Combination of Cortical Stimulation with Other Therapies

运动康复利用了运动学习的机制，现在已经非常确定的是，运动学习导致包括人类在内的成年动物大脑中的神经连接和活动模式发生重大变化。这使得运动康复非常适合于促进运动皮质卒中后功能适当的神经连接的形成，但当与其他治疗方法结合使用时，它可能是最有效的。来自该项目研究团队的聚合证据表明，局灶性皮质电刺激(CS)增强了康复的效力 训练(RT)。所使用的RT的类型可能是CS/RT疗效的关键变量，到目前为止，只有一种RT被检查过。项目2将使用感觉运动皮质局灶性缺血损伤的大鼠模型来优化与硬膜外CS相结合的运动康复。其具体目的是：(1)评估优化的CS/RT与啮齿动物版本的强制诱导运动疗法相结合的疗效；(2)确定与CS相结合的最佳运动康复训练方案；以及(3)确定CS/RT所产生的增强运动能力在治疗停止后是否长期存在。

Motor rehabilitation capitalizes upon mechanisms of motor learning and it is now very well-established that motor learning induces major changes in neural connectivity and activity patterns in the brains of adult animals, including humans. This makes motor rehabilitation extremely well suited to promote the formation of functionally appropriate neural connectivity after motor cortical strokes, but it is likely to be most effective when used in combination with other treatment approaches. Converging evidence from the research teams of this program indicate that focal cortical electrical stimulation (CS) enhances the potency of rehabilitative training (RT). The type of RT used is likely to be a critical variable in the efficacy of CS/RT and, to date, only one type of RT has been examined. Project 2 will use a rat model of focal ischemic damage to the sensorimotor cortex to optimize the motor rehabilitation that is combined with epidural CS. The specific aims are to (1) assess the efficacy of combining the optimized CS/RT with a rodent version of constraint-induced movement therapy (2) determine the optimal motor rehabilitative training regime to combine with CS, and (3) determine whether enhanced performance produced by CS/RT is long-lasting after the cessation of the treatment.