Genetic variation, stress, and functional outcomes after stroke rehabilitation

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。康复治疗作为中风后的标准治疗，因为有力的证据支持它可以改善患者的预后。然而，患者对脑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，可以深入了解这些学科间差异的基础，但总体知识仍然有限。拟议的研究将研究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，我们建立在我们之前的工作，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对压力的遗传易感性可能对创伤后的福祉和健康结果产生的重要影响。克莱默博士研究了中风恢复及其基因影响。与麻省总医院人类遗传研究中心的遗传学家合作，该团队将研究压力和特定遗传因素如何与康复治疗的反应相关，并随着时间的推移保持这些成果。中风后治疗诱导的恢复的可变性很大。目前的研究可能为这种现象背后的生物学因素提供深入的见解，因此可能有助于个性化康复护理。

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.