Biomarkers of stroke recovery: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable.
Biomarkers of stroke recovery: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable.
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DOI：
10.1177/1747493017714176
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发表时间：
2017-07
期刊：
影响因子：
--
通讯作者：
Cramer SC
中科院分区：
文献类型：
--
作者：
Boyd LA;Hayward KS;Ward NS;Stinear CM;Rosso C;Fisher RJ;Carter AR;Leff AP;Copland DA;Carey LM;Cohen LG;Basso DM;Maguire JM;Cramer SC
中风康复中最困难的临床问题是“这个病人的康复潜力是什么？”和“考虑到他/她的临床情况，这个人的最佳康复策略是什么？”没有这些问题的答案，临床医生就难以决定治疗的内容和重点，研究人员设计的研究无意中混淆了有高反应可能性的参与者和没有反应可能性的参与者。开发和实施区分患者亚组的生物标志物将有助于解决这些问题，并揭示对恢复过程重要的因素。本文的目的是就卒中恢复生物标志物的证据现状提供一个共识声明。运动、体感、认知和语言领域的生物标志物在中风后的恢复时间被考虑；重点关注大脑结构和功能，排除血液标记和遗传学。我们为那些被认为已经准备好纳入临床试验的生物标志物，以及其他有希望但尚未准备好，因此代表了发展重点的生物标志物提供证据。最后，我们以一个例子来说明生物标志物在恢复和康复研究中的效用，展示了生物标志物的纳入如何增强未来的临床试验。通过这种方式，我们提出了一种前进的方式，即何时何地我们可以包括生物标志物，以提高中风后康复和恢复的实践和研究的功效。
The most difficult clinical questions in stroke rehabilitation are “What is this patient’s potential for recovery?” and “What is the best rehabilitation strategy for this person, given her/his clinical profile?” Without answers to these questions, clinicians struggle to make decisions regarding the content and focus of therapy, and researchers design studies that inadvertently mix participants who have a high likelihood of responding with those who do not. Developing and implementing biomarkers that distinguish patient subgroups will help address these issues and unravel the factors important to the recovery process. The goal of the present paper is to provide a consensus statement regarding the current state of the evidence for stroke recovery biomarkers. Biomarkers of motor, somatosensory, cognitive and language domains across the recovery timeline post-stroke are considered; with focus on brain structure and function, and exclusion of blood markers and genetics. We provide evidence for biomarkers that are considered ready to be included in clinical trials, as well as others that are promising but not ready and so represent a developmental priority. We conclude with an example that illustrates the utility of biomarkers in recovery and rehabilitation research, demonstrating how the inclusion of a biomarker may enhance future clinical trials. In this way, we propose a way forward for when and where we can include biomarkers to advance the efficacy of the practice of, and research into, rehabilitation and recovery after stroke.
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影响因子：
2.9
作者：
Borstad A;Schmalbrock P;Choi S;Nichols-Larsen DS
通讯作者：
Nichols-Larsen DS
影响因子：
6.7
作者：
Bernhardt, Julie;Hayward, Kathryn S.;Cramer, Steven C.
通讯作者：
Cramer, Steven C.
影响因子：
14.5
作者：
Baldassarre, Antonello;Ramsey, Lenny;Corbetta, Maurizio
通讯作者：
Corbetta, Maurizio
影响因子：
2.2
作者：
Borstad, Alexandra L.;Nichols-Larsen, Deborah S.
通讯作者：
Nichols-Larsen, Deborah S.
影响因子：
8.3
作者：
Cramer, Steven C.
通讯作者：
Cramer, Steven C.