. The final segment discusses studies that are essential for further understanding the efficacy of this approach for preventing or treating TLE.
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Affiliation(s)
- Anandh Dhanushkodi
- Medical Research and Surgery Services, Veterans Affairs Medical Center, Durham, NC 27705, USA
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