Técnicas de Neuroimagenología en la Cuantificación de la Neuroplasticidad en Pacientes con Enfermedad Vascular Cerebral / Neuroimaging Techniques for Neuroplasticity Quantification in Stroke Patients

RESUMEN Las técnicas de neuroimagenología otorgan información relevante del estado funcional y anatómico del cerebro humano. Esta información es particularmente importante cuando existe una lesión cerebral causada por alguna patología, tal como la enfermedad vascular cerebral (EVC). En pacientes afectados por esta enfermedad, se ha determinado que la neuroplasticidad es el mecanismo principal de recuperación de la función motora perdida. Debido a la alta prevalencia de la EVC a nivel mundial y especialmente en países en vías de desarrollo, es necesario continuar investigando los mecanismos de recuperación involucrados en esta patología. La resonancia magnética funcional (RMF) y la imagenología por tensor de difusión (ITD) son dos de las técnicas de neuroimagenología más utilizadas con este fin. La RMF permite analizar la actividad neuronal generada al ejecutar tareas de movimiento, mientras que la ITD proporciona información estructural de la anatomía cerebral. En esta revisión narrativa, se presentan diversos estudios que han utilizado estas técnicas de neuroimagenología en la cuantificación de los cambios de neuroplasticidad en pacientes con EVC tras participar en algún programa de neurorrehabilitación. Comprender mejor estos cambios de neuroplasticidad permitiría diseñar esquemas de rehabilitación que proporcionen un mayor beneficio a los pacientes con EVC.

ABSTRACT Neuroimaging techniques provide relevant information of the functional and anatomical status of the human brain. This information is of particular importance when a pathology, like stroke, produces a brain injury. In stroke patients, it has been determined that neuroplasticity is the primary recovery mechanism of the lost motor function. Due to worldwide high prevalence, especially in developing countries, it is necessary to continue the research of the recovery mechanisms involved in this pathology. To this end, functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) are two of the most used neuroimaging techniques. In stroke patients, fMRI allows the analysis of the neural activity produced by the execution of motor tasks, whereas DTI provides structural information of the brain anatomy. In this narrative review, multiple studies that employ these neuroimaging techniques for quantification of neuroplasticity changes in stroke patients after undergoing a neurorehabilitation program are presented. Better understanding of these neuroplasticity changes would allow researchers to design and provide more beneficial rehabilitation schemes to stroke patients.

Neuroplasticidade, memória e aprendizagem: Uma relação atemporal / Neuroplasticity, memory and learning: A timeless relationship

O presente texto tem como objetivo geral versar sobre a relação atemporal existente entre a neuroplasticidade, a memória e a aprendizagem humanas. Além disso, pretende-se tratar de maneira específica sobre os principais aspectos que influenciam a memória, como as emoções, os estados de ânimo e o nível de atenção. Essa temática é de crucial importância para os estudantes brasileiros, eis que na medida em que se conhece o que influencia positiva e negativamente na memória é possível obter melhores resultados no que toca à aprendizagem. Como modalidade de pesquisa, adota-se a bibliográfica; como método, utiliza-se o indutivo.

The present text has as its general objective to deal with the timeless relationship between neuroplasticity, human memory and learning. In addition, it is intended to deal specifically with the main aspects that influence memory, such as emotions, moods and the level of attention. This theme is of crucial importance for Brazilian students, since, as it is known what positive and negative influence on memory, it is possible to obtain better results in terms of learning. As a research modality, bibliography is adopted; as a method, the inductive is used.

