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针对脑老化和神经可塑性的药理学方法:来自中风模型的见解

Pharmacologic approaches to cerebral aging and neuroplasticity: insights from the stroke model.

作者信息

Chollet François

机构信息

Department of Neurology and Institute for Neurosciences, CHU and Toulouse University, Hôpital Purpan, Toulouse, France.

出版信息

Dialogues Clin Neurosci. 2013 Mar;15(1):67-76. doi: 10.31887/DCNS.2013.15.1/fchollet.

Abstract

Brain plasticity is an intrinsic characteristic of the nervous system that allows continuous remodeling of brain functions in pathophysiological conditions. Although normal aging is associated with morphological modifications and decline of cerebral functions, brain plasticity is at least partially preserved in elderly individuals. A growing body of evidence supports the notion that cognitive enrichment and aerobic training induce a dynamic reorganization of higher cerebral functions, thereby helping to maintain operational skills in the elderly and reducing the incidence of dementia. The stroke model clearly shows that spontaneous brain plasticity exists after a lesion, even in old patients, and that it can be modulated through external factors like rehabilitation and drugs. Whether drugs can be used with the aim of modulating the effects of physical training or cognitive stimulation in healthy aged people has not been addressed until now. The risk:benefit ratio will be the key question with regard to the ethical aspect of this challenge. We review in this article the main aspects of human brain plasticity as shown in patients with stroke, the drug modulation of brain plasticity and its consequences on recovery, and finally we address the question of the influence of aging on brain plasticity.

摘要

脑可塑性是神经系统的一种内在特性,它使脑功能在病理生理条件下能够持续重塑。尽管正常衰老与脑形态学改变及脑功能衰退相关,但老年人的脑可塑性至少部分得以保留。越来越多的证据支持这样一种观点,即认知强化和有氧训练可诱导高级脑功能的动态重组,从而有助于维持老年人的操作技能并降低痴呆的发生率。中风模型清楚地表明,即使在老年患者中,脑损伤后也存在自发的脑可塑性,并且这种可塑性可通过康复和药物等外部因素进行调节。迄今为止,尚未探讨能否使用药物来调节健康老年人体育锻炼或认知刺激的效果。风险与获益比将是这一挑战在伦理方面的关键问题。在本文中,我们将综述中风患者所表现出的人脑可塑性的主要方面、脑可塑性的药物调节及其对恢复的影响,最后我们将探讨衰老对脑可塑性的影响问题。

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