Cellular and Molecular Targets for Non-Invasive, Non-Pharmacological Therapeutic/Rehabilitative Interventions in Acute Ischemic Stroke

International Journal of Molecular Sciences, Journal Year: 2022, Volume and Issue: 23(2), P. 907 - 907

Published: Jan. 14, 2022

Cerebral circulation delivers the blood flow to brain through a dedicated network of sanguine vessels. A healthy human can regulate cerebral (CBF) according any physiological or pathological challenges. The is protected by its self-regulatory mechanisms, which are dependent on neuronal and support cellular populations, including endothelial ones, as well metabolic, even myogenic factors.Accumulating data suggest that "non-pharmacological" approaches might provide new opportunities for stroke therapy, such electro-/acupuncture, hyperbaric oxygen hypothermia/cooling, photobiomodulation, therapeutic gases, transcranial direct current stimulations, magnetic stimulations. We reviewed recent mechanisms clinical implications these non-pharmaceutical treatments.To present state-of-the-art currently available non-invasive, non-pharmacological-related interventions in acute ischemic stroke, we accomplished this synthetic systematic literature review based Preferred Reporting Items Systematic Principles Reviews Meta-Analyses (PRISMA).The initial number obtained articles was 313. After fulfilling five steps filtering/selection methodology, 54 fully eligible papers were selected review. enhanced our documentation with other bibliographic resources connected subject, identified within non-standardized search, fill knowledge gaps. Fifteen trials also identified.Non-invasive, non-pharmacological therapeutic/rehabilitative mainly holistic therapies. Therefore, most them not yet routinely used practice, despite some possible beneficial effects, have be supplementarily proven more related studies. Moreover, few already completed do final results.This synthesizes findings interventions, described non-invasive non-pharmacological.

Language: Английский

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Exploring the transformative influence of neuroplasticity on stroke rehabilitation: a narrative review of current evidence

Annals of Medicine and Surgery, Journal Year: 2023, Volume and Issue: 85(9), P. 4425 - 4432

Published: Aug. 7, 2023

This review aims to assess the role of neuroplasticity in facilitating stroke recovery and identify challenges limitations associated with its implementation. A comprehensive literature search was conducted relevant studies, which were meticulously evaluated determine potential solutions for effectively harnessing neuroplasticity. The results indicate that holds significant promise rehabilitation; however, individual variability response interventions, timing duration interventions sociocultural clinical factors pose challenges. Tailoring patient characteristics is crucial optimising impact Despite limitations, transformative rehabilitation undeniable. abstract concludes by emphasising importance a understanding variability, intervention considering factors. Future research practice should prioritise personalised interdisciplinary collaborations fully exploit vast recovery.

Language: Английский

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Melatonin enhances neurogenesis and neuroplasticity in long-term recovery following cerebral ischemia in mice

Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease, Journal Year: 2025, Volume and Issue: 1871(4), P. 167738 - 167738

Published: Feb. 22, 2025

Language: Английский

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Effectiveness of Virtual Reality in the Rehabilitation of Motor Function of Patients With Subacute Stroke: A Meta-Analysis

Frontiers in Neurology, Journal Year: 2021, Volume and Issue: 12

Published: May 5, 2021

Stroke is a major cause of death and disability in adults. Conventional therapy (CT) has limited effectiveness, therefore, various virtual reality (VR) rehabilitation programs have been designed. However, their efficacy regaining motor function patients with subacute stroke questionable. Therefore, we conducted this meta-analysis to determine the VR, compared CT, restoring patient population. Up October 10, 2020, nine electronic databases were searched for relevant articles reporting effectiveness VR stroke. This search was updated on March 7, 2021, no additional added articles. The control group included physical therapy, occupational or combination them. Effectiveness defined as positive change from baseline values last follow-up point. Cochrane's revised risk-of-bias tool used quality trials. A metaregression analysis effect “time since stroke” reported outcomes. Publication bias sensitivity analyses also carried out. total 19 studies (17 randomized controlled trials, 1 cohort study, crossover trial) qualitative analysis, whereas 16 trials meta-analyzed. great improvement noted group, when preintervention [standardized mean difference (SMD) = 1.14; 95% confidence interval (CI) 0.77–1.52; I 2 82%; P < 0.001]. When resulted mild (SMD 0.47; CI 0.22–0.72; 75%; 0.001). upon trim-and-fill adjustment, finding deemed insignificant 0.08; −0.16 0.33; 82.6%; Ten had low risk, five some concerns, three high one moderate risk bias. can be jointly CT more are still warranted these interventions retaining cognitive performance such patients.

