Posts Tagged Neuroplasticity

[VIDEO] What is Neuroplasticity? – YouTube

What is Neuroplasticity? Dr. Matthew Antonucci from Plasticity Brain Centers of Orlando, Florida gives us a breakdown of what the term really means.

 

 

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[VIDEO] Recovery from Brain Injury Occurs for the Rest of a Person’s Life – YouTube

The human brain is a wonderful organ with amazing flexibility. Learn more about recovery.

 

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[WEB SITE] Can a Bit of Electricity Improve Your Brain?

Neuromodulation expands beyond health care.

PublicDomainPictures/Pixabay

Source: PublicDomainPictures/Pixabay

Neuromodulation is the use of electrical, magnetic, or chemical stimulation to modulate nervous tissue function. Research studies with promising results from novel treatments using neuromodulations are emerging.

On October 4, 2019, a study published in the American Journal of Psychiatry, led by Professor Helen S. Mayberg, M.D. at the Icahn School of Medicine at Mount Sinai and Dr. Andrea Crowell at Emory University, showed that deep brain stimulation for treatment-resistant depression for a majority of the participants had a “robust and sustained antidepressant response” in an over eight-year period, and there were not any suicides.

Earlier this year, in April, Boston University scientists Robert M. G. Reinhart and John A. Nguyen published in Nature Neuroscience a neuromodulation study that demonstrated noninvasive electrical brain stimulation temporarily improved the working memory accuracy in older adults. The study used 84 people—half between the ages of 20-29, and the other half between 60-76 years old.

The scientists hypothesize that their technique improved behavior due to neuroplastic changes in functional connectivity for up to 50 minutes afterward. Additional studies with more test subjects are needed to test the hypothesis and determine the full course potential of the effects.

These are just a few examples of the numerous research studies in neuromodulation. Neuromodulation methods include optogenetics, cochlear implants, retinal implants, deep brain and spinal cord stimulators, pharmacotherapy, and electroceuticals. Potential applications for neuromodulation may include chronic pain managementAlzheimer’s disease, depression, complications due to stroke, traumatic brain injuries, Parkinson’s disease, epilepsy, migraines, spinal cord injuries, and other conditions. Currently, there are over 590 neuromodulation clinical studies worldwide, according to the U.S. National Institute of Health’s Library of Medicine database of privately and publicly funded clinical studies conducted around the world.

Within the growing neuromodulation market, one segment, transcranial direct current stimulation (tDCS), is moving beyond health care and is making inroads into the consumer segment. Transcranial direct current stimulation is a form of noninvasive brain stimulation using a constant weak electrical current. Typically the voltage is less than two milliamps.

One of the earliest records of transcranial direct current stimulation dates to the ancient Roman Empire. The physician to Roman Emperor Tiberius Claudius Nero Caesar, Scribonius Largus, put a live torpedo fish, an electric ray capable of delivering up to 220 volts, directly on a patient in an effort to use the animal’s electrical discharges for pain therapy.

Fast forward to present day, and transcranial direct current stimulation is being used for a variety of purposes as an emerging technology for neuroscientists, elite athletes, e-sports gamers, neurologists, musicians, and psychiatrists—sans the torpedo fish. Instead, electronic devices in various form-factors are used to deliver currents to the human brain noninvasively via the scalp. Consumer-based transcranial direct current stimulation devices operate on the principle of neuroplasticity—the brain’s ability to change neural connections and behavior.

“Neuroplasticity is the property of the brain that enables it to change its own structure and functioning in response to activity and mental experience,” wrote the New York Times bestselling author, psychiatrist, and psychoanalyst, Norman Doidge, FRCPC, in his 2015 book The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity.

An example of a consumer-based transcranial direct current stimulation device is the Halo Sport 2, a wireless headset introduced in January 2019 that stimulates the brain’s motor cortex through electrical currents to create a temporary state of neuroplasticity. Whether the activity is learning music, dance, or sports, the human brain learns movement via the motor cortex.

