RESUMO
Stroke is a leading cause of death and disability worldwide. A common, chronic deficit after stroke is upper limb impairment, which can be exacerbated by compensatory use of the nonparetic limb. Resulting in learned nonuse of the paretic limb, compensatory reliance on the nonparetic limb can be discouraged with constraint-induced movement therapy (CIMT). CIMT is a rehabilitative strategy that may promote functional recovery of the paretic limb in both acute and chronic stroke patients through intensive practice of the paretic limb combined with binding, or otherwise preventing activation of, the nonparetic limb during daily living exercises. The neural mechanisms that support CIMT have been described in the lesioned hemisphere, but there is a less thorough understanding of the contralesional changes that support improved functional outcome following CIMT. Using both human and non-human animal studies, the current review explores the role of the contralesional hemisphere in functional recovery of stroke as it relates to CIMT. Current findings point to a need for a better understanding of the functional significance of contralesional changes, which may be determined by lesion size, location, and severity as well stroke chronicity.
Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Animais , Terapia por Exercício/métodos , Humanos , Recuperação de Função Fisiológica/fisiologia , Acidente Vascular Cerebral/terapia , Reabilitação do Acidente Vascular Cerebral/métodos , Extremidade SuperiorRESUMO
Stroke is the leading cause of long-term disability in the United States, making research on rehabilitation imperative. Stroke rehabilitation typically focuses on recovery of the impaired limb, although this process is tedious. Compensatory use of the intact limb after stroke is more efficient, but it is known to negatively impact the impaired limb. Exercise may help with this problem; research has shown that exercise promotes neuronal growth and prevents cell death. This study used a mouse model to investigate if post-stroke exercise could prevent deterioration of the function of the impaired limb despite compensatory training of the intact limb. Results showed that mice that exercised, in combination with intact limb training, demonstrated improved functional outcome compared to mice that received no training or compensatory limb training only. These findings suggest that exercise can prevent the deterioration of impaired limb functional outcome that is typically seen with intact limb use.
Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Animais , Terapia por Exercício , Extremidades , Humanos , Camundongos , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/terapia , Resultado do TratamentoRESUMO
BACKGROUND: Stroke is a leading cause of disability worldwide. Focused training of the impaired limb has been shown to improve its functional outcome in animal models. However, most human stroke survivors exhibit persistent motor deficits, likely due to differences in rehabilitation intensity between experimental (animal) and clinical (human) settings. OBJECTIVE: The current study investigated the effect of training intensity on behavioral outcome in a mouse model of stroke. METHODS: Mice were trained preoperatively on a skilled reaching task. After training, mice received a unilateral photothrombotic stroke. Postoperatively, animals received either daily rehabilitative training (traditional intensity), intermittent rehabilitative training (every other day), or no rehabilitative training (control). Assessment of the impaired limb occurred after 14 training sessions (14 days for the Traditional group; 28 days for the Intermittent group). RESULTS: Assessment of the impaired limb illustrated that traditional, daily training resulted in significantly better performance than no training, while intermittent training offered moderate performance gains. Mice receiving intermittent training performed significantly better than control mice but did not exhibit reaching performance as strong as that of animals trained daily. CONCLUSIONS: The intensity of rehabilitation is important for optimal recovery. Although intermediate intensity offers some benefit, it is not intensive enough to mimic the performance gains traditionally observed in animal models. These results suggest that intensive training, which is often unavailable for human stroke survivors, is necessary to achieve an optimal functional outcome. The lower bounds of training intensity for functional benefit still need to be determined.
