Advances and challenges in stroke rehabilitation

The Lancet Neurology, Год журнала: 2020, Номер 19(4), С. 348 - 360

Опубликована: Янв. 28, 2020

Язык: Английский

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Ischemic stroke: experimental models and reality

Acta Neuropathologica, Год журнала: 2017, Номер 133(2), С. 245 - 261

Опубликована: Янв. 7, 2017

The vast majority of cerebral stroke cases are caused by transient or permanent occlusion a blood vessel ("ischemic stroke") eventually leading to brain infarction. final infarct size and the neurological outcome depend on multitude factors such as duration severity ischemia, existence collateral systems an adequate systemic pressure, etiology localization infarct, but also age, sex, comorbidities with respective multimedication genetic background. Thus, ischemic is highly complex heterogeneous disorder. It immediately obvious that experimental models can cover only individual specific aspects this multifaceted disease. A basic understanding principal molecular pathways induced ischemia-like conditions comes already from in vitro studies. One most frequently used vivo research endovascular suture filament model rodents middle artery (MCA), which causes reproducible infarcts MCA territory. does not require craniectomy allows reperfusion withdrawal occluding filament. Although promptly restored flow far pathophysiology spontaneous human stroke, it more closely mimics therapeutic situation mechanical thrombectomy expected be increasingly applied patients. Direct arteries represents alternative approach requires craniectomy. Application endothelin-1, potent vasoconstrictor, induction focal ischemia nearly any region lacunar stroke. Circumscribed cortical lesions characteristic photothrombotic where photoactivation systemically given dye through intact skull. major shortcoming near complete lack penumbra. two mimicking various embolic models. Closeness reality has its price goes along higher variability location well unpredictable onset versus clot

Язык: Английский

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Glial Cells: Role of the Immune Response in Ischemic Stroke

Frontiers in Immunology, Год журнала: 2020, Номер 11

Опубликована: Фев. 26, 2020

Ischemic stroke, which accounts for 75-80% of strokes, is a predominant cause morbidity and mortality worldwide. Recently, post-stroke immune response becomes new breakthrough the treatment strategy ischemic stroke. Glial cells, including microglia, astrocytes, oligodendrocytes, are major components peri-infarction environment in central nervous system have been elucidated to play critical roles regulation. However, increasing evidences suggest that glial cells exert different, even contrary effect Microglia, survey CNS homostasis regulate innate response, rapidly activated following The microglia would release inflammatory cytokines induce neuronal tissue injuries. On contrary, anti-inflammatory neurotrophic factors secreted by alternatively considered be benefit recovery Astrocytes activation reactive gliosis stroke contribute limitaion brain injury stabalize homeostasis. scar developed astrocytes also hinder reconnectivity extension. Oligodendrocytes shown extensively involved demyelination remyelination after Oligodendrocyte precursor able differentiate into reactived supposed lead functional recovery. Here we discuss mechanisms regulation mediated interaction between neurons. present review, from perspective various describes their possible at different stages future intervention targets.

Язык: Английский

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BCI for stroke rehabilitation: motor and beyond

Journal of Neural Engineering, Год журнала: 2020, Номер 17(4), С. 041001 - 041001

Опубликована: Июль 2, 2020

Abstract Stroke is one of the leading causes long-term disability among adults and contributes to major socio-economic burden globally. frequently results in multifaceted impairments including motor, cognitive emotion deficits. In recent years, brain–computer interface (BCI)-based therapy has shown promising for post-stroke motor rehabilitation. spite success received by BCI-based interventions domain, non-motor are yet receive similar attention research clinical settings. Some preliminary encouraging rehabilitation using BCI seem suggest that it may also hold potential treating deficits such as impairments. Moreover, past studies have an intricate relationship between functions which might influence overall outcome. A number highlight inability current treatment protocols account implicit interplay functions. This indicates necessity explore all-inclusive plan targeting synergistic these standalone interventions. approach lead better recovery than individual isolation. this paper, we review advances use systems beyond particular, improving cognition stroke patients. Building on findings domains, next discuss possibility a holistic system affect synergistically promote restorative neuroplasticity. Such would provide all-encompassing platform, overarching outcomes transfer quality living. first works analyse cross-domain functional enabled