Effect of Shugan Tiaoshen acupuncture combined with western medication on depression-insomnia comorbidity due to COVID-19 quarantine: a multi-central randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of Shugan Tiaoshen acupuncture (acupuncture for soothing the liver and regulating the mentality) combined with western medication on depression and sleep quality in the patients with depression-insomnia comorbidity due to COVID-19 quarantine, and investigate the potential mechanism from the perspective of cortical excitability.@*METHODS@#Sixty patients with depression-insomnia comorbidity due to COVID-19 quarantine were randomly divided into an acupuncture group and a sham-acupuncture group, 30 cases in each one. The patients of both groups were treated with oral administration of sertraline hydrochloride tablets. In the acupuncture group, Shugan Tiaoshen acupuncture was supplemented. Body acupuncture was applied to Yintang (GV 24+), Baihui (GV 20), Hegu (LI 4), Zhaohai (KI 6), Qihai (CV 6), etc. The intradermal needling was used at Xin (CO15), Gan (CO12) and Shen (CO10). In the sham-acupuncture group, the sham-acupuncture was given at the same points as the acupuncture group. The compensatory treatment was provided at the end of follow-up for the patients in the sham-acupuncture group. In both groups, the treatment was given once every two days, 3 times a week, for consecutive 8 weeks. The self-rating depression scale (SDS) and insomnia severity index (ISI) scores were compared between the two groups before and after treatment and 1 month after the end of treatment (follow-up) separately. The cortical excitability indexes (resting motor threshold [rMT], motor evoked potential amplitude [MEP-A], cortical resting period [CSP]) and the level of serum 5-hydroxytryptamine (5-HT) were measured before and after treatment in the two groups.@*RESULTS@#After treatment and in follow-up, SDS and ISI scores were decreased in both groups compared with those before treatment (P<0.05), and the scores in the acupuncture group were lower than those in the sham-acupuncture group (P<0.05), and the decrease range in the acupuncture group after treatment was larger than that in the sham-acupuncture group (P<0.05). After treatment, rMT was reduced (P<0.05), while MEP-A and CSP were increased (P<0.05) in the acupuncture group compared with that before treatment. The levels of serum 5-HT in both groups were increased compared with those before treatment (P<0.05). The rMT in the acupuncture group was lower than that in the sham-acupuncture group, while MEP-A and CSP, as well as the level of serum 5-HT were higher in the acupuncture group in comparison with the sham-acupuncture group (P<0.05).@*CONCLUSION@#Shugan Tiaoshen acupuncture combined with western medication can relieve depression and improve sleep quality in the patients with depression-insomnia comorbidity due to COVID-19 quarantine, which is probably related to rectifying the imbalanced excitatory and inhibitory neuronal functions.

Combining transcranial magnetic stimulation with interactive virtual scenario training can improve the upper limb motor function of stroke survivors / 中华物理医学与康复杂志

Objective:To observe any effect of combining low-frequency transcranial magnetic stimulation (rTMS) with interactive virtual scenario training on the recovery of upper limb motor function after a stroke.Methods:Ninety stroke survivors were randomly divided into a pseudo-rTMS group, an rTMS group and a combination group, each of 30. In addition to basic medication, conventional rehabilitation and nursing care, the pseudo-rTMS, rTMS and combination groups received either sham rTMS treatment, 1Hz rTMS or virtual situational interaction along with 1Hz rTMS 5 days a week for 4 weeks. Before and after the 4 weeks their motor evoked potentials, cortical latency and central motor conduction time were measured, and surface electromyography was applied to the affected biceps brachii and triceps brachii. Meanwhile, the National Institutes of Health Stroke Scale, the Fugl-Meyer upper extremity assessment and the modified Barthel index were employed to assess the degree of neurological deficit, upper extremity motor function and ability in the activities of daily living (ADL).Results:After the 4-week intervention, a significant improvement was observed in all of the outcome measurements with all three groups. At that time the average scores of the rTMS group were significantly better than the pseudo-rTMS group′s averages but the average scores of the combination group were significantly better than those of either of the other two groups.Conclusion:Repeated application of low-frequency transcranial magnetic stimulation combined with virtual scenario interactive training can effectively improve the upper limb motor function and ADL performance of stroke survivors, and relieve the symptoms of neurological deficit. The combined therapy is worthy of application in clinical practice.

Frontiers in the research of autism pathogenesis / Fronteras en la investigación de la patogenia del autismo

Abstract This review focuses on four interrelated teams and research lines that form the basis for new research on the pathogenesis of autism spectrum disorder (ASD) at the Marcus Autism Center, in Atlanta (US). These themes probe typical social behavior and brain development from birth, and disruptions thereof in babies later diagnosed with ASD. These four themes are: to leverage lifetime maximal neuroplasticity; to test the hypothesis that developmental disruption of early-emerging mechanisms of socialization drives pathogenesis and results in autistic social disability; the focus on the infant-caregiver dyad, and the iterative context associated with mutually reinforcing and adapted social and communitive inter-action, or emerging cycles of social contingency, from the first days and weeks of life; and the study of time-varying neurodevelopmental transitions in social behavior from experience-expectant (reflexive, endogenous) and subcortically-guided to experience-dependent (caregiver- and reward-driven) and cortically-guided, a transition that our work suggests is uniquely disrupted in babies later diagnosed with ASD. This science is opening a world of opportunities to optimize children's outcomes despite the genetic liabilities that they are born with. It provides the scientific grounding for new community-viable solutions for increasing access to early interventions using treatments that scaffold and strengthen infant-caregiver interactions, which is the platform for early brain development.

