Genetic Variation and Neuroplasticity: Role in Rehabilitation After Stroke

Stewart, Jill Campbell; Cramer, Steven C.

doi:10.1097/npt.0000000000000180

Cited by 40 publications

(36 citation statements)

References 100 publications

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“…Researchers and therapists are still looking for a new possibility of impact of the neuronal system; it will contribute in the future to the functional progress and usage capacity of the mechanisms of neuronal plasticity in the case of his damage [ 108 ].…”

Section: Discussionmentioning

confidence: 99%

Brain Functional Reserve in the Context of Neuroplasticity after Stroke

et al. 2019

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Stroke is the second cause of death and more importantly first cause of disability in people over 40 years of age. Current therapeutic management of ischemic stroke does not provide fully satisfactory outcomes. Stroke management has significantly changed since the time when there were opened modern stroke units with early motor and speech rehabilitation in hospitals. In recent decades, researchers searched for biomarkers of ischemic stroke and neuroplasticity in order to determine effective diagnostics, prognostic assessment, and therapy. Complex background of events following ischemic episode hinders successful design of effective therapeutic strategies. So far, studies have proven that regeneration after stroke and recovery of lost functions may be assigned to neuronal plasticity understood as ability of brain to reorganize and rebuild as an effect of changed environmental conditions. As many neuronal processes influencing neuroplasticity depend on expression of particular genes and genetic diversity possibly influencing its effectiveness, knowledge on their mechanisms is necessary to understand this process. Epigenetic mechanisms occurring after stroke was briefly discussed in this paper including several mechanisms such as synaptic plasticity; neuro-, glio-, and angiogenesis processes; and growth of axon.

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Section: Discussionmentioning

confidence: 99%

Brain Functional Reserve in the Context of Neuroplasticity after Stroke

et al. 2019

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“…Another factor that may be a source of a lot of variation between studies is the genetics of the individuals involved. Research suggests that polymorphisms in genes such as BDNF and apolipoprotein E may influence stroke recovery, and specifically may interact with treatments (Stewart and Cramer, 2017 ). Genetic polymorphisms potentially impacting dopaminergic response exist at varying rates in the population notably for COMT, DAT, D 1 R, D 2 R and D 3 R (Pearson-Fuhrhop et al, 2013 ).…”

Section: Clinical Evidence For the Use Of Da-enhancing Drugs In Motormentioning

confidence: 99%

The Intersection of Central Dopamine System and Stroke: Potential Avenues Aiming at Enhancement of Motor Recovery

Gower

Tiberi

2018

Front. Synaptic Neurosci.

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Dopamine, a major neurotransmitter, plays a role in a wide range of brain sensorimotor functions. Parkinson's disease and schizophrenia are two major human neuropsychiatric disorders typically associated with dysfunctional dopamine activity levels, which can be alleviated through the druggability of the dopaminergic systems. Meanwhile, several studies suggest that optimal brain dopamine activity levels are also significantly impacted in other serious neurological conditions, notably stroke, but this has yet to be fully appreciated at both basic and clinical research levels. This is of utmost importance as there is a need for better treatments to improve recovery from stroke. Here, we discuss the state of knowledge regarding the modulation of dopaminergic systems following stroke, and the use of dopamine boosting therapies in animal stroke models to improve stroke recovery. Indeed, studies in animals and humans show stroke leads to changes in dopamine functioning. Moreover, evidence from animal stroke models suggests stimulation of dopamine receptors may be a promising therapeutic approach for enhancing motor recovery from stroke. With respect to the latter, we discuss the evidence for several possible receptor-linked mechanisms by which improved motor recovery may be mediated. One avenue of particular promise is the subtype-selective stimulation of dopamine receptors in conjunction with physical therapy. However, results from clinical trials so far have been more mixed due to a number of potential reasons including, targeting of the wrong patient populations and use of drugs which modulate a wide array of receptors. Notwithstanding these issues, it is hoped that future research endeavors will assist in the development of more refined dopaminergic therapeutic approaches to enhance stroke recovery.

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“…In speech and language research, several functional and structural neuroimaging studies have shown that both residual and new neural mechanisms can be recruited in the recovery process after stroke [e.g., see ( 67 , 68 )]. Genetic ( 69 ) and biological ( 70 ) factors also likely contribute to recovery across domains. The role of neuroplasticity in speech and language recovery is however not fully understood yet ( 71 ).…”

Section: Discussionmentioning

confidence: 99%

Recovery of Apraxia of Speech and Aphasia in Patients With Hand Motor Impairment After Stroke

et al. 2021

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Objective: Aphasia and apraxia of speech (AOS) after stroke frequently co-occur with a hand motor impairment but few studies have investigated stroke recovery across motor and speech-language domains. In this study, we set out to test the shared recovery hypothesis. We aimed to (1) describe the prevalence of AOS and aphasia in subacute stroke patients with a hand motor impairment and (2) to compare recovery across speech-language and hand motor domains. In addition, we also explored factors predicting recovery from AOS.Methods: Seventy participants with mild to severe paresis in the upper extremity were assessed; 50% of these (n = 35) had left hemisphere (LH) lesions. Aphasia, AOS and hand motor assessments and magnetic resonance imaging were conducted at 4 weeks (A1) and at 6 months (A2) after stroke onset. Recovery was characterized in 15 participants showing initial aphasia that also had complete follow-up data at 6 months.Results: All participants with AOS and/or aphasia had LH lesions. In LH lesioned, the prevalence of aphasia was 71% and of AOS 57%. All participants with AOS had aphasia; 80% of the participants with aphasia also had AOS. Recovery in aphasia (n = 15) and AOS (n = 12) followed a parallel pattern to that observed in hand motor impairment and recovery correlated positively across speech-language and motor domains. The majority of participants with severe initial aphasia and AOS showed a limited but similar amount of recovery across domains. Lesion volume did not correlate with results from behavioral assessments, nor with recovery. The initial aphasia score was the strongest predictor of AOS recovery.Conclusion: Our findings confirm the common occurrence of AOS and aphasia in left hemisphere stroke patients with a hand motor impairment. Recovery was similar across speech-language and motor domains, even in patients with severe impairment, supporting the shared recovery hypothesis and that similar brain recovery mechanisms are involved in speech-language and motor recovery post stroke. These observations contribute to the knowledge of AOS and its relation to motor and language functions and add information that may serve as a basis for future studies of post stroke recovery. Studies including neuroimaging and/or biological assays are required to gain further knowledge on shared brain recovery mechanisms.

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Genetic Variation and Neuroplasticity: Role in Rehabilitation After Stroke

Cited by 40 publications

References 100 publications

Brain Functional Reserve in the Context of Neuroplasticity after Stroke

Brain Functional Reserve in the Context of Neuroplasticity after Stroke

The Intersection of Central Dopamine System and Stroke: Potential Avenues Aiming at Enhancement of Motor Recovery

Recovery of Apraxia of Speech and Aphasia in Patients With Hand Motor Impairment After Stroke

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