Assuntos
Extremidades/fisiopatologia , AVC Isquêmico/fisiopatologia , AVC Isquêmico/reabilitação , Córtex Sensório-Motor/fisiopatologia , Reabilitação do Acidente Vascular Cerebral , Animais , Modelos Animais de Doenças , Masculino , Camundongos , Camundongos Endogâmicos C57BLRESUMO
Stroke is a leading cause of long-term disability, though current rehabilitative strategies fail to yield complete recovery. Focused training of the impaired limb improves functional outcome in rodents, but these strategies require intensive training that is difficult to practice in humans. Because aerobic exercise has been found to induce beneficial changes in the brain, it is a promising rehabilitative strategy after stroke. The current study investigated the effect of voluntary poststroke aerobic exercise on functional outcome in young and aged mice. Mice were trained on a skilled reaching task before receiving focal ischemic stroke and being subdivided into 3 different groups for rehabilitative training: traditional skilled reach rehabilitation, aerobic exercise, and control procedures. Both young and aged mice benefited from aerobic exercise after stroke, though the behavioral profile somewhat differed. Aerobic exercise in young mice yielded poststroke performance levels that were equivalent to preinjury levels. In aged mice, aerobic exercise accelerated improvement in motor performance without an effect on the absolute level of performance compared with controls. Our results suggest that aerobic exercise may be an effective alternative or adjunctive rehabilitative strategy after stroke. Potential mechanisms of this effect need to be further investigated. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Assuntos
Isquemia Encefálica/reabilitação , Atividade Motora , Recuperação de Função Fisiológica , Reabilitação do Acidente Vascular Cerebral/métodos , Envelhecimento , Animais , Modelos Animais de Doenças , Endotelina-1 , Aprendizagem , Masculino , Camundongos Endogâmicos C57BL , VoliçãoRESUMO
Injury due to stroke and traumatic brain injury result in significant long-term effects upon behavioral functioning. One central question to rehabilitation research is whether the nature of behavioral improvement observed is due to recovery or the development of compensatory mechanisms. The nature of functional improvement can be viewed from the perspective of behavioral changes or changes in neuroanatomical plasticity that follows. Research suggests that these changes correspond to each other in a bidirectional manner. Mechanisms surrounding phenomena like neural plasticity may offer an opportunity to explain how variables such as experience can impact improvement and influence the definition of recovery. What is more, the intensity of the rehabilitative experiences may influence the ability to recover function and support functional improvement of behavior. All of this impacts how researchers, clinicians, and medical professionals utilize rehabilitation.
Assuntos
Lesões Encefálicas Traumáticas/fisiopatologia , Lesões Encefálicas Traumáticas/reabilitação , Encéfalo/fisiopatologia , Plasticidade Neuronal , Recuperação de Função Fisiológica , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/fisiopatologia , Animais , Comportamento Animal , HumanosRESUMO
Stroke is a leading cause of long-term disability that most often results in impairment of a single limb, contralateral to the injury (paretic limb). While stroke survivors often receive some type of rehabilitative training, chronic deficits persist. It has been suggested that compensatory use of the nonparetic limb immediately after injury may underlie these long-term consequences. The current study investigated the behavioral effects of early compensatory limb use on behavioral outcome of the paretic limb in a mouse model of stroke. Mice received unilateral stroke after acquiring skilled motor performance on a reaching task. Following injury, mice received either delayed rehabilitation of the paretic limb or compensatory limb training prior to delayed rehabilitative training. After 28 days of focused rehabilitative training of the paretic limb, mice that had previously received compensatory limb training exhibited performance that was similar to their initial deficit after stroke while mice that received delayed rehabilitative training improved to pre-operative performance levels. Our results indicate that even with extensive focused training of the paretic limb, early compensatory limb use has a lasting impact on the behavioral flexibility and ultimate functional outcome of the paretic limb.
Assuntos
Destreza Motora , Paresia/reabilitação , Acidente Vascular Cerebral/complicações , Animais , Extremidades , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Paresia/etiologia , Recuperação de Função FisiológicaRESUMO
BACKGROUND: The incidence of stroke in adulthood increases with advancing age, but there is little understanding of how poststroke treatment should be tailored by age. OBJECTIVE: The goal of this study was to determine if age and task specificity of rehabilitative training affect behavioral improvement and motor cortical organization after stroke. METHODS: Young and aged mice were trained to proficiency on the Pasta Matrix Reaching Task prior to lesion induction in primary motor cortex with endothelin-1. After a short recovery period, mice received 9 weeks of rehabilitative training on either the previously learned task (Pasta Matrix Reaching), a different reaching task (Tray Reaching), or no training. To determine the extent of relearning, mice were tested once weekly on the Pasta Matrix Reaching Task. Mice then underwent intracortical microstimulation mapping to resolve the remaining forelimb movement representations in perilesion motor cortex. RESULTS: Although aged mice had significantly larger lesions compared with young mice, Pasta Matrix Reaching served as effective rehabilitative training for both age-groups. Young animals also showed improvement after Tray Reaching. Behavioral improvement in young mice was associated with an expansion of the rostral forelimb area ("premotor" cortex), but we failed to see reorganization in the aged brain, despite similar behavioral improvements. CONCLUSIONS: Our results indicate that reorganization of motor cortex may be limited by either aging or greater tissue damage, but the capacity to improve motor function via task-specific rehabilitative training continues to be well maintained in aged animals.
