BioMedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland, Canada.
Neurorehabil Neural Repair. 2009 Nov;23(9):886-94. doi: 10.1177/1545968309341067. Epub 2009 Aug 12.
For most stroke survivors, rehabilitation therapy is the only treatment option available. The beneficial effects of early rehabilitation on neuroplasticity and functional recovery have been modeled in experimental stroke using a combination of enriched environment and rehabilitation. However, the impact of a secondary intervention, such as a periodic return to therapy, remains unclear.
This study examines whether a return to enriched rehabilitation (ie, "tune-up") can further promote functional recovery or produce beneficial changes in brain plasticity in the chronic phase of stroke recovery.
Rats were exposed to focal ischemia (endothelin-1 applied to forelimb sensorimotor cortex and dorsolateral striatum) and allowed to recover either in standard housing or in a combination of enriched environment and rehabilitative reaching for 9 weeks. Animals were then exposed to rotating periods of standard housing (5 weeks) and intensive "tune-up" therapy consisting of various sensorimotor/cognitive activities (2 weeks). Functional recovery was assessed using the Montoya staircase, beam-traversing, and cylinder tests, and Golgi-Cox analysis was used to examine dendritic complexity in the contralesional forelimb motor cortex.
Although early enriched rehabilitation significantly improved sensorimotor function in both the beam and staircase tests, "tune-up" therapy had no effect on recovery. Golgi-Cox analysis revealed no effect of treatment on dendritic complexity.
This study reaffirms the benefits of early rehabilitation for functional recovery after stroke. However, "tune-up" therapy provided no benefit in ischemic animals regardless of earlier rehabilitation experience. It is possible that alternative approaches in the chronic phase may prove more effective.
对于大多数中风幸存者来说，康复治疗是唯一可用的治疗选择。通过组合丰富的环境和康复治疗，在实验性中风中已经对早期康复对神经可塑性和功能恢复的有益影响进行了建模。然而，二次干预（例如周期性返回治疗）的影响尚不清楚。
本研究旨在探讨定期返回丰富的康复治疗（即“调整”）是否可以进一步促进功能恢复或在中风恢复的慢性阶段产生有益的大脑可塑性变化。
将大鼠暴露于局灶性缺血（内皮素-1施加于前肢感觉运动皮层和背外侧纹状体），并允许其在标准环境或丰富环境与康复性抓握相结合的情况下恢复 9 周。然后，将动物暴露于标准环境（5 周）和密集的“调整”治疗（包括各种感觉运动/认知活动）的旋转周期（2 周）。使用蒙托亚阶梯、横梁穿越和圆筒测试评估功能恢复情况，并用 Golgi-Cox 分析评估对侧前肢运动皮层的树突复杂性。
尽管早期丰富的康复治疗显著改善了横梁和阶梯测试中的感觉运动功能，但“调整”治疗对恢复没有影响。Golgi-Cox 分析显示治疗对树突复杂性没有影响。
本研究再次证实了早期康复对中风后功能恢复的益处。然而，无论早期康复经历如何，“调整”治疗对缺血动物都没有益处。在慢性阶段可能需要采用替代方法可能会更有效。