Language: Английский

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Left or right ear? A neuroimaging study using combined taVNS/fMRI to understand the interaction between ear stimulation target and lesion location in chronic stroke

Brain stimulation, Journal Year: 2023, Volume and Issue: 16(4), P. 1144 - 1153

Published: July 1, 2023

Implanted vagus nerve stimulation (VNS) and transcutaneous auricular VNS (taVNS) have been primarily administered clinically to the unilateral-left nerve. This left-only convention has proved beneficial in brain disorders. However, stroke survivors, presence of a lesion may complicate VNS-mediated signaling, it is important understand laterality effects survivors optimize intervention.To whether taVNS delivered different ear targets relative (ipsilesional vs contralesional bilateral sham) impacts blood oxygenation level dependent (BOLD) signal propagation survivors.We enrolled 20 adults with prior history stroke. Each participant underwent single visit, during which was concurrently functional magnetic resonance imaging (fMRI) acquisition. received three discrete active conditions (ipsilesional, contralesional, bilateral) one sham condition randomized order. Stimulation-related BOLD changes were compared interaction effects.All deactivated default mode network related regions sham, however only ipsilesional enhanced activations visuomotor secondary visual cortex. Furthermore, we reveal an task between cortical areas, where significantly increased activity decreased sham.Laterality critical factor optimizing population, providing largest direct activation should be explored further when designing studies neurorehabilitation.

Language: Английский

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The Effectiveness of Paired Associative Stimulation on Motor Recovery after Stroke: A Scoping Review

Neurology International, Journal Year: 2024, Volume and Issue: 16(3), P. 567 - 589

Published: May 14, 2024

Paired associative stimulation (PAS) is a non-invasive brain technique combining transcranial magnetic and peripheral nerve stimulation. PAS allows connections between cortical areas nerves (C/P PAS) or regions (C/C to be strengthened weakened by spike-timing-dependent neural plasticity mechanisms. Since modulates both neurophysiological features motor performance, there growing interest in its application neurorehabilitation. We aimed synthesize evidence on the rehabilitation role of stroke patients. performed literature search following PRISMA Extension for Scoping Reviews Framework. Eight studies were included: one investigated C/C cerebellum affected primary area (M1), seven applied C/P over lesional, contralesional, M1. Seven evaluated outcome upper limb lower recovery. Although several omit crucial methodological details, highlighted effects mainly corticospinal excitability, and, more rarely, an improvement performance. However, most failed prove correlation changes improvement. current seem suggest post-stroke rehabilitation, their heterogeneity limited number do not yet allow definitive conclusions drawn.

Language: Английский

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Effectiveness of an Intensive, Functional, and Gamified Rehabilitation Program on Upper Limb Function in People With Stroke (EnteRtain): A Multicenter Randomized Clinical Trial

Neurorehabilitation and neural repair, Journal Year: 2024, Volume and Issue: 38(4), P. 243 - 256

Published: Jan. 29, 2024

Despite a growing interest in gaming rehabilitation for upper limb (UL) recovery post-stroke, studies investigating the effects of game-based incorporating functional games are lacking.

