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Cheng HY, Xie HX, Tang QL, Yi LT, Zhu JX. Light and classical music therapies attenuate chronic unpredictable mild stress-induced depression via BDNF signaling pathway in mice. Heliyon 2024; 10:e34196. [PMID: 39071672 PMCID: PMC11283034 DOI: 10.1016/j.heliyon.2024.e34196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 06/17/2024] [Accepted: 07/04/2024] [Indexed: 07/30/2024] Open
Abstract
Depression, a pervasive mental health issue, often necessitates innovative therapeutic interventions. This study explores the efficacy of music therapy, a non-pharmacological approach, in ameliorating depression symptoms in a murine model. Employing a chronic unpredictable mild stress (CUMS) model to induce depressionlike behaviors in mice, we investigated the therapeutic potential of four distinct music genres: light, classical, atonal composition, and rock music. Behavioral assessments, including sucrose preference and immobility time, were conducted to evaluate the impact of music therapy. Additionally, we measured the levels of brain-derived neurotrophic factor (BDNF), synaptic proteins and neurogenesis to elucidate the underlying biological mechanisms. Our findings indicated that light and classical music significantly alleviated depression-like behaviors in mice, evidenced by increased sucrose preference and reduced immobility time. Conversely, atonal composition and rock music did not yield similar therapeutic benefits. Biochemically, light and classical music were associated with decreased levels of corticosterone and increased levels of glucocorticoid receptor, alongside enhanced BDNF signaling, synaptic proteins and neurogenesis. In conclusion, the study demonstrates that specific genres of music, notably light and classical music, may contribute to alleviating depression-like symptoms, potentially through mechanisms associated with BDNF signaling and neurogenesis. These results highlight the potential of targeted music therapy as a complementary approach in treating depression, with implications for its incorporation into broader therapeutic regimes. Further re-search is warranted to translate these findings into clinical practice.
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Affiliation(s)
- Hong-Yu Cheng
- Department of Music Therapy (Musicology), College of Humanities, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, 330004, PR China
| | - Hao-Xue Xie
- Department of Chemical and Pharmaceutical Engineering, College of Chemical Engineering, Huaqiao University, Xiamen, 361021, Fujian Province, PR China
| | - Qian-Lan Tang
- Department of Music Therapy (Musicology), College of Humanities, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, 330004, PR China
| | - Li-Tao Yi
- Department of Chemical and Pharmaceutical Engineering, College of Chemical Engineering, Huaqiao University, Xiamen, 361021, Fujian Province, PR China
| | - Ji-Xiao Zhu
- Research Center of Traditional Chinese Medicine Resources and Ethnic Medicine, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, 330004, PR China
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Mao Y, Tao X, Zhang G, Chen H. Effect of Music Therapy on Negative Psychology, Sleep, and Quality of Life in Elderly Patients Recovering from Cerebral Infarction with Depression and Anxiety: A Retrospective Analysis. Noise Health 2024; 26:430-435. [PMID: 39345088 PMCID: PMC11539996 DOI: 10.4103/nah.nah_84_24] [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: 05/09/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 10/01/2024] Open
Abstract
OBJECTIVE To observe the effects of music therapy on negative psychology, sleep, and quality of life in elderly patients recovering from cerebral infarction accompanied by depression and anxiety. METHODS We performed a retrospective analysis of 160 patients with convalescent cerebral infarction diagnosed between December 2022 and December 2023 in the Affiliated Brain Hospital of Nanjing Medical University. Cases from the control group (n = 76) were treated with conventional rehabilitation training. Meanwhile, the music therapy group (n = 84) cases were managed with standard and music therapy. Various measures, including polysomnography, the general quality of life questionnaire-74 (GQOL-74), the self-rating anxiety scale (SAS), and the self-rating depression scale (SDS) were collected at baseline (admission) and 4 weeks post-admission. RESULTS After 4 weeks, the music therapy group exhibited higher GQOL-74 scores, lower SAS scores, and lower SDS scores (P < 0.001). Furthermore, compared with the control group, the music therapy group had shorter sleep latency, longer sleep duration, higher sleep efficiency, lower wake time, fewer wake times, shorter S1 stage, longer S3 + S4 stage, and longer REM period (P < 0.001). CONCLUSIONS Music therapy appears to be effective in improving negative psychology, sleep quality, and quality of life in elderly patients with comorbid depression and anxiety during recovery from cerebral infarction.
