[WEB SITE] Research into brain’s ability to heal itself offers hope for novel treatment of traumatic brain injury

Innovative angles of attack in research that focus on how the human brain protects and repairs itself will help develop treatments for one of the most common, costly, deadly and scientifically frustrating medical conditions worldwide: traumatic brain injury. In an extensive opinion piece recently published online on Expert Opinion on Investigational Drugs, Henry Ford Hospital researcher Ye Xiong, M.D., Ph.D., makes the case for pioneering work underway in Detroit and elsewhere seeking to understand and repair brain function at the molecular level.

“To date, all attempts at treating traumatic brain injury with experimental drugs have failed once testing moved from animal studies to clinical trials in humans,” Dr. Xiong explains. “Although this is disappointing, we believe innovations now at the preclinical stage hold great promise for a deeper understanding of traumatic brain injury and how to treat it.”

Also known as TBI, traumatic brain injury most commonly results from a sudden, violent blow to the head, in some cases driving broken bone into the brain, or from a bullet or other object piercing the skull and entering the brain.
This trauma sets off a complex “cascade” of reactions in the brain that can impair thinking and reasoning, behavior and movement.

Each year, at least 10 million TBIs that are serious enough to result in hospitalization or death occur around the world.
Most attempts at treatment have targeted the physical damage with drugs aimed at protecting neurons — the cells that carry messages from the brain to the rest of the body — from further damage. But while such attempts have shown promise in animal studies, they’ve all failed to help human patients.

Over the past three decades, more than 30 such clinical trials have ended in failure. More recently, evidence has been amassed by researchers showing that the human brain has “a significant, albeit limited” ability to repair itself both physically and functionally, including:

• • Angiogenesis — the creation of new blood vessels.
• • Neurogenesis — the formation of new nerve cells.
• • Oligodendrogenesis — the development of several types of cells including those that make up the myelin sheath, a protective coating on parts of nerves.
• • Axonal sprouting — the process of in which undamaged axons, threadlike parts of nerve cells that carry signals to other cells, grow new nerve endings to relink damaged neurons.

The new approach to TBI therapy described by Dr. Xiong aims at enhancing these restorative, or “neuroplastic,” processes as they work together to improve neurological recovery. “Significant advances in the understanding of the mechanisms underlying TBI’s behavioral, cognitive or psychiatric effects have been made, and the use of cell-based and pharmacological interventions to improve symptoms, function and outcome is still under development,” Dr. Xiong explains.

Among interventional drugs now in early clinical trials are:

• Glibenclamide. Already best known for treatment of type 2 diabetes, it has recently been found to significantly reduce brain swelling and bleeding after ischemic stroke, suggesting potential use for treating TBI.
• Minocycline. Derived from the antibiotic tetracycline, it has been shown in different dosages to provide both short-term and long-term benefits in treating closed head injuries in mice.
• Statins. Widely used to reduce cholesterol levels, studies at Henry Ford Hospital have demonstrated that these drugs restore cognitive function after TBI in rats.

Other promising investigational biologics and drugs that are now in promising preclinical development at Henry Ford include thymosin beta 4, exosomes recombinant human tissue plasminogen activator and microRNAs.
“Although it is still important to further investigate neuroprotective treatments for TBI, these novel, neurorestorative or neuroplastic approaches will facilitate development of treatments for TBI with the ultimate goal of reducing brain injury, promoting brain repair and remodeling, and eventually improving functional recovery and quality of life,” Dr. Xiong concludes.

Research into brain’s ability to heal itself offers hope for novel treatment of traumatic brain injury — Bloglovin.

[WEB SITE] Study: Listening to classical music improves activity of genes involved in brain functions

Published on March 13, 2015 at 8:50 AM

Although listening to music is common in all societies, the biological determinants of listening to music are largely unknown. According to a latest study, listening to classical music enhanced the activity of genes involved in dopamine secretion and transport, synaptic neurotransmission, learning and memory, and down-regulated the genes mediating neurodegeneration. Several of the up-regulated genes were known to be responsible for song learning and singing in songbirds, suggesting a common evolutionary background of sound perception across species.

Listening to music represents a complex cognitive function of the human brain, which is known to induce several neuronal and physiological changes. However, the molecular background underlying the effects of listening to music is largely unknown. A Finnish study group has investigated how listening to classical music affected the gene expression profiles of both musically experienced and inexperienced participants. All the participants listened to W.A. Mozart’s violin concert Nr 3, G-major, K.216 that lasts 20 minutes.

