Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada.
Neurorehabil Neural Repair. 2011 Oct;25(8):740-8. doi: 10.1177/1545968311407517. Epub 2011 Jun 24.
Enriched rehabilitation (ER; environmental enrichment plus skilled reaching) improves recovery after middle cerebral artery occlusion (MCAo) in rats. Fundamental issues such as whether ER is effective in other models, optimal rehabilitation intensity, and underlying recovery mechanisms have not been fully assessed.
The authors tested whether the efficacy of ER varies with ischemia model and assessed the importance of rehabilitation intensity and brain-derived neurotrophic factor (BDNF) in recovery.
Rats in experiment 1 received 8 weeks of ER or remained in standard housing. Functional outcome was assessed with the staircase and cylinder tasks. Surprisingly, ER provided no functional benefit in any model. In this experiment, ER was delivered during the light phase, whereas other studies delivered ER in the dark phase of the light cycle. It was hypothesized that in the light, rats engaged in less rehabilitation or alternatively that BDNF was lower. Experiment 2 tested these hypotheses. Following MCAo, rats received ER in either the light or dark phase of the light cycle. Functional outcome was assessed and BDNF levels were measured in the motor cortex and hippocampus.
Recovery was accompanied by increased BDNF. This occurred only in rats that received ER in the dark and these animals reached more than those in the light condition.
Data suggest that there is a critical threshold of rehabilitation, below which recovery will not occur, and that BDNF mediates functional recovery. The use of intensive rehabilitation therapies for stroke patients is strongly supported.
丰富康复（ER；环境丰富加熟练抓取）可改善大脑中动脉闭塞（MCAo）后大鼠的恢复。尚未充分评估 ER 是否在其他模型中有效、最佳康复强度以及潜在的恢复机制等基本问题。
作者测试了 ER 的疗效是否因缺血模型而异，并评估了康复强度和脑源性神经营养因子（BDNF）在恢复中的重要性。
实验 1 中的大鼠接受 8 周的 ER 治疗或留在标准环境中。功能结果通过楼梯和圆筒任务进行评估。令人惊讶的是，ER 在任何模型中都没有提供功能益处。在该实验中，ER 在光照阶段进行，而其他研究则在光周期的暗相期间进行 ER。假设在光下，大鼠进行的康复活动较少，或者 BDNF 水平较低。实验 2 检验了这些假设。MCAo 后，大鼠在光周期的光照或暗相中接受 ER。评估功能结果并测量运动皮层和海马体中的 BDNF 水平。
恢复伴随着 BDNF 的增加。这种情况仅发生在在黑暗中接受 ER 的大鼠中，这些动物的恢复程度超过了在光照条件下的大鼠。
数据表明存在一个关键的康复阈值，低于该阈值则不会发生恢复，并且 BDNF 介导了功能恢复。强烈支持对中风患者使用强化康复疗法。