Язык: Английский

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Microglia and monocytes in inflammatory CNS disease: integrating phenotype and function

Acta Neuropathologica, Год журнала: 2021, Номер 143(2), С. 179 - 224

Опубликована: Дек. 1, 2021

Abstract In neurological diseases, the actions of microglia, resident myeloid cells CNS parenchyma, may diverge from, or intersect with, those recruited monocytes to drive immune-mediated pathology. However, defining precise roles each cell type has historically been impeded by lack discriminating markers and experimental systems capable accurately identifying them. Our ability distinguish microglia from in neuroinflammation advanced with single-cell technologies, new drugs that identify deplete them, respectively. Nevertheless, focus individual studies on particular types, diseases approaches limited our connect phenotype function more widely across diverse pathologies. Here, we critically review, tabulate integrate disease-specific functions immune profiles provide a comprehensive atlas responses viral encephalitis, demyelination, neurodegeneration ischemic injury. emphasizing differential severe neuroinflammatory disease inflammatory pathways common equally incapacitating less inflammation. We examine these findings context human highlight benefits inherent limitations animal models impede facilitate clinical translation. This enables us contrasting, non-redundant often opposing could be targeted therapeutically.

Язык: Английский

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Immersive Virtual Reality in Post-Stroke Rehabilitation: A Systematic Review

Sensors, Год журнала: 2023, Номер 23(3), С. 1712 - 1712

Опубликована: Фев. 3, 2023

In recent years, next to conventional rehabilitation’s techniques, new technologies have been applied in stroke rehabilitation. this context, fully immersive virtual reality (FIVR) has showed interesting results thanks the level of immersion subject illusional world, with feeling being a real part environment. This study aims investigate efficacy FIVR PubMed, Web Science and Scopus were screened up November 2022 identify eligible randomized controlled trials (RCTs). Out 4623, we included 12 RCTs involving post-acute chronic survivors, total 350 patients (234 men 115 women; mean age 58.36 years). High heterogeneity outcomes considered, that provides additional benefits, comparison standard particular, an improvement upper limb dexterity, gait performance dynamic balance, influencing patient independence. Therefore, represents adaptable, multi-faceted rehabilitation tool can be considered post-stroke rehabilitation, improving compliance treatment increasing functioning quality life survivors.

Язык: Английский

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Neuroimmune mechanisms and therapies mediating post-ischaemic brain injury and repair

Nature reviews. Neuroscience, Год журнала: 2023, Номер 24(5), С. 299 - 312

Опубликована: Март 27, 2023

Язык: Английский

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Vagus Nerve Stimulation Paired With Upper Limb Rehabilitation After Chronic Stroke

Stroke, Год журнала: 2018, Номер 49(11), С. 2789 - 2792

Опубликована: Окт. 15, 2018

Background and Purpose— We assessed safety, feasibility, potential effects of vagus nerve stimulation (VNS) paired with rehabilitation for improving arm function after chronic stroke. Methods— performed a randomized, multisite, double-blinded, sham-controlled pilot study. All participants were implanted VNS device received 6-week in-clinic followed by home exercise program. Randomization was to active (n=8) or control (n=9) rehabilitation. Outcomes at days 1, 30, 90 post-completion therapy. Results— completed the course There 3 serious adverse events related surgery. Average FMA-UE scores increased 7.6 5.3 points day 1 post–in-clinic therapy (difference, 2.3 points; CI, −1.8 6.4; P =0.20). At 90, mean 9.5 from baseline VNS, improved 3.8 5.7 −1.4 11.5; =0.055). The clinically meaningful response rate 88% 33% ( <0.05). Conclusions— acceptably safe feasible in upper limb motor deficit ischemic A pivotal study this is justified. Clinical Trial Registration— URL: https://www.clinicaltrials.gov . Unique identifier: NCT02243020.

Язык: Английский

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MiR-126 Affects Brain-Heart Interaction after Cerebral Ischemic Stroke

Translational Stroke Research, Год журнала: 2017, Номер 8(4), С. 374 - 385

Опубликована: Янв. 18, 2017

Язык: Английский

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The High Cost of Stroke and Stroke Cytoprotection Research

Translational Stroke Research, Год журнала: 2016, Номер 8(4), С. 307 - 317

Опубликована: Дек. 30, 2016

Язык: Английский

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