Listening to music enhanced the activity of genes involved in dopamine secretion and transport, synaptic function, learning and memory. One of the most up-regulated genes, synuclein-alpha (SNCA) is a known risk gene for Parkinson’s disease that is located in the strongest linkage region of musical aptitude. SNCA is also known to contribute to song learning in songbirds.

“The up-regulation of several genes that are known to be responsible for song learning and singing in songbirds suggest a shared evolutionary background of sound perception between vocalizing birds and humans”, says Dr. Irma Järvelä, the leader of the study.

In contrast, listening to music down-regulated genes that are associated with neurodegeneration, referring to a neuroprotective role of music.

“The effect was only detectable in musically experienced participants, suggesting the importance of familiarity and experience in mediating music-induced effects”, researchers remark.

The findings give new information about the molecular genetic background of music perception and evolution, and may give further insights about the molecular mechanisms underlying music therapy.

The responsible researcher of the study is MSc (bioinformatics) Chakravarthi Kanduri from the University of Helsinki. The study protocol was designed by MuD Pirre Raijas and associate professor Irma Järvelä, University of Helsinki, with the help of Professor Harri Lähdesmäki, Aalto University. The Academy of Finland and the Biomedicum Helsinki Foundation have financed the study.

Source: University of Helsinki

via Study: Listening to classical music improves activity of genes involved in brain functions.

[Supplement] It Takes Two: Noninvasive Brain Stimulation Combined With Neurorehabilitation- Full Text

The goal of postacute neurorehabilitation is to maximize patient function, ideally by using surviving brain and central nervous system tissue when possible. However, the structures incorporated into neurorehabilitative approaches often differ from this target, which may explain why the efficacy of conventional clinical treatments targeting neurologic impairment varies widely.

Noninvasive brain stimulation (eg, transcranial magnetic stimulation [TMS], transcranial direct current stimulation [tDCS]) offers the possibility of directly targeting brain structures to facilitate or inhibit their activity to steer neural plasticity in recovery and measure neuronal output and interactions for evaluating progress. The latest advances as stereotactic navigation and electric field modeling are enabling more precise targeting of patient’s residual structures in diagnosis and therapy.

Given its promise, this supplement illustrates the wide-ranging significance of TMS and tDCS in neurorehabilitation, including in stroke, pediatrics, traumatic brain injury, focal hand dystonia, neuropathic pain, and spinal cord injury. TMS and tDCS are still not widely used and remain poorly understood in neurorehabilitation. Therefore, the present supplement includes articles that highlight ready clinical application of these technologies, including their comparative diagnostic capabilities relative to neuroimaging, their therapeutic benefit, their optimal delivery, the stratification of likely responders, and the variable benefits associated with their clinical use because of interactions between pathophysiology and the innate reorganization of the patient’s brain. Overall, the supplement concludes that whether provided in isolation or in combination, noninvasive brain stimulation and neurorehabilitation are synergistic in the potential to transform clinical practice.

The incidence of many neurologic diseases is rising partly because of an increasingly aged population and improved delivery and timing of acute care for neurologic disorders. As a result, more survivors are emerging from acute care, with most exhibiting life-altering impairments that require neurorehabilitation. One prominent example of this trend is stroke; taking into account both the years of potential life lost from premature death and long-term disability, stroke is also one of the most costly diseases, with 36% of this growing population exhibiting a discernable disability 5 years poststroke,1 and almost half of survivors remaining dependent on others 6 years poststroke because of the severity of their disability.2

The focus of medical teams during hyperacute and acute neurologic care is usually 3-fold: ensure survival/reduce mortality; manage and prevent medical complications; and when possible, salvage existing central nervous system tissue (eg, through the use of thrombolytics in stroke).3 In contrast, the goal of postacute neurorehabilitation is to maximize patient function, ideally by using surviving brain and central nervous system tissue when possible. However, despite their widely appreciated importance, the efficacy of conventional clinical treatments targeting specific neurologic impairments and sequelae vary widely. Again in the case of stroke, conventional rehabilitative strategies targeting upper extremity hemiparesis in adults offer negligible or no efficacy.4, 5

