Modulating brain plasticity in rehabilitation of stroke and other brain lesions

调节中风和其他脑损伤康复中的大脑可塑性

• 批准号: 7969650
• 负责人: Leonardo Gregorio Cohen
• 金额: $ 71.49万
• 依托单位: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7969650
• 关键词: Adult; Affect; Area; Brain; Collaborations; Data; Development; Disease; Epilepsy; Extramural Activities; Future; Goals; Hand; Intervention; Journals; Knowledge; Laboratories; Lead; Lesion; Motor; Motor Cortex; Movement; Neurological outcome; Neurology; Neurorehabilitation; Paralysed; Patients; Physiology; Plastics; Preparation; Process; Recovery; Recovery of Function; Rehabilitation therapy; Research Personnel; Secondary to; Stroke; Techniques; Training; Traumatic Brain Injury; Work; base; brain computer interface; cost; disability; effective intervention; improved; intervention effect; loss of function; novel therapeutic intervention; post stroke; research study; skills; social; somatosensory; stroke rehabilitation

Background: Disability resulting from stroke and traumatic brain injury represent the main cause of long term disability among adults. There are no universally accepted treatments available for the treatment of this condition and the financial, personal, familiar and social cost of this disability cannot be underestimated. Preliminary data from different laboratories has shown that it is possible to modulate plastic processes in the lesioned brain by pharmacological, brain stimulation and somatosensory stimulation techniques. The purpose of this Z01 is to characterize the most promising techniques to improve cortical plasticity in these patients in order to enhance functional recovery. Findings this year: This year we studied motor cortical function associated with post stroke epilepsy, an area that has not been explored before in detail, finding important correlates between changes in motor cortical excitability and this condition. We expanded our work on the usefulness of somatosensory stimulation on motor function after stroke and studied in particular function in the contralesional primary motor cortex after this intervention. One of our fellows was honored by describing the development of neurorehabilitation as a subspecialty in the journal Neurology. We continued work to better understand the physiology of brain-computer interfaces in patients with paralysis secondary to stroke and other disorders. We characterized the effects of action observation on physical training after stroke, noting its benefits. We also characterized an important set of interactions between somatosensory stimulation of the paretic hand after stroke and changes in interhemispheric interactions. We advanced our understanding of the interactions between interhemispheric interactions and intracortical inhibitory gabaergic circuits during movement preparation after stroke. In collaboration with extramural investigators, we proceeded to study further the influence of somatosensory stimulation on motor function when administered in the weeks following stroke. Our future plans include advancing our understanding of the mechanisms by which each of these different stimulation techniques including somatosensory stimulation, cortical stimulation and brain computer interfaces contribute to recovery of motor functions after brain lesions. Some of this work will be focused in the upcoming year on traumatic brain injury, predominantly mild to moderate. Additionally, we will try to determine the optimal parameters of stimulation and techniques to enhance the beneficial effects of this intervention on neurorehabilitative treatments. Implications: The significance of this project is that it can lead to a better understanding of the mechanisms underlying rehabilitative processes and to the development of more effective interventions to improve neurological outcome after stroke and traumatic brain injury using brain stimulation techniques.

背景：脑卒中和创伤性脑损伤导致的残疾是成年人长期残疾的主要原因。目前还没有普遍接受的治疗这种疾病的方法，这种残疾的经济、个人、熟悉和社会成本不容低估。来自不同实验室的初步数据表明，可以通过药物、脑刺激和体感刺激技术来调节受损大脑的可塑性过程。本Z01的目的是描述最有前途的技术，以改善这些患者的皮质可塑性，以增强功能恢复。