Department of Neurology and Rehabilitation, San Francisco Veterans Administration Medical Center, University of California, San Francisco, San Francisco, CA; Departments of Neurology, University of California, San Francisco, San Francisco, CA.
Ann Neurol. 2013 Sep;74(3):373-81. doi: 10.1002/ana.23994.
The field of neurorehabilitation aims to translate neuroscience research toward the goal of maximizing functional recovery after neurological injury. A growing body of research indicates that the fundamental principles of neurological rehabilitation are applicable to a broad range of congenital, degenerative, and acquired neurological disorders. In this perspective, we will focus on motor recovery after acquired brain injuries such as stroke. Over the past few decades, a large body of basic and clinical research has created an experimental and theoretical foundation for approaches to neurorehabilitation. Recent randomized clinical trials all emphasize the requirement for intense progressive rehabilitation programs to optimally enhance recovery. Moreover, advances in multimodal assessment of patients with neuroimaging and neurophysiological tools suggest the possibility of individualized treatment plans based on recovery potential. There are also promising indications for medical as well as noninvasive brain stimulation paradigms to facilitate recovery. Ongoing or planned clinical studies should provide more definitive evidence. We also highlight unmet needs and potential areas of research. Continued research built upon a robust experimental and theoretical foundation should help to develop novel treatments to improve recovery after neurological injury.
神经康复领域旨在将神经科学研究转化为神经损伤后最大限度地恢复功能的目标。越来越多的研究表明,神经康复的基本原则适用于广泛的先天性、退行性和获得性神经疾病。从这个角度来看,我们将重点关注中风等获得性脑损伤后的运动康复。在过去的几十年中,大量的基础和临床研究为神经康复方法创造了实验和理论基础。最近的随机临床试验都强调需要进行强化的、渐进的康复计划,以最大限度地促进康复。此外,神经影像学和神经生理学工具的多模态评估的进展表明,基于恢复潜力制定个体化治疗计划的可能性。医学和非侵入性脑刺激范式也有促进恢复的有希望的迹象。正在进行或计划中的临床研究应该提供更明确的证据。我们还强调了未满足的需求和潜在的研究领域。在强大的实验和理论基础上继续研究,应该有助于开发新的治疗方法,以改善神经损伤后的恢复。