Restorative Neurology and Neuroscience - Volume 31, issue 4

Authors: Wang, Jiangbi | Feng, Xiang | Du, Yi | Wang, Lei | Zhang, Shengxiang

Article Type: Research Article

Abstract: Purpose: The present study was aimed to investigate whether combination treatment with progesterone and rehabilitation training would be more effective than monotherapy after cerebral ischemia. Methods: C57BL/6 mice were subjected to focal ischemia by photothrombosis and were treated with progesterone (2 mg/kg), rehabilitation training or their combination. 2,3,5-triphenyltetrazolium chloride (TTC) staining and Nissl staining were used to measure infarct size at day 3 and day 7 after surgery, and rotarod test and grip strength test were conducted to evaluate behavioral outcomes. Results: TTC staining indicated that progesterone, rehabilitation training and their combination produced a different degree of reduction in infarct …volume compared with vehicle control at day 3 after ischemia (progesterone: 16.70 ± 0.93 mm3 , p < 0.01, rehabilitation training: 22.19 ± 0.93 mm3 , p < 0.05, progesterone + rehabilitation training: 14.76 ± 0.92 mm3 , p < 0.01, vehicle control: 28.73 ± 1.05 mm3 ). Nissl staining revealed that prolonged treatment of progesterone, rehabilitation training and their combination led to a significant decrease in infarct volume at day 7 after ischemia (progesterone: 18.64 ± 1.83 mm3 , p < 0.01, rehabilitation training: 25.07 ± 1.70 mm3 , p < 0.05, progesterone + rehabilitation training: 17.09 ± 0.92 mm3 , p < 0.01, vehicle control: 30.31 ± 1.36 mm3 ). No accumulative effect in the reduction of infarct volume was observed in combination therapy at both day 3 and day 7 after ischemia. However, combination therapy significantly improved behavioral performances in the first week after photothrombosis. Combination treatment significantly enhanced rotarod performance and forelimb grip strength at all time points within 7 days after ischemia compared with rehabilitation alone, and significantly improved rotarod performance and forelimb grip strength from day 2 after ischemia compared with progesterone alone. Conclusion: Our results suggested that combination treatment with progesterone and rehabilitation training had no additive effect in reducing infarct volume, but combination therapy exhibited enhanced efficacy in promoting functional recovery after ischemic stroke, suggesting progesterone and rehabilitation training may exert their effects via different mechanisms. Show more

Keywords: Progesterone, rehabilitation training, ischemic stroke, infarct, functional recovery

DOI: 10.3233/RNN-130312

Citation: Restorative Neurology and Neuroscience, vol. 31, no. 4, pp. 487-499, 2013

Authors: Torres, Jose | Drebing, Daniel | Hamilton, Roy

Article Type: Research Article

Abstract: Aphasia is a common result of stroke, affecting over one million Americans. Currently, intensive speech therapy is the mainstay of treatment, although its efficacy has been variable at best. Recent years have seen the emergence of non-invasive brain stimulation, specifically Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS), as potential treatments for post-stroke aphasia. A growing body of investigations has shown the efficacy of both modalities in facilitating recovery from chronic aphasia, while data regarding subacute aphasia are much more limited and evidence in the acute post-stroke phase are still lacking. Much remains unknown about how these techniques …cause clinical improvement or about their long-term efficacy, side-effects, and safety. In this article, we examine the data demonstrating the safety and efficacy of TMS and tDCS, discuss the major differences between them, and consider how those differences may inform the use of each modality. We also consider the different models of neuroplasticity in the setting of post-stroke aphasia and how these models may influence when and in which patients each modality would impart the most benefit. Show more

Keywords: Transcranial Magnetic Stimulation (TMS), Transcranial Direct Current Stimulation (tDCS), aphasia, neuroplasticity, stroke

DOI: 10.3233/RNN-130314

Citation: Restorative Neurology and Neuroscience, vol. 31, no. 4, pp. 501-515, 2013