Posts Tagged neural plasticity

[WEB SITE] Inosine treatment helps recovery of motor functions after brain injury.

First study in primates shows promise reports restorative neurology and neuroscience

Date:
August 3, 2016
Source:
IOS Press
Summary:
Brain tissue can die as the result of stroke, traumatic brain injury, or neurodegenerative disease. When the affected area includes the motor cortex, impairment of the fine motor control of the hand can result. Researchers found that inosine, a naturally occurring purine nucleoside that is released by cells in response to metabolic stress, can help to restore motor control after brain injury.

Brain tissue can die as the result of stroke, traumatic brain injury, or neurodegenerative disease. When the affected area includes the motor cortex, impairment of the fine motor control of the hand can result. In a new study published inRestorative Neurology and Neuroscience, researchers found that inosine, a naturally occurring purine nucleoside that is released by cells in response to metabolic stress, can help to restore motor control after brain injury.

Based on evidence from rodent studies, researchers used eight rhesus monkeys ranging in age from 5 to 10 years (approximately equivalent to humans from 15 to 30 years of age). All received medical examinations and motor skills were tested, including video recording of fine motor functions used to retrieve small food rewards. All monkeys were given initial MRI scans to ensure there were no hidden brain abnormalities.

Brain injuries were created in the area controlling each monkey’s favored hand. Four monkeys received inosine treatment, while four received a placebo. Research staff were not informed regarding which monkeys were included in the treatment vs placebo groups. Recovery of motor function was then measured for a period of 14 weeks after surgery.

While both the treated and placebo groups recovered significant function, three out of four of the treated monkeys were able to return to their pre-operative grasping methods. The placebo group developed a compensatory grasping method for retrieving food rewards unlike the original thumb-and-finger method.

“In the clinical context, the enhanced recovery of grasp pattern suggests that inosine facilitates greater recovery from this type of cortical injury and motor impairment,” explained lead investigator Tara L. Moore, PhD, of the Department of Anatomy & Neurobiology and the Department of Neurology, Boston University School of Medicine, Boston, MA, USA. “To our knowledge, this is the first study to demonstrate the positive effects of inosine for promoting recovery of function following cortical injury in a non-human primate.”

Inosine has also been administered in human clinical trials for multiple sclerosis and Parkinson’s disease and has been proven to be safe in doses up 3000 mg/day. Athletes have used inosine as a nutritional supplement for decades, and inosine supplements are widely available commercially. “Given the effectiveness of inosine in promoting cortical plasticity, axonal sprouting, and dendritic branching, the present evidence of efficacy after cortical injury in a non-human primate, combined with a long history of safe use, indicates a need for clinical trials with inosine after cortical injury and spinal cord injury,” noted Dr. Moore.

The study points to neural plasticity, whereby the brain essentially “re-wires” connections between neurons to reestablish control pathways, as a therapeutic target for the recovery of fine motor control and grasping ability. Further study of cortical tissue from these monkeys is currently being completed and may provide further insights into the mechanisms underlying recovery.


Story Source:

The above post is reprinted from materials provided by IOS Press. Note: Content may be edited for style and length.


Journal Reference:

  1. Tara L. Moore, Monica A. Pessina, Seth P. Finklestein, Ronald J. Killiany, Bethany Bowley, Larry Benowitz, Douglas L. Rosene. Inosine enhances recovery of grasp following cortical injury to the primary motor cortex of the rhesus monkey. Restorative Neurology and Neuroscience, 2016; 1 DOI: 10.3233/RNN-160661

Source: Inosine treatment helps recovery of motor functions after brain injury: First study in primates shows promise reports restorative neurology and neuroscience — ScienceDaily

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[ARTICLE] Neural Plasticity in Rehabilitation and Psychotherapy: New Perspectives and Findings.

