Efficacy of Rehabilitative Experience Declines with Time after Focal Ischemic Brain Injury
By J. Biernaskie, G. Chernenko, Dale Corbett. Journal of Neuroscience, 2004
704 citations recorded by the source corpus.
To maximize the effectiveness of rehabilitative therapies after stroke, it is critical to determine when the brain is most responsive (i.e., plastic) to sensorimotor experience after injury and to focus such efforts within this period. Here, we compared the efficacy of 5 weeks of enriched rehabilitation (ER) initiated at 5 d (ER5), ER14, or ER30 after focal ischemia, as judged by functional outcome and neuromorphological change. ER5 provided marked improvement in skilled forelimb reaching ability and ladder-rung- and narrow-beam-walking tasks and attenuated the stroke-induced reliance on the unaffected forepaw for postural support. ER14 provided improvement to a somewhat lesser extent, whereas recovery was diminished after ER30 such that motor function did not differ from ischemic animals exposed to social housing. To examine potential neural substrates of the improved function, we examined dendritic morphology in the undamaged motor cortex because our previous work (Biernaskie and Corbett, 2001) suggested that recovery was associated with enhanced dendritic growth in this region. ER5 increased the number of branches and complexity of layer V neurons compared with both social housing and control animals. Dendritic arbor after ER14 (although increased) and ER30 did not differ from those exposed to social housing. These data suggest that the poststroke brain displays heightened sensitivity to rehabilitative experience early after the stroke but declines with time. These findings have important implications for rehabilitation of stroke patients, many of whom experience considerable delays before therapy is initiated.
Subfields: Epidemiology, Neurology, Rehabilitation
View Paper: https://www.semanticscholar.org/paper/028db76ce9aa576e701bc1ac1428e4f77bf3f5e2
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Citations in the corpus
- Ankle dorsiflexion as an fMRI paradigm to assay motor control for walking during rehabilitation (2004, background): “…and migration, growth and retraction of dendritic spines, production of neurotrophins, and other biological responses to motor learning (Biernaskie et al., 2004; Cramer and Chopp, 2000; Frost et al., 2003; Gomez-Pinilla et al., 2002; Johansson and Belichenko, 2002; Kleim et al., 2002;…”
- Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. (2008, background): “Proponents of early therapy cite evidence from functional neuroimaging [500] and animal studies [501, 502] that define the peri-infarct period as the crucial time to begin rehabilitation.”
- Repairing the human brain after stroke: I. Mechanisms of spontaneous recovery (2008, background): “Delays in initiating environmental enrichment after stroke reduce impact of this intervention.(258) Many factors have been found to contribute to the effect that environment has after stroke, including the complexity of the surroundings and the quality/ quantity of motor activity.”
- Neuronal Circuit Remodeling in the Contralateral Cortical Hemisphere during Functional Recovery from Cerebral Infarction (2009, background): “, 2004), which is enhanced by early onset of rehabilitative tasks in mice (Biernaskie et al., 2004).”