Broad Therapeutic Time Window for Driving Motor Recovery After TBI Using Activity-Dependent Stimulation.

IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Neurorehabilitation and Neural Repair Pub Date : 2023-06-01 Epub Date: 2023-01-12 DOI:10.1177/15459683221145144
Heather M Hudson, David J Guggenmos, Meysam Azin, Nicholas Vitale, Katelyn A McKenzie, Jonathan D Mahnken, Pedram Mohseni, Randolph J Nudo
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Abstract

Background: After an acquired injury to the motor cortex, the ability to generate skilled movements is impaired, leading to long-term motor impairment and disability. While rehabilitative therapy can improve outcomes in some individuals, there are no treatments currently available that are able to fully restore lost function.

Objective: We previously used activity-dependent stimulation (ADS), initiated immediately after an injury, to drive motor recovery. The objective of this study was to determine if delayed application of ADS would still lead to recovery and if the recovery would persist after treatment was stopped.

Methods: Rats received a controlled cortical impact over primary motor cortex, microelectrode arrays were implanted in ipsilesional premotor and somatosensory areas, and a custom brain-machine interface was attached to perform the ADS. Stimulation was initiated either 1, 2, or 3 weeks after injury and delivered constantly over a 4-week period. An additional group was monitored for 8 weeks after terminating ADS to assess persistence of effect. Results were compared to rats receiving no stimulation.

Results: ADS was delayed up to 3 weeks from injury onset and still resulted in significant motor recovery, with maximal recovery occurring in the 1-week delay group. The improvements in motor performance persisted for at least 8 weeks following the end of treatment.

Conclusions: ADS is an effective method to treat motor impairments following acquired brain injury in rats. This study demonstrates the clinical relevance of this technique as it could be initiated in the post-acute period and could be explanted/ceased once recovery has occurred.

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使用活动依赖性刺激的TBI后驱动运动恢复的宽治疗时间窗。
背景:运动皮层获得性损伤后,产生熟练动作的能力受损,导致长期运动损伤和残疾。虽然康复治疗可以改善一些人的预后,但目前还没有能够完全恢复丧失功能的治疗方法。目的:我们以前使用损伤后立即启动的活动依赖性刺激(ADS)来驱动运动恢复。本研究的目的是确定延迟应用ADS是否仍能导致恢复,以及停止治疗后恢复是否会持续。方法:大鼠在初级运动皮层上接受受控的皮层冲击,在同侧前运动和体感区域植入微电极阵列,并连接定制的脑机接口来执行ADS。刺激开始于1、2或3 受伤后数周,并在4周内持续分娩。另外一组被监测了8 终止ADS后数周,以评估效果的持久性。将结果与未接受刺激的大鼠进行比较。结果:ADS延迟了3 从损伤开始数周后,仍然导致显著的运动恢复,其中延迟1周组的恢复最大。电机性能的改善至少持续了8年 治疗结束后数周。结论:ADS是治疗大鼠获得性脑损伤后运动功能障碍的有效方法。这项研究证明了这项技术的临床相关性,因为它可以在急性期后开始,一旦恢复,就可以移植/停止。
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来源期刊
CiteScore
8.30
自引率
4.80%
发文量
52
审稿时长
6-12 weeks
期刊介绍: Neurorehabilitation & Neural Repair (NNR) offers innovative and reliable reports relevant to functional recovery from neural injury and long term neurologic care. The journal''s unique focus is evidence-based basic and clinical practice and research. NNR deals with the management and fundamental mechanisms of functional recovery from conditions such as stroke, multiple sclerosis, Alzheimer''s disease, brain and spinal cord injuries, and peripheral nerve injuries.
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