Publication Cover

Print ISSN: 2190-8370 Online ISSN: 2151-2604 Published in German from 1890 to 2006 and in English since 2007

It is only a short period of time since one of the most basic convictions about the brain, postulated by the Spanish neuroanatomist, Santiago Ramon y Cajal, became undermined by new and opposing discoveries. In 1928, Ramon y Cajal postulated that the neural setup of the human brain would be fixed and unable to change beyond the end of maturation of the brain around the age of 22–24 years. What structure or function of the human brain is not shaped until that time point by an individual’s interaction with her/his physical and social environments and through learning and adaptation would not be changeable any more during the succeeding years of life. The only accepted reason for change was damage of the brain by traumatization and/or inflammation or by changes in genetic functioning. This view of the human brain has changed considerably since the early 1970s and has been replaced by a myriad of experimental evidence demonstrating that the brain’s structure and functions are open to change throughout the whole lifetime.

The terms coined for this form of modification are “neuroplasticity” and “reorganization.” Although there is currently no generally accepted definition of neuroplasticity and reorganization, most contemporary scientists in this field would agree that neuroplasticity refers to a property at all levels of the human brain, that is, from molecules to larger cortical neural networks, to adapt its structures and functions to environmental pressures, experiences, and challenges, including brain damage (Johansson, 2011; Merzenich, Van Vleet, & Nahum, 2014). In addition, neural reorganization refers to the capacity of the brain to extend and/or change the control of behavior, cognition, and emotion by enlarging the neural networks involved through learning-induced response coordination (Merzenich et al., 2014). Other options represent optimization and economizing the activity of neural networks or the transference of the control of behavior and cognition to other structures that formerly did not control these actions (Merzenich, 2013). The latter was often addressed as rewiring the brain.

Three forms of neuroplasticity and reorganization can further be distinguished by: (a) developmental or maturational plasticity, where changes of brain structures and functions occur as a function of natural development and maturation; (b) adaptive neuroplasticity, where plasticity is induced in the course of adaptation to new environmental conditions, by learning and by skill formation, and (c) restorative neuroplasticity, where plasticity and reorganization occur as a consequence of trauma, inflammation, or epigenetic reprogramming (Will, Dalrymple-Alford, Wolff, & Cassel, 2008).

Following the conviction of the Nobel laureate Eric Kandel (1979, 2008) that any positive outcome of therapy and rehabilitative measure will only occur when the interventions significantly change the underlying neural structures and/or functions of the brain, the present topical issue of the Zeitschrift für Psychologie focuses on structural and functional plasticity of the brain as a result of behavioral and cognitive training and training of emotion regulation in several areas of therapy and rehabilitation.

The first article by Thomas Straube (2016) presents recent findings and developments of neuroplasticity in the psychotherapy of anxiety disorders. He summarizes current evidence that cognitive and behavioral interventions have demonstrated massive cortical plasticity of structures and functions that are considered central in the generation and individual expression of anxiety, like the amygdala, the anterior cerebral cortex (ACC), the insula, and the bed nucleus of the stria terminalis. He also presents a number of methodological issues in the use of functional brain imaging techniques that are critical in order to obtain valid experimental results in this field.

Thomas Weiss (2016) comprehensively summarizes current evidence for neural plasticity and cortical reorganization in subjects suffering from chronic pain in the next paper. In contrast to traditional views that postulated changes of peripheral neural systems being central causes of chronicity, he shows that cortical neuroplasticity and reorganization of neural networks in the somatosensory cortex, motor cortex, limbic and cognitive functional structures mainly account for the chronification of pain, and that these structures are also relevant targets for successful interventions in the behavioral and cognitive treatment of pain.

Eckart Altenmüller’s and Christos Ioannou’s paper (Altenmüller & Ioannou, 2016) specifies some negative sides of neuroplasticity, namely that neuroplasticity is not always beneficial but can lead to massive impairments of motor functions. Too intensive behavioral training of musicians in order to master their instruments might induce a serious condition known as musician’s dystonia and related disorders. Altenmüller and Ioannou elegantly show that in most cases such developments are consequences of training-induced maladaptive processes of plasticity in cortical and subcortical networks.

