Corbett Dale, Jeffers Matthew, Nguemeni Carine, Gomez-Smith Mariana, Livingston-Thomas Jessica
Heart & Stroke Foundation Canadian Partnership for Stroke Recovery and Department of Cellular & Molecular Medicine, University of Ottawa, Ottawa, Canada.
Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Canadian Partnership for Stroke Recovery, University of Ottawa, Ottawa, Ontario, Canada.
Prog Brain Res. 2015;218:413-34. doi: 10.1016/bs.pbr.2014.12.002.
Stroke is the second leading cause of death and the preeminent cause of neurological disability. Attempts to limit brain injury after ischemic stroke with clot-dissolving drugs have met with great success but their use remains limited due to a narrow therapeutic time window and concern over serious side effects. Unfortunately, the neuroprotective strategy failed in clinical trials. A more promising approach is to promote recovery of function in people affected by stroke. Following stroke, there is a heightened critical period of plasticity that appears to be receptive to exogenous interventions (e.g., delivery of growth factors) designed to enhance neuroplasticity processes important for recovery. An emerging concept is that combinational therapies appear much more effective than single interventions in improving stroke recovery. One of the most promising interventions, with clinical feasibility, is enriched rehabilitation, a combination of environmental enrichment and task-specific therapy.
中风是第二大致死原因，也是导致神经功能障碍的首要原因。使用溶栓药物限制缺血性中风后脑损伤的尝试取得了巨大成功，但由于治疗时间窗狭窄以及对严重副作用的担忧，其应用仍然有限。不幸的是，神经保护策略在临床试验中失败了。一种更有前景的方法是促进中风患者的功能恢复。中风后，存在一个增强的可塑性关键期，似乎对外源性干预（例如递送生长因子）敏感，这些干预旨在增强对恢复很重要的神经可塑性过程。一个新出现的概念是，联合疗法在改善中风恢复方面似乎比单一干预有效得多。最有前景且具有临床可行性的干预措施之一是强化康复，即环境丰富化与特定任务疗法的结合。