Recently developed neurorehabilitative strategies offer slightly more promise but remain limited because of the considerable time and resources that they require to administer. Perhaps the most notable example is constraint-induced movement therapy (CIMT), which has been applied to the affected upper extremity after stroke and other neurologic disorders (eg, multiple sclerosis, aphasia, traumatic brain injury [TBI]). One of the hallmarks of CIMT is long-duration training using an affected body part (eg, paretic upper extremity) or capacity (eg, speaking) that lasts up to 6 hours per day and is administered over multiple days (usually 10 consecutive weekdays). Although results have been promising,6 several studies7, 8 have found that most patients with stroke do not wish to participate in CIMT because of these long-duration treatment parameters, have reported high attrition rates,9 have reported poor compliance with the CIMT restrictive device wear,10, 11 and have reported on patient inability to participate in the entire 6-hour regimen as a result of fatigue.12 As a result of the required time, financial resources, and human resources, CIMT has not realized widespread clinical application.13, 14

Other new neurorehabilitative approaches being taught by training programs and/or adopted by clinics worldwide (eg, partial weight-supported treadmill training, certain automated and splinting approaches) offer negligible efficacy when compared with more conventional strategies15, 16, 17 and/or only work on patients displaying a particular level of impairment. As a result, there remains a gap centering on the need for techniques that extend the efficacy, duration of treatment effect, and/or number of patients who may benefit from promising neurorehabilitative therapies. Noninvasive brain stimulation offers the ability to meet all of these needs and offers efficacy as a stand-alone treatment approach for many neurologic impairments.

Continue –>  It Takes Two: Noninvasive Brain Stimulation Combined With Neurorehabilitation – Archives of Physical Medicine and Rehabilitation.

[WEB SITE] FLEXIBLE FITNESS: Neuroplasticity and brain injury

Posted Mar. 18, 2015 at 6:03 PM

The term neuroplasticity has gotten a lot of press over the last few decades. It refers to the brain’s amazing capacity to change and remodel itself.

Neuroplasticity is how we adapt to changing conditions, learn new facts and develop new skills. From the time the brain begins to develop in utero until the day we die, the cells in our brains reorganize in response to our changing needs. It’s what allows us to walk, learn how to ride a bike, store memories and learn multiplication tables.

This concept is easy to grasp for a healthy and well-functioning brain. If you want to get better at a new skill, you must practice it and you will improve your abilities. But what about a brain that has been damaged somehow – either through an accident, head injury, stoke, etc? Researchers used to believe that brain nerve pathways were fixed or unchangeable. This meant that if a function was performed by a certain area of the brain, it could only be performed by that area. Therefore, it was believed that after a stroke or brain injury, any damage would be permanent.

The good news is that we now know that if the brain is injured, it still tries to repair itself. It maintains the ability to reorganize and adapt when challenged. Although parts of the brain may be damaged, destroyed or even missing, remaining parts can learn how to take over the functions that were lost. This re-wiring of the brain can make it possible to resume lost function. It’s important to note that different parts of the brain control different body functions and the brain adapts better to some areas of damage more than others.

The key to recovering function after a stroke or other forms of brain injury is to ingrain the new pathways through repetition. You must be determined to practice a specific skill with the affected part of the body, over and over again, and increase the challenge continuously.

When it comes to using your limbs and other basic functions, it is basically a “use it or lose it” situation. For instance, if you don’t use your right arm, the part of the brain corresponding to its usage will deteriorate. If you’ve had a stroke and you are unable to pick up a cup with your right arm, you must purposefully try to do this action repetitively, or your brain won’t be stimulated to create a new pathway. Rather, it will strengthen the left arm’s ability to compensate, and the brain areas that are not being used will shrivel away.

Therefore, the emphasis in neuro-rehabilitation is on repetition and task specific practice- a “use it and improve it” approach. Probably the most commonly used therapy that is based on neuroplasticity is constraint-induced therapy. Constraint induced therapy forces patients to use the affected limb by constraining the unaffected limb. There have been some extremely positive research results with constraint-induced therapy, however, this therapy may not be for every stroke survivor.

Continue –>  FLEXIBLE FITNESS: Neuroplasticity and brain injury – LIFESTYLE – Wicked Local Rockport – Rockport, MA.

[JOURNAL] Current Issue Neurology Today – March 19, 2015 – Volume 15 – Issue 6

Current Issue : Neurology Today.

[Review] Brain Plasticity and Rehabilitation in Stroke Patients – Full Text PDF

In recent years, our understanding of motor learning, and functional recovery after the occurrence of brain lesion has grown significantly. Novel findings in basineuroplasticity c neuroscience have provided an impetus for research in motor rehabilitation.

