Neuroplasticity in the context of motor rehabilitation after stroke.
Neuroplasticity in the context of motor rehabilitation after stroke.
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DOI：
10.1038/nrneurol.2010.200
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发表时间：
2011-02
期刊：
影响因子：
--
通讯作者：
Cohen LG
中科院分区：
文献类型：
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作者：
Dimyan MA;Cohen LG
大约三分之一的中风患者在最初的脑血管疾病发作后表现出持续性残疾，其中运动障碍是中风后残疾的主要原因。长期以来，运动和训练一直被用来恢复中风后的运动功能。目前正在为中风后残疾制定更好的训练战略和治疗方案，以提高这些康复方案的效果。促进我们对卒中后运动损伤相关的神经可塑性变化和固有的修复机制的理解对这一努力至关重要。增强神经可塑性的药物、生物和电生理治疗正在探索中，以进一步扩大中风后康复的界限。潜在的运动康复疗法，如干细胞疗法、外源性组织工程和脑机接口技术，在帮助中风患者重新获得运动控制方面可能是不可或缺的。随着提供运动康复的方法的变化，卒中后康复的主要目标将由个别患者的活动和生活质量需求驱动。这篇综述旨在提供与卒中后运动障碍相关的神经可塑性的重点概述，以及正在开发的操纵神经可塑性以促进运动康复的最新实验干预措施。
Approximately one-third of patients with stroke exhibit persistent disability after the initial cerebrovascular episode, with motor impairments accounting for most poststroke disability. Exercise and training have long been used to restore motor function after stroke. Better training strategies and therapies to enhance the effects of these rehabilitative protocols are currently being developed for poststroke disability. The advancement of our understanding of the neuroplastic changes associated with poststroke motor impairment and the innate mechanisms of repair is crucial to this endeavor. Pharmaceutical, biological and electrophysiological treatments that augment neuroplasticity are being explored to further extend the boundaries of poststroke rehabilitation. Potential motor rehabilitation therapies, such as stem cell therapy, exogenous tissue engineering and brain–computer interface technologies, could be integral in helping patients with stroke regain motor control. As the methods for providing motor rehabilitation change, the primary goals of poststroke rehabilitation will be driven by the activity and quality of life needs of individual patients. This Review aims to provide a focused overview of neuroplasticity associated with poststroke motor impairment, and the latest experimental interventions being developed to manipulate neuroplasticity to enhance motor rehabilitation.