Factors affecting post-stroke motor recovery: Implications on neurotherapy after brain injury

Abstract

Neurological disorders are a major cause of chronic disability globally among which stroke is a leading cause of chronic disability. The advances in the medical management of stroke patients over the past decade have significantly reduced mortality, but at the same time increased numbers of disabled survivors. Unfortunately, this reduction in mortality was not paralleled by satisfactory therapeutics and rehabilitation strategies that can improve functional recovery of patients. Motor recovery after brain injury is a complex, dynamic, and multifactorial process in which an interplay among genetic, pathophysiologic, sociodemographic and therapeutic factors determines the overall recovery trajectory. Although stroke recovery is the most well-studied form of post-injury neuronal recovery, a thorough understanding of the pathophysiology and determinants affecting stroke recovery is still lacking. Understanding the different variables affecting brain recovery after stroke will not only provide an opportunity to develop therapeutic interventions but also allow for developing personalized platforms for patient stratification and prognosis. We aim to provide a narrative review of major determinants for post-stroke recovery and their implications in other forms of brain injury.

Phycocyanobilin reduces brain injury after endothelin‐1‐ induced focal cerebral ischaemia

“…The variables used were distance travelled, speed of displacement and resting time. In patients with ischaemic brain injury, motor deficits directly impact functional capacity, socialization, and quality of life, impairing rehabilitation as well as social interaction, for which PCB may provide an effective treatment. In a long‐term study after injury (30 days), PCB was also able to preserve viable neurons in the cerebral cortex of ischaemic rats in a dose‐response manner, by reducing the number of cells showing atrophy, shrinkage, nuclear pyknosis, dark cytoplasmic coloration or empty spaces, indicating neurodegeneration .…”

Stroke recovery and rehabilitation in 2016: a year in review of basic science and clinical science

“…2016 is an exciting year for scientists and patients, with several breakthroughs in both benchwork research as well as the clinical research, as highlighted above. Looking into 2017, the priorities of stroke recovery should be: (1) to better understand the pathophysiology and factors underlying the recovery trajectory, 47 especially in the first 90 days after stroke during which the majority of improvement occurs; (2) to identify the novel targets; (3) to maximally preserve, protect and recover brain function by harnessing brain plasticity; (4) to ensure basic and translational science research are closely engaged and to address the unmet needs in clinical practice and (5) to translate restorative poststroke therapeutics through collaborative, rigorous, transparent research efforts.…”

Brainstem Stroke Presenting as Wake-Up Diplopia in a Patient With an Incomplete Circle of Willis

“…A worrying observation was that the proportion of patients arriving early after stroke onset remained unchanged over the six years of the study. While advances in treatment and rehabilitation have achieved lower mortality rates for ischemic stroke, they have also resulted in an increase in disabled survivors [17]. A broad effort to educate the public on the importance of acting quickly in the presence of stroke symptoms could help alleviate this situation by increasing the number of treatable patients.…”