Genetic variation, stress, and functional outcomes after stroke rehabilitation

中风康复后的遗传变异、压力和功能结果

• 批准号: 9246343
• 负责人: Steven C. Cramer
• 金额: $ 51.32万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-06-17 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9246343
• 关键词: Activities of Daily Living; Address; Affect; American; Behavior; Behavioral; Biological; Biological Factors; Biological Models; Brain-Derived Neurotrophic Factor; Chronic; Collaborations; Development; Dopamine; Dose; Endocannabinoids; Event; Exposure to; Funding; General Hospitals; Genetic; Genetic Polymorphism; Genetic Predisposition to Disease; Genetic Research; Genetic Variation; Genotype; Health; Human; Human Genetics; Individual; Injury; Intervention; Investigation; Ischemic Stroke; Knowledge; Lead; Life; Longitudinal Studies; Maintenance; Massachusetts; Measures; Molecular; Motor; NR3C2 gene; Neurological status; Outcome; Oxytocin; Patient-Focused Outcomes; Patients; Persons; Phase; Post-Traumatic Stress Disorders; Process; Psychosocial Factor; Questionnaires; Recovery; Rehabilitation therapy; Renin-Angiotensin-Aldosterone System; Research; Serotonin; Stress; Stroke; Supratentorial; Symptoms; System; Therapeutic Studies; Time; Trauma; Variant; Work; acute stress; acute traumatic stress disorder; apolipoprotein E-4; arm; behavioral outcome; depressive symptoms; disability; experience; functional outcomes; gene repair; genetic makeup; geriatric depression; hypothalamic-pituitary-adrenal axis; improved; insight; motor deficit; motor recovery; nerve injury; personalized care; personalized medicine; post stroke; post-traumatic stress; public health relevance; reduce symptoms; rehabilitative care; relating to nervous system; repaired; response; standard of care; stress symptom; stressor; stroke recovery; stroke rehabilitation; stroke survivor; treatment planning; treatment response

 DESCRIPTION (provided by applicant): Stroke continues to represent the leading cause of long-term disability in Americans. Rehabilitation therapy is provided as standard of care following stroke, as strong evidence supports that it can improve patient outcomes. However, patients show a great deal of variability in their response to post-stroke rehabilitation therapy. While a number of factors have been identified that provide insight into the basis for these inter-subject differences, overall knowledge remains limited. The proposed studies will examine how genetic polymorphisms interact with rehabilitation therapy and with stress to affect treatment-induced recovery after stroke. In this research we build on our prior work and take a unique approach to understanding therapeutic response in stroke survivors. Dr. Holman has addressed the important impact that stress and genetic susceptibilities to stress may have on well-being and health outcomes following trauma. Dr. Cramer has studied stroke recovery and its genetic influences. In collaboration with geneticists in the Center for Human Genetic Research at Massachusetts General Hospital, the team will study how stress and specific genetic factors are related to the response to rehabilitation therapy, and the maintenance of these gains over time. Variability in therapy-induced recovery after stroke is wide. The current studies may provide insight into biological factors underlying this phenomenon, and so may help individualize rehabilitation care.

 描述（由申请人提供）：中风仍然是美国人长期残疾的主要原因。康复治疗作为卒中后的标准治疗提供，因为强有力的证据支持它可以改善患者的结局。然而，患者对卒中后康复治疗的反应存在很大差异。虽然已经确定了一些因素，提供了深入了解这些学科间差异的基础，总体知识仍然有限。拟议的研究将检查遗传多态性如何与康复治疗和压力相互作用，以影响中风后治疗诱导的恢复。在这项研究中，我们建立在我们以前的工作，并采取独特的方法来了解中风幸存者的治疗反应。霍尔曼博士阐述了压力和遗传对压力的易感性可能对创伤后的幸福感和健康结果产生的重要影响。Cramer博士研究了中风恢复及其遗传影响。该团队将与马萨诸塞州总医院人类遗传研究中心的遗传学家合作，研究压力和特定遗传因素如何与康复治疗的反应相关，以及随着时间的推移这些收益的维持。中风后治疗诱导的恢复差异很大。目前的研究可能会提供深入了解这种现象背后的生物学因素，因此可能有助于个性化康复护理。