Enhanced Motor Recovery After Stroke With Combined Cortical Stimulation and Rehabilitative Training Is Dependent on Infarct Location.
Enhanced Motor Recovery After Stroke With Combined Cortical Stimulation and Rehabilitative Training Is Dependent on Infarct Location.
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DOI：
10.1177/1545968315624979
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发表时间：
2016-02
影响因子：
4.2
通讯作者：
Kleim JA
中科院分区：
文献类型：
--
作者：
Boychuk JA;Schwerin SC;Thomas N;Roger A;Silvera G;Liverpool M;Adkins DL;Kleim JA
运动皮层的皮层电刺激与康复训练 (CS/RT) 相结合已被证明可以增强局灶性皮层中风动物模型的运动恢复，但在临床试验中，效果远不那么稳健。人类患者群体（包括皮质和皮质下脑区域）中风位置的可变性可能导致临床上未能找到一致的效果。本研究旨在确定梗塞位置是否影响先前观察到的 CS/RT 反应中增强的运动恢复。在两种不同的中风大鼠模型中检查了 CS/RT 促进运动功能改善的功效，这两种模型改变了皮质和皮质下损伤的数量和位置。通过将血管收缩肽内皮素-1 注射到 1) 大脑中动脉 (MCAo) 上，对额叶皮层和外侧纹状体造成损害，或 2) 注射到皮质下区域，对后丘脑和内囊 (SCII) 造成损害，从而诱发缺血性梗塞。然后每天进行 CS/RT 或单独 RT，持续 20 天，在此期间评估熟练到达任务的表现。与单独的 RT 相比，患有 MCAo 梗塞的动物对 CS/RT 的反应在熟练完成任务方面表现出增强的改善。在治疗 20 天的 SCII 梗塞动物中，没有观察到这种增强。皮质刺激对于增强中风后运动恢复的功效可能部分取决于缺血性梗塞的范围和位置。
Cortical electrical stimulation of motor cortex in combination with rehabilitative training (CS/RT) has been shown to enhance motor recovery in animal models of focal cortical stroke yet in clinical trials the effects are much less robust. The variability of stroke location in human patient populations that include both cortical and subcortical brain regions may contribute to the failure to find consistent effects clinically. This study sought to determine whether infarct location influences the enhanced motor recovery previously observed in response to CS/RT. The efficacy of CS/RT to promote improvements in motor function was examined in two different rat models of stroke that varied the amount and location of cortical and subcortical damage. Ischemic infarctions were induced by injecting the vasoconstricting peptide endothelin-1 either 1) onto the middle cerebral artery (MCAo) producing damage to frontal cortex and lateral striatum or 2) into a subcortical region producing damage to the posterior thalamus and internal capsule (SCII). Daily CS/RT or RT alone was then given for twenty days during which time performance on a skilled reaching task was assessed. Animals with MCAo infarctions exhibited enhanced improvements on a skilled reaching task in response to CS/RT relative to RT alone. No such enhancement was observed in animals with SCII infarctions across the twenty days of treatment. The efficacy of cortical stimulation for enhancing motor recovery after stroke may depend in part on the extent and location of the ischemic infarct.
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影响因子：
5.3
作者：
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