The paper by Wolfgang Miltner (2016) summarizes a number of processes that demonstrate the enormous plasticity and reorganization capacity of the human brain following brain lesion and highlights a series of behavioral and neuroscientific studies that indicate that successful intensive behavioral rehabilitation is paralleled by plastic changes of brain structures and by cortical reorganization. He shows that the amount of such plastic changes is obviously significantly determining the overall outcome of rehabilitation.

In the final review article, Klingner, Brodoehl, Volk, Guntinas-Lichius, and Witte (2016) explore the plasticity which is induced in the brain when it experiences a pronounced disturbance of the expected body responses: within the face, a lesion of the seventh nerve causes a motor paralysis with intact sensory input which is conveyed through the fifth cranial nerve. As a consequence, the intact brain orders a motor command, which is not executed, resulting in a mismatch between perceived and expected sensory information. This mismatch requires a major adaptive plasticity of the brain, which was studied in detail by this group.

Turning to the original articles, firstly Wolfgang Miltner, Heike Bauder, and Edward Taub (2016)present an example how neuroplasticity can be addressed by means of electroencephalographic measures known as Bereitschaftspotential (BP) that normally precede that execution of voluntary movements of, for example, fingers, hands, and legs. This technique was applied in a group of patients with chronic stroke who were given constraint-induced movement therapy (CIMT) over an intensive 2-week course of treatment. The intervention resulted in a large improvement in use of the more affected upper extremity in the laboratory and in the real-world environment. The evaluation of BP showed that the treatment produced marked changes in cortical activity that correlated with the significant rehabilitative effects. The results are consistent with the rehabilitation treatment having produced a use-dependent cortical reorganization and demonstrate where the physiological data interdigitates with and provides additional credibility to the clinical data.

Brodoehl, Klingner, Schaller, and Witte (2016) explore, in the second original article, the adaptation which the brain performs upon eye closure: with closure of the eyes the brain fundamentally alters the processing of afferent information, from a visually dominated multisensory mode to a monosensory mode. This plasticity is independent of the visual information and takes place in complete darkness, indicating that this switch of processing modes is caused by state-dependent, inherent brain plasticity. Based on these observations one can assume that the ability to cause functional reorganizations can be substantially modified by optimized conditions for such learning processes.

In their opinion piece, Otto Witte and Malgorzata Kossut (2016) emphasize the impact of inflammatory factors on brain plasticity: following a stroke or in the aging brain, the inflammatory system is activated and impairs brain plasticity. The analysis of these processes opens a window for therapeutic interventions that may be employed to enhance the efficacy of behavioral and other rehabilitative procedures.

