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New Directions in Treatments Targeting Stroke Recovery

Published on Dec 1, 2018in Stroke6.058
· DOI :10.1161/strokeaha.118.021359
David Lin12
Estimated H-index: 12
(Harvard University),
Seth P. Finklestein53
Estimated H-index: 53
(Harvard University),
Steven C. Cramer65
Estimated H-index: 65
(UCI: University of California, Irvine)
Abstract
Stroke is the leading cause of neurological disability in the U.S. and worldwide. Remarkable advances have been made over the last 20 years in acute vascular treatments to reduce infarct size and improve neurological outcome. Substantially less progress has been made in treatments to enhance neurological recovery after stroke. However, a number of promising research directions have been identified for treatments targeting stroke recovery and are the focus of the current review (Figure 1). Open in a separate window Figure 1. Summary of current experimental treatments for stroke recovery and their readiness for incorporation into clinical practice based on synthesis of current evidence. Readiness for clinical application ranges from preclinical development (i.e. in animal studies only, red) to broad clinical application (green).
  • References (64)
  • Citations (1)
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References64
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#1Fred Stephen Sarfo (KNUST: Kwame Nkrumah University of Science and Technology)H-Index: 22
#2Uladzislau Ulasavets (Jagiellonian University Medical College)H-Index: 1
Last. Bruce Ovbiagele (MUSC: Medical University of South Carolina)H-Index: 56
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Background Tele-rehabilitation for stroke survivors has emerged as a promising intervention for remotely supervised administration of physical, occupational, speech, and other forms of therapies aimed at improving motor, cognitive, and neuropsychiatric deficits from stroke. Objective We aimed to provide an updated systematic review on the efficacy of tele-rehabilitation interventions for recovery from motor, higher cortical dysfunction, and poststroke depression among stroke survivors. Methods W...
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#1Anne Sophie Champod (Dal: Dalhousie University)H-Index: 7
#2Rachel C. Frank (Dal: Dalhousie University)H-Index: 1
Last. Gail A. Eskes (Dal: Dalhousie University)H-Index: 28
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ABSTRACTStudies that have investigated prism adaptation (PA) effects on symptoms of visuospatial neglect have primarily used neuropsychological tests as outcome measures. An important question that remains to be answered is whether PA effects translate into improvements in patients’ daily life activities. In the present review, we examined systematically the evidence for the effect of PA treatment on daily life activities in patients with neglect. Two authors independently assessed the methodolo...
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#1Pawel KiperH-Index: 6
#2Andrzej Szczudlik (Jagiellonian University Medical College)H-Index: 30
Last. Andrea Turolla (University of Sheffield)H-Index: 16
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Abstract Objective To evaluate the effectiveness of reinforced feedback in virtual environment (RFVE) treatment combined with conventional rehabilitation (CR) in comparison with CR alone, and to study whether changes are related to stroke etiology (ie, ischemic, hemorrhagic). Design Randomized controlled trial. Setting Hospital facility for intensive rehabilitation. Participants Patients (N=136) within 1 year from onset of a single stroke (ischemic: n=78, hemorrhagic: n=58). Interventions The ex...
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#1Anna Aminov (ACU: Australian Catholic University)H-Index: 3
#2Jeffrey RogersH-Index: 31
Last. Peter H. Wilson (ACU: Australian Catholic University)H-Index: 32
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Background Virtual-reality based rehabilitation (VR) shows potential as an engaging and effective way to improve upper-limb function and cognitive abilities following a stroke. However, an updated synthesis of the literature is needed to capture growth in recent research and address gaps in our understanding of factors that may optimize training parameters and treatment effects.
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#1Rebecca Lewthwaite (SC: University of Southern California)H-Index: 24
#2Carolee J. Winstein (SC: University of Southern California)H-Index: 49
Last. Steven L. Wolf (Emory University)H-Index: 69
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#1Eric Meyers (UTD: University of Texas at Dallas)H-Index: 5
#2Bleyda R. Solorzano (UTD: University of Texas at Dallas)H-Index: 3
Last. Seth A. Hays (UTD: University of Texas at Dallas)H-Index: 18
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Background and Purpose— Chronic impairment of the arm and hand is a common consequence of stroke. Animal and human studies indicate that brief bursts of vagus nerve stimulation (VNS) in conjunction with rehabilitative training improve recovery of motor function after stroke. In this study, we tested whether VNS could promote generalization, long-lasting recovery, and structural plasticity in motor networks. Methods— Rats were trained on a fully automated, quantitative task that measures forelimb...
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#2Corinna RingmaierH-Index: 1
Last. Rainer DziewasH-Index: 34
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#1Jessica M. Cassidy (UCI: University of California, Irvine)H-Index: 7
#2George Tran (UCI: University of California, Irvine)H-Index: 2
Last. Steven C. Cramer (UCI: University of California, Irvine)H-Index: 65
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BACKGROUND AND PURPOSE:Patient heterogeneity reduces statistical power in clinical trials of restorative therapies. Valid predictors of treatment responsiveness are needed, and several have been studied with a focus on corticospinal tract (CST) injury. We studied performance of 4 such measures for predicting behavioral gains in response to motor training therapy. METHODS:Patients with subacute-chronic hemiparetic stroke (n=47) received standardized arm motor therapy, and change in arm Fugl-Meyer...
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#1Mou-Xiong ZhengH-Index: 6
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#1Matthew S. Jeffers (U of O: University of Ottawa)H-Index: 10
#2Dale Corbett (U of O: University of Ottawa)H-Index: 50
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#1Akira Ito (Kyoto University)H-Index: 12
#2Naoko Kubo (Kyoto University)
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Neurological diseases severely affect the quality of life of patients. Although existing treatments including rehabilitative therapy aim to facilitate the recovery of motor function, achieving complete recovery remains a challenge. In recent years, regenerative therapy has been considered as a potential candidate that could yield complete functional recovery. However, to achieve desirable results, integration of transplanted cells into neural networks and generation of appropriate microenvironme...
Source
Abstract Stroke is the leading cause of long-term disability with no current treatment addressing post-stroke disability. The complex pathophysiology of stroke and the brain’s limited potential for regeneration prevents sufficient endogenous repair for complete recovery. While engineered materials provide an exciting opportunity to augment endogenous repair in conjunction with other therapies that address post-stroke disability, much of the preclinical work in this arena is still in its infancy....
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#1Robert W. Regenhardt (Harvard University)H-Index: 11
#2Hajime Takase (Harvard University)H-Index: 11
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Stroke is among the most common causes of adult disability worldwide, and its disease burden is shifting towards that of a long-term condition. Therefore, the development of approaches to enhance recovery and augment neural repair after stroke will be critical. Recovery after stroke involves complex interrelated systems of neural repair. There are changes in both structure (at the molecular, cellular, and tissue levels) and function (in terms of excitability, cortical maps, and networks) that oc...
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#1Emily DaltonH-Index: 1
#2Leonid ChurilovH-Index: 33
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Introduction: Despite an increase in the quality of clinical trials in stroke recovery, interventions have failed to markedly impact the trajectory of recovery after stroke. Failure may be due to the lack of consideration for the complexity of dose and its articulation within research trials. Prior to commencing the scoping review, we identified two research gaps to be addressed. Firstly, transparent application of a multidimensional definition of dose to clinical trial phases and secondly, the ...
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#1Julie Bernhardt (Florey Institute of Neuroscience and Mental Health)H-Index: 37
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