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Affiliation(s)
- Ying Mao
- Intensive Care Medicine Department, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu, China
| | - Xumei Tao
- Department of Geriatrics (Geriatric Neurology), The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu, China
| | - Ge Zhang
- Department of Geriatrics (Geriatric Neurology), The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu, China
| | - Hounan Chen
- Department of Geriatrics (Geriatric Neurology), The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu, China
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Liu H, Peng XG, Gao R, Yang K, Zhao YB. Comparative analysis of noise and music exposure on inflammatory responses on lipopolysaccharide-induced septic rats. Hum Exp Toxicol 2024; 43:9603271241282584. [PMID: 39240701 DOI: 10.1177/09603271241282584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2024]
Abstract
OBJECTIVE Environmental factors such as noise and music can significantly impact physiological responses, including inflammation. This study explored how environmental factors like noise and music affect lipopolysaccharide (LPS)-induced inflammation, with a focus on systemic and organ-specific responses. MATERIALS AND METHODS 24 Wistar rats were divided into four groups (n = 6 per group): Control group, LPS group, noise-exposed group, and music-exposed group. All rats, except for the Control group, received 10 mg/kg LPS intraperitoneally. The rats in the noise-exposed group were exposed to 95 dB noise, and the music-exposed group listened to Mozart's K. 448 music (65-75 dB) for 1 h daily over 7 days. An enzyme-linked immunosorbent assay was utilized to detect the levels of inflammatory cytokines, including tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β), in serum and tissues (lung, liver, and kidney). Western blot examined the phosphorylation levels of nuclear factor-κB (NF-κB) p65 in organ tissues. RESULTS Compared with the Control group, LPS-induced sepsis rats displayed a significant increase in the levels of TNF-α and IL-1β in serum, lung, liver, and kidney tissues, as well as a remarkable elevation in the p-NF-κB p65 protein expression in lung, liver, and kidney tissues. Noise exposure further amplified these inflammatory markers, while music exposure reduced them in LPS-induced sepsis rats. CONCLUSION Noise exposure exacerbates inflammation by activating the NF-κB pathway, leading to the up-regulation of inflammatory markers during sepsis. On the contrary, music exposure inhibits NF-κB signaling, indicating a potential therapeutic effect in reducing inflammation.
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Affiliation(s)
- Hu Liu
- Department of Emergency and Critical Care Center, Renmin Hospital, Hubei University of Medicine, Hubei, China
| | - Xing-Guo Peng
- Department of Emergency and Critical Care Center, Renmin Hospital, Hubei University of Medicine, Hubei, China
| | - Ran Gao
- Department of Emergency and Critical Care Center, Renmin Hospital, Hubei University of Medicine, Hubei, China
| | - Kai Yang
- Department of Emergency and Critical Care Center, Renmin Hospital, Hubei University of Medicine, Hubei, China
| | - Yan-Bo Zhao
- Department of Emergency and Critical Care Center, Renmin Hospital, Hubei University of Medicine, Hubei, China
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Moschonas EH, Ranellone TS, Vozzella VJ, Rennerfeldt PL, Bondi CO, Annas EM, Bittner RA, Tamura DM, Reddy RI, Eleti RR, Cheng JP, Jarvis JM, Fink EL, Kline AE. Efficacy of a music-based intervention in a preclinical model of traumatic brain injury: An initial foray into a novel and non-pharmacological rehabilitative therapy. Exp Neurol 2023; 369:114544. [PMID: 37726048 PMCID: PMC10591861 DOI: 10.1016/j.expneurol.2023.114544] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/29/2023] [Accepted: 09/16/2023] [Indexed: 09/21/2023]
Abstract
Traumatic brain injury (TBI) causes neurobehavioral and cognitive impairments that negatively impact life quality for millions of individuals. Because of its pernicious effects, numerous pharmacological interventions have been evaluated to attenuate the TBI-induced deficits or to reinstate function. While many such pharmacotherapies have conferred benefits in the laboratory, successful translation to the clinic has yet to be achieved. Given the individual, medical, and societal burden of TBI, there is an urgent need for alternative approaches to attenuate TBI sequelae and promote recovery. Music based interventions (MBIs) may hold untapped potential for improving neurobehavioral and cognitive recovery after TBI as data in normal, non-TBI, rats show plasticity and augmented cognition. Hence, the aim of this study was to test the hypothesis that providing a MBI to adult rats after TBI would improve cognition, neurobehavior, and histological endpoints. Adult male rats received a moderate-to-severe controlled cortical impact injury (2.8 mm impact at 4 m/s) or sham surgery (n = 10-12 per group) and 24 h later were randomized to classical Music or No Music (i.e., ambient room noise) for 3 h/day from 19:00 to 22:00 h for 30 days (last day of behavior). Motor (beam-walk), cognitive (acquisition of spatial learning and memory), anxiety-like behavior (open field), coping (shock probe defensive burying), as well as histopathology (lesion volume), neuroplasticity (BDNF), and neuroinflammation (Iba1, and CD163) were assessed. The data showed that the MBI improved motor, cognitive, and anxiety-like behavior vs. No Music (p's < 0.05). Music also reduced cortical lesion volume and activated microglia but increased resting microglia and hippocampal BDNF expression. These findings support the hypothesis and provide a compelling impetus for additional preclinical studies utilizing MBIs as a potential efficacious rehabilitative therapy for TBI.