Altenmüller, E. & Ioannou, C. I. (2016). Maladaptive plasticity induces degradation of fine motor skills in musicians: Apollo’s curse. Zeitschrigt für Psychologie, 224, 8090. doi: 10.1027/2151-2604/a000242 Link
Brodoehl, S., Klingner, C. M., Schaller, D. & Witte, O. W. (2016). Plasticity during short-term visual deprivation. Zeitscrift für Psychologie, 224, 125132. doi: 10.1027/2151-2604/a000246 Link
Johansson, B. B. (2011). Current trends in stroke rehabilitation: A review with focus on brain plasticity. Acta Neurologica Scandinavica, 123, 147159. CrossRef
Kandel, E. R. (1979). Psychotherapy and the single synapse: The impact of psychiatric thought on neurobiological research. New England Journal of Medicine, 301, 10281037. CrossRef
Kandel, E. R. (2008). Psychiatrie, Psychoanalyse und die neue Biologie des Geistes [Psychiatry psychoanalysis, and the new biology of the mind]. Frankfurt/M, Germany: Suhrkamp Verlag.
Klingner, C. M., Brodoehl, S., Volk, G. F., Guntinas-Lichius, O. & Witte, O. W. (2016). Adaptive and maladaptive neural plasticity due to facial nerve palsy: What can we learn from pure deefferentation?Zeitschrift für Psychologie, 224, 102111. doi: 10.1027/2151-2604/a000244 Link
Merzenich, M. M. (2013). Soft-wired: How the new science of brain plasticity can change your life.San Francisco, CA: Parnassus Publishing.
Merzenich, M. M., Van Vleet, T. M. & Nahum, M. (2014). Brain plasticity-based therapeutics.Frontiers in Human Neuroscience, 8, 385. doi: 10.3389/fnhum.2014.00385 CrossRef
Miltner, W. H. R. (2016). Plasticity and reorganization in the rehabilitation of stroke: The constraint-induced movement therapy (CIMT) example. Zeitschrift für Psychologie, 224, 91101. doi:10.1027/2151-2604/a000243 Link
Miltner, W. H. R., Bauder, H. & Taub, E. (2016). Change in movement-related cortical potentials following constraint-induced movement therapy (CIMT) after stroke. Zeitschrift für Psychologie, 224,112124. doi: 10.1027/2151-2604/a000245 Link
Straube, T. (2016). Effects of psychotherapy on brain activation patterns in anxiety disorders.Zeitscrift für Psychologie, 224, 6270. doi: 10.1027/2151-2604/a000240 Link
Weiss, T. (2016). Plasticity and cortical reorganization associated with pain. Zeitschrift für Psychologie, 224, 7179. Abstract
Will, B., Dalrymple-Alford, J., Wolff, M. & Cassel, J.-C. (2008). The concept of brain plasticity: Paillard’s systemic analysis and emphasis on structure and function (followed by the translation of a seminal paper by Paillard on plasticity). Behavioural Brain Research, 192, 27. doi:10.1016/j.bbr.2007.11.008 CrossRef
Witte, O. W. & Kossut, M. (2016). Impairment of brain plasticity by brain inflammation. Zeitschrift für Psychologie, 224, 133138. doi: 10.1027/2151-2604/a000247 Link
Correspondence concerning this article shoud be addressed to:
Wolfgang H. R. Miltner
Department of Biological and Clinical Psychology
Friedrich Schiller University (FSU)
Am Steiger 3/1
07743 Jena
Germany

Tel. +49 3641 945140, Fax +49 3641 945142, E-mail

Source: Neural Plasticity in Rehabilitation and Psychotherapy: Neural Plasticity in Rehabilitation and Psychotherapy: Zeitschrift für Psychologie: Vol 224, No 2

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[Abstract] Brain–machine interfaces for rehabilitation of poststroke hemiplegia

Abstract

Noninvasive brain–machine interfaces (BMIs) are typically associated with neuroprosthetic applications or communication aids developed to assist in daily life after loss of motor function, eg, in severe paralysis.

However, BMI technology has recently been found to be a powerful tool to promote neural plasticity facilitating motor recovery after brain damage, eg, due to stroke or trauma.

In such BMI paradigms, motor cortical output and input are simultaneously activated, for instance by translating motor cortical activity associated with the attempt to move the paralyzed fingers into actual exoskeleton-driven finger movements, resulting in contingent visual and somatosensory feedback.

Here, we describe the rationale and basic principles underlying such BMI motor rehabilitation paradigms and review recent studies that provide new insights into BMI-related neural plasticity and reorganization.

Current challenges in clinical implementation and the broader use of BMI technology in stroke neurorehabilitation are discussed.

 

Source: Brain–machine interfaces for rehabilitation of poststroke hemiplegia

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[Abstract] Brain–machine interfaces for rehabilitation of poststroke hemiplegia

Abstract

Noninvasive brain–machine interfaces (BMIs) are typically associated with neuroprosthetic applications or communication aids developed to assist in daily life after loss of motor function, eg, in severe paralysis. However, BMI technology has recently been found to be a powerful tool to promote neural plasticity facilitating motor recovery after brain damage, eg, due to stroke or trauma. In such BMI paradigms, motor cortical output and input are simultaneously activated, for instance by translating motor cortical activity associated with the attempt to move the paralyzed fingers into actual exoskeleton-driven finger movements, resulting in contingent visual and somatosensory feedback. Here, we describe the rationale and basic principles underlying such BMI motor rehabilitation paradigms and review recent studies that provide new insights into BMI-related neural plasticity and reorganization. Current challenges in clinical implementation and the broader use of BMI technology in stroke neurorehabilitation are discussed.

