Dalise Stefania, Ambrosio Fabrisia, Modo Michel
University of Pittsburgh, Department of Physical Medicine and Rehabilitation, Pittsburgh, PA 15219, USA - Email:
University of Pittsburgh, McGowan Institute for Regenerative Medicine, Department of Radiology, 3025 East Carson St, Pittsburgh, PA 15203, USA. Email:
Arch Ital Biol. 2014 Dec;152(4):190-215. doi: 10.12871/00039829201442.
Post-stroke recovery relies on neurobiological changes that modify the organization and function of the brain under pathophysiological conditions. The changes can be adaptive (i.e. restoration of function) or maladaptive (i.e. worsening of function). Preclinical models of stroke exhibit adaptive plasticity that leads to a "spontaneous recov- ery" of functions. This recovery can be modulated through external factors, such as rehabilitation, pharmacology or other adjuvant strategies. Nevertheless, current interventions only result in a limited improvement of deficits and there is also potential for maladaptation. Hence, a better understanding of the mechanisms underlying recovery is essential for the design of more efficient and targeted treatment strategies. Here, we review the main features of adaptive plasticity that are thought to underlie the spontaneous and induced recovery of function in animal models of stroke. Within this context, therapeutic interventions, used in isolation or synergistically to modulate recovery, are discussed. It is hoped that a focus on neurobiological principles and their manipulation will enhance interven- tional strategies to maximize therapeutic benefit. To ensure translation of these interventions into a clinical setting, a close interaction between basic and applied research is required.
中风后的恢复依赖于神经生物学变化,这些变化在病理生理条件下改变大脑的组织和功能。这些变化可以是适应性的(即功能恢复)或适应不良的(即功能恶化)。中风的临床前模型表现出适应性可塑性,导致功能的“自发恢复”。这种恢复可以通过外部因素进行调节,如康复、药理学或其他辅助策略。然而,目前的干预措施仅能有限地改善功能缺陷,而且还存在适应不良的可能性。因此,更好地理解恢复的潜在机制对于设计更有效、更有针对性的治疗策略至关重要。在这里,我们回顾了适应性可塑性的主要特征,这些特征被认为是中风动物模型中功能自发恢复和诱导恢复的基础。在此背景下,还讨论了单独使用或协同使用以调节恢复的治疗干预措施。希望关注神经生物学原理及其调控将增强干预策略,以最大化治疗效益。为确保将这些干预措施转化为临床应用,基础研究和应用研究之间需要密切互动。