Resumen Esta revisión se centra en cuatro equipos y líneas de investigación interrelacionados que forman la b ase de nuevas investigaciones sobre la patogenia del Trastorno del Espectro Autista (TEA) en el Marcus Autism Center, en Atlanta (EE.UU.). Estos temas investigan el comportamiento social típico y el desarrollo del cerebro desde el nacimiento, y las altera ciones del mismo en los bebés a los que luego se les diagnostica TEA. Estos cuatro temas son: aprovechar la neuroplasticidad máxima en la vida; probar la hipótesis de que la interrupción del desarrollo de los mecanismos de socialización emergentes impulsa la patogénesis y da como resultado una discapacidad social autista; el enfoque en la díada bebé-cuidador, y el contexto iterativo asoc iado con la mutua interacción de refuerzo social y comunitario, o ciclos emergentes de contingencia social, desde los primeros días y semanas de vida; y el estudio de las transiciones del comportamiento social variable en el tiempo del neurodesarrollo desde la experiencia-expectante (reflexiva, endógena) y guiada subcorticalmente, a la experiencia-dependiente (cuidador e impulsado por la recompensa) y guiada corticalmente, una transición que nuestro trabajo sugiere que se interrumpe única mente en bebés diagnosticados posteriormente con TEA.

Effect of Wenyang Jieyu Decoction on Hippocampal Neuroplasticity in Depressed Rats Induced by Corticosterone / 中国实验方剂学杂志

ObjectiveTo observe the effect of Wenyang Jieyu decoction （WYJY） on the hippocampal structure of depressed rats with kidney-yang deficiency. MethodThe 105 SD rats were randomly divided into normal group， model group， fluoxetine group （4.17 mg·kg-1）， Xiaoyaosan group （1.88 g·kg-1）， and low-， medium- and high-dose （1.25，2.50，5.00 g·kg-1） WYJY groups，15 in each group. The depression model was induced by subcutaneous injection of corticosterone in rats except for those in the normal group and the rats were orally administered once a day for 28 days. The depression-like behaviors of rats were observed by sucrose preference test， novelty-suppressed feeding test， forced swimming test， and open field test. The morphology of hippocampal neurons was observed by hematoxylin-eosin（HE） staining， and the density of hippocampal neurons was detected by Nissl staining. The ultrastructure of hippocampal synapses was observed by transmission electron microscopy （TEM）. The expression of synaptophysin （SYP）， postsynaptic density-95 （PSD95）， and apoptosis-related protein Caspase-3 in hippocampal neurons was observed by immunohistochemistry， and bromodeoxyuridine （BrdU） and doublecortin （DCX） were used to observe the apoptosis and regeneration of hippocampal neurons. ResultWYJY could improve weight loss in depressed rats. As revealed by the behavioral tests， the model group showed depression-like behaviors， which were relieved in the WYJY groups and the positive drug groups. HE staining showed that the nuclei of hippocampal neurons in the model group were constricted， deeply stained， and sparsely arranged， while the neurons in the WYJY groups and the positive drug groups were significantly improved. Nissl staining demonstrated that the cell density of the model group was lower than that of the normal group （P<0.05）. Compared with model group， the groups with drug intervention showed increased cell density （P<0.05） and compact arrangement. According to the results in TEM， compared with normal group， the model group showed shortened synaptic active zone （P<0.05）， widened synaptic cleft （P<0.05）， and thinned tight zone （P<0.05）. Compared with model group， the groups with drug intervention showed shortened synaptic active zone （P<0.05）， narrowed synaptic cleft （P<0.05）， and thickened tight zone （P<0.05）. As displayed by the results of immunocytochemistry and immunofluorescence， compared with the normal group， the model group showed decreased protein expression of SYP， PSD95， BrdU， and DCX in the hippocampus （P<0.05） and increased protein expression of Caspase-3 （P<0.05）. Compared with the model group， the groups with drug intervention showed increased protein expression of SYP， PSD95， BrdU， and DCX in the hippocampus （P<0.05） and decreased protein expression of Caspase-3 （P<0.05）. ConclusionWYJY can promote the regeneration of hippocampal neurons in rats and improve the depression of rats.

Total Flavones of Spatholobi Caulis Regulate Hippocampal Neuroplasticity in Depressed Rats Through CREB/BDNF Pathway / 中国实验方剂学杂志