 

Source: Brain–machine interfaces for rehabilitation of poststroke hemiplegia

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[Abstract] Brain–machine interfaces for rehabilitation of poststroke hemiplegia

Abstract

Noninvasive brain–machine interfaces (BMIs) are typically associated with neuroprosthetic applications or communication aids developed to assist in daily life after loss of motor function, eg, in severe paralysis. However, BMI technology has recently been found to be a powerful tool to promote neural plasticity facilitating motor recovery after brain damage, eg, due to stroke or trauma. In such BMI paradigms, motor cortical output and input are simultaneously activated, for instance by translating motor cortical activity associated with the attempt to move the paralyzed fingers into actual exoskeleton-driven finger movements, resulting in contingent visual and somatosensory feedback. Here, we describe the rationale and basic principles underlying such BMI motor rehabilitation paradigms and review recent studies that provide new insights into BMI-related neural plasticity and reorganization. Current challenges in clinical implementation and the broader use of BMI technology in stroke neurorehabilitation are discussed.

Keywords

 

Source: Brain–machine interfaces for rehabilitation of poststroke hemiplegia

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[Abstract] Combination Protocol of Low-Frequency rTMS and Intensive Occupational Therapy for Post-stroke Upper Limb Hemiparesis: a 6-year Experience of More Than 1700 Japanese Patients

Translational Stroke ResearchAbstract

Several years ago, we proposed a combination protocol of repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy (OT) for upper limb hemiparesis after stroke. Subsequently, the number of patients treated with the protocol has increased in Japan.

We aimed to present the latest data on our proposed combination protocol for post-stroke upper limb hemiparesis as a result of a multi-institutional study. After confirming that a patient met the inclusion criteria for the protocol, they were scheduled to receive the 15-day inpatient protocol. In the protocol, two sessions of 20-min rTMS and 120-min occupational therapy were provided daily, except for Sundays and the days of admission/discharge.

Motor function of the affected upper limb was evaluated by the Fugl-Meyer assessment (FMA) and Wolf motor function test (WMFT) at admission/discharge and at 4 weeks after discharge if possible. A total of 1725 post-stroke patients were studied (mean age at admission 61.4 ± 13.0 years). The scheduled 15-day protocol was completed by all patients. At discharge, the increase in FMA score, shortening in performance time of WMFT, and increase in functional ability scale (FAS) score of WMFT were significant (FMA score 46.8 ± 12.2 to 50.9 ± 11.4 points, p < 0.001; performance time of WMFT 2.57 ± 1.32 to 2.21 ± 1.33, p < 0.001; FAS score of WMFT 47.4 ± 14. to 51.4 ± 14.3 points, p < 0.001).

Our proposed combination protocol can be a potentially safe and useful therapeutic intervention for upper limb hemiparesis after stroke, although its efficacy should be confirmed in a randomized controlled study.

Source: Combination Protocol of Low-Frequency rTMS and Intensive Occupational Therapy for Post-stroke Upper Limb Hemiparesis: a 6-year Experience of More Than 1700 Japanese Patients – Online First – Springer

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[Abstract] Promoting recovery from ischemic stroke – Expert Review of Neurotherapeutics –

21 DEC 2015

Summary

Over recent decades, experimental and clinical stroke studies have identified a number of neurorestorative treatments that stimulate neural plasticity and promote functional recovery. In contrast to the acute stroke treatments thrombolysis and endovascular thrombectomy, neurorestorative treatments are still effective when initiated days after stroke onset, which makes them applicable to virtually all stroke patients. In this article, selected physical, pharmacological and cell-based neurorestorative therapies are discussed, with special emphasis on interventions that have already been transferred from the laboratory to the clinical setting. We explain molecular and structural processes that promote neural plasticity, discuss potential limitations of neurorestorative treatments, and offer a speculative viewpoint on how neurorestorative treatments will evolve.