The device is made by venture-backed startup Halo Neuroscience, a company founded in 2013 by Daniel Chao, Brett Wingeier, Lee von Kraus, Ph.D., and Amol Sarva, with investments from Jazz Venture Partners, Lux Capital, TPG, Andreessen Horowitz, and others. To use the Halo Sport 2 is simple—neuroprime with the headset on for 20 minutes, then train for an hour afterward.

Halo Sport users include athletes, musicians, and the military—such as members of Major League Baseball’s San Francisco Giants, National Basketball Association’s Golden State Warriors, the U.S. Navy SEALs, USA Cycling, the United States Ski Team, Berklee College of Music, Invictus, as well as many others.

World champion triathlete Timothy O’Donnell is a Halo Sport user. O’Donnell has over 50 podium finishes, including 22 wins. He won two IRONMAN titles, six Armed Forces National Championships, nine Ironman 70.3 races, an ITU Long Distance World Champion race, and many other prestigious competitive triathlon medals. As a world-class elite athlete, O’Donnell is constantly seeking innovative ways to improve his performance. He reportedly reached out to Halo Neuroscience after reading about the technology and incorporates Halo Sport neuropriming in his training to give him an edge.

A number of investments in neuroscience companies have emerged in recent years, such as Bryan Johnson’s Kernel, Elon Musk’s Neuralink, and Tej Tadi’s MindMaze. Other neurotechnology startups include Synchron, founded by Nicholas Opie and Thomas Oxley, BIOS founded by Emil Hewage and Oliver Armitage, BrainCo founded by Bicheng Han, Nextmind founded by Gwendal Kerdavid and Sid Kouider, Thync founded by Isy Goldwasser and Jamie Tyler, EMOTIV founded by Tan Le and Dr. Geoff Mackellar, Paradromics founded by Matt Angle, Bitbrain founded by Javier Minguez Zafra and Maria Lopez Valdes, Flow Neuroscience founded by Daniel Månsson and Erik Rehn, Dreem founded by Hugo Mercier and Quentin Soulet de Brugière, Neuros Medical founded by Jon J. Snyder, Neurable founded by James Hamet, Michael Thompson and Ramses Alcaide, Cognixion founded by Andeas Forsland, Q30 Innovations founded by Bruce Angus and Thomas Hoey, Neuroscouting founded by Dr. Wesley Clapp and Dr. Brian Miller, and Meltin MMI founded by Masahiro Kasuya, and Neuropace founded by David R. Fischell.

The global neuromodulation device industry is expected to increase to 13.3 billion by 2022, according to Neurotech Reports figures published in September 2018. Within this growing space, consumer-based transcranial direct current stimulation is an emerging market to watch.

 

via Can a Bit of Electricity Improve Your Brain? | Psychology Today

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[REVIEW] Repetitive transcranial magnetic stimulation in stroke rehabilitation: review of the current evidence and pitfalls – Full Text

Acute brain ischemia causes changes in several neural networks and related cortico-subcortical excitability, both in the affected area and in the apparently spared contralateral hemisphere. The modulation of these processes through modern techniques of noninvasive brain stimulation, namely repetitive transcranial magnetic stimulation (rTMS), has been proposed as a viable intervention that could promote post-stroke clinical recovery and functional independence. This review provides a comprehensive summary of the current evidence from the literature on the efficacy of rTMS applied to different clinical and rehabilitative aspects of stroke patients. A total of 32 meta-analyses published until July 2019 were selected, focusing on the effects on motor function, manual dexterity, walking and balance, spasticity, dysphagia, aphasia, unilateral neglect, depression, and cognitive function after a stroke. Only conventional rTMS protocols were considered in this review, and meta-analyses focusing on theta burst stimulation only were excluded. Overall, both HF-rTMS and LF-rTMS have been shown to be safe and well-tolerated. In addition, the current literature converges on the positive effect of rTMS in the rehabilitation of all clinical manifestations of stroke, except for spasticity and cognitive impairment, where definitive evidence of efficacy cannot be drawn. However, routine use of a specific paradigm of stimulation cannot be recommended yet due to a significant level of heterogeneity of the studies in terms of protocols to be set and outcome measures that have to be used. Future studies need to preliminarily evaluate the most promising protocols before going on to multicenter studies with large cohorts of patients in order to achieve a definitive translation into daily clinical practice.