Language: Английский

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Effects of control strategies on gait in robot-assisted post-stroke lower limb rehabilitation: a systematic review

Journal of NeuroEngineering and Rehabilitation, Journal Year: 2022, Volume and Issue: 19(1)

Published: June 3, 2022

Stroke related motor function deficits affect patients' likelihood of returning to professional activities, limit their participation in society and functionality daily living. Hence, robot-aided gait rehabilitation needs be fruitful effective from a learning perspective. For this reason, optimal human-robot interaction strategies are necessary foster neuroplastic shaping during therapy. Therefore, we performed systematic search on the effects different control algorithms quantitative objective parameters post-acute stroke patients.We conducted four electronic databases using Population Intervention Comparison Outcome format. The heterogeneity performance assessment, study designs numerosity prevented possibility conduct rigorous meta-analysis, thus, results were presented through narrative synthesis.A total 31 studies (out 1036) met inclusion criteria, without applying any temporal constraints. No controller preference with respect improvements was found. However, preferred solutions encountered implementation force mostly rigid devices therapeutic scenarios. Conversely, soft devices, which all position-controlled, found more commonly used assistive effect controllers could not evaluated since conspicuous for both metrics designs.Overall, due impossibility performing review calls an outcome standardisation evaluation rehabilitation. This allow comparison adaptive human-dependent conventional ones, identifying most suitable specific pathologic patterns. latter aspect bolster individualized personalized choices or path.

Language: Английский

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The Multifaceted Role of Cofilin in Neurodegeneration and Stroke: Insights into Pathogenesis and Targeting as a Therapy

Cells, Journal Year: 2024, Volume and Issue: 13(2), P. 188 - 188

Published: Jan. 18, 2024

This comprehensive review explores the complex role of cofilin, an actin-binding protein, across various neurodegenerative diseases (Alzheimer’s, Parkinson’s, schizophrenia, amyotrophic lateral sclerosis (ALS), Huntington’s) and stroke. Cofilin is essential protein in cytoskeletal dynamics, any dysregulation could lead to potentially serious complications. Cofilin’s involvement underscored by its impact on pathological hallmarks like Aβ plaques α-synuclein aggregates, triggering synaptic dysfunction, dendritic spine loss, impaired neuronal plasticity, leading cognitive decline. In Parkinson’s disease, cofilin collaborates with α-synuclein, exacerbating neurotoxicity impairing mitochondrial axonal function. ALS frontotemporal dementia showcase cofilin’s association genetic factors C9ORF72, affecting actin dynamics contributing neurotoxicity. Huntington’s disease brings into focus microglial migration influencing plasticity through AMPA receptor regulation. Alzheimer’s, schizophrenia exhibit 14-3-3 proteins as a shared mechanism. case stroke, takes center stage, mediating cell death. Notably, there potential overlap pathologies diseases. this context, referencing dysfunction provide valuable insights common associated aforementioned conditions. Moreover, promising therapeutic interventions, including inhibitors gene therapy, demonstrating efficacy preclinical models. Challenges inhibitor development, brain delivery, tissue/cell specificity, long-term safety are acknowledged, emphasizing need for precision drug therapy. The call action involves collaborative research, biomarker identification, advancing translational efforts. emerges pivotal player, offering target. However, unraveling complexities requires concerted multidisciplinary efforts nuanced effective interventions intricate landscape presenting hopeful avenue improved patient care.

Language: Английский

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Simultaneous high-definition transcranial direct current stimulation and robot-assisted gait training in stroke patients

Scientific Reports, Journal Year: 2024, Volume and Issue: 14(1)

Published: Feb. 23, 2024

This study investigates whether simultaneous high-definition transcranial direct current stimulation (HD-tDCS) enhances the effects of robot-assisted gait training in stroke patients. Twenty-four participants were randomly allocated to either with real HD-tDCS group (real group) or sham (sham group). Over four weeks, both groups completed 10 sessions. The Meter Walk Test, Timed Up and Go, Functional Ambulation Category, Reach Berg Balance Scale, Dynamic Gait Index, Fugl-Meyer Assessment, Korean version Modified Barthel Index conducted before, immediately after, one month after intervention. showed significant improvements Scale intervention, compared before Significant Assessment also observed no any tests. Application during has a positive effect on physical function chronic patients, ensuring long-term effects. Our results suggest effectiveness as complementary tool enhance robotic rehabilitation therapy

Language: Английский

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