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Source: Promoting recovery from ischemic stroke – Expert Review of Neurotherapeutics –

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[ARTICLE] Improvement in paretic arm reach-to-grasp following Low frequency repetitive transcranial magnetic stimulation depends on object size: a pilot study – Full Text PDF

Abstract

Introduction. Low frequency repetitive transcranial magnetic stimulation (LF-rTMS) delivered to the non-lesioned hemisphere has shown to improve limited function of the paretic upper extremity (UE) following stroke. The outcome measures have largely included clinical assessments with little investigation on changes in kinematics and coordination. To date, there is no study investigating how the effects of LF-rTMS are modulated by the sizes of an object to be grasped.

Objective. To investigate the effect of LF- rTMS on kinematics and coordination of the paretic hand reach-to-grasp (RTG) for two object sizes in chronic stroke.

Methods: Nine participants received two TMS conditions: real-and sham-rTMS conditions. Before and after the rTMS conditions, cortico-motor excitability (CE) of the non-lesioned hemisphere, RTG kinematics and coordination. Object sizes were 1.2 and 7.2 cm in diameter. Results. Compared to sham rTMS, real rTMS significantly reduced CE of the non-lesioned M1. While rTMS had no effect on RTG action for the larger object, real-rTMS significantly improved movement time, aperture opening and RTG coordination for the smaller object.

Conclusions. LFrTMS improves RTG action for only the smaller object in chronic stroke. The findings suggest a dissociation between effects of rTMS on M1 and task difficulty for this complex skill.

Full Text PDF

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[ARTICLE] Rehabilitation with Poststroke Motor Recovery: A Review with a Focus on Neural Plasticity – Full Text HTML

Abstract

Motor recovery after stroke is related to neural plasticity, which involves developing new neuronal interconnections, acquiring new functions, and compensating for impairment. However, neural plasticity is impaired in the stroke-affected hemisphere. Therefore, it is important that motor recovery therapies facilitate neural plasticity to compensate for functional loss. Stroke rehabilitation programs should include meaningful, repetitive, intensive, and task-specific movement training in an enriched environment to promote neural plasticity and motor recovery. Various novel stroke rehabilitation techniques for motor recovery have been developed based on basic science and clinical studies of neural plasticity. However, the effectiveness of rehabilitative interventions among patients with stroke varies widely because the mechanisms underlying motor recovery are heterogeneous. Neurophysiological and neuroimaging studies have been developed to evaluate the heterogeneity of mechanisms underlying motor recovery for effective rehabilitation interventions after stroke. Here, we review novel stroke rehabilitation techniques associated with neural plasticity and discuss individualized strategies to identify appropriate therapeutic goals, prevent maladaptive plasticity, and maximize functional gain in patients with stroke.

Continue —> Rehabilitation with Poststroke Motor Recovery: A Review with a Focus on Neural Plasticity.

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[ARTICLE] Visual rehabilitation: visual scanning, multisensory stimulation and vision restoration trainings

Neuropsychological training methods of visual rehabilitation for homonymous vision loss caused by postchiasmatic damage fall into two fundamental paradigms: “compensation” and “restoration”. Existing methods can be classified into three groups: Visual Scanning Training (VST), Audio-Visual Scanning Training (AViST) and Vision Restoration Training (VRT). VST and AViST aim at compensating vision loss by training eye scanning movements, whereas VRT aims at improving lost vision by activating residual visual functions by training light detection and discrimination of visual stimuli.

This review discusses the rationale underlying these paradigms and summarizes the available evidence with respect to treatment efficacy. The issues raised in our review should help guide clinical care and stimulate new ideas for future research uncovering the underlying neural correlates of the different treatment paradigms. We propose that both local “within-system” interactions (i.e., relying on plasticity within peri-lesional spared tissue) and changes in more global “between-system” networks (i.e., recruiting alternative visual pathways) contribute to both vision restoration and compensatory rehabilitation that ultimately have implications for the rehabilitation of cognitive functions.

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via Frontiers | Visual rehabilitation: visual scanning, multisensory stimulation and vision restoration trainings | Frontiers in Behavioral Neuroscience.

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