Background

Stroke is a common acute neurovascular disorder that causes disabling long-term limitations to daily living activities. The most common consequence of a stroke is motor deficit of variable degree,1 although nonmotor symptoms are also relevant and often equally disabling.2 To date, to the best of the authors’ knowledge, there is no validated treatment that is able to restore the impaired functions by a complete recovery of the damaged tissue. Indeed, stroke management basically consists of reducing the initial ischemia in the penumbra, preventing future complications, and promoting a functional recovery using physiotherapy, speech therapy, occupational therapy, and other conventional treatments.3,4

Ischemic damage is associated with significant metabolic and electrophysiological changes in cells and neural networks involved in the affected area. From a pure electrophysiological perspective, however, beyond the affected area, there is a local shift in the balance between the inhibition and excitation of both the affected and contralateral hemisphere, consisting of increased excitability and disinhibition (reduced activity of the inhibitory circuits).3,5 In addition, subcortical areas and spinal regions may be altered.3,5 In particular, the role of the uninjured hemisphere seems to be of utmost significance in post-stroke clinical and functional recovery.

Different theoretical models have been proposed to explain the adaptive response of the brain to acute vascular damage. According to the vicariation model, the activity of the unaffected hemisphere contributes to the functional recovery after a stroke through the replacement of the lost functions of the affected areas. The interhemispheric competition model considers the presence of mutual inhibition between the hemispheres, and the damage caused by a stroke disrupts this balance, thus producing a reduced inhibition of the unaffected hemisphere by the affected side. This results in increased inhibition of the affected hemisphere by the unaffected side. More recently, a new model, called bimodal balance recovery, has been proposed.3,5 It introduces the concept of a structural reserve, which describes the extent to which the nondamaged neural pathways contribute to the clinical recovery. The structural reserve determines the prevalence of the interhemispheric imbalance over vicariation. When the structural reserve is high, the interhemispheric competition model can predict the recovery better than the vicariation model, and vice versa.3

Repetitive transcranial magnetic stimulation

One of the proposed interventions to improve stroke recovery, by the induction of neuromodulation phenomena, is based on methods of noninvasive brain stimulation. Among them, transcranial magnetic stimulation (TMS) is a feasible and painless neurophysiological technique widely used for diagnostic, prognostic, research, and, when applied repetitively, therapeutic purposes.69 By electromagnetic induction, TMS generates sub or suprathreshold currents in the human cortex in vivo and in real time.10,11

The most common stimulation site is the primary motor cortex (M1), that generates motor evoked potentials (MEPs) recorded from the contralateral muscles through surface electromyography electrodes.11 The intensity of TMS, measured as a percentage of the maximal output of the stimulator, is tailored to each patient based on the motor threshold (MT) of excitability. Resting MT (rMT) is found when the target muscle is at rest, it is defined as the minimal intensity of M1 stimulation required to elicit an electromyography response with a peak-to-peak amplitude > 50 µV in at least 5 out of 10 consecutive trials.11 Alternatively TMS MTAT 2.0 software (http://www.clinicalresearcher.org/software.htm) is a free tool for TMS researchers and practitioners. It provides four adaptive methods based on threshold-tracking algorithms with the parameter estimation by sequential testing, using the maximum-likelihood strategy for estimating MTs. Active MT (aMT) is obtained during a tonic contraction of the target muscle at approximately 20% of the maximal muscular strength.11

