Genetic Variation and Neuroplasticity: Role in Rehabilitation After Stroke.
Genetic Variation and Neuroplasticity: Role in Rehabilitation After Stroke.
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DOI：
10.1097/npt.0000000000000180
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发表时间：
2017-07
期刊：
影响因子：
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通讯作者：
Cramer SC
中科院分区：
文献类型：
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作者：
Stewart JC;Cramer SC
在许多神经学诊断中，康复结果存在显著的个体差异。可能影响对康复干预反应的一个因素是遗传变异。遗传变异是指一个种群中个体之间存在的DNA序列差异。遗传多态性是相对普遍发生的变异，虽然不会引起疾病，但可以影响生物系统的功能。这篇文章的目的是描述可能影响神经可塑性、运动学习和中风后恢复的遗传多态性。脑源性神经营养因子（BDNF）、多巴胺和载脂蛋白E的遗传多态性已被证明会影响神经可塑性和运动学习。依赖于这些因子的分子和细胞通路的康复干预可能受到多态性存在的影响。例如，有假设认为，具有BDNF多态性的个体可能对基于神经可塑性的干预反应较低，学习率较低，中风后总体恢复较差。然而，迄今为止的研究是有限的，需要进一步的工作来充分了解遗传变异在学习和恢复中的作用。在研究中风后神经可塑性、运动学习或运动恢复的研究中，应将遗传多态性视为可能的预测因子或协变量。未来中风恢复的预测模型可能包括遗传因素和其他传统因素（如年龄、病变类型、皮质脊髓束完整性）的组合，以确定个体对特定康复干预的预期反应。
In many neurologic diagnoses significant inter-individual variability exits in the outcomes of rehabilitation. One factor that may impact response to rehabilitation interventions is genetic variation. Genetic variation refers to the presence of differences in the DNA sequence among individuals in a population. Genetic polymorphisms are variations that occur relatively commonly and, while not disease-causing, can impact the function of biological systems. The purpose of this article is to describe genetic polymorphisms that may impact neuroplasticity, motor learning, and recovery after stroke. Genetic polymorphisms for brain-derived neurotrophic factor (BDNF), dopamine, and apolipoprotein E have been shown to impact neuroplasticity and motor learning. Rehabilitation interventions that rely on the molecular and cellular pathways of these factors may be impacted by the presence of the polymorphism. For example, it has been hypothesized that individuals with the BDNF polymorphism may show a decreased response to neuroplasticity-based interventions, decreased rate of learning, and overall less recovery after stroke. However, research to date has been limited and additional work is needed to fully understand the role of genetic variation in learning and recovery. Genetic polymorphisms should be considered as possible predictors or covariates in studies that investigate neuroplasticity, motor learning, or motor recovery after stroke. Future predictive models of stroke recovery will likely include a combination of genetic factors and other traditional factors (e.g. age, lesion type, corticospinal tract integrity) to determine an individual’s expected response to a specific rehabilitation intervention.