Stradecki-Cohan Holly M, Cohan Charles H, Raval Ami P, Dave Kunjan R, Reginensi Diego, Gittens Rolando A, Youbi Mehdi, Perez-Pinzon Miguel A
Department of Neurology Cerebral Vascular Disease Research Laboratories, Miami, FL, USA.
Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL, USA.
J Alzheimers Dis. 2017;60(s1):S87-S105. doi: 10.3233/JAD-170057.
Cerebral ischemia affects millions of people worldwide and survivors suffer from long-term functional and cognitive deficits. While stroke and cardiac arrest are typically considered when discussing ischemic brain injuries, there is much evidence that smaller ischemic insults underlie neurodegenerative diseases, including Alzheimer's disease. The "regenerative" capacity of the brain relies on several aspects of plasticity that are crucial for normal functioning; less affected brain areas may take over function previously performed by irreversibly damaged tissue. To harness the endogenous plasticity mechanisms of the brain to provide recovery of cognitive function, we must first understand how these mechanisms are altered after damage, such as cerebral ischemia. In this review, we discuss the long-term cognitive changes that result after cerebral ischemia and how ischemia alters several plasticity processes. We conclude with a discussion of how current and prospective therapies may restore brain plasticity and allow for recovery of cognitive function, which may be applicable to several disorders that have a disruption of cognitive processing, including traumatic brain injury and Alzheimer's disease.
脑缺血影响着全球数百万人，幸存者会遭受长期的功能和认知缺陷。虽然在讨论缺血性脑损伤时通常会考虑中风和心脏骤停，但有大量证据表明，较小的缺血性损伤是神经退行性疾病（包括阿尔茨海默病）的基础。大脑的“再生”能力依赖于可塑性的几个方面，这些方面对正常功能至关重要；受影响较小的脑区可能会接管以前由不可逆损伤组织执行的功能。为了利用大脑的内源性可塑性机制来恢复认知功能，我们必须首先了解这些机制在损伤（如脑缺血）后是如何改变的。在这篇综述中，我们讨论了脑缺血后导致的长期认知变化以及缺血如何改变几种可塑性过程。我们最后讨论了当前和未来的治疗方法如何恢复大脑可塑性并实现认知功能的恢复，这可能适用于几种存在认知加工障碍的疾病，包括创伤性脑损伤和阿尔茨海默病。