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Affiliation(s)
- Eleni H Moschonas
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Tyler S Ranellone
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Vincent J Vozzella
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Piper L Rennerfeldt
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Corina O Bondi
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Neurobiology, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Ellen M Annas
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Rachel A Bittner
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Dana M Tamura
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Rithika I Reddy
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Rithik R Eleti
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Jeffrey P Cheng
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Jessica M Jarvis
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Ericka L Fink
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Anthony E Kline
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Psychology, University of Pittsburgh, Pittsburgh, PA 15213, United States of America.
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Zhu J, Ji X, Shi R, He T, Chen SY, Cong R, He B, Liu S, Xu H, Gu JH. Hyperglycemia Aggravates the Cerebral Ischemia Injury via Protein O-GlcNAcylation. J Alzheimers Dis 2023:JAD230264. [PMID: 37334605 DOI: 10.3233/jad-230264] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
BACKGROUND At least one-third of Alzheimer's disease (AD) patients have cerebrovascular abnormalities, micro- and macro-infarctions, and ischemic white matter alterations. Stroke prognosis impacts AD development due to vascular disease. Hyperglycemia can readily produce vascular lesions and atherosclerosis, increasing the risk of cerebral ischemia. Our previous studies have proved that protein O-GlcNAcylation-a dynamic and reversible post-translational modification, protects against ischemic stroke. However, the role of O-GlcNAcylation in hyperglycemia aggravating cerebral ischemia injury remained unclear. OBJECTIVE In the present study, we investigated the role and mechanism of protein O-GlcNAcylation in hyperglycemia exacerbating cerebral ischemia injury. METHODS High glucose-cultured brain microvascular endothelial (bEnd3) cells were injured by oxygen-glucose deprivation. Cell viability was used as the assay result. Stroke outcomes and hemorrhagic transformation incidence were assessed in mice after middle cerebral artery occlusion under high glucose and streptozotocin-induced hyperglycemic conditions. Western blot estimated that O-GlcNAcylation influenced apoptosis levels in vitro and in vivo. RESULTS In in vitro analyses showed that Thiamet-G induces upregulation of protein O-GlcNAcylation, which attenuates oxygen-glucose deprivation/R-induce injury in bEnd3 cells cultured under normal glucose conditions, while aggravated it under high glucose conditions. In in vivo analyses, Thiamet-G exacerbated cerebral ischemic injury and induced hemorrhagic transformation, accompanied by increased apoptosis. While blocking protein O-GlcNAcylation with 6-diazo-5-oxo-L-norleucine alleviated cerebral injury of ischemic stroke in different hyperglycemic mice. CONCLUSION Overall, our study indicates a critical role for O-GlcNAcylation in that hyperglycemia aggravates cerebral ischemia injury. O-GlcNAcylation may be a potential therapeutic drug for ischemic stroke associated with AD.
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Affiliation(s)
- Jing Zhu
- Department of Rehabilitation Medicine, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, China
- Nantong Institute of Genetics and Reproductive Medicine, Affiliated Maternity & Child Healthcare Hospital of Nantong University, Nantong, China
| | - Xin Ji
- Department of Pharmacy, Affiliated Maternity & Child Healthcare Hospital of Nantong University, Medical School of Nantong University, Nantong, China
- Nantong Institute of Genetics and Reproductive Medicine, Affiliated Maternity & Child Healthcare Hospital of Nantong University, Nantong, China
| | - Ruirui Shi
- Nantong Institute of Genetics and Reproductive Medicine, Affiliated Maternity & Child Healthcare Hospital of Nantong University, Nantong, China
| | - Tianqi He
- Department of Pharmacy, Affiliated Maternity & Child Healthcare Hospital of Nantong University, Medical School of Nantong University, Nantong, China
- Nantong Institute of Genetics and Reproductive Medicine, Affiliated Maternity & Child Healthcare Hospital of Nantong University, Nantong, China
| | - Su-Ying Chen
- Department of Radiology, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China
| | - Ruochen Cong
- Department of Radiology, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China
| | - Bosheng He
- Department of Radiology, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China
| | - Su Liu
- Department of Rehabilitation Medicine, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, China
| | - Hui Xu
- Nantong Institute of Genetics and Reproductive Medicine, Affiliated Maternity & Child Healthcare Hospital of Nantong University, Nantong, China
| | - Jin-Hua Gu
- Department of Pharmacy, Affiliated Maternity & Child Healthcare Hospital of Nantong University, Medical School of Nantong University, Nantong, China