Assuntos
Envelhecimento/fisiologia , Terapia por Exercício/métodos , Córtex Motor/fisiopatologia , Plasticidade Neuronal/fisiologia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/fisiopatologia , Envelhecimento/patologia , Animais , Isquemia Encefálica/patologia , Isquemia Encefálica/fisiopatologia , Isquemia Encefálica/reabilitação , Modelos Animais de Doenças , Estimulação Elétrica , Endotelina-1 , Masculino , Camundongos Endogâmicos C57BL , Córtex Motor/crescimento & desenvolvimento , Córtex Motor/patologia , Destreza Motora/fisiologia , Recuperação de Função Fisiológica/fisiologia , Acidente Vascular Cerebral/patologiaRESUMO
BACKGROUND: Motor rehabilitative training improves behavioral functionality and promotes beneficial neural reorganization following stroke but is often insufficient to normalize function. Rodent studies have relied on skilled reaching tasks to model motor rehabilitation and explore factors contributing to its efficacy. It has been found that greater training intensity (sessions/day) and duration (training days) facilitates motor skill learning in intact animals. Whether rehabilitative training efficacy varies with intensity following stroke is unclear. METHODS: Mice were trained preoperatively on a skilled reaching task. Following focal ischemic lesions, mice received rehabilitative training either twice daily (high intensity [HI]), once daily (low intensity [LI]), or not at all (control) to determine the effects of rehabilitative training intensity on skilled motor performance. RESULTS: Within 7 days, the HI-trained mice achieved preischemic levels of performance. Mice receiving LI training eventually reached similar performance levels but required a greater quantity of training. Training intensity did not consistently affect the maintenance of performance gains, which were partially lost over time in both groups. DISCUSSION: These data indicate that increased training intensity increases the rate of functional improvements per time and per training session following ischemic insult. Thus, training intensity is an important variable to consider in efforts to optimize rehabilitation efficacy.
Assuntos
Isquemia Encefálica/reabilitação , Terapia por Exercício/métodos , Destreza Motora , Animais , Isquemia Encefálica/patologia , Modelos Animais de Doenças , Lateralidade Funcional , Masculino , Camundongos Endogâmicos C57BL , Córtex Motor/patologia , Acidente Vascular Cerebral/patologia , Reabilitação do Acidente Vascular Cerebral , Fatores de Tempo , Resultado do TratamentoRESUMO
Mouse models have become increasingly popular in the field of behavioral neuroscience, and specifically in studies of experimental stroke. As models advance, it is important to develop sensitive behavioral measures specific to the mouse. The present protocol describes a skilled motor task for use in mouse models of stroke. The Pasta Matrix Reaching Task functions as a versatile and sensitive behavioral assay that permits experimenters to collect accurate outcome data and manipulate limb use to mimic human clinical phenomena including compensatory strategies (i.e., learned non-use) and focused rehabilitative training. When combined with neuroanatomical tools, this task also permits researchers to explore the mechanisms that support behavioral recovery of function (or lack thereof) following stroke. The task is both simple and affordable to set up and conduct, offering a variety of training and testing options for numerous research questions concerning functional outcome following injury. Though the task has been applied to mouse models of stroke, it may also be beneficial in studies of functional outcome in other upper extremity injury models.
Assuntos
Modelos Animais de Doenças , Aprendizagem/fisiologia , Destreza Motora/fisiologia , Córtex Sensório-Motor/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Animais , Comportamento Animal/fisiologia , Membro Anterior/fisiopatologia , CamundongosRESUMO
Behavioral experience, in the form of skilled limb use, has been found to impact the structure and function of the central nervous system, affecting post-stroke behavioral outcome in both adaptive and maladaptive ways. Learning to rely on the less-affected, or non-paretic, body side is common following stroke in both humans and rodent models. In rats, it has been observed that skilled learning with the non-paretic forelimb following ischemic insult leads to impaired or delayed functional recovery of the paretic limb. Here we used a mouse model of focal motor cortical ischemic injury to examine the effects of non-paretic limb training following unilateral stroke. In addition, we exposed some mice to increased bimanual experience in the home cage following stroke to investigate the impact of coordinated dexterous limb use on the non-paretic limb training effect. Our results confirmed that skilled learning with the non-paretic limb impaired functional recovery following stroke in C56BL/6 mice, as it does in rats. Further, this effect was avoided when the skill learning of the non-paretic limb was coupled with increased dexterous use of both forelimbs in the home cage. These findings further establish the mouse as an appropriate model in which to study the neural mechanisms of recovery following stroke and extend previous findings to suggest that the dexterous coordinated use of the paretic and non-paretic limb can promote functional outcome following injury.
