论脑卒中后长期功能评估对提高临床转归的重要性。

Thomas Freret, Pascale Schumann-Bard, Michel Boulouard, Valentine Bouet
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引用次数: 32

摘要

尽管在脑缺血领域进行了广泛的研究,但在转化过程中仍有许多令人失望的结果。即使实验研究显示了大量有希望的药物,但大多数药物在临床试验中都没有发挥作用。根据这些报告,已经确定了导致动物实验和临床试验结果差异的重要因素;该领域的最新研究试图抛弃它们,以提高结果的范围。然而,必须继续努力,特别是长期的功能评价。在临床实践中观察到,动物在中风后表现出很大程度的自发恢复。在啮齿类动物中,通过基本项目评估的神经损伤通常在中风后的第一周消失。相反,要求更高的感觉运动和认知任务强调了其他缺陷,这些缺陷通常是持久的。不幸的是,针对这种行为障碍的研究并不多见。由于长期功能恢复的特征对于评估实验性中风潜在治疗药物的疗效至关重要,行为测试被证明足够敏感,可以检测出长期缺陷。由于任何中风治疗的最终目标都是恢复正常功能,因此应该对行为缺陷进行客观评估。
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On the importance of long-term functional assessment after stroke to improve translation from bench to bedside.

Despite extensive research efforts in the field of cerebral ischemia, numerous disappointments came from the translational step. Even if experimental studies showed a large number of promising drugs, most of them failed to be efficient in clinical trials. Based on these reports, factors that play a significant role in causing outcome differences between animal experiments and clinical trials have been identified; and latest works in the field have tried to discard them in order to improve the scope of the results. Nevertheless, efforts must be maintained, especially for long-term functional evaluations. As observed in clinical practice, animals display a large degree of spontaneous recovery after stroke. The neurological impairment, assessed by basic items, typically disappears during the firsts week following stroke in rodents. On the contrary, more demanding sensorimotor and cognitive tasks underline other deficits, which are usually long-lasting. Unfortunately, studies addressing such behavioral impairments are less abundant. Because the characterization of long-term functional recovery is critical for evaluating the efficacy of potential therapeutic agents in experimental strokes, behavioral tests that proved sensitive enough to detect long-term deficits are reported here. And since the ultimate goal of any stroke therapy is the restoration of normal function, an objective appraisal of the behavioral deficits should be done.

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