The rMT is considered a basic parameter in providing the global excitation state of a central core of M1 neurons.11 Accordingly, rMT is increased by drugs blocking the voltage-gated sodium channels, where the same drugs may not have an effect on the gamma-aminobutyric acid (GABA)-ergic functions. In contrast, rMT is reduced by drugs increasing glutamatergic transmission not mediated by the N-methyl-D-aspartate (NMDA) receptors, suggesting that rMT reflects both neuronal membrane excitability and non-NMDA receptor glutamatergic neurotransmission.12 Finally, the MT increases, being often undetectable, when a substantial portion of M1 or the cortico-spinal tract is damaged (i.e. by stroke or motor neuron disease), and decreases when the motor pathway is hyperexcitable (such as epilepsy).13

Repetitive (rTMS) is a specific stimulation paradigm characterized by the administration of a sequence of consecutive stimuli on the same cortical region, at different frequencies and inter sequence intervals. As known, rTMS can transiently modulate the excitability of the stimulated cortex, with both local and remote effects outlasting the stimulation period. Conventional rTMS modalities include high-frequency (HF-rTMS) stimulation (>1 Hz) and low-frequency (LF-rTMS) stimulation (⩽1 Hz).11 High-frequency stimulation typically increases motor cortex excitability of the stimulated area, whereas low-frequency stimulation usually produces a decrease in excitability.14 The mechanisms by which rTMS modulates the brain are rather complex, although they seem to be related to the phenomena of long-term potentiation (LTP) and long-term depression (LTD).15

When applied after a stroke, rTMS should ideally be able to suppress the so called ‘maladaptive plasticity’16,17 or to enhance the adaptive plasticity during rehabilitation. These goals can be achieved by modulating the local cortical excitability or modifying connectivity within the neuronal networks.10

rTMS in stroke rehabilitation: an overview

According to the latest International Federation of Clinical Neurophysiology (IFCN) guidelines on the therapeutic use of rTMS,10 there is a possible effect of LF-rTMS of the contralesional motor cortex in post-acute motor stroke, and a probable effect in chronic motor stroke. An effect of HF-rTMS on the ipsilesional motor cortex in post-acute and chronic motor stroke is also possible.

The potential role of rTMS in gross motor function recovery after a stroke has been assessed in a recent comprehensive systematic review of 70 studies by Dionisio and colleagues.18 The majority of the publications reviewed report a role of rTMS in improving motor function, although some randomized controlled trials (RCTs) were not able to confirm this result,1923 as shown by a recent large randomized, sham-controlled, clinical trial of navigated LF-rTMS.24 It has also been suggested that rTMS can specifically improve manual dexterity,10 which is defined as the ability to coordinate the fingers and efficiently manipulate objects, and is of crucial importance for daily living activities.25 Notably, most of the studies focused on motor impairment in the upper limbs, whereas limited data is available on the lower limbs.18 Walking and balance are frequently impaired in stroke patients and significantly affect the quality of life (QoL),26,27 and rTMS might represent a valid aid in the recovery of these functions.28,29 Spasticity is another common complication after a stroke, consisting of a velocity-dependent increase of muscular tone,30 and for which rTMS has been proposed as a rehabilitation tool.31

Dysphagia is highly common in stroke patients, it impairs the global clinical recovery, and predisposes to complications.32 It has been pointed out that rTMS targeting the M1 area representing the muscles involved in swallowing may contribute to the treatment of post-stroke dysphagia.33

Nonmotor deficit is also a relevant post-stroke disability that negatively impacts the QoL. Aphasia is a very common consequence of stroke, affecting approximately 30% of stroke survivors and significantly limiting rehabilitation.34 According to the IFCN guidelines, to date, there is no recommendation for LF-rTMS of the contralesional right inferior frontal gyrus (IFG). Similarly, no recommendation for HF-rTMS or intermittent theta burst stimulation (TBS) of the ipsilesional left IFG or dorsolateral prefrontal cortex (DLPFC) in Broca’s aphasia has been currently approved.10 The same is true for LF-rTMS of the right superior temporal gyrus in Wernicke’s aphasia.10