ObjectiveTo investigate the effect and mechanism of total flavones of Spatholobi Caulis （TFSC） against depression in rats. MethodThe fifty KM mice were randomly divided into the normal group and high-， medium-， and low-dose （1， 0.5， 0.25 g·kg-1） TFSC groups and gavaged with the corresponding drugs for 12 successive days. One hour after the last administration， the immobility time in forced swimming test and tail suspension test was recorded. The SD rats were randomly divided into the normal group， model group， fluoxetine （5 mg·kg-1） group， and high- and low-dose （1， 0.25 g·kg-1） TFSC groups. Following the exposure of rats to two different kinds of stimuli daily for inducing chronic unpredictable stress， they were administered with the corresponding drugs for 21 d. After the experiment， the levels of serum neurotransmitters and inflammatory factors in rats were detected by enzyme-linked immunosorbent assay （ELISA）. The changes in hippocampal neurons of rats were observed by hematoxylin-eosin （HE） and Nissl staining. The mRNA expression levels of nuclear factor-κB （NF-κB） and tumor necrosis factor-α （TNF-α） in the hippocampus of rats were detected by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）， and the protein expression levels of cAMP-response element binding protein （CREB）， phosphorylated CREB （p-CREB）， and brain-derived neurotrophic factor （BDNF） in hippocampal tissues by Western blot. ResultCompared with the normal group， TFSC significantly shortened the immobility time of mice in tail suspension and swimming tests （P<0.05）. Compared with the normal group， the model group exhibited reduced sucrose intake and wilderness activity （P<0.01）， decreased 5-HT， DA， NE （P<0.05， P<0.01）， MAO， IL-6， TNF-α （P<0.05， P<0.01）， damaged neurons， increased mRNA levels of TNF-α and NF-κB （P<0.01）， and down-regulated BDNF and CREB protein expression （P<0.05）. Compared with the model group， TFSC significantly enhanced sucrose intake and wilderness activity of rats （P<0.05）， increased the serum 5-HT， DA and NE （P<0.05， P<0.01）， and decreased the serum MAO， IL-6， and TNF-α （P<0.05， P<0.01） as well as NF-κB and TNF-α mRNA expression （P<0.01）， up-regulated the protein expression levels of BDNF and CREB （P<0.01）， and improved the pathological symptoms of hippocampus. ConclusionTFSC improved the hippocampal neurons of rats via CREB/BDNF signaling pathway and reduced depressive pathological damage， thus relieving depression.

Progress of cellular growth factors in neurorehabilitation and neuroplasticity / 中国康复理论与实践

@#With potent biological activities, cellular growth factors are polypeptide factors that primarily stimulate cell growth and proliferation. They participate in the regulation of not only normal physiological functions such as human embryonic development and cell growth, but also neurorehabilitation and neuroplasticity in pathological processes such as nerve injury and recovery. Specifically, cellular growth factors have been shown to promote neuron survival, facilitate nerve regeneration and regulate synaptic plasticity, promote cell differentiation/vascular regeneration and modulate the microenvironment, promote nerve fiber myelination and improve nerve conduction. This review summarized current knowledge on the roles and various growth factors in neurorehabilitation and neuroplasticity, providing an update on potential clinical application of cellular growth factors in the field of neural rehabilitation.

Terapia narrativa e neuroplasticidade: pensando suas conexões / Narrative therapy, neuroplasticity and their connections

Foi investigado, nesse artigo, a forma com que a terapia narrativa, a partir da construção de histórias alternativas, pode estimular a plasticidade neuronal, promovendo mudanças psicológicas e comportamentais. Realizou-se uma revisão bibliográfica para analisar as contribuições teóricas e práticas da relação entre histórias alternativas e a neuroplasticidade. Foi observado que esta interface tem sido pouco estudada enquanto tema unificado. Na terapia narrativa o terapeuta ajuda o paciente a olhar detalhes até então não percebidos de sua história, trazendo novos estímulos e permitindo ao paciente recontar repetidas vezes sua própria história alternativa. Isso contribui para uma ressignificação de sua história e o desenvolvimento de novos pensamentos e sentimentos, que resultarão em novos comportamentos. A vivência desse processo, ativa a neuroplasticidade do cérebro e cria novas conexões neuronais, gerando mudanças saudáveis e funcionais na vida do paciente.

This work investigates how narrative therapy can stimulate neuroplasticity, with basis on the construction of alternative histories, thus promoting psychological and behavioral changes. A literature review was carried out to analyze the contribution, theoretical and practical, arising from the relationship between neuroplasticity and alternative histories. It was noticed that this interface has been little studied as a unified theme. In narrative therapy, the therapist helps the patient to look at details of his/her history so far unnoticed, bringing new stimuli and allowing the patient to recall his/her alternative history, over and over again. This contributes to a resignification of his/her history and the development of new thoughts and feelings, which will result in behavioral changes. The experience of the process of creating and recalling such alternative history, activates brain’s neuroplasticity, establishing new neural connections and contributing to healthy and functional changes in the patient's life.