The brain reveals a spectrum of intrinsic capacities to react as a highly dynamic system which can change the properties of its neural circuits. This brain plasticity can lead to an extreme degree of spontaneous recovery and rehabilitative training may modify and boost the neuronal plasticity processes. Animal studies have extended these findings, providing insight into a broad range of underlying molecular and physiological events. Neuroimaging studies in human patients have provided observations at the systems level that often parallel findings in animals.

In general, the best recoveries are associated with the greatest return toward the normal state of brain functional organization. Reorganization of surviving central nervous system elements supports behavioral recovery, for example, through changes in interhemispheric lateralization, activity of association cortices linked to injured zones, and organization of cortical representational maps.

Evidence from animal models suggests that both motor learning and cortical stimulation alter intracortical inhibitory circuits and can facilitate long-term potentiation and cortical remodeling. Current researches on the physiology and use of cortical stimulation animal models and in humans with stroke related hemiplegia are reviewed in this article. In particular, electromyography (EMG)-controlled electrical muscle stimulation improves the motor function of the hemiparetic arm and hand. A multi-channel near-infrared spectroscopy (NIRS) studies in which the hemoglobin levels in the brain were non-invasively and dynamically measured during functional activity found that the cerebral blood flow in the injured sensory-motor cortex area is greatest during an EMG-controlled FES session.

Only a few idea is, however, known for the optimal timing of the different processes and therapeutic interventions and for their interactions in detail. Finding optimal rehabilitation paradigms requires an optimal organization of the internal processes of neural plasticity and the therapeutic interventions in accordance with defined plastic time windows. In this review the mechanisms of spontaneous plasticity after stroke and experimental interventions to enhance plasticity are summarized, with an emphasis on functional electrical stimulation therapy. (J Nippon Med Sch 2015; 82: 4―13)

Continue –> Full Text PDF

[WEB SITE] Experts to Collaborate in Development of Wearable Soft Robotics

A news release issued by Loughborough University reports that it will be working with six other universities in an effort to develop wearable robotics engineered to assist individuals with mobility impairments, disabilities, and age-related difficulties to move easily without assistance.

According to the release, the “smart” clothing is intended to support areas of limb injury or limited mobility to allow individuals to engage in greater degrees of physical activity.

The project, known as Wearable Soft Robotics for Independent Living is being funded by the Engineering and Physical Sciences Research Council (EPSRC) and is due for completion by June 2018, the release says. Additional research partners include the Universities of Bristol (project leader), Stratchclyde, Southampton, Nottingham, Leeds, and the West of England.

The release notes that Russel Harris, professor of Medical Engineering and Advanced Manufacturing, is slated to lead Loughborough’s involvement in the study. The research team is based out of the School of Mechanical and Manufacturing Engineering. The team will investigate how electroactive polymers can be integrated into high performance fabrics to create clothing that is both supportive and comfortable to wear.

Harris points out in the release that some wearable options can be uncomfortable and do not always provide the correct support in the right places.

“The aim of this project is to create wearable soft robotics that represent normal clothing whilst offering comprehensive mobility support. We are delighted to be part of this project and to be able to use our expertise in the area of digital and additive manufacturing processes to make a difference to the lives of people with restricted mobility,” Harris says.

The clothing is designed to assist movement through integrating forms of artificial “muscle” made from smart materials and reactive polymers, which are capable of exerting physical force. The release states that this will be developed using advanced wearable soft robotic, nanoscience, 3D fabrication, functional electrical stimulation, and full-body monitoring technologies, all driven by the need of the end users, who will also be directly involved in the project. They will also reportedly include control systems built to monitor the wearer and adapt to give the most suitable assistance, working with the body’s own muscles.

To meet the needs of patients requiring rehabilitation, the release says the smart clothing can initially provide strong support and subsequently reduce assistance as the patient recovers mobility and strength.

The release notes that the project is part of a £5.3 million funding program announced by the EPSRC to transform the design of assistive and rehabilitative devices.

via Experts to Collaborate in Development of Wearable Soft Robotics – Physical Therapy Products.

[WEB SITE] Robotic Glove Aims to Boost Stroke Recovery After Acute Stage

A prototype robotic glove has been developed by researchers based at the University of Hertfordshire, Hatfield, England, that can be used by individuals affected by stroke in their homes to support rehabilitation and personal independence in receiving therapies.