Neglect is the incapacity to respond to tactile or visual contralateral stimuli that are not caused by a sensory-motor deficit.35 Although hard to treat, rTMS has been proposed as a tool for neglect rehabilitation.36 However, the IFCN guidelines state that currently there is no recommendation for LF-rTMS of the contralesional left posterior parietal cortex, or for HF-rTMS of the ipsilesional right posterior parietal cortex.10 In a recent systematic review, most of the included studies supported the use of TMS for the rehabilitation of aphasia, dysphagia, and neglect, although the heterogeneity of stimulation protocols did not allow definitive conclusions to be drawn.37

Post-stroke depression is a relevant complication of cerebrovascular diseases.38 The role of rTMS in the management of major depressive disorders is well documented,39,40 and currently, rTMS is internationally approved and indicated for the treatment of major depression in adults with antidepressant medication resistance, and in those with a recurrent course of illness, or in cases of moderate-to-severe disease severity.39 In major depression disorders, according to the IFCN guidelines, there is a clear antidepressant effect of HF-rTMS over the left DLPFC, a probable antidepressant effect of LF-rTMS on the right DLPFC, and probably no differential antidepressant effect between right LF-rTMS and left HF-rTMS. Moreover, there is currently no recommendation for bilateral stimulation combining HF-rTMS of the left DLPFC and LF-rTMS of the right DLPFC. The mentioned guidelines also state that the antidepressant effect when stimulating DLPFC is probably additive, and possibly potentiating, to the efficacy of antidepressant drugs.10 However, no specific recommendation currently addresses the use of rTMS in post-stroke depression. Recently, rTMS has been proposed as a treatment option for the late-life depression associated with chronic subcortical ischemic vascular disease, the so called ‘vascular depression’.4144 Three studies tested rTMS efficacy in vascular depression (one was a follow-up study with citalopram). Although presenting positive findings, further trials should refine clinical and diagnostic criteria to assess its impact on antidepressant efficacy.45

Approximately 25–30% of stroke patients develop an immediate or delayed cognitive impairment or an overt picture of vascular dementia.46 There is evidence of an overall positive effect on cognitive function for both LF-rTMS47 and HF-rTMS,48 supported by studies on experimental models of vascular dementia.4952 Nonetheless, the few trials examining the effect on stroke-related cognitive deficit produced mixed results.5356 In particular, two studies found no effect on cognition when stimulating the left DLPFC at 1 Hz and 10 Hz,53,54 whereas a pilot study found a positive effect on the Stroop interference test with HF-rTMS over the left DLPFC in patients with vascular cognitive impairment without dementia.55 However, this finding was not replicated in a follow-up study.56 To summarize, rTMS can induce beneficial effects on specific cognitive domains, although data are limited and their clinical significance needs to be further validated. Major challenges exist in terms of appropriate patient selection and optimization of the stimulation protocols.57

Central post-stroke pain (CPSP) is the pain resulting from an ischemic lesion of the central nervous system.58 It represents a relatively common complication after a stroke, although it is often under-recognized and, therefore, undertreated.59 According to the IFCN guidelines for the use of rTMS in the treatment of neuropathic pain, there is a definite analgesic effect of HF-rTMS of contralateral M1 to the pain side, and LF-rTMS of contralateral M1 to the pain side is probably ineffective. In addition, there is currently no recommendation for cortical targets other than contralateral M1 to the pain side.10 Notably, rTMS might be effective in drug-resistant CPSP patients.58 A recent systematic review that included nine HF-rTMS studies suggested an effect on CPSP relief, but also underlined the insufficient quality of the studies considered.60

Study objective

In this article, we aim to provide an up-to-date overview of the most recent evidence on the efficacy of rTMS in the rehabilitation of stroke patients. Although several studies have been published, a conclusive statement supporting a systematic use of rTMS in the multifaceted clinical aspects of stroke rehabilitation is still lacking.

[…]

 

Continue —> Repetitive transcranial magnetic stimulation in stroke rehabilitation: review of the current evidence and pitfalls – Francesco Fisicaro, Giuseppe Lanza, Alfio Antonio Grasso, Giovanni Pennisi, Rita Bella, Walter Paulus, Manuela Pennisi, 2019

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[WEB SITE] Virtual Reality is Finding a Home in Physical Therapy

Credit to: Neuro Rehab VR

Virtual reality has plenty of applications for fitness — you’re here, so you already know that. However, it is increasingly becoming a tool for rehabilitation, as well. Neuro Rehab VR aims to make physical therapy more enjoyable, and it promises to help patients more than traditional physical therapy.