Rapid and long-lasting antidepressant-like effects of ketamine and their relationship with the expression of brain enzymes, BDNF, and astrocytes

Ketamine (KET) is an N-methyl-D-aspartate (NMDA) antagonist with rapid and long-lasting antidepressant effects, but how the drug shows its sustained effects is still a matter of controversy. The objectives were to evaluate the mechanisms for KET rapid (30 min) and long-lasting (15 and 30 days after) antidepressant effects in mice. A single dose of KET (2, 5, or 10 mg/kg, po) was administered to male Swiss mice and the forced swim test (FST) was performed 30 min, 15, or 30 days later. Imipramine (IMI, 30 mg/kg, ip), a tricyclic antidepressant drug, was used as reference. The mice were euthanized, separated into two time-point groups (D1, first day after KET injection; D30, 30 days later), and brain sections were processed for glycogen synthase kinase-3 (GSK-3), histone deacetylase (HDAC), brain-derived neurotrophic factor (BDNF), and glial fibrillary acidic protein (GFAP) immunohistochemical assays. KET (5 and 10 mg/kg) presented rapid and long-lasting antidepressant-like effects. As expected, the immunoreactivities for brain GSK-3 and HDAC decreased compared to control groups in all areas (striatum, DG, CA1, CA3, and mainly pre-frontal cortex, PFC) after KET injection. Increases in BDNF immunostaining were demonstrated in the PFC, DG, CA1, and CA3 areas at D1 and D30 time-points. GFAP immunoreactivity was also increased in the PFC and striatum at both time-points. In conclusion, KET changed brain BDNF and GFAP expressions 30 days after a single administration. Although neuroplasticity could be involved in the observed effects of KET, more studies are needed to explain the mechanisms for the drug's sustained antidepressant-like effects.

Development of an integrative learning program for community dwelling old people with dementia / Desarrollo de un programa de aprendizaje integrador para personas de edad avanzada con demencia que viven en la comunidad / Desenvolvimento de um programa de aprendizagem integrativa para idosos com demência residentes na comunidade

Objective: to develop an integrative learning program for people with dementia. Method: a methodological study was conducted using Delphi technique to develop the learning program, followed by a feasibility test. An expert panel was invited to develop the integrative learning program based on the neuroplasticity and learning framework. A feasibility test was conducted to evaluate the implementation of the program in two centers after the training of personnel who run the program. Verbatim transcripts of case conferences were coded, analyzed, and collapsed into themes and sub-themes by consensus. Results: there was no indication for content modification during the period of program implementation. Qualitatively, the participating older adults showed improvement in communications, emotions, connectedness with self and others, and well-being. Conclusion: the integrative learning program was uneventfully implemented with promising results. The program is ready for full-scale research on its efficacy in multiple centers to obtain more robust evidence.

Objetivo: desarrollar un programa de aprendizaje integrador para personas con demencia. Método: se realizó un estudio metodológico empleando la técnica Delphi para desarrollar el programa de aprendizaje, seguida de una prueba de viabilidad. Se invitó a un panel de expertos a que desarrollara el programa de aprendizaje integrador sobre la base del marco de la neuroplasticidad y el aprendizaje. Se realizó una prueba de viabilidad para evaluar la implementación del programa en dos centros después de haber capacitado al personal que dirige el programa. Las transcripciones literales de los debates de casos se codificaron, analizaron y resumieron en temas y subtemas por medio de consenso. Resultados: no hubo ninguna indicación para modificar el contenido durante el período de implementación del programa. En forma cualitativa, los adultos mayores que participaron del programa evidenciaron mejoras en la comunicación, las emociones, la capacidad de conexión con ellos mismos y con los demás y el bienestar. Conclusión: el programa de aprendizaje integrador se implementó sin inconvenientes con resultados prometedores. El programa es apto para ser sometido a una investigación a gran escala con respecto a su eficacia en varios centros para obtener evidencia más sólida.

Objetivo: desenvolver um programa de aprendizagem integrativa para pessoas com demência. Método: foi realizado um estudo metodológico com a técnica Delphi para desenvolver o programa de aprendizagem, seguido de um teste de viabilidade. Um grupo de especialistas foi convidado para desenvolver o programa de aprendizagem integrativa com base no framework da neuroplasticidade e da aprendizagem. Um teste de viabilidade foi realizado para avaliar a implementação do programa em dois centros após treinamento do pessoal que dirige o programa. Transcrições literais de conferências de casos foram codificadas, analisadas e agrupadas em temas e subtemas por consenso. Resultados: não houve indicação de modificação de conteúdo durante o período de implementação do programa. Qualitativamente, os idosos participantes apresentaram melhora nas comunicações, emoções, conexão consigo e com os outros e bem-estar. Conclusão: o programa de aprendizagem integrativa foi implementado sem intercorrências com resultados promissores. O programa está adequado para ser submetido a pesquisas em grande escala relacionadas com sua eficácia em vários centros a fim de obter evidências mais robustas.

Application and progress of binocular therapy in amblyopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#Amblyopia is the leading cause of visual impairment in children. It is also one of the main causes of monocular vision loss in adults. It is effectively treated using correct treatment when initiated during the sensitive period of visual development. Historically, patching or other means of penalization following refractive correction has been the main treatment for amblyopia. With the advancing of exploration on the neural mechanism of amblyopia, binocular treatment has been proposed as an innovative method for the treatment of amblyopia. Different forms of binocular treatment were reported by researchers. This review will focus on the application and progress of binocular treatment in amblyopia.