According to a media release from the University of Hertfordshire, the aim of the glove is to provide therapies that target impairments that linger among patients who are in the chronic stages of stroke, a period when treatment typically may have decreased or stopped.

The team has spent the last 3 years developing two prototype robotic gloves. Both are engineered to facilitate repetitive movement and exercise of the hand and wrist. The device reportedly also records the patient’s performance and sends the data to a therapist so that treatment may be customized remotely and arrangements can be made for follow-up.

Farshid Amirabdollahian, PhD, described in the university’s media release as an expert in rehabilitation robotics and assistive technologies, and a senior lecturer in adaptive systems at the University’s School of Computer Science, coordinated the €4,643,983 project, known as Supervised Care and Rehabilitation Involving Personal Tele-robotics (SCRIPT).

“This project focused on therapies for stroke patients at home,” Amirabdollahian says in the media release. “Our goal was to make motivating therapies available to people to practice at home using this system, hoping that they have a vested interest to practice and will do so. We tried this system with 30 patients and found that patients indeed practised at home, on average around 100 minutes each week, and some showed clinical improvements in their hand and arm function.”

The overall aim of the project, according to the media release, was to provide an educational, motivational and engaging interaction, making a more positive therapy session for the patient, while providing feedback to them and their health care professionals. As a result of the study’s outcomes, the team is considering a follow-up project that will strive to improve recovery outcomes.

via Robotic Glove Aims to Boost Stroke Recovery After Acute Stage – Rehab Managment.

[BOOK] Neuro-Rehabilitation with Brain Interface – Google Books

 

Neuro-Rehabilitation with Brain Interface



 

 

[Editorial] Technological Advances in Instrumental Assessment in Rehabilitation – Full Text PDF

Copyright © 2015 Hindawi Publishing Corporation. All rights reserved.
This is a special issue published in “BioMed Research International.” All articles are open access articles distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Contents

Technological Advances in Instrumental Assessment in Rehabilitation, Giorgio Ferriero, Stefano Carda, Sasa Moslavac, and Alessia Rabini
Volume 2015, Article ID 264067, 2 pages

Ankylosing Spondylitis and Posture Control:The Role of Visual Input, Alessandro Marco De Nunzio, Salvatore Iervolino, Carmela Zincarelli, Luisa Di Gioia, Giuseppe Rengo, Vincenzo Multari, Rosario Peluso, Matteo Nicola Dario Di Minno, and Nicola Pappone
Volume 2015, Article ID 948674, 9 pages

Use of a Robotic Device for the Rehabilitation of Severe Upper Limb Paresis in Subacute Stroke: Exploration of Patient/Robot Interactions and the Motor Recovery Process, Christophe Duret, Oph´elie Courtial, Anne-Ga¨elle Grosmaire, and Emilie Hutin
Volume 2015, Article ID 482389, 7 pages

A Game System for Cognitive Rehabilitation, Azrulhizam Shapi’i, Nor Azan Mat Zin, and Ahmed Mohammed Elaklouk
Volume 2015, Article ID 493562, 7 pages

Grasps Recognition and Evaluation of Stroke Patients for Supporting RehabilitationTherapy, Beatriz Leon, Angelo Basteris, Francesco Infarinato, Patrizio Sale, Sharon Nijenhuis, Gerdienke Prange, and Farshid Amirabdollahian
Volume 2014, Article ID 318016, 14 pages

Assessment ofWaveform Similarity in Clinical Gait Data: The Linear FitMethod, M. Iosa,A. Cereatti, A. Merlo, I. Campanini, S. Paolucci, and A. Cappozzo
Volume 2014, Article ID 214156, 7 pages

Inter- and Intrarater Reliability of Modified Lateral Scapular Slide Test in Healthy Athletic Men, Azadeh Shadmehr, Mohammad Hassan Azarsa, and Shohreh Jalaie
Volume 2014, Article ID 384149, 5 pages

Design and Reliability of a Novel Heel Rise Test Measuring Device for Plantarflexion Endurance, Amy D. Sman, Claire E.Hiller, Adam Imer,AldrinOcsing, Joshua Burns, and KathrynM. Refshauge
Volume 2014, Article ID 391646, 7 pages

Reliability in the Parameterization of the Functional Reach Test in Elderly Stroke Patients: A Pilot Study, Jose AntonioMerch´an-Baeza, Manuel Gonz´alez-S´anchez, and Antonio Ignacio Cuesta-Vargas
Volume 2014, Article ID637671, 8 pages

Full Text PDF