Patel Jaylan, Shim Iris, Agrawal Devendra K
Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California 91766 USA.
Arch Intern Med Res. 2025;8(3):246-258. doi: 10.26502/aimr.0217. Epub 2025 Aug 25.
Stroke is a leading cause of long-term disability, and enhancing neural plasticity is a central strategy in promoting functional recovery. This review examines a range of interventions that target plasticity to improve outcomes in stroke survivors. Neural plasticity is assessed using neuroimaging tools, such as fMRI, EEG, and fNIRS, as well as clinical scales, including the Fugl-Meyer Assessment (FMA) and the Modified Rankin Scale (mRS). Biomarkers, like brain-derived neurotrophic factor (BDNF), GABA, and nerve growth factor (NGF), are also useful for predicting patient outcomes. These tools offer insight into recovery potential and intervention effectiveness. The interventions discussed include physical therapy, cognitive behavioral therapy (CBT), dietary support, and emerging technologies such as virtual reality, video games, and exoskeleton-assisted training. Pharmacological strategies, including Levodopa, selective serotonin reuptake inhibitors (SSRIs), and ginkgo diterpene lactone meglumine (GDLM), have shown mixed results, while stem cell therapies remain under investigation. Physical therapy remains the foundational treatment, but other interventions may provide added benefit depending on patient characteristics. This review highlights the need for a personalized, multidimensional approach to stroke rehabilitation. Continued research is necessary to refine these therapies and optimize recovery through tailored treatment strategies.
中风是导致长期残疾的主要原因,增强神经可塑性是促进功能恢复的核心策略。本综述探讨了一系列针对可塑性的干预措施,以改善中风幸存者的预后。使用功能磁共振成像(fMRI)、脑电图(EEG)和功能性近红外光谱(fNIRS)等神经影像学工具以及包括Fugl-Meyer评估(FMA)和改良Rankin量表(mRS)在内的临床量表来评估神经可塑性。脑源性神经营养因子(BDNF)、γ-氨基丁酸(GABA)和神经生长因子(NGF)等生物标志物也有助于预测患者的预后。这些工具有助于深入了解恢复潜力和干预效果。所讨论的干预措施包括物理治疗、认知行为疗法(CBT)、饮食支持以及虚拟现实、电子游戏和外骨骼辅助训练等新兴技术。包括左旋多巴、选择性5-羟色胺再摄取抑制剂(SSRI)和银杏二萜内酯葡胺(GDLM)在内的药物策略显示出参差不齐的结果,而干细胞疗法仍在研究中。物理治疗仍然是基础治疗,但根据患者特征,其他干预措施可能会带来额外益处。本综述强调了采用个性化、多维度方法进行中风康复的必要性。持续研究对于完善这些疗法并通过量身定制的治疗策略优化恢复至关重要。