Advances in the study of visual pathway injury in glaucoma and the neuroplasticity of the visual system after injury / 国际眼科杂志(Guoji Yanke Zazhi)

@#Glaucoma is a group of diseases characterized by progressive optic nerve atrophy and visual field defects. Some evidence demonstrate that glaucoma's pathological damage affects the retina and optic nerve and involves the entire visual pathway. Recent studies have found that the nerve injury is not completely irreversible but has certain plasticity. Furthermore, studies have shown that neurons in the visual pathway of glaucoma can be repaired and remodeled under certain conditions to restore visual function, which offers a new way to treat glaucoma.

Brain-Computer Interfaces for upper limb motor rehabilitation of stroke patients / Interfaces Cerebro-Computadora para la Rehabilitación Motora de Miembro Superior de Pacientes con Enfermedad Vascular Cerebral

Abstract Brain-Computer Interfaces (BCI) decode users' intentions from the central nervous system and could be applied for upper limb motor rehabilitation of patients that have suffered stroke, one of the main causes of disability worldwide. Despite that research groups have reported the efficacy of these systems, a consensus has not yet been reached regarding their true potential. For this reason, a review of up-to-date assessments of BCI for upper limb stroke rehabilitation is presented from the perspective of analyzing common and different design variables presented across studies. Clinical and pilot studies with a control group were included in the review. Most BCI interventions assessments were performed with robotic assistive devices as feedback, followed by neuromuscular electrical stimulation (NMES) and visual feedbacks. Compared to other experimental interventions, the effects of a BCI intervention have been reported in a low number of patients. In addition, high variability between studies' designs such as stroke etiology and interventions' duration, do not allow to assess the potential of BCI for stroke rehabilitation. However, a trend towards significant rehabilitation outcomes with BCI systems can be highlighted, encouraging research groups to better coordinate in order to make valuable contributions to the field.

Resumen Las interfaces cerebro-computadora (BCI) decodifican del sistema nervioso central las intenciones de los usuarios, y pueden ser aplicadas para la rehabilitación motora del miembro superior de pacientes con enfermedad vascular cerebral (EVC), una de las principales causas de discapacidad a nivel mundial. A pesar de que diversos grupos han reportado la eficacia de estos sistemas, no se ha logrado un consenso sobre su verdadero potencial. Por esta razón, una revisión de la evaluación reciente de las BCI para rehabilitación del miembro superior en la EVC es presentado desde la perspectiva de analizar diferencias y similitudes entre las variables reportadas en los estudios. En la esta revisión se incluyeron estudios clínicos y pilotos con un grupo control. La mayor parte de los estudios utilizaron sistemas robóticos como retroalimentación, seguido por estimulación eléctrica neuromuscular y retroalimentación visual. En comparación con otras terapias experimentales, los efectos de intervenciones con BCI se han reportado en pocos pacientes. Además, la alta variabilidad en el diseño de los estudios, como la etiología de la EVC y la duración de las intervenciones, no permiten comparar los efectos de las terapias BCI. Sin embargo, se puede resaltar una tendencia hacia recuperaciones motoras significativas con BCI, motivando a grupos de investigación a coordinarse de mejor forma para continuar realizando contribuciones al campo.

Effects of physical activity on hippocampal plasticity and cognition / 中国组织工程研究

BACKGROUND: As a practical model, physical activity can study the relationship between exercise and brain health In various ways, so as to better understand the promotion of exercise to the brain. In particular, how physical activity changes the structure and function of the hippocampus. OBJECTIVE: To review the researches on the physical activity, hippocampus and cognition, and to put forward the problems that need to be solved in current practice and research application. METHODS: PubMed database was retrieved for relevant studies published from 1995 to 2019. The keywords were “physical activity, exercise, hippocampus, cognition, neuroplasticity, adaptive, mechanisms” in English. The articles about the practical application and regulation mechanism for physical activity, hippocampus and cognition were included. RESULTS AND CONCLUSION: Totally 142 collected articles were searched firstly, the irrelevant and repetitive articles were excluded, and finally 89 eligible articles were included. The hippocampal dentate gyrus has the ability to regenerate nerves. Regular physical activity has a profound effect on the health of the body and brain, and can promote the nerve regeneration of hippocampus dentate gyrus, which can be increased by 2-3 times. This type of nerve mainly occurs in the dorsal side of dentate gyrus. In addition, exercise is also important for changes in neuronal maturation, morphology, and connectivity, and can alter the integration pathways of new neurons and increase the number of incoming neonatal and afferent cell synapses. The nerve regeneration of dentate gyrus is related to various factors induced by exercise. Exercise can promote changes in hippocampal synaptic plasticity by regulating excitatory and inhibitory neurotransmitters. Exercise-induced increase in serum brain derived neurotrophic factor levels may reduce hippocampal volume changes. The duration and intensity of exercise can differentially regulate cerebral blood flow, which in turn affect neuronal activity. Overexpression of vascular endothelial growth factor after long-term exercise can promote the proliferation of hippocampus and increase the hippocampal neurogenesis. Besides, exercise can also alter the synaptic plasticity and connectivity of adult newborn neurons, enhancing the integration of adult newborn neurons with existing hippocampal-enveloping pathways.