- Nantong Institute of Genetics and Reproductive Medicine, Affiliated Maternity & Child Healthcare Hospital of Nantong University, Nantong, China
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Sachdeva S, Persaud S, Patel M, Popard P, Colverson A, Doré S. Effects of Sound Interventions on the Permeability of the Blood-Brain Barrier and Meningeal Lymphatic Clearance. Brain Sci 2022; 12:brainsci12060742. [PMID: 35741627 PMCID: PMC9221168 DOI: 10.3390/brainsci12060742] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/28/2022] [Accepted: 05/31/2022] [Indexed: 01/25/2023] Open
Abstract
The meningeal lymphatic, or glymphatic, system is receiving increasing attention from the scientific community. Recent work includes noninvasive techniques to demonstrate relationships between blood-brain barrier (BBB) activity and the glymphatic system in the human central nervous system. One potential technique is the use of music/sound to enhance BBB permeability regarding the movement of small molecules in and out of the brain. However, there is minimal knowledge regarding the methodical investigation(s) of the uses of music/sound on BBB permeability and glymphatic clearance and the outcomes of these investigation(s). This review contains evidence discussing relationships between music/sound, BBB permeability, and meningeal lymphatic clearance. An overview of the anatomy and physiology of the system is presented. We discuss the uses of music/sound to modulate brain and body functions, highlighting music's effects on mood and autonomic, cognitive, and neuronal function. We also propose implications for follow-up work. The results showed that music and sound interventions do, in fact, contribute to the opening of the BBB and subsequently increase the function of the meningeal lymphatic system. Evidence also suggests that music/sound has the ability to reduce the collateral effects of brain injuries. Unfortunately, music/sound is rarely used in the clinical setting as a medical intervention. Still, recent research shows the potential positive impacts that music/sound could have on various organ systems.
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Affiliation(s)
- Sean Sachdeva
- Department of Anesthesiology, Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, FL 32610, USA; (S.S.); (S.P.); (M.P.); (P.P.)
| | - Sushmita Persaud
- Department of Anesthesiology, Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, FL 32610, USA; (S.S.); (S.P.); (M.P.); (P.P.)
| | - Milani Patel
- Department of Anesthesiology, Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, FL 32610, USA; (S.S.); (S.P.); (M.P.); (P.P.)
| | - Peyton Popard
- Department of Anesthesiology, Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, FL 32610, USA; (S.S.); (S.P.); (M.P.); (P.P.)
| | - Aaron Colverson
- Musicology/Ethnomusicology Program, School of Music, College of the Arts, University of Florida, Gainesville, FL 32603, USA;
| | - Sylvain Doré
- Department of Anesthesiology, Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, FL 32610, USA; (S.S.); (S.P.); (M.P.); (P.P.)
- Departments of Pharmaceutics, Psychology, and Neuroscience, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville, FL 32610, USA
- Correspondence:
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Xiong F, Liao X, Xiao J, Bai X, Huang J, Zhang B, Li F, Li P. Emerging Limb Rehabilitation Therapy After Post-stroke Motor Recovery. Front Aging Neurosci 2022; 14:863379. [PMID: 35401147 PMCID: PMC8984121 DOI: 10.3389/fnagi.2022.863379] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 02/24/2022] [Indexed: 11/13/2022] Open
Abstract
Stroke, including hemorrhagic and ischemic stroke, refers to the blood supply disorder in the local brain tissue for various reasons (aneurysm, occlusion, etc.). It leads to regional brain circulation imbalance, neurological complications, limb motor dysfunction, aphasia, and depression. As the second-leading cause of death worldwide, stroke poses a significant threat to human life characterized by high mortality, disability, and recurrence. Therefore, the clinician has to care about the symptoms of stroke patients in the acute stage and formulate an effective postoperative rehabilitation plan to facilitate the recovery in patients. We summarize a novel application and update of the rehabilitation therapy in limb motor rehabilitation of stroke patients to provide a potential future stroke rehabilitation strategy.
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Affiliation(s)
- Fei Xiong
- Department of Operation Room, The First People’s Hospital of Jiande, Hangzhou, China
| | - Xin Liao
- Department of Orthopedics, The First People’s Hospital of Jiande, Hangzhou, China
| | - Jie Xiao
- Department of Orthopedics, The First People’s Hospital of Jiande, Hangzhou, China
| | - Xin Bai
- Department of Orthopedics, The First People’s Hospital of Jiande, Hangzhou, China
| | - Jiaqi Huang
- Department of Orthopedics, The First People’s Hospital of Jiande, Hangzhou, China
| | - Bi Zhang
- Department of Orthopedics, The First People’s Hospital of Jiande, Hangzhou, China
| | - Fang Li
- Department of Orthopedics, The First People’s Hospital of Jiande, Hangzhou, China
| | - Pengfei Li
- Department of Orthopedics, The First People’s Hospital of Jiande, Hangzhou, China
- *Correspondence: Pengfei Li,
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