Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States; Neurobiology, University of Pittsburgh, Pittsburgh, PA 15213, United States.
Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, United States; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, United States.
Neuropharmacology. 2019 Feb;145(Pt A):13-24. doi: 10.1016/j.neuropharm.2018.02.032. Epub 2018 Feb 27.
Traumatic brain injury (TBI) is a significant health care issue that affects over ten million people worldwide. Treatment options are limited with numerous failures resulting from single therapies. Fortunately, several preclinical studies have shown that combination treatment strategies may afford greater improvement and perhaps can lead to successful clinical translation, particularly if one of the therapies is neurorehabilitation. The aim of this review is to highlight TBI studies that combined environmental enrichment (EE), a preclinical model of neurorehabilitation, with pharmacotherapies. A series of PubMed search strategies yielded only nine papers that fit the criteria. The consensus is that EE provides robust neurobehavioral, cognitive, and histological improvement after experimental TBI and that the combination of EE with some pharmacotherapies can lead to benefits beyond those revealed by single therapies. However, it is noted that EE can be challenged by drugs such as the acetylcholinesterase inhibitor, donepezil, and the antipsychotic drug, haloperidol, which attenuate its efficacy. These findings may help shape clinical neurorehabilitation strategies to more effectively improve patient outcome. Potential mechanisms for the EE and pharmacotherapy-induced effects are also discussed. This article is part of the Special Issue entitled "Neurobiology of Environmental Enrichment".
创伤性脑损伤 (TBI) 是一个重大的医疗保健问题，影响着全球超过 1000 万人。由于单一疗法的多次失败，治疗选择有限。幸运的是，几项临床前研究表明，联合治疗策略可能提供更大的改善，或许可以成功转化为临床应用，特别是如果其中一种疗法是神经康复。本综述的目的是强调将环境富集 (EE) 与药物治疗相结合的 TBI 研究，EE 是神经康复的临床前模型。一系列 PubMed 搜索策略仅产生了符合标准的九篇论文。共识是，EE 在实验性 TBI 后提供了强大的神经行为、认知和组织学改善，并且 EE 与某些药物治疗的联合应用可以带来单一疗法所无法带来的益处。然而，需要注意的是，EE 可能会受到一些药物的挑战，如乙酰胆碱酯酶抑制剂多奈哌齐和抗精神病药氟哌啶醇，这些药物会削弱其疗效。这些发现可能有助于制定更有效的临床神经康复策略，以改善患者的预后。还讨论了 EE 和药物治疗诱导效应的潜在机制。本文是题为“环境富集的神经生物学”的特刊的一部分。