Research Progress and Application Prospect of Nerve Rehabilitation by Transcranial Electrical and Magnetic Stimulation / 中国医疗器械杂志

Accidents or diseases may cause impairment or even loss of human motor function, among which stroke is a disease which is most likely to cause disability and seriously endangers social health. During recent years, as a new nerve regulation technology, non-invasive brain stimulation technology can achieve the application of nerve stimulation to the brain, induce and promote neuroplasticity and improve the excitability of cerebral cortex. Especially, transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation(TMS) have shown high therapeutic potential in motor rehabilitation. This paper summarizes the mechanism and progress of the research and application of tDCS and TMS in the field of neurorehabilitation. Its technical challenges and future development trends are provided as well.

Effect of Task-based Rehabilitation Training on Neural Circuit Plasticity and Forelimb Motor Function post Spinal Cord Injury in Mice / 中国康复理论与实践

Objective:To explore the effect of task-based rehabilitative training on neural circuit plasticity and forelimb motor function after C5 spinal cord injury in mice. Methods:A total of 21 healthy C57/BL mice were randomly and equally divided into sham group, model group and training group. The model was established by left C5 spinal cord crush injury. The lamina was removed without damaging the spinal cord in the sham group. Four weeks after injury, the training group received task-based rehabilitative training for four weeks. The horizontal ladder and rearing tests were used to assess motor function for forelimb before injury, and three days, two weeks, four weeks, six weeks and eight weeks after injury. The axons of the corticospinal tract in all mice were observed six weeks after injury by using biotinylated dextran amin (BDA) anterograde tracing. Eight weeks after injury, motor-evoked potential was applied to measure nerve conduction velocities in forelimb, while the axon sprouting and syntagmatic relation of neuron in the anterior horn of gray matter above lesion were observed by immunofluorescence double-labeling of BDA/neuron-specific nuclei protein (NeuN); the expression of Synapsin in the anterior horn of gray matter at lesion was observed by immunofluorescence double-labeling of NeuN/Synapsin I. Results:Eight weeks after injury, the latency of P1 and N1 was longer in the model group than in the sham group (P < 0.05), and was shorter in the training group than in the model group (P < 0.05). Compared with the sham group, the error rate of left forelimb increased, and the usage rate decreased (P < 0.05) in the model group and the training group; compared with the model group, the error rate of left forelimb decreased six weeks and eight weeks after injury (P < 0.05), and the usage rate increased eight weeks after injury (P < 0.05) in the treatment group. Compared with the model group, more axon sprouting co-localized with neurons in the anterior horn of gray matter above lesion (P < 0.05), and the expression of Synapsin I increased in the training group (P < 0.05). Conclusion:Task-based rehabilitative training could promote the neural circuit plasticity and improve the motor function of forelimb after spinal cord injury in mice.

Medición de reserva cognitiva: estudio en una muestra de adultos chilenos / Cognitive reserve assessment: a study in a sample of chilean adults

Mayor reserva se asocia con resistencia al deterioro en sujetos con enfermedades neurodegenerativas. En personas sanas explica las diferencias interindividuales en el rendimiento de tareas. Medir los factores de reserva cognitiva permite contar con un índice numérico de la ganancia cognitiva acumulada por un sujeto. Este índice puede ser correlacionado con otras funciones cuantificables. El presente trabajo tiene como objetivo presentar los índices de reserva obtenidos por una población chilena en la aplicación del Cognitive Reserve Index Questionnaire (CRIq). Para ello 90 adultos (18-85 años) sin evidencias de trastorno cognitivo, de la región de Valparaíso-Chile, fueron entrevistados sobre actividades de estudio, laborales y de tiempo libre ejecutadas desde los 18 años.Los resultados muestran que los índices de reserva de los sujetos varían en función del tiempo de ejecución de actividades promotoras de reserva y no por su edad. Se encontraron diferencias estadísticamente significativas entre los grupos etarios. Estos resultados permiten concluir que la ejecución de actividades de estudio, laborales, sociales, entre otras aumenta los índices de reserva cognitiva, que es una variable diferenciadora entre individuos. La medición de dichos índices puede ser útil en un amplio campo de disciplinas (medicina, neurología, neuropsicología, educación, psicología, fonoaudiología, neurociencias y en las ciencias cognitivas en general).