Making physical therapy fun

With only about one-third of patients fully adhering to their rehabilitation plans, Neuro Rehab VR’s goal was to create a platform that was more engaging without making things more cumbersome. During the early days of the Oculus Rift, with its many sensors, that was not possible.

This was made possible with the Oculus Quest, which eliminated the need for extra equipment or wires. Neuro Rehab VR provides several different exercise applications that run patients through less-abstract goals, such as going grocery shopping. The applications are available for the entire body, and also include sports and combat.

In addition to being more interesting, VR physical therapy can have more effective results. Because of  the brain’s neuroplasticity, Neuro Rehab VR says playing games can establish better connections in the brain as you work toward concrete goals. This can, in turn, lead to more complete recovery. Neuro Rehab VR is partnered with Fort Worth’s Neurological Recovery Center. It has dealt with patients of spinal injuries, brain injuries, strokes, and multiple sclerosis. The team decided to expand and make its systems available elsewhere after seeing its success.

Neuro Rehab VR believes its systems can work not only in hospitals, but also for in-home recovery. The low cost of the Quest itself makes it affordable for rental or purchase by the patient. Therapists can see every movement patients make to determine if they are doing exercises correctly. Once the patient is feeling better, they’ll still have a device capable of helping them stay fit from within their home.

via Virtual Reality is Finding a Home in Physical Therapy

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[VIDEO] What’s, Why’s and How’s of the Vagus Nerve Stimulator

Dr Nemechek Discusses the Vagus Nerve Stimulator, how it’s used and what it can do for a patient.

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[Abstract] Cognitive Training in Young Patients With Traumatic Brain Injury: A Fixel-Based Analysis

Background. Traumatic brain injury (TBI) is associated with altered white matter organization and impaired cognitive functioning.

Objective. We aimed to investigate changes in white matter and cognitive functioning following computerized cognitive training.

Methods. Sixteen adolescents with moderate-to-severe TBI (age 15.6 ± 1.8 years, 1.2-4.6 years postinjury) completed the 8-week BrainGames program and diffusion weighted imaging (DWI) and cognitive assessment at time point 1 (before training) and time point 2 (after training). Sixteen healthy controls (HC) (age 15.6 ± 1.8 years) completed DWI assessment at time point 1 and cognitive assessment at time point 1 and 2. Fixel-based analyses were used to examine fractional anisotropy (FA), mean diffusivity (MD), and fiber cross-section (FC) on a whole brain level and in tracts of interest.

Results. Patients with TBI showed cognitive impairments and extensive areas with decreased FA and increased MD together with an increase in FC in the body of the corpus callosum and left superior longitudinal fasciculus (SLF) at time point 1. Patients improved significantly on the inhibition measure at time point 2, whereas the HC group remained unchanged. No training-induced changes were observed on the group level in diffusion metrics. Exploratory correlations were found between improvements on verbal working memory and reduced MD of the left SLF and between increased performance on an information processing speed task and increased FA of the right precentral gyrus.

Conclusions. Results are indicative of positive effects of BrainGames on cognitive functioning and provide preliminary evidence for neuroplasticity associated with cognitive improvements following cognitive intervention in TBI.

via Cognitive Training in Young Patients With Traumatic Brain Injury: A Fixel-Based Analysis – Helena Verhelst, Diana Giraldo, Catharine Vander Linden, Guy Vingerhoets, Ben Jeurissen, Karen Caeyenberghs,

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[Abstract] Optimizing brain performance: Identifying mechanisms of adaptive neurobiological plasticity

Highlights

  • Neural processes interact with dynamic environments to generate adaptive functions.
  • Neural plasticity is differentially influenced by individual and context specific variables.
  • Targeted training enhances adaptive neuroplasticity across the lifespan.

Abstract

Although neuroscience research has debunked the late 19th century claims suggesting that large portions of the brain are typically unused, recent evidence indicates that an enhanced understanding of neural plasticity may lead to greater insights related to the functional capacity of brains. Continuous and real-time neural modifications in concert with dynamic environmental contexts provide opportunities for targeted interventions for maintaining healthy brain functions throughout the lifespan. Neural design, however, is far from simplistic, requiring close consideration of context-specific and other relevant variables from both species and individual perspectives to determine the functional gains from increased and decreased markers of neuroplasticity. Caution must be taken in the interpretation of any measurable change in neurobiological responses or behavioral outcomes, as definitions of optimal functions are extremely complex. Even so, current behavioral neuroscience approaches offer unique opportunities to evaluate adaptive functions of various neural responses in an attempt to enhance the functional capacity of neural systems.

via Optimizing brain performance: Identifying mechanisms of adaptive neurobiological plasticity – ScienceDirect

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[Abstract] Forced, Not Voluntary, Aerobic Exercise Enhances Motor Recovery in Persons With Chronic Stroke

Background. The recovery of motor function following stroke is largely dependent on motor learning–related neuroplasticity. It has been hypothesized that intensive aerobic exercise (AE) training as an antecedent to motor task practice may prime the central nervous system to optimize motor recovery poststroke.

Objective. The objective of this study was to determine the differential effects of forced or voluntary AE combined with upper-extremity repetitive task practice (RTP) on the recovery of motor function in adults with stroke.

Methods. A combined analysis of 2 preliminary randomized clinical trials was conducted in which participants (n = 40) were randomized into 1 of 3 groups: (1) forced exercise and RTP (FE+RTP), (2) voluntary exercise and RTP (VE+RTP), or (3) time-matched stroke-related education and RTP (Edu+RTP). Participants completed 24 training sessions over 8 weeks.

Results. A significant interaction effect was found indicating that improvements in the Fugl-Meyer Assessment (FMA) were greatest for the FE+RTP group (P = .001). All 3 groups improved significantly on the FMA by a mean of 11, 6, and 9 points for the FE+RTP, VE+RTP, and Edu+RTP groups, respectively. No evidence of a treatment-by-time interaction was observed for Wolf Motor Function Test outcomes; however, those in the FE+RTP group did exhibit significant improvement on the total, gross motor, and fine-motor performance times (P ≤ .01 for all observations).

Conclusions. Results indicate that FE administered prior to RTP enhanced motor skill acquisition greater than VE or stroke-related education. AE, FE in particular, should be considered as an effective antecedent to enhance motor recovery poststroke.

via Forced, Not Voluntary, Aerobic Exercise Enhances Motor Recovery in Persons With Chronic Stroke – Susan M. Linder, Anson B. Rosenfeldt, Sara Davidson, Nicole Zimmerman, Amanda Penko, John Lee, Cynthia Clark, Jay L. Alberts, 2019

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[Abstract] Optimizing brain performance: Identifying mechanisms of adaptive neurobiological plasticity

Abstract

Although neuroscience research has debunked the late 19th century claims suggesting that large portions of the brain are typically unused, recent evidence indicates that an enhanced understanding of neural plasticity may lead to greater insights related to the functional capacity of brains. Continuous and real-time neural modifications in concert with dynamic environmental contexts provide opportunities for targeted interventions for maintaining healthy brain functions throughout the lifespan. Neural design, however, is far from simplistic, requiring close consideration of context-specific and other relevant variables from both species and individual perspectives to determine the functional gains from increased and decreased markers of neuroplasticity. Caution must be taken in the interpretation of any measurable change in neurobiological responses or behavioral outcomes, as definitions of optimal functions are extremely complex. Even so, current behavioral neuroscience approaches offer unique opportunities to evaluate adaptive functions of various neural responses in an attempt to enhance the functional capacity of neural systems.

via Optimizing brain performance: Identifying mechanisms of adaptive neurobiological plasticity – ScienceDirect

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