Assuntos
Meio Ambiente , Membro Anterior/fisiopatologia , Lateralidade Funcional/fisiologia , Aprendizagem/fisiologia , Paresia/prevenção & controle , Reabilitação do Acidente Vascular Cerebral , Análise de Variância , Animais , Modelos Animais de Doenças , Endotelina-1/farmacologia , Privação de Alimentos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Destreza Motora/fisiologia , Paresia/etiologia , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/complicações , Fatores de TempoAssuntos
Modelos Neurológicos , Plasticidade Neuronal/fisiologia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/fisiopatologia , Animais , Comportamento Animal/fisiologia , Infarto Cerebral/patologia , Infarto Cerebral/fisiopatologia , Modelos Animais de Doenças , Humanos , Córtex Motor/patologia , Córtex Motor/fisiopatologia , Paralisia/etiologia , Paralisia/reabilitação , Ratos , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/patologiaRESUMO
Aerobic exercise promotes rapid and profound alterations in the brain. Depending upon the pattern and duration of exercise, these changes in the brain may extend beyond traditional motor areas to regions and structures normally linked to learning, cognition, and emotion. Exercise-induced alterations may include changes in blood flow, hormone and growth factor release, receptor expression, angiogenesis, apoptosis, neurogenesis, and synaptogenesis. Together, we believe that these changes underlie elevations of mood and prompt the heightened behavioral plasticity commonly observed following adoption of a chronic exercise regimen. In the following paper, we will explore both the psychological and psychobiological literatures relating to exercise effects on brain in both human and non-human animals and will attempt to link plastic changes in these neural structures to modifications in learned behavior and emotional expression. In addition, we will explore the therapeutic potential of exercise given recent reports that aerobic exercise may serve as a neuroprotectant and can also slow cognitive decline during normal and pathological aging.
RESUMO
UNLABELLED: Behavioral experience is at work modifying the structure and function of the brain throughout the lifespan, but it has a particularly dramatic influence after brain injury. This review summarizes recent findings on the role of experience in reorganizing the adult damaged brain, with a focus on findings from rodent stroke models of chronic upper extremity (hand and arm) impairments. A prolonged and widespread process of repair and reorganization of surviving neural circuits is instigated by injury to the adult brain. When experience impacts these same neural circuits, it interacts with degenerative and regenerative cascades to shape neural reorganization and functional outcome. This is evident in the cortical plasticity resulting from compensatory reliance on the "good" forelimb in rats with unilateral sensorimotor cortical infarcts. Behavioral interventions (e.g., rehabilitative training) can drive functionally beneficial neural reorganization in the injured hemisphere. However, experience can have both behaviorally beneficial and detrimental effects. The interactions between experience-dependent and injury-induced neural plasticity are complex, time-dependent, and varied with age and other factors. A better understanding of these interactions is needed to understand how to optimize brain remodeling and functional outcome. LEARNING OUTCOMES: Readers will be able to describe (a) experience effects that are maladaptive for behavioral outcome after brain damage, (b) manipulations of experience that drive functionally beneficial neural plasticity, and (c) reasons why rehabilitative training effects can be expected to vary with age, training duration and timing.
Assuntos
Lesões Encefálicas/fisiopatologia , Plasticidade Neuronal/fisiologia , Envelhecimento/fisiologia , Animais , Lesões Encefálicas/reabilitação , Modelos Animais de Doenças , Humanos , Aprendizagem/fisiologia , Ratos , Recuperação de Função Fisiológica/fisiologia , Acidente Vascular Cerebral/fisiopatologia , Reabilitação do Acidente Vascular Cerebral , Fatores de TempoRESUMO
In its strictest application, the term "reinforcement learning" refers to a computational approach to learning in which an agent (often a machine) interacts with a mutable environment to maximize reward through trial and error. The approach borrows essentials from several fields, most notably Computer Science, Behavioral Neuroscience, and Psychology. At the most basic level, a neural system capable of mediating reinforcement learning must be able to acquire sensory information about the external environment and internal milieu (either directly or through connectivities with other brain regions), must be able to select a behavior to be executed, and must be capable of providing evaluative feedback about the success of that behavior. Given that Psychology informs us that reinforcers, both positive and negative, are stimuli or consequences that increase the probability that the immediately antecedent behavior will be repeated and that reinforcer strength or viability is modulated by the organism's past experience with the reinforcer, its affect, and even the state of its muscles (e.g., eyes open or closed); it is the case that any neural system that supports reinforcement learning must also be sensitive to these same considerations. Once learning is established, such a neural system must finally be able to maintain continued response expression and prevent response drift. In this report, we examine both historical and recent evidence that the cerebellum satisfies all of these requirements. While we report evidence from a variety of learning paradigms, the majority of our discussion will focus on classical conditioning of the rabbit eye blink response as an ideal model system for the study of reinforcement and reinforcement learning.
RESUMO
Long-term aerobic exercise improves cognition in both human and nonhuman animals and induces plastic changes in the central nervous system (CNS), including neurogenesis and angiogenesis. However, the early and immediate effects of exercise on the CNS have not been adequately explored. There is some evidence to suggest that exercise is initially challenging to the nervous system and that the plastic changes commonly associated with chronic exercise may result as adaptations to this challenge. The current experiment assessed levels of apoptosis, angiogenesis, and neurogenesis during the first week of an exercise regimen in the adult rat. The results indicate that exercise rapidly induces these processes in the hippocampus and cerebellum. The temporal pattern of these events suggests that voluntary exercise in the adult rat rapidly and transiently induces apoptosis, followed by angiogenesis. Neurogenesis is an immediate and independent consequence of exercise in the hippocampus that may require the additional metabolic support supplied by angiogenesis. This is the first report of CNS neuronal apoptosis as a consequence of exercise in the adult rat and suggests that this process is a potential mediator of rapid exercise-induced plasticity.
Assuntos
Apoptose/fisiologia , Cerebelo/citologia , Hipocampo/citologia , Neurogênese/fisiologia , Plasticidade Neuronal/fisiologia , Condicionamento Físico Animal/fisiologia , Fatores Etários , Animais , Contagem de Células , Morte Celular/fisiologia , Cerebelo/patologia , Cerebelo/fisiologia , Hipocampo/patologia , Hipocampo/fisiologia , Masculino , Neovascularização Fisiológica/fisiologia , Neurônios/citologia , Condicionamento Físico Animal/métodos , Ratos , Ratos Long-Evans , Fatores de TempoRESUMO
Recently identified pathways from the dentate nuclei of the cerebellum to the rostral cerebral cortex via the thalamus suggest a cerebellar role in frontal and prefrontal non-motor functioning. Disturbance of cerebellar morphology and connectivity, particularly involving these cerebellothalamocortical (CTC) projections, has been implicated in motivational and cognitive deficits. The current study explored the effects of CTC disruption on motivation in male Long Evans rats. The results of two experiments demonstrate that electrolytic lesions of the cerebellar dentate nuclei lower breaking points on an operant conditioning progressive ratio schedule and decrease open field exploration compared to sham controls. Changes occurred in the absence of motor impairment, assessed via lever pressing frequency and rotarod performance. Similar elevated plus maze performances between lesioned and sham animals indicated that anxiety did not influence task performance. Our results demonstrate hedonic and purposive motivational reduction and suggest a CTC role in global motivational processes. These implications are discussed in terms of psychiatric disorders such as schizophrenia and autism, in which cerebellar damage and motivational deficits often present concomitantly.
Assuntos
Núcleos Cerebelares/fisiopatologia , Condicionamento Operante/fisiologia , Comportamento Exploratório/fisiologia , Motivação/fisiologia , Análise de Variância , Animais , Ansiedade/fisiopatologia , Masculino , Aprendizagem em Labirinto/fisiologia , Ratos , Ratos Long-EvansRESUMO
The present study was conducted in an effort to evaluate whether chromosomal substitution can repair impaired exploration learning and memory. It has previously been observed that Dahl salt-sensitive (SS) rodents exhibit impaired cognitive function along with abnormal physiological responses to muscle stimulation. Introgression of Brown Norway chromosome (13(BN)) has been found to restore normal physiological processes in SS animals. However, the effect of chromosomal substitution on cognitive performance has not been explored. It was hypothesized that 13(BN) also rescues cognitive impairments in these animals. Visual spatial learning and cognitive flexibility were evaluated using the Morris water maze (MWM) and the T-maze. This manipulation is effective in rescuing impaired task acquisition, but not perseveration observed in the SS animal. These animals may represent a natural animal model in which to isolate genetic information responsible for learning and memory function.