A higher cognitive reserve is linked to higher resistance to deterioration among subjects suffering from neurodegenerative disorders. In healthy persons the cognitive reserve explains inter-individual differences in task performance. Measuring the cognitive reserve factors involves obtaining a numerical index of the cumulative cognitive gain accumulated by a subject. This index can be correlated with other measurable functions.This study was conceived to determine the reserve indexes accumulated by a Chilean sample, by means of the administration of the Cognitive Reserve Index Questionnaire (CRIq).In order to do so, 90 adults (18-85 years old) without evidence of cognitive disorder, living in Valparaíso region, Chile, were interviewed about their education, their work environment and their and leisure activities carried out since they were 18 years old.Results showed that reserve indexes of the subjects vary as a function of the time of execution of reserve-promoting activities, not age. Statistically significant differences were found among age-groups. These findings allow us to conclude that studying, working and engaging in social activities, among other things, increase the cognitive reserve indexes, which are a differentiating variable among individuals.The measurement of these indexes can be useful in a wide array of disciplines: medicine, neurology, neuropsychology, education, psychology, phonoaudiology, neurosciences and cognitive sciences in general.

Effect of periapical inflammation on calcium binding proteins and ERK in the trigeminal nucleus / Efecto de la inflamación periapical sobre las proteínas fijadoras de calcio y ERK en el núcleo trigeminal

Peripheral inflammation induces plastic changes in neurons and glia which are regulated by free calcium and calcium binding proteins (CaBP). One of the mechanisms associated with the regulation of intracellular calcium is linked to ERK (Extracellular Signal-Regulated Kinase) and its phosphorylated condition (pERK). ERK phosphorylation is important for intracellular signal transduction and participates in regulating neuroplasticity and inflammatory responses. The aim of this study is to analyse the expression of two CaBPs and pERK in astrocytes and neurons in rat trigeminal subnucleus caudalis (Vc) after experimental periapical inflammation on the left mandibular first molar. At seven days post-treatment, the periapical inflammatory stimulus induces an increase in pERK expression both in S100b positive astrocytes and Calbindin D28k positive neurons, in the ipsilateral Vc with respect to the contralateral side and control group. pERK was observed coexpressing with S100b in astrocytes and in fusiform Calbindin D28k neurons in lamina I. These results could indicate that neural plasticity and pain sensitization could be maintained by ERK activation in projection neurons at 7 days after the periapical inflammation.

La inflamación periférica induce cambios plásticos en las neuronas y en la glía, los cuales están regulados por el calcio libre y las proteínas fijadoras calcio (CaBP). Uno de los mecanismos asociados con la regulación del calcio intrace-lular está vinculado con la fosforilación de la pro teína quinasa ERK. Asimismo, ERK fosforilado es importante para la trans-ducción de señales intracelulares y participa en la regulación de la neuroplasticidad y las respuestas inflamatorias. El objetivo de este estudio es analizar la expresión de dos CaBPs y pERK en astrocitos y neuronas del subnúcleo caudal del trigémino (Vc) después de una inflamación periapical experimental en el primer molar inferior izquierdo en ratas. A los siete días posteriores al tratamiento, el estímulo inflamatorio periapical induce un aumento en la expresión de pERK, en el número de astrocitos positivos para la proteína marcadora astroglial S100b y en neuronas positivas para Calbindina D28k, en el Vc ipsilateral respecto del lado contralateral y el grupo de control. Además, se observó coexpresión de pERK tanto en astrocitos S100b positivos, como en neuronas fusiformes Calbindin D28k positivas, de la lámina I. Estas observaciones podrían indicar que la neuroplasticidad y la sensibilización al dolor podrían mantenerse mediante la activación de ERK en las neuronas de proyección a los 7 días de la inflamación periapical.

Mecanismos neurofisiológicos de la rehabilitación vestibular / Neurophysiological mechanisms of vestibular rehabilitation

RESUMEN La rehabilitación vestibular es un concepto terapéutico utilizado en pacientes que presentan síntomas como vértigos y/o mareos, asociados a una afectación vestibular, además de otras manifestaciones clínicas. Este artículo busca entregar un análisis amplio de los elementos que interactúan para definir una patología, como a su vez intervenir en su compensación. Serán presentados elementos neuroanatómicos, fisiológicos y conceptuales de la rehabilitación para este tipo de pacientes con un enfoque clínico basados en la evidencia.

ABSTRACT Vestibular rehabilitation is a therapeutic concept used in patients suffering from dizziness and/or dizziness, in addition to other clinical manifestations. This article gives a broad analysis of the elements that interact to define a pathology, as well as to intervene in their compensation. Neuro anatomical, physiological and conceptual elements of rehabilitation for this type of patients will be presented with a clinical approach based on evidence.