An integrated view on the role of receptor mosaics at perisynaptic level: focus on adenosine A(2A), dopamine D(2), cannabinoid CB(1), and metabotropic glutamate mGlu(5) receptors.

The available evidence for receptor-receptor interactions between adenosine A(2A), dopamine D(2), cannabinoid CB(1), and metabotropic glutamate mGlu(5) receptors (A(2A), D(2), CB(1), and mGlu(5), respectively) is revised under the "receptor mosaic" perspective. Furthermore, the concept of "hub receptor" is defined in accordance with informatics and it is tentatively illustrated in the case of the hypothesized tetramer formed by the above mentioned receptors. On the basis of some biochemical features of the four receptors and of a bioinformatics analysis, an objective deduction of their "similarity" has been obtained. To this aim the Canberra, Euclidean and Chebyshev multivariate distance metrics have been used. It is interesting to note that A(2A) and D(2) are the most different ones, while CB(1) and mGlu(5) are the most similar ones among the four receptors analyzed. Finally, by means of a bioinformatics analysis based on different approaches the possible binding sites mediating G-protein-coupled receptor (GPCR) interactions have been indicated. It is interesting to note that in some instances accordance has been found between the bioinformatics indications and the available experimental data.

The augmented-feedback rehabilitation technique facilitates the arm motor recovery in patients after a recent stroke.

Previous studies have shown that the motor training in a virtual-environment with the augmented feedback promotes motor learning in normal subjects and in long-term post-stroke patients. We evaluated whether this approach could be useful also for treating patients with arm motor deficits due to a recent stroke. Twenty-four patients were included in the study within 3 months from an ischemic stroke in the territory of the middle cerebral artery. Twelve subjects received virtual-environment-training (VET) therapy for the arm, and twelve patients received an equal amount of a conventional rehabilitation therapy focused to the upper limb. Before and after therapy, the autonomy of daily living activities were assessed with the Functional Independence Measure and the degree of motor impairment was measured with the Fugl-Meyer scale for the upper extremity. For both groups the therapy lasted from 5 to 7 weeks, 1 hour daily for five days a week. The VET therapy group showed 20,2% and 12,4% improvements in the Fugl-Meyer and the Functional Independence Measure scale mean scores respectively. In a comparable way, the conventional therapy determined significant, but smaller scores improvements: 11,3% and 9,1%, respectively. These data indicate that the recovery of arm motor function in patients after a recent stroke is promoted by an augmented feedback strategy applied through a virtual-environment.

Virtual environment system for motor tele-rehabilitation.

The present cutting-edge communication technology applied to the rehabilitation may change the real possibility of providing therapeutic treatments to the patients at their home. In order to confirm this assertion a current study on motor telerehabilitation was undertaken. Through a virtual reality based system, and a complementary video conference apparatus, we supplied five post stroke patients with a motor rehabilitation therapy. The rehabilitation technique was based on the augmented feedback. Subjects underwent the telerehabilitation program for six weeks. Before and after the evaluated therapy, arm motor performance and the activities of daily living were evaluated by the means of clinical scales and measuring the affected arm velocity (end-effector). This pilot study suggested that telerehabilitation could promote the learning of arm motor abilities at distance from the health facilities. From an economic point of view, it could be proposed also as an opportune strategy for saving resources.

Motor tele-rehabilitation in post-stroke patients.

PRIMARY OBJECTIVE: The advanced communication technology may allow rehabilitative interventions to patients living at home from a remote provider. We evaluated the effects of a tele-rehabilitation system for the therapy of arm motor impairments due to a stroke. RESEARCH DESIGN: Experimental observational study. METHODS AND PROCEDURES: We selected five patients suffering from mild/intermediate arm motor impairments due to a long-lasting ischaemic stroke. Two workstations were utilized, one in the patient's house and the other in the rehabilitation hospital, connected through the phone lines. A virtual reality based software allowed the patient to perform adequate motor tasks created by the physiotherapist. During performance, the patient could see not only their movement but also the correct trajectory that they had to accomplish. The feedback derived from the patient's action, its outcome, and feedback from the supervision of the physiotherapist may favour the acquisition of new motor abilities. MAIN OUTCOME MEASURES: The arm motor performance and the activities of daily living were evaluated using the Fugl-Meyer and Functional Independence Measure scale, together with the determination of the velocity and duration of 10 representative reaching movements. RESULTS: Subjects underwent the tele-rehabilitation programme for 4 weeks. The therapy significantly improved the Fugl-Meyer mean score, the mean duration and the velocity of the movements, but not the Functional Independence Measure scale score. CONCLUSIONS: These results indicated that this tele-rehabilitation system did not appear to adversely affect rehabilitation; rather it may improve arm motor deficits due to a stroke. If these evidences are further confirmed, tele-rehabilitation may represent a new home-